Unit 3 Flashcards by Bryan Groff

When is a bronchial blocker beneficial compared to a DLT?

-Challenging airways
-Small airways
-Previous neck surgery
-Patients with a trach
-Children under 8
-When postop ventilation is required

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Does a bronchial blocker or DLT do better at isolating a lung?

DLT is superior

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What happens to BP when an aortic cross clamp is applied? What drug should be available?

Increased afterload (HTN) so a fast-acting drug like nitroglycerin is best to treat the high afterload

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What is the strongest predictor of a AAA?

Previous positive family history

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What size aneurysm is recommended for surgery?

Greater than 5.5cm

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How does smoking cessation affect a AAA?

Decreases growth by 20%

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What is unique to cardiac muscle cells when compared to neural and skeletal muscle cells?

Intercalated discs

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What do intercalated discs allow for?

Facilitates synchronized contractions

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Can neural tissue generate a RMP and propagate action potentials?

YES

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Does inhaling nitric oxide cause, cGMP or cAMP to increase or decrease

Causes cGMP to increase which causes smooth muscle relaxation

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Which drug class is sildenafil apart of?

PDE5 inhibitor

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How do PDE5 inhibitors work?

Increases cGMP

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Beside smooth muscle relaxation, what other side effect do PDE5 inhibitors have?

Anti-inflammatory properties
Increased Plt aggregation

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Which two receptors decrease cAMP?

Muscarinic 2

Dopamine 2

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What is the most common rhythm disturbance of a cardiac contusion?

R BBB

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What are patients with mitral stenosis dependent on?

Atrial kick

What are the 3 phase 1 reactions ?

Oxidation
Reduction
Hydrolysis

What is a phase 2 reaction? Examples?

Conjugation

Propofol
Morphine

What is oxidation? Examples of drugs that undergo?

Adds a molecule of oxygen

Fent
Midaz

What is reduction? Examples of drugs?

Adds an electron

Warfarin

What is hydrolysis? Examples of drugs?

Add a water molecule

Fast acting drugs

Succ
Remi

For a TAVR, what is the best type of pacing? What rate must be achieved?

Transvenous

200 bpm for one minute

Which congenital heart defect is most associated with increased risk for aortic root dilation?

Bicuspid aortic valve

Which type of cardioplegia is best for CAD, aortic insufficiency, and aortic valve issues?

Retrograde

What are the 2 primary functions of potassium rich cardioplegia?

- Stop the heart -Reduce myocardial demand

What is the classic triad of aortic stenosis?

- Chest pain -Exertional dyspnea -Syncope

Where is a murmur heard in a patient with AS?

Systolic murmur at the 2nd intercostal space Best heard laying in left lateral

When the aortic cross clamp is applied, does myocardial O2 consumption increase or decrease?

Increases and coronary flow increases

How does nitric oxide effect the RV?

Decreases RV afterload

Does NO effect arteries or veins more?

More arterial

Does NO have more systemic or concentrated effects?

More concentrated

How does NO effect platelets?

Inhibits adhesion and aggregation

What conserves blood the most during bypass ?

Sequestration of platelets before bypass

What valve area indicates severe AS?

<1 cm

What mean gradient and mac velocity indicate severe AS?

Mean gradient > 40 Max velocity > 4

ACE inhibitors are absolutely contraindicated in what?

Pregnancy