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Sp: Coexisting I > 1. Respiratory Obstructive > Flashcards

1. Respiratory Obstructive Flashcards

1
Q

Obstructive TLC

A

increased

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2
Q

obstructive RV

A

incereased

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3
Q

obstructive FEV1

A

decreased

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4
Q

Obstructive FVC

A

decreased

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5
Q

obstructive FEV1/FVC

A

decreased

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6
Q

compliance =

A

C= V/P

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7
Q

the supine position _______ FRC

A

decreases

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8
Q

does anesthesia change airway resistance

A

no NET change
– atelectasis: incr R
– VA bronchodilation: decr R

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9
Q

common obstructive diseases (5)

A

URI
Asthma
COPD
Bronchiectasis
Cystic fibrosis

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10
Q

what percentage of URI are viral

A

95% are nasopharyngitis

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11
Q

viral URI

A

non-productive cough
sneezing
rhinorrhea

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12
Q

bacterial URI

A

fever
purulent drainage
productive cough
malaise

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13
Q

which type of URI has a higher rate of post-op complications

A

bacterial

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14
Q

COLDS scoring

A

Current symptoms
Onset of symptoms
Lung disease
airway Device
Surgery

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15
Q

how long from symptom onset are you most at risk for anesthetic complications with a URI

A

less thatn 2 weeks from symptom onset

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16
Q

which airway device has a higher risk with URI

A

ETT

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17
Q

how long should you wait for a non-urgent surgery in pts with URI

A

6 weeks from start of symptoms

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18
Q

asthma

A

reversible airway obstruction due to inflammation

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19
Q

asthma pt factors

A

genetic
environmental
maternal smoking during preg
limited exposure to infectious enviro

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20
Q

asthma trigger

A

allergen
NSAIDs
infections
excercise
endorphin/vagal mediated

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21
Q

asthma inflammatory cascade

A

histamine
prostaglandin D2
leukotrines

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22
Q

asthma clinical signs

A

expiratory wheeze
cough
dyspnea
chest tightness
eosinophilia (labs)

23
Q

severe asthma
FEV1
FEV1/FVC

A

FEV1<60%

FEV1/FVC: decr by 5+%

24
Q

asthma flow-volume loop

A

scooping/concave

25
Q

status asthmatics

A

life threatening bronchospasms that persist with treatment

26
Q

status asthmaticus treatment

A

high does beta2 agonists
corticosteroids
anticholinergics
IV Mg2+
IV epi
supp O2
volatile agents (bronchodilation)
ECMO

27
Q

what predicts increased risk for PRAE in asthmatic pts

A

FVC and FEV1 <70%

28
Q

which opioid produced histamine

A

morphine

29
Q

emergence in asthmatic pts will be _________

A

slower

30
Q

COPD PFTs
FEV1:FVC
FEF
FRC
TLC
RV

A

FEV1:FVC < 70%
forced exp flow: 25-75% of VC
incr FRC
incr TLC
incr RV

31
Q

mild COPD

A

FEV1 >= 80%

32
Q

mod COPD

A

FEV1 betwee 50-80%

33
Q

severe COPD

A

FEV1 between 30-50%

34
Q

very severe COPD

A

FEV1 <30%

35
Q

BODE index

A

BMI
Obstruction degree
Dyspnea level
Exercise tolerance

36
Q

high BODE score

A

greater risk of COPD exacerbations, hospitalizations, and death

37
Q

COPD blood tests

A

alpha1 antitrypsin definciency
increased eosinophiles
ABG PaO2 decreases w/severe

38
Q

COPD treatment

A

1st line: muscarinic antagonist
2nd: beta2 agonist
3rd: glucocoricoids

39
Q

should pts take COPD meds day of surgery

A

yes

40
Q

COPD pre-op

A

smoking cessation > 6 weeks
medication
alb >3.5 mg/dL
pre-op incentive spirometry

41
Q

what is the most important factor to decrease COPD risk pre-surgery

A

incentive spirometry

42
Q

COPD blocks to avoid

A

above T6
interscalene block

43
Q

can you use N2O with COPD pts

A

no
may rupture bullae and cause a pneumothorax

44
Q

mech ventilation goals: COPD

A

avoid dynamic hyperinflation/auto-peep
will incr intrathoracic pressure

45
Q

air trapping detection

A

upsloping capnography
flow doesnt go to 0 before inhalation

46
Q

air trapping intervention

A

decr RR
incr expiratory time

47
Q

bronchospasm treatment

A

propofol
incr gas
albuterol
epi

48
Q

bronchiectasis

A

irreversible airway dilation
inflammation
chronic bacterial infection

49
Q

bronchiectasis symtpoms

A

cough w/purulent sputum
dyspnea
wheezing
pleuritic chest pain
clubbing of fingers

50
Q

gold std for bronchiectasis diagnosis

A

CT

51
Q

bronchiectasis treatment

A

chest physiotherapy
abx
bronchodilators
steroids

52
Q

bronchiectasis management

A

suction ETT frequently

53
Q

cystic fibrosis anesthetic managment

A

VA
high FiO2
avoid anticholinergic
suction ETT frequently

Sp: Coexisting I (11 decks)

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