Lung disease and anesthetic concerns

Question 1

What 2 questions to ask smokers?

Answer 1

Do you smoke?
When did you stop?

Question 2

How to assess dyspnea in copd pt?

Answer 2

Exercise tolerance
Home O2 requirements
Vaseline spo2

Question 3

Most common signs of chronic bronchitis

Answer 3

Cough
Sputum
Recurrent infections

Question 4

Causes of emphysema

Answer 4

Smoking
Alpha 1 antitripsin deficiency

Question 5

Is asthma reversible

Answer 5

Only partiallyy

Question 6

Sympathetic affect from nicotine

Answer 6

Increases HR BP SVR for 30 minutes after last cig

Question 7

Considerations when intubating smokers

Answer 7

Preoxygenate well
Avoid DL/ VL until deep anesthesia

Question 8

Advise to smokers

Answer 8

Advise to stop smoking 12 hours prior to surgery for nicotinic levels and COHGB to normalize
2 days- reactivity decreases
10 days- reactivity normalizes
8 weeks- reduce PPC
2 years- reduce MI to normal levels

Question 9

When to avoid histamine releasing drugs? What are histamine releasing drugs

Answer 9

COPD, asthma
Morphin, meperidine
Mivacurium, atracurium
Neostigmine
STP (Pentothal
Use albuterol before extubation

Question 10

FEV1 normal, old, rld

Answer 10

4/5- .8
1/3- .33
2.8/3.1- .9

Question 11

High risk PFT results
FEV1
FEV1/FVC ratio
VC

Answer 11

<2L
50%
15cc/kg or 10cc/kg

Question 12

Causes of bronchitis

Answer 12

Smoking, occupational exposure

Question 13

ETCO2 of bronchospasm

Answer 13

Shark fin
Slow upstroke to alpha angle then straight down

Question 14

Neuraxial block above ___ will cause inability to cough

Answer 14

T10