Anesthesia for Vascular Surgery - Quiz 4, Part 2

Question 1

AOX at what levels may be associated w a higher incidence of altered renal dynamics

Answer 1

Suprarenal and juxtarenal

Question 2

Is renal blood flow reduced if the AoX is below the renal arteries?

Answer 2

Yes.

Question 3

Does renal insufficiency occur most commonly with suprarenal or infrarenal AoX?

Answer 3

Suprarenal

Question 4

What is the best method to assess and anticipate which its may develop post-op renal dysfx?

Answer 4

per-op eval of renal fx

Question 5

Interruption of blood flow through this artery in the absence of collateral flood flow has been identified as a factor that causes paraplegia in its having an AAA repair

Answer 5

Artery of Adamkiewicz

greater radicular artery

Question 6

Does placing the AoX in a higher or more proximal area increase or decrease the incidence of neurologic complications?

Answer 6

increases

Question 7

What type of monitoring reflects dorsal spinal cord fx? Does it provide any info about the integrity of the anterior spinal cord?

Answer 7

SSEP

Nope. MEP does

Question 8

Ischemic colon injury is most often attributed to:

Answer 8

manipulation of the inferior mesenteric artery

Question 9

Pathophys of aortic cross-clamping depends on:

Answer 9

1. level of AoX
2. extent of CAD and heart fx
3. decree of periaortic collateralization
4. blood vol and distribution
5. activation of sympNS
6. anes agents and techniques

Question 10

Ischemic complications of higher AoX levels

Answer 10

1. Renal failure
2. Hepatic ischemia
3. Coagulopathy
4. Bowel infarction
5. Paraplegia

Question 11

What factor associated with the AoX may decrease global ventricular fx or cause overt myocardial ischemia?

Answer 11

increased ventricular wall stress

Question 12

Drug of choice to decrease preload and therefore decrease myocardial O2 demand during AoX

Answer 12

Nitroglycerin

Question 13

Inotropes used to improve CO during AoX

Answer 13

Dopamine

Dobutamine

Question 14

Drug used to decrease after load in AoX

Answer 14

Nipride

Question 15

IA used to decrease SVR in AoX

Answer 15

Isoflurane

Question 16

What triggers the inflammatory response from AOX including increased body temp, leukocytosis, tachycardia, tachypnea, and fluid sequestration?

Answer 16

Neuroendocrine response mediated by cytokines, TNF, plasma catecholamines, and cortisol