1. #general intrathecal clonidine has bee shown to reduce hyperalgesia and reduce postsurgical pain. IT ketamine does not.
6. #Peds Infants who receive total spinal anesthesia by mistake will suffer apnea. They hemodynamics won't change much 2/2 infant's low sympathetic tone compared to adults.
12. #general Stimulating needles for regional techniques need to be cathode polarity (cathode is negative so electrons decrease positive charges on cell membrane making depolarization easier), insulated (no dispersion of current), square wave (to avoid accommodation which occurs when subthreshold stimulus inactivates Na channels before threshold is achieved).
15. #general SLE drugs: methotrexate - pulm infiltrates, azathioprine - resistance to non-depolarizing blockers, procainamide - prolongs sux
21. LEAST not MOST
23. #general Treatment of MH: stop volatiles and sux. Give 100% FiO2 and increase MV. Give 2.5mg/kg of dantrolene. Cool to below 38 then stop. Give the normal meds for hyperkalemia.
30. #general peribulbar block - larger volume behind the eye but outside the medullary cone, will block OO muscle of the eyelid, possibly less complication than retrobulbar
31. #general minimal sedation: normal response to verbal stimulus and unaffected airway and vitals
moderate sedation (conscious sedation): purposeful response to verbal or tactile, no airway intervention
Deep sedation: purposeful response for repeated or painful stimulation, airway may be required
General anesthesia: unarousable except withdrawal to pain, intervention airway required
38. #general Aspiration of nonparticular matter, give 100% FiO2, PEEP, tracheal suctioning. Bronchial lavage is discouraged 2/2 pushing material further.
47. #cards Atrial fibrillation after cardiothoracic surgery is likely in pts who are >60 yos, Male, preop tachycardia, previous afib, low CO, increased postop BNP.
50. #general critical illness myopathy vs poluneuropathy. Myopathy has normal nerve conduction studies and increased CK. Treatment is supportive and mechanical vent.
51. #general TRALI is the greatest case of mortality 2/2 blood transfusions. More likely with platelets and plasma. MOre likely with multiparous women than men.
54. #general Bezold-Jarsich reflex - bradycardia, vasodilation, hypotension w/ spinal anesthesia
Bainbridge reflex - increase in HR 2/2 increase in CVP. This is likely in autotransfusion
57. #general mannitol extravasation can cause tissue necrosis.
63. #general CO2 laser is used to burn cornea not retina. Other lasers are used to burn retina.
65. #OBGYN placental transfer of meds, all opioids and ketamine. NMB do not get through.
66. #OBGYN uterine tone with volatiles. N2O does nothing. Other volatiles decrease tone. Des<Sevo.
68. #Peds TOtal lung capacity is smaller per weight in children compared to adults. FRC and TV is same. RR and MVO2 are increased.
72. #general Static compliance = V/P, tidal volume/(Plateau P - PEEP)
Dynamic compliance = tidal volume/(PIP - PEEP)
74. #general Myotonic dystrophy contraindicates sux, etomidate, and neostigmine. Use regional if possible. Shivering and hypothermia not hyperthermia induces contractions.
81. #general blood is not tested for CMV 2/2 general prevalence. More dangerous for pregmamt women and newborns.
84. #general GBS presents with pain and peripheral muscle weakness (no tendon reflex).Fever at the time of presentation suggests GBS is unlikely
85. #general indications for intubation vital capacity less than 15ml/kg and NIF less negative than -20
86. #general treatment of GBS: plasma exchange and IVIG. Not steroids or exchange transfusion. Remember interferon 1B is useful for multiple sclerosis but not GBS. Other treatments for GBS include steroids and plasma exchange for acute attacks. Glatiramer and ineterferon 1B for chronic treatment.
98. #OBGYN for women with preeclampsia underoging cesarean delivery, neuraxial anesthesia is preferred 2/2 airway concerns and hypertension w/ laryngoscopy. Studies show that women w/ preeclampsia is less likely to develop hypotension w/ spinal or epidural. (and no difference bewteen spinal and epidural)
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