CPAN CAPA CERT EXAM III EXAMPREP
QUESTIONS AND DETAILED SOLUTIONS
◉ what medications should be avoided for patients with LAST.
Answer: vasopressin
calcium channel blockers
beta blockers
propofol
high doses of epi
addition local anesthetic
◉ how does local anesthetic absorption work.
Answer: to slow or prevent cell membrane depolarization which
leads to the complete loss of information across the length of the
neuron resulting in patient percieved "numbness"
- the higher the fat solubility, the faster the absorption
◉ S&S of malignant hyperthermia.
Answer: muscle rigidity
hypercapnia
rhabdomyolysis
hypeerthermia
,tachycardia
tachypnea
metabolic acidosis
respiratory acidosis
hyperkalemia
myobloinuria
increased creatinine
dysrhymthias
cyanosis
rigidity
sweating
◉ 2nd degree AV block type 2 (mobitz).
Answer: some P waves are not conducted to the ventricule and
therefore not followed by the QRS complex
◉ 2nd degree AV block type 2 (mobitz) treatment.
Answer: avoid atropine
transcutaneous or temporary transvenous pacing if placed
perioperatively
permanent pacer required to support heart rhythm
,◉ 3rd degree AV block.
Answer: total loss of electrical conduction between atria and
ventricles
◉ 3rd degree AV block treatment.
Answer: transcutaneous pacing
insertion of permanent pacer required
◉ triggering pharmacological agents for malignent hyperthermia.
Answer: Isoflurane, sevoflurane, desflurane, halothane, enflurane,
ether, and the depolarizing muscle relaxant succinylcholine
◉ cincinnati prehopsital neurologic screening tool to identify stroke.
Answer: facial drooping
arm drift
abnormal speech
◉ symptomatic bradycardia treatment.
Answer: atropine: 1mg IV bolus repeat every 3-5 minutes to
maximum of 3mg IV
transcutaneous pacing
dopamine: 5-20mcg/kg/min
, epinephrine: 2-10 mcg/min
◉ hemorrhagic stroke treatment.
Answer: consult neurology - begin hemorrhage pathway
◉ ischemic stroke treatment.
Answer: consider fibrolytic therapy (rTPA)
- no anticoagulants or antiplatelet treatment for 24 hours
- if not canidate for fibrolytic therapyL administer aspirin
◉ S&S of LAST.
Answer: agitation
blurred vision
numbness
tinnitus
metallic taste
twitching
unconsciousness
seizures
cardiac and respiratory arrest
◉ Vtach treatment.
QUESTIONS AND DETAILED SOLUTIONS
◉ what medications should be avoided for patients with LAST.
Answer: vasopressin
calcium channel blockers
beta blockers
propofol
high doses of epi
addition local anesthetic
◉ how does local anesthetic absorption work.
Answer: to slow or prevent cell membrane depolarization which
leads to the complete loss of information across the length of the
neuron resulting in patient percieved "numbness"
- the higher the fat solubility, the faster the absorption
◉ S&S of malignant hyperthermia.
Answer: muscle rigidity
hypercapnia
rhabdomyolysis
hypeerthermia
,tachycardia
tachypnea
metabolic acidosis
respiratory acidosis
hyperkalemia
myobloinuria
increased creatinine
dysrhymthias
cyanosis
rigidity
sweating
◉ 2nd degree AV block type 2 (mobitz).
Answer: some P waves are not conducted to the ventricule and
therefore not followed by the QRS complex
◉ 2nd degree AV block type 2 (mobitz) treatment.
Answer: avoid atropine
transcutaneous or temporary transvenous pacing if placed
perioperatively
permanent pacer required to support heart rhythm
,◉ 3rd degree AV block.
Answer: total loss of electrical conduction between atria and
ventricles
◉ 3rd degree AV block treatment.
Answer: transcutaneous pacing
insertion of permanent pacer required
◉ triggering pharmacological agents for malignent hyperthermia.
Answer: Isoflurane, sevoflurane, desflurane, halothane, enflurane,
ether, and the depolarizing muscle relaxant succinylcholine
◉ cincinnati prehopsital neurologic screening tool to identify stroke.
Answer: facial drooping
arm drift
abnormal speech
◉ symptomatic bradycardia treatment.
Answer: atropine: 1mg IV bolus repeat every 3-5 minutes to
maximum of 3mg IV
transcutaneous pacing
dopamine: 5-20mcg/kg/min
, epinephrine: 2-10 mcg/min
◉ hemorrhagic stroke treatment.
Answer: consult neurology - begin hemorrhage pathway
◉ ischemic stroke treatment.
Answer: consider fibrolytic therapy (rTPA)
- no anticoagulants or antiplatelet treatment for 24 hours
- if not canidate for fibrolytic therapyL administer aspirin
◉ S&S of LAST.
Answer: agitation
blurred vision
numbness
tinnitus
metallic taste
twitching
unconsciousness
seizures
cardiac and respiratory arrest
◉ Vtach treatment.
