Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Co-Existing Disease 1 > Bariatric Anesthesia > Flashcards

Bariatric Anesthesia Flashcards

1
Q

American Heart Association defines obesity as body weight what percent greater than the ideal body wt?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is obesity a disease?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BMI equation?

A

Wt (kg)/ht(m)^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Overweight classification:

A

> 25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Obesity classification:

A

> 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Extreme obesity classification:

A

> 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which BMI has coexisting comorbidities?

A

35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Super obese pt classification:

A

> 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Obesity class 3 BMI

A

> 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Obesity class 2 BMI:

A

35-39.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Obesity class 1 BMI:

A

30-34.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Overweight BMI:

A

25-29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Normal BMI:

A

18.5-24.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

For every 13.6 kg fat wt gain how many miles is that?

A

25 miles of neovascularization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

0.1 L/min CO increase for how much of fat?

A

Every 1 kg of fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sympathetic activation contributes to obesity induced Na retention and HTN bc why?

A

Adrenergic blockade or renal denervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What plays a key role in mediating obesity HTN?

A

Excess renal Na reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Recent observations suggest that what may be a partial link between excess wt gain and increased sympathetic activity?

A

Leptin and its multi interactions with other neuro chemical pathways in hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the key role in the elevation of SNS?

A

Leptin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Does insulin stimulate SNS?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The ‘satiation hormone’ is made by adipose cells that helps to regulate energy balance by inhibiting hunger

A

Leptin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Leptin is opposed by the actions of the what other hormone?

A

Ghrelin (hunger hormone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do leptin levels in hypothalamus do in response to fasting and evoke profound changes in energy balance and hormone levels?

A

Fall rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Adipose tissue source of pro-inflammatory molecules (4)

A
  1. Leptin
  2. Tumor necrosis factor alpha
  3. Ang II
  4. Interleukin-6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is an important predictor of DM?

A

Decreased secretion of adiponectin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is a signal-averaged ECG?

A

More detailed type of ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Restrictive lung disease is accentuated by what 2 positions?

A

Supine and trendelenburg

28
Q

Normal neck circumference equation:

A

Ideal wt (kg)/ 2

29
Q

If normal neck circumference is increased by how much then will be difficult intubation?

A

13%

30
Q

Severely obese TBW is how much?

A

40%

31
Q

Estimated blood volume in obese pt is?

A

45-55 actually body wt

32
Q

4 facts of volume replacement:

A
  1. Avoid rapid rehydration
  2. Administer colloids at recommendations of IBW (20ml/kg)
  3. Albumin 5% and 25%
  4. Replace blood loss with crystalloid (3:1 ratio)
33
Q

Obese pts have a lower incidence of what stomach contents compared with lean pts?

A

High volume, low pH

34
Q

After how long of a fast does obese pts have larger volumes of gastric content?

A

9 hrs

35
Q

Your obese pts should be drinking clear liquids until what time before surgery?

A

2 hrs

36
Q

What should be used with risk for aspiration pneumonitis?

A

Consider H2 antagonists (cimetidine, ranitidine)

37
Q

What limited mobility do obese pts have? (2)

A
  1. TM joint

2. Atlanto-occipital

38
Q

FRC in obese pts?

A

Greatly decreased and direct inverse relationship between BMI and FRC

39
Q

Tidal volume should be accorded to what wt?

A

IBW (5-7 ml/kg) bc lungs aren’t bigger

40
Q

What should the rate be put at on machine for obese pt?

A

Increased rate

41
Q

An increase in Vd dose what to half life?

A

Prolongs the elimination half-life, despite increased clearance

42
Q

There is a significant increase in volume of distribution for a number of what type of drugs?

A

Highly fat soluble (benzodiazepines and barbiturates)

43
Q

Highly fat soluble drugs should be dosed in what wt?

A

TBW

44
Q

In obese pts there is a little or no change in volume of distribution to which drugs?

A

Less fat soluble (NMB agents)

45
Q

What should less fat soluble drugs be dosed in wt wise?

A

LBW (or IBW+20%)

46
Q

What the the one exception to less fat soluble drugs being dosed in LBW?

A

Sux should be dosed to TBW

47
Q

Local anesthetic doses should be reduced by how much for subarachnoid and epidural blocks?

A

25%

48
Q

Some drugs are cleared more rapidly in obese pts and why is this?

A

Higher CO and splanchnic BF

49
Q

Males IBW equation:

A

50kg + 2.3kg for each inch over 60

50
Q

Females IBW equation:

A

45.5 (kg) +2.3kg for each inch over 60

51
Q

Propofol dosing should be in what for induction and infusion?

A

Induction: IBW
Infusion: TBW

52
Q

What should sux be dosed at?

A

TBW

53
Q

What should vec and roc be dosed at?

A

IBW

54
Q

What should cisatracurium be dosed at for loading and maintenance?

A

TBW loading, IBW maintenance

55
Q

Fentanyl, sufentanil, remi should be dosed at what?

A

IBW

56
Q

What position is poorly tolerated in obese pts?

A

Prone

57
Q

Watch position keeps abdominal wt off chest?

A

Lateral decubitus

58
Q

What is semi-Fowler’s semi-recumbent position?

A

Upper body elevated 30-40 degrees that is best position during post op period

59
Q

How should morbidly obese pts NEVER lie?

A

Flat

60
Q

What is the best intraop position?

A

Reverse trendelenburg

61
Q

Reverse trendelenburg may be better solution than what other 2 options?

A

Large TV and PEEP

62
Q

Postop analgesic techniques?

A

NSAIDS instead of narcotics

63
Q

Pulmonary emboli occur in what percent of obese pts who undergo surgery?

A

5-12%

64
Q

Alpha 2 agonist, clonidine, tizanidine, and dexmedetomidine cause what in obese pts?

A

Hypotension and bradycardia

65
Q

What form is best when taking acetaminophen?

A

Orally

Co-Existing Disease 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions