24 CHRONIC PULMONARY DISEASE Flashcards
1
Q
- What are some examples of obstructive pulmonary disease?
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2
Q
- What is obstructive pulmonary disease
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3
Q
- Why does arterial hypoxemia occur in patients with obstructive pulmonary disease?
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4
Q
- Why does carbon dioxide retention occur in patients with obstructive pulmonary
disease?
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5
Q
- What are common physical, radiographic, and functional findings in patients with
obstructive pulmonary disease?
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6
Q
- What characterizes asthma?
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7
Q
- How is the diagnosis of asthma made?
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8
Q
- What are some of the physical examination findings noted in patients with asthma
during periods of normal pulmonary function? What are some of the physical
examination findings noted in patients with bronchial asthma during periods of
exacerbation of their asthma?
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9
Q
- What are some findings found in the pulmonary function studies and flow-volume
loops during asthma exacerbations?
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10
Q
- What agents are commonly used for the chronic treatment of asthma?
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11
Q
- How can an acute asthmatic attack be treated?
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12
Q
- How should the patient with asthma be assessed preoperatively?
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13
Q
- How should a patient with asthma be assessed before a thoracic or abdominal
procedure?
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14
Q
- Is regional anesthesia the preferred anesthetic choice in patients with bronchial
asthma scheduled to undergo surgery on the extremities?
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15
Q
- What is the goal of the anesthetic management of patients with asthma?
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16
Q
- What agents may be used for the induction of general anesthesia in patients
with asthma? What is an advantage and a disadvantage of ketamine for these
patients?
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17
Q
- Which neuromuscular blocking drugs are associated with histamine release? What
is the concern regarding the use of these neuromuscular blocking drugs in patients
with asthma?
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18
Q
- What is the benefit of using a slow respiratory rate when mechanically ventilating
the lungs of a patient with asthma?
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19
Q
- What is a benefit of maintaining adequate hydration intraoperatively in patients
with asthma and chronic obstructive pulmonary disease (COPD)?
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20
Q
- What are the options for extubation of the trachea that will minimize the degree of
airway hyperreactivity in response to manipulation of the endotracheal tube?
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21
Q
- How can the reversal of neuromuscular blocking drugs with anticholinesterases
cause bronchospasm?
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22
Q
- Name five potential causes of intraoperative bronchospasm.
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23
Q
- How should intraoperative bronchospasm be treated?
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24
Q
- What characterizes pulmonary emphysema physiologically?
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25
Q
- What characterizes chronic bronchitis physiologically?
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26
Q
- How do emphysema and chronic bronchitis differ clinically?
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27
Q
- Why is the work of breathing increased in patients with pulmonary
emphysema?
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28
Q
- For patients with COPD scheduled to undergo a surgical procedure, what should the
preoperative evaluation include? When might preoperative pulmonary function
tests be necessary?
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29
Q
- What are some pulmonary function test and arterial blood gas measurement
results that indicate that the patient is at an increased risk of postoperative
respiratory failure? What are some treatment interventions that may be warranted
by the preoperative evaluation of the patient’s pulmonary function?
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30
Q
- What are the main considerations for the anesthetic management of patients with
COPD?
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31
Q
- What are some potential disadvantages of using nitrous oxide as part of a general
anesthetic in patients with COPD?
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32
Q
- What are two methods by which anesthesiologists may minimize the drying of
secretions in the airways of patients with COPD in the intraoperative period?
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33
Q
- What ventilatory settings are appropriate for intraoperative mechanical ventilation
of the lungs of patients with COPD?
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34
Q
- What characterizes chronic bronchitis physiologically? What is the major
predisposing factor to the development of chronic bronchitis?
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35
Q
- What is the impact of COPD on the postoperative course?
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36
Q
- What is the clinical significance of an exacerbation of COPD, and what is its
implication on an upcoming surgical procedure?
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37
Q
- How is pulmonary hypertension defined? What is the most common form of
pulmonary hypertension?
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38
Q
- What are the physiologic effects of pulmonary hypertension?
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39
Q
- How can pulmonary hypertension affect the performance of the left ventricle?
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40
Q
- What are the main anesthetic considerations for patients with pulmonary
hypertension?
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41
Q
- Is obstructive sleep apnea a rare or common disease?
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42
Q
- What are the physiologic characteristics of sleep apnea that may affect anesthetic
management and outcome?
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43
Q
- What are the main anesthetic implications of obstructive sleep apnea?
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44
Q
- What are some preoperative considerations for the patient scheduled to undergo
thoracic surgery?
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45
Q
- What are some specific preoperative history and physical examination findings that
are indicative of an increased risk of postoperative pulmonary complications
after thoracic surgery?
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46
Q
- What are some preoperative prophylactic measures that may be taken in an attempt
to minimize postoperative pulmonary complications?
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47
Q
- How does cigarette smoking affect the lungs physiologically?
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48
Q
- What is the benefit of the preoperative cessation of cigarette smoking? After
what duration of time after the cessation of smoking are these benefits noted
to occur?
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49
Q
- For which patients are preoperative pulmonary function tests indicated?
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50
Q
- What values derived from pulmonary function tests are indicative of an increased
risk of postoperative pulmonary morbidity after a pneumonectomy?
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51
Q
- What are PPO FEV1 (predicted postoperative FEV1) and PPO – DLCO (predicted
postoperative DLCO)?
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52
Q
- What are some benefits of the administration of volatile anesthetics for patients
undergoing thoracic surgery?
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53
Q
- What is a disadvantage of the administration of nitrous oxide for patients
undergoing thoracic surgery?
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54
Q
- What is a benefit of the administration of nondepolarizing neuromuscular blocking
drugs for patients undergoing thoracic surgery?
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55
Q
- What are some absolute indications for one-lung ventilation during surgery and
anesthesia? What are some relative indications for one-lung ventilation during
surgery and anesthesia?
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56
Q
- What is the most frequently used double-lumen endotracheal tube used for the
isolation of the right or left lung or for one-lung ventilation during thoracic
surgery?
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57
Q
- What is the potential problem with an endobronchial tube placed in the right
bronchus for isolation of the right lung? How can this problem be avoided?
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58
Q
- What size double-lumen endotracheal tube is usually appropriate for adult patients?
What depth in centimeters typically places the endobronchial tube in approximately
the correct position in most adult patients of average height?
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59
Q
- What is the technique for placement of a left-sided double-lumen endotracheal
tube? How is the proper placement of a double-lumen endotracheal tube best
confirmed?
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60
Q
- What is the single-lumen Univent tube? What is its potential advantage for
ventilation?
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61
Q
- What is a Arndt endobronchial blocker?
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62
Q
- What is a Cohen tip deflecting endobronchial blocker?
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63
Q
- How does a bronchial blocker compare to a double-lumen endotracheal tube?
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64
Q
- How does the lateral decubitus position during mechanical ventilation of the lungs
affect the ventilation-to-perfusion ratio in the lungs?
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65
Q
- What are four factors that influence the amount of perfusion that goes to the
nondependent, unventilated lung during ventilation of a patient in the lateral
decubitus position with a double-lumen endotracheal tube?
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66
Q
- What are the interventions that can be made when arterial hypoxemia is noted in
a patient during ventilation for thoracic surgery?
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67
Q
- Why is the placement of chest tubes after thoracic surgery necessary
postoperatively?
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68
Q
- When should extubation of the trachea after thoracic surgery occur?
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69
Q
- What are the common postoperative pulmonary complications after thoracic
surgery?
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70
Q
- What is the importance of adequate analgesia after thoracic surgery?
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71
Q
- What is the most frequent reason for the performance of a mediastinoscopy?
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72
Q
- What are the complications associated with mediastinoscopy?
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