Term
| which class of murmurs should get an echo |
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Definition
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Term
| prophylaxis is recommended for endocarditis prevention under what circumstances? |
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Definition
| prosthetic cardiac valve, previous endocarditis, congenital heart disease, cardiac valvulpathy developing in a cardiac tx pt. |
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Term
| which class of patients should get an EKG |
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Definition
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Term
| which class of patients should continue their beta blockers preop |
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Definition
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Term
| what are the 5 steps in determining risks of CAD in the pre-operative patient |
|
Definition
1. urgency
2. cardiac conditions: HF?MI?Angina?
3. surgical risks
4. functional capacity. MET Score
5. frail patients |
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Term
| if a patient has a bare metal stent when can they be a possible canidate for surgery |
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Definition
| At least one month must pass before any further surgery |
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Term
| how many classes of heart failure are there? |
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Definition
| 4 classes. Class 1 is the least and Class 4 is the most severe. |
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Term
| if a patient has class IV heart failure can they proceed to surgery? |
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Definition
| No, need evaluation by cardiologist. If they are stable then can continue if not seroius case. |
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Term
| diastolic dysfunction can be found on EKG by looking for? |
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Definition
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Term
| what do you hear with aortic sclerosis |
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Definition
| there is a systolic ejection murmur similar to stenosis but does not compromise hemodynamics like stenosis. |
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Term
| a pressure gradient of ____ is mild aortic stenosis. While a pressure >___ is severe aortic stenosis |
|
Definition
Mild AS: 25 mm Hg
Moderate: 25-50 mm Hg
Severe AS: >50 mm Hg |
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Term
| If a patient has an AICD, what surgieris will you need to turn them off to avoid it firing off inappropriately |
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Definition
| Any cases involving above the umbilicus youd need to disable the AICD |
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Term
| elective surgery should be delayed if SBP > and DBP > ? |
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Definition
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Term
| the largest swing in someones blood pressure should not exceed ___ % |
|
Definition
| Keep BP within 15% of baseline |
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|
Term
| what age contributes to higher post op pulmonary complications |
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Definition
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Term
| Do Routine PFT, chest x ray, ABG predict postoperative pulmonary complication risk ? |
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Definition
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Term
| the three most common causes of acute dyspnea |
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Definition
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Term
| a h1aC of ___ or higher is consistent with increased risk for micro and macro vascular disease |
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Definition
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Term
| morbidly obese is > ???? BMI. Which makes the patient a ASA # __? |
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Definition
| BMI >40 = morbid obesity and that patient is a an ASA 3 risk class. |
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Term
| the mallampati score for a pregnant woman is? |
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Definition
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Term
|
Definition
| 24 hours prior to procedure |
|
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Term
| for insulin take or not take long acting? Take or not take intermediate acting? Take or not take short acting? |
|
Definition
Short acting: Stop
Intermediate acting: take 1/3 - 1/2 dose
Long acting: Take all. |
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Term
| non human milk you have to wait __ hours prior to surgery |
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Definition
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Term
| the three A's of anesthesia |
|
Definition
1. amnesia
2. analgesia
3. akinesia |
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|
Term
| eyelash reflex is lost in what stage |
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Definition
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|
Term
| breath holding is during what stage of aneshtesia |
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Definition
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|
Term
| onset of automatic respirations is what stage of anesthesia |
|
Definition
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|
Term
| laryngeal and corneal reflex is lost in what stage/plane |
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Definition
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|
Term
| Do you continue autoimmune meds? |
|
Definition
| No. D/C drops like methotrexate, entanercept, infliximab, adalimumab. |
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|
Term
| Would you continue Cox 2 inhibitos |
|
Definition
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|
Term
| Should continue ASA with vascular disease |
|
Definition
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|
Term
| Would you continue the full lantus dose? |
|
Definition
| Yes. Only decrease if lantus dose is > or equal to 1 unit/kg |
|
|
Term
| can light anesthesia cause increase intrathoracic pressure |
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Definition
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|
Term
| supine position is also known as |
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Definition
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|
Term
| to avoid torsion of the legs you should manipulate them how when getting a patient into a lithotomy position |
|
Definition
| move them together into stirups ect.. |
|
|
Term
| where should you take BP/Pulse oximetry readings in the lateral patient... dependent or non-dependent side? |
|
Definition
| on the dependent side so you can see a problem coming |
|
|
Term
| median and radial nerves are most commonly caused by? |
|
Definition
| axillary blocks or traumatic insertion of IV or infiltration of IVs |
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|
Term
| ventricular systolie occurs between what waves on the CVP |
|
Definition
| Ventricular systole starts at the C wave on the CVP which marks the closure of the tricupsid valve. It continues till the opening of the tricupsid valve which is the V wave on the CVP. |
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|
Term
| accuracy of pulse oximetery can be affected by all the following: |
|
Definition
1. low blood flow states
2. patient movement
3. ambient light
4. dysfunctional hb (carboxyheme, methemob)
5. methylene blue
6. shifts in oxy-heme curve |
|
|
Term
| what phase during capnography is alveolar exhalation |
|
Definition
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|
Term
| a BIS of _____ is indicative of a higher likelihood of awareness |
|
Definition
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|
Term
| best method to measure temp is? |
|
Definition
|
|
Term
| How many cartilages are in the larynx |
|
Definition
| 9x cartilages. Out of which there are 3x paired and 3 unpaired. |
|
|
Term
| What are the three unpaired cartilages of larynx |
|
Definition
1. thyroid
2. cricoid
3. epiglottis |
|
|
Term
| thyromental distance should be |
|
Definition
| equal to or greater 6cm (4 finger breadths) |
|
|
Term
| sniffing position aligns what axes for airway managmenet |
|
Definition
1. pharyngeal axis
2. laryngeal axis |
|
|
Term
| nasal cannula delivers what % of O2 |
|
Definition
|
|
Term
| what are two contraindications for a supraglottic airway device |
|
Definition
1. aspiration risk
2. if pt needs high pressure |
|
|
Term
| nasal intubation is contraindicated in what types of facial fx |
|
Definition
|
|
Term
| what is unique about the McCoy laryngeoscope |
|
Definition
| its tip can flex with a rod you pull in on the handle |
|
|
Term
| #1 complication from airway insertions |
|
Definition
| dental damage and lip contusions |
|
|
Term
| cylinders have unique hangar yoke assembly knownn as |
|
Definition
|
|
Term
| most common reason for a leak in the vaporizer is due to |
|
Definition
|
|
Term
| what breathing system has rebreathing? How do you know if you have enough flow |
|
Definition
| mapleson breathing circuits rebreath. Watch CO2. if it rises then increase gas flow |
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|
Term
| to prevent rebreathing onthe mapleson F you need to do what |
|
Definition
| Make sure Fresh gas flow is 2-3x the minute venitlation |
|
|
Term
| in a closed system the FGF will ___ patient's O2 consumption |
|
Definition
|
|
Term
| why is it better to have bellows that rise during expiration |
|
Definition
| b/c if there's a leak these bellows will not move and this will notify you theres a problem. |
|
|
Term
| OSHA reccomends less than ___ ppm of n20 and ___ ppm of volatile anesthetic |
|
Definition
<25 ppm N2O
<2 ppm of voltailes |
|
|
Term
| what do you know about lidocaine |
|
Definition
pka of 7.7, medium acting local, lung extraction occurs, max dose without epi is 4mg/kg, max dose with epi is 7 mg/kg.
-CNS Toxicity occurs with blood levels of 5-10mcg/mL.
-Methemeglobin is possible. |
|
|
Term
| what other local is nearly identical to lidocaine |
|
Definition
|
|
Term
| what local has the fastest onset? |
|
Definition
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