Arab Board Anesthesia Final Clinical and Oral Exam flashcards

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

ASA Physical Status IV

A patient with severe systemic disease that is a constant threat to life, such as severe cardiac dysfunction or end-stage organ failure. Modifier E denotes emergency surgery.

RCRI Predictors

Six predictors: ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, creatinine above 2 mg/dL, and high-risk surgery. Each adds roughly one point.

PONV Risk Factors

Female sex, nonsmoker status, history of postoperative nausea and vomiting or motion sickness, and postoperative opioid use. Each factor increases baseline risk by about 20%.

Lipid Emulsion for LAST

Twenty percent lipid emulsion given as 1.5 mL/kg bolus followed by 0.25 mL/kg/min infusion in local anesthetic systemic toxicity, continued with airway support and seizure control.

Interscalene Block Sparing

The interscalene brachial plexus block typically spares the ulnar nerve (C8-T1) and causes phrenic nerve palsy in most patients, so it is unsuitable for ulnar-sided hand surgery.

Epidural Test Dose

Three milliliters of lidocaine 1.5% with epinephrine 1:200,000. A positive test shows heart rate rise above 20 bpm or systolic pressure rise above 15-20 mmHg within 60 seconds.

MOANS Mnemonic

Predictors of difficult mask ventilation: Mask seal, Obesity, Age over 55, No teeth, and Snores or Stiff lungs. Used in preoperative airway assessment.

LEMON Airway Assessment

Difficult intubation predictors: Look externally, Evaluate 3-3-2, Mallampati score, Obstruction, and Neck mobility. A structured bedside airway evaluation tool.

Cormack-Lehane Grade III

Laryngoscopy view in which only the epiglottis is visible and no glottic structures are seen. Grade IV shows no glottic structures at all.

CICO Emergency Airway

Cannot intubate, cannot oxygenate. Immediate front-of-neck access using a scalpel-bougie-tube or cannula technique is indicated to restore oxygenation.

Cardiac Index Formula

Cardiac index equals cardiac output divided by body surface area. Normal cardiac output is 4-8 L/min and normal cardiac index is 2.5-4 L/min/m squared.

Cerebral Perfusion Pressure

Cerebral perfusion pressure equals mean arterial pressure minus intracranial pressure. A target of at least 60 mmHg is recommended in traumatic brain injury.

Fluid Responsiveness Threshold

Stroke volume variation or pulse pressure variation above 13% in a mechanically ventilated patient predicts that cardiac output will rise with a fluid bolus.

Monro-Kellie Doctrine

Intracranial volume is the sum of brain, blood, and cerebrospinal fluid within a rigid skull. An increase in one compartment must be offset by a decrease in another.

Hyperventilation and CBF

Lowering PaCO2 causes cerebral vasoconstriction and reduces cerebral blood flow by roughly 3-4% per mmHg change. It is reserved for impending herniation.

Glasgow Coma Scale

Eye score 1-4, verbal 1-5, motor 1-6, total 3-15. A score of 8 or less indicates severe injury and prompts consideration of airway protection.

Aortocaval Compression

From about 20 weeks gestation the gravid uterus compresses the inferior vena cava and aorta when supine. Left uterine displacement relieves it during anesthesia and resuscitation.

Magnesium Sulfate Toxicity

In preeclampsia treatment, monitor for loss of deep tendon reflexes, respiratory depression, and oliguria. Calcium gluconate is the antidote for severe magnesium toxicity.

Pediatric Uncuffed Tube Size

Estimated uncuffed endotracheal tube internal diameter in millimeters equals age in years divided by four, plus four. A cuffed tube uses plus 3.5 instead.

Pediatric 4-2-1 Rule

Hourly maintenance fluid equals 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, and 1 mL/kg for each kilogram above 20.

Pediatric Laryngospasm Management

Give 100% oxygen, apply jaw thrust and continuous positive airway pressure, deepen anesthesia with propofol, and use small-dose succinylcholine if the spasm persists.

Septic Shock Definition

Persistent hypotension requiring vasopressors to keep mean arterial pressure at least 65 mmHg, with serum lactate above 2 mmol/L despite adequate fluid resuscitation.

ARDS Berlin Criteria

Acute onset within one week, bilateral opacities on imaging, respiratory failure not fully explained by cardiac failure, and PaO2/FiO2 ratio of 300 or less with PEEP at least 5 cm H2O.

Lung-Protective Ventilation

Tidal volume of 6 mL/kg predicted body weight, plateau pressure 30 cm H2O or less, and permissive hypercapnia. This strategy reduces mortality in acute respiratory distress syndrome.

Succinylcholine Contraindications

Hyperkalemia, burns older than 24 hours, denervation injuries, prolonged immobility, and malignant hyperthermia susceptibility. These predispose to dangerous potassium release.

Sugammadex Reversal Dose

Two to four mg/kg reverses moderate rocuronium block; 16 mg/kg is used for immediate reversal after a rapid-sequence induction dose of rocuronium.

Etomidate Characteristics

Induction dose 0.2-0.3 mg/kg IV. It provides hemodynamic stability but causes transient adrenal suppression and frequent myoclonus, with no analgesic effect.

Capnography Sudden Loss

A sudden loss of end-tidal carbon dioxide suggests circuit disconnection, airway obstruction, esophageal intubation, or cardiac arrest and requires immediate assessment.

Malignant Hyperthermia Treatment

Stop triggering agents, give dantrolene 2.5 mg/kg IV, hyperventilate with 100% oxygen, actively cool the patient, and treat hyperkalemia and acidosis.

Informed Consent Elements

Capacity, adequate disclosure of risks and alternatives, comprehension, and voluntariness. An emergency exception applies when delaying treatment would threaten life.

ACLS Shockable Rhythm Sequence

Defibrillate at 120-200 J biphasic, provide two minutes of CPR, give epinephrine 1 mg every 3-5 minutes, and add amiodarone 300 mg after the third shock.

Anaphylaxis Epinephrine Dose

Adults receive 0.5 mg intramuscular epinephrine 1:1000, repeated every 5-15 minutes as needed, along with intravenous fluids and airway support.