ACE Review - OR Management

Question 1

Radiation therapy. What is it’s effect on bone marrow

Answer 1

Suppression.

Question 2

Radiation therapy. What effects does it have on the heart most commonly.

Answer 2

Pericarditis.

Question 3

Radiation therapy. When can this pericarditis occur.

Answer 3

6-24 months post treatment

Question 4

Radiation therapy. What is the symptom of pericarditis.

Answer 4

It is usually asymptomatic.

Question 5

Radiation therapy. What is the concerning cardiac condition.

Answer 5

Myocardial infarction.

Question 6

Radiation treatment. How many people can develop radiation pneumonitis

Answer 6

From 5-20%

Question 7

Radiation treatment. When can it occur

Answer 7

It can occur from 2-6 months after treatment

Question 8

Radiation. Treatment. What increases the chances of radiation pneumonitis.

Answer 8

The use of chemotherapy and antibiotic based chemos like bleomycin.

Question 9

heat loss. what is the most common way of heat loss

Answer 9

radiation

Question 10

heat loss. what are the modes

Answer 10

conduction, convection, evaporation, radiation

Question 11

heat loss. how does radiation work

Answer 11

lost of heat 2ndry to temperature difference in room to the 4th power

Question 12

heat loss. how does evaporation work

Answer 12

it only accounts for 10% of heat loss

Question 13

heat loss. how does conduction work

Answer 13

it is the heat loss by the temp differentials between 2 surfaces

Question 14

heat loss. how does convection work

Answer 14

It is the loss of heat by a flowing fluid across a surface.

Question 15

Anaphylaxis. What immunoglobulin is it mediated by

Answer 15

Ige

Question 16

Anaphylaxis. When can symptoms manifest.

Answer 16

Within 10-15 minutes of admin of drug causing reaction.

Question 17

Anaphylaxis. Why do no need to keep pt in step down unit after anaphylactic reaction.

Answer 17

Because anaphylaxis can reoccur in patients 6-10hours after first inciting episode.

Question 18

Anaphylaxis. How many grades are there

Answer 18

4 grades.

Question 19

Anaphylaxis. What is grade 4 of anaphylaxis

Answer 19

It is cardiac arrest. This can happen as the coronaries an also be affected and vasospasm. The patient can suffer a cardiac arrest.

Question 20

Anaphylaxis. What is the cause of Bronchoconstriction of anaphylaxis

Answer 20

Prostaglandin d2

Question 21

Anaphylaxis. What is the difference between anaphylaxis versus anaphylactoid.

Answer 21

Ige is the mediator for anaphylaxis. Not anaphylactoid.

Question 22

Anaphylaxis. Can you tell the difference between anaphylactoid and anaphylaxis clinically

Answer 22

No.

Question 23

Anaphylaxis. How can you tell on your ventilator that it is bronchospasm.

Answer 23

Elevated peak pressures but normal plateau pressures.

Question 24

Anaphylaxis. What is the most common drug that causes anaphylaxis.

Answer 24

Muscle relaxants.

Question 25

Anaphylaxis. What is the second most common cause for anaphylaxis.

Answer 25

Latex.

Question 26

Anaphylaxis. What is the second most common cause for anaphylaxis.

Answer 26

Antibiotics.

Question 27

Anaphylaxis. What to look for in lidocaine that can cause allergic reaction.

Answer 27

See if the lidocaine is multidose vial. PABA use to be added to lidocaine that can cause allergic reaction. However now we have MPF lidocaine multiuse vials that can avoid this allergic reaction.

Question 28

Anaphylaxis. What is PABA

Answer 28

Para-amino benzoic acid.

Question 29

Anaphylaxis. What is MPF.

Answer 29

Methyl-parabin free

Question 30

Anaphylaxis. What is the drug to administer.

Answer 30

Epinephrine.

Question 31

Anaphylaxis. What is the dosing of epinephrine.

Answer 31

It depends on the grade. If it is grade 2, 10-20 mcg. If it is grade 3, 100-200mcg every 2 minutes until the patient is stable and an infusion could be started.

Question 32

Postoperative cognitive dysfunction. What is the highest risk factor

Answer 32

Advanced age.

Question 33

Postoperative cognitive dysfunction. What is considered advanced age.

Answer 33

Age greater than 80.

Question 34

Postoperative cognitive dysfunction. What is the rate of advanced age pts getting pocd

Answer 34

33 percent

Question 35

Fires. When determining what to do first. What should u look for.

Answer 35

If there is an airway fire or not.

Question 36

Fires. What should be the order of things if there is no airway fire.

Answer 36

Stop all flows. Remove burning material. Flood field with water

Question 37

Fires. What should be done in order if there was an airway fire.

Answer 37

Pull tube. Stop flows. Remove fired material. Flood field.

Question 38

pulmonary artery catheter. what is the most common complication

Answer 38

dysrythmia

Question 39

pulmomary artery catheter. what is the most common type of bbb seen with it

Answer 39

right bundle branch block

Question 40

pulmonary artery catheter. what preexisting bbb is concerning for pac placement

Answer 40

a lbbb bc if a rbbb is caused by placement then the pt is now in complete heart block

Question 41

pulmonary artery catheter. what is the mech of action of pulm art cath assc infarction

Answer 41

malposition of pac....this is more common than emboli from pac

Question 42

pulmonary artery catheter. what is the most common type of infarction by pac if an infarction does occur

Answer 42

a pulmonary infarction

Question 43

pulmonary artery catheter. does changing out the pac decrease the chance of bacteremia

Answer 43

no. bc the cordis is still in place. the whole thing needs to be chagned

Question 44

Latex allergy. Who is at an increased risk for latex allergy.

Answer 44

Spina bifida or urinary tract abnormality pts bc they have an increase in usage of latex gloves at a young age.

Question 45

Latex allergy. What is the treatment when pt develops latex anaphylaxis

Answer 45

Removal all latex and start fluids epi and bronch dilators

Question 46

SIRS. what are the 4 major criteria

Answer 46

wbc>12000/10%bands; heart rate greater than 90; rr>20/paco238 or <36

Question 47

SIRS. what is sepsis.

Answer 47

when SIRS + source of infection

Question 48

SIRS. when is it considered severe

Answer 48

when there is end organ hypoperfusion.

Question 49

SIRS. what are signs of end organ hypoperfusion

Answer 49

prolong cap refill, oliguira, lactate level >2, alt mental status, thrmobocytopenia, dic, ards, cardiac dysfunc

Question 50

SIRS. how is hypotension defined as

Answer 50

sbp <90