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Test Taking Tips

  • 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 ET tube 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 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?


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