AKT Study Guide Anesthesia Knowledge 2025-2026 Tests, Exams of Anesthesiology

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AKT Study Guide Anesthesia Knowledge 2025 - 2026 Tests

DUA AU UU UU UU GGRRECTEINGWER Barbiturates = compensatory ptor reflexes maintains incr HR & incr myocardial contractili IV anesthestics Barorecpet or effec barore UNLESS baroreceptor response will be blunted or absent CO & BP will FALL Sevoflurane, desflurane, and isoflurane all diminish baroreceptor responses. Complications of cricoid pressure (Sellick’s maneuver) SORRECHMNGIER )) ditticulty measuring the 5 kg of weight that is recommended 2) the possibly evoking upper airway reflexes and relaxing the LES 3) displacing the esophagus laterally as opposed to compressing it Endobronchial intubation Earliest evidence? Ches to Dx?- ([RRECANSHER increase in peak inspiratory pressure videnee of bronchial intubation often is Clues dx: - unilateral broath sounds d hypoxia with pulse oxim - unexpe (unreliable with high inspired oxygon conecntrations) IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU - inability to palpate the TT cuff in the sternal notch during cuff inflation - decreased breathing bag compliance (high peak inspiratory pressures) Movement of Head with ETT Flexion? Extonsion? Lateral rotation? - GORRECTEINGWER flexion = advance the ETT 1.9 em —> endobronchial intubation Extension =remove the ETT 1.9 cm Latoral rotation = adjust 0.7 em Head movemennt - ETT position - GORREGTENGWER sniffing position Head position for tracheal intubation 3 axis - CORRECT ANSWER-cral axis = axis of the cavity of the mouth pharyngeal axis = axis of the cavi ty of the pharynx laryngeal axis = axis of the larynx and trachea Predictors of difficult facemask - CORRECT ANSWER-> 33 yo >26 BMI Beard lack of teeth Snoring HX IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU rapid sequence induction - GORRECTEINGWER Cricoid pressure Rapid induction with rapid onset of paralysis Avoidance of positive-pressure ventilation via mask Intubation as soon as possible Succinylcholine induction dose vs Receuronium induction dose (RST) - CORRECT ANSWER- Suce: 1.5 mg/ke Roc: 0.9-1.2 mg/kg in or NEC?) ARB refractory hypotension RX CORRECT ANSWER calment: vasopre may be resistent to alpha-l R meds (phenylephrine, ephredrine and NE) bradycardia during e HR? - GGRRECTEINGWER. oculocardiac reflex: decrease in heart rate by 10% follo pressure to the globe or traction of the ocular muscles surgery Afferent: CN 5 (cilary ganglion --> gasserian ganglion --> main trigemnial sensory nucleus) Efferent: CN 10 (afferent --> visceral motor nucleus [reticular formation] --> efferent --> heart and deer SA node} colloid vs crystalloid - CORRECT ANSWER- IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU continuum of sedation/anesthesia Minimal sedation -responsi Ness -airway -sponlancous ventilation CV fine - (RRECRANSIER- -others unaffected normal response to verbal stimulation Moderate sedation -responsiveness airway -spontaneous ventilation CV fine - (RRECRANSIER- -AIRWA’ purposeful response to verbal or tactile stimulation -SPON VENT: adequate CV: maintained Decp sedation responsiveness -airway -spontaneous ventilation CV fine - (GRRECHARSIER purposeful reponse folowing repeated painful stimulation IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU drug dosing for morbid obesi Remifentanyl - GGRRECTERGWER LEW drug dosing for morbid obesi Atracurium - GGRRECTEIGWER BW drug dosing for morbid obes Cis-atracuriium - GGRRECTEIGWER BW drug dosing for morbid obesit: Rocuronium - SGRRECTMINGWER IEW drug dosing for morbid obesity Vecuronium - GGRRECTEIGWER BW ing for morbid ob Propofol - GGRRECTENGWER infuction: LBW TIVA: TB CORRECT ANSWER © sa, chills : chest & flank pain, naus Dx hemoly lic transfusion rxn Under GENA: fever, hypotension, RED colored urine (from hemoglobinuria) IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU Dx: Coombs test, repeat ABO, RH, antibody screen, urine free hemoglobin, serum bilirubin, se haptoglobin ensuring adequate denitrogenation - GGRRECTENGWER. ovtimal preoxygenation is achieved when ETOQ2 = 90% electrosurgical unit burns: Line isolation monitor - GGRREGTAINGWER.cctermines amount of isolation b/v 2 different power lines and the ground - predicts amount of current that could flow if there was a 2nd fault -alarm: possibility of large amount of current that could flow if 1 more fault, bul no shock yeu! clectrosurgical unit burns: Microshock - GGRRECTENGWER low voltage ondocardimm --> V fib ectrical current. --> CVL or pacing wires --> 10 microAmps = max current leakage 20-100 microAmps = Vfib @endocardium electrosurgical unit burns: Macroshock - CORRECT ANSWER-1 mA = threshold for perception 3d mA = upper limit for shock without harm 10-20 mA = let-go reflex before sustained muscle contraction IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU Hyperkalemia Hypervolemia side effects of normal saline infusion - CORRECT ANSWER-- Hypercloremic metabolic acidosis - HyperNat - fluid rentention - Kidney damage lransfision reaction Transfusion-related acute lung injury (TRALI) Definition - CORRECT ANSWER Noncardiogenic pulmonary edema, 5% mortalit Plasma containing blood products (Plt and FFP >>> pRBCs) Reaction b/w donor anli-HLA or anlileukocyte Ab’s & recipient louko: sequestration in microcirculation of lings capillary endothelial damage/Icak. transfusion reaction Transfusion-related acute lung injury (TRALI) IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU Diagnosis Treatment - SGRREGHENSIER Acute onset of hypoxemia (within 6 hrs of transfusion) Bilateral CXR infiltrates c/w ALI Normal LA pressures (<18mmHg) Absence of other causes of ALI Tx: PEEP + TV < 8ml/ke PRONE lransfision reaction Acute hemolytic reactions - GGRREGTINGWER Repaid destruction of cells by host antibodies (gM, IgG) - ABO fever, Low BP, anxiety, red urine Tx: stop tranfusion. vigorous hydration with IV crystalloids watch out for DIC -- FFP, fibrinogen, platelet IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU -Thrombosis (PE) -Thrombosis MD -Toxin - tamponade - tension PNX - trauma vascular access during CPR - CORRECT ANSWER-DO it dob ouil deadspace - CORRECT ANSWER-2cy ond the Y-piece anesthesia cir Cale oxy: en concentration from gas flows - CORRECT ANSWER- color coding of gas cylinders Oxy gon - FCRREGIAISHER- Cre color coding of gas cylinders (:02- CORRECT ANSWER color coding of gas cylinders NO - CGRREGIENGWER 61. color coding of gas cylinders IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU Cyclopropane - SGRREGHENSWER Oranze color coding of gas cylinders Helium - (@RREGHANSWER-Brown color coding of gas cylinders Ethylene - CORRECT ANSWER-Red Niltrogen- color lank - GGRRECTAINGWER Black Air - (GRREGHANSWER-v1l0 Malfunction Exp valve - GORREGTMINGWER Stuck Closed: rise in airway pressures, reduced MV : failure of capnogram to return to zero Pin index system adverse effects Ondanestron - CORRECT ANSWER- fever -HA - dizziness - constipation IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU alpha l =++ alpha 2=" beta l =++ beta2=+ iner HR, MAP, COQ, PVR, Bronchodilation DECR RENAL BLOOD FLOW SORREGRANGWER winimal resp depression Dexmedclomidine resp effects effects of catecholamines on renal blood flow NE = EPI =~ GGRREGRANSWER NE = deere REF EPI = deercases RBF fac ors enhancing inhalation induction - CORRECT ANSWER-- Chronic ETOH - Infant - Red hair -hypermatremia - hyperthermia IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU factors decrease anesthetic reg - CORRECT ANSWER-- acute ETOH - elderly -hypo Nat - hypothermia - anemia (hgh > NO?- GGRREGTIINGWER Halogenated volatile anesthetics have a potentiating effe nondepolarizing muscle relaxants. The mechanism appears to be incompletely understood, but is on likely a combination of: 1. effect on central motor neurons 2. augmentation of the NMB’s affinity for the receptor site 3. inhibition of post-synaptic nicotinic acetylcholine receptors desflurane > sevoflurane > isoflurane. Nitrous oxide has largely been considered as having no effect on neuromuscular blockade. local anesthetic toxicity (LAST) - GORREGTINGWER initial CNS symptoms IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU Naloxone dose for respiratory depression Diluated to? titrated to? q"what"? - GORRECTENGWER intravenous naloxone (0.4 mg/mL vial diluted in 9 mL saline to 0.04 mg/mL) can be titrated in increments of 0.5-1 meg/kg every 3-3 min until adcquale ventilation and alertness are achicved. phenylephrine HR effeet - GORRECTIINSWER < fcx bradycardia rocuronium climination - SGRREGRMINGWER 1 iver side effects of desflurane - GGRRECTENGWER incr HR. CVP, Pulmonary Artery pressure iner CBF, CBV, ICP single breath inductio ‘Io in % GGRRECTEINGWER sevoflurane (7-8% sevoflurane in 60% nitrous oxide) to speed the induction. sodium bicarbonate effects - GORRECTENGWER kK: of 6.1 (best if given pH <7.1) IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY DUA AU UU UU UU converted to CO2 succinylcholine and stroke Peaks? May occur? duralion - GGRRECTANGWER P aticnis with neuromuscular discasc such as a slroke have of serious hyperkalemia after succinylcholine. usually peaks 7-10 days after insult, but increased K+ release may occur as soon as 2-4 days after denervation injury, or after several days of immobility. Duration of risk has not been adequately characterized but is suspected to be for 3-6 months. time constant anesthesia circuit CORRECT ANSWER- olume/flaw time constant is the volume of the circuit divided by the fresh gas flow rate (units of L divided by Lénin results in min) in lung terms: FRC (volume of the hng)minute ventilation Meaning: il lakes three ume constants for 95% of a concentration change Lo be achieved volume of distribution - GORRECTEIGWER-dose/ concentration ANS, NE release - GGRRECTENGWER Sympathetic: ACh --> NE IUVUVUVUUUVUYUYUUUVUYUVUVUVUVUVUVUNUUYVUYVUVUNYVUVUYUVUVUYUYYVUVUYUUYUUYVUVVNYVYYVYVUVYYYVYYVUYYVUVYVUVVYYY