Bariatric

Question 1

Overweight BMI

Answer 1

25-29.9

Question 2

BMI forumula

Answer 2

weight (kg)/height (m^2)

Question 3

Ideal body weight formula

Answer 3

2.54 cm per inch

height in cm - 100 (men)

height in cm - 105 (women)

Question 4

Men IBW formula

Answer 4

Height (cm) - 100

Question 5

Women IBW formula

Answer 5

Height (cm)-105

Question 6

Calculate the BMI of 440 lb pt that is 5ft 2 inches

Answer 6

81 bmi

Question 7

hyperinsulinemia pathophys r/t HTN

Answer 7

activates SNS–>Na+ retention–>50-60% increase in incidence of HTN

Question 8

obesity increases risk of HTN by

Answer 8

50-60%

Question 9

Closing capacity formula

Answer 9

closing volume + residual volume

relationship at which small airways begin to close

Question 10

closing volume is

Answer 10

the amount of air in the lungs at which the flow from lower sections of the lungs becomes severely reduced or halts

Question 11

FRC

Answer 11

reduced due to decreased ERV (FRC = RV +ERV)

Question 12

ERV

Answer 12

reduced

Question 13

vital capacity

Answer 13

decreased

Question 14

total lung capacity

Answer 14

decreased

Question 15

Decreased FRC is related to

Answer 15

the relationship at which small airways begin to close

Question 16

Most sensitive indicator of the effect of obesity on pulmonary function

Answer 16

ERV

Question 17

GA causes FRC to fall by (obesity)

Answer 17

50%

(20% normally)

Question 18

chronic hypoxemia can lead to (3)

Answer 18

polycythemia
pulmonary HTN
Core pulmanole

Question 19

Obesity hypoventilation syndrome aka

Answer 19

pickwickian

Question 20

pickwickian/OHS and resp depressant effeects of anesthesia

Answer 20

increase

Question 21

RV failure can occur from

Answer 21

hypoxic pulmonary vasoconstriction

Question 22

Hypopnea

Answer 22

50% reduction in airflow with 4% fall in SaO2–>requires sleep study

Question 23

Gold standard for OSA diagnosis

Answer 23

Overnight polysomnography (OPS)

Question 24

Clues to OSA (3)

Answer 24

1. BMI >35
2. neck circumfrence >16

hyperinsulinemia
elevated glycosylated hemoglobin

Question 25

STOP BANG

Answer 25

Snoring Tiredness Observed stop breathing Pressure BMI >35 Age Neck circum >40 Gender male >3 questions yes = high risk for OSA

Question 26

hypertrophy in obesity

Answer 26

Eccentric

Question 27

ECG changes

Answer 27

-.Low QRS voltage -LVH criteria -left atrial enlargement -t wave flattening inferior and lateral leads -prolonged QT interval

Question 28

Portal triad clamping - mechanism and why

Answer 28

TO reduce blood loss hepatic artery portal vein Common bile duct

Question 29

WIth previou bariatric surgery, what happens with mebranes

Answer 29

premature rupture of membranes (pregnancy)

Question 30

Lean body weight on induction

Answer 30

Propofol Roc Vec Remifent

Question 31

Lean body weight maintancance

Answer 31

Roc Vec Remifent Sufent fent

Question 32

total body water obesity

Answer 32

decreased

Question 33

IV drug delivery obesity

Answer 33

higher CO-->shorter drug circulation time and faster delivery to site of action

Question 34

good predictors of difficult intubation

Answer 34

BMI with Mallampati >3 with a large neck circumference* and history OSA

Question 35

Cricoid pressure position

Answer 35

Below thyroid cartiladge, above cricoid cartiladge

Question 36

FiO2

Answer 36

preoxygenate 100% for 3-5 min intraop: 50%-80%

Question 37

PEEP

Answer 37

10-12

Question 38

TV

Answer 38

6-8 mL/kg iBW

Question 39

PaCO2 intraop

Answer 39

40-45 (permissive hypercapnia OK)

Question 40

only parameter that has consistently shown improved rspiraty funciton is

Answer 40

PEEP! up to 10 cm H2O

Question 41

Fluids should be calculated by

Answer 41

lean body weight ideal body weight x 1.3

Question 42

Least invasive bariatric procedsure

Answer 42

restrictive (laprascopic sleeve gastrectomy or gastric. band)

Question 43

Most common cause of surgical related mortality in obese patients

Answer 43

Anastomotic leak

Question 44

Top 3 symptoms of anastomotic leak

Answer 44

1. tachycardia 2. fever 3. abdominal/pelvic pain also SOB, restlessness, L soulder pain, increased thirst, hypotension