Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > 1. Patient Evaluation > Flashcards

1. Patient Evaluation Flashcards

1
Q

Patient history consists of

A 
ID 
Chief complaint
History of present illness 
Past medical Hx 
Ongoing medical care 
Past surgical Hx 
Family Hx 
Social Hx 
ROS (Review of systems) 
Meds
Allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F Want to avoid oral surgery in patients receiving radiation to head/neck? Why or why not?

A

yes because risk of osteoradionecrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What drugs trigger malignant hyperthermia

A

Anesthesia gases: Halothane, Enflurane, Isoflurane, Sevoflurane, Desflurane.
Muscle relaxants: Succinylcholine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F Family history of malignant hyperthermia is irrelevant

A

f- More likely to have it when it runs in the family so avoid muscle relaxants and anesthesia gases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why is knowing someones social history (tobacco and alcohol use) important?

A

Because it tells you if they will have delayed healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does HEENT stand for

A

Head, eye, ear, nose and throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are symptoms of reflux/heartburn intraorally

A

lingual erosion of teeth

burning tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the vitals of a person experiencing a thyroid storm

A

Sporadic vitals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

syncope describes an issue with what system in the body

A

neurologic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 6 vital signs

A
  • Temperature
  • BP
  • Pulse
  • Respiration
  • Height
  • Weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the acronym OBESE used to determine and what does it mean

A

-Predictive of difficulty with mask ventilation
O= Obesity (also difficult instrumentation and oxygenation)
B=Beard- Poor seal on mask
E=Elderly
S=Snorer
E=Edentulous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Skin elasticity (increases/decreases) with age

A

decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The thyromental height is measured from

A

the thyroid cartilage to the most anterior aspect of the chin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the thyromental height tell us about the patient

A
  • <50 mm associated with difficulty in airway instrumentation
  • Dentofacial/craniofacial abnormalities (i.e retrognathia of mandible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What other measurement can indicate issues with difficult airway instrumentation

A

<30 mm interincisal opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Child airway is more (anterior/posterior) relative to adult airway

A

anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Objects get lodged in (adult/child) airway easier

A

child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the narrowest part of the child airway

A

cricoid cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F Infants are obligate nose breathers

A

t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Larynx is more _ and _ in location relative to child larynx

A

Inferior and posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Epiglottis is bigger and floppier in (child/adult) airway

A

child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Trachea is (more/less) rigid in child compared to adult

A

less

23
Q

Describe the 4 different classes of Mallampati airway classification

A 
1= faucial pillars, soft palate and uvula visible 
2= Faucial pillars and soft palate can be seen but uvula masked by base of tongue 
3= Can see soft palate
4= Only hard palate seen
24
Q

What factors relating to the neck affect an individuals airway

A
  • Atanto-occipital and cervical range of motion
  • Neck circumference (anterior fat neck)
  • Tracheal anatomy
  • Past surgery, radiation, injury
25
Q

(Upper/lower) lobes of the lungs are more affected in smokers Why? Pneumonia

A

upper because smoke rises… pneumonia affects the lower lung lobes

26
Q

Describe the different ASA categories

A 
I= Normal and healthy no modification needed 
II= Mild systemic disease- no limitations (smoker= ASA 2 and drinkers)
III= Severe systemic disease (activity limited but not incapacitating 
IV= Severe systemic disease- constant threat to life 
V= Moribund and not expected to live >24 hrs 
VI= Declared brain dead and will undergo organ harvest for donation 
E= Emergency operation
27
Q

Describe anxiety

A

Interactive relationship between pyschological and physical signs.symptoms which arise in response to a stressor (actual or perceived)

Characterized by feelings of impending doom

28
Q

Systemic symptoms that may arise in someone which anxiety are

A
  • Tachycardia (palpitations)
  • Tachypnea, dyspnea
  • Pupillary dilitation
  • Psychomotor agitation
29
Q

Features of general anxiety disorder include

A
  • Persistant pervasive generalized anxiety
  • Anxiety is unexplainable in terms of tangible idea, object, or situation
  • “Free floating” anxiety (Unable to ID triggers of anxiety)
  • Impairment in social/ occupational function
30
Q

Describe maladaptive anxiety

A
  • Exaggerated response to stressor which is in the subconcious
  • Pathologic if maladaptive and disabling or crippling
  • Interferes with social/occupational functioning or health care.
31
Q

Define phobic disorders

A

Irrational fear of specific object, place or situation

32
Q

What are the three different types of phobias

A
  • Simple phobias (Everyone has this about dentistry)
  • Social phobias
  • Agoraphobia (These patients will not show up and this phobia may have arised due to previous traumatic experiences)
33
Q

Describe the difference between dental phobia (simple phobia) and dental anxiety

A

Dental phobia

  • Irrational fear of situation/place
  • May have familial componenet

Dental anxiety

  • Maladaptive in nature
  • F>M
  • May co-exist with generalized anxiety ot other anxiety disorders
  • May have familial componenet
34
Q

What are the main etiologies of dental anxiety

A
  • Novelty- new/unfamiliar experiences
  • Uncertainty- Unknown is often source of general arousal
  • Expectation- Formulated from information obtained from others or vicariously experiencing fear provoking situations accompanied by negative cognitions
  • Genetics
  • Neurotransmitter systems (noradrenergic, GABA, and serotonin systems in frontal lobe and limbic system)
35
Q

Behavioral signs of dental anxiety

A
  • Avoidance
  • Posture (skeletal muscle tension)
  • Activity (restlessness, talkative)
  • Severe psychologic distress
  • Substance abuse (Informed consent issue)
36
Q

Physiologic features of dental anxiety

A
  • Tremulousness
  • Diaphoresis (Sweating)
  • Syncope
  • Lowered pain threshold
  • Tachycardia (Make sure you aspirate!)
  • Increased BP
  • Tachypnea
37
Q

Biochemical evidence of dental anxiety

A
  • Increase serum catecholamines
  • Increased serum ACTH and corticosteroid levels
  • Increased salivary corticosteroid levels
  • Increased urinary catecholamine metabolities
  • Increased urinary corticosteroid metabolite levels
38
Q

Ways to assess dental anxiety

A
  • Simple observation
  • Patient self-report
  • Assessment tools
39
Q

What population is the toughest to gauge their level of anxiety

A

children

40
Q

What 4 questions are asked in the Corah Dental anxiety Scale

A
  1. If you had to go to the dentist tomorrow how would you feel about it
  2. When you are waiting in the dentist’s office for your turn in the chair how do you feel
  3. When you are in the chair waiting while the dentist gets the drill ready to begin working how do you feel?
  4. You are in the dentist’s chair to have your teeth clean. While you are waiting and the dentist is getting out the instruments which will be used to scrape around your gums how do you feel?
41
Q

Aside from the Corah DAS what other assessment scales are available to gauge dental anxiety

A
  • Modified child DAS (MCDAS)
  • Faces version of MCDAS
  • Index of dental anxiety and fear (IDAF-4C)
42
Q

What are the claimed benefits of the Index of dental anxiety and fear scale (IDAF-4C)

A
  • Takes multi-dimensional nature of dental anxiety and fear into account
  • Asks 8 questions
  • Additional modules available for phobias and stimuli
43
Q

What cardiovascular conditions are exacerbated by anxiety

A
  • Coronary artery disease
  • Angina
  • Dysrhythmias
  • Cardiomyopathies
  • Hypertension
44
Q

What pulmonary disorders are exacerbated by anxiety

A
  • Asthma

- COPD

45
Q

What GI issues are exacerbated by anxiety

A
  • Peptic Ulcers

- GERD

46
Q

What neurological conditions are exacerbated by anxiety

A
  • Cerebrovascular disease

- Seizure disorders

47
Q

What endocrine conditions are exacerbated by anxiety

A
  • DM
  • Adrenal insufficiency
  • Thyroid disease (hyperthyroic, hypothyroid, and myxedema)
  • Psychologic (Generalized anxiety, panic disorder, and depression)
48
Q

What pharmacoloigc medication should be used to treat dental anxiety

A

something reversible like a benzodiazepiene

49
Q

T/F There was an improvement in dental anxiety and attendance is groups put under general anesthesia

A

f

50
Q

What is iatrosedation

A

Any technique of anxiety reduction in which no drug administration is required (talking to the patient)

51
Q

Describe the 4 major components of an iatrosedation interview

A
  1. Recognition
  2. Dx (determine origin of fear)
  3. Education
  4. Build trust and confidence
52
Q

Management of a mildly anxious patient

A
  • Morning appts
  • Iatrosedation
  • Close attention with regional analgesia and post-op pain management
53
Q

Management of moderately anxious patient

A
  • Evaluate coping methods
  • Intra/post op analgesia
  • Teach new coping skills
  • Hypnosis
  • Behavior therapy + pharmacosedation
54
Q

Management of severely anxious and or phobic patient

A

*Multidisciplinary team approach**
Psychotherapist
-Pharmacologic therapy (anxiolytics, antidepressants, and beta blockers)
-Systematic desensitization

Dentist

  • Good pain control
  • Iatrosedation + pharmacosedation
  • General anesthesia for most severe cases - last resort.

Anesthesia (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions