Podiatric Pearls- Anesthesia/emer Med

Front 1

what are the stages of anesthesia and what stage is considered surgical anesthesis

Back 1

1. induction stage
2. excitement stage (inc RR before LOC)
3. SkM relax, reg RR
4. OD, fatal
-stage 3 is surgical

Front 2

what is Reglan and what is the generic name

Back 2

-metoclopramide; anti N/V
reduces gastric mobility

Front 3

Peds have a limited amt of glycogen stores, so what should always be administered to them under sedation

Back 3

D5W

Front 4

what does low serum Ca cause on EKG

Back 4

wide QRS complex

Front 5

how does ketamine work and what are its affects

Back 5

-blocks NMDA receptors
-produces amnesia only (similar to PCP)

Front 6

first symptom of malignant hyperthermia

Back 6

Tachycardia
(then inc CO2 production, hyperthermia, muscle rigidity, acidosis)

Front 7

how does local anesthesia provide pain relief

Back 7

-prevents Na migration through the nerve membrane (prevents depolarization and prevents conduction)

Front 8

list contraindications to tourniquet use

Back 8

-previous pop-DP bypass
-sickle cell(tourniquet causes low O2 tension causing cells to sickle)
-

Front 9

McArdles disease

Back 9

-muscle phosphorylase deficiency
- can get compartment syndrome with tourniquet

Front 10

MC cx of a supine patient during general

Back 10

ulnar nerve neuropathy

Front 11

MC cx of a prone pt during anesthesia

Back 11

pressure on the orbit and dorsum of the foot

Front 12

during a spinal, where in the lumbar spine is anesthetic placed

Back 12

-subarachnoid space, deep to the dura

Front 13

cx of spinal anesthesia

Back 13

-headache
-HYPO tension
-cauda equina syndrome
-infection

Front 14

what is used to treat malig hyperthermia; what is its MOA

Back 14

-dantrolene IV
-interfers with Ca release w/in skeletal muscle cells from SR

Front 15

when performing tendon transfer procedures, which type of anesthesia could you use

Back 15

-general, spinal or epidural bc all eliminate LE muscle activity

Front 16

rule of thumb for tourniquet pressure in the ankle and thigh

Back 16

--ankle is 100 over systolic
-thigh is 200 over systolic due to large soft tissue mass of upper thigh

Front 17

what is the difference b/w spinal and epidural

Back 17

-spinal is 1 dose that lasts 2 hours
-epidural is a catheter left in place for steady flow

Front 18

pt awakes from general; is shaking and cold, what can u give

Back 18

-demerol (opiod analgesic)

Front 19

why shouldnt IDDM take their oral hypoglycemics

Back 19

-they are NPO and could become severely hypoglycemic

Front 20

adverse reaction of toradol

Back 20

peptic ulcer

Front 21

during a local field block, what is the order of the loss of the types of sensation

Back 21

-loss of pain/temp (post column)
-loss of touch and motor

Front 22

why does local injected into an infected area become less active

Back 22

-the acidity converts the local thus decreasing the penetration into the cell membrane

Front 23

5 nerves of an ankle block

Back 23

-saphenous, tibial, deep peroneal, superficial peroneal, sural

Front 24

pt has syncopy, what do you do

Back 24

-oxygen
-trendelenberg (supine, feet higher then head)
-monitor vitals

Front 25

amides are broken down in the liver, where are esters broken down

Back 25

-hydrolyzed in the PLASMA by pseudocholinesterase

Front 26

which inhalation agent in NON flammable

Back 26

halothane

Front 27

if a pt becomes HYPER kalemic during sx, what may u observe

Back 27

-muscle weakness
-EKG changes

Front 28

describe EKG changes of MI

Back 28

ST segment elevation greater then 1 mm in 2 leads and new Q waves

Front 29

anaphhylactic reaction involves skin, resp, CV and GI changes; list them

Back 29

Skin: redness, itch, angioedema
Resp: nasal congestion, coughing, hoarseness, tightness of throat, dyspnea
CV: hypotension, syncope, dizzy, CP, MI
GI: ab pain, N/V/D

Front 30

in anaphylaxis; what does the allergen attach to that initiates the immune response (Type 1, immediate sensitivity)

Back 30

IgE

Front 31

what are the 4 mediators involved in anaphylactic reaction

Back 31

-histamine
-leukotrine C4
-prostaglandin D2
-tryptase

Front 32

why are esters more likely for an allergic reaction

Back 32

-they are derivatives of PABA's

Front 33

pt has allergic reaction to local in your office; what do you do

Back 33

-benadryl for mild rxn
-epinephrine for severe rxn-25-50 mg benadryl

Front 34

what bacteria is the MC cause of septic shock and why

Back 34

-Gram Negs
-related to release of endotoxin, part of the bacterial cell wall

Front 35

what is the most common cause of sudden cardiac death

Back 35

V tach

Front 36

seizures can be generalized or partial; what is the difference

Back 36

-partial involve a discrete area of the brain
-general involve simultaneous onset from both hemispheres

Front 37

antidote to acetaminophen toxicity

Back 37

N-acetylcysteine

Front 38

what is the MC form of shock

Back 38

-hypovolemic

Front 39

gold std for detection of MI

Back 39

CPK-MB (creatine phophokinase)

Front 40

dose of epinephrine

Back 40

0.3-0.5 mL 1:1000 solution Q15 minutes

Front 41

what is the most effective IV agent for rapid blood pressure control

Back 41

Na Nitroprusside

Front 42

what physical exam sign is pathognomic for hypertensive encephalopathy

Back 42

-papilledema (edema of the optic disc)

Front 43

CPR breath to compression ratio for adult and infant

Back 43

adult and infant are 30-2