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68 Cards in this Set
- Front
- Back
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Which is not effective in preventing emergence delerium from Ketamine?
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pyridostigmine
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purpose of subpolarizing dose of NDMR prior to succ?
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to attenuate myalgias
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the % of blockade that exists if only 1 twitch is present of TOF?
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90%
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Dibucaine number of 20-- ?
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pt is homozygous atypical for pseudocholinesterase def.
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which antiemetic is DA-2 antagonist?
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Reglan
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which of the following is true regarding Nm or 2 type receptors:
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Ach binding to alpha subunits results in Na flux and depolarization
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Duchenne's MD , with RSI and oral ETT-- which MR is least appropriate?
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Succ's
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Which of the drugs do not have signicant NMB properties?
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Cefazolin
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A pt has been hemiplegic for 6mo should not get SCh due to what risk?
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hyperkalemic cardiac arrest
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Which is true regarding tetanus without phase?
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occurs with a phase I block
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possible generalized mechanism of action for antidysrhytmics:
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-Dec slope of phase 4
-increase RMP to more negative -make threshhold potential more positive |
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a dysrhythmia during anesthesia does not require dysrhythmic agents if it is cause by what?
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Hypercarbia
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which enzyme is inhibited following multiple doses of etomidate and causes adrenal suppression?
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11-beta hydroxylase
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Which MR is a steroid?
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vecuronium
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what is true about amiodarone and support of cardiac conduction
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is resistant to atrophine, and not classified as a antidysrhythmic
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which short acting agent is used for supraventricular tachycardia--
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adenosine
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Which is class IA antiarrhythmic?
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Lidocaine
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What is true about use of CCB?
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they effect primarily arterial rather than venous vascular tone
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what would be the initial intervention for a ventricular arrhythmia and elevated blood pressure?
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assess for hypoxia and hypercarbia
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preferred post-op position for high risk for emesis?
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side lying
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area of CNS not involved in nausea and vomiting:
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IML grey columns
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post-ganglionic PNS and SNS firber are classified as?
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C fibers
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which is selective beta-1 antagoinist:
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atenolol
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pt on timolol eye gtts for 6 months, what is true
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significant bradycardia when under anesthesia
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CCB act at which phase of the action potential--
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phase 2
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Slow Ca++ channell has two gates, the outer gate on the extracellular membrane does what?
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Opens with depolarization
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pt on verapamil for HTN, has MH crisis and gets dantrolene what is the potential consequence
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Hyperkalemia
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compared to phentolaine, prazosin is:
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less likely to cause reflex tachycardia
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during a vagotomy - pt develops SVT, what is your Ca++ channel blocker or choice?
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verapamil
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nephrotoxicity as a result of antibiotic administration is most likely to occur
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with long term aminlglycoside therapy
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phenothiazine induced extrapyramidal reactions are appropriately treated with :
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benzotropine (acts as dopamine reuptake inhibitor)
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cardiac condition with the highest risk of bacterial endocarditis ?
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Prosthetic aortic valve
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mechanism of action of NSAIDS?
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inhibition of cyclooxygenase enzyme
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anaphylactic reactions differ from anaphylactoid in that
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anaphylactic reactions are mediated by IgE & IgG
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following a dose of cefazolin -pt develops HOTN, bronchospasm, airway edema, what do you give first?
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epinephrine
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H2 blocker known to prolong the half life of propranolol?
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cimetidine
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how do NSAIDs result in GI irritation and ulceration:
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inhibition of gastric mucosa prostagandin synthesis
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all of the following would weigh against intraoperative administration of ketorolac except?
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last motrin within 5 days.
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rapid IV administration of cimetidine most likely will be accompanied by
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bradycardia and hypotension
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histamine is found where?
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inside mast cells in perivascular tissue
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which of the following isn t a significant H&P finding for a patient with a history of latex allergy:
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Oral contraceptives for birth control
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precautuion for a latex allergy?
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using nonlatex breathing circuit and IV anesthesia
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what is the % of NM blockade if 2/4 twitches on the TOF monitor?
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80%
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heparin inhibits clotting by:
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increasing AT3 formation and activity
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bowel contents spilled into peritoneum during surgery
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considered as a contaminated field
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what is the difference between neuromuscular weakness from aminoglycosides versus that caused by polymixin B
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aminoglycoside neuromuscular weakness can be reversed with calcium
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an example of a aminoglycoside:
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a-meek-a cin
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give vanco too fast -they get hypotensive, wheezy and flushed. The histamine release is a result of
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polypeptide structure of vanco molecule
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a patient with a true penicillin allery is ordered to receive 1 g ancef- --what should you do?
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describe the allergy symptoms to surgeon and suggest a non-cephalosporin. (Cipro, levaquin, vanco, gent)
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a steep slope in the dose response curve suggests that small increases in dose...
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will cause a large increase in pharmacologic effect
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What is the common position related injury when using fracture table?
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Pudendal nerve injury
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The release of vasopressin from te posterior pituitary is stimulated by what?
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Increased carbon dioxide
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Renal autoregulation is primarily mediated by the
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afferent arterioles
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Dexmeditomidate hydrochloride may result in what cardiovascular response when administered in a bolus dose of 2 mcg/kg?
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Hypertension and bradycardia
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A PA catheter positioned in Zone 3 of the lung most accurately measures:
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Pulmonary alveolar pressure
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A preoperative PT/PTT would be indicated if a patient presented with what?
a. renal insufficiency b. Systemic Lupus erythermatosis c. coronary artery disease d. pre-eclampsia |
Systemic Lupus erythermatosis
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Normal plasma cholinesterase is espressed by a dibucaine number of:
1. 16-30 2. 50-60 3. 70- 80 4. 90 - 100 |
70-80
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In this patient undergoing laparoscopic surgery the appearance of decreased ETCO3, decreased SaO2 and hypotension most likely signals:
a. capnothorax b. CO2 embolus c. endobronchial intubation d. subcutaneous emphysema |
CO2 embolus
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The patient who undergoes laparoscopic surgery is at highest risk fro serious complications:
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While initiateing the pneumothorax
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During regional anesthesia above T-4, renal blood flow and filtration are dependent on
a. autoregulation b. renal prostaglandins c. redistribution to the inner cortex d. perfusion pressure |
perfusion pressure
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Three hours into a thyroidectomy, the patient develops tacycardia, hypotension and hyperpyrexia. The most appropriate initial intervention is to administer:
a. dantrolene 2.5mg/kg ivp b. esmolol 100-300 mcg/kg/min c. hexxtend 500 ml bolus d. propylthiouracil 200mg IVP |
esmolol 100-300 mcg/kg/min
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Blood pressure during carotid endarteerectomy should be maintained
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20% higher than highest awake pressure
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Maintaining SVR and myocardial compensation following aortic cross-clamping may be facillitated by administration of:
a. isodlurane b. sodium nitroprusside c. nitroglycerine d. hydralazine |
c. nitroglycerin
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Which group of drugs readily cross the placenta to th fetus?
a. high lipid solubility b. low lipid solubility c. High molecular weight d. Highly ionized |
a. high lipid solubility
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What cardiovascular parameter increases in the elderly?
a.. EF b. CO c. Early diastolic filling d. systolic arterial pressure |
systolic arterial pressure
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what would you expect when administering thiopental to a geriatric patient?
a. increased brain sensitivity b. decreased volume of distribution c. increased beta elimination d. decreased plasma protein binding |
b. decreased volume of distribution
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In the elderly patient the altered effect of Beta agonist is due to :
a. enhanced adenyl cyclase activity b. increased cell membrane fluidity c. receptor proliferation d. reduced receptor affinity |
d. reduced receptor affinity
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the most common intraoperative cause of myoglobin-induced renal failure is:
a. malignant hyperthermia b. traumatic crush injury c. muscle ischemia induced rhabdomyolysis d. myxedema |
c. muscle ischemia induced rhabdomyolysis
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