BSNC 3000 Midterm (Module 1-6)
Questions With Complete Solutions
ambulatory surgery CORRECT ANSWERS includes outpatient, same-day, or short-stay
surgery that does not require an overnight hospital stay
what is included in a CBC? CORRECT ANSWERS hematocrit, hemoglobin, red cell
count, white cell count, platelet count.
What does NPO stand for and what does it mean? CORRECT ANSWERS nil per os
(nothing by mouth)
Why are pt NPO before surgery CORRECT ANSWERS dec risk of aspiration
- dec gastric volume and acidity
carb loading pre-op CORRECT ANSWERS 2-4hr before
fasted -> fed
dec post-op insulin resistance, thirst, hunger, anxiety, nausea, and muscle protein loss
what does ERAS stand for? CORRECT ANSWERS Enhanced Recovery After Surgery
balanced anesthesia CORRECT ANSWERS the practice of using combinations of
different drug classes rather than a single drug to produce anesthesia
- reduce total dose of one -> dec side effects
Stages of General Anesthesia CORRECT ANSWERS induction, maintenance, recovery
- maintenance at stage 3 (sk muscle relaxation) = safe
Types of general anesthesia CORRECT ANSWERS IV, inhaled gases and volatile
liquids
IV GA CORRECT ANSWERS propofol
midazolam
ketamine
*induction mainly (rapid, but short duration)
used for maintenance too
inhaled gases GA CORRECT ANSWERS nitrous oxide
*no muscle relaxation
volatile liquids GA CORRECT ANSWERS deflurane
sevoflurane
,*maintenance mainly (slower but more predictable)
used in induction too
adverse effects of GA CORRECT ANSWERS respiratory depression, unable to
maintain airway
hypotension, dysrhythmias
urinary retention, n/v
hypothermia, malignant hyperthermia
spinal anesthesia CORRECT ANSWERS regional anesthesia produced by injecting
medication into the subarachnoid space
- L3/4/5
- greater effect in lower extremities/pelvis
epidural anesthesia CORRECT ANSWERS regional anesthesia produced by injecting
medication into the epidural space
- does not cross dura mater
- affects spinal nerves nearby
- any level of spinal cord
peripheral nerve block CORRECT ANSWERS regional anesthesia into specific nerve or
nerve plexus (e.g. brachial plexus)
local anesthesia CORRECT ANSWERS causes the loss of sensation in a limited area
by injecting an anesthetic solution near that area
- blocks voltage-gated Na+ channels -> inhibits AP generation and propagation
- fewer adverse effects (bc not systemic)
e.g. lidocaine or bupivacaine
post dural puncture headache CORRECT ANSWERS Caused by a leakage of CSF
after spinal surgery.
Increased pressure on the brain by a decrease of fluid surrounding your brain. More
present when standing versus laying down
assessments r/t general and spinal anesthesia (post-op) CORRECT ANSWERS - VS
(BP, HR, RR, O2, T)
- pain assessment
- LOC, mental status assessment
- motor block assessment
- dermatome assessment
stressors post-op CORRECT ANSWERS pain!!
tissue injury!
, blood loss/hemorrhage!
infection (and other complications of sx)
sleep disturbance
hospital env
fear of surgical outcome etc.
finance/family concerns
loss or grief (e.g. hysterectomy)
SAM CORRECT ANSWERS sympathetic adrenal medullary response
- sympathetic response to stressor -> release of catecholamines (epi/NE)
functions of glucocorticoids CORRECT ANSWERS (cortisol) -MOBILIZE ENERGY
- gluconeogenesis
- lipolysis
- protein breakdown
- inc clotting factor and platelet synth
- immune suppression and anti-inflammatory effects
- mobilization of energy stores (inc in glucose/FA in blood)
- (bone breakdown)
- inc appetite (for more energy)
PSR and insulin resistance CORRECT ANSWERS transient
inc with severity of sx
primarily effects sk muscle and glucose uptake mechanism
- r/t stress hormones and inflammatory cytokines (?)
(carb loading pre-op can dec insulin resistance)
H1 receptors CORRECT ANSWERS histamine receptors responsible for allergic
symptoms
H2 receptors CORRECT ANSWERS secretion of gastric acid (parietal cells)
phospholipase A2 CORRECT ANSWERS Releases arachidonic acid from phospholipid
membrane
arachidonic acid CORRECT ANSWERS activates COX and LOX to produce
prostaglandins and leukotrienes respectively
are prostaglandins and leukotrienes released immediately? CORRECT ANSWERS no,
they are synthesized as needed
there is a lag time, unlike histamine
what releases cytokines? CORRECT ANSWERS macrophages and mast cells
low dose ASA CORRECT ANSWERS blocks COX-1 only -> only for dec risk of clotting
(dec platelet aggregation)
Questions With Complete Solutions
ambulatory surgery CORRECT ANSWERS includes outpatient, same-day, or short-stay
surgery that does not require an overnight hospital stay
what is included in a CBC? CORRECT ANSWERS hematocrit, hemoglobin, red cell
count, white cell count, platelet count.
What does NPO stand for and what does it mean? CORRECT ANSWERS nil per os
(nothing by mouth)
Why are pt NPO before surgery CORRECT ANSWERS dec risk of aspiration
- dec gastric volume and acidity
carb loading pre-op CORRECT ANSWERS 2-4hr before
fasted -> fed
dec post-op insulin resistance, thirst, hunger, anxiety, nausea, and muscle protein loss
what does ERAS stand for? CORRECT ANSWERS Enhanced Recovery After Surgery
balanced anesthesia CORRECT ANSWERS the practice of using combinations of
different drug classes rather than a single drug to produce anesthesia
- reduce total dose of one -> dec side effects
Stages of General Anesthesia CORRECT ANSWERS induction, maintenance, recovery
- maintenance at stage 3 (sk muscle relaxation) = safe
Types of general anesthesia CORRECT ANSWERS IV, inhaled gases and volatile
liquids
IV GA CORRECT ANSWERS propofol
midazolam
ketamine
*induction mainly (rapid, but short duration)
used for maintenance too
inhaled gases GA CORRECT ANSWERS nitrous oxide
*no muscle relaxation
volatile liquids GA CORRECT ANSWERS deflurane
sevoflurane
,*maintenance mainly (slower but more predictable)
used in induction too
adverse effects of GA CORRECT ANSWERS respiratory depression, unable to
maintain airway
hypotension, dysrhythmias
urinary retention, n/v
hypothermia, malignant hyperthermia
spinal anesthesia CORRECT ANSWERS regional anesthesia produced by injecting
medication into the subarachnoid space
- L3/4/5
- greater effect in lower extremities/pelvis
epidural anesthesia CORRECT ANSWERS regional anesthesia produced by injecting
medication into the epidural space
- does not cross dura mater
- affects spinal nerves nearby
- any level of spinal cord
peripheral nerve block CORRECT ANSWERS regional anesthesia into specific nerve or
nerve plexus (e.g. brachial plexus)
local anesthesia CORRECT ANSWERS causes the loss of sensation in a limited area
by injecting an anesthetic solution near that area
- blocks voltage-gated Na+ channels -> inhibits AP generation and propagation
- fewer adverse effects (bc not systemic)
e.g. lidocaine or bupivacaine
post dural puncture headache CORRECT ANSWERS Caused by a leakage of CSF
after spinal surgery.
Increased pressure on the brain by a decrease of fluid surrounding your brain. More
present when standing versus laying down
assessments r/t general and spinal anesthesia (post-op) CORRECT ANSWERS - VS
(BP, HR, RR, O2, T)
- pain assessment
- LOC, mental status assessment
- motor block assessment
- dermatome assessment
stressors post-op CORRECT ANSWERS pain!!
tissue injury!
, blood loss/hemorrhage!
infection (and other complications of sx)
sleep disturbance
hospital env
fear of surgical outcome etc.
finance/family concerns
loss or grief (e.g. hysterectomy)
SAM CORRECT ANSWERS sympathetic adrenal medullary response
- sympathetic response to stressor -> release of catecholamines (epi/NE)
functions of glucocorticoids CORRECT ANSWERS (cortisol) -MOBILIZE ENERGY
- gluconeogenesis
- lipolysis
- protein breakdown
- inc clotting factor and platelet synth
- immune suppression and anti-inflammatory effects
- mobilization of energy stores (inc in glucose/FA in blood)
- (bone breakdown)
- inc appetite (for more energy)
PSR and insulin resistance CORRECT ANSWERS transient
inc with severity of sx
primarily effects sk muscle and glucose uptake mechanism
- r/t stress hormones and inflammatory cytokines (?)
(carb loading pre-op can dec insulin resistance)
H1 receptors CORRECT ANSWERS histamine receptors responsible for allergic
symptoms
H2 receptors CORRECT ANSWERS secretion of gastric acid (parietal cells)
phospholipase A2 CORRECT ANSWERS Releases arachidonic acid from phospholipid
membrane
arachidonic acid CORRECT ANSWERS activates COX and LOX to produce
prostaglandins and leukotrienes respectively
are prostaglandins and leukotrienes released immediately? CORRECT ANSWERS no,
they are synthesized as needed
there is a lag time, unlike histamine
what releases cytokines? CORRECT ANSWERS macrophages and mast cells
low dose ASA CORRECT ANSWERS blocks COX-1 only -> only for dec risk of clotting
(dec platelet aggregation)
