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ABOMS > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

What is the ideal thyromental distance in airway evaluation?

A

Greater than 6 cm

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2
Q

What are the preoperative NPO guidelines

A
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3
Q

ASA Classifications system

A
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4
Q

Common sources of error for pulse oximetry

(10 pts)

A

-Shivering
-Fingernail Polish
-Corboxyhemoglobin
-Methemoglobin
-Methylene Blue
-Hypothermia
-Hypotension
-Hypovolemia
-Hypoxia
-Ambient light

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5
Q

What are the most sensitive EKg monitors to ischemia

A

Leads II and V5

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6
Q

EKG helps determines

A

Ischemia, disarrhythmias, and pacemaker function

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7
Q

When is invasive BP indicated

A

-In major surgeries
-Hemodynamic instability
-Vasocactive meds
-Frequent blood draws.

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8
Q

Too large of a BP cuff?

A

falsely low BP

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9
Q

Too small of a BP cuff?

A

Falsely elevated bP

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10
Q

CO2 monitoring allows for measurement of:

A

-Assessment of ventilation
-Assessment of ciculation
-Identification of intubation
-Identification of anesthetic circuit malfunction (leaks, disconnection)

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11
Q

Bispectral index

A

Yes EEG data via scalp electrodes to record the depth of anesthesia via IV or inhalation

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12
Q

Levels of consciousness

A
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13
Q

Responsivness for minimal, moderate, deep, general

A
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14
Q

Airway, spontaneous ventilation, cardiovascular function

for minimal moderate, deep, general

A
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15
Q

T/F: LMA’s can be used for airway emergencies when intubation has failed.

A

True, it is a suprglottic airway and does not protect the airway though.

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16
Q

what does oral RAE stand for?

A

Ring-Adair-Elwyn

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17
Q

When is a cricothyrotomy used?

A

It is used during airway emergencies when other nonsurgical attempts at securing the airway have failed.

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18
Q

Volume of distribution

A

Dose of drug administered/concentration of drug in plasma
-Decreased by high protein binding affinity, ionization, decreased lipid solubility.

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19
Q

What is drug clearance?

A

The volume of plasma cleared of drug in mL per minute as a result of renal elimination and metabolism (liver and other tissues: kidney, lung, gastrointestinal tract)

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20
Q

How is renal elimination improved

A

It is improved with increased water solubility and inhibited by protein binding and lipid solubility

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21
Q

Elimination half time:

A

Time required to decrease drug concentration by 50% _5 half times required for total elimination.

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22
Q

Redistribution

A

Drugs preferentially distribute to highly perfused tissues (eg brain, heart, kidneys)

Eventually a gradient is reached that allows perfusion to the less perfused tissues (fat, skeletal muscle)

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23
Q

First-pass hepatic effect

A

Oral drugs are absorbed by the GI tract and pass through the liver via the portal circulation before entering the systemic circulation

Drugs are metabolized in this process

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24
Q

PAP

A

Pulmonary artery pressure-the partial pressure of volatile agent in the brain is in equilibrium with the blood and alveoli

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25
Q

MAC

A

Minimum alveolar concentration is the concentration (partial pressure) of volatile anesthetic (at 1 atm and measured during steady state) that prevents movement in 50% of patients during surgical stimulus.

The higher the MAC, the less the potency

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26
Q

MAC of Sevo

A

2.1

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27
Q

What are the advantages and disadvantages of Sevo?

A

Advantages-Rapid induction/recovery
Minimal airway irritation

Disadvantages-Potential renal concerns ( compound A)

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28
Q

What are the advantages and disadvantages of Iso?

A

Advantages-Relatively slower onset of action, Pungent odor

Disadvantages-Coronary steal effect

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29
Q

MAC of Iso

A

1.15

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30
Q

What are the advantages and disadvantages of Des?

A

Advantages-Rapid induction/recovery

Disadvantages-Airway irritation

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31
Q

MAC of des

A

6.0

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32
Q

What are the advantages (4) and disadvantages (6) of Nitrous Oxide?

A

Advantages-
-Analgesia,
-second gas effect,
-safe in malignant hypothermia susceptible patients,
-rapid induction/recovery

Disadvantages-Expansion of air-filled spaces, higher combustion risk, PONV, megaloblastic anemia, Chronic use may result in peripheral neuropathy, possible teratogen

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33
Q

MAC of Nitrous Oxide

A

105

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34
Q

True/FalseBlood pressure reduces from halothane, isoflurane, desflurane, sevoflurane

A

True, only NO seems to cause it to rise

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35
Q

When does HR increase on iso, des, sevo

A

Only if MAC is greater than 1.5

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36
Q

Cardiac contractility

A

All volatile agents cause a decrease in contractility

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37
Q

Volatile anesthetics impact on respiratory rate, TV, MV, and CO2 level

A

Most volatile anesthetics (except isoflurane)

1-Increased respiratory rate
2-Decreased tidal volume
3-Decreased minute ventilation
4-Produce a high carbon dioxide level

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38
Q

Which opioids are included in the Morphine group?

(10 meds)

A

Morphine
-Codeine
-Hydrocodone
-Oxycodone
-Oxymorphone
-Hydromorphone
-Nalbuphine
-Butorphanol
-Levophanol
-Pentazocine

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39
Q

Which opioids are included in the phenylpiperidine group?

A

-Meperidine
-Fentanyl
-Sufentanil
-Remfentanil

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40
Q

What is the mechanism of action of opioids?

A

-Agonist at various endogenous opioid receptors (Mu1, Mu2, delta, kappa, sigma) within the nociceptive pathways.

-Involves decreased presynaptic release of acetylcholine and substance P

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41
Q

What are the effects of opioids on the:

CNS
CV
Respiratory
GI
GU

A
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42
Q

What concerns do you have with opioids?

A

-Tolerance and dependence
-Chest Wall rigidity
-Crosses placenta
-Histamine release with morphine and meperidine

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43
Q

How do you reverse opioids?

A

Naloxone
-Adult dose is 0.04 to 0.4 mg IV; repeat dose or increase dose to 2 mg if no response.
-Pediatric dose: 0.001 to 0.005 mg/kg IV

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44
Q

Pseudoallergy of opioids

A

Minor symptoms of flushing, hives, diaphoresis, dysphagia, facial/airway swelling,

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45
Q

IV Meds-Bartbituates include

A

Pentobarbital, methohexital

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46
Q

What is the mechanism of action of barbiturates?

A

GABA potentiation, direction action on GABA, receptor chloride channels, some action on calcium ion channels

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47
Q

What is the induction/sedation dosage of barbituates

A

Induction: 1 to 1.5 mg/kg
Sedation: 0.75 to 1 mg/kg followed by 0.5 mg/kg every 2-5 minutes

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48
Q

Ketamine-MOA

(5 receptors)

A

Various receptors (NMDA agonist, opioid, monoaminergic, muscarinic, calcium ion channels)

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49
Q

What are the pharmacokinetics of Ketamine?

A

-High lipid solubility: Crosses blood-brain barrier easily
-Hepatic metabolism

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50
Q

What is the dosage of Ketamine

A

Induction: 1 to 4.5 mg/kg IV
Sedation (IV): 1 to 2 mg/kg IV followed by 0.25 to 0.5 mg/kg IV very 5 to 10 min
Sedation IM: 2 to 5 mg/kg IM

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51
Q

Indications for Ketamine

(3 pts)

A

-Dissociative anesthetic with analgesic properties
-Induction agent
-Sedation

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52
Q

Effects of Ketamine

CNS
CV
Respiratory

A
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53
Q

T/F: Ketamine contraindicated in head trauma

A

True, because it increased CBF and ICP

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54
Q

What can help mitigate the hallucinatory issues of Ketamine?

A

Benzodiazpines

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55
Q

T/F: Ketamine depresses respiratory rate significantly

A

False

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56
Q

T/F: Ketamine decreases secretions

A

False, it increases and so sometimes people pretreat with hypersalivation

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57
Q

Is Ketamine a bronchodilator or bronchoconstrictor

A

It is a bronchodilator

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58
Q

Benzodiapeines

A

Midazolam-Versed
Diazepam-Vallium
Lorazepam-Ativan
Alprazolam-Xanax

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59
Q

MOA of benzos

A

mediated by GABA

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60
Q

Are benzodiazepines anticonvulsants?

A

Yes, they are

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61
Q

Effects of Benzodiazepines

CNS
CV
Respiratory

A
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62
Q

Which drug decreases metabolism of Benzodiazpines

A

Erythromycin

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63
Q

What is the reversal agent for Benzos?

A

Flumazenil: Competitive Antagonist
Adult dose: 0.2 mg IV; repeated doses may be given at 1 minute intervals to a maximum of 3 mg

Pediatric Dose: 0.01 mg/kg may be repeated at 1 - minute intervals to a maximum dose of 1 mg

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64
Q

What is the danger of flumazenil?

A

the half life is less then benzodiazepines so the resection is possible of recurring.

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65
Q

Benzodiapines doses…What is the duration for Midazolam (Versed), Diazepam (Vallium), and Lorazepam (Ativan)

A
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66
Q

What is dexmedetomidine used for?

A

Sedation in short term in intubated patients?

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67
Q

MOA of dexmedetomidine?

A

alpha 2 adrenoceptor agonist

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68
Q

What are the effects of alpha, beta receptors.

A
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69
Q

Effects of dexmedetomidine

CNS
CV
Respiratory

A
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70
Q

What are the nueromuscular blockers used for?

A

Skeletal muscle relaxation during intubation, ventilation or during treatment of laryngospams refractory to positive pressure.

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71
Q

What are the depolarizing agents?

A

Succinylcholine

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72
Q

What are the non depolarizing agents

A

Rocuronium, Vecuronium, Cisatracurium

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73
Q

What is the reversal agent for neuromuscular blockers?

A

It is Neostigmine (Anticholinesterase, but this is only for nondepolarzing agents only)

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74
Q

What is neostigmine’s MOA

A

It inhibits acetyl cholinesterase, leading to a build up of acetylcholine within the neuromuscular junction (NMJ)

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75
Q

Dosage for Neostigmine

A

0.03 to 0.07 mg/kg over 1 minute

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76
Q

What are the side effects of neostigmine?

A

Bradycardia (that is why atropine or glycopyrollate are also given)

77
Q

What drugs are given in with neostigmine to fight the effects of bradycardia?

A

Glycopyrollate and atropine?

78
Q

MOA of Succinylcholine

A

Competitive agonist at ACh receptor
-Produces a sustained depolarization of the post junctional mebrane of the NMJ

78
Q

MOA of Succinylcholine

A

Competitive agonist at ACh receptor
-Produces a sustained depolarization of the post junctional mebrane of the NMJ

79
Q

What are the pharmocokinetics of succinylcholine?

A

Hydrolyzed by plasma cholinesterase

80
Q

Onset of Succinylcholine?

A

30 to 60 seconds

81
Q

What is the adult dosage of succinylcholine for induction?

A

0.6 mg/kg IV

82
Q

What is the dosage of Succinylcholine for treating a larygospasm?

A

0.1 to 0.5 mg/kg IV or 4 to 6 mg/kg IM

83
Q

Side effects of Succinylcholine

A

-Fasiculations (body aches)
-Hyperkalemia
-Cardiac dysrhythmias
-Malignant hyperthermia

84
Q

Contraindications of Succinylcholine

A
85
Q

Name 5 non-depolarizing agents?

A

vecuronium, rocuronium, pancuronium, cisatraciruium, atracurium

86
Q

What is the MOA non-depolarizing agents

A

Competitive altoists of EACh at post junctional membrane

87
Q

Which non-depolarizing agents can be used in renal or hepatic failure patients?

A

Cisatracurium because it is degraded via Hoffman elimination

Hofmann elimination and ester hydrolysis occur from both central and peripheral compartments

an elimination reaction of an amine to form alkenes

88
Q

Dosage of non depolarizing agents

A
89
Q

Local anesthetics-Amides
How are they metabolized?

A

Metabolized by the liver microsomal enzymes, incidence of allergic reaction is lower than with esters and is likely related to the preservative

90
Q

Local anesthetics-Esters
How are they metabolized?

A

Esters: Metabolized by plasma psudocholinesterase (consider if severe liver disease); p aminobenzoic acid is a metabolite and may be associated with allergy in some patients.

91
Q

Patient’s with self allergies may have a higher incidence of allergy to…..

A

esters

92
Q

MOA of local anesthetics

A

Inhibits depolarization and impulse propagation of nerve cells through blockade of sodium ion channels in the inactivated state.

93
Q

Amide anesthetics

A

lidocaine, bupivacaine (marcaine), ropivacaine, mepivacaine (carboacinae), articaine

94
Q

Anesthetic duration of action, maximum dosage
for Lidocaine, Mepivcaine, Prilocaine, articaine, and Bupivacaine

A
95
Q

High doses of anesthetics

CNS
CV
Respiratory

A
96
Q

SIMV stands for

A

Synchronizd intermittent mandatory ventilation

97
Q

What is SIMV?

A

Patients can take additional spontaneous breaths that are not supported by the ventilator

Indications: Facilitating from full ventilatory support to partial support

98
Q

What ar the advantages of SIMV?

A

-Maintains respiratory muscle strength by avoiding muscle atrophy
-Decreases mean airway pressure
-Facilitates ventilatory discontinuation, weaning

99
Q

What is a complication of SIMV (stacking?

A

Mechanical rate and spontaneous rate may be asynchronous and cause stacking (incomplete expiration resulting in residual air adding to volume of next inspiration.”

-This may cause barotrauma

100
Q

CPAP

A

Continuous postive airway pressure

-Positiv pressure provided continuously throughout inspiration and expiration.

101
Q

BiPAP

A

Bilevel positive airway pressure

-Inspiratory and expiratory positive airway pressure in preset
-The difference between the two pressures determines the total volume

102
Q

PEEP

A

Positive end expiratory pressure

-Positive pressure only applied during the expiratory phase
-Helps prevent early airway closure and alveolar collapse at the end of expiratory by increasing and normalizing the functional residual capacity (FRC) of the lungs

103
Q

For extubation, what should be your RSBI, NIF, and FiO2 score?

A

NIF should be -30
FiO2 should be <60%
RSBI should be l<105

104
Q

Causes of HTN-Perioperative

A

HTN, hypoxia, drug errors, pain,

105
Q

Uncommon causes of HTN

A

MH, pheochromocytoma, Hyperthyroidism, fluid overload

106
Q

What options should you consider pharmacologically for HTN

A

Esmolol (short acting)
Labetalol
-Calcium channel blockers
-Hydralazine
-Nitroprusside
-Nitroglycerine

107
Q

How to treat HTN with bradycardia

A

Hydralzine 2.5 to 5.0 mg IV every 10 minutes to a max dose of 24 mg

Nitroglycerine sublingual tablet 0.4 mg every 5 minutes

108
Q

How to Treat HTN with tachycardia?

A

Esmolol (5 to 10 mg) every 3 minutes up to a max dose of 100 to 300 mg or labetalol (5 to 10 mg) every 10 minutes to a max dose of 300 mg

109
Q

Hypotension-etiology perioperative?

A

Hypovolemia
-administered medications/depth of anesthesia,
-cardiogenic (dysrhythmia)
-myocardial infarction
-pulmonary ( PE, Pneumothorax)
-Anaphylaxis

110
Q

Which patient’s are more likely to experience hypotension?

A

Those taking a diuretic and angiotensin-converting enzyme (ACE inhibitor ) or angiotensin receptor blockers (ARB) inhibitor are more prone to experience hypotension.

111
Q

First line of action for hypotension

A

-Intravenous fluid bolus should be the first line of treatment ->250 mL of LR or normal saline solution

112
Q

Treating hypotension with bradycardia?

A

Atropine 0.5 mg every 3 to 5 minutes up to a maximum dose of 3.0 mg

113
Q

Hypotension with tachycardia

A

Phenylephrine 1% (alpha agonist with reflex bradycardia effect) 100 ug per dose every 5 minutes

114
Q

Hypotension with normal heart rate

A

Ephedrine (alpha and beta agonist 5 mg every 5 to 10 minutes

115
Q

Hypotension related with anaphylactic reaction

A

Epinephrine IM 0.3 mg of 1:1000 (mild case), epinephrine IV 10 to 20 ug 1:10,000 (severe case

116
Q

Tachycardia

A

1-Determine if sinus tachycardia, obtain ECG
2-Common causes of sinus tachycardia preoperatively include pain, anxiety; other causes include fluid depletion, hypoxia, pulmonary embolism, residual effects of anesthetics/medications, hyperparathyroidism, acute coronary syndrome, chronic obstructive pulmonary disease
3-If tacharrythmia (vagal maneuvers, adenosine if paroxysmal supraventriclar tachycardia), refer to ACLS guidlines

117
Q

How to manage perioprative bradycardia?

A
118
Q

Angina-how to manage

A
119
Q

Syncope-How to manage?

A
120
Q

How to manage a laryngospasm

A
121
Q

How to manage a bronchospasm

A
122
Q

What is malignant hyperthermia

A

Hypercatabolilc state that develops in genetically susceptible individuals as a response to a variety of inhalation anesthetics such as sevofluroane, desflurane, isoflurane, as well as succinylcholine

123
Q

What is the pathogenesis of MH?

A

Mediated by calcium release form the sarcoplasmic reticulum in skeletal muscle

124
Q

What are the early signs of MH

A

Hypercapnia, tachycardia, muscle ridgidity

125
Q

What are the later signs of MH

A

ECG changes 2ndary to hyperkalemia, rhabdomyolysis (elevated plasma creatine kinase and urine myoglobin–dark urine), and hyperthermia.

126
Q

What is the most common cause of death in MH

A

Hyperkalemia and.coagulopathy from hyperthermia

127
Q

What is the treatment of MH?

A
128
Q

What is the 4 2 1 rule

A
129
Q

Why is albumin a colloid?

A

It contains large molecular weigh substances with less membrane permeability to allow for increased intravascular osmotic pressure (albumin, hetastarch)

130
Q

Why is albumin a colloid?

A

It contains large molecular weigh substances with less membrane permeability to allow for increased intravascular osmotic pressure (albumin, hetastarch)

131
Q

How to calculate NPO deficit

A

Number of hrs NPO x maintenance requriement

132
Q

What does each unit of RBC’s increase hematocrit and hemoblogin by?

A

Hematocrit by 3% and Hemoglobin by 1%

133
Q

What is the ratio of crystalloid used to restore blood loss?

A

3 cc of crystalloid are used for every 1 cc of blood lost.

134
Q

If using RBCs or colloid to restore volume,what restoration ratio can be used?

A

1:1

135
Q

What are the risks of transfusion

A

1-Hemolytic/nonhemolytic immune reactions
2-Infection (viral/bacterial/parasitic)
3-Coagulopathy disorders (eg, disseminated intravascular coagulation)

Administer product using normal saline (avoid using LR solution)

136
Q

Platelets increase the count of platelets by?

A

1 unit will increase 5,000-10,000

137
Q

In general, what platelet count minimum is needed for surgery?

A

50,000/mm3

138
Q

What does FFP have?

A

It contains all the coagulation factors; may be used for several of warfarin as well as replacement of deficient factors?

139
Q

What is cryoprecipitate?

A

Enriched with fibrinogen as well as von Willebrand factor, Factor VIII-C and factor XII

140
Q

What is the name of the Post-Op anesthesia recovery discharge criteria?

A

Modified Aldrete

141
Q

What 5 things are taken into consideration for the Modified Aldrete discharge score?

A

1-Respiration
2-Oxygen Saturdation
3-Consciousness
4-Circulation
5-Activity

142
Q

What score must there Aldrete score be above for discharge?

A

> 8

143
Q

What are your serotonin antagonists for PONV?

A

Odansetron
Dolasetron

144
Q

What works against Histamine for PONV?

A

Promethazine

145
Q

What targets the dopamine receptors for PONV

A

Droperidol
Metoclopramide

146
Q

What PONV med works gains ts the muscarine receptor?

A

scopalamine

147
Q

What are the causes of delayed awakening?

A

1-Overdose
2-Hypothermia
3-Hypercarbia
4-Hypoxia
5-CVA

148
Q

What can you do to troubleshoot delayed awakening?

A

1-Rule out stroke
2-Vitals signs assessment
3-electrolyte and glucose level eval

149
Q

What meds can you give someone with delayed awakening?

A

1-Flumazenil
2-Naloxone for opiates
3-Physostigmine for reversal of anticholinergics?

150
Q

Emergency doses for Naloxone, Atropine, Vasopressin, Epinephrine and Lidocaine given down the endotracheal tube

A
151
Q

What are the main anatomical differences between pediatric and adult airways?

A

1-Tongue is larger
2-Epiglottis is floppy and omega shaped
3-Larynx if funnel shaped
4-Narrowest point of the airway is in the subglottic region.

152
Q

How do you determine the size of an endotracheal tube for a pediatric patient?

A

Age /4 + 4

153
Q

True or False, pediatric airways are more reliant on the diaphragm?

A

true

154
Q

True/False: Cardiac output in pediatrics is mostly driven by HR

A

True

155
Q

T/F: Elderly patients have decreased MAC

A

True, decreased minimal alveolar concentrations (increased sensitivity to inhalation agents)

156
Q

T/F: Elderly patients are more likely to be HTN

A

True, because of decreased vessel compliance, decreased cardiac output and HR

157
Q

T/F: Elderly patients have an increased V/Q mismatch

A

True

158
Q

BMI

A

stands for body mass index in kg/m2

159
Q

What are BMI ranges?

A

Overweight > 25 BMI
Obese - BMI >30
Severe/morbid obesity BMI>40

160
Q

What is the single biggest predictor of a probelmeatic intubation in obese patients?

A

Neck circumference 40-60 cm neck circumferences mean probelematic intubations

161
Q

What is Pickwickian syndrome?

A

Obesity hypoventilation syndrome

162
Q

Obesity & Physiological differences with respiratory function?

A

1-Decreased chest wall compliance
2-Decreased function residual capacity; adequate pre-oxygenation is necessary prior to intubation

163
Q

Obese patients have a high GFR? T/F

A

True, with quicker renal clearance except for lipophilic drugs

164
Q

Preoperative risks for diabetic patients?
8 come to mind

A

1-Dehydration (osmotic diuresis with hyperglycemia)
2-Autonomic dysfunction (postural hypotension)
3-Gastroparesis/increased aspiration risk
4-Wound healing
5-Infection
6-Stiff joints
7-Diabetic ketoacidosis risk (type 1 DM)
8-Hypoglycemia

165
Q

Management of diabetic patients

A

1-Schedule type 1 DM in early morning
2-Obtain glucose level on arrival
3-Consider halfing the daily dose

166
Q

What can occur with hyperglycemic patient’s and what symptoms can they present with?

A

DKA for type 1 DM, or hyperglycemic hypoerosmolar nonketotic state (type II DM)

1-Tachypnea, tachycardia, abdominal pain, temp alteration
2-Ketone breath in type 1 DM

167
Q

In office, how do you manage DKA

A

1-Regular insulin infusion 0.1 units/kg/h
2-Normal saline 5 to 10 mg/kg/h, you can add 5% glucose if blood glucose is less than 250
3-REplenish potassium 03. to 0.5 mEg/Kg/h

168
Q

What is diaphoresis

A

Diaphoresis refers to excessive sweating, commonly associated with an underlying medical condition that alters hormone levels in the body.

169
Q

What are the symptoms of hypoglycemia?

A

1-Mental status change
2-Diaphoresis
3-Tachycardia
4-Possible seizure disorder

170
Q

How to manage hypoglycemic patients?

A

1-oral glucose
2-1 to 2 mg of IM glucagon
3-10 - 25 grams of glucose with IV access

171
Q

What symptoms may occurs with hyperthyroidism?

A

1-Hyperpyrexia (extreme body temp)
2-Tachycardia
3-HF
4-CNS changes
5-GI disturbances

172
Q

What can cause hyperthyroidism?

A

1-Infection
2-Trauma
3-Surgical sTress
4-Withdrawl/medicine compliance

173
Q

In neurological trauma patients, what fluids?

A

Isotonic fluids only to prevent intracranial fluid shifts

174
Q

Which med do you avoid in Neurologic trauma patients?

A

Ketamine!

175
Q

Which meds should you be careful of with Myasthenia gravis patients?

A

Ester anesthetics especially if patient is receiving anti cholinesterase therapy.

176
Q

What med do Myasthenia Gravis patient’s have decreased metabolism for?

A

Succinylcholine

177
Q

What therapy are Myasthenia Gravis patients on?

A

antichoinesterase therapy

178
Q

What is the treatment of myasthenia gravis?

A

Anticholinesterases
Thymectomy
Immunosuppression
Plasma exchange
IV immune noglobulin

179
Q

What symptoms can present with a myasthenia crisis

A

1-Muscle weakness
2-Bronchospams
3-Wheezing
4-Respiratory failure
5-Diaphoresis
6-Cyanosis

180
Q

What is the preferred method of airway treatment for asthematics

A

Laryngeal airway over ET tube

181
Q

Which. meds inhibit bronchoconstriciton for asthmatics

A

1-Propofol
2-Ketamine

182
Q

Which paralytics should be avoided for asthmatics

A

Atracurium and mivacurium because they induce histamine release

183
Q

Whare are the main treaters of bronchoconstriction

A

Beta 2 agonists

184
Q

Spastic CP vs Dyskinetic CP

A

1-Spastic CP-injury to the cerebral motor cortex
2-Dyskinetic-Inure to the basal gangliay

185
Q

Cerebral Palsy

A

A nonprogressive movement disorder that results form injury to the developing brain

186
Q

Ataxic CP

A

injury to the cerebellum
Characterized by tremor, loss of balance, and difficulty with speach

187
Q

Preop eval of cerebral palsy patients

A

1-Degree of spacicity and limb contracture
2-Evaluate hx of seizure episodes
3-Evaluate severity of GI reflux and impaired pharyngeal function with pooling of oral secretions
4-Evaluate respiratory function, airway tone, restrictive pulmonary disease

188
Q

Cerebral Palsy patients and nondepolarizing skeletal muscle realxants

A

CP patients may need higher dosage due to drug resistance

ABOMS (9 decks)

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