Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex Review > Obesity 2 > Flashcards

Obesity 2 Flashcards

1
Q

Considerations for the cardiovascular effects of morbid obesity include: (select 2)
a. tachycardia
b. increased EKG voltage
c. diastolic dysfunction
d. increased venous return

A

c. diastolic dysfunction
d. increased venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

__________ and _____________ place a higher workload on the myocardium for obese patients.

A

increased intravascular volume and a high cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The myocardium suffers ____________ with obese patients.

A

diastolic dysfunction; systolic dysfunction can progress to biventricular heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hypertension in obese patients results from

A

hyperinsulinemia
SNS + RAAS activation
increased cytokine concentrations in the plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Common EKG changes for obese patients include

A

axis deviation (right or left), low voltage, dysrhythmias (QT prolongation), & ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cardiac output increases by ___________ for every extra kg of fat.

A

100 mL/min.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should you use to calculate perioperative fluid requirements for the obese patient?

A

lean body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The presence of _____________ on TEE may be the most useful confirmation of pulmonary hypertension in the obese patient.

A

tricuspid regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why is cardiac output increased in the obese patient?

A

stroke volume increases
blood volume increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In the obese patient, which factors are expected to increase? (select 2)
a. MAC
b. circulation time
c. volume of distribution of lipophilic drugs
d. volume of distribution of hydrophilic drugs

A

c. volume of distribution of liphophilic drugs
d. volume of distribution of hydrophilic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

As a general rule, water-soluble drug doses are calculated with _______, while lipid-soluble drug doses are calculated with _______. Obesity complicates things so you can’t rely on this oversimplified approach

A

IBW; TBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_______ is not affected by obesity

A

MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Volatile agents are ________ so agents with _________ should be used in the obese patient.

A

liphophilic lowest blood:gas coefficients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

______ is generally avoided in the obese patient because ___________

A

Nitrous oxide; restricts the maximum FiO2 that can be delivered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Obesity increases the volume of distribution for

A

lipid-soluble AND water-soluble drugs (lipid&raquo_space;> water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

_________ should be used to calculate drug doses for the obese patient.

A

Lean body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The volume of distribution of a drug in the obese patient is altered by:

A

increased blood volume
increased cardiac output
altered plasma protein binding
lipid solubility of the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

LBW can be estimated by

A

IBW x 1.3

19
Q

The initial dose of which drugs should be based on total body weight? (select 2)
a. propofol
b. succinylcholine
c. remifentanil
d. midazolam

A

b. succinylcholine
d. midazolam

20
Q

Lean body weight should be used to calculate the following drug doses for induction/loading doses:

A

propofol
rocuronium
vecuronium
remifentanil

21
Q

Lean body weight should be used to calculate that following drug doses for maintenance doses of:

A

rocuronium
vecuronium
fentanyl
sufentanil
remifentanil

22
Q

Total body weight should be used to calculate the induction/loading doses of

A

succinylcholine
cisatricurium
atracurium
fentanyl
sufentanil
midazolam (this does NOT include preoperative anxiolysis)

23
Q

Total body weight should be used to calculate the maintenance doses of

A

propofol
cisatracurium
atracurium
midazolam

24
Q

Engorgement of the epidural veins and increased epidural fat content will cause

A

a greater spread of local anesthetic in the epidural space
dose should be reduced 75% of the normal dose

25
Q

What is the difference in the absorption of orally administered medications for the obese population?

A

no difference in absorption

26
Q

All of the following muscles dilate the upper airway EXCEPT the:
a. tensor palatine
b. genioglossus
c. hyoid muscles
d. thyroarytenoid

A

d. thyroarytenoid
they relax the vocal cords

27
Q

The incidence of OSA is directly proportional to

A

BMI

28
Q

OSA is an independent risk factor for the development of

A

hypertension
cardiovascular morbidity
death

29
Q

Obstructive sleep apnea is defined as the cessation of airflow for

A

at least 10 seconds (apnea) with 5 or more unsuccessful efforts to breathe (obstruction) and a greater than 4% reduction in SaO2

30
Q

Hypopnea is defined as a

A

50% reduction in airflow for 10 seconds, 15 or more times per hour

31
Q

Hypopnea is linked to

A

snoring & decreased oxygen saturation

32
Q

Things that increase the likelihood a patient has OSA includes:

A

BMI >30 kg/m^2
abdominal fat distribution
large neck girth (>17 inches for men or >16 inches for women)

33
Q

Which apnea/hypopnea index score is consistent with mild obstructive apnea?
a. 3
b. 12
c. 25
d. 40

A

b. 12

34
Q

The apnea/hypopnea index helps quantify

A

the severity of OSA

35
Q

The apnea/hypopnea index is derived from

A

the number of apnea episodes and hypopnea divided by the total hours of sleep

36
Q

A mild apnea/hypopnea index is defined as

A

5-15 episodes/hr

37
Q

A moderate hypopnea index is defined as

A

15-30 episodes/hr

38
Q

A severe hypopnea index is defined as

A

> 30 episodes/hr

39
Q

Most patients with OSA are

A

undiagnosed

40
Q

The definitive test for OSA is

A

polysomnography

41
Q

Patients with severe sleep apnea are at higher risk for

A

difficult mask ventilation and difficult intubation

42
Q

The classic triad of dysfunctional sleep includes

A

apnea or snoring with hypopnea during sleep
arousal from sleep
daytime somnolence

43
Q

What is the stopbang?

A

Snoring
Tiredness
Observed Apnea
Pressure
BMI (>35)
Age (>50)
Neck circumference (>40 cm)
Gender (male)

44
Q

Answering yes to ________ or more questions indicates a high risk for OSA

A

3

Apex Review (224 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions