Review Deck 4

Question 1

To come off of bypass,

Answer 1

core temp must be >35
corrected labs
heart paced or SR at sufficient rate of 90

Question 2

Complications of aortic cross clamp include

Answer 2

hemorrhage
dislodgement of atheromas
aortic dissection

Question 3

Protamine is given slowly because it can cause

Answer 3

hypertension, right heart failure, and hypotension related to type 1 histamine release

Question 4

Protamine is derived from

Answer 4

salmon sperm

Question 5

Contraindications to heart transplant are

Answer 5

> 70
chronic renal dysfunction
obesity

Question 6

Platelet function is lost or altered by

Answer 6

hemodilution
hypothermia
contact with CPB circuit

Question 7

_____ is the leading cause of periop mortality at the time of vascular surgery

Answer 7

Coronary artery disease

-silent or unrecognized MIs are possible

Question 8

Coexisting disease for vascular surgery include

Answer 8

DM
HTN
renal impairment
pulmonary disease
systemic atherosclerosis 
CAD

Question 9

Drug eluting stents should be continued for

Answer 9

6 months on dual anti-platelet therapy

Question 10

_____ strongly predicts long-term mortality

Answer 10

chronic renal disease

Question 11

The principle cause of CAD is

Answer 11

atherosclerosis

Question 12

Best monitor of neurological function for carotid endarterectomy is

Answer 12

awake anesthesia

Question 13

Arterial blood pressure should be maintained in the _______ range throughout the procedure & during the period of carotid clamping to increase collateral flow & prevent cerebral ischemia

Answer 13

high-normal range

Question 14

Surgical manipulation of carotid sinus includes

Answer 14

baroreceptor reflex leading to decreased HR & BP

-tell surgeon to stop, infiltrate with lidocaine, give glyco

Question 15

Describe the difference in symptoms between aortic aneurysm compared to dissection

Answer 15

aneurysm- asymptomatic

dissection- severe sharp pain

Question 16

This concept applies to aneurysms

Answer 16

Law of Laplace

Question 17

Elective repair of aneurysm is for AAA

Answer 17

6 cm or larger
becomes symptomatic
more than 0.5 cm in a 6 month period

Question 18

Classic triad for rupture AAA:

Answer 18

hypotension
back pain
pulsatile abdominal mass

Question 19

For patients who you’re concerned about giving contrast to

Answer 19

limit the contrast load & provide adequate hydration to decrease the viscosity of iodine based dyes

Question 20

Artery of adamkiewicz is

Answer 20

T9-T12

Question 21

Describe what happens above and below the clamp

Answer 21

arterial hypertension above

hypotension below

Question 22

Cross clamping of the thoracic aorta decreases

Answer 22

total body O2 consumption by approximately 50%

Question 23

These drugs can be used for renal protection

Answer 23

mannitol or dopamine

Question 24

The strongest predictor of postoperative renal dysfunction is

Answer 24

preoperative renal insufficiency

Question 25

During cross-clamp, the lower part of the body

Answer 25

should not be warmed because it can increase metabolic demands

Question 26

Spinal cord protection strategies include

Answer 26

CSF drainage
mild hypothermia
limit cross clamp <30 minutes
monitor SSEPs/MEPs

Question 27

Goals during cross clamping include in respect to afterload, preload, CO

Answer 27

reduce afterload
maintain normal preload
maintain CO

Question 28

Hemodynamic response to unclamping can lead to

Answer 28

hypotension–> prepare to decrease vasodilators, inhaled anesthetics, increased fluid administration, consider cross clamp reapplication