Arab Board Anesthesia Final Written flashcards

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

Functional residual capacity

Volume of gas remaining in the lungs after a normal expiration; equals expiratory reserve volume plus residual volume; serves as the main oxygen reservoir during apnea.

Minimum alveolar concentration

Alveolar concentration of an inhaled anesthetic at 1 atmosphere that prevents movement in 50% of subjects to a standard surgical stimulus; MAC values are additive.

Revised Cardiac Risk Index

Six-factor index (ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, creatinine >2 mg/dL, high-risk surgery) predicting major perioperative cardiac events.

STOP-BANG score

Eight-item screening tool (snoring, tiredness, observed apnea, pressure, BMI, age, neck circumference, gender) that identifies high risk for obstructive sleep apnea when score is 3 or more.

Cormack-Lehane classification

Four-grade system describing glottic view during direct laryngoscopy; grade I shows full vocal cords and grade IV shows no laryngeal structures.

Sugammadex reversal

Modified gamma-cyclodextrin that encapsulates rocuronium and vecuronium; dose 2 mg/kg for train-of-four count 2 and 16 mg/kg for immediate reversal after rapid sequence intubation.

Epidural test dose

3 mL of lidocaine 1.5% with epinephrine 1:200,000; a rise in heart rate above 20 bpm or systolic pressure above 15-20 mmHg suggests intravascular placement.

Interscalene brachial plexus block

Regional block at the C5-C7 nerve roots providing shoulder and upper arm anesthesia; reliably spares the ulnar nerve and causes ipsilateral phrenic nerve palsy in nearly all patients.

Capnography waveform phases

Four phases: inspiratory baseline, expiratory upstroke, expiratory plateau (end-tidal CO2), and inspiratory downstroke; a sloping plateau suggests expiratory obstruction.

Train-of-four ratio

Ratio of the fourth to the first evoked muscle response during train-of-four stimulation; a ratio of 0.9 or greater indicates adequate recovery from neuromuscular blockade.

4-2-1 maintenance fluid rule

Hourly crystalloid maintenance: 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, and 1 mL/kg for each kilogram thereafter.

Massive transfusion protocol

Balanced delivery of packed red cells, fresh frozen plasma, and platelets (commonly 1:1:1) with warming, calcium replacement, and tranexamic acid to treat hemorrhagic shock.

One-lung ventilation settings

Lung-protective ventilation during thoracic surgery using tidal volumes of 4-6 mL/kg predicted body weight, PEEP of 5 cmH2O, and permissive hypercapnia.

Cerebral perfusion pressure

Mean arterial pressure minus intracranial pressure; normal range 60-80 mmHg; maintained by blood pressure support and control of intracranial pressure.

Sepsis-3 definition

Suspected infection with a SOFA score increase of 2 or more; septic shock adds vasopressor requirement for MAP 65 mmHg or greater and lactate above 2 mmol/L.

ARDS Berlin criteria

Acute onset within one week, bilateral opacities, PaO2/FiO2 ratio 300 mmHg or less on PEEP of at least 5 cmH2O, and exclusion of cardiac causes of edema.

Opioid equianalgesic conversion

Oral morphine 30 mg is approximately equal to oral oxycodone 20 mg, IV morphine 10 mg, or IV hydromorphone 1.5 mg; used to rotate opioids safely.

Local anesthetic systemic toxicity treatment

Stop injection, secure the airway, give 20% lipid emulsion 1.5 mL/kg bolus then 0.25 mL/kg/min infusion, and avoid vasopressin and calcium channel blockers.

WHO surgical safety checklist

Three-phase checklist (sign in, time out, sign out) completed before induction, before incision, and before leaving the operating room; reduces surgical morbidity and mortality.

Informed consent elements

Capacity, disclosure of material risks and alternatives, patient understanding, and voluntariness; the anesthesiologist must discuss anesthetic options and their risks.

Obstructive sleep apnea management

Continue CPAP perioperatively, avoid sedative premedication, use opioid-sparing analgesia, and monitor postoperatively when STOP-BANG score is 3 or higher.

ASRA anticoagulation intervals

Neuraxial anesthesia timing: stop clopidogrel 5-7 days, prophylactic low-molecular-weight heparin 12 hours, and therapeutic low-molecular-weight heparin 24 hours before the procedure.

Adult cardiac arrest CPR

Compressions at 100-120 per minute, depth 5-6 cm, full recoil, minimal interruptions, and early defibrillation for shockable rhythms; epinephrine 1 mg every 3-5 minutes.

Malignant hyperthermia treatment

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

Neostigmine mechanism

Inhibits acetylcholinesterase, increasing acetylcholine at the neuromuscular junction to reverse nondepolarizing block; glycopyrrolate is co-administered to prevent bradycardia.

Soda lime exhaustion

Depletion of the carbon dioxide absorber causes rebreathing and hypercapnia; color change of the indicator signals the need for replacement.

Supraglottic airway limitations

Laryngeal mask devices are avoided in full stomach, obesity with reflux, and prolonged procedures; they do not protect against aspiration.

Apfel PONV score

Four risk factors (female sex, nonsmoker, history of postoperative nausea and vomiting, postoperative opioids); each adds risk and guides prophylaxis.

Arterial line damping

Underdamped waveforms show systolic overshoot and overestimate pressure; overdamped waveforms underestimate systolic pressure; assess with a square-wave test.

Balanced crystalloid advantage

Lactated Ringer's and Plasma-Lyte have lower chloride than 0.9% saline and may reduce hyperchloremic metabolic acidosis with large-volume resuscitation.

TRALI

Transfusion-related acute lung injury: noncardiogenic pulmonary edema within 6 hours of transfusion; managed with oxygen, ventilation, and supportive care.

TURP syndrome

Absorption of hypotonic irrigation fluid during transurethral prostate resection causing hyponatremia, hypervolemia, confusion, and seizures; treat with hypertonic saline if symptomatic.

Cement implantation syndrome

Hypotension, hypoxia, and arrhythmias during hip arthroplasty from cement and fat emboli; managed with fluids, vasopressors, and oxygenation.

Tension pneumothorax

Air in the pleural space causing mediastinal shift and obstructive shock; treat with immediate needle decompression followed by chest tube placement.

Sepsis bundle

Obtain cultures, give broad-spectrum antibiotics within 1 hour, give 30 mL/kg crystalloid for hypotension or lactate 4 mmol/L or higher, and start vasopressors as needed.

Patient-controlled analgesia

Patient-triggered opioid delivery with demand dose, lockout interval, and optional basal rate; morphine 1 mg demand with 5-10 minute lockout for opioid-naive adults.

Neuropathic pain treatment

First-line agents include gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors; opioids are less effective for neuropathic pain.

Anesthesia awareness

Explicit recall of events during general anesthesia; incidence about 1-2 per 1,000 anesthetics; higher in cardiac, obstetric, and trauma surgery.

Root cause analysis

System-based investigation of adverse events that identifies latent failures and process gaps rather than assigning individual blame.

Perioperative beta-blocker continuation

Continue beta-blockers in patients on chronic therapy to avoid rebound tachycardia and ischemia; do not initiate high-dose beta blockade on the day of surgery.

Obesity drug dosing

Succinylcholine and other drugs are dosed by total body weight, while propofol and opioids are dosed by lean body weight to avoid overdose.

Pediatric cardiac arrest

Compressions at 100-120 per minute, depth one-third of chest anteroposterior diameter, and epinephrine 0.01 mg/kg IV or IO every 3-5 minutes.

Neonatal resuscitation

Warm, dry, and stimulate; provide positive pressure ventilation if apneic or heart rate below 100; start compressions if heart rate remains below 60 after effective ventilation.

Spinal cord termination level

The spinal cord ends at L1-L2 in adults; the L3-L4 interspace is below the conus medullaris and is a safe site for lumbar puncture.

Oxygen E-cylinder capacity

A full E-cylinder holds approximately 660 L of oxygen at about 2,200 psi; pressure gauge reading is proportional to remaining content when full.

ASA physical status

Six-level classification: I healthy, II mild systemic disease, III severe systemic disease, IV severe disease with constant threat to life, V moribund, VI brain-dead organ donor.

Mallampati classification

Four-class airway assessment based on visible oropharyngeal structures with mouth open and tongue protruded; class III-IV predicts difficult laryngoscopy.

Cricothyrotomy technique

Emergency surgical airway through the cricothyroid membrane using a scalpel-bougie-tube technique when intubation and oxygenation fail.

Post-extubation stridor

Inspiratory stridor after extubation from laryngeal edema; treat with nebulized epinephrine, dexamethasone, and heliox; reintubate if worsening.

Bier block

Intravenous regional anesthesia using lidocaine 0.5% at 3 mg/kg without epinephrine; the tourniquet must stay inflated at least 20 minutes.

Combined spinal-epidural

Technique combining a spinal injection for rapid dense block with an epidural catheter for extension of anesthesia or postoperative analgesia.

Dicrotic notch

Feature on the arterial pressure waveform corresponding to aortic valve closure; its position and amplitude help assess vascular tone and compliance.

Cardiac index

Cardiac output divided by body surface area; normal range 2.5-4.0 L/min/m2; measured by thermodilution or pulse contour analysis.

Compartment syndrome

Increased pressure within a closed fascial compartment causing pain out of proportion, paresthesia, pallor, and pulselessness; treated with emergency fasciotomy.

Albumin 5%

Colloid solution that expands plasma volume approximately equal to the volume infused; used for volume resuscitation when crystalloid is insufficient.

Postobstructive pulmonary edema

Negative-pressure pulmonary edema occurring after relief of upper airway obstruction; managed with oxygen, positive pressure ventilation, and diuretics if needed.

Liver transplant reperfusion syndrome

Hypotension, hyperkalemia, acidosis, and arrhythmias occurring when the graft is reperfused; treated with calcium, bicarbonate, and vasopressors.

Status asthmaticus

Severe refractory asthma treated with inhaled beta-agonists, systemic steroids, magnesium, and heliox; intubation uses low tidal volumes and prolonged expiratory time.

Diabetic ketoacidosis management

Isotonic fluids, insulin infusion, and potassium replacement once potassium is below 5.2 mEq/L; bicarbonate only if pH is below 6.9.

Acetaminophen maximum dose

Up to 4 g per day in healthy adults; reduce to 2-3 g per day in liver disease or chronic alcohol use to avoid hepatotoxicity.

Spinal cord stimulation

Neuromodulation therapy for refractory neuropathic pain such as failed back surgery syndrome and complex regional pain syndrome; delivers electrical pulses to the dorsal columns.

Duty of candor

Ethical and professional obligation to disclose harmful errors to patients and families promptly, honestly, and with an explanation and apology.

Just culture

Patient safety framework that distinguishes human error from at-risk or reckless behavior; encourages reporting and learning rather than blame.