ANE-664-GERIATRICS TEST WITH
COMPLETE SOLUTIONS
What are the most 3 postop complications in geriatrics - ANSWER 1. cardiac
2. pulmonary
3. neurological
what are 3 factors that perioperative outcomes are related to - ANSWER 1. emergency
surgery
2. number of comorbidities
3. type of surgical procedure
what is part of the preoperative assessment and is important for developing an
anesthetic plan & providing informed consent - ANSWER identifying perioperative risks
what should preoperative assessment include - ANSWER cognitive ability
decision making
depression
postoperative delirium
ETOH and substance abuse
cardiac
pulmonary
frailty
functional
nutritional
medications
patient counseling
diagnostic tests
frailty score - ANSWER S - shrinkage
W - weakness
,E - exhaustion
L - low physical status
S - slowness
what disease is more prevalent in the geriatric population - ANSWER cardiac disease
what is the most common cardiac complication and leading cause of death in the post
op period - ANSWER MI
pathological change in geriatrics - ANSWER atherosclerosis
true age related changes - ANSWER 1. decreased vascular and myocardial compliance
2. decreased ANS response
what is preserved in the absence of coexisting disease - ANSWER resting systolic
cardiac function
what causes a decreased heart rate - ANSWER 1. increased vagal tone
2. decreased sensitivity of adrenergic receptors
maximal heart rate decreases how much a year after age 50 - ANSWER 1 bpm/year after
age 50
what increases risk of dysrhythmias such as A. fib and A. flutter - ANSWER 1. fibrosis of
the conduction system
2. loss of SA nodal cells
what preop tests are recommended by the AGS & NSQIP - ANSWER 1. 12 lead EKG
2. hemoglobin
3. kidney
4. albumin
what causes increased incidence of diastolic dysfunction - ANSWER when ventricles
become less compliant and filling pressures are increased (does not mean pt has
diastolic heart failure)
what tends to go along with diastolic dysfunction - ANSWER 1. systemic HTN
2. CAD
3. cardiomyopathies
4. valvular heart disease (aortic stenosis)
, what symptoms may the pt exhibit with diastolic dysfunction - ANSWER 1. dyspnea
2. exercise intolerance
3. cough
4. fatigue
what predisposes a patient to a. fib or a. flutter - ANSWER atrial enlargement
what may you see with a patient that has a diminished cardiac reserve - ANSWER
exaggerated decrease in BP during induction
consideration of IV drugs - ANSWER prolonged d/t decreased circulation time
considerations of inhaled anesthetics - ANSWER fast d/t decreased circulation time
structural and functional changes in CV system - ANSWER 1. increased afterload
2. increased SBP
3. ventricular hypertrophy
4. diastolic dysfunction
5. decreased end organ adrenergic response
6. prolonged circulation time
7. calcification of conduction system
8. loss of SA nodal cells
what increases the risk of perioperative complications - ANSWER increased BP
what are higher BP d/t - ANSWER 1. increased PVR
2. decreased arterial elasticity
3. decreased cardiac work load
what test should be done if diastolic dysfunction is suspected - ANSWER
echocardiograph
what should you consider with prolonged circulatory time in the geriatric patients -
ANSWER have patience when giving IV medications-takes longer to work
what does decreased vein compliance lead to - ANSWER decreased venous return and
right atrial filling
what does decreased sensitivity of myocardium to beta adrenergic modulation cause -
ANSWER decreased HR
COMPLETE SOLUTIONS
What are the most 3 postop complications in geriatrics - ANSWER 1. cardiac
2. pulmonary
3. neurological
what are 3 factors that perioperative outcomes are related to - ANSWER 1. emergency
surgery
2. number of comorbidities
3. type of surgical procedure
what is part of the preoperative assessment and is important for developing an
anesthetic plan & providing informed consent - ANSWER identifying perioperative risks
what should preoperative assessment include - ANSWER cognitive ability
decision making
depression
postoperative delirium
ETOH and substance abuse
cardiac
pulmonary
frailty
functional
nutritional
medications
patient counseling
diagnostic tests
frailty score - ANSWER S - shrinkage
W - weakness
,E - exhaustion
L - low physical status
S - slowness
what disease is more prevalent in the geriatric population - ANSWER cardiac disease
what is the most common cardiac complication and leading cause of death in the post
op period - ANSWER MI
pathological change in geriatrics - ANSWER atherosclerosis
true age related changes - ANSWER 1. decreased vascular and myocardial compliance
2. decreased ANS response
what is preserved in the absence of coexisting disease - ANSWER resting systolic
cardiac function
what causes a decreased heart rate - ANSWER 1. increased vagal tone
2. decreased sensitivity of adrenergic receptors
maximal heart rate decreases how much a year after age 50 - ANSWER 1 bpm/year after
age 50
what increases risk of dysrhythmias such as A. fib and A. flutter - ANSWER 1. fibrosis of
the conduction system
2. loss of SA nodal cells
what preop tests are recommended by the AGS & NSQIP - ANSWER 1. 12 lead EKG
2. hemoglobin
3. kidney
4. albumin
what causes increased incidence of diastolic dysfunction - ANSWER when ventricles
become less compliant and filling pressures are increased (does not mean pt has
diastolic heart failure)
what tends to go along with diastolic dysfunction - ANSWER 1. systemic HTN
2. CAD
3. cardiomyopathies
4. valvular heart disease (aortic stenosis)
, what symptoms may the pt exhibit with diastolic dysfunction - ANSWER 1. dyspnea
2. exercise intolerance
3. cough
4. fatigue
what predisposes a patient to a. fib or a. flutter - ANSWER atrial enlargement
what may you see with a patient that has a diminished cardiac reserve - ANSWER
exaggerated decrease in BP during induction
consideration of IV drugs - ANSWER prolonged d/t decreased circulation time
considerations of inhaled anesthetics - ANSWER fast d/t decreased circulation time
structural and functional changes in CV system - ANSWER 1. increased afterload
2. increased SBP
3. ventricular hypertrophy
4. diastolic dysfunction
5. decreased end organ adrenergic response
6. prolonged circulation time
7. calcification of conduction system
8. loss of SA nodal cells
what increases the risk of perioperative complications - ANSWER increased BP
what are higher BP d/t - ANSWER 1. increased PVR
2. decreased arterial elasticity
3. decreased cardiac work load
what test should be done if diastolic dysfunction is suspected - ANSWER
echocardiograph
what should you consider with prolonged circulatory time in the geriatric patients -
ANSWER have patience when giving IV medications-takes longer to work
what does decreased vein compliance lead to - ANSWER decreased venous return and
right atrial filling
what does decreased sensitivity of myocardium to beta adrenergic modulation cause -
ANSWER decreased HR
