List style questions Flashcards

1
Q

Hypoxemic vs hypercapnic RF symptoms:

A

Early manifestations:
- Mental status changes
- Increased HR
- Increased RR
- Mild HTN

Hypoxemic RF:
- Paradoxical breathing
- Retractions
- Nasal flaring
- Tachypnea/dyspnea
- Cyanosis

Hypercapnic RF:
- Pursed-lip breathing
- Morning headache
- Retractions
- Rapid shallow breahting
- Tripod position

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2
Q

Type 1 vs Type 2 RF symptoms:

A

Type 1:
- Dyspnea, irritability, confusion, fits, somnolence, cyanosis, pulmonary HTN

Type 2:
- High CBF, headache, blurred vision (papilledema), excitation, coma, warm extremities, asterix, collapsing pulse due to hypercapnic peripheral vasodilation, acidosis

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3
Q

Part of a tracheostomy tube:

A

Neck plate, obturator, inner cannula

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4
Q

Main types of tracheostomy tube:

A

Cuffed, fenestrated, cuffless

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5
Q

Oral intubation advantages and disadvantages:

A
  • Advantages - Performed easily and quickly, Larger tube used (facilitates suctioning and procedure, lesskinking of the tube)
  • Disadvantages - Not reccommended with cervical injury, uncomfortable, risk of dental trauma, more difficult to perform mouth care
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6
Q

Nasal intubation advantages and disadvantages:

A
  • Advantages - Greater patient comfort and tolerance, better cmouth care, lower risk of accidental intubation
  • Disadvantages - More difficult to perform, may cause nasal hemorrhage, sinusitis, nasal septal necrosis, suctioning more difficult
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7
Q

Complications of intubation:

A

Trauma to airway stuructures
Hypoxia
Dysrhythmias
Aspiration
Intubation of esophagus or right mainstem bronchus
Laryngospasm, bronchospasm

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8
Q

Advantages of tracheostomy over endotracheal intubation:

A
  • Faster weaning, enhanced patient comfort and communication, possibility of oral feeding, more effective clearing of secretion
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9
Q

Disadvantages of tracheostomy:

A
  • Hemorrhage, pneumothorax, tracheal stenosis, accidental decannulation, need for an operative procedure
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10
Q

Regional anesthesia advantages and disadvantages:

A
  • Advantages - Cheap, high patient satisfaction, maintin patent airway, decreased blood loss, selective muscle relaxation, decreased incidence of DVT, PE
  • Disadvantages - Hypotension, toxicity risk, many patients prefer to sleep instead, skills required, patient can talk, patient anxiety, not reliable
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11
Q

Spinal anesthesia:

A

Only in lumbar region, brief duration, high quality of block

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12
Q

Drug contraindicated with vasoconstrictors:

A

CHLORPROCAINE is CONntraindicated with vasoCONstrictors

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13
Q

Absolute contraindications of spinal anesthesia:

A

Increased intracranial presure
Sepsis
Coagulation therapy / disorders
Hypovolemia
Infection at site
Patient refusal
Severe hypovolemia

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14
Q

Relative contraindications of spinal anesthesia:

A

Peripheral neuropathy
Mini-dose heparin
Psychosis
Aspirin and antiplatelet drugs
Demyelinated CNS disease
Cardiac lesions **
Emotional instability
Prolong surgery
Surgical team resistance

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15
Q

Complications of spinal anesthesia:

A

Failed block
Back pain
Hypotension
Local anesthesia toxicity
High blockade
Urinary retention
Local infection
Meningism
Epidural hematoma
Spinal headache

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16
Q

Epidural test:

A

3mL lidocaine 1.5% w/ epinephrine

Positive:
Tachycardia (increase>30bpm)
High BP
Lightheadedness
Metallic taste in mouth
Ringing in ears
Facial numbness

17
Q

Complications of epidural anesthesia:

A

Penetration of blood vessels
Hypotension
Nausea and vomiting
Headache
Back pain
Intravascular cathetization
Dural puncture
Infection

18
Q

Factors increzasing MAC:

A

Hyperthermia
Hypernatremia
Drugs that increase catecholamine levels (tricyclic antidepressants, acute cocaine ingestions)
Chronic ethanol abuse

19
Q

Factors decreasing MAC:

A

Hypothermia
Hyponatremia
Pregnancy
Li, lidocaine, a2 agonsists
PaO2<38mmHg
BP <40mmHg
Increased age
Preoperative medication
Drugs that decrease CNS catecholamine levels (a-methyldopa, clonidine)
Acute ethanol ingestion

20
Q

Factors not affecting MAC:

A

Duration of anesthesia
Potassium disturbances
Magnitude of anesthetic metabolism
Gender
PaCO2 15-95
PaCO2 >38mmHg
BP<>40mmHg

21
Q
A