Anesthesia for Therapeutic & Diagnostic Procedures - Quiz 3 Flashcards

1
Q

How does JACAHO define Anesthesia?

A

IV, IM, or Inhaled Meds that cause loss of Protective Reflexes

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2
Q

What are the Drugs of Choice for Anesthesia at the Office (ENT or Dental)

A

Propofol

Sevo

Des

N2O

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3
Q

What is required by the ASA & JCAHO for Office Anesthesia?

A

Maintained Anesthesia Equipment

Documentation

Monitoring & Emergency Equipment

Staffed PACU

Plan for Emergency Transport

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4
Q

How should patients who are at risk for adverse reactions to Contrast be pretreated?

A

Prednisone 50mg 12 Hours Before

&

Benadryl 50mg right before

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5
Q

What can be given to reduce the risk of Nephrotoxicity from Contrast?

A

Acetylcysteine

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6
Q

What can develop in Type 2 Diabetic Renal Patients on Metformin who receives Contrast?

A

Severe Lactic Acidosis

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7
Q

Why is Deliberate HYPERtension needed for Cerebral Ischemia?

A

Maximizes Collateral Flow

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8
Q

Why should Emergence be Smooth for Interventional Radiology Procedures?

A

To avoid Device Migration & Intracranial Hemorrhage

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9
Q

What should the ACTs be for Cerebral Coiling?

A

2 - 2.5X above normal

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10
Q

What degree of Coronary Stenosis is considered hemodynamically significant?

A

50 - 70%

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11
Q

What can happen after a Stenotic Coronary Artery is Dilated?

A

Ventricular Arrhythmias

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12
Q

What are the adverse effects of Protamine?

A

Vasodilation

Anaphylaxis

Pulmonary Vasoconstriction

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13
Q

What is an important side effect of Abciximab?

A

Increased ACT without Heparin

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14
Q

Which drugs are Platelet Aggregation Inhibitors?

A

Abciximab

Ticlopidine

Clopidogrel

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15
Q

What can the use of Glucagon cause when used during an ERCP?

A

Tachycardia

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16
Q

What meds should be avoided during Sphincter of Oddi Manometry due to their effect on sphincter tone?

A

Opioids

Glycopyrrolate

Atropine

Glucagon

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17
Q

What is the purpose of a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure?

A

Decompresses Portal Circulation by connecting the right or left portal vein to one of three hepatic veins

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18
Q

TIPS procedure is normally performed under _______

A

TIPS procedure is normally performed under GENERAL ANESTHESIA

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19
Q

What is Electroconvulsive Therapy used for?

A

Depression

Mania

Schizophrenia

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20
Q

How often is Electroconvulsive Therapy performed to treat mental disorders?

A

3x per week for for 6-12 treatments

then weekly or monthly treatments

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21
Q

How does Electroconvulsive Therapy work?

A

Release Neurotransmitters during Grand Mal Seizure

↑Stress Hormones

↑NorEpi & Epi

Improved Glucose Control for DM2

Hyperglycemia for DM1

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22
Q

Which hormones are increased following Electroconvulsive Therapy?

A

ACTH

Cortisol

Vasopressin

Prolactin

Growth Hormone

23
Q

Electroconvulsive Therapy _______ Cerebral Blood Flow & Intracranial Pressure

A

Electroconvulsive Therapy INCREASES Cerebral Blood Flow & Intracranial Pressure

24
Q

How is the Heart affected by Electroconvulsive Therapy?

A

Bradycardia, then HTN & Tachycardia

Dysrhythmias

Myocardial Ischemia

25
What are the physical effects of Electroconvulsive Therapy?
Short Term Memory Loss Muscle Aches Fractures Seizures Sudden Death
26
What is an _absolute_ contradication to Electroconvulsive Therapy?
Pheochromocytoma
27
What are some _relative_ contraindications to Electroconvulsive Therapy?
↑ICP Recent CVA Heart Conduction Problems High Risk Preggos Aortic/Cerebral Aneurysms
28
Which muscle relaxant is preferred for Electroconvulsive Therapy?
Succinylcholine 0.75 - 1.5 mg/kg
29
What are some EKG changes related to Electroconvulsive Therapy?
PACs PVCs ST Depression T-Wave Inversion
30
What are the most common cause of death related to Electroconvulsive Therapy?
MI & Arrhythmia
31
The goal of Electroconvulsive Therapy is a seizure that lasts \_\_\_\_\_\_\_
The goal of Electroconvulsive Therapy is a seizure that lasts **30-60 SECONDS**
32
During Electroconvulsive Therapy, there will be Bradycardia, then HTN & Tachycardia. How should this be treated?
Esmolol
33
What are the anesthetic considerations for patients with Down Syndrome?
Abnormal Cardiac Conduction A-O Dislocation Macroglossia Hypoplastic Maxilla Abnormal Palate Mandibular Protrusion
34
What are the Ketamine doses for Dental Procedures?
Ketamine 1-2 mg/kg IV 5-10 mg/kg Oral 2-4 mg/kg IM
35
What anesthetics are usually used for Dental Procedures?
Ketamine Oral Versed EMLA Cream for IV
36
What are the Airway Consideration for Dental Procedures?
Nasal Tracheal Intubation LMA Post-Op Bleeding, Obstruction, and Larygospasm
37
What is considered Minimal Sedation or Anxiolysis?
Patient can respond to Verbal Commands & Preserved Airway, Ventilatory, and CV Reflexes
38
What is considered Moderate or Conscious Sedation?
Patient responds to Verbal Commands _WITH Light Tactile Stimulation_ Patent Airway Preserved Spont. Ventilation & CV Function
39
What is considered Deep Sedation?
Patient responds to _repeated PAINFUL stimuli_ Impaired Ventilation & Airway Preserved CV Function
40
What is considered General Anesthesia?
Patient NOT arousable Impaired Ventilation, Airway, and CV Function
41
What is a Ramsay Scale of 1?
Patient Anxious, Agitated, or Restless
42
What is a Ramsay Scale of 2?
Patient Cooperative, Oriented, and Calm
43
What is a Ramsay Scale of 3?
Patient responds to commands only
44
What is a Ramsay Scale of 4?
BRISK response to Light Glabellar Tap or Auditory Stimuli
45
What is a Ramsay Scale of 5?
SLOW response to Glabellar Tap or Auditory Stimuli
46
What is a Ramsay Score of 6?
No Response Glabellar Tap or Auditory Stimuli
47
What is the Adult Fasting Protocol for Solids & Non-Clear Liquids?
6-8 Hrs or NPO after Midnight
48
What is the \>3 y.o Child Fasting Protocol for Solids & Non-Clear Liquids?
6 - 8 Hours
49
What is the Fasting Protocol for Solids & Non-Clear Liquids for Kids 6-36 months?
6 Hours
50
What is the Fasting Protocol for Solids & Non-Clear Liquids for Kids \< 6 months?
4 - 6 hrs
51
What is the Fasting Protocol for Clear Liquids?
2 Hours for Kids \< 6 months & 2-4 Hours for everyone else
52
For Recovery, the patient must have V/S every 10 minutes x 3, then every hour x two OR until they have an Aldrete score of at least \_\_\_\_\_\_
For Recovery, the patient must have V/S every 10 minutes x 3, then every hour x two OR until they have an Aldrete score of at least **9**
53
What's the minimum time a patient is to be observed post procedure?
30 min & 1 Hour if Resuscitive measures were needed