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RUSVM Anesthesiology 2016 > GI Disease > Flashcards

GI Disease Flashcards

1
Q

What are the considerations for GI disease in a patient?

A

Reperfusion of compromised tissues causing a release of inflammatory mediators
Manipulation of the GI tract can cause vagal stimulation

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2
Q

Megaesophagus

A

Dilation of esophagus with poor motility

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3
Q

What are the mechanical causes of Megaesophagus?

A 
Vascular ring anomaly 
Esophageal stricture
Tumor 
granuloma
foreign body
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4
Q

What are the neurological causes of Megaesophagus?

A

Myasthenia gravis

Peripheral neuropathy

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5
Q

What are the concerns associated with Megaesophagus?

A

Regurgitation and aspiration

Gastroesophageal reflux

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6
Q

What are the characteristics of GI disease?

A

Hypoproteinemia

Thin BCS

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7
Q

When performing a GI study what should you be prepared with?

A

Anticholinergics

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8
Q

What are the clinical signs of Hemoabdomen?

A 
Severe weakness
Collapse
Hypovolemic shock 
Hypotension 
tachycardia
pale or white mucous membranes
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9
Q

What is Hemoabdomen secondary to?

A

Hemangiosarcoma or Hemangioma

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10
Q

What fluids are needed for GI disease?

A

Balanced replacement crystalloids
Colloid
Blood

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11
Q

What is the drug of choice for ventricular arrhythmias?

A

Lidocaine

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12
Q

What ECG pattern is associated with Splenic disease?

A

Ventricular arrhythmias

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13
Q

What kind of resuscitation do you use on patients with GI disease?

A

Goal-directed resuscitation

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14
Q

What drugs should you avoid with Hemoabdomen?

A

Drugs with significant CV effects (Ace, Dexmed, and propofol)
Avoid large doses of induction agents (use balanced anesthesia)

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15
Q

What drugs should you use with Hemoabdomen?

A

Opioids and Benzos for premed

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16
Q

Why do you use balanced anesthesia for Hemoabdomen patients?

A

to decrease the dose of inhalant required

17
Q

What should you add in monitoring Hemoabdomen patients?

A

Invasive blood pressure

18
Q

What should the MAP be kept above for patients with Hemoabdomen?

A

60mmHg

19
Q

How do you treat hypotension in patients with hemoabdomen?

A

If hypovolemia: need fluids

If vasodilation or decreased ionotropy - DECREASE inhalant +/- CV drugs

20
Q

What are hemoabdomen patients susceptible to Post-op?

A

ventricular arrhythmias

21
Q

What are the clinical signs of GI foreign body?

A

Vomiting

Abdominal pain

22
Q

What are the chemistry abnormalities seen with GI foreign body?

A

Hypochloremic metabolic alkalosis

23
Q

What should you avoid in patients with GI foreign body?

A

Acepromazine

Dexmedetomidine

24
Q

If the patient is very sick or septic what drugs should you avoid?

A

Acepromazine
Dexmedetomidine
Propofol
Etomidate

25
Q

What drugs should you use in a patient who is very sick or septic from GI foreign body?

A

Opioid and Benzos +/- ketamine or alfaxalone

26
Q

What techniques should you used with Patients having a Cholecystectomy?

A

Use MAC sparing techniques and vasopressors/inotropes

27
Q

What does GDV cause?

A

Decreased venous return

Pressure on diaphragm causing hypoventilation

28
Q

What do you do for GDV before induction?

A

Gastric trocharization

29
Q

What drugs should you avoid in GDV?

A

Etomidate

Propofol

30
Q

What is recommended for GDV monitoring?

A

Direct invasive BP monitoring

31
Q

How do you treat hypotension in GDV?

A

Turn down vaporizer
add injectables for MAC-sparing effects
FLuid bolus
Vasopressors/inotropes

32
Q

What are the factors that decide whether an equine colic is medical or surgical?

A

Ability to control pain pharmacologically
Amount of ongoing gastric reflux obtained through NGT
Abdominocentesis
Serum chemistry and CBC

33
Q

What is hyperlactatemia a sign of?

A

poor perfusion +/- GIT ischemia

34
Q

What is the volume of crystalloids needed before induction of an equine for Colic surgery?

A

10-20L

35
Q

All equine patients receiving inhalant anesthesia should have what as monitoring?

A

Direct Blood pressure

36
Q

What are the complications of Equine colic surgery?

A

Hypotension/ poor perfusion
Hypoxemia
Hypercapnia

RUSVM Anesthesiology 2016 (38 decks)

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