Notes in 21 Anesthesia for Patients with Cardiovascular Disease

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Published	12/13/2023	In patients with aortic stenosis, what rhythm should be maintained?{{c1::Normal sinus}}
Published	12/13/2023	In patients with aortic stenosis, what vasopressors are used for hypotension?{{c1::α-agonists (ex. phenylephrine)}}
Published	12/13/2023	What blood product can be administered to reverse warfarin?{{c1::FFP}}
Published	12/13/2023	The preferred paralytic for patients with mitral valve regurgitation is {{c1::pancuronium.}}
Published	12/13/2023	Primary hypertension is related to increased {{c1::cardiac output}} or {{c2::SVR}}
Published	12/13/2023	Chronic hypertension shifts the cardiac/cerebral autoregulation curve to the {{c1::right}}.
Published	12/13/2023	β-blockers also can mask {{c1::hypoglycemic}} symptoms in patients with diabetes.
Published	12/13/2023	{{c3::Nimodipine}} is a Ca2+ channel blocker that is used to prevent cerebral {{c2::vasospasm}} following a {{c1::s…
Published	12/13/2023	What patients population should receive β blockers before surgery?{{c1::Patients already taking them}}
Published	12/13/2023	What is the recommendation for a patient with a bare metal stent undergoing noncardiac elective surgery?{{c1::Delay 30 days}}
Published	12/13/2023	Use of the antiarhythmics {{c1::adenosine}}, {{c1::amiodarone}}, {{c2::digoxin}}, or {{c2::non-dihydropyridine CCBs}} may increase {{c3::ven…
Published	12/13/2023	Older patients are most likely to develop {{c1::atrial fibrillation::rhythm}} after cardiothoracic surgery.
Published	12/13/2023	Ventricular premature contractions (PVCs) can appear perioperatively secondary to electrolyte abnormalities including hypo{{c1::kalemia}}, hypo{{c2::m…
Published	12/13/2023	For patients with an ICD undergoing electrocautery, safety measures include using {{c1::bi}}polar cautery, placing the {{c2::return pad}} far from the…
Published	12/13/2023	Placement of a magnet over an ICD will {{c1::prevent shock delivery}}.
Published	12/13/2023	The body compensate for LV systolic failure through activation of the {{c1::sympathetic nervous system}} and {{c2::renin–angiotensin–aldosterone syste…
Published	12/13/2023	Hypertrophic cardiomyopathy is detected by the murmur of {{c1::dynamic left ventricular outflow tract (LVOT)}} obstruction in {{c2::late systole}…
Published	12/13/2023	Perioperative management of patients with hypertrophic cardiomyopathy is aimed at minimizing the degree of {{c1::LVOT}} obstruction.
Published	12/13/2023	What valvular change commonly occurs as a late complication of rheumatic fever?{{c1::Mitral stenosis}}
Published	12/13/2023	What is the size of a normal mitral valve orifice?{{c1::4-6 cm2}}
Published	12/13/2023	In the setting of mitral stenosis, increases in {{c1::heart rate}} results in increased tranvalvular pressure gradients.
Published	12/13/2023	In mitral stenosis, increased {{c1::pulmonary vascular resistance}} can precipitate right ventricular failure.
Published	12/13/2023	What is the goal for management of preload in patients with mitral stenosis?{{c1::normal (maintain)}}
Published	12/13/2023	What two findings on a PAOP waveform are characteristic of mitral stenosis?{{c1::Prominent a waves}}{{c2::Decreased y descent}}
Published	12/13/2023	Chronic mitral regurgitation is characterized by {{c1::eccentric}} LV hypertrophy.
Published	12/13/2023	In the setting of mitral valve regurgitation, {{c1::decreases}} in heart rate will increase the regurgitant fraction.
Published	12/13/2023	What is the goal for management of preload in patients with mitral regurgitation?{{c1::High-normal}}
Published	12/13/2023	Concentric left ventricular hypertrophy enables the ventricle to maintain stroke volume by generating the increased {{c2::transvalvular pressure gradi…
Published	12/13/2023	The normal aortic valve orifice is {{c1::2.5}}-{{c1::3.5}} cm2
Published	12/13/2023	In aortic stenosis, patients are {{c1::rate}}-dependent because they behave as if they have a fixed {{c2::stroke volume}}.
Published	12/13/2023	Optimal intraoperative HR for most patients with aortic stenosis is between {{c1::70}} and {{c1::80}} beats/min
Published	12/13/2023	The preferred neuraxial anesthetic technique in patients with aortic stenosis is {{c1::epidural}}.
Published	12/13/2023	What factors increase regurgitant volume in patients with aortic stenosis?{{c2::Bradycardia::HR}}{{c1::Increased SVR::SVR}}
Published	12/13/2023	With chronic aortic regurgitation, the left ventricle progressively dilates and undergoes {{c1::eccentric}} hypertrophy
Published	12/13/2023	In aortic stenosis, increase in the {{c1::preload}} maintain effective stroke volume.
Published	12/13/2023	{{c1::Acute}} aortic regurgitation is characterized by hemodynamic instability.
Published	12/13/2023	Symptomatic aortic regurgitation usually manifests as {{c1::pulmonary congestion}}.
Published	12/13/2023	{{c1::Chronic}} aortic regurgitation is often symptomatic (for 10-20 years).
Published	12/13/2023	What is the goal for management of heart rate in patients with aortic regurgitation?{{c1::High-normal}}
Published	12/13/2023	In {{c1::aortic regurgitation}}, the PAOP {{c2::under}}estimates the LVEDV.
Published	12/13/2023	{{c2::Tricuspid regurgitation::valvular disease}} is most commonly due to dilation of the {{c1::right ventricle}} from {{c3::pulmonary hypertension}}.
Published	12/13/2023	Antibiotic prophylaxis for infective endocarditis is recommended for patients with a {{c1::prosthetic}} heart valve prior to …
Published	12/13/2023	{{c2::Eisenmenger}} syndrome: In left-to-right shunts, increased right-sided pressures will eventually lead to the development of a {{c1::right-to-lef…
Published	12/13/2023	What shunt occurs when PVR > SVR?{{c1::right-to-left}}
Published	12/13/2023	{{c1::Ostium secundum}} is the most common form of ASDs and usually occur in the area of the {{c1::fossa ovalis}}
Published	12/13/2023	{{c1::Sinus venosus}} ASDs are located in the next to the {{c2::inferior vena cava}}.
Published	12/13/2023	{{c1::Ostium primum}} ASDs are located in the lower region of the atrial septum, above the tricuspid valves.
Published	12/13/2023	What is the most common type of VSD?{{c1::Perimembranous (type II)}}
Published	12/13/2023	The biggest determinant of VSD severity is {{c1::defect size}}.
Published	12/13/2023	What is the hemodynamic goal of treating a left-to-right shunt?{{c1::Avoiding increased SVR}}
Published	12/13/2023	What cardiac drugs may precipitate infundibular spasm in tetralogy of Fallot?{{c1::Inotropes (ephedrine, dobutamine, epinephrine)}}
Published	12/13/2023	What is the induction drug of choice for tetralogy of Fallot?{{c1::Ketamine}}
Published	12/13/2023	What is the surgical treatment for single-ventricle lesions (e.g. pulmonary atresia, hypoplastic left heart syndrome)?{{c1::Fontan operation…
Published	12/13/2023	After a Fontan surgery, which ventricle pumps blood into the pulmonary circulation?{{c1::None → blood from IVC is shunted to pulmonary circulation}}
Published	12/13/2023	In patients with {{c1::transposition of the great arteries}}, the aorta arises from the {{c2::right ventricle}}, and the pulmonary artery arises from …
Published	12/13/2023	A {{c1::truncus arteriosus}} defect is characterized by a single arterial trunk supplying the pulmonary and systemic circulation.
Published	12/13/2023	Patients with a transplanted heart have a {{c1::elevated}} resting heart rate because of {{c2::denervation}} of the transplanted heart.
Published	12/13/2023	The cardiac output of a transplanted heart is {{c1::preload}}-dependent.
Published	12/13/2023	The EKG in a heart transplant usually demonstrates two sets of {{c1::P waves}}.
Published	12/13/2023	LVADs drain blood from the {{c1::apex of the left ventricle}} and pump blood into the {{c3::aorta}}.
Published	12/13/2023	What medication should be used first in prophylaxis of infective endocarditis?{{c1::PO Amoxicillin}}
Published	12/13/2023	If a patient is allergic to penicillin for prophylaxis of infective endocarditis, the next options are:{{c1::Clindamycin, Azithromycin, Clarithro…
Published	12/13/2023	The preferred IV/IM antibiotic prophylaxis in patients at risk for infective pericarditis is: {{c1::ampicillin, cefazolin, ceftriaxone (3)}}
Published	12/13/2023	If a patient is allergic to penicillin for prophylaxis of infective endocarditis, the IV/IM option is:{{c1::Clindamycin}}
Published	12/13/2023	Ventricular premature contractions (PVCs) can appear due to ischemic heart muscle that creates an {{c2::acidotic}} environment.
Published	12/13/2023	{{c2::Ventricular premature contractions (PVCs)}} can appear due to mechanical irritation of the heart from insertion of {{c1::central lines}} and car…
Published	12/13/2023	{{c1::Torsades des pointes}} is a form of ventricular tachycardia associated with a {{c2::prolonged QT interval}}, producing a sine wave-like ven…
Published	12/13/2023	Management of patients with hypertrophic cardiomyopathy includes maintaining adequate {{c1::intravascular volume}}.
Published	12/13/2023	What is the goal for management of heart rate in patients with mitral regurgitation?{{c1::High-normal}}
Published	12/13/2023	Aortic stenosis will lead to {{c1::diastolic}} dysfunction as a result of the increase in ventricular muscle mass, fibrosis, and myocardial ischemia.&…
Published	12/13/2023	With a {{c4::diastolic}} dysfunction, a loss of {{c1::atrial systole}} can precipitate {{c2::congestive heart failure::pulmonary}} or {{c3::hypotensio…
Published	12/13/2023	{{c2::Pulsus bisferiens::ABP waveform finding}} is seen in {{c1::aortic regurgitation::condition}}
Published	12/13/2023	Severe right ventricular failure in a patient with pulmonary hypertension produces {{c1::right to left}} shunting by opening the {{c2::foramen ovale}}…
Published	12/13/2023	In patients with {{c1::tricuspid regurgitation}}, thermodilution cardiac output measurements are unpredictable.
Published	12/13/2023	Patients with previous {{c1::infective endocarditis}} are at high risk for infective endocarditis.
Published	12/13/2023	Patients with {{c1::unrepaired}} congenital heart disease are at high risk for infective endocarditis.
Published	12/13/2023	Patients with congenital heart disease with {{c1::residual defects}} following repair are at high risk for infective endocarditis.
Published	12/13/2023	Patients with congenital heart disease within {{c1::6}} months of a complete repair are at high risk for infective endocarditis.
Published	12/13/2023	{{c1::Cardiac transplant}} patients with valvuloplasties are at high risk for infective endocarditis.
Published	12/13/2023	What shunt occurs when SVR > PVR?{{c1::left-to-right}}
Published	12/13/2023	The hemodynamic goals in management of VSD (normal shunt flow):Avoid {{c1::increases}} in the SVRAvoid {{c1::decreases}} in the PVR
Published	12/13/2023	{{c2::β-Blockers}} in tetralogy of Fallot are effective in relieving {{c1::infundibular spasm}}
Published	12/13/2023	In a Fontan procedure, the venous drainage is directed into the {{c1::pulmonary circulation}}.
Published	12/13/2023	Patients with a Fontan procedure are {{c1::preload}}-dependent for cardiac output.
Published	12/13/2023	{{c1::Indirect::direct/indirect}} vasopressors are less effective than {{c1::direct::direct/indirect}} vasopressors in heart transplant patients becau…
Published	12/13/2023	β-blockers are contraindicated in patients with {{c1::pheochromocytoma}} because it may cause a {{c2::HTN crisis}}.
Published	12/13/2023	Placement of a magnet over a pacemaker will {{c1::convert to asynchronous mode}}.
Published	12/13/2023	{{c2::β2}}-receptor agonists activate the Na+/K+ ATP-ase pump, which will cause {{c1::hypokalemia}}.
Published	12/13/2023	Reversal of warfarin can be accomplished with the drugs {{c1::vitamin K}} or {{c1::K-centra}}.
Published	12/13/2023	Management of patients with hypertrophic cardiomyopathy includes administration of {{c1::phenylephrine}} for vasoconstriction.
Published	12/13/2023	Mitral stenosis is considered severe when the valve orifice is < {{c1::1.0 cm2}}
Published	12/13/2023	Mitral stenosis is considered severe when the transvalvular pressure gradient is > {{c1::10 mmHg}}.
Published	12/13/2023	Mitral stenosis is considered severe when the pulmonary artery systolic pressure > {{c1::50 mmHg. }}
Published	12/13/2023	What is the goal for management of afterload in patients with aortic regurgitation?{{c1::low-normal}}
Published	12/13/2023	After a Fontan procedure, pulmonary circulation is dependent on {{c1::negative intrathoracic}} pressure.
Published	12/13/2023	Management of patients with hypertrophic cardiomyopathy includes {{c1::decreasing}} myocardial contractility.
Published	12/13/2023	Is vaso-dilation or vaso-constriction preferred in hypertrophic cardiomyopathy?{{c1::Vasoconstriction}}
Published	12/13/2023	Is brady- or tachy-cardia preferred in hypertrophic cardiomyopathy?{{c1::Bradycardia}}
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