Funny how the heart can be deceiving
Some days like i'm barely breathing
My heart will always know you're name
You just keep makin' me ill
Doesn't mean you're gonna die
100
Which inhalational anesthetic is the only one to have no effect on MAP but increases SVR?
Nitrous oxide
100
Following the 'rule of 5's' you would expect a patient with an FiO2 of 60% to have a PaO2 of what?
300
100
What is normal coronary blood flow in ml/min?
225-250 ml/min
100
What is the most effective treatment of hypoxia while performing one-lung ventilation
CPAP to the non-dependent lung
100
A surgeon is about to proceed with a local anesthetic only approach to a carotid endartectomy, but asks you to be in the room in case sedation or conversion to GA is needed. Name 2 advantages to a CEA performed under local anesthesia?
Shorter hospital stay, direct assessment of neuro function/cerebral perfusion, avoidance of intubation, stable hemodynamics
200
What is the #1 perioperative complication with abdominal aortic repair that requires cross-clamping
Myocardial dysfunction
200
What are the traditional PaO2 and PaCO2 cut-off values for pulmonary resection?
PaO2 < 60
PaCO2 < 45
200
What are the 3 classic signs of aortic stenosis?
Syncope
Angina
Dyspnea (on exertion or otherwise)
200
What is the most common intra-operative complication associated with a double-lumen endotracheal tube
tube malposition
200
Which medication is best suited to treat hypotension in a patient with severe aortic stenosis
Phenylephrine
300
Name 2 cardiac related metrics that you would expect to increase with crossing clamping of the aorta during an abdominal aortic aneurysm repair
BP above clamp, SVR, PaOP, CVP, Coronary flow, SVO2
300
Alveolar pressure is greatest in which West lung zone?
Zone 1
300
In regards to mitral regurgitation, which of the following parameters would you like increased versus decreased?
Preload:
Heart rate:
Afterload:
Increased preload
Increased heart rate
Decreased afterload
300
Name 2 medications (not inhaled anesthetics) that inhibit hypoxic pulmonary vasoconstriction
NTG, beta-agonists, nitroprusside, Ca++ channel blockers, minoxidill, theophylline, PGE1, adenosine, prostacyclin (PGI2), Nitric oxide, Lisinopril, NE, Epi
300
What is the ppoFEV1 of a patient undergoing a right lower lobectomy with a pre-op FEV1 of 55%
Round to the nearest whole number
ppoFEV1 = pre-op FEV1 (%) x (42-segments removed)/42
55 x (42-12)/42
55 x.71 = 39%
400
A patient in pacu is having a myocardial infarction of the left ventricular lateral wall - you know you will see ST elevation in which 4 EKG leads?
I, aVL, V5, V6
400
Calculate the A-a gradient using the following parameters (at sea level) round to the nearest whole number:
PaO2: 90 mmHg
PaCO2: 60 mmHg
FiO2: 50%
192 mmHg
400
Which of the following cardiac pressure/volume loops is indicative of increased afterload?
A B C
B
A = increased pre-load
C = increased contractility
400
What are 3 ways we can help treat/mitigate the effects of pulmonary edema?
Nitroglycerin, O2, Diuretics, Prone positioning
400
An TEE is ordered under anesthesia for suspected regional cardiac wall abnormalities. What region of the heart would you expect to have wall abnormalities from occlusion of the right marginal artery?
Lateral right ventricle
500
A patient that has type II DM controlled by Metformin, CHF, HTN, CAD and Sjogren's disease is having a total knee replacement. What is his revised cardiac index score given his history and surgical procedure?
2 = 2.4% chance of major cardiac event
500
Draw the flow/volume loop you would expect to see from a patient with a tracheal tumor
500
C
500
Name all 4 bronchial blockers in this picture
From Left... Arndt, Cohen, Uniblocker, EZ blocker
500
Calculate this patients SVR using the following parameters:
mean arterial pressure: 75 mmHg
central venous pressure: 8 mmHg
cardiac output: 4.5 L/min
1190
((MAP-CVP)/CO) x 80