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Flashcards in Review Deck (14)
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1
Q

1) Compensatory vasoconstriction is blocked therefore decreased BP during spinal or epidural block may be exaggerated?
2) Associated with hemodynamic instability and decreased BP during GETA (GA with ETT)?
3) Decrease BP with induction?

A

1) Prazosin
2) ACE inhibitors (-prils)
3) Angiotensin II Blockers (-artans)

2
Q

Hypertensive Crisis (DBP >130, place A-line and foley)

  • Decrease BP by ___ during first ___ of treatment (ongoing treatment over 24-48 hours).
  • Drug of choice?
A
  • 20% during first 2 hours

- Nipride (nitroprusside, SNP) 0.5-10 mcg/kg/min

3
Q

Hypertensive crisis can result in the following????

A

Renal insufficiency
Subarachnoid hemorrhage
Encephalopathy
CHF

4
Q

Intraop HTN usually due to ___!!
Incidence higher in people with essential hypertension!
-Treat with ___ if pain is obvious cause
-IAs (too much ___ can cause increased ___)
-BB, NTG, nipride

A

Pain!!

  • narcotics
  • desflurane, increased SNS outflow
5
Q
Intraop Hypotension Treatment:
-Decrease \_\_\_
-fluids
-\_\_\_ = ??
-Check rhythm is it \_\_\_ 
(maintain \_\_\_, avoid increasing concentration of \_\_\_)
A

-anesthetic depth
-sympathomimetics (ephedrine, phenylephrine)
-Junctional
(normocapnea, inhalational agents)

6
Q

1) May see rebound SNS stimulation?
- Avoid these in people with ?????
2) Cause rebound hypertension and decreased anesthetic requirements??
3) May cause angina in patients with ischemic heart disease?

A

1) Beta blockers
- asthma, COPD, CHF, HB, sick sinus
2) Clonidine and Methyldopa
3) Hydralazine

7
Q

Anesthetic Management of Cardiac Tamponade:

  • Percardiocentesis, Subxiphoid/Thoracic Pericardiostomy
  • Expand?
  • Increase? Use?
  • Correct?
  • Can do??
A

-intravascular volume
-myocardial contractility - isoproterenol
-Metabolic acidosis
under local or with ketamine

8
Q

Anesthetic Management Constrictive Pericarditis:

  • Pericardiectomy
  • Minimize changes to HR, SVR, Preload, Contractility use???
  • Avoid?
  • Maintain ___ to avoid Hypotension
  • A-line
  • ___ may be necessary to treat blood losses assoc. with pericardiec.
A
  • ketamine, etomidate, pancuronium
  • bradycardia
  • intravascular volume
  • Blood transfusions (type and cross 2 units)
9
Q

Most common nutritional deficiency in children and infants?

A

Iron deficiency anemia

10
Q

Associated with lots of neuro changes - neuropathies, decreased DTRs, loss of proprioception and vibration in LEs, unsteady gait, memory impairment and mental depression?

  • Avoid ___ due to neuropathies
  • Avoid ___
  • Maintain oxygen
  • Emergency correction for imminent surgery?
A

Vitamin B12 Deficiency Anemia

  • regional blocks
  • Nitrous
  • Transfuse PRBCs
11
Q

Need alternate airway management plan with this type of anemia?

A

Folic acid deficiency anemia (smooth, thick tongue)

12
Q

Both of these types of anemia may result in pernicious anemia?

A

-Folic acid deficiency
-Vitamin B12 deficiency anemia
(both macrocytic, megaloblastic)

13
Q
  • Potential difficult airway s/t maxillary deformities seen with? Very sensitive to?
  • Co-existing congenital abnormalities associated with this are fanconi anemia, heart defects and cleft palate?
A
  • Thalassemia
  • digitalis

-Aplastic anemia (BM failure)

14
Q
  • Anemia often secondary to manifestation of another disease process?
  • identify and treat underlying disease
  • do not disrupt compensatory mechanisms
  • rarely require blood transfusion
  • May need less ___ for effect (may be less soluble in plasma of anemic patient)
A
  • Chronic Anemia

* volatile anesthetics