Exam 3 (VAs pt II) Flashcards
What VA would be safer to use in a patient with concerns for an elevated ICP?
A. Sevoflurane
B. Desflurane
C. Isoflurane
A. Sevoflurane
What VA would be best to use for a patient with myocardial injury or heart failure?
A. Desflurane
B. Sevoflurane
C. Isoflurane
B. Sevoflurane
How much pressure is required to increase ICP?
7 mmHg
What VA has the best bronchodilatory effects?
A. Isoflurane
B. Desflurane
C. Sevoflurane
C. Sevoflurane
What VA may increase the risk of bronchospasm in patients who smoke, have COPD or an URI?
A. Isoflurane
B. Desflurane
C. Sevoflurane
B. Desflurane
VAs promote skeletal muscle relaxation primarily through _________ receptors and the inhibitory NT _________.
nACh ; Glycine
What gas has NO effect on skeletal muscle relaxation?
Nitrous
Cardiac ischemic preconditioning followed by exposure to VAs is mediated by _________.
Adenosine
EEG Burst suppression occurs with ______ MAC.
1.5
Which of the following VAs have anticonvulsant effects?
select all that apply
A. Isoflurane
B. Enflurane
C. Desflurane
D. Sevoflurane
E. Nitrous
A, C, and D
The VA ______ can potentiate seizure activity. What two factors further increase the risk?
Enflurane ; PaCO2 < 30 or 2 MAC
What anesthesia options are useful in a surgery where monitoring of SSEPs or MEPs is required?
60% nitrous with 0.5 MAC of a VA
or
TIVA
What VA has no effect on the refractory period of accessory pathways in the cardiac conduction system, and is useful for anesthesia during a catheter ablation?
A. Sevoflurane
B. Desflurane
C. Isoflurane
A. Sevoflurane
Specify if general anesthetics maintain/ increase / or decrease blood flow for the following vessel-rich groups
Total hepatic flow: maintain/ increase / decrease
Hepatic artery flow: maintain/ increase / decrease
Portal vein flow: maintain/ increase / decrease
Total hepatic flow: maintain
Hepatic artery flow: maintain
Portal vein flow: increase (at 1-1.5 MAC)
Iso=Des=Sevo
*halothane does decrease hepatic flow
Sevoflurane reacts with desiccated absorbant to form what byproducts? What is added to help prevent this?
Baralyme, methanol, formaldehyde
water added
What test can confirm suspected MH in a patient with a family history?
Caffeine contracture test
Dantrolene works by blocking intracellular release of _______
Calcium
Nitrous is ematogenic at what percent?
> 50%
Nitrous can cause what vitamin deficiency?
B12
Nitrous can cause what type of immune suppression? How long would the exposure need to be?
Megaloblastic bone marrow suppression; 24 hours or repeated exposures within a 3 day period
Nitrous can increase _____ which is associated with a higher rate of atherosclerosis.
homocysteine
VAs decrease ______ contractility
uterine
OB
VAs can be useful with a retained _______ BUT they can increase blood loss in uterine ______
placenta; atony
4 big concerns with halothane
catecholamine-induced arrhythmias
hepatic necrosis
pediatric bradyarrhythmias
decomposition into HCl acid
A highly pungent, longer acting VA that isnt great for mask induction
Isoflurane
A surgical patient’s post-operative plan involves admission to the ICU where they will require a few days of mechanical ventilation. What VA may be useful in this scenario?
A. Isoflurane
B. Desflurane
C. Sevoflurane
A. Isoflurane
what volatile is the MOST pungent
Desflurane
VAs can degrade into CO when absorbent is dehydrated. Organize the following VAs from most CO degredation to least CO degradation.
Isoflurane
Sevoflurane
Desflurane
Enflurane
Des>Enf>Iso>Sevo
Dah Environment Is Screwed
VA of choice for inhalation induction
Sevo
What ratio does this represent and what property of nitrogen makes it the highest?
The ratio of end-tidal alveolar concentration of an anesthetic (FA) relative to the inspired anesthetic concentration (FI). The ratio climbs faster for drugs related to their low solubility. When the decrease becomes more stable/plateaus this represents tissue saturation of vessel-rich groups.
