Potent Potables
Obesity
Laparoscopic
Positioning
Potpourri
100
What is the chemical structure for ethyl alcohol/ ethanol?
100
height(cm) - x
where x = 100 for males and x = 105 for females
What is ideal body weight calculation?
the result of ideal body weight calculation by this equation is called Broca's Index. [Nagelhout & Plaus, NA. 4th. 2009 ppl024; Barash, Clin. Anes. 6'h. 2009 pp1231; Yao, Yao & Artusio's POPM. 6e. 2008 pp12Sl]
100
Pneumoperitoneum insufflation pressures of 20-25 cm H2O produce increases in CVP and cardiac output. Blood pressure and heart rate may change in what way?
Blood pressure increases and heart rate decreases reflexively
[Davison, et. al., Mass Gen, 1993, p473]
100
This is the most common cardiovascular complication when moving a patient rapidly from lithotomy to supine position
What is hypotension?
100
Fat-soluble vitamins
What are A, D, E, K?
200
A combination of vodka, Kahlua, and cream
What is a White Russian?
bonus points! does the dude have a beard or facial hair? which one may make mask ventilation more difficult?
200
A waist-to-hip ratio of 0.85 for males and 0.92 for females. Characterized by predominant adipose tissue distribution in the upper body.
What is android obesity?
[Nagelhout & Plaus, NA. 4th. 2009 pp1026; Barash, Clin. Anes. 6'h. 2009 pp1230; Hines, Stoelting's Co-existing. 5e. 2008 pp299]
200
This is suspected when a patient undergoing laparoscopic cholecystectomy becomes hypotensive, tachycardia, bilateral wheezing is heard, and endtidal CO2 decreases.
What is venous gas embolism?
CO2 gas lock of the right heart produces hypotension, cyanosis, hypoxia, pulmonary edema(wheezing), and hypocapnia with large embolism.
200
Shoulder brace used for steep Trendelenburg positioning should be placed over this anatomical location.
What is the acromion or acromioclavicular joint?
not the clavicle nor the root of the neck.
200
Lymphatic tissue located in the upper posterior aspect of the nasopharynx.
What are the adenoids?
300
This is the most common cause of chronic hepatitis.
What is alcohol abuse?
[Apex anesthesia]
300
This pulmonary disease pattern is exhibited by morbidly obese patients
What is a restrictive disease?
[Stoelting and Dierdorff, Co-Existing, 1993, p38S]
300
A patient scheduled for laparoscopic cholecystectomy. During this phase of the procedure the patient is at the highest risk for serious complication.
What is the initial establishment of pneumoperitoneum?
during this period of access and insufflation the likelihood of CO2 embolism and hemorrhage, the two most dreaded complications of laparoscopy, is highest.
300
To reduce the risk associated with excessive cervical flexion in the "beach chair" position, this should be maintained between the mandible and sternum
What is two fingerbreadths?
[Miller, Anesthesia. 7th, 2009 pp1163; Duke, Secrets. 4th. 2011 pp145]
300
The Bainbridge reflex causes an acceleration of the heart rate as a result of this structure stretching.
What is the Atrium?
400
Federal regulations say it must be distilled from a mash of not less than 51% corn.
Hint: I drink it after failing an apex quiz
What is Bourbon?
400
Number of calories produced by one gram of fat
What is nine?
400
A transesophageal echocardiogram is the most sensitive assessment tool for detecting a gas embolism, with the ability to detect emboli as small as ____
What is 0.02mL/kg?
400
In steep Trendelenburg position, most of the lungs are in this west zone.
What is zone 3 or 4?
most of the lung may be below the left atrium. consequently, much of the lung may be susceptible to pulmonary interstitial edema (zone 4 conditions)
[Miller, Anesthesia, 5th ed., 2000, p607]
400
All of the following drugs should be avoided in the patient with acute hepatitis but one:
amiodarone
tetracycline
acetaminophen
propranolol
What is propranolol?
500
"La Cerveza Mas Fina"
Hint: also the reason we are going to clinical until December 4th.
What is Corona?
500
This condition results in respiratory acidosis, pulmonary hypertension, right ventricular failure, and cor pulmonale. The presence of both obesity (BMI > 30kg/m2) and awake arterial hypercapnia (PaC02 >45 mmHg) support this diagnosis.
What is Pickwickian syndrome? Obesity hypoventilation syndrome (OHS)
seen in 5-10% of morbidly obese patients
500
These are the (5) steps to manage a gas embolism during laparoscopic surgery.
1. halting the insufflation of gas
2. discontinue nitrous oxide administration/ administer 100% O2
3. release the pneumoperitoneum
4. place patient in left lateral decubitus position (durant maneuver)
5. aspirate the gas through a central venous catheter
500
The anesthetist is likely worried about this nerve injury in the following position
What is the Saphenous nerve?
feet suspended outside vertical bars
500
The most common inherited disorder of platelet function.
What is Von Willebrand disease?
600
Alcohol activates these receptors causing chloride channels to open, which hyperpolarize the membrane and increase the threshold to depolarization.
What are GABA receptors?
600
Lean body weight is used to calculate the loading dose for two of the following drugs:
propofol
midazolam
remifentanil
succinylcholine
What is Propofol & remifentanil?
while it's true that opioids are highly lipophilic and have a large volume of distribution, the behavior of remifentanil is unique. since it is rapidly cleared by non-specific plasma esterases it behaves like it's a low Vd drug. Thus dosed on lean body weight.
even though succs is a water-soluble drug, the loading dose is based on TBW. a clear exception to the rule for water-soluble drugs. the combination of increased plasma volume and increased pseudocholinesterase activity necessitates the higher dose.
[Nagelhout. Nurse Anesthesia. 6th ed. 2019, p1007]
600
In the closed technique to initiating pneumoperitoneum, this needle is used to pierce the abdominal wall and CO2 gas is insufflated through the needle.
What is a Veress needle?
600
All of the following increase the risk of brachial plexus injury but one:
1. arms extended over the head in the prone position
2. shoulder braces
3. axillary roll placed caudal to the axilla
4. head turned laterally + contralateral arm abduction
What is axillary roll placed caudal to the axilla? #3
A roll placed inside the axilla can cause neurovascular compression
600
These two organs do not require insulin for glucose uptake.
What are Brain and Liver?