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Advanced Anesthesia 2 > Obesity & Thermal Injury - Quiz 1 > Flashcards

Obesity & Thermal Injury - Quiz 1 Flashcards

1
Q

How is BMI calculated?

A

Wt (kg) ÷ Ht (m2)

or

Wt (lbs) ÷ Ht (in2) x 703

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2
Q

What BMI is considered “Overweight”

A

25 - 29.9

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3
Q

What BMI is Class III Obese or Extreme Obese?

A

40 - 44.9

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4
Q

A BMI of 30 - 34.9 is considered ________

A

A BMI of 30 - 34.9 is considered Class I Obese

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5
Q

What BMI is Obese Class II?

A

35 - 39.9

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6
Q

At what BMI is a person considered Severly Obese or Class IV Obese?

A

BMI > 45

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7
Q

How is Ideal Body Weight calculated for Males using Broca’s Index?

A

Height (cm) - 100

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8
Q

How is Ideal Body Weight calculated for Females using Broca’s Index?

A

Height (cm) - 105

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9
Q

How is Lean Body Weight Calculated?

A

Ideal Body Weight (IBW) x 1.3

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10
Q

What are the functions of Adipose Tissue?

A

Protein Secretion

Energy

Insulation

Triglyceride & Lipid Synthesis

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11
Q

Android Adipose distribution is _____, whereas Gyencoid Adipose distribution is ______

A

Android Adipose distribution is APPLE-SHAPED, whereas Gyencoid Adipose distribution is PEAR-SHAPED

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12
Q

Which type of Adipose Distribution is associated with more Comorbidities?

A

Android: Heart Disease, DM, HTN, HLD, Death

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13
Q

How much Cardiac Demand is needed for each Kg of Fat?

A

0.1 L/min

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14
Q

What does Obesity do to the Heart?

A

Cardiomegaly

Atrial/Ventricle Dilatation

Hypertrophy

CAD

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15
Q

How does Obesity double the risk for HTN?

A

↑Blood Viscosity

↑Mineralocoticoids

Hyper-Insulin

Sodium Reabsorption

Kidney Compression

RAA Activation

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16
Q

How does Obesity affect the Lungs?

A

Restrictive Flow Volume –> Inhibited Lung Inflation –> Hypoventilation & Hypercarbia

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17
Q

With Restrictive Lung Disease, what is Decreased?

A

FRC

ERV

VC

TLC

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18
Q

How is Obstructive Sleep Apnea defined?

A

5 Apneic Episodes of 10 seconds per Hour or 30 Episodes per Night

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19
Q

What is the Gold Standard for Diagnosing OSA?

A

Polysomnography (PSG)

20
Q

What are the signs of Obese Hypoventilation or Pickwickian Syndrome?

A

Sudden Somnolence

OSA

Right Heart Failure

Pulm. HTN

Polycythemia

21
Q

How does Obese Hypoventilation or Pickwickian cause Right Heart Failure?

A

Hypoxic Pulmonary Vasoconstriction

or

Pulmonary HTN

or

Cor Pulmonale

22
Q

Which anesthetic drug doses are based on Total Body Weight?

A

Maintenance Propofol

Induction Succinylcholine

Fentanyl Loading

23
Q

All doses of Rocuronium, Vecuronium, and Cisatrcurium are based on what kind of weight?

A

Ideal Body Weight

24
Q

How much is FRC reduced in the Obese Patient vs Non-Obese under General Anesthesia?

A

50% Reduced in Obese

vs

20% in Non Obese

25
Q

What can Improve FRC, but also Reduce Cardiac Output & O2 Delivery?

A

PEEP

26
Q

How does Obesity affect Volume Replacement?

A

↑Total Body Volume

&

↓EBV

27
Q

What does a 1st Degree Burn affect?

A

Epidermis - no treatment needed

28
Q

What does a 2nd Degree Burn affect?

A

Dermis - Deep, Superficial Partial Thickness

May need grafting

29
Q

What does a 3rd Degree Burn affect?

A

Subcutaneous - Full Thickness

Grafting NEEDED

30
Q

What does a 4th Degree Burn affect?

A

Muscle

Fascia

Bone

Requires Extensive Treatment

31
Q

What is classified as a Major Burn?

A

2nd or 3rd Degree Burn > 10% for Adults & 20% for Age Extremes

32
Q

How does the Rule of Nines work for Adults?

A

Head = 9%

Front Torso = 18%

Back Torso = 18%

Each Arm = 9%

Each Leg = 18%

33
Q

How does the Rule of Nines work for Pediatrics?

A

Head = 18% - 1% for each year over 1 y.o

Front Torso = 18%

Back Torso = 18%

Each Arm = 9%

Each Leg = 14% + 0.5% for each year over 1 y.o.

34
Q

What is the Initial Treatment for Chemical Burns?

A

Lots of Water/Saline

35
Q

What types of burns can cause Myoglobinuria & Renal Failure?

A

Electrical Burns

36
Q

When is it ok to give Succinylcholine from the Time of Burn Injury?

A

Before 24 hours after Injury

37
Q

How do Burn Injuries affect NDNMB dosing?

A

Increases Dosage requirement 2-3x

38
Q

How does Carbon Monoxide poisoning kill 50-60% of Fire Victims?

A

Carbon Monixde has 200x more affinity to Hemoglobin & impaires O2 Delivery to tissues.

39
Q

How is Carbon Monoxide Poisoning treated?

A

100% O2 - decreases CO half-life from 4 hours to 40 min.

40
Q

When is Hypovolemic Shock the greatest after a Burn Injury?

A

First 12 Hours, then stabilizes after 24 hours

41
Q

How should Fluids be given to an Adult for burn-related Hypovolemic Shock?

A

LR 2-4 mL / kg x %BSA Burned

42
Q

How should Fluids be given to Children for burn-related Hypovolemic Shock?

A

LR 3-4 mL / kg x % BSA Burned

43
Q

How fast should Fluid Resuscitation happen for Burn Victims?

A

Half in First 8 hours & Second Half in 16 hours

44
Q

What are the signs of the Hypermetabolic / Hyperdanamic Phase 48 hours after a Burn Injury?

A

Hyperthermia

Tachypnea

Tachycardia

↑Catecholamines

↑O2 Consumption

↑Catabolism

↑BMR

45
Q

What is the Hallmark of Burn Shock?

A

Decreased Cardiac Output

46
Q

How do Burn Injuries affect the Lungs?

A

↓FRC & Function

↑Ventilation up to 40 L/min

Pulm Edema

Advanced Anesthesia 2 (8 decks)

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