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M5 BOARD REVIEW

Comprehensive Anesthesiology Question Bank

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Respiratory

Alveolar Gas Equation

 

PA O 2 = FI O 2

(

P ATM P H 2 O

) Pa CO 2 / RQ

PA O 2

= Alveolar partial pressure of oxygen

= Arterial partial pressure of CO2

Pa CO 2 FI O 2

= Inspired O2

 

P

ATM

= Atmospheric pressure

P

H 2 O

= Saturated vapor pressure

RQ

= Respiratory Quotient

Q’s

Respiratory Physiology: Q14 Basic Pulmonary Physiology: Q7

Shunt Equation

 

Q

shunt

 

(Cc’ O 2 - Ca O 2 )

Q

total

=

(Cc’ O 2 - C mv O 2 )

Cc’ O 2

= Post-capillary blood oxygen content

 

(typically assumed to be the

Saturation of haemoglobin utilizing

the PAO2 haemoglobin

concentration 1.34)

Ca O 2

= Arterial Hbsat Hb 1.34

C mv O 2

= Mixed venous Hbsat Hb 1.34

Qs

 

Basic Pulmonary Physiology: Q17

Equations

’ s   Basic Pulmonary Physiology: Q17 Equations Dead Space (Bohr Equation) V D P a

Dead Space (Bohr Equation)

V

D

P a CO 2 P E CO 2

=

V

T

P a CO 2

P

a CO 2

= Arterial partial pressure of oxygen

P

E CO 2

= Partial pressure of CO2 from all expired gases

Qs

Basic Pulmonary Physiology: Q14

Ventilation/Perfusion Index (ratio)

VQI =

(1 Arterial Hbsat)

(1 Mixed Venous Hbsat )

Qs

Basic Pulmonary Physiology: Q17

Ohm’s Law

Pressure Gradient = Air Flow Airway Resistance

Pressure Gradient = Air Flow Airway Resistance

Qs

Basic Pulmonary Physiology: Q17

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Equations

Respiratory

Airway Resistance for Laminar Flow (Poiseuille’s Law)

Laminar Flow

Laminar Flow  
 

Resistance

= (8 Length • Viscosity of gas) Radius

(

= ( 8 Length • Viscosity of gas ) Radius ( 4 )

4

)

Q’s

Respiratory Physiology: Q7 Basic Pulmonary Physiology: Q5

 

Reynold’s Number

 

R = (Velocity Density Diameter ) Viscosity

 
 

>2000 consistent with turbulent flow

Q’s

Respiratory Physiology: Q7 Respiratory Physiology: Q8 Basic Pulmonary Physiology: Q4

Law of LaPlace

Pressure =

2 • Wall Tension

Radius

Note:

Wall thickness is typically not considered for alveoli

Qs

Basic Pulmonary Physiology: Q5

Time Constant

TC = Compliance Resistance

Qs

Basic Pulmonary Physiology: Q5

Static Compliance

Static compliance = Volume Pressure

Tidal volume delivered

=

(Plateau pressure – PEEP)

Qs

Basic Pulmonary Physiology: Q33

Dynamic Compliance

Dynamic compliance = Volume Pressure

Tidal volume delivered

=

(Peak pressure – PEEP)

Qs

Basic Pulmonary Physiology: Q33

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= ( P e a k pressure – PEEP ) Q ’ s Basic Pulmonary Physiology:

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Comprehensive Anesthesiology Question Bank

Respiratory

Equations

Transpulmonary Pressure

 

Transpulmonary pressure

=

Alveolar pressure – Pleural pressure

Qs

ICU: Advanced Cardiopulmonary: Q1

Transthoracic Pressure

 

Transthoracic pressure

=

Pleural pressure – Atmospheric pressure

Qs

ICU: Advanced Cardiopulmonary: Q1

Predicted PaO2 by Age

Predicted PaO2 = 110-(age • 0.4)

Q’s

Special Situations: Q12 Respiratory Physiology: Q6

Boyle’s Law

Pressure1 • Volume1 = Pressure2 • Volume2

Qs

Basic Cardiac Physiology: Q12

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Pressure1 • Volume1 = Pressure2 • Volume2 Q ’ s Basic Cardiac Physiology: Q12 www.m 5

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Comprehensive Anesthesiology Question Bank

Respiratory

Equations

Henry’s Law

Partial Pressure = k • C

k = Henry’s Law Constant C = Concentration of dissolved gas

Henry’s Law Partial Pressure = k • C k = Henry’s Law Constant C = Concentration

Ohm’s Law

Pressure = Cardiac Output • Resistance

Qs

Cardiac Physiology: Q14

Henderson-Hasselbach

pH = pK + log[HCO3-/ (0.03 • PaCO2)]

Henderson-Hasselbach pH = pK + log[HCO3-/ (0.03 • PaCO2)]
Henderson-Hasselbach pH = pK + log[HCO3-/ (0.03 • PaCO2)]

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s Cardiac Physiology: Q14 Henderson-Hasselbach pH = pK + log[HCO3-/ (0.03 • PaCO2)] www.m 5 boardreview.com

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Cardiac

Equations

Myocardial Perfusion Pressure

MPP = Aortic diastolic pressure – LVEDP

Qs

Cardiac Physiology: Q23

LaPlace Law

Tension = (Pressure • Radius)/(2 • Wall Thickness)

Note: Notice that as opposed to the equation in the Respiratory Section, the equation is solved for wall tension

Qs

Basic Cardiac Physiology: Q12

Poiseuille’s Law

Flow Rate = (π • Pressure • radius4)/(8 • viscosity • length)

Note: Notice that as opposed to the equation in the Respiratory Section, the equation is solved for flow.

Qs

Basic Cardiac Physiology: Q12

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Section, the equation is solved for flow. Q ’ s Basic Cardiac Physiology: Q12 www.m 5

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Cardiac

Equations

Fick Principle

CO = VO2/(CaO2 – CmvO2)

CO = Cardiac Output

VO2 = Oxygen consumption

CaO2 = Arterial content of oxygen

CmvO2 = Mixed venous content of oxygen

Qs

ICU Principles: Q1

Consumption of Oxygen (not including O2 dissolved in blood for simplicity)

VO2 = Hb • (Sata - Satmv) X 1.34 • CO

Rearranged: Satmv = Sata – [VO2/ (Hb • 1.34 • CO)]

CO = Cardiac Output

VO2 = Oxygen consumption

Sata = Arterial saturation of haemoglobin

Satmv = Mixed venous saturation of haemoglobin

Hb = Haemoglobin

Q’s

ICU Principles: Q1 ICU Principles: Q2 ICU Principles: Q19

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Hb = Haemoglobin Q’s ICU Principles: Q1 ICU Principles: Q2 ICU Principles: Q19 www.m 5 boardreview.com

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Comprehensive Anesthesiology Question Bank

Cardiac

Arterial Content of Oxygen

CaO2 = [Hb • Sata • 1.34] + 0.003 • PaO2

Sata = Arterial saturation of haemoglobin

Pa O2 = Partial pressure of oxygen in arterial blood

Qs

ICU Principles: Q1

Elimination of CO2

VCO2 = Hb X SatmvCO2 • CO

SatmvCO2 = CO2 saturation in mixed venous blood

Q’s

ICU Principles: Q1

Respiratory Quotient

RQ = VCO2/VO2

VCO2 = Elimination of CO2

VO2 = Oxygen consumption

Q’s

ICU Principles: Q15

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Equations

Oxygen Delivery

DO2 = CaO2 • CO

CaO2 = Arterial content of oxygen

CO = Cardiac Output

Q’s

ICU Principles: Q1

Oxygen Extraction Ratio

ER = VO2/DO2

VO2 = Oxygen consumption

DO2 = Delivery of oxygen

Q’s

ICU Principles: Q1 ICU Principles: Q3

Cardiac Output

CO = Stroke Volume • Heart Rate

Cardiac Output CO = Stroke Volume • Heart Rate
Cardiac Output CO = Stroke Volume • Heart Rate
of oxygen Q’s ICU Principles: Q1 ICU Principles: Q3 Cardiac Output CO = Stroke Volume •

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Cardiac

Stroke Volume

SV = End-diastolic volume – End-systolic volume

Qs

Basic Cardiac Physiology: Q29

Pulmonary Vascular Resistance

PVR = [(PAP-Wedge)/CO] • 80

PAP = Pulmonary Arterial Mean Mressure CO = Cardiac Output

Q’s

ICU Principles: Q6

Stroke Work

SW = Stroke volume • mean arterial pressure

Q’s

Basic Cardiac Physiology: Q29

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Equations

Cardiac Index

CI = CO/BSA

CO = Cardiac Output BSA = Body Surface Area

Cardiac Index CI = CO/BSA CO = Cardiac Output BSA = Body Surface Area

Systemic Vascular Resistance

SVR = [(MAP-CVP)/CO] • 80

MAP = Mean Arterial Pressure CVP = Central Venous Pressure CO = Cardiac output

Q’s

Basic Cardiac Physiology: Q13

Arterial Pressure CVP = Central Venous Pressure CO = Cardiac output Q’s Basic Cardiac Physiology: Q13

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Comprehensive Anesthesiology Question Bank

Cardiac

Starling Equation

Q = kA X [(Pc – Pi) + σ(πi-πc)]

Q

= Net Fluid Filtration

k = Capillary Filtration Coefficient (of water)

A

= Area of the Membrane

σ = Reflection Coefficient (of albumin)

Pc = Capillary Hydrostatic Pressure

Pi = Interstitial Hydrostatic Pressure

πi = Interstitial Colloid Osmotic Pressure

πc = Capillary Colloid Osmotic Pressure.

 

Q’s

Basic Cardiac Physiology: Q30

Allowable Blood Loss

ABL = EBV X [(Hb – Minimum allowable Hb)/Hb]

EBV= Estimated Blood Volume

Allowable Blood Loss ABL = EBV X [(Hb – Minimum allowable Hb)/Hb] EBV = Estimated Blood
Allowable Blood Loss ABL = EBV X [(Hb – Minimum allowable Hb)/Hb] EBV = Estimated Blood

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Equations

Cerebral Perfusion Pressure

Cerebral Perfusion Pressure

CPP = MAP – ICP

CPP = MAP – ICP

MAP = Mean arterial pressure

MAP = Mean arterial pressure

ICP = Intracranial pressure

ICP = Intracranial pressure

Q’s

Clinical Neurophysiology: Q2 Clinical Neurophysiology: Q3

Perfusion Pressure

PP = MAP – Venous Presure

Perfusion Pressure PP = MAP – Venous Presure
Perfusion Pressure PP = MAP – Venous Presure
Q’s Clinical Neurophysiology: Q2 Clinical Neurophysiology: Q3 Perfusion Pressure PP = MAP – Venous Presure p

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Comprehensive Anesthesiology Question Bank

Pharmacology

Equations

It is important to understand the concepts of pharmacokinetics, but few equations need to be memorized. Memorizing complex clearance and half-life equations, accounting for peripheral compartments are very low yield…just understand the concept.

Volume of Distribution

VD = Dose / Concentration

Q’s

Basic Pharmacology: Anesthesia Adjuncts Q1 Basic Pharmacology: Anesthesia Adjuncts Q2 Basic Pharmacology: Induction Agents Q12

Half Life

Half-life = Volume of distribution / Rate of clearance

Q’s

Basic Pharmacology: Anesthesia Adjuncts Q1 Basic Pharmacology: Anesthesia Adjuncts Q2 Basic Pharmacology: Induction Agents Q12

Clearance

Clearance = dose/ area under time concentration curve Clearance = (Urine concentration • Urine flow) / Plasma concentration

Q’s

Basic Pharmacology: Anesthesia Adjuncts Q1 Basic Pharmacology: Anesthesia Adjuncts Q2 Basic Pharmacology: Induction Agents Q12

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Q1 Basic Pharmacology: Anesthesia Adjuncts Q2 Basic Pharmacology: Induction Agents Q12 www.m 5 boardreview.com p 10

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Comprehensive Anesthesiology Question Bank

Pharmacology

Equations

Opioid Conversions

Drug

IV

Oral

Morphine

10 mg

30 mg

Hydromorphone

1.5 mg

7.5 mg

Fentanyl

100 mcg

N/A

Codeine

N/A

200 mg

Hydrocodone

N/A

30 mg

Oxycodone

N/A

20-30 mg

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Codeine N/A 200 mg Hydrocodone N/A 30 mg Oxycodone N/A 20-30 mg www.m 5 boardreview.com p

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Comprehensive Anesthesiology Question Bank

Equipment

Endotracheal Size (for children)

Size = 4 + (Age/4)

Endotracheal Size (for children) Size = 4 + (Age/4)
Endotracheal Size (for children) Size = 4 + (Age/4)

Equations

Endotracheal Depth

Depth = 12 + (Age/2), or 3 • ETT size

Qs

Pediatrics: Q4

Gas Tanks (E)

 

Gas

Volume

Pressure

Oxygen

625 L (US)

2200 psig

Nitrous Oxide

1590 L

745 psig

Q’s

Equipment: Q1

Equipment: Q2

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psig Nitrous Oxide 1590 L 745 psig Q’s Equipment: Q1 Equipment: Q2 www.m 5 boardreview.com p

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Statistics

Equations

Incidence & Prevalence

Incidence & Prevalence Incidence = Number of occurrences / Sum of person-time at risk Prevalence =

Incidence = Number of occurrences / Sum of person-time at risk Prevalence = Number of cases/ Number of individuals sampled

= Number of occurrences / Sum of person-time at risk Prevalence = Number of cases/ Number

Measure of Effect

Measure of Effect Absolute measure of effect = Rate Difference = Rate of risk exposed –

Absolute measure of effect = Rate Difference = Rate of risk exposed – Rate of risk not exposed Relative measure of effect = Rate Ratio = Rate of risk exposed /Rate of risk not exposed

– Rate of risk not exposed Relative measure of effect = Rate Ratio = Rate of

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Relative measure of effect = Rate Ratio = Rate of risk exposed /Rate of risk not

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Statistics

Equations

Disease Screening

 
 

Has Disease

No Disease

Positive Test

True Positive (TP)

False Positive (FP)

Negative Test

False Negative (FN)

True Negative (TN)

Sensitivity = TP/ (TP + FN) Specificity = TN/ (TN + FP) Positive Predictive Value = TP/ (TP + FP) Negative Predictive Value = TN/ (TN + FN)

Q’s

Statistics: Q17

Statistics: Q18

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Negative Predictive Value = TN/ (TN + FN) Q’s Statistics: Q17 Statistics: Q18 www.m 5 boardreview.com

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Statistics

Equations

Disease Screening

 
 

Has Disease

No Disease

Exposed

A

B

Not Exposed

C

D

Odds Ratio = AD/BC

 

Relative Risk = [A/(A+B)] / [C/(C+D)]

Q’s

Statistics: Q16

Number needed to Treat

NNT = 1 / ARR

ARR = Absolute Risk Reduction = Control event rate – Experimental event rate

Q’s

Statistics: Q19

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Risk Reduction = Control event rate – Experimental event rate Q’s Statistics: Q19 www.m 5 boardreview.com

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