Miscellaneous

Question 1

Headache progressing to seizures 5 days after CEA? Treatment?

Answer 1

Cerebral hyperperfusion syndrome

Dilantin

Question 2

Most common nerve injury during CEA?

Answer 2

Hypoglossal nerve

Question 3

T/F

In patients with COPS, oxygen administration has a prolonged effect on respiratory drive and can result in apnea?

Answer 3

False

Only has transient effect on respiratory drive

Question 4

T/F

In patients with COPD, oxygen administration induces increase in pCO2

Answer 4

True

Question 5

T/F

In patients with COPD, oxygen administration raises pCO2 by reducing respiratory drive

Answer 5

False

True mechanism is through hypoxic pulmonary vasoconstriction and Haldane effect

Question 6

In patients with COPD, oxygen administration should be titrated to SpO2 of 96-100%

Answer 6

False

Target SpO2 88-92% for decreased rates of respiratory acidosis

Question 7

Hypoxic pulmonary vasoconstriction

Answer 7

Hypoxic (non-ventilated) alveoli are vasoconstricted to prevent shunting (V/Q mismatch)
Administration of high FiO2 increases oxygen tension in poorly ventilated alveoli resulting in impaired hypoxic pulmonary vasoconstriction
Arterial CO2 is shunted through non-ventilated alveoli, resulting in increased pCO2

Question 8

Haldane effect

Answer 8

Deoxygenated hemoglobin binds CO2 at much higher affinity than that of oxygenated hemoglobin
Increasing HbO2 will result in increased pCO2 due to CO2 disassociating from Hb
Explains 25% of increased pCO2 from O2 administration