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23 Cards in this Set
- Front
- Back
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calculate the BMI of a person 70 kg and 1.8 meters tall
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BMI= wt in kg divided by Ht in meters squared. 1" = 0.0254 meters
The BMI would be 21.6 kg/m2 |
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what is the best fluid status indicator of an NPO person?
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Urine output. Oliguria suggests hypovolemia
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What does the TMD tell you?
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the probable ease of intubation.Normally >6.5 cm
If < 6 cm, it increases the difficulty of visualizing the larynx |
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Assessment of C-spine is critical in which pt population?
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Pts with trauma, rheumatoid arthritis or downs syndrome. (also h/o diabetes)
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T/F. The prerioperative period is associated with a hypercoagulable state, and surges in catecolamines both of which can exacerbate underlying unstable angina leading to an MI
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T
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T/F. In pts with prior MI and subseqeunt intervention should be evaluated preoperatively based on their risk for onging ischemia
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True
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In a diabetic pt, what is the best predictor of silent CAD
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Autonomic neuropathy. These pts usually have silent MIs so a preop EKG is indicated (look for Q waves)
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According to AHA/ACC what are the high risk procedures for a person with known CAD?
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Reported cardiac risks( > 5%) for emergent major, aortic, major vascular, peripheral vascular, anticipated prolong procedure with lots of fluid shifts and or blood loss.
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According to AHA/ACC what are the intermediate risk procedures for a person with known CAD?
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Reported cardiac risks (<5%) include CEA, head/neck, intraperitoneal and intrathoracic, orthopedic, and prostate
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What are the low risk surgeries for a person with CAD
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Reported cardiac risks (<1%) for endoscopic procedures, superficial, cataract and breast procedures
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Why is it important to determine a pts exercise tolerance?
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Exercise tolerance is one of the most important determinants of peri op risks and the need for further testing and invasive monitoring. The risk of serious adverse events is inversley related to the number of blocks they could walk.
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Who is at high risk for silent MI?
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pts with HTN and DM have a silent MI rate of 30%
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What does an exercise EKG tell you?
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it has a sensitivity of 70-80% and a specificity of 60-75% for ID CAD. A positive test means the pt is at risk for ischemia over a wide range of HR. Those who have ischemia after mild exercise are at highest risk
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What does a pharmacologic stress EKG tell you?. What agents are used?
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Useful in pts unable to exercise. Uses adenosine or dipyridamole. It assesses flow heterogeneity. Presence of redistribution defect is predictive of post op cardiac events.
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What is a stress echo and what does it tell you? which one has the best predictive value?
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Stress echos is a dynamic assessment of ventricular fxn. A positive test means there is regional wall motion abnormalities with exercise. Dobutamine echo has the best predictive value
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What can you seen in an Mallampati (MP) and laryngoscopic view (LV) 1
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MP: pillars, tip of uvula, soft & hard palate
LV: entire glottic |
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What can you seen in an Mallampati and laryngoscopic view 2
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MP: uvula, soft and hard palate
LV: posterior commissure |
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What can you seen in an Mallampati and laryngoscopic view 3
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MP; soft and hard palate (uvula base)
LV: tip of epigottis |
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What can you seen in an Mallampati and laryngoscopic view 4
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MP: hard palate only
LV: no glottal structures |
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Define overweight, obese, and extreme obesity
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overweight: BMI of >24 kg/m2
Obese: BMI of >30 extreme obesity: BMI of >40 |
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Risk classification of a pt undergoing non cardiac surgery: What are the predictors of a high risk pt?
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unstable coronary sydrome
*recent MI *unstable angina *CHF-decompensated *Significant arrhythmia:( AV block, ventricular arrhythmia, uncontrolled SVT) * severe valve dz |
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Risk classification of a pt undergoing non cardiac surgery: What are the predictors of a intermediate risk pt?
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*mild chest pain
*prior MI * CHF -compensated *diabetes |
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Risk classification of a pt undergoing non cardiac surgery: What are the predictors of a low risk pt?
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* advanced age
*abnorm EKG (LVH, LBBB, ST-T abnormalities) * in a rhythm besides SR (a-fib) *Low functional capacity *h/o stroke *uncontrolled HTN |
