ABPS Anesthesiology (BCA) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Oxygen content formula

Arterial oxygen content equals 1.34 times hemoglobin times arterial oxygen saturation plus 0.003 times arterial oxygen partial pressure; dissolved oxygen contributes little.

Henderson-Hasselbalch equation

pH equals 6.1 plus the logarithm of bicarbonate concentration divided by 0.03 times PaCO2; this relationship predicts changes in arterial pH from respiratory or metabolic derangements.

Meyer-Overton correlation

Within homologous series, anesthetic potency correlates with lipid solubility, supporting a lipid membrane site of action, but the correlation has notable exceptions such as nonimmobilizers and stereoisomers.

Capnogram phase III

Phase III is the alveolar plateau of the capnogram, representing gas from alveoli; its terminal point approximates end-tidal CO2 and a sloping plateau suggests bronchospasm or obstruction.

Low-pressure leak test

Close the adjustable pressure-limiting valve, occlude the Y-piece, and pressurize the breathing system to 30 cm H2O; a sustained pressure without decay indicates an airtight circuit.

Pulse oximetry limitations

Pulse oximetry uses 660 and 940 nm light and may be inaccurate with carboxyhemoglobin, methemoglobin, poor perfusion, motion, venous pulsation, or dark nail polish; it estimates saturation, not ventilation.

Revised cardiac risk index

The RCRI assigns one point each for high-risk surgery, ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, and creatinine greater than 2.0 mg/dL.

Preoperative fasting intervals

Elective patients fast two hours for clear fluids, four hours for breast milk, six hours for light meal or formula, and eight hours for fatty or fried food.

STOP-BANG screening

STOP-BANG screens for obstructive sleep apnea using snoring, tiredness, observed apnea, pressure, BMI, age, neck circumference, and gender; a score of three or more indicates increased risk.

Cricothyrotomy indication

Cricothyrotomy is indicated in a cannot-intubate, cannot-oxygenate situation when supraglottic rescue fails; it is the emergency front-of-neck access of choice in adults.

Difficult mask ventilation predictors

MOANS predicts difficult mask ventilation: mask seal, obesity, age over 55, no teeth, and snoring or stiff lungs; two or more features warrant preparation for difficulty.

Awake fiberoptic intubation

Awake fiberoptic intubation is preferred when mask ventilation is expected to fail or aspiration risk is high, preserving spontaneous ventilation; topicalization and sedation require careful titration to avoid apnea.

Sevoflurane MAC

Sevoflurane has an MAC of approximately 2.0 percent in adults; MAC is lower in neonates, the elderly, pregnant patients, and with hypothermia, opioids, or nitrous oxide.

Succinylcholine dose

Succinylcholine for rapid sequence intubation is 1 to 1.5 mg/kg intravenously; it is contraindicated in hyperkalemia, burns, denervation, malignant hyperthermia susceptibility, and pseudocholinesterase deficiency.

Sugammadex dosing

Sugammadex reverses rocuronium: 2 mg/kg for train-of-four count of two, 4 mg/kg for post-tetanic count of one to two, and 16 mg/kg for immediate reversal after a large dose.

Malignant hyperthermia treatment

Dantrolene 2.5 mg/kg intravenously is repeated until hyperthermia and rigidity resolve; stop triggering agents, hyperventilate with 100 percent oxygen, cool the patient, and treat hyperkalemia.

Lipid emulsion for LAST

For local anesthetic systemic toxicity, give 20 percent lipid emulsion 1.5 mL/kg as a bolus, then 0.25 mL/kg/min infusion; continue CPR and avoid vasopressin, calcium channel blockers, and beta blockers.

Epidural test dose

A typical epidural test dose is 3 mL of lidocaine 1.5 percent with epinephrine 1:200,000; an increase in heart rate or blood pressure suggests intravascular placement.

Interscalene block complication

Interscalene brachial plexus block frequently affects the phrenic nerve, causing hemidiaphragmatic paresis; it should be used cautiously in patients with severe pulmonary disease.

Apfel PONV score

The Apfel score assigns one point each for female sex, nonsmoker status, history of PONV, and postoperative opioids; a score of two or more warrants multimodal prophylaxis.

Aldrete discharge score

The Aldrete score assesses activity, respiration, circulation, consciousness, and oxygen saturation, each scored zero to two; a total of nine or more is often required for discharge.

Postoperative shivering

Postoperative shivering increases oxygen consumption; treatment includes forced-air warming, meperidine 12.5 to 25 mg, clonidine, or dexmedetomidine, after excluding hypothermia and other causes.

Multimodal postoperative analgesia

Combining acetaminophen, NSAIDs, regional blocks, and opioids at reduced doses improves pain control and reduces opioid-related adverse effects such as nausea, sedation, and respiratory depression.

ACLS CPR ratio

For adult cardiac arrest with one or two rescuers, compress at 100 to 120 per minute, 30 compressions to 2 breaths, depth 5 to 6 cm, with full recoil.

Septic shock bundle

Measure lactate, obtain cultures, give broad-spectrum antibiotics within one hour, and administer 30 mL/kg crystalloid for hypotension or lactate of 4 mmol/L or greater.

ARDS lung-protective ventilation

Use tidal volume 6 mL/kg predicted body weight and target plateau pressure below 30 cm H2O, accepting hypercapnia; higher PEEP may be needed in moderate to severe ARDS.

Pediatric uncuffed tube size

Uncuffed endotracheal tube internal diameter in millimeters approximates age in years divided by four plus four; cuffed tubes generally use one half size smaller.

Obstetric left uterine displacement

Left uterine displacement after 20 weeks gestation relieves aortocaval compression, improving venous return and cardiac output; it is essential during spinal anesthesia for cesarean delivery.

Magnesium toxicity

In preeclampsia, magnesium sulfate toxicity causes loss of deep tendon reflexes, respiratory depression, and cardiac arrest; calcium gluconate is the antidote, and levels are monitored clinically.

ASA closed claims

Respiratory events, including inadequate oxygenation and ventilation, are the most common cause of anesthesia malpractice claims; nerve injury and awareness are also frequent.

WHO surgical safety checklist

The checklist has three phases: sign in before induction, time out before incision, and sign out before the patient leaves the operating room, confirming identity, site, allergies, and counts.

Informed consent elements

Valid informed consent requires decision-making capacity, disclosure of diagnosis, proposed treatment, risks, benefits, and alternatives, including no treatment, and voluntary authorization without coercion.