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37 Cards in this Set
- Front
- Back
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____ requires 2 molecules of ATP and yields 4 molecules of ATP.
a. glycolysis b. glucogenisis c. citric acid cycle d. electron transport |
a. glycolysis
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Every 2 molecules of acetyl coA that are oxidized result in 2 molecules of GTP.
a. glycolysis b. glucogenisis c. citric acid cycle d. electron transport |
c. citric acid cycle
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Energy stored in the Coenzymes is transfered to adenosine diphosphate and inorganic phosphate to yield 34 ATP.
a. glycolysis b. glucogenisis c. citric acid cycle d. electron transport |
d. electron transport
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ATP production is reduced by ___% during hypoxia.
a. 25% b. 45% c. 75% d. 95% |
d. 95%
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Glucose supply and washout of metabolites is interrupted, ATP dependent ion pump activity is reduced causing intracellular sodium and calcium increase and potassium levels decrease These describe:
a. Apoptosis b. reperfusion c. ischemia d. anesthetic effects |
c. ischemia
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Neurons depolarize and release excitatory amino acids like glutamate causing further depolarization = increase metabolic demand. This describes:
a. apoptosis b. cerebral edema c. ischemia d. anesthetic effects |
c. ischemia
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___ raises free fatty acid levels ie: arachidonic acid and free radicals.
a. cytoplasmic calcium b. phospholipases c. peroxynitrite d. lactate |
b. phospholipases
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What is the most damaging free radical?
a. cytoplasmic calcium b. phospholipase c. peroxynitrite d. lactate |
peroxynitrite
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______ triggers events that lead to ischemic damage - increased protease and phospholipase activity.
a. cytoplasmic calcium b. phospholipase c. peroxynitrite d. lactate |
a. cytoplasmic calcium
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_____ activation leads to excess arachidonic acid production, which upon reoxygenation can form: Dicosanoids, thromboxane, prostaglandins, leukotrienes.
a. cytoplasmic calcium b. phospholipase c. peroxynitrite d. lactate |
b. phospholipase activation
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Dicosanoids, thromboxane, prostaglandins, leukotrienes cause:
a. vasoconstriction b. reduce blood flow c. alter BBB and enhance free radical formation after reperfusion d. all of the above |
d. all of the above
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What are some triggers of cell death?
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Decreased ATP, Increased extracellular K, Increased intracellular Na, Ca, increased free radical levels, depolarization, and glutamate levels
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Which is more severe necrosis or apoptosis?
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Necrosis - mitochondria lose function
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Focal ischemia has 3 regions, place in order:
*Normally perfused *No blood flow *Receives collateral flow and is partially ischemic |
Region 1 - Receives no blood flow
Region 2 - Penumbra - receives collateral flow and is partially ischemic Region 3 - Normally perfused |
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Which region of focal ischemia is the stage of ischemia that we try to rescue?
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Region 2 - Penumbra
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What is en example of global ischemia?
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Stroke
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What is the target temperature to preserve neurologic function after cardiac arrest?
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32-34 degrees celcius
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Myocardial depression, dysrhythmias, hypotension, decreased tissue perfusion,ischemia, thrombocytopenia, fibrinolysis, platelet dysfunction & increased bleeding are all complications of what therapy?
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Deep hypothermia
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Calcium channel blockers, hypertension, hypervolemia, and hemodilution are recommended treatments for:
a. vasoconstriction b. vasospasm |
b. vasospasm
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What anesthetic agent can ceate an isoelectric EEG without death?
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Isoflurane/forane
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What anesthetic agents have been shown to be neuroprotective by blocking Na, K and Ca fluxes, scavenging free radicals, blocking seizures, improving regional blood flow and decresing ICP.
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Barbiturates
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Etomidate/Propofol: reduces cerebral metabolic rate in given to burst suppression doses but does not improve recover from ischemic or anoxic damage.
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Etomidate
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_____ enhance neuronal inhibition, reduce brain metabolism and cerebral blood flow.
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Benzodiazepines
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Use caution with what drug with patients with space occupying lesions.
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Versed or benzodiazepines
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Hypothermia, lidocaine, thiopental and sevo are shown to be ______ .
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Neuroprotective
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Seizure is the #1 sign for adult _____.
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Tumor
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Hypo/Hyperventilate a patient that you want to have a good seizure.
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Hyperventilate - it causes K to leave the cells and Na and Ca to enter the cells
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Enhanced excitability causes ____ release and excitotoxicity and exacerbates damage.
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glutamate
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High __ is responsible for large progressive depolarization.
a. Na b. K c. Ca |
b. K
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Intracellular ___ levels rise, precipitating the damage.
a. Na b. K c. Ca |
c. Ca
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Blood flow increases/decreases with epileptic damage.
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increases
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T/F: It is important to treat lactic acidosis, reduced arterial oxygenation, and increased carbon dioxide associated with epileptic damage.
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True - maintain oxygenation, ventilation and blood pressure
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What is the formula for calculating CPP?
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CPP= MAP - CVP or ICP
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Increased ICP or cerebral edema can lead to hypoperfusion how can it be treated?
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Diuretics - Mannitol, hypertonic saline, lasix, hyperventilate
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T/F: Intracranial hemorrhage may increase ICP and reduce CPP.
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True
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Hypotension/Hypertension should be avoided because it worsens outcome.
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Hypotension
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Lower ICP, maintain blood flow, reduce vasospasm, high dose corticosteroids, Magnesium, Nimodipine are all ways to treat___.
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Hemorrhage from trauma
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