Exam 1 Reading (N.Ch20) Flashcards

CHAPTER 20

1
Q

Which of the following are characteristics of unstable angina?
Pain that began when?
Severity / duration?
Changes on ECG?

A

Bubsternal chest pain that began less than 2 months ago, has progressively increased in severity, duration, or frequency, is less responsive to pharmacologic therapy, occurs at rest, lasts longer than half an hour, or exhibits transient T-wave or ST segment changes.

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2
Q

Associated with cigarette smoking

A

carboxyhemoglobin in the blood, dysfunction of the mucociliary escalator, and an increase in elastase activity in the alveoli that leads to emphysema.

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3
Q

Sarcoidosis is a disorder of the

A

immune system.

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4
Q

What is the overall risk for a perioperative MI in the general population undergoing general anesthesia?

A

0.3%.

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5
Q

the best predictor of silent coronary artery disease in diabetic patients,

A

Autonomic neuropathy

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6
Q

A normal intercisor distance is

A

at least 4 cm.

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7
Q

MAC and a history of chronic alcohol abuse would result in

A

an increased inhalational anesthetic requirement

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8
Q

Alcoholic hepatic insufficiency and Albumin

A

Alcoholic hepatic insufficiency can lead to decreased albumin concentrations.

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9
Q

Which medication should be withheld the morning of surgery for all patients

A

Oral hypoglycemics

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10
Q

How long should a patient refrain from smoking before the ability of the lungs to respond to pulmonary infection returns to normal?

A

8 weeks

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11
Q

What improves significantly at about 8 weeks of smoking cessation?

A

Mucociliary and immune function

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12
Q

Airway management may be made even more difficult prior to that amount of time as there is an

A

increase in pulmonary secretions during the first month of smoking cessation.

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13
Q

Elective surgery should be cancelled in patients with chronic bronchitis if they exhibit (select two)

A

Elective surgery should be postponed in these patients if they exhibit severe dyspnea, wheezing, pulmonary congestion, or a PaCO2 greater than 50 mmHg.

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14
Q

Metabolic equivalents (METs) help identify the

A

quantity of cardiovascular exercise a patient can tolerate.

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15
Q

4 METs indicate what?

A

indicates good functional capacity.

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16
Q

Strenuous exercise, such as swimming or playing basketball, represents about

A

10 METs.

17
Q

Self-care and walking around the house represents____ MET.

A

1

18
Q

You explain to a patient who smokes cigarettes that in order to minimize the effects of carbon monoxide on oxygen-carrying capacity, he/she should refrain from smoking for at least

A

12-18 hours
The elimination half-life of carbon monoxide is about 4 to 6 hours which means that a smoke free interval of 12 to 18 hours results in marked decreases in carboxyhemoglobin levels and a corresponding increase in oxygen carrying capacity.

19
Q

Which of the following disorders would be most likely to exhibit evidence of its presence on chest x-ray?

A

COPD

20
Q

COPD shows those characteristics on XRAY

A

hyperlucency

bullae, and diaphragmatic flattening.

21
Q

A preoperative finding of nystagmus would be consistent with potential abuse of which drug?

A

Phencyclidine (PCP)

22
Q

Fentanyl abuse and pupils

A

Constricted

23
Q

Cocaine abuse and pupils

A

Midriasis

24
Q

During the perioperative evaluation, you discover that a patient with a pacemaker occasionally experiences dizziness while exercising his chest muscles. Based on this finding, which of the following would you avoid during his anesthetic?

A

Avoid succinylcholine
This indicates that myopotentials may be inhibiting the pacemaker. From this information, you know that muscle fasciculations from succinylcholine should be avoided to prevent inadvertent pacemaker inhibition.

25
Q

How long after a myocardial infarction is the risk for reinfarction the greatest?

A

one month ; 30 days; The mortality rate with reinfarction is 50%. Because of these statistics, it is recommended that no patient undergo elective surgery until at least 60 days after the MI.

26
Q

hich herbal medication lowers blood glucose and has the potential to increase bleeding?

A

Ginseng lowers blood glucose and has the potential to increase bleeding.

27
Q

Which of the following findings would warrant postponement of an elective procedure for further diagnostic evaluation?

A

Symptomatic mitral stenosis
mitral stenosis, new onset ventricular tachycardia, symptomatic ventricular arrhythmias, unstable angina, MI within the past 30 days, severe aortic stenosis, symptomatic bradycardia, and high-grade heart block.