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Advanced Anesthesia 2 > Anesthesia for Therapeutic & Diagnostic Procedures - Quiz 3 > Flashcards

Anesthesia for Therapeutic & Diagnostic Procedures - Quiz 3 Flashcards

1
Q

How does JACAHO define Anesthesia?

A

IV, IM, or Inhaled Meds that cause loss of Protective Reflexes

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2
Q

What are the Drugs of Choice for Anesthesia at the Office (ENT or Dental)

A

Propofol

Sevo

Des

N2O

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3
Q

What is required by the ASA & JCAHO for Office Anesthesia?

A

Maintained Anesthesia Equipment

Documentation

Monitoring & Emergency Equipment

Staffed PACU

Plan for Emergency Transport

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4
Q

How should patients who are at risk for adverse reactions to Contrast be pretreated?

A

Prednisone 50mg 12 Hours Before

&

Benadryl 50mg right before

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5
Q

What can be given to reduce the risk of Nephrotoxicity from Contrast?

A

Acetylcysteine

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6
Q

What can develop in Type 2 Diabetic Renal Patients on Metformin who receives Contrast?

A

Severe Lactic Acidosis

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7
Q

Why is Deliberate HYPERtension needed for Cerebral Ischemia?

A

Maximizes Collateral Flow

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8
Q

Why should Emergence be Smooth for Interventional Radiology Procedures?

A

To avoid Device Migration & Intracranial Hemorrhage

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9
Q

What should the ACTs be for Cerebral Coiling?

A

2 - 2.5X above normal

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10
Q

What degree of Coronary Stenosis is considered hemodynamically significant?

A

50 - 70%

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11
Q

What can happen after a Stenotic Coronary Artery is Dilated?

A

Ventricular Arrhythmias

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12
Q

What are the adverse effects of Protamine?

A

Vasodilation

Anaphylaxis

Pulmonary Vasoconstriction

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13
Q

What is an important side effect of Abciximab?

A

Increased ACT without Heparin

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14
Q

Which drugs are Platelet Aggregation Inhibitors?

A

Abciximab

Ticlopidine

Clopidogrel

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15
Q

What can the use of Glucagon cause when used during an ERCP?

A

Tachycardia

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16
Q

What meds should be avoided during Sphincter of Oddi Manometry due to their effect on sphincter tone?

A

Opioids

Glycopyrrolate

Atropine

Glucagon

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17
Q

What is the purpose of a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure?

A

Decompresses Portal Circulation by connecting the right or left portal vein to one of three hepatic veins

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18
Q

TIPS procedure is normally performed under _______

A

TIPS procedure is normally performed under GENERAL ANESTHESIA

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19
Q

What is Electroconvulsive Therapy used for?

A

Depression

Mania

Schizophrenia

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20
Q

How often is Electroconvulsive Therapy performed to treat mental disorders?

A

3x per week for for 6-12 treatments

then weekly or monthly treatments

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21
Q

How does Electroconvulsive Therapy work?

A

Release Neurotransmitters during Grand Mal Seizure

↑Stress Hormones

↑NorEpi & Epi

Improved Glucose Control for DM2

Hyperglycemia for DM1

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22
Q

Which hormones are increased following Electroconvulsive Therapy?

A

ACTH

Cortisol

Vasopressin

Prolactin

Growth Hormone

23
Q

Electroconvulsive Therapy _______ Cerebral Blood Flow & Intracranial Pressure

A

Electroconvulsive Therapy INCREASES Cerebral Blood Flow & Intracranial Pressure

24
Q

How is the Heart affected by Electroconvulsive Therapy?

A

Bradycardia, then HTN & Tachycardia

Dysrhythmias

Myocardial Ischemia

25
Q

What are the physical effects of Electroconvulsive Therapy?

A

Short Term Memory Loss

Muscle Aches

Fractures

Seizures

Sudden Death

26
Q

What is an absolute contradication to Electroconvulsive Therapy?

A

Pheochromocytoma

27
Q

What are some relative contraindications to Electroconvulsive Therapy?

A

↑ICP

Recent CVA

Heart Conduction Problems

High Risk Preggos

Aortic/Cerebral Aneurysms

28
Q

Which muscle relaxant is preferred for Electroconvulsive Therapy?

A

Succinylcholine 0.75 - 1.5 mg/kg

29
Q

What are some EKG changes related to Electroconvulsive Therapy?

A

PACs

PVCs

ST Depression

T-Wave Inversion

30
Q

What are the most common cause of death related to Electroconvulsive Therapy?

A

MI & Arrhythmia

31
Q

The goal of Electroconvulsive Therapy is a seizure that lasts _______

A

The goal of Electroconvulsive Therapy is a seizure that lasts 30-60 SECONDS

32
Q

During Electroconvulsive Therapy, there will be Bradycardia, then HTN & Tachycardia. How should this be treated?

A

Esmolol

33
Q

What are the anesthetic considerations for patients with Down Syndrome?

A

Abnormal Cardiac Conduction

A-O Dislocation

Macroglossia

Hypoplastic Maxilla

Abnormal Palate

Mandibular Protrusion

34
Q

What are the Ketamine doses for Dental Procedures?

A

Ketamine

1-2 mg/kg IV

5-10 mg/kg Oral

2-4 mg/kg IM

35
Q

What anesthetics are usually used for Dental Procedures?

A

Ketamine

Oral Versed

EMLA Cream for IV

36
Q

What are the Airway Consideration for Dental Procedures?

A

Nasal Tracheal Intubation

LMA

Post-Op Bleeding, Obstruction, and Larygospasm

37
Q

What is considered Minimal Sedation or Anxiolysis?

A

Patient can respond to Verbal Commands

&

Preserved Airway, Ventilatory, and CV Reflexes

38
Q

What is considered Moderate or Conscious Sedation?

A

Patient responds to Verbal Commands WITH Light Tactile Stimulation

Patent Airway

Preserved Spont. Ventilation & CV Function

39
Q

What is considered Deep Sedation?

A

Patient responds to repeated PAINFUL stimuli

Impaired Ventilation & Airway

Preserved CV Function

40
Q

What is considered General Anesthesia?

A

Patient NOT arousable

Impaired Ventilation, Airway, and CV Function

41
Q

What is a Ramsay Scale of 1?

A

Patient Anxious, Agitated, or Restless

42
Q

What is a Ramsay Scale of 2?

A

Patient Cooperative, Oriented, and Calm

43
Q

What is a Ramsay Scale of 3?

A

Patient responds to commands only

44
Q

What is a Ramsay Scale of 4?

A

BRISK response to Light Glabellar Tap or Auditory Stimuli

45
Q

What is a Ramsay Scale of 5?

A

SLOW response to Glabellar Tap or Auditory Stimuli

46
Q

What is a Ramsay Score of 6?

A

No Response Glabellar Tap or Auditory Stimuli

47
Q

What is the Adult Fasting Protocol for Solids & Non-Clear Liquids?

A

6-8 Hrs

or

NPO after Midnight

48
Q

What is the >3 y.o Child Fasting Protocol for Solids & Non-Clear Liquids?

A

6 - 8 Hours

49
Q

What is the Fasting Protocol for Solids & Non-Clear Liquids for Kids 6-36 months?

A

6 Hours

50
Q

What is the Fasting Protocol for Solids & Non-Clear Liquids for Kids < 6 months?

A

4 - 6 hrs

51
Q

What is the Fasting Protocol for Clear Liquids?

A

2 Hours for Kids < 6 months

&

2-4 Hours for everyone else

52
Q

For Recovery, the patient must have V/S every 10 minutes x 3, then every hour x two

OR

until they have an Aldrete score of at least ______

A

For Recovery, the patient must have V/S every 10 minutes x 3, then every hour x two

OR

until they have an Aldrete score of at least 9

53
Q

What’s the minimum time a patient is to be observed post procedure?

A

30 min

&

1 Hour if Resuscitive measures were needed

Advanced Anesthesia 2 (8 decks)

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