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109 Cards in this Set
- Front
- Back
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Which level of anesthesia is considered surgical anesthesia
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Level III
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There are four reflexex progressively lost in level III anesthesia. The third reflex lost in the progression is?
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thoracic muscular
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While performing an Austin bunionectomy under Gerneral naesthesia, you over hear the anesthesiologist mention that he/she is adminstering Reglan. What is theis for?
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Reduce gastric motility
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Pediatric hypoglycemia is extremely dangerous! Pediatric patients have a very limited amount of glycogen stores, nad therefore should always have what fluid rnnin in their IV
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D5W
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What are the effects of low serum calcium on the EKG
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Wid QRS complex
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What effect does ketamine have on a patient?
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Amnesia only
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Which levle of anesthesia is considered surgical anesthesia
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Level III
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Fentanyl is used as what?
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narcottic analgesic
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There are four reflexex progressively lost in level III anesthesia. The third reflex lost in the progression is?
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thoracic muscular
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What drug has largely replaced Sodium Pentothal
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Diprivan
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While performing an Austin bunionectomy under Gerneral naesthesia, you over hear the anesthesiologist mention that he/she is adminstering Reglan. What is theis for?
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Reduce gastric motility
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What is the first symptom of malgnant hyperthermia
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Tachycardia
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Pediatric hypoglycemia is extremely dangerous! Pediatric patients have a very limited amount of glycogen stores, nad therefore should always have what fluid rnnin in their IV
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D5W
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Which levle of anesthesia is considered surgical anesthesia
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Level III
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Describe the mechnaism of breakdown for Esters & Amides
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Esters are hydrolyzed by pseudocholinestease in plasma; amides are metabloized in the liver
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There are four reflexex progressively lost in level III anesthesia. The third reflex lost in the progression is?
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thoracic muscular
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What are the effects of low serum calcium on the EKG
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Wid QRS complex
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What effect does ketamine have on a patient?
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Amnesia only
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While performing an Austin bunionectomy under Gerneral naesthesia, you over hear the anesthesiologist mention that he/she is adminstering Reglan. What is theis for?
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Reduce gastric motility
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Fentanyl is used as what?
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narcottic analgesic
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Pediatric hypoglycemia is extremely dangerous! Pediatric patients have a very limited amount of glycogen stores, nad therefore should always have what fluid rnnin in their IV
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D5W
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What drug has largely replaced Sodium Pentothal
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Diprivan
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What are the effects of low serum calcium on the EKG
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Wid QRS complex
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What is the first symptom of malgnant hperthermia
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TAchycardia
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What effect does ketamine have on a patient?
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Amnesia only
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Describe the mechnaism of breakdown for Esters & Amides
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Esters are hydrolyzed by pseudocholinestease in plasma; amides are metabloized in the liver
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Fentanyl is used as what?
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narcotic analgesic
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What drug has largely replaced Sodium Pentothal
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Diprivan
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What is the first symptom of malgnant hperthermia
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TAchycardia
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Describe the mechnaism of breakdown for Esters & Amides
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Esters are hydrolyzed by pseudocholinestease in plasma; amides are metabloized in the liver
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What is the treatment for convulsions
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valium
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Describe a Mayo block
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local "ring" block of the 1st metatrsophalngeal joint
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Describe MAC anesthesia
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IV sedation with a local anesthesia block
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How does local anesthesia provide pain relief
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prevents sodium migration through the nerve membrane, which prevents depolarization and cause inhibition of nerve conduction.
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What is the basic treatment for shock?
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Fluids, ABC's, monitor vitals
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The ASA classifies a "healthy patient as what class?
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Class I
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List he complications associated with tourniquet use?
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Tissue necrosis, inflammation, paralysis, thrombosis, circulatory volume overload
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A contraindication to tourniquet use would be?
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previous popliteal-dorsalis pedis byupass grafting. Sickle cell disease is potentially a contraindcation as well because the tournquet casues low oxygen tension which could cause cells to sickle
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List the potential complications of endotracheal intubation?
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sore throat, tracheal edema, croup, laceration, pneumothorax
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When positioning a patient in the supine psition during general anesthesia the most common complcation is
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ulnar nerve neruopathy
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When postioning a patient i nthe prone position during general anesthesia, the most common complication is?
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pressure on the orbit as well as the dorsum of the foot
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During spinal anesthesi, the space itn eh lumbar area of the spine in to which hthe anesthetic is place is the ?
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subarachnoid space, deep to the dura
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Complications o f spinal anssethesi include?
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hadache, hypotension, cauda equina syndrome, and infection
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What is the most common cause of temperature elevation intraoperatively?
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malignant hyperthermia
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What medication is used to treat malginant hyperthermia
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dantrolen IV
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When postioning a patient i nthe prone position during general anesthesia, the most common complication is?
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pressure on the orbit as well as the dorsum of the foot
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During spinal anesthesi, the space itn eh lumbar area of the spine in to which hthe anesthetic is place is the ?
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subarachnoid space, deep to the dura
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When postioning a patient i nthe prone position during general anesthesia, the most common complication is?
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pressure on the orbit as well as the dorsum of the foot
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Complications o f spinal anssethesi include?
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hadache, hypotension, cauda equina syndrome, and infection
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During spinal anesthesi, the space itn eh lumbar area of the spine in to which hthe anesthetic is place is the ?
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subarachnoid space, deep to the dura
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What is the most common cause of temperature elevation intraoperatively?
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malignant hyperthermia
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Complications of spinal anesthesia include?
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headache, hypotension, cauda equina syndrome, and infection
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What medication is used to treat malginant hyperthermia
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dantrolen IV
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What is the most common cause of temperature elevation intraoperatively?
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malignant hyperthermia
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What medication is used to treat malginant hyperthermia
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dantrolen IV
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What type of allergic reaction is anaphylaxis?
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A type I antibody mediated hypersensitvieity reaction, seen immediately
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What are early signs of anaplylaxis
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flush, difficulty in breathing, wheezing, stridor, laryngeal edema
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What is the treatment for anaphylaxis?
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Epinephrine 0.3-0.5 ml sub Q of a 1:1000 solution, along with antihistamines
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Describe the mechanism of action of local anesthics
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Local anesthetics prevent conduction of the nerve by decreasing sodium permeability thus increasing the excitation threshold
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What is the toxic dose of lidocaine 1% plain
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300 mg (30 ml)
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What is the toxic dose of lidocaine 1% with epinephrine?
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500 mg (50 mL)
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What is the toxic doese of Bupvacaine 0.25% plain?
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175 mg (70 ml)
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What is the toxic does of bupivacaine 0.25% with epinephrine?
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225 mg (90 ml)
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List four common amide based local anesthtics
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lidocaine, bupivacaine, mepivaciane, and etidocaine
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list four common ester based local anesthetics.
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prociane, tetracaine, choroprocaine, and hexylcaine
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When performing tendon transfer type procedures lis the type of potential anesthesia that may be used.
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General, spinal, and epidural (because each of these modalities will temporarily eliminate lower extremity muscular activity).
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What type of local block is most widely accepted when perfoming HAV surgery in a healthy patient?
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MAC with local May block
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What nerve lies within the 1st intermetatarsal space?
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deep peroneal
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What nerve lies anterior ot the medial malleolus?
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saphenous
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Cervical spine radographs shoudl be obtained on a patient with a history of ...
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rheumatoid arthritis
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When using a high thigh tourniquet, which type sof anesthesia would be unwise?
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MAC, and local types because the high thigh tourniquet cause too much discomfort and gerally requires a genera anesthetic
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The reccomended pressure for a high thigh tourniquet is ?
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200mm HG over systolic pressure due to the large soft tissue mass in the thigh.
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During which sate of anesthesia woudl it be appropriate to elevate an extremity tourniquet
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stage II
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When comparing a spinal block which will alow greater control?
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epidural block
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When a patient has just completed geneeral anesthesia and is violently shaking as if cold, which medication will help releive these symptoms?
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demerol
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On the mornign of surgery a patient with non-insulin dependent diabetes, hypothyroidism, and hypertension should be told to take all of therir medication except?
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They should not take their oroal hypoglycemic because they have nNPO and could become severly hypogycemic and go into insulin shock.
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True or Fals - The toxic dose of loca anesthetics inincreased with taddtion of epinephrine ot the anesthetic?
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True . epinephrine slows the absorption of the anesthetic and terefore allows more to be used.
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Anesthesia is defined as?
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Loss of sensation with or without the loss of consciousness
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Factors that affect he concentration of a drug at a site of action, as funciton of time is referreed to as?...
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Pharmokinetics
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During which stage in anesthesia woudl it be appropriate to elevate an extremityu tourniqauet ?
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stage II
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When comparing a spinal block to a epidural block which will alow greater control?
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epidural block
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Factors that affect the concentration of a drug at a site of action, as a funtion of time is referred to as?
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pharmokinetics
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Succinycholine is primarily used ot achieve?
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muscle relaxation through depolarization
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During which stage in anesthesia woudl it be appropriate to elevate an extremityu tourniqauet ?
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stage II
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Succinylcholine can cause what adverse reactions?
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fasciculations as well as hyperkalemia
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When comparing a spinal block to a epidural block which will alow greater control?
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epidural block
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Factors that affect the concentration of a drug at a site of action, as a funtion of time is referred to as?
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pharmokinetics
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Succinycholine is primarily used ot achieve?
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muscle relaxation through depolarization
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Succinylcholine can cause what adverse reactions?
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fasciculations as well as hyperkalemia
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List a potential adverse reaction cause by toradol
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It can cause a peptic ulcer
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Do ester type anesthetics have a higher or lower allergic potential than amides?
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higher
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The protien -binding characteristic of a drug will affect what?
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duration of action
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Why is eating withing 6 hours prior to a general anesthetic a cause to cancel the surgery?
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Due to the risk of regurgitation and aspiration
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During a local field block what sensation is lost first?
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Pain and temperature first, second is touch and motor
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A local block injected into an infected area is less active because of what action?
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The acidic area of the infection converts the anesthetic chemically thus decreasing penetrationinto the cell membrane.
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When performing an ankle block which nerves are blocked?
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Saphenous, posterior tibial, sural, superficial, peroneal, and deep peroneal
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When performing various types of aneshtesia on pediatric patients what is the common during anesthesia
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hypothermia (temperature fluctuations)
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What is the drug of choice to increase the threshold of convulsions during the intraoperative period?
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valium
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What are the initial stpes to perform once it si determined the patient is having a sycope reaction?
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oxygen, trendelenburg positioning, monitor vitals
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Wydase works by what action?
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Wydase (hyaluronidase) works by permitting a more rapid spread of solution in the area
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When using halothane, what vasoconstrictive drug is contraindicated?
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epinephrine
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Esters are hydrolyzed in the ___?
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Plasma (higher allergic potential)
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Amides are metabolized in the ___?
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liver
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What type of anesthesia causes the least interference with preexisting diseases?
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regional nerve block
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During surgery if a patient becomes hyperkalemic what may you observe?
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Muscle weakness, cardiac conduction (EKG) changes
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Which has a greater duration of action Lidocaine or Marcaine?
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Marcaine
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What are the various etiologies of sycope?
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Syncope may be due to many etiologies including vasovagal, psotural hypotension, chronic orthostatic hypotension, cardiac, carotid sinus, secondary to cerebrovascular diseae, etc.
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What are the adverse effects of narcotics?
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respiratory depression, emsis, and dependence
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Which inhalation agent is nonflammable
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halothane
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