Flashcards in Quiz 11 - Lung Disease and Anesthetic Concerns Deck (21):
What are the classical triad of symptoms for asthma?
Preop history - what should you always ask about COPD history?
Smoking history (how long, when did you quit and have you ever smoked)
* Dyspnea - exercise tolerance, home O2 requirement, baseline SPO2 on RA
What other preop history would you like to know for COPD?
Admissions to hospital/ER
Prior Surg Hx
Preop studies for COPD
SpO2 on RA
CBC (may have elevated Hct)
PFT (FEV1 < 2 liters is not good)
Electrolytes (may have elevated bicarb)
What FEV1 and FEV1/FVC values would indicate high risk?
FEV1 < 2 Liters
FEV1/FVC < 0.5
What are some signs/symptoms of Chronic Bronchitis?
What are some causes of Chronic Bronchitis?
Smoking and occupational exposure
What are some common characteristics of a "Blue Bloater"?
Short, fat neck
Obese, OSA, Pickwickian syndrome
What are some signs and symptoms of Emphysema?
Progressive dyspnea (SOB)
Loss of pulmonary elastic recoil
What are some common characteristics of a "Pink Puffer"?
dyspnea, hyperinflation, distant breath sounds
Pursed lip breathing = auto PEEP
What are some causes of emphysema?
alpha-1 antitrypsin deficiency (auto digestion of lung tissue by proteases)
What is asthma?
-Bronchial wall INFLAMMATION
-Degrees of REVERSIBLE airflow dyspnea
What is the normal inspiration and expiratory ratio?
What is the inspiration and expiratory ratio for COPD?
What type of drugs should be avoided during broncho spasms?
-HISTAMINE releasing drugs:
Cessation of greater than _____ weeks will reduce post-op pulmonary complications.
Cessation of smoking 12 hours prior to surgery does what?
-Reduce Carbon Monoxide (COHb)
-Reduce nicotine levels
What does nicotine stimulate?
-Sympathetic ganglia - catecholamines released form adrenal medulla - increasing HR BP, and SVR.
How long will nicotine stimulation persist for?
-30 minutes after last cigarette
What should be done prior to intubation of a smoker?
-Avoid instrumentation of airwayuntil deep level of anesthesia