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Basics of Anesthesia II > Week 10 Quiz (Greg Study Guide) > Flashcards

Week 10 Quiz (Greg Study Guide) Flashcards

1
Q

How does obesity affect respiratory function?

A

compression of fat on structures, kyphosis/lordosis, impaired rib movement, decreased lung compliance, increased metabolic demand, CO2 retention, CC>FRC, OSA, impaired gas exchange

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2
Q

What is Pickwickian syndrome?

A

obesity hypoventilation syndrome- characterized by OSA, hypercapnia, daytime hypersomnolence, hypoxemia, cyanosis-induced polycythemia, respiratory acidosis, pulmonary hypertension, and R sided heart failure

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3
Q

What are some considerations when intubating an obese patient with OSA?

A

conservative sedation (may use dexmedetomidine), extensive airway assessment, STOP BANG, regional when able, use ramp, CPAP during preoxygenation, use short acting agents, have another provider available

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4
Q

What are some considerations when preparing to extubate an obese patient with OSA?

A

use CPAP, avoid opiates, anticipate longer monitoring in PACU

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5
Q

What is non-alcoholic fatty liver disease?

A

excess of intrahepatic triglycerides, impaired insulin activity, and release of inflammatory cytokines as a result of obesity–> leads to destruction of hepatocytes and disruption of hepatic physiology

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6
Q

Patients with nonalcoholic fatty liver disease are at increased risk for?

A

cardiovascular disease and diabetes, cirrhosis

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7
Q

What is the concern in those with OHS/Pickwickian syndrome?

A

even light sedation can cause complete airway collapse/respiratory arrest

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8
Q

What endocrine disorder is characterized by insulin deficiency, young onset, autoimmune, and destruction of beta cells?

A

Type 1 diabetes

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9
Q

what endocrine disorder is characterized by relative insulin deficiency, insulin resistance, impaired insulin secretion, and excessive hepatic glucose production?

A

Type 2 diabetes

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10
Q

What endocrine condition is characterized by rapid onset, ketosis, hypoveolemia, and is precipitated by acute illness and stress?

A

DKA

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11
Q

How is HHS different than DKA?

A

no ketosis, more often with T2DM, slower onset

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12
Q

What endocrine disorder is characterized by abdominal pain and distention, N/V, fever, dehydration, hypotension, hypocalcemia, renal failure and pleural effusion?

A

acute pancreatitis

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13
Q

What are some causes of acute pancreatitis?

A

GB disease, ETOH, trauma, elevated lipids and calcium, infection, drugs, ERCP, abdominal and cardiac surgery

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14
Q

What endocrine disorder is characterized by steatorrhea, pancreatic calcifications, and DM?

A

chronic pancreatitis

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15
Q

What are some causes of chronic pancreatitis?

A

chronic ETOH use, chronic biliary tract disease, pancreatic injury

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16
Q

What endocrine disorder is characterized by vague symptoms such as pain, anorexia, weight loss, fatigue, and biliary tract obstruction?

A

pancreatic tumors

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17
Q

What are some characteristics of insulinomas?

A

tumor of beta cells, causes increased insulin secretion and hypoglycemia

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18
Q

What are some characteristics of gastrinoma (Zollinger-Ellison syndrome)?

A

causes hypersecretion of gastrin and gastric ulcer disease

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19
Q

What endocrine disease did JFK have?

A

Addison’s

20
Q

What is DI?

A

neurogenic- inadequate secretion of ADH from posterior pituitary

nephrogenic- resistance to ADH in renal tubules

21
Q

What are symptoms of DI?

A

polydipsia, hypernatremia, high output of poorly concentrated urine, hypovolemia

22
Q

What are some causes of DI?

A

intracranial trauma, infiltrating lesions, surgery, damage to kidney

23
Q

What is SIADH? What are the symptoms?

A

excessive ADH; dilutional hyponatremia, decreased serum osmolality, decreased uo with high osmolality

24
Q

What are some etiologies of hyperthyroidism?

A

Graves disease (most common- overproduction of TH), benign follicular adenomas, thyrotoxicosis (usually iatrogenic from excessive iodine)

25
Q

What are some etiologies of hypothyroidism?

A

primary hypothyroidism, autoimmune (Hashimoto’s), secondary hypothyroidism (pituitary or hypothalamic disorder)

26
Q

What is Graves characterized by?

A

diffuse glandular enlargement, exopthalmos, skin disorders, clubbed fingers

27
Q

What is the difference between a “hot” and “cold” thyroid adenoma?

A

hot- produces excessive TH

cold- does not

28
Q

What are some less common causes of hyperthyroidism?

A

pregnancy, iodine therapy, TSH secreting pituitary adenomas, TH replacement, iodide exposure (radiocontrast dye), amiodarone

29
Q

What are s/s of hyperthyroidism?

A

hypermetabolic state, tachycardia, weight loss, tremors, difficulty sleeping, fatigue, muscle weakness, heat intolerance, exopthalmos, goiter

30
Q

What is thyroid storm?

A

acute stress in hyperthyroidism- causes tachycardia, hyperthermia, hypercarbia, HTN, dysrythmias, CHF, sweating, agitation (can be confused with MH)

31
Q

What are s/s of hypothyroidism?

A

weakness, fatigue, weight gain, puffy appearance (myxedema), dry skin, cold intolerance, coarse brittle hair and nails, slow mental function, loss of lateral 1/3 of eyebrows

32
Q

What are CV effects of hypothyroidism?

A

vasoconstriction, hypertension, bradycardia, dysrhythmias, cardiomegaly, CHF, labile BP

33
Q

What are patients with hypothyroidism at risk for?

A

effusions of pleura, pericardium, and peritoneum

34
Q

What is myxedema coma?

A

end stage of severe hypothyroidism, hypothermia, hypoventilation, hyponatremia–> coma

35
Q

What is hypoparathyroidism and what is it caused by?

A

inadequate secretion of PTH or resistance to its effect (parathyroidectomy, gland injury, chronic Mg deficiency)

36
Q

What are some s/s of hypoparathyroidism?

A

restlessness, Chvostek’s and Trousseau sign, stridor (laryngospasm)

37
Q

Hypoparathyroidism may be a transient effect after?

A

renal transplant

38
Q

What is the most common cause of chronic hypoparathyroidism? What are s/s?

A

chronic renal failure; fatigue, cramps, prolonged QT, lethargic, cataracts, personality changes, skull thickening, candida infections, impaired clotting

39
Q

, What is primary hyperparathyroidism caused by? What are the s/s?

A

adenoma, hyperplasia, cancer; bone demineralization, increased alk phos, pancreatitis, kidney stones, HTN, dysrhythmias, ulcers, lethargy, confusion, N/V, hyperchloremic metabolic acidosis, polyria, renal stones

40
Q

What does the anterior pituitary secrete?

A

FSH, LH, ACTH, GH, TSH, M(o)SH, prolactin (“FLAT PeG”)

41
Q

What does the posterior pituitary secrete?

A

ADH and oxytocin

42
Q

What can a deficiency in growth hormone cause?

A

dwarfism

43
Q

What can an excess in growth hormone cause?

A

acromegaly, gigantism (before puberty)

44
Q

What is primary aldosteronism (Conn’s syndrome)?

A

mineralcorticoid (aldosterone) excess from hyperplasia or carcinoma; characterized by HTN and hypokalemia

45
Q

What is Cushing’s disease?

A

glucocorticoid (cortisol) excess from overproduction by adrenal cortex or exogenous administration; results in muscle atrophy, central obesity, moon face, striae, weakness

46
Q

What is Addison’s disease?

A

primary adrenocortical insufficiency due to destruction of adrenal glands- characterized by wasting, hyperpigmentation, fagitue, weight loss, hypoglycemia, hyponatremia

Basics of Anesthesia II (9 decks)

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