Quiz 1 Flashcards
1
Q
Risks of anesthesia
A
- Decreased systemic vascular resistance
- Decreased stroke volume
- Induction of general anesthesia lowers systemic arterial pressures by 20-30%, tracheal intubation increases the blood pressure by 20-30 mm Hg, and many anesthetic agents lower cardiac output by 15%
2
Q
High risk surgeries?
A
- vascular procedures-
- prolonged, complicated
- thoracic, abdominal
- head and neck procedures
3
Q
does the presence of anemia place the patient at higher perioperative risk?
A
yes
4
Q
Risk factors:
A
- presence of CAD and CHF
- a history of cerebrovascular disease
- preoperative elevated creatinine greater than 2 mg per deciliter
- insulin treatment for diabetes mellitus
- high-risk surgery
5
Q
Eval of cardiac risk:
A
- Risk factors (Age (but not alone), HTN, DM, Lipids, Tobacco)
- Angina
- Previous MI
- Dysrhythmias
- associated CVS disease (Aortic, Carotid, Renal)
- valvular disease
- presence of pacer/AICD
6
Q
displaced apical pulse means?
A
cardiomegaly
7
Q
s3 gallop means
A
increased LVEDP
8
Q
S4 means?
A
decreased compliance
9
Q
One MET represents the oxygen consumption of a resting adult, which is?
A
3.5 ml/kg/min
10
Q
If patients reduce exertion because of cardiac symptoms but still meet a 4-MET threshold, clinicians will _________ risk
A
underestimate
11
Q
Examples of 4 METS activities?
A
- light work like dusting or doing dishes
- climb a flight of stairs or walk uphill
- walk level at 4mph
- Run a short distance
- heavy work like scrubbing floors or moving furniture
- golf, bowling, tennis, dancing, playing catch
12
Q
What heart blocks require further testing?
A
- block greater than 1st degree
- LBBB
13
Q
Major clinical predictors of periop CV risk
A
- Unstable Coronary Syndromes (acute or recent MI, severe or unstable angina)
- Decompensated Heart Failure
- Significant Arrhythmias
- Severe Valvular Disease
14
Q
intermediate clinical predictors of periop CV risk
A
- Mild Angina
- History of MI, Pathologic Q’s
- Compensated or Prior CHF
- Diabetes Mellitus (controlled/uncontrolled)
- Renal Insufficiency (CKD)
15
Q
Minor clinical predictors of periop CV risk
A
- Advanced age
- Abnormal ECG (LVH,LBBB, ST-T abnormalities),
- Rhythm other than sinus (e.g. AF)
- Low functional capacity (e.g., inability to climb one flight of stairs)
- History of stroke
- Uncontrolled systemic hypertension
