OMSA Flashcards Preview

Dentistry > OMSA > Flashcards

Flashcards in OMSA Deck (316)
Loading flashcards...
1
Q

2 chambers of heart contain

A

Right and left atria (receive) and right and left ventricles (pump)

2
Q

Function of the 2 heart chambers

A

Right pumps to lungs left pumps everywhere else

3
Q

Valve found between right atrium and right ventricle

A

Tricuspid

4
Q

What do valves do

A

Prevent back flow of blood and separates chambers

5
Q

What valve lies between the left atrium and left ventricle

A

Mitral

6
Q

What valve allows blood to flow through right ventricle to pulmonary artery

A

Pulmonary valve

7
Q

What valve allows blood to flow from the left ventricle into the aorta

A

Aortic valve

8
Q

What noise is the first sound of the heart beat (lub) caused by

A

Mitral and tricuspid valves closing

9
Q

What is the second sound of a heart beat (dub) caused by

A

Aortic and pulmonic valves closing

10
Q

Angina pectoris

A

Decrease in blood supply to heart causing chest pain

11
Q

Myocardial infarction

A

Necrosis of the heart caused by deprivation of oxygen for too long or heart attack

12
Q

What does the info on the EKG represent

A

Electrical activity of contraction of the myocardium

13
Q

What is another term for negative myocytes

A

Polarized

14
Q

Cells while resting are

A

Negative

15
Q

Beta one controls

A

Heart

16
Q

Name the two systems that comprise the autonomic nervous system

A

Sympathetic and parasympathetic

17
Q

Follow the blood flow of the heart: superior and inferior vena cava to the ____ atrium, past the ___ valve and into the ____ ventricle. Past the ____ valve to the ____ artery to the lungs for oxygen

A

Right, tricuspid, right, pulmonic, pulmonary

18
Q

Trace the path of the conduction system through the heart: ___ node to the ___ node to the bundle of his to the ___ and finally to the ___

A

SA, AV, bundle branches,purkinjie fibers

19
Q

The ___ valve lies between the right atrium and right ventricle, while the ___ valve lies between the left atrium and left ventricle

A

Tricuspid, mitral

20
Q

From the lungs blood travels through the ___ vein to the ___ atrium past the __ valve to the __ ventricle then through the __ valve into the __ where it is pumped into the rest of the body

A

Pulmonic, left, mitral, left, aortic, aorta

21
Q

Stimulation of the vagus nerve will ___ the heart rate

A

Decrease

22
Q

Another name for the sympathetic nerve is the cholinergic system

A

False

23
Q

Insufficient blood flow through the coronary arteries can result in

A

Angina

24
Q

What is the difference between angina and myocardial infarction

A

Angina is chest pain due to inadequate oxygenation while myocardial infarction is death of the actual heart muscle

25
Q

What does ischemia mean

A

Inadequate blood supply

26
Q

What causes a heart murmur

A

Turbulence in the blood flow across the heart valves

27
Q

Symptoms of right sided heart failure

A

Ascities and pitting edema

28
Q

What is the mnemonic for a patient having a myocardial infarction

A

MONA

29
Q

Symptoms of left sided heart failure

A

Shortness of breath, pulmonary edema

30
Q

What medication is used in the treatment for angina

A

Nitroglycerin

31
Q

What do beta blockers do

A

Reduce the heart rate and blood pressure

32
Q

What are the two kinds of heart failure

A

Right and left

33
Q

Left sided heart failure often leads to

A

Right sided heart failure

34
Q

Which patient needs antibiotic premedication

A

A 70 year old with a prosthetic valve

35
Q

The first heart sound is caused by

A

Mitral and tricuspid valves closing

36
Q

A patient that has a history of CABG (Coronary Artery Bypass Grafting) needs to be premeditated with antibiotics

A

False

37
Q

Causes of hypotension include what

A

Excessive medication, allergic reaction and cardiac dysthymia but not seizures

38
Q

Symptoms of severe hypotension include what

A

Dizziness, fainting, orthostatic hypotension but not chest pain

39
Q

Your pt wonders if they should stop their blood pressure medication the morning of their surgery since they can’t have anything to eat or drink. What do u tell them

A

Take your meds with a small sip of water

40
Q

The blood pressure that is considered the upper level of normal is

A

140/90

41
Q

2 kinda of stroke include

A

Ischemic and hemorrhagic

42
Q

Treatment for a hypertensive crisis include

A

A beta blocker and vasodilator

43
Q

High blood pressure may increase a chance of heart attack and

A

Stroke

44
Q

Pt in hypertensive crisis may complain of

A

Headache

45
Q

The pneumonic for diagnosing a stroke is

A

FAST: Face, Arm, Speech, Time

46
Q

Sinus arrhythmia is the same as asystole

A

False

47
Q

What is the correct sequence of impulses through the heart

A

SA node-AV node-Bundle of His-perkinjie fibers

48
Q

The best treatment for ventricular fibrillation is

A

Defibrillation

49
Q

Ur pt has an irregularly irregular pulse. They most likely have

A

Atrial fibrillation

50
Q

The most common rhythm of cardiac arrest is

A

Ventricular fibrillation

51
Q

The T wave is caused by

A

Repolarization of the ventricles

52
Q

The QRS complex is caused by

A

Depolarization of the ventricles

53
Q

What is the intrinsic rate of the SA node

A

60-100 beats per minute

54
Q

The P wave is caused by

A

Depolarization of the atria

55
Q

___ is more dangerous than ___

A

Multifocal PVC; unifocal PVC

56
Q

A pt who is in a narrow complex tachycardia is complaining of chest pain. U notice that the BP is falling and the pt has an altered level of consciousness. What do u do

A

Sedate then perform a synchronized cardioversion

57
Q

Vagal maneuvers can be used in diagnosis and treatment in pts with what rhythm

A

Supraventricular tachycardia

58
Q

The first medication for a pt in ventricular fibrillation is

A

Epinephrine 1 mg IV

59
Q

U come across a pt that is not breathing and is without a pulse. What do u do next?

A

Start chest compressions

60
Q

All bradycardias with a rate lower than 50 beats should be given atropine
.5 mg

A

False

61
Q

When doing CPR what is the rate of chest compressions per minute

A

100

62
Q

A pt in ventricular fibrillation has a pulse

A

False

63
Q

You can defibrillate asystole

A

False

64
Q

The second medication used in the treatment for ventricular fibrillation is

A

Amiodarone

65
Q

The hairlike projections on the cells within the trachea are called

A

Cilia

66
Q

Foreign bodies that are aspirated usually go down the ____ mainstem bronchus

A

Right

67
Q

Inspiration is more of a ___ process and expiration is more of a ____ process

A

Active; passive

68
Q

The anatomic structure where a circothyrotomy is performed is

A

Through the circothyroid membrane

69
Q

Oxygen is carried by the

A

Red blood cell

70
Q

The order of airflow of the upper respiratory system is

A

Nasopharynx, oropharynx, larygopharynx, trachea

71
Q

The __ bronchus is straighter and wider while the __ bronchus is narrower and at a more acute angle

A

Right, left

72
Q

Gas exchange (where oxygen goes from the air to the blood and CO2 goes from blood to the air) takes place in the:

A

Alveoli

73
Q

Control of respiration is dependent on

A

The level of carbon dioxide in the blood

74
Q

The order of airflow in the lower respiratory system is

A

Trachea, right and left mainstream bronchi, bronchioles, alveoli

75
Q

Asthma is a disease of

A

Bronchoconstriction

76
Q

An LMA is the most ideal, preferred method to maintain airway

A

False

77
Q

With nitrous oxide delivery systems, at the maximum nitrous oxide delivery rate, at least how much oxygen should be concurrently delivered

A

22%

78
Q

Rescue inhalers are usually a

A

Bronchodilator

79
Q

Ideally, how long should a patient stop smoking before a procedure

A

8 weeks

80
Q

You can insert an LMA (laryngeal mask airway) on a conscience patient with an intact gag reflex

A

False

81
Q

Normal adult patients should show a pulse oximeter reading of __% on room air

A

96

82
Q

What medication is NOT used for asthma

A

A (alpha) agonist

83
Q

What medications ARE used for asthma

A

Corticosteroids, B agonist (bronchodilator), antihistamines

84
Q

Pulse oximeter readings can be affected by

A

Patient movement, nail polish, chronic exposure to nicotine, cold extremities, venous congestion

85
Q

Treatment of emesis is to turn the patient to the

A

Right

86
Q

Medication to treat persistent laryngospasm is

A

Succinylcholine (10-20mg)

87
Q

Treatment for respiratory depression from an overdose of narcotics and benzodiazepines is __ and __ respectively

A

Naloxone, flumazenil

88
Q

Initial treatment for laryngospasm is

A

Suction the oropharynx

89
Q

The most common cause of airway obstruction is

A

Tongue

90
Q

The symptoms of hyperventilation are caused by

A

The decrease in blood CO2

91
Q

Medication to treat bronchospasm are usually

A

Beta agonists

92
Q

If a patient hasn’t had asthma in year, you don’t have to have them puff their inhaler

A

False

93
Q

The crowing sound indicating a laryngospasm is called

A

Stridor

94
Q

Protective reflex closure of the vocal chord is

A

Laryngospasm

95
Q

What is the danger of doing surgery on a patient who is adrenally suppressed

A

They may experience a drop in blood pressure and shock

96
Q

What is the normal blood glucose level

A

70-100

97
Q

What is the problem with performing surgery on a patient who’s blood sugar is too high

A

They will have difficulty with wound healing

98
Q

What does the thyroid do

A

Produces hormones that control metabolism and growth

99
Q

The two types of diabetes are

A

Type 1: beta cells don’t produce insulin at all

Type 2: insulin binds to cells but gates don’t open for glucose

100
Q

What is the function of insulin

A

To drive glucose into the cells

101
Q

What is the endocrine system

A

The study of glands that secrete hormones that regulate the body

102
Q

What are symptoms of diabetes

A

Polyphagia (always hungry), polydypsea (always thirsty), polyuria (frequent restroom)

103
Q

What is the function of glucagon

A

To release glucose from the cells into the bloodstream

104
Q

Where is insulin produced

A

Pancreas

105
Q

An important blood level count to inquire about in an HIV positive patient is

A

T helper cell count

106
Q

What are signs of a true allergic reaction

A

Itchy rash

107
Q

In a patient in anaphylactic shock, the two most important considerations are: 1-the drop in blood pressure and 2-

A

Laryngeal edema

108
Q

An extreme allergic reaction is called

A

Anaphylactic shock

109
Q

Patients with liver disease should be given high doses of anesthetic agents

A

False

110
Q

Indications for patients to be on Coumadin are

A

Stroke or cerebral vascular accident

111
Q

Your patient is in kidney failure and requires dialysis. He is on a Monday Wednesday Friday dialysis schedule. Which day do u want to do surgery on?

A

Tuesday Thursday

112
Q

The optimal time for elective procedures to be performed on a pregnant patient is

A

Second trimester

113
Q

Medication for allergic reaction include Benadryl and

A

Decadron

114
Q

Johnny’s mother states he is allergic to penicillin because he got sick to his stomach last time he took it. You calmly tell mom:

A

No Mom, Johnny had an adverse reaction not a true allergy

115
Q

What is the preferred IV fluid

A

NS

116
Q

The danger of an intra-arterial injection is

A

Intense chemical inflammation destroying the inner layer of the artery, preventing blood supply tot he limb

117
Q

Which is the preferred vein for the IV site for oral surgery procedure

A

Antecubital fossa

118
Q

Why must you run the IV fluid through the line before administering to the patient

A

To prevent air embolus

119
Q

Treatment of an intra-arterial injection is

A

10cc 1% procaine

120
Q

Less severe venipuncture complications include

A

Phlebitis and extravasation

121
Q

The preferred method of starting an IV is to use

A

A catheter

122
Q

When inserting the catheter which artery is at risk

A

Brachial artery

123
Q

Treatment for phlebitis includes

A

Pressure, moist heat and elevation

124
Q

Inflammation of the vein is called

A

Phlebitis

125
Q

The stimulus for respiration is

A

Increasing CO2 levels

126
Q

Increased heart rate and blood pressure are due to stimulation of the

A

Sympathetic system

127
Q

Anesthetic agents act by

A

Interfering with the depolarization of the membrane

128
Q

Increase in salivation is due to stimulation of the

A

Parasympathetic system

129
Q

Normally a nerve cell is polarized. This means…

A

There are more positive ions on the outside of the cell membrane and more negative ions on the inside of the cell

130
Q

Nerves conduct impulses by

A

Depolarization of the nerve membrane

131
Q

The main organ that eliminates the drugs is

A

Kidney

132
Q

The two components of the autonomic nervous system are

A

Parasympathetic and sympathetic

133
Q

Your patient is very very nervous. You probably want to give them an anesthetic Agent targeted at

A

The center for emotion

134
Q

The main organ that Processes the anesthetic drugs and changes the chemical Structure of the drug is

A

Liver

135
Q

Nitrous oxide is

A

Stored in blue tanks, is a non-flammable gas, should always be administered with oxygen, Produces euphoria and promotes relaxation

136
Q

Atropine or glycopyrrolate are sometimes given to

A

Reduce salivary secretions

137
Q

Steroids are used to

A

Decrease swelling and inflammation

138
Q

The function of a narcotic is to

A

Minimize or eliminate pain

139
Q

Benzodiazepines are reversed by

A

Romazicon (flumazinil)

140
Q

The most rapid an effective method of administering drugs is

A

Intravenously

141
Q

Oxygen is

A

Stored in green tanks, Should be administered to every patient undergoing surgery with sedation, Should be administered at a concentration of 30%Or higher when given with other inhaled agents,Should be given with caution two patients with COPD

142
Q

The action of benzodiazepines are

A

To relax and sedate the patient

143
Q

Morphine is stronger than Fentenyl

A

False

144
Q

Simply shutting off the nitrous oxide and allowing the patient to breathe room air can result in

A

Diffusion hypoxia

145
Q

Early signs of a local anesthetic overdose include

A

Anxiety, Disoriented, talkative

146
Q

Ketamine is classified as a

A

Disassociative anesthetic

147
Q

Contra indications for use of propofol are allergies to

A

Soy, egg, sulfa

148
Q

What category of patients will usually require more propofol

A

Children and women

149
Q

Ketamine can cause respiratory depression

A

False

150
Q

Acetaminophen toxicity affects which organ

A

Liver

151
Q

Brevital is classified as a

A

Barbiturate

152
Q

Propofol is classified as a

A

Sedative hypnotic

153
Q

Brevital can cause respiratory depression

A

True

154
Q

Brevital may predispose the patient to

A

Laryngospasm

155
Q

It is easy to prevent the patient from progressing From a Moderate sedation to a general anesthesia

A

False

156
Q

A 78-year-old female is given 5 mg of verse said and 50 µg of fentanyl. She now needs her chin tilted upwards to keep her airway openAnd she does not respond to verbal stimuli. Her level of sedation is

A

Deep sedation possibly general anesthetic

157
Q

A target organ for anesthetic drugs is

A

Brain

158
Q

Versed is classified as a

A

Benzodiazepine

159
Q

ASA NPO Guidelines recommend Restriction of clear fluids __ hours Before the procedure and restriction of solid food for __ hours Before the procedure

A

2, 6

160
Q

Agents that induce respiratory depression include

A

Opioids, benzodiazepines, alkylphenols

161
Q

What agents do not induce respiratory depression

A

Disassociative anesthetics

162
Q

838-year-old female presents for a consultation. Her past medical history includes asthma, for which she takes daily medication, Adviar, as well as a rescue inhaler. She also has diabetes for which she takes metformin And insulin. Her ASA classification is

A

Class III

163
Q

The function of a narcotic is

A

Analgesia or relief of pain

164
Q

A Dr. request his assistant to take the patient’s vital signs Which include

A

Blood pressure, temperature, pulse

165
Q

Examination of a patient with a protruded tongue reveals Visualization of the soft palate and the base of the uvula Only. This patient’s malampatti classification is

A

Class III

166
Q

Eyelash reflex is a form of ___ reflex

A

Palpebral

167
Q

It is OK to use the patient’s family to watch them during recovery while we deal with the next patient

A

False

168
Q

Elderly patients require ___ medications than younger adults

A

Less

169
Q

The most ideal airway management is

A

Endotracheal intubation

170
Q

The following questions should be asked to a patient in recovery in the order of

A

Do they still need airway assistance, what is there oxygen saturation in room air, Is the patient awake

171
Q

The trachea is ___ To the esophagus. This means that when the patient is laying supine The trachea will be __ To the esophagus

A

Anterior, superior

172
Q

Johnny is a five-year-old male who requires extraction of four carious baby teeth. His mom calls the day before surgery stating he has come down with a cold. You should tell her

A

Wait until Johnny feels better and then we will schedule an appointment for two weeks after he is well

173
Q

The stage of Anastasia or surgery can be Performed is

A

Stage three

174
Q

Passage of the air into the lungs follows the course of

A

Nose/mouth, nasopharynx, oropharynx, larynx,trachea,

175
Q

Children have __ Heart rates and __ blood pressure When compared to adults

A

Higher, lower

176
Q

Your sedated patient vomits mid procedure. What do you do

A

Roll the patient to the right side and suction airway

177
Q

Treatment for respiratory depression is

A

Narcan .4 mg IV

178
Q

Laryngospasm is

A

Protective closure reflex of the vocal cords To prevent foreign material from Entering into lungs

179
Q

The most common cause of airway obstruction is

A

Base of tongue falling back and occluding the airway

180
Q

Bronchospasm occurs when

A

Constriction of smooth muscle walls of the bronchioles

181
Q

The danger of administering Narcan For treatment of respiratory depression is

A

The Narcan may wear off before the respiratory depressive Effect of the narcotics wears off

182
Q

Treatment of bronchospasm is

A

Suction airway, positive pressure ventilation

183
Q

Bronchospasm could be diagnosed by

A

Expiratory wheeze and difficulty in positive pressure Ventilation

184
Q

The side effect of succinylcholine to be careful of is

A

It’s a muscle relaxant and can cause the patient to stop breathing

185
Q

Treatment for angina is

A

Nitroglycerin

186
Q

The drug for treatment of a narcotic overdose is

A

Narcan

187
Q

Preliminary treatment of a patient with hypotension is

A

Fluid challenge

188
Q

The difference between angina and myocardial infarction is

A

Angina is caused by lack of oxygen in the coronary arteries while an MI implies necrosis or death of the heart muscle

189
Q

MONA stands for

A

Morphine, Oxygen, nitroglycerin, aspirin

190
Q

If a pt doesn’t take their antihypertensive medication before surgery it can result in

A

Rebound hypertension

191
Q

Patients with ____ are more at risk of cardiovascular disease

A

Smokers, hypercholesterolemia, fam history, diabetes, obesity, sedentary life style, hypertension, advancing age, history of MI congestive heart failure, heart valve dysfunction

192
Q

Treatment for a hypertensive crisis includes

A

Beta blocker

193
Q

Symptoms of angina include

A

Crushing, squeezing chest pain

194
Q

If your pt is determined to be in respiratory depression with a respiratory rate of 7 you

A

Head tilt to open the airway and apply full face mask with positive pressure O2

195
Q

The medication used to treat overdose of a benzo is

A

Romazicon

196
Q

What is more dangerous multifocal PVC or unifocal PVC

A

Multifocal

197
Q

A patient is in asystole, your next move is to

A

Start CPR and give epinephrine 1mg

198
Q

Is it possible to see a normal sinus rhythm on an EKG with no pulse

A

True

199
Q

The cardiac rhythm in which the pt does not have a pulse are asystole, pulseless ventricular tachycardia, pulseless electrical activity and

A

Ventricular fibrillation

200
Q

The drug of choice to speed up the heart in a symptomatic bradycardia is

A

Atropine

201
Q

Pts with a dysrhythmia who are symptomatic will complain of chest pain, shortness of breath and

A

Dizziness and hypotension

202
Q

The drug of choice used to treat a supraventricular tachycardia is

A

Adenosine

203
Q

Your pt is extremely nervous and apprehensive. The EKG shows a sinus rhythm of 135 bpm. Your next step is to

A

Go ahead and sedate the pt because sinus tachycardia is normal to see in an anxious pt

204
Q

An example of a vagal maneuver is

A

Have the pt bear down as if having a bowel movement

205
Q

The most effective treatment for a pt in ventricular fibrillation is

A

Defibrillation

206
Q

If a patient with a known seizure disorder doesn’t take his medication It can precipitate a seizure

A

True

207
Q

For moderate allergic reactions in addition to Benadryl, This drug is often added

A

Decadron

208
Q

Treatment of a mild allergic reaction Usually is prescribing

A

Benadryl

209
Q

Treatment for syncope is

A

02, Trendelenburg position

210
Q

If a diabetic take their medication as usual the day of the surgery We would worry about

A

Hypoglycemia

211
Q

The first medication to consider in an anaphylactic crisis is

A

Epinephrine

212
Q

The causes of syncope is

A

Slowed heart rate and blood pressure

213
Q

A patient’s mother states the patient is allergic to Vicodin. She says he becomes nauseated with it is this a true allergy

A

No

214
Q

The most common presentation of an allergic reaction is

A

Itchy red rash

215
Q

A severe allergic reaction is called

A

Anaphylaxis

216
Q

The trachea branches into the right and left main stem Bronchus. The patient is undergoing general anesthesia in your office To remove a tooth. The patient aspirates the tooth. Which long would you guess the tooth ended up in

A

Right

217
Q

A patient with type two (non-insulin-dependent) Diabetes would typically be taking pills To control their blood glucose and their diabetes

A

True

218
Q

You have a 17-year-old patient that is undergoing General Anastasia to remove four wisdom teeth. During the surgery you hear a high-pitched crowing sound. You look down and her chest and abdomen are not in sync When she is breathing. Her oxygen saturation begins to fall rapidly. Your diagnosis and treatment are

A

Laryngospasm: Administer positive pressure and succinylcholine if needed

219
Q

The right side of the heart carries deoxygenated blood

A

True

220
Q

Which of the following general drug categories Are used to treat someone experiencing an asthma attack

A

Beta agonist

221
Q

A laryngospasm is a disorder of the

A

Upper airway

222
Q

Your patients presents for surgery at 10am. He states that he has not had anything to eat or drink but out of habit he took his daily dose of insulin. He is pale trembling and no feeling well. You perform a finger stick as you do with all your diabetic patients. His blood glucose is 50. You have not started an IV yet. The best treatment option for this pt is to…

A

Start an IV and give D5W as your IV fluids

223
Q

The most Common cardiac rhythm on an EKG For an adult patient in cardiac arrest is

A

Ventricular fibrillation

224
Q

The classification of drugs Used to relieve pain is

A

Narcotics

225
Q

Your patient is a relatively difficult anesthetic patient. He is morbidly obese With a short neck, recessed jaw, and a mallampatti class of four. You’re struggling to chin him. You already have a nasopharyngeal airway in. What else might you try before you into beat him

A

Laryngeal mask airway

226
Q

The most frequent anatomical airway obstruction is

A

The tongue

227
Q

The most concerning signs and symptoms of An acute anaphylactic reaction are

A

Airway edema and circulatory collapse

228
Q

Two types of diabetes that are characteristically classified as the following

A

Type one: Insulin-dependent and type two: non-insulin-dependent

229
Q

A patient with type one diabetes would typically be giving themselves shots Of insulin to control their blood glucose And to control their Diabetes

A

True

230
Q

The correct air flow sequence from the nose to the lungs is

A

Nose, nasal pharynx, oral pharynx, laryngopharynx, Trachea, lungs

231
Q

The agent used to reverse the effects of versed is

A

Romazicon (flumazenil)

232
Q

The acronym fast refers to facial droop, Arm weakness, Speech problems, and time to call 911. This refers to what condition

A

Stroke

233
Q

Which monitor gives the most information About ventilation

A

Capnograph

234
Q

Dilation or widening of blood vessels And arteries will cause your blood pressure to increase

A

False

235
Q

You are starting an IV on your patient through the anti-cubital fossa. The artery you want to avoid in the anti-cubital fossa is

A

Brachial artery

236
Q

The ASA classification is used For assessing patients prior to General Anesthesia As a risk assessment tool. You have a patient with a history of only hypertension, high blood pressure, what classification would they be

A

ASA 2

237
Q

The QRS complex on the EKG represents

A

Ventricular depolarization

238
Q

A pediatric airway is different from an adult airway in that

A

Kids have a large tongue and conical shaped airway

239
Q

Your patient has stopped breathing. What is the main primary physiological Mechanism that will restart this patient’s breathing

A

Excess of carbon dioxide

240
Q

Drugs given to patients are usually metabolized In the body by what organ

A

Liver

241
Q

You have a 68-year-old male patient with a history of hypertension. He had a heart attack a while back. When he had a heart attack He states he had it angioplasty with one stent placed. He’s anxious and wants to go to sleep for his extractions. Which anesthetic agent would you want to avoid

A

Ketamine

242
Q

A patient calls one day after the removal of an infected tooth. She reports an itchy red rash all over her body after taking amoxicillin That your doctor prescribed. She is worried that she is allergic to amoxicillin. Your recommendation to her is

A

Stop the amoxicillin and take over-the-counter Benadryl

243
Q

The difference between angina and myocardial infarction is

A

A myocardial infarction implies death or necrosis of the heart muscle

244
Q

Your doctor has started an IV. You are hooking the IV line with the catheter. Which bag of IV fluids is the preferred Fluid for a routine healthy patient

A

LR

245
Q

There are two main categories of local anesthetics used in dentistry. Most common category of local anesthetic used in oral and maxillofacial surgery’s is

A

Amide

246
Q

What drug is most commonly associated with respiratory depression when given IV

A

Fentanyl

247
Q

The P-wave in the EKG represents

A

Atrial depolarization

248
Q

Constriction of or narrowing Of the coronary arteries can cause angina

A

True

249
Q

Indications for patients to be on anticoagulants are

A

Stroke, pulmonary embolism, History of blood clot in the legs

250
Q

The doctor asks you to assess the patient’s ventilation. The things you look at include the rising and falling of the chest and

A

Oxygen saturation and end title CO2

251
Q

When insulin is given to a patient at lowers the patient’s blood glucose

A

True

252
Q

Myocardial infarction of the heart muscle is reversible

A

False

253
Q

A contraindication for the use of propofol is

A

Allergy to eggs

254
Q

A patient has taking 20 mg of prednisone daily for the last 30 years for the rheumatoid arthritis. Your doctor is planning to remove a difficult deeply impacted wisdom tooth. Our concern preoperatively for this patient is

A

The patient will not be able to properly handle a flight or fight response From a stressful procedure

255
Q

Anginas potentially reversible

A

True

256
Q

Asthma is a disease of the long. Specifically Considered a disease of the

A

Lower airway, bronchiolar constriction

257
Q

Normal pathway of the conducting system in the heart is

A

SA node, AV node, Bundle of his, Purkinje fibers

258
Q

Stimulation of the sympathetic nervous system will result in

A

Increased heart rate, increased blood pressure

259
Q

Classic symptoms of congestive heart failure include

A

Shortness of breath, Swollen ankles

260
Q

Angina is due to

A

Decreased blood flow to the heart muscle

261
Q

Atrial fib relation is a type of heart rhythm. Patients who have this rhythm will have an irregular pulse

A

True

262
Q

Ketamine can cause hallucinations. The best medication to give with ketamine To reduce the incidence of the side effects is

A

Versed

263
Q

In compartment syndrome, one can see an increase pressure in the forearm. This can be caused by venipuncture. This is considered a true medical emergency

A

True

264
Q

Epinephrine is one of the components of local anesthesia. When epinephrine is added to local anesthesia It helps maintain the local anesthetic Close to the inferior alveolar nerve Potential he making it more effective for profound Local anesthesia. They should theoretically

A

Decrease the number of cartridges used to obtain a profound local anesthesia

265
Q

Insulin converts

A

Glucose into glycogen

266
Q

Can you compare the ventricles of the heart to the atria of the heart, The walls of the ventricles are thicker than the atria

A

True

267
Q

Constrictions of or narrowing of the blood vessels and arteries Will cause your blood pressure to increase

A

True

268
Q

One way for your doctor to know that they have inadvertently Placed an IV into an artery is

A

Pulsatile movement and bright red blood in the IV line

269
Q

The left side of the heart carries deoxygenated blood

A

False

270
Q

You just completed a surgical procedure on a patient. This patient received fentanyl, versed, and propofol Intravenously with LR As the fluids. The patient has been in recovery for 45 minutes And is still drowsy. Which medication is most likely causing them to be drowsy

A

Versed

271
Q

The following is the correct sequence of blood flow through the heart

A

Superior/inferior vena cava, Right atrium, tricuspid valve, Right ventricle, Pulmonic valve, Pulmonary artery, pulmonary vein, Left atrium, mitral valve, left ventricle, Aortic valve, aorta

272
Q

A patient with type one diabetes calls the morning of the surgery. She states that she knows she’s not supposed to have anything to eat or drink and is not sure what to do about her insulin. She Asks for instructions On her insulin that she normally injects her self with every morning. You instruct her to

A

You tell her to inject yourself with half the normal dose

273
Q

Drugs given to the patient are usually excreted from the body after passing through what organ

A

Kidney

274
Q

Signs and symptoms of a myocardial infarction

A

Chest pain not relieved by nitroglycerin, pain may radiate down the left arm or up to the left jaw, Blood pressure will drop with weak pulse, may experience nausea or vomiting

275
Q

Signs and symptoms of congestive heart failure

A

Right sided failure: swelling of ankles and belly and distended neck veins. Left sided failure coughs pink frothy sputum, shortness of breath when they lay down, often wakes upIn the middle of the night gasping for air

276
Q

Cerebral vascular accident is another name for

A

Stroke

277
Q

What are the two types of strokes

A

Embolic stroke: a blood clot causes the blood vessel to become occluded Hemorrhagic stroke: a blood vessel ruptures and bleeds

278
Q

Signs and symptoms of stroke

A

Weakness in extremities usually right side, facial palsy/slurred speech, headache

279
Q

What What does not show up on an EKG

A

Atrial repolarization

280
Q

What is considered bradycardia

A

A heart rate less than 60

281
Q

What is tachycardia mean

A

Heart rate over 100

282
Q

What are corticosteroids used for

A

Suppress inflammation

283
Q

Where is cortisol produced

A

In the adrenal gland

284
Q

Symptoms of adrenal insufficiency

A

Hypoglycemia, dehydration, weight loss, disorientation

285
Q

What does your thyroid gland do

A

Produces hormones that regulate metabolism and growth

286
Q

What does PVC stand for

A

Premature ventricular contraction (wide bizarre QRS complex) wave not traveling along right/left perkinjie fibers simultaneously

287
Q

What is multifocal PVC caused by

A

Hypoxia

288
Q

What is ventricular tachycardia

A

Looks like string of PVC run together. Potentially fatal. Low blood output.

289
Q

What is SVT

A

Supraventricular Tachycardia

290
Q

What is bigeminy

A

A PVC every other beat

291
Q

On an ekg graph how much time is measured from dark line to dark line

A

.2 seconds

292
Q

On an elf graph how much time does one square represent

A

.04

293
Q

What is the intrinsic rate of that atria

A

60-80 bpm

294
Q

What is the inherit rate of the ventricles

A

20-40 bpm

295
Q

What is an ectopic foci

A

Excitable cell area of heart fired out of normal rhythm

296
Q

What are PJC’s

A

Premature junctional contraction

297
Q

What is congestive heart failure

A

Pump failure causing blood to back up.

298
Q

What is the treatment for CHF

A

Diuretic

299
Q

What are Korotkoff sounds

A

The force of ventricular contraction (systolic number)

300
Q

What is the rule of 2’s

A

If pt has taken more than 20mg of hydrocortisone more than 2 weeks in the last 2 yrs then double their dose before surgery

301
Q

Pts that have had chemotherapy need to have what checked before surgery

A

CBC (complete blood count)

302
Q

What does LR stand for

A

Lactated ringers (like saline but with more electrolytes

303
Q

What is normal physiologic tonicity of human fluid

A

.9%

304
Q

What does 1:100,000 mean

A

1 gram in 100,000 cc or solution

305
Q

What is a millimeter

A

One thousandth of a liter

306
Q

What is a milligram

A

One thousandth of a gram

307
Q

Anatomy from top to bottom of arm

A

Biceps brachii, brachialis muscle, median nerve, brachial artery, tendon of biceps brachii, pronator teres, brachioradialis, flexor carpi radialis

308
Q

What are some drugs that are considered narcotics

A

Morphine, fent, Demerol, codeine

309
Q

What does ketamine do

A

Dissociative anesthetic. Causes blockade of an excitatory neurotransmitter. Potent analgesia and amnesia

310
Q

What is cyanosis

A

Blue skin color

311
Q

What are normal values of CO2 expiration

A

5-6% or 35-45 mm Hg

312
Q

What can happen with pts with compromised liver function

A

May not be able to clot and cannot process drugs as fast and therefore will need less

313
Q

What does propofol affect

A

Wakefulness, euphoria, and is an anti-nausea

314
Q

Another word for zofran

A

Ondansetron (for nausea)

315
Q

What is dyspnea

A

Difficultly breathing

316
Q

What is bronchitis

A

Acute inflammation of mucus membranes of bronchial tube