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Sp: Coexisting I > 1. Respiratory Obstructive > Flashcards

1. Respiratory Obstructive Flashcards

1
Q

Obstructive TLC

A

increased

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2
Q

obstructive RV

A

incereased

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3
Q

obstructive FEV1

A

decreased

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4
Q

Obstructive FVC

A

decreased

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5
Q

obstructive FEV1/FVC

A

decreased

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6
Q

compliance =

A

C= V/P

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7
Q

the supine position _______ FRC

A

decreases

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8
Q

does anesthesia change airway resistance

A

no NET change
– atelectasis: incr R
– VA bronchodilation: decr R

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9
Q

common obstructive diseases (5)

A

URI
Asthma
COPD
Bronchiectasis
Cystic fibrosis

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10
Q

what percentage of URI are viral

A

95% are nasopharyngitis

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11
Q

viral URI

A

non-productive cough
sneezing
rhinorrhea

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12
Q

bacterial URI

A

fever
purulent drainage
productive cough
malaise

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13
Q

which type of URI has a higher rate of post-op complications

A

bacterial

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14
Q

COLDS scoring

A

Current symptoms
Onset of symptoms
Lung disease
airway Device
Surgery

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15
Q

how long from symptom onset are you most at risk for anesthetic complications with a URI

A

less thatn 2 weeks from symptom onset

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16
Q

which airway device has a higher risk with URI

A

ETT

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17
Q

how long should you wait for a non-urgent surgery in pts with URI

A

6 weeks from start of symptoms

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18
Q

asthma

A

reversible airway obstruction due to inflammation

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19
Q

asthma pt factors

A

genetic
environmental
maternal smoking during preg
limited exposure to infectious enviro

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20
Q

asthma trigger

A

allergen
NSAIDs
infections
excercise
endorphin/vagal mediated

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21
Q

asthma inflammatory cascade

A

histamine
prostaglandin D2
leukotrines

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22
Q

asthma clinical signs

A

expiratory wheeze
cough
dyspnea
chest tightness
eosinophilia (labs)

23
Q

severe asthma
FEV1
FEV1/FVC

A

FEV1<60%

FEV1/FVC: decr by 5+%

24
Q

asthma flow-volume loop

A

scooping/concave

25
status asthmatics
life threatening bronchospasms that persist with treatment
26
status asthmaticus treatment
high does beta2 agonists corticosteroids anticholinergics IV Mg2+ IV epi supp O2 volatile agents (bronchodilation) ECMO
27
what predicts increased risk for PRAE in asthmatic pts
FVC and FEV1 <70%
28
which opioid produced histamine
morphine
29
emergence in asthmatic pts will be _________
slower
30
COPD PFTs FEV1:FVC FEF FRC TLC RV
FEV1:FVC < 70% forced exp flow: 25-75% of VC incr FRC incr TLC incr RV
31
mild COPD
FEV1 >= 80%
32
mod COPD
FEV1 betwee 50-80%
33
severe COPD
FEV1 between 30-50%
34
very severe COPD
FEV1 <30%
35
BODE index
BMI Obstruction degree Dyspnea level Exercise tolerance
36
high BODE score
greater risk of COPD exacerbations, hospitalizations, and death
37
COPD blood tests
alpha1 antitrypsin definciency increased eosinophiles ABG PaO2 decreases w/severe
38
COPD treatment
1st line: muscarinic antagonist 2nd: beta2 agonist 3rd: glucocoricoids
39
should pts take COPD meds day of surgery
yes
40
COPD pre-op
smoking cessation > 6 weeks medication alb >3.5 mg/dL pre-op incentive spirometry
41
what is the most important factor to decrease COPD risk pre-surgery
incentive spirometry
42
COPD blocks to avoid
above T6 interscalene block
43
can you use N2O with COPD pts
no may rupture bullae and cause a pneumothorax
44
mech ventilation goals: COPD
avoid dynamic hyperinflation/auto-peep will incr intrathoracic pressure
45
air trapping detection
upsloping capnography flow doesnt go to 0 before inhalation
46
air trapping intervention
decr RR incr expiratory time
47
bronchospasm treatment
propofol incr gas albuterol epi
48
bronchiectasis
irreversible airway dilation inflammation chronic bacterial infection
49
bronchiectasis symtpoms
cough w/purulent sputum dyspnea wheezing pleuritic chest pain clubbing of fingers
50
gold std for bronchiectasis diagnosis
CT
51
bronchiectasis treatment
chest physiotherapy abx bronchodilators steroids
52
bronchiectasis management
suction ETT frequently
53
cystic fibrosis anesthetic managment
VA high FiO2 avoid anticholinergic suction ETT frequently

Sp: Coexisting I (11 decks)

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