DAANCE STUDY QUESTIONS, ENTIRE DAANCE GLOSSARY, DAANCE DRUGS WITH 100% CORRECT ANSWERS

Nose/nasal passages, sinuses, pharynx - correct answer What consists of the upper airway? Larynx, trachea, bronchi, bronchioles, pulmonary alveoli - correct answer What consists of the lower airway? Immediate hypersensitivity response that involves antigen-antibody reactions (IgE) - correct answer What is the most severe type of allergic reaction? Liver - correct answer What is the largest gland in the body? Pediatric patients - correct answer What age group of patients will hypoxia occur much more rapidly in? Bradycardia is a sign relating to hypoxia Health Insurance Portability and Accountability Act (HIPAA) - correct answer What does HIPAA stand for? Ischemia - correct answer A decrease in blood flow in the coronary arteries? Can temporarily or permanently damage the heart muscle by decreasing O2 available to the muscle cells? 1 year- Plavix & Aspirin - correct answer If a cardiac patient just had stent placement, how long are they required to be on antiplatelet drugs? What are the 2 drugs they usually do together? Subacute Bacterial Endocarditis (SBE) aka infectious endocarditis - correct answer Type of infection that can further damage heart valves or cause systemic infections? Requires antibiotic prophylaxis P wave - correct answer Atrial depolarization (contraction) QRS complex - correct answer Ventricular depolarization T wave - correct answer Ventricular repolarization (relaxation) Cushing's disease - correct answer Type of disease due to excessive secretion of corticosteroid due to a presence of a tumor or from administration of high doses of corticosteriod drugs (ex: Prednisone) Myxedema - correct answer Chronic long-term hypothyroidism, most commonly seen in older adults (elderly women) who have had a stroke or stopped taking their thyroid medication Thyroid crisis - correct answer Most severe complication of hyperthyroidism from an OMS perspective Hyperthyroidism - correct answer Untreated __________ are at an increased risk for outpatient anesthesia and tend to be sensitive to epinephrine in a local anesthetic Diabetes Type 1 - correct answer Insulin-dependent Diabetes Type 2 - correct answer Non-insulin dependent Elevated LFTs (Liver function tests) - correct answer Elevated level of several liver enzymes and bilirubin is often termed? Women - correct answer What gender is Propofol more rapidly redistributed in and require 10-15% larger dose? Children - correct answer What age group would Propofol redistribute very rapidly, and require at least 50% increase in drug dose? Diffusion hypoxia - correct answer What is a complication of N2O rapidly moving from blood to alveoli of lungs, and displaces other gases, including O2 General anesthesia - correct answer Patient is not aroused, even during painful stimulation. Required airway intervention & cardiovascular function is impaired Deep sedation/analgesia - correct answer Can't be easily aroused, purposeful response to pain, and requires airway assistance Moderate sedation (conscious sedation) - correct answer Response to verbal or light tactile touch with no compromise of airway Minimal sedation (anxiolysis) - correct answer Normal response to verbal stimulation with airway reflexes, ventiliation & cardiovascular functions are unaffected Valium or Versed - correct answer What drugs are given for minimal sedation (anxiolysis) Balanced anesthesia - correct answer Anesthesia that relies on the use of several agents together to benefit from each other. Using each drug at a smaller dose than required if it were being used alone 0.2 mg - correct answer Maximum does of Epi for a healthy patient? 100% O2, Dantrolene (2.5 mg/kg) and IV cold saline (NOT Ringer's) - correct answer What is the treatment for Malignant Hyperthermia? Hypertension - correct answer What emergency would a beta blocker be given? 0.04 mg - correct answer What is the maximum dose of Epi for a patient with cardiovascular disease? Asystole - correct answer Cardiac arrest- has no rhythm or contraction of EKG Ventricular fibrillation (V-fib) - correct answer No discernable P, QRS or T waves noted. No pumping of blood at all and no depolarization of the ventricles V-Fib or Asytole - correct answer What are 2 emergencies would Epi be given in? Lidocaine - correct answer What are PVCs treated with? Versed, valium or propofol - correct answer What medications can be given for a severe case of hyperventilation? Ventricular tachycardia (V-tach) - correct answer Dysrhythmia with a rapid firing of an ectopic focus with a rate of 140-200 BPM but no P wave Amiodarone - correct answer What medication would be given for V-tach? Adenosine, Inderal or Esmolol - correct answer What are 3 different medications that could be given for SVT? Atropine - correct answer What medication would be given for symptomatic bradycardia? Airway obstruction - correct answer What emergency would a cricothyrotomy typically be performed? ETT, LMA or ETA (endotracheal tube, laryngeal mask airway, esophageal tracheal airway) - correct answer What type of intubation is preferred with emesis and aspiration? Medical information that helps oral surgeons identify poor-risk patients, guide treatment, and written evidence the patient was given to evaluate the treatment plan - correct answer What are the 3 basic requirements to follow when gathering medical information? Hematuria - correct answer What is the term for blood in the urine? Pulmonary artery - correct answer What is the artery that carries oxygen-poor (venous) blood from the heart to the lungs? Right atrium, right ventricle, pulmonary artery, lungs, pulmonary veins, left atrium, left ventricle, aorta - correct answer What is the blood flow through the heart? 100% O2, turn patient to their right side with head down, tonsil suction, intubate - correct answer What is the treatment for emesis with aspiration? Laryngospasm - correct answer Crowing sounds, labored breathing, suprasternal retraction & rocking of the chest and abdomen (paradoxical) are signs of what? 100% O2, head tilt chin position, tonsil suction, bag/mask, succinylcholine - correct answer Treatment of a laryngospasm Tracheostomy - correct answer Surgical airway below level of larynx into the trachea is called what? Capnograph/capnometer - correct answer Device that monitors ventilation in real time by measuring the level of O2 the patient exhales Pulse oximeter - correct answer Device that monitors ventilation and circulation Bronchspasm - correct answer Difficulty with expiration not inspiration, wheezing and labored breathing are signs of what medical emergency? 100% O2, Albuterol inhaler, epi, ETT/LMA or Igel, and a steroid - correct answer Treatment of bronchospasm MP 1 - correct answer What MP classification is visualization of soft palate, fauces, uvula, anterior and posterior pillars? MP 2 - correct answer What MP classification is visualization of soft palate, fauces & uvula? MP 3 - correct answer What MP classification is visualization of soft palate and base of tongue? MP 4 - correct answer What MP classification would the soft palate not be visible at all? Morphine, oxygen, nitroglycerin, aspirin - correct answer What does MONA stand for? Oxygen, nitroglycerin, aspirin, and morphine (ONAM) - correct answer What is the actual order of MONA? Systolic blood pressure - correct answer Ventricular contraction is which phase of BP? Dystolic blood pressure - correct answer Ventricular relaxation is what phase of BP? Repolarization of the ventricles - correct answer The T wave on a cardiac monitor tracing is evidence of what change in polarization? Epiglottis - correct answer What anatomical structure located at the top of the larynx closes the airway and prevents foreign bodies from entering the trachea? Tongue - correct answer What is most likely to cause obstruction of the airway when an anesthetized patient is lying in a supine position? Pulmonary artery - correct answer Blood is pumped to the lungs from the heart through what vessel? Alveoli - correct answer Small, sac-like structures located at the end of the respiratory tract in which O2 and CO2 are exchanged. Epiglottis - correct answer Soft tissue valve that covers the larynx and allows food to enter the esophagus is called the? Common carotid - correct answer Artery located in the neck that is readily palpated when looking for a patient's pulse. Brain and spinal cord - correct answer CNS consists of: Blood supply to the brain - correct answer Patient with a history of TIA has had a temporary lessening of? Ischemic heart disease - correct answer Decreased blood flow in the coronary arteries is caused by? Medical history - correct answer Main purpose of the review of systems is to obtain a careful evaluation of the patient's ______________? Drug excretion - correct answer Patient who has renal disease would be expected to have difficulty with what? Basic medical information, process of evaluating the patient & the patient's psychological status - correct answer Medical history is used to document? SOB, edema, ascites - correct answer CHF can result in all of the following: 95-100% - correct answer Normal blood O2 saturation in an ASA (class) I patient ranges from: Subject to postoperative infections - correct answer Diabetic patients are at risk for oral surgery because they are: 6 months - correct answer Patient who has had a MI should wait how long before having elective surgery? Grave's disease - correct answer Hyperthyroidism is also considered? Hepatitis A - correct answer Hepatitis caused by contaminated food or water Hepatitis B - correct answer Hepatitis most frequently in patients who have been incarcerated or who have been treated for STDs Hepatitis C - correct answer Hepatitis caused by contaminated needles (IV drug use) Ascites - correct answer What is the term for large fluid filled abdomen? Hepatic coma - correct answer Prolonged CNS depression in a patient with liver disease can result in a condition called? Liver disease - correct answer Patients who have ______ disease don't have the ability to produce clotting factors INR (international normalized ratio) - correct answer Ratio of how long it takes a patient's blood to clot Cirrhosis - correct answer Liver disease with the formation of fibrous tissue and is most commonly caused by alcoholism is called what? Acute renal failure - correct answer Sudden onset, can't have NSAIDS, caused by heavy blood loss, dehydration, injury Chronic renal failure - correct answer the progressive loss of renal function over a period of months or years, usually on dialysis Hemodialysis - correct answer Patients go to a dialysis center several hours a day, usually 3 days/week. Are given Heparin during dialysis, and have a shunt or AV fistula Periotoneal dialysis - correct answer Natural membrane in patients abdomen is used for dialysis, less efficient and carried out for a longer period of time Anemic - correct answer Renal failure patients tend to become _____ because they can't produce adequate blood cells Seizures - correct answer Transient disturbance of cerebral functions Tonic-clonic (grand mal) seizure - correct answer Most common type of seizure Prodromal phase, ictal tonic clonic phase, post ictal phase - correct answer 3 phases of grand mal seizures Grand mal status (status epilepticus) - correct answer Seizure lasting 5 minutes or longer Petit mal seizure - correct answer 2nd type of seizure Dilantin hyperplasia - correct answer Drug given to seizure patients that cause swelling/inflammation of gingival tissues TIA stroke (transient ischemic attack) - correct answer Mini stroke- recovery within 24 hours Aspiration and respiratory obstruction - correct answer Patients who have had strokes in the past are more prone to _______ and ______ during anesthesia 2nd trimester - correct answer Best trimester to perform oral surgery in 1st trimester - correct answer What trimester has the greatest risk for oral surgery? Obesity - correct answer 20% above ideal body weight Overwight - correct answer BMI 25-29 is considered Obese - correct answer BMI over 30 is considered Morbidly obese - correct answer BMI over 40 is considered Obstructive sleep apnea (OSA) - correct answer Cessation of air flow for more than 10 seconds 2-3 - correct answer Patients INR is often _____ when on Coumadin 3-4 days - correct answer How long should a patient hold their Coumadin prior to surgery? Heparin - correct answer Given IV only, immediate effect and wears off rapidly. Given to patients on Coudmadin Plavix, Aspirin, Ticlid - correct answer Medications that interfere with platelets developing "sticky" characteristics. Life cycle of these drugs are 7-10 days Propofol, ketamine, versed, fentanyl - correct answer 4 most common drugs used together for balanced anesthesia Analgesia - correct answer Inability to feel pain - Fentanyl, ketamine & local Amnesia - correct answer Loss of memory - Versed & valium Versed, propofol, brevital & ketamine - correct answer 4 drugs that can be essential for a patient to be relaxed and immobile during procedure. Hypnosis - correct answer Loss of consciousness "put to sleep"- Propofol & brevital Anxiolytics - correct answer Centers for emotion- Valium & versed Dissociative anesthesia - correct answer Isolated from the environment "relay center"- Ketamine Opioid receptors - correct answer Calming/euphoric effects "pain free"- Demerol & Fentanyl Homeostasis/homeostatic state - correct answer Depress respiration and cause hypotension- minimal variation to respiration and expiration Pharmacokinetics - correct answer Effects the body has on the drugs Pharmacodynamics - correct answer Effects the drug has on the body Intravenous - correct answer Most common route of drug administration Rapid redistribution - correct answer Short-acting drugs wear off rapidly because they are only attached to receptor sites for a short amount of time before they move to other tissues like fat or muscle Propofol - correct answer Type of short-acting drug Valium - correct answer Type of long-acting drug Intramuscular (IM) - correct answer Unpredictable onset of drug effect upon injection Subcutaneous (SQ) - correct answer Beneath the skin- emergency use for Epinephrine By mouth (PO) - correct answer Delayed onset of drug absorption 1.7 mL / carpule - correct answer How much Epinephrine is in 1 carpule of Lidocaine for a 1% solution Minimal sedation - correct answer Normal response to verbal stimulation with airway reflexes, ventilation & cardiovascular function uneffected (Anxiolysis) - Oral preop meds Moderate sedation - correct answer Response to verbal light tactile touch, no airway compromise ("conscious sedation") - N2O or EMLA Deep sedation - correct answer Cannot be easily aroused, purposeful response to painful stimulation, airway assistance may be required, ventilation may be inadequate, cardiovascular function is usually maintained (analgesia) Vitals, ambulation, N/V, pain, surgical bleeding - correct answer What are the 5 things you evaluate for modified post-anesthesia discharge score? Total score is 10 (Score of 9 or greater is considered fit for discharge) Local, local with N2O or IV sedation, IV balanced anesthesia or inhalation anesthesia - correct answer What are the 4 categories of anesthesia? 30% - correct answer What percentage of O2 is required when administering N2O? 3-4 minutes - correct answer How long should you administer O2 after turning off the N2O 15 minutes - correct answer How long should you keep a patient in the office after they have been on N2O 8 hours - correct answer How long is it required to be NPO for IV sedation? 15-20 mL/kg - correct answer What is the recommended fluid volume administration throughout an IV sedation? Versed - correct answer What drug is for relaxation & amnesia? Fentanyl - correct answer What drug is for analgesia? Inhalation anesthetics - correct answer _________ anesthetics are potential triggers for malignant hypothermia Propofol - correct answer What drug is used quite often due to its antiemetic effects, and does not predispose laryngospasms? 12 hours - correct answer After opening a vial of Propofol, how long do you have before it is no longer good to use? Children - correct answer What age group rapidly redistributes Propofol and requires a 50% increase in dosage? Older patients - correct answer What age group has an increased sensitivity to Propofol and requires the dosage to be reduced? Women - correct answer What gender rapidly redistributes Propofol and requires a 10-15% larger dose? Lean body mass - correct answer For obese patients, how should the dosage of Propofol be determined? Mild bradycardia - correct answer What is noticed in the first 10 minutes of administering Propofol? Hypotension - correct answer Large doses, rapid administration and advanced age can cause _________ when adminstering Propofol Propofol - correct answer What drug induces bronchodilation and can decrease the incidence of intraoperative wheezing in patients with asthma & COPD? Ketamine 10mg - correct answer What drug can you give 30 seconds before giving Propofol to reduce the incidence of pain during Propofol infiltration? Catatonic state - correct answer Ketamine causes a patient to be dissociated from sensory inputs in his environment which is called _________ state? Nystagmic - correct answer Distant/wandering gaze Ketamine - correct answer What drug is twice as rapidly eliminated in children then adults? Vivid dreaming and illusions - correct answer What can Ketamine cause a patient to do? Increases salivation - correct answer One disadvantage of Ketamine is? Liver - correct answer Where are barbiturates detoxified? Barbiturates - correct answer Produces amnesia and hypnotic effects along with sedative properties. Thought to make patients more sensitive to pain Hematomas - correct answer What is most frequently encountered during injection in posterior aspect of maxilla in the 3rd molar region? Esters - correct answer Metabolized in bloodstream by pseudocholinesterase Amides - correct answer Metabolized in the liver Cocaine & Procaine - correct answer 2 types of Esters Lidocaine, mepivacaine, prilocaine, bupivacaine, articaine - correct answer 5 types of Amides Vasonconstrictors - correct answer Dilate blood vessels 10-11 carpules - correct answer Maximum amount of Lidocaine for an average patient 7-8 carpules - correct answer Maximum amount of Mepivacaine for an adult patient 6 carpules - correct answer Maximum amount of Prilocaine for a patient 10 carpules - correct answer Maximum amount of Bupivacaine for a patient 7 carpules - correct answer Maximum amount of Articaine for a patient Inadverent injection of Epinephrine - correct answer This type of injection in a vessel can lead to tachycardia, hypertension and sense of heart pounding in chest 20% O2 - correct answer What percentage of O2 is in room air? 1 hour - correct answer How long is the contact time for EMLA cream to be sufficient? Capnography - correct answer Level of CO2 expired in each breath- this is mandatory when an ETT is being used