Week 12 Handout-Flipped 3 - part 3

Question 1

What is thromboelastography (TEG)?

Answer 1

A visual representation of clot formation, strength, and fibrinolysis in real-time.

Question 2

What does TEG evaluate compared to standard tests?

Answer 2

TEG evaluates the interaction of all components including platelets, fibrinogen, and clot stability.

Question 3

What is the clinical purpose of TEG?

Answer 3

To guide patient-specific treatment decisions and coagulation therapy.

Question 4

How does TEG help in transfusion therapy?

Answer 4

Reduces unnecessary blood product transfusions.

Question 5

What is the normal range for R TIME in TEG?

Answer 5

4 to 8 minutes.

Question 6

What does K TIME measure in TEG?

Answer 6

Time until clot has achieved fixed strength.

Question 7

What is the normal range for K TIME?

Answer 7

1 to 4 minutes.

Question 8

What does A-ANGLE indicate in TEG?

Answer 8

Speed of fibrin accumulation.

Question 9

What is the normal range for A-ANGLE?

Answer 9

53 to 72 degrees.

Question 10

What does MAXIMUM AMPLITUDE (MA) measure?

Answer 10

Clot strength (platelet specific).

Question 11

What is the normal range for MAXIMUM AMPLITUDE (MA)?

Answer 11

50-70 mm.

Question 12

What does LYSIS AT 30 MINUTES (LY30) measure?

Answer 12

Percentage decrease in clot strength after 30 minutes.

Question 13

What is the normal range for LYSIS AT 30 MINUTES (LY30)?

Answer 13

0 to 8%.

Question 14

What are possible TEG findings in trauma patients?

Answer 14

• Prolonged R time * Prolonged K time * Low MA * Elevated LY30.

Question 15

What management strategies might be used for prolonged R time?

Answer 15

FFP (fresh frozen plasma).

Question 16

What is the focus of Phase 1 resuscitation in trauma?

Answer 16

Early and aggressive use of hemostatic products in combination with RBCs.

Question 17

What does TEG help differentiate in cardiac surgery?

Answer 17

Bleeding resulting from surgical causes versus CPB induced coagulopathies.

Question 18

What is a typical TEG finding in obstetrics?

Answer 18

Decrease in R and K values, increase in the α angle and MA, decrease in LY30.

Question 19

What is a major risk associated with postpartum uterine atony?

Answer 19

It is the leading cause of maternal death worldwide.

Question 20

What does TEG indicate in liver disease management?

Answer 20

It estimates bleeding risk more accurately than standard tests.

Question 21

What are possible TEG findings in liver transplantation?

Answer 21

• Preanhepatic: Near normal results * Anhepatic: Increased fibrinolysis * Neohepatic: Severe fibrinolysis after reperfusion.

Question 22

What are some risks and limitations of TEG?

Answer 22

• Device variability * Lack of specificity * Costly * Delay in treatment.

Question 23

What is the normal range for Alpha Angle?

Answer 23

47-74 degrees.

Question 24

What does a prolonged R time indicate?

Answer 24

Hypocoagulability (delayed clot formation).

Question 25

What does a low MA indicate?

Answer 25

Hypocoagulability (platelet dysfunction or deficiency).

Question 26

What does a LY30 above normal indicate?

Answer 26

Hyperfibrinolysis (excessive breakdown, risk of hemorrhage).

Question 27

What is the title of the book authored by R. and Holt?

Answer 27

Clinical anesthesia (8th ed.)

Question 28

Who are the authors of 'Chestnut's obstetric anesthesia: Principles and practice'?

Answer 28

Chesnut, D. H., Wong, C. A., Tsen, L. C., Ngan Kee, W. D., Beilin, Y., Mhyre, J. M., Bateman, B. T., & Nathan, N.

Question 29

What edition of 'Miller's anesthesia' was published in 2020?

Answer 29

9th ed., Vols. 1–2

Question 30

What is the name of the hemostasis analyzer system mentioned?

Answer 30

TEG® 5000 hemostasis analyzer system

Question 31

In what year was the user manual for TEG® 5000 published?

Answer 31

2007

Question 32

What is the title of the book by Nagelhout, Elisha, & Heiner?

Answer 32

Nurse Anesthesia (7th ed.)

Question 33

Fill in the blank: The user manual for TEG® 5000 was published by _______.

Answer 33

Haemoscope Corporation

Question 34

True or False: 'Chestnut's obstetric anesthesia' is in its 5th edition.

Answer 34

False

Question 35

Who are the editors of 'Miller's anesthesia'?

Answer 35

Gropper, M. A., Eriksson, L. I., Fleisher, L. A., Wiener-Kronish, J. P., Cohen, N. H., & Leslie, K.

Question 36

What is a 12 lead EKG?

Answer 36

A diagnostic tool that records electrical activity of the heart from 12 different perspectives.

Question 37

What are the benefits of using a 12 lead EKG?

Answer 37

* Rapid * Non-invasive * Ease of use

Question 38

In what situations is a 12 lead EKG used?

Answer 38

* Suspected heart disease * Preoperative cardiac screening * Electrolyte imbalance assessment * Monitoring cardiac medication effects * Identify arrhythmias * Detect myocardial ischemia or infarction * Assess conduction defects * Evaluate electrolyte imbalances

Question 39

What are common arrhythmias identified by a 12 lead EKG?

Answer 39

* A-fib * V-tach * Heart blocks

Question 40

What are the limitations of EKG interpretation?

Answer 40

* Poor electrode placement * Artifact from movement * Non-MI cause of abnormal readings

Question 41

What is the first step in EKG interpretation?

Answer 41

Determine the rate.

Question 42

What should be assessed in the QRS complex during EKG interpretation?

Answer 42

Assess QRS duration.

Question 43

What is the significance of chest leads V3-V5?

Answer 43

They are most sensitive for detecting ischemia.

Question 44

What are the normal cardiac axis ranges?

Answer 44

Normal Axis: -30° to +90°

Question 45

What is Left Axis Deviation (LAD)?

Answer 45

More negative than -30°.

Question 46

What is Right Axis Deviation (RAD)?

Answer 46

More positive than +90°.

Question 47

What characterizes a normal EKG?

Answer 47

* P waves before each QRS * PR interval 0.12-0.20 sec * QRS duration < 0.12 sec * ST segment is isoelectric

Question 48

What is a characteristic of ST elevation on an EKG?

Answer 48

Indicates STEMI.

Question 49

What indicates NSTEMI on an EKG?

Answer 49

ST depression and/or T wave inversion.

Question 50

What are the inferior leads in a 12 lead EKG?

Answer 50

II, III, aVF.

Question 51

What are the lateral leads in a 12 lead EKG?

Answer 51

I, aVL, V5, V6.

Question 52

What are the anterior leads in a 12 lead EKG?

Answer 52

V3, V4.

Question 53

What are the septal leads in a 12 lead EKG?

Answer 53

V1, V2.

Question 54

What is coronary steal?

Answer 54

A phenomenon where blood flow is diverted away from ischemic tissue.

Question 55

Do volatile anesthetics have cardiac effects?

Answer 55

Yes, they can affect cardiac function.

Question 56

What is the PR interval range in a normal EKG?

Answer 56

0.12-0.20 seconds.

Question 57

Fill in the blank: The EKG leads V3-V5 are most sensitive for detecting _______.

Answer 57

ischemia

Question 58

True or False: The EKG is predictive of perioperative major cardiac events.

Answer 58

False