Cerebral Blood Flow
Nitrous Oxide ___ CBF, ____ CMR, ____ ICP
(increases or decreases)
increases all. So Just avoid it in Neuro cases!!
Name 3 methods for monitoring a patient during CEA
awake patient, EEG, SSEPS, carotid stump pressure, transcranial dopplers
How long do you continue anti epileptics after TBI to prevent seizures?
What are the three components of GCS
Eye opening, best verbal response, best motor response
-What was the first Major League Baseball team?
Cincinnati Reds
Propofol ___ CBF, ___ CMR, ____ ICP
decreases all
Bradycardia during dissection at the bifurcation is likely due to stimulation of the _____
carotid sinus baroreceptor
What is used for seizure prophylaxis in preeclamptic women
Magnesium
At what GCS is TBI considered severe
-What baseball player has the most hits of all time
Pete Rose
What are the lower and upper MAP pressure limits of CBP autoregulation
60 and 160mm HG
(50-150 also acceptable)
Name some complications from CEA
Stroke (embolic), MI, hematoma
What is the effect that many AEDS have on NMBs
They reduce the effectiveness. Patients may require increased dose and more frequent dosing. Chronic AED use causes increased alpha acid glycoprotein, which binds NMBS
An alert, confused patient that follows commands
What NFL player was injured at the game vs the Bengals in Cincinnati last year and returned this year to say thanks to the medical team that helped him.
Ryan Shazier
What percentage does CBF change for each mm Hg increase in PaCO2
Bilateral carotid endarterectomy can result in significant impairment of the hypoxic drive due to
disruption of the carotid bodies
Carotid bodies are sensory organs that detect changes in arterial blood oxygen, and the ensuing reflexes are critical for maintaining homeostasis during hypoxemia
Which AED can cause thrombocytopenia
A patient with decorticate posturing (flex), makes incomprehensible sounds and opens eyes to pain
What is the name of the only pro Cincinnati basketball team?
Cincinnati Royals
A patient is not waking up at the end of the case. How would you evaluate for the cause of delayed emergence?
Check ABCs, oxygenation, ventilation, vital signs, ABG, review intra op meds and premeds. Too much narcotic/bdz? Check twitches, last dose of NMB?, check pupils, electrolytes, glucose. Consider CT head
What are the options for Anesthesia for a Catotid Enderaterectomy and name an advantage for each
Regional anesthesia with deep or superficial cervical plexus block – an awake patient is more sensitive and specific for neuromonitoring, GA – patient still, no need for cooperation
A patient presents with seizures and his toxicology screen reveals a lithium level of 4mEq/L. How do you treat? What are some early symptoms of Lithium toxicity
Emergent hemodialysis
Levels above 2 can cause severe toxicity. Early sx include diarrhea, vomiting, stomach pains, tremors
A patient with withdraws to pain, is confused and opens eyes when you say his name
Who is the only heavy weight champion from Cincinnati?
Ezzard Charles