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NA 1 > Exam 4 > Flashcards

Exam 4 Flashcards

(65 cards)

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1
Q

what is chronological age

A

age since birth

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2
Q

what is biologic age

A

functional status

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3
Q

BP in elderly

A

increase in afterload –> leads to ventricular hypertrophy
Diastolic dysfunction

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4
Q

Catecholamine changes in elderly

A

increase in circulating catecholamines with decreased end organ responsiveness
Leads to reduced capacity to increase HR in response to hypotension, hypovolemia, hypoxia

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5
Q

Onset of IV drugs in elderly

A

delayed

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6
Q

elderly effects on breathing

A

decrease in chest wall compliance
loss of elastic recoil of lungs
increase in lung compliance

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7
Q

What lung volumes are decreased in elderly

A

Vital capacity
inspiratory reserve
Expiratory reserve

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8
Q

what lung volumes are increased in elderly

A

residual volume
functional residual capacity

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9
Q

in elderly is total lung capacity changed

A

NO
due to increase in residual volume and decrease in vital capacity

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10
Q

how is regulation of breathing affected with aging

A

decreased response to hypoxemia and hypercarbia

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11
Q

elderly response to CNS depressants

A

exaggerated response

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12
Q

postop delirium vs cognitive dysfunction

A

delirium appears soon after surgery
cognitive dysfunction appears weeks to months after

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13
Q

CV changes for obesity

A

increase in CO .1L/min per kg of fat
increase in O2 consumption
increase in CO2 production
LV hypertrophy

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14
Q

EKG changes for obesity

A

low voltage EKG
QT prolongation
Ischemia
Dysrhythmias

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15
Q

what is Pickwickian Syndrome

A

obesity hypoventilation syndrome - long term consequence of respiratory center in medulla failing to respond to hypercarbia

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16
Q

how is Pickwickian syndrome defined

A

BMI >30
Daytime PCO2>45
sleep disordered breathing in absence of other causes of hypoventilation

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17
Q

in obese patients how is volume of distribution altered

A

increased blood volume
increased CO
altered plasma binding
lipid solubility is altered

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18
Q

how are lipophilic drugs dosed

A

dosed on LBW (IBW x 1.3)

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19
Q

Loading and Maintenance dose type for Prop

A

Loading: LBW
Maintenance: TBW

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20
Q

Loading and Maintenance dose type for Roc

A

Loading: LBW
Maintenance: LBW

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21
Q

Loading and Maintenance dose type for Fentanyl

A

Loading: TBW
Maintenance: LBW

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22
Q

Loading dose type for Succs

A

Loading: TBW

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23
Q

what is Ma Huang

A

natural source of ephedrine

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24
Q

what is phentermine

A

norepi reuptake inhibitor

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25
what is sibutramine
norepi reuptake inhibitor
26
what % of surgeries are outside of OR
55%
27
Position 1 of ICD
shock chambers
28
Position 2 of ICD
anti-tachy pacing
29
Position 3 of ICD
tachycardia detection
30
Position 4 of ICD
anti-bradycardia pacing
31
doses for ECT
lower than normal
32
why are anticholinergics given during ECT
reduce secretions, reduce risk of bradycardia
33
methohexital dose for ECT
.5 - 1mg/kg IV
34
what are absolute contraindications to ECT
pheo Recent Mi recent CVA recent intracranial hemorrhage intracranial mass unstable cervical spine
35
lithium effects on anesthetics
prolongs effects of succs and NDMRs
36
MAOIs effect on anesthetic plan
MAOI prevent breakdown of catecholamines, at risk of hypertensive crisis
37
CV effects of pneumoperitoneum
increase in MAP, SVR, and HR possible bradycardia on initial insufflation
38
Respiratory effects of pneumoperitoneum
increase in ETCO2 diaphragm is shifted cephalad (decreases FVC, and FRC)
39
signs of gas embolism
decrease of loss of ETCO2 hypotension hypoxia dysrhythmias mill-wheel murmur
40
best way to diagnose gas embolism
TEE
41
treatment for gas embolism
stop CO2 flood field with NS place patient in left lateral aspirate gas through CVC hydrate patient
42
most common post op problem with laparoscopic surgery
PONV
43
benefit of robotic surgery
shorter hospital stay
44
position commonly used in robotic surgery
steep trendelenberg
45
common position for GYN surgery
lithotomy
46
what neuraxial level is needed for GYN surg
T10
47
what response may occur with cervical dilation
vasovagal
48
difference in induction for ectopic pregnancy
needs RSI
49
what is TURP syndrome
hypo-osmolar state due to water intoxiction
50
TURP syndrome signs
hypertension bradycardia arrhythmia PE hypoxia CHF confusion coma visual disturbance
51
treatment of TURP syndrome
supportive care treat hyponatremia slowly
52
1L of fluid into circulation in 1 hour during TURP effects NA+ how much
can decrease sodium 5-8 mEq/L
53
sodium <120 sodium <115 sodium <110
<120 = CNS <115 = EKG changes <110 = VT/VF
54
preferred paralytic in kidney transplant
Nimbex roc needs partial renal elimination and succs can raise K+
55
what is the leading cause of disability in the US
arthritis
56
what structures are affected by OA
all structures of joint capsule cartilage, subchondral bone, synovium
57
what CV effect is seen in ankylosing spondylitis
aortic regurg and conduction defects
58
anesthetic management for AS
have glidescope and fiberoptic ready
59
signs of BCIS
abrupt decrease in ETCO2 dyspnea
60
treatment for BCIS
100% FiO2 fluids phenylephrin
61
what is a potential problem of interscalene block
phrenic nerve block
62
what is Horner's syndrome
miosis, ipsilateral ptosis, and anhidrosis from interscalene block
63
what is oculocardiac reflex
vasovagal stimulation from traction on extraocular muscles
64
normal IOP
16 +/- 6
65
what medication increases IOP
succs

NA 1 (4 decks)

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