CV Pathophysiology

Question 1

Risk of Reinfarction:
if > 6 months ago:
If 3-6 months ago:
If < 3 months ago:

Answer 1

6%
15%
30%

Question 2

High Cardiac risk for surgery > 5%

Answer 2

Emergency surgery (especially in elderly)
Open aortic surgery
Peripheral vascular surgery
Long surgical procedures with lots of volume shifts / blood loss

Question 3

Intermediate cardiac Risk 1-5%

Answer 3

Carotid Endarterectomy
Head and Neck surgery
intrathoracic
Orthopedic
Prostate

Question 4

CPP =

Answer 4

Aortic Diastolic pressure - LVEDP (PAOP)

Question 5

Conditions that INCREASE PVR:

Answer 5

hypoxia, hypervarbia, acidosis, hypothermia, high PEEP, nitrous oxide

Question 6

Anesthetic management for heart failure:

Answer 6

maintain higher afterload
slow the HR

Question 7

The most common cause of secondary HTN is:

Answer 7

renal artery stenosis

Question 8

_____ and____ are great choices to reduce HR in the patient with tachycardia, a-fib/flutter

Answer 8

Verapamil and Diltiazem

Question 9

_______ is the only CCB proven to reduce morbidity and motrality from cerebral vasospasm

Answer 9

Nimodipine

Question 10

Anesthetics considerations for constrictive pericarditis:

Answer 10

avoid bradycardia
preserve contractility
maintain afterload

Question 11

Beck’s Triad:

Answer 11

JVD, hypotension and muffled heart tones

Question 12

Best induction drug for a patient with pericardial tamponade?

Answer 12

Ketamine

local anesthesia preferred over GA for hemodynamic stability

Question 13

Is antibiotic prophylaxis against endocarditis required for mitral valve prolapse, CABG, or coronary stent placement?

Answer 13

NO

Question 14

IV abx for Infective endocarditis include:

Answer 14

ampicillin, cefazolin, ceftriaxone, clindamycin

Question 15

Conditions that WORSEN LVOT include: (3)

Answer 15

-decreased preload
-increased contractility
-decreased afterload

Question 16

Key treatments for LVOT reduction

Answer 16

-Beta-blockers
-CCBs
-Fluids
-Phenylephrine

Question 17

How long to wait for elective surgery after stent placement:
1. angioplasty without stent =
2. bare metal stent =
3. drug eluting stent =

Answer 17

1. 2-4 weeks
2. 1-3 months
3. 6-12 months

Question 18

Can aspirin be continued throughout the perioperative period for most surgeries?

Answer 18

Yes

Question 19

A ____ pump is preferred over a roller pump

Answer 19

centrifugal

Question 20

A _____ oxygenator is preferred over a bubble oxygenator

Answer 20

membrane

Question 21

Most common complications of IABP are:

Answer 21

vascular injury
infection at site
thrombocytopenia

Question 22

Crawford: Type ___ aneurysms present the most significant risk for paraplegia and/or renal failure following surgery

Answer 22

II

Question 23

Crawford type __ and __ are the most difficult to repair because they involved the thoracic and abdominal aorta.

Answer 23

2 and 3

Question 24

AAA repair is recommended when the diameter is > ___.

Answer 24

5.5 cm

Question 25

In the patient with right subclavian steal syndrome, arterial flow is diverted from the:

Answer 25

right vertebral artery to the right subclavian artery