Unit 3 Flashcards
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
Does a bronchial blocker or DLT do better at isolating a lung?
DLT is superior
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
What is the strongest predictor of a AAA?
Previous positive family history
What size aneurysm is recommended for surgery?
Greater than 5.5cm
How does smoking cessation affect a AAA?
Decreases growth by 20%
What is unique to cardiac muscle cells when compared to neural and skeletal muscle cells?
Intercalated discs
What do intercalated discs allow for?
Facilitates synchronized contractions
Can neural tissue generate a RMP and propagate action potentials?
YES
Does inhaling nitric oxide cause, cGMP or cAMP to increase or decrease
Causes cGMP to increase which causes smooth muscle relaxation
Which drug class is sildenafil apart of?
PDE5 inhibitor
How do PDE5 inhibitors work?
Increases cGMP
Beside smooth muscle relaxation, what other side effect do PDE5 inhibitors have?
Anti-inflammatory properties
Increased Plt aggregation
Which two receptors decrease cAMP?
Muscarinic 2
Dopamine 2
What is the most common rhythm disturbance of a cardiac contusion?
R BBB
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
