Anesthesia Board cheat sheet

Poiseuille's law: flow ∝ (ΔP × r⁴)/(8ηL); halving a tube's radius reduces laminar flow 16-fold.

Reynolds number above roughly 2000 predicts turbulent flow, which is proportional to the square root of the pressure gradient and depends on gas density.

Arterial oxygen content: CaO2 = (1.34 × Hb × SaO2) + (0.003 × PaO2), in mL O2 per dL of blood.

Fick principle: oxygen consumption = cardiac output × (arterial O2 content − mixed venous O2 content).

Henderson–Hasselbalch: pH = pKa + log([HCO3⁻]/(0.03 × PaCO2)).

Laplace relationship for alveoli: P = 2T/r; surfactant lowers surface tension so small alveoli are not preferentially collapsed.

Aminosteroid neuromuscular blockers are rocuronium, vecuronium, and pancuronium; atracurium and cisatracurium undergo organ-independent Hofmann elimination.

Propofol and barbiturates potentiate GABA-A chloride currents; ketamine antagonizes the NMDA receptor.

Cerebral perfusion pressure = mean arterial pressure − intracranial pressure; cerebral blood flow is autoregulated between MAP 50 and 150 mmHg.

ASA physical status: I healthy; II mild systemic disease; III severe disease limiting activity; IV constant threat to life; V moribund; VI brain-dead organ donor; suffix E denotes emergency.

Rapid sequence induction pairs preoxygenation with a rapidly acting induction agent and succinylcholine 1–1.5 mg/kg or rocuronium 1.2 mg/kg, without intervening mask ventilation.

Approximate adult MAC values: nitrous oxide 105%, desflurane 6%, sevoflurane 2%, isoflurane 1.15%, halothane 0.75%.

Difficult airway management: limit intubation attempts, maintain oxygenation, place a supraglottic airway, and move to a surgical airway if ventilation cannot be established.

Spinal anesthesia produces sympathetic blockade; hypotension is treated with intravenous fluid, phenylephrine, or ephedrine.

Succinylcholine is avoided in burns, denervation injury, prolonged immobility, and known malignant hyperthermia susceptibility because of hyperkalemic risk.

Neostigmine 0.03–0.07 mg/kg reverses nondepolarizing blockade and is paired with glycopyrrolate 0.2 mg per 1 mg of neostigmine to blunt bradycardia.

Laryngospasm: stop the stimulus, apply 100% oxygen with CPAP and jaw thrust, deepen anesthesia, and give succinylcholine 0.5–1 mg/kg IV if it persists.

Postoperative nausea and vomiting prophylaxis targets the Apfel factors: female sex, nonsmoking status, prior PONV or motion sickness, and postoperative opioids.

After 20 weeks' gestation, left uterine displacement relieves aortocaval compression in the supine parturient and preserves venous return.

Pediatric uncuffed endotracheal tube internal diameter (mm) = age in years/4 + 4; a cuffed tube is chosen approximately half a size smaller.

Local anesthetic systemic toxicity: 20% lipid emulsion 1.5 mL/kg bolus followed by 0.25 mL/kg/min; avoid vasopressin, calcium channel blockers, and beta blockers.

In neuroanesthesia, hyperventilation to PaCO2 30–35 mmHg reduces cerebral blood volume and lowers intracranial pressure.

Nitrous oxide is avoided in pneumocephalus, pneumothorax, bowel obstruction, and middle-ear surgery because it diffuses into and expands gas-filled spaces.

One-lung ventilation hypoxemia: confirm double-lumen tube position and hemodynamics, then apply CPAP to the non-dependent lung or PEEP to the dependent lung.

Massive transfusion protocols approximate a 1:1:1 ratio of packed red blood cells, fresh frozen plasma, and platelets.

Awake fiberoptic intubation preserves spontaneous ventilation and is indicated when mask ventilation and direct laryngoscopy are expected to fail.

Valid informed consent requires patient capacity, adequate disclosure, comprehension, and voluntariness.

Anesthesia payment: total units = ASA base units for the procedure + time units (1 unit per 15 minutes), multiplied by the contracted conversion factor.

EMTALA obligates Medicare-participating hospitals with emergency departments to perform a screening examination and provide stabilizing treatment regardless of ability to pay.

A negligence claim requires four elements: duty, breach of the standard of care, causation, and compensable damages.

ASA closed claims data identify respiratory events and inadequate oxygenation or ventilation as leading causes of anesthesia-related injury.

The pre-anesthesia evaluation documents airway examination, comorbidities, prior anesthetics, allergies, NPO status, and the planned anesthetic.

HIPAA permits disclosure of protected health information without written authorization for treatment, payment, and health care operations.

Anesthesia care team staffing ratios and supervision requirements derive from state law, payer rules, and hospital bylaws rather than a single national standard.

WHO surgical safety checklist phases: sign in before induction, time out before skin incision, sign out before the patient leaves the operating room.

The fire triad requires an oxidizer (oxygen, nitrous oxide), a fuel (drapes, endotracheal tube, alcohol-based prep), and an ignition source (electrocautery, laser).

Airway fire management: stop gas flow, remove the endotracheal tube, flood the airway with saline, ventilate with air, then reassess the airway.

Malignant hyperthermia: discontinue volatile agents and succinylcholine, give dantrolene 2.5 mg/kg IV repeated as needed, cool the patient, and treat hyperkalemia and acidosis.

Anaphylaxis: epinephrine 0.1–0.5 mg IV or 0.3–0.5 mg IM, fluid resuscitation, removal of the trigger, plus antihistamine and corticosteroid adjuncts.

Look-alike/sound-alike medications and unlabeled syringes are major sources of anesthesia drug error; standardized labels and concentrations reduce risk.

Alarm fatigue is addressed by individualizing alarm limits and eliminating nonactionable alarms rather than by silencing or disabling alarms.

Sentinel events are analyzed with root cause analysis, which focuses on system failures rather than individual blame.

The Donabedian framework classifies quality measures as structure, process, or outcome.

The Model for Improvement poses three questions: what are we trying to accomplish, how will we know a change is an improvement, and what changes will produce improvement.

PDSA cycles test a change on a small scale before spread: Plan, Do, Study, Act.

Control charts separate common-cause variation from special-cause variation; a special-cause signal triggers investigation.

Failure mode and effects analysis is prospective and scores severity, occurrence, and detectability; root cause analysis is retrospective after harm has occurred.

Six Sigma DMAIC phases are Define, Measure, Analyze, Improve, and Control.

Anesthesia quality indicators include unplanned reintubation, dental injury, postoperative nausea and vomiting, and wrong-site procedures.

Never events such as wrong-site surgery and retained surgical items are reportable and generally considered preventable.