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IDC Anes Principles 3 - Respiratory > PRIN 3 - Test 3 Anes Resp Dz YSK > Flashcards

PRIN 3 - Test 3 Anes Resp Dz YSK Flashcards

1
Q

Ventilation that does not participate in gas exchange

A

Dead Space

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2
Q

Pulmonary Blood Flow, what does zone 1 represent?

A

Represents alveolar dead space because the region is ventilated but not perfused

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3
Q

Distribution of pulmonary blood flow in the isolated lung in zone 1 is

A

alveolar pressure (PA) exceeds pulmonary artery pressure (Ppa), and no flow occurs because the vessels are collapsed.

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4
Q

What is the solubility coefficient of oxygen in plasma?

A

0.003

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5
Q

What is the methhemoglobin contaminiation factor (constant)?

A

1.36

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6
Q

Oxygen Dissociation curve what shifts the curve to the Left

A 
(Increase affinity for O2)
INC pH
DEC 2,3 DPG
DEC Temp
High Saturation for given pO2
P50 decreases
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7
Q

Oxygen Dissociation curve what shifts the curve to the Left

A 
(Decreased affinity to O2)
DEC pH
INC DPG
INC Temp
O2 readily diffusions to the tissues
P50 increase
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8
Q

What is the O2 content equation?

A

CaO2 = ( 1.36 x Hgb x arterial Hgb saturation) + ( PaO2 X 0.003)

Where CaO2 = arterial O2 content

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9
Q

What is normal CaO2 when Hgb = 15g/dl and PaO2 is > 90mmHg

A

20mL of O2 per 100mL of arterial blood

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10
Q

What is the equation for calculating CvO2 (Mixed Venous Blood)

A

CvO2= ( 1.36 x Hgb x arterial Hgb saturation) + (PvO2 x 0.003)

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11
Q

What is normal CvO2 when Hgb is 15g/dL & OvO2 is 40 mmHg

A

15mL of O2 per 100mL of mixed venous blood

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12
Q

CO2 dissociation curve

A

When blood contains mainly oxygenated hgb, the CO2 dissociation curve shifts to the right, reducing the blood’s capacity to hold CO2.

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13
Q

For a give PCO2, CO2 content of blood increase as PO2 falls, this is called?

A

The Haldane effect.

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14
Q

Blood containing mainly oxygenated Hgb that has a reduced capacity to hold CO2

A

Causes a Right shift to the CO2 Dissociation Curve

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15
Q

Blood containing mainly deoxyhemoglobin blood has an INCreased capacity to hold CO2
Permits more CO2 to be carried in form of HCO3
Metabolic Acidosis

A

Produces a Left shift to the CO2 Dissociation curve.

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16
Q

Polysomnography

A

Polysomnography is the gold standard used to establish the diagnosis of OSA, which is based upon the number of abnormal respiratory events per hour of sleep (the apnea plus hypopnea index, AHI)

17
Q

What is the “Tx” for COPD

A

Beta2 Agonists (bronchodilators - albuterol)
Corticosteroids
Anticholinergics (Atrovent an anticholinergic bronchodilator)

18
Q

For intraoperative management of Asthma, which are the good drug choices (8)?

A 
Ketamine DOC
Propofol ok
Sevoflurane
Esmolol
Glyco & Atropine
Fentanyl
Steroids
19
Q

What are some drugs that should be avoided in the asthmatic pt (10)?

A 
Isoflurane & Desflurane
Morphine
Atracurium & Mivicurium
Ketorolac
Beta Blockers
Cimetidine & Ranitidine
Meperidine
20
Q

What are the steps 6 things you can do to treat and intraoperative bronchospasm?

A

1) Deepen the level of anesthesia with a volatile agent, ketamine, propofol, lidocaine, or a combination that rapidly increases anesthetic depth.
2) Administer 100% O2.
3) Administer a short-acting β2-agonist (SABA).
4) In severe cases, administer epinephrine intravenously or subcutaneously (in doses of 10 mcg/kg).
5) Administer intravenous corticosteroids—hydrocortisone 2 to 4 mg/kg.
6) Consider intravenous aminophylline if long-term postoperative mechanical ventilation is planned.

21
Q

An enlargement of the right ventricle due to high blood pressure in the lungs. Usually caused by chronic lung disease (COPD)

A

Cor Pulmonale

22
Q

When and how does Negative-Pressure Pulmonary Edema (NPPE) occur?

A

After extubation, if the pt experiences laryngospasm or airway obstruction & attempts a forceful inhalation against a closed glottis

23
Q

A type of rapid onset post-obstructive pulmonary edema that occurs during emergence from anesthesia that is treatable

A

Negative-pressure pulmonary edema

24
Q

Why does NPPE occur?

A

The drastic increase in negative intrathoracic pressure pulls fluid from the pulmonary capillaries & into lung tissue.

25
Q

How soon after an episode of NPPE are patients normally discharged from the hospital?

A

(as soon as) 24 hours

Rapid resolution of symptoms

26
Q

Unlike pulmonary edema, tx of NPPE does not ROUTINELY include?

A

Diuretics

27
Q

What is the treatment of NPPE?

A

1) Remove the precipitating condition (relieving airway obstruction)
2) Support oxygenation and ventilation:
with supplemental oxygen, CPAP, mechanical ventilation and PEEP.
3) Steroids to stabilize the capillary membrane.

28
Q

The hallmark sign of aspiration pneumonitis is?

A

Arterial Hypoxemia

29
Q

Clinical features of aspiration pneumonitis include?

A 
Arterial hypoxemia
Tachypnea
Dyspnea
Tachycardia
Hypertension
Cyanosis
30
Q

What is a good indicator of aspiration pneumonitis?

A

Witnessed gastric contents in the ETT or LMA

31
Q

What is a common finding for aspiration pneumonitis on CXR?

A

Pulmonary edema

32
Q

When developing a care plan for a patient with ankylosing spondylitis, the plan for airway management will include?

A

AWAKE FIBEROPTIC INTUBATION

33
Q

A common clinical sign of ankylosing spondylitis is?

A

Limited neck movement

34
Q

Pt’s with Ankylosing spondylitis are susceptible to what types of injuries?

A

Hyperextension injuries

Cervical fractures

35
Q

In a patient with Ankylosing spondylitis, when is a tracheostomy indicated as a therapeutic measure?

A

In the presence of Cricoarytenoid dysfunction.

36
Q

Regional Anesthesia for a patient with ankylosing spondylitis?

A

Regional may not be possible d/t skeletal involvement and proper positioning may not be possible.

IDC Anes Principles 3 - Respiratory (6 decks)

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