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Test Taking Tip

Remember to review lidocaine toxicity, especially the signs and symptoms and the maximum dose that can be given. Know the advantages and disadvantages of using an epidural versus a PCA for postoperative pain control.

What is the optimal distance above the carina for an endotracheal tube (ETT)?

  • 2 cm above the carina

What are the steps of rapid-sequence induction?

  • Oxygenation and short-acting induction agent muscle relaxant → cricoid pressure → intubation → inhalational anesthetic

What is the most commonly used technique for induction of general anesthesia in children?

  • Inhalational

What are the steps that both the surgeon and anesthesiologist should take during an airway fire?

  • Stop all gas and oxygen flow → extinguish fire with water/saline → remove ETT and any foreign body in airway → perform mask ventilation until patient is reintubated → perform bronchoscopy to assess extent of airway damage

What factors affect the accuracy of pulse oximetry?

  • Decreased reading—intense environmental lighting, motion, methylene blue dye, hypothermia, low cardiac output, hypotension, peripheral edema, nail polish

  • Increased reading—bilirubin, carbon monoxide

Define minimum alveolar concentration (MAC):

  • The smallest concentration of gas at which 50% of patients will not move to painful stimuli such as incision

Relate lipid solubility, speed of induction, and potency for an inhalational agent with a low MAC:

  • Low MAC means that the agent is more lipid soluble and more potent but has a slower speed of induction

What inhalational agent has the fastest speed of induction, high minimal alveolar concentration, and low potency?

  • Nitrous oxide (NO2)

Name contraindications to the use of nitrous oxide:

  • Middle ear occlusion, pneumothorax, small-bowel obstruction, and any other instance where there is an air-filled body pocket

Which inhalational agent can cause eosinophilia, fever, increased liver function tests, and jaundice and is associated with the highest degree of cardiac depression and arrhythmias?

  • Halothane

Which inhalational agent has a pleasant smell and is ideal for mask induction in children?

  • Sevoflurane

What induction agent should not be used in patients with an egg allergy?

  • Propofol

What induction agent is contraindicated in head injury?

  • Ketamine

Which induction agent can cause adrenocortical suppression with continuous infusion?

  • Etomidate

First muscle to be paralyzed after administration of a paralytic? Last muscle?

  • Face and ...

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