APEX FINAL 1 LATEST 2024 ACTUAL EXAM
Major cause of apnea with neuraxial anesthesia (and what is
usually not the cause) – ANSWER- Usually the result of cerebral
hypoperfusion, not phrenic nerve paralysis
Cause of drowsiness with neuraxial anesthesia – ANSWERreduces sensory input to the Reticular Activating System (RAS),
causing drowsiness.
saddle block – ANSWER- given at the lower end of the spinal
column (sacrum) to block the perineal area, or hyperbaric
solution in lumbar w/ sitting position maintained until block sets
up.
opioid moa – ANSWER- inhibit pain transmission (afferent
signals) in the substantia gelatinosa via the dorsal horn
benefit to using opioids with LA – ANSWER- creates a denser
block
Recommendations for block placement: Glycoprotein IIb/IIIa
antagonists – ANSWER- Abciximab: Hold 1-2 days
Tirofiban, Eptifibatide: Hold 8h
Recommendations for block placement: Cox inhibitors –
ANSWER- Proceed if pt has normal clotting mechanism and is
not on any other blood thinners
Recommendations for block placement: Thienopyridine
inhibitors – ANSWER- Clopidogrel: Hold 7 days
Ticlopidine: Hold 14 days
Recommendations for block placement/catheter removal:
Unfractionated Heparin – ANSWER- SQ: Proceed if pt has
normal clotting mechanism and is not on any other blood
thinners
IV: Hold 2-4 hours b/f block, and 1h after block placement
Hold 2-4h after removing catheter
Recommendations for block placement/catheter removal: low
molecular weight Heparin – ANSWER- Enoxaparin, Dalteparin,
Tinzaparin
Before block placement:
Prophylactic (Once daily): Hold 12h
Therapeutic (twice daily): Hold 24h
Before catheter removal: Hold 12h
After catheter removal: Hold 2h
After single shot block
Prophylactic (Once daily): Hold 6-8h
Therapeutic (twice daily): Hold 24h
Recommendations for block placement/catheter removal:
warfarin – ANSWER- before block: Hold 5d
Can remove catheter when INR < 1.5
Recommendations for block placement/catheter removal:
thrombolytic agents – ANSWER- TPA, streptokinase, alteplase,
Urokinase
Absolute contraindication to neuraxial anesthesia
Recommendations for block placement/catheter removal: Herbal
therapies – ANSWER- Garlic, Ginkgo, Ginseng
Proceed if pt is not on any other blood thinners
Normal length of transient neurological symptoms (TNS) –
ANSWER- 1-7 days
Most common LA to cause transient neurological symptoms
(TNS) – ANSWER- Lidocaine
List the structures a needle passes through for an epidural block
- ANSWER- Skin -> subcutaneous tissue -> subcutaneous fat ->
supraspinous ligament -> intraspinous ligament -> ligamentum
flavum -> epidural space
List the structures a needle passes through for a subarachnoid
block – ANSWER- Skin -> subcutaneous tissue -> subcutaneous
fat -> supraspinous ligament -> intraspinous ligament ->
ligamentum flavum -> epidural space -> dura mater -> subdural
space -> arachnoid mater -> subarachnoid space
Organism most likely to cause post-spinal bacterial meningitis? –
ANSWER- Streptococcus viridans
neurotransmission is reduced by: – ANSWER- -decreased cAMP
-decreased Ca2+ conductance
-decreased K+ conductance
Body System
A group of organs that work together to perform related functions.
Coping Strategies
Techniques or behaviors a person uses to handle stress.
Delayed Gratification
The act of avoiding an immediately enjoyable behavior in the hopes of getting an even better reward at a later time.
Health
A person’s overall physical, mental, and social condition, not just the absence of disease of “feeling sick”.
Health Literacy
A person’s understanding of her own health, as well as the ability to comprehend new information about health and medicine.
Health-Promoting behavior
An action that improves a person’s health and reduces the risk of illness or injury.
impulse
An immediate desire for something.
Mental & emotional health
The ability of a person to learn new ideas, tolerate differences, distinguish fantasy from reality, and appropriately control and express his or her feelings.
Organs
Specialized structures that carry out a specific function in a living organism
Physical Health
The condition of a living organism’s body at a given time.
Risk Behaviors
Actions that increase a person’s change of suffering an illness or injury
Self-Discipline
The ability to resist impulses and consistently behave in healthful and positive ways.
Self-image
A persons conception or mental image of him or herself.
Social Health
The condition of a persons relationships with others.
Stress
A mental state consisting of strong feelings of anxiety, worry, or even anger caused by problematic events in ones life.
Adolescents
People who are developing into adults.
Anxiety
A feeling or worry nervousness or unease.
bullying
Behavior that in intended to hurt other people. This behavior may happen repeatedly. The person being bullied often feels that he or she cannot do anything to stop the behavior.
Coping Skills
Methods used to deal with or menage a stressful situation.
cyberbullying
The use of social networking to attack, bully, or harass another person.
Emotional well-being
A state of positive emotional health.
empathy
The ability to understand another persons experiences and emotions
greif
A response to loss involving many emotions.
Mental well-being
A state of positive mental health.
Obsesity
The condition of having an excessive weight for ones height, usually assessed by body mass index. (BMI)
Peer pressure
A sense of pressure to do something just because others are doing it.
Peers
People of the same age or group.
Self-esteem
The way a person feels about him or herself at any particular time.
Social Media
Computer content in which people share, create, or exchange information or ideas.
Social Networking
A technology platform where people interact and exchange ideas.
Stress management
The use of coping skills to manage or reduce stress,
Stressors
Stimuli or situations that cause stress.
bipolar disorder
A mental health condition, marked by periods of intense excitement followed by periods
Conflict resolution
A method of eliminating a problem. Can happen through negotiation and mediation.
Depression
A mental health condition. Symptoms include sadness and loss of interest in day-to-day activities.
Desensitize
to cause someone to react less to something through repeated exposure
gang
An organized group of criminals with a structured membership and a defined leader
no-tolerance police
A method of discipline in which anyone who breaks even a minor rule receives punishment. Such a policy is intended to reinforce the importance of the rules and deter violations. No tolerance policies are also called “Zero tolerance policies.”
schizophrenia
A mental health condition in which a person loses touch with reality.
Self harming behavior
Hurting oneself on purpose with acts that may include cutting, piercing, or burning.
Suicide
The act of taking ones own life voluntarily.
aggressive communication
Communicating ones thoughts and feelings. Happens in a harsh or angry manner that does not respect the feelings of other people.
assertive communication
Communicating ones thoughts and feelings clearly. Happens while respecting the thoughts and feelings of other people.
Collaborate
To work with others to achieve or do something.
Collaborative decision
A decision made by two or more people working toward a common goal.
Negotiation Skills
Skills used to work with other people to resolve differences, negotiation often involves compromise.
Body composition
The proportion of body fat to lean body mass.
Body mass index
A measure of body fat derived from comparing a persons height with his or her weight.
Cardio respiratory Endurance
The ability of the bodys circulatory and respiratory systems to supply oxygen to the muscles during sustained physical activity.
Deficiency
The lack of a specific nutrient in ones diet,
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