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50 Cards in this Set
- Front
- Back
What surgical prep solution is contraindicated for use on the face?
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Hibiclens, caustic to eyes
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why are iodine solutions superior to chlorhexidine as surgical antiseptic
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chlorhexidine not effective against viruses and fungi
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which nasal spray has less cardiac toxicity: oxymetazoline or neosynephrine
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oxymetazoline
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which medication has been shown to decrease the catecholamine response during suspension laryngoscopy
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fentanyl
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what factors are responsible for transfusion-induced immunosuppression
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serum factors and fragmented debris from white blood cells and platelets
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what should be given to cancer patients who need a blood transfusion to minimize the immunosuppression
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washed RBCs
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what is the best time to begin prophylactic antibiotic therapy for elective surgery
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1hr prior to operation
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what are the daily maintenance fluid requirements of a healthy 60-kg woman
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2100cc
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what is a reliable alternative induction technique in a 5yr struggling child who refuses the mask and cannot be managed with IV bc of lack of accessible veins
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sedating IM injection of ketamine 3mg/kg
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what are the negative side effects of ketamine
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increased airway secretions
transient increase in intracranial pressure audiotory/visual hallucinations |
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what is the preferred anesthetic technique for bronchoscopy in adults
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modified endotracheal tube or jetting system used with a relaxant and controlled ventilation
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what is the preferred anesthetic technique for bronchoscopy in infants and children
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spontaneous respiration with inhalation anesthesia
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all of the inhaled anesthetics are bronchodilators except
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nitrous oxide
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which neuromuscular blocker's metabolism is independent of renal or liver failure
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cisatracurium
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shortly after induction of general anesthesia, the patient's body temp significantly rises, PVCs are noted on the ECG and skin becomes flushed. What is likely dx
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malignant hyperthermia
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symptoms of malignant hyperthermia
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masseter spasm
sustained muscle rigidity myoglobinuria |
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what is the mechanism of action behind malignant hyperthermia
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inhibition of calcium reuptake into the sarcoplasmic reticulum of skeletal muscle
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what is the treatment for malignant hyperthermia
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total body cooling
vigorous hydration dantrolene |
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90yo woman given morphine before bedside laryngoscopy RR drops to 6 and lips turn blue. What med should be given
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naloxone
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what is a complication of rapid administration of naloxone
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flash pulmonary edema
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what med is used to reverse benzodiazepines
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flumazenil 200ug over 15 seconds
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which anesthetic should be discontinued 15min prior to placing a TM graft
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nitrous oxide
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what is the mechanism of action of local anesthetic
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prevent increases in the permeability of nerve membranes to sodium ions
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what are two main classes of local anesthetic
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ester linkage
amide linkage |
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how do ester vs amide differ in metabolism
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ester: metabolized in plasma by cholinesterase
amide: liver by P-450 |
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what local are amides?
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lidocaine
ropivacaine bupivacaine |
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which antiHTN prolongs the effect of regional anesthesia with amide anesthetics
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clonidine
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what are the toxic side effects of local
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CNS excitability or depression
myocardial depression peripheral vasodilation methemoglobinemia allergic rxn |
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which local anesthetic produces toxicity at the lowest dose
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tetracaine
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T/F: all locals are weak bases and produce vasodilation
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F: cocaine and ropivacaine
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which local anesthetics have been shown to induce methemoglobinemia
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prilocaine
benzocaine lidocaine procaine |
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what is the treatment for methemoglobinemia
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slow IV infusion of 1% methylene blue
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what is max recommended dose of bupivacaine
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2-3mg/kg
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what is duration of action of bupivacaine
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3-10 hours
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T/F: bupivacaine has a depressant effect on cardiac contractility 4x of lidocaine
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True
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how does ropivacaine differ from bupivacaine
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ropivacaine has less potential for serious cardiotoxic reactions
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what is max dose of lidocaine in 60kg woman
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300mg without epi (4mg/kg)
420mg with epi (7mg/kg) |
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how much epi in 1cc of 1:100,000 epi
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10ug
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where should local anesthetic be injected to block superior laryngeal nerve
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halfway between hyoid and thyroid cartilages
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where should local anesthetic be injected to anesthetize subglottis and preepiglottic space
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cricothyroid membrane
thyroid notch |
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what makes midazolam useful in outpatient setting
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short onset of action, half-life 2-4hr
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which benzo is preferred in pts with liver disease
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lorazepam
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which a-agonist is 5-10x more potent than clonidine
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dexmedetomidine
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T/F: all opioids cause bradycardia
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F: meperidine
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what is the primary advantage of using remifentanil over fentanyl
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shorter onset and offset
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allergy to what substance is contraindication to propofol
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soy
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what are adverse effects of succinylcholine
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dysrhythmia
fasciculations hyperkalemia |
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which pts are more likely to have adverse rxns to succinylcholine
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closed-angle glaucoma
space-occupying intracranial lesions crush injury |
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what is inheritance pattern of pseudocholinesterase deficiency
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autosomal recessive
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what patient population might have a decreased amount of pseudocholinesterase
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those taking anticholinesterase meds for glaucoma or myasthenia gravis
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