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DAANCE MODULE 2 ASSESMENT
EXAM TEST (2025/2026)
Ischemia
- whatrcausesrit?
- Whatrdoesritrresultrin?r-rCORRECTrANSWER- 1.rBuildruprofrfattyrplaquerwithinrthercoronaryrarteries.
- Acutercoronaryrsyndrome. RepolarizationrofrtherventriclesrshowsrupratrwhatronranrECG?r-rCORRECTrANSWER-Trwave Whichrthreeressentialrcharacteristicsrshouldrberidentifiedrwhenrassessingrabnormalrrhythms?r- rCORRECTrANSWER-Rate,rrhythm,randrregularity. Formationrofrarbloodrclotrinrarbloodrvessel;r(usuallyrarvein.)r-rCORRECTrANSWER-rthrombosis Prophylaxisrrecommendationsrarerforrpt.sratrtherhighestrriskrofrendocarditisrduertorwhatrthreerfactors ?r(4)r-rCORRECTrANSWER- 1.rArprostheticrheartrvalverorrpt.srwhorhaverhadrarheartrvalverrepairedrwithrprostheticrmaterial 2.rArHXrofrendocarditis
- Arheartrtransplantrwithrabnormalrvalverfunction
- Certainrcongenitalrdefects Endocarditisr-rCORRECTrANSWER-inflammationrofrtherinnerrliningrofrtherheart HypertensionrWhatri srit? Symptoms?r-rCORRECTrANSWER-abnormallyrhighrbloodrpressurer(higherrthanr120/80). Frequentrdizziness,rnosebleeds,r/rheadaches Majorrcomplicationsrofrhypertensionr-rCORRECTrANSWER- Stroke,rcoronaryrarteryrdisease,randrrenalrfailure congestiverheartrfailurer(CHF)
- Whatrisrit?
- characteristics?r-rCORRECTrANSWER- 1.Arclinicalrsyndromerduertorheartrdisease.rCausedrbyrtherheartsrinabilityrtorhandlerbloodrvolumer comingrbackrfromreitherrtherlungsrorrperipheralrcirculation. 2.breathlessnessrandrabnormalrwaterrandrsodiumrretentionrresultingrinredema.
Anyrvariationrfromrthernormalrrhythmrofrtherheartrbeatr-rCORRECTrANSWER-rArrythmia disturbancerofrarcardiacrrhythmr-rCORRECTrANSWER-Dysrhythmia VentricularrRhythmsr-rCORRECTrANSWER- CardiacrdysrhythmiarinrwhichrtherpacemakerrisrinrtherventriclesrratherrthanrinrtherSArnoderorratria.rM orerlikelyrtorleadrtorarrestrrhythms. PRrinterval
- HowrlongrisritronranrEKGrstrip?
- Whatrheartrfunctionrdoesritrrepresent?
- Whatrdoesritrmeasure?r-rCORRECTrANSWER- 1.rLessrthanronerblockr(200rmillisecondsrorr0.2rseconds.) 2.rTherdelayrbetweenrtherSArandrAVrnode 3.rAVrconductionrtime.rNormalrisr0.12-0.2rsecondsr(3- 5 rsmallrboxes.) paroxysmalr-rCORRECTrANSWER-beginningrsuddenlyrorrabruptly Prwaver-rCORRECTrANSWER-depolarizationr(contraction)rofrtheratria QRSrcomplex 1.rWhatrdoesrisrrepresent? 2.rHowrbigrisritronranrEKGrstrip?r-rCORRECTrANSWER-1.rdepolarizationr(contraction)rofrtherventricles. 2.rWidthrofrlessrthanr1/2rofronerlargerblock.r(Approximatelyr 100 rmil lisecondsrorr0.1rsecond.) WhatrdoesrsmokingrpredisposerPt.srto?r-rCORRECTrANSWER-Laryngospasmsrandrbronchospasms Heartrandrlungrdisease Mallampatirclassificationr-rCORRECTrANSWER-Arvisualranalysisrofrtheroral/pharyngealranatomy Classr1.rVisualizationrofrthersoftrpalate,rfauces,ruvula,ranteriorrandrposteriorrpillarsrClassr2.rVisualiz ationrofrthersoftrpalate,rfauces,randruvula Classr3.rVisualizationrofrthersoftrpalate,randrbaserofruvula.rClass4.rSoftrpala ternotrvisibleratrall. Upperrrespiratoryrinfectionr(URI)r-rCORRECTrANSWER- infectiousrdiseaserofrtherupperrrespiratoryrtractrinvolvingrthernasalrpassages,rpharynx,randrbronchi,r makingrtherpt.rArpoorrcandidaterforrout-patientrsedationrorrGA.
Isletsrofrlangerhansrinrtherpancreas., typer 1 rdiabetesrmellitus
- Whatrisrit?
- Whatrcausesrit?
- Signsrandrsymptoms?r-rCORRECTrANSWER-- bodyrcannotrproducerinsulinr(betarcellsrinrtherisletsrofrlangerhansrhaverbeenrdestroyed.)
- pt.srhavertortakerinsulin
- eitherrgeneticrorrautoimmune
pt.srpresentras:rthin,rusuallyryoung,randronsetrisrsudden.rKetonesrA RErpresentrinrurine. typer 2 rdiabetesr-rCORRECTrANSWER-Pt.srbodyrisrinsulinrresistant
- therbodyrmayrproducertoormuchrinsulin,rwhichrmayrleadrtormetabolicrsyndrome
- TX;rdiet,rexercise,randroralrmeds.
- pt.rMayrneedrinsulinrinjectionsrbeforersurgery,rorrduringrstress/rinfectionrCausedrb y:rlifestyle,rpoorrdiet,rgenetics. Pt.rPresentsras;roverweightroverrtimerRarertorha verketonesrinrurine. Gestationalrdiabetesr-rCORRECTrANSWER- arformrofrdiabetesrmellitusrthatroccursrduringrsomerpregnancies. Usuallyrgoesrawayrafterrbirth ManagementrofrdiabetesrinrOMSrofficer-rCORRECTrANSWER- Generally,rpt.srwithrdiabetesrmayrnotrhealrasrquicklyrandrareratrhigherrriskrofrinfection. *oralrhypoglycemicragentsrandrinjectionsrofrinsulinrmayrneedrtorberadjustedrforranesthesia. *adequatercontrolrusuallyrequatesrtorarfastingrBSLrofrlessrthanr 125 rmg.dL *atrtherSXrappointment,rBSrshouldrbercheckedrbeforerandrafterrsurgeryr(sometimesrduringrifrsurgeryri srlonger.) HemoglobinrA1cr-rCORRECTrANSWER- ArtestrthatrmeasuresrtherlevelrofrhemoglobinrA1crinrtherbloodrasrarmeansrofrdeterminingrtheraverager bloodrsugarrconcentrationsrforrtherprecedingrtwortorthreermonths. 4 - 6% Hypoglycemiar-rCORRECTrANSWER- abnormallyrlowrlevelrofrsugarrinrtherblood.rCanrresultrinrdeathrifrleftruntreated. Symptoms:rsweating,rnervousness,rirritability,rtremor,rconfusion,rhunger,rdoublervision. Treatedrwithrarsimplercarbrlikerhardrcandyrorrjuice.
Whenrartyper 1 rdiabeticrhasrfasterrbutrtakesrtheirrnormalrinsulinrdose,rtheyrmayrberatrhighrriskrforrhypo glycemia.
Whererisrtherthyroidrglandrlocated?r-rCORRECTrANSWER-Onrtheranteriorraspectrofrtherneck. Hypothyroidism Manifestations? Risksrofroutpatientranesthesia?r-rCORRECTrANSWER- Deficiencyrofrthyroidractivityrresultingrinrlethargy,rcoldrintolerance,rweightrgain,rslowrpulse,rmuscler weakness,rcoarserdryrskin. Sensitivityrtornarcoticsrandrtranquilizers. hyperthyroidism/rgrave'srdisease Symptoms? Sensitivityrto:r-rCORRECTrANSWER- Increasedrbasalrmetabolism,rgoiter,randrdisturbancesrofrthenrautonomicrnervousrsystem.rBulgingrey es Epinephrine Chronicrlongrtermrhypothyroidismrisrcalled- rItrisrmostroftenrseenrin- Arseverrhypothyroidrstatercanrleadrto-r-rCORRECTrANSWER- MyxedemarElderlyrwomenrwhorhaverstoppedrtakingrtheirrthyroidrmeds Becomingrprogressivelyrmorerconfused,rslippingrintorarcomarandrdying. Thyroidrcrisisr-rCORRECTrANSWER- Thererisranrincreasedrdemandrofrtissuerforrnutrients,rmakingrtherheartrincreaseritsroutputrbyrelevatin grHRrandrBP. Itralsorincreasesrtherutilizationrofroxygenrandrformationrofrcarbonrdioxiderinrthertissues,rcausingranrincreas erofrraterandrdepthrofrrespiration. Kidneys Primaryrfunction?r-rCORRECTrANSWER- Filteringrblood;reliminationrofrwasterproductsrandrmaintenancerofrtherconstitutionrofrbodyrfluids. *goodrkidneyrfunctionrisrrequiredrforreliminationrofranesthesiardrugs acuterrenalrfailurer-rCORRECTrANSWER-suddenrlossrofrkidneyrfunction Causedrbyrheavyrbloodrloss,rinjury,rdehydrationr,rreactionrtordrugsrsuchrasribuprofenrandrotherrNSAI DS,rkidneyrstones,renlargedrprostate.
Itrcanrberreversed.
whenrtherpt.risrsubjectedrtorstress. AdrenocortialrInsufficiencyrinrOMSr-rCORRECTrANSWER- whenrarpt.risrsubjectedrtorarhighlyrstressfulrsituationrsuchrasrsurgeryrorranesthesia,rtherpt.srBPrcanrfal l.
Pt.srwhorhaverAI,rshouldrreceiverarsteroidrpreprofrarlargerdoserofrhydrocortisonerorrprednisonerpriorrtorproc edures,rfollowedrbyrartaperingrdoseroverrthernextrfewrdays. Adrenocorticalrinsufficiencyrcardr 3 r-rCORRECTrANSWER- canrberinducedrinrpt.srwhorhaverbeenrtakingrlargerdosesrofrcoritcosteroidsrsuchrasrprednisone. therbodyrsensesrthatrthererisrenoughrcirculatingrcortisolrandrtheradrenalrcortexrisrsignaledrtorcurtailrc ortisolrproduction. sincerthercellsrofrthercortexrarernotrbeingrused,rtheyrtendrtoratrophy. adrenalrglandsr-rCORRECTrANSWER- arpairrofrendocrinerglandsrthatrsitrjustrabovertherkidneysrandrsecreterhormonesr(epinephrinerandrnor epinephrine)rthatrhelprarousertherbodyrinrtimesrofrstress. thercentralrportionrofrthergland,rthermedulla,rsecretesrtherhormonesrnorepinephrinerandrepinephrin erinrresponsertorstimulationrbyrthersympatheticrnervousrsystem.rtherouterrrimrofrthergland,rthercortex ,rsecretesrcorticosteroidrhormones. Cushing'srdiseaser-rCORRECTrANSWER-excessiversecretionrofrcorticosteroids. itrmayrberduertortherpresencerartumorrorrfromrtheradministrationrofrhighrdosesrofrcorticosteroidsrsuchrasrpr ednisone. pt.srmayrpresentrwithrhumpedrback,rmoonrface,rthickrskin,randreasyrbruisingrandrsufferrfromrhyperte nsionr,rpoorrhealing,randrosteoporosis. Addison'srdiseaser-rCORRECTrANSWER- occursrwhenrtheradrenalrglandsrdornotrproducerenoughrofrtherhormonesrcortisol. itrisrmostroftenrarresultrofrimmunerdestructionrofrthercortexrandrcanrbecomerliferthreatening. clinialrfindings:rpigmentedrpatchesrofrskinrandroralrmucosa. weightrloss,rvariousrgastrointestinalrproblems,rhypotension,rtiredr&rweak. rheumatoidrarthritis/drugsr-rCORRECTrANSWER-pt.srwithrRArareroftenrTX'drwithraspirin,rnon- steroidalranti- inflammatoryragents,rlowrdosersteroidsrsuchrasrprednisonerorrimmunosuppressiveragents. ifrtheyrhavertakenrrelativelyrlargerdosesrofrcorticosteriodrmeds,rtheyrmayrrequirersteroidrsupplementsrpriorr torSX. rheumatoidrarthritisrandrOMSr-rCORRECTrANSWER- RArisrusuallyrinvolvedrwithrtherfingersrandrwrists,randrcanralsoraffectrtherTMJ.
rheumatoidrarthritisr-rCORRECTrANSWER- archronicrmultirsystemrinflammatoryrdisorderrofranrunknownrcause. itrleadsrtorsymmetricalrjointrdeformitiesrandrcartilagerdestruction.rAffectsr 1 %rofrtherpopulation,rwomenr3Xrmorerthanrmen. drugraddiction/addictsr-rCORRECTrANSWER-- usuallyrhaverarhighrtolerancertoranalgesicsrandrsedativerdrugsrandrarerhardrtormanagerunderranesthe sia.
- allrpt.srshouldrberaskedrifrtheyrhavertakenranyrmedsrorrdrugsrinrtherpastr 24 rhrs.
- ifrrecentrdrugruserisrsuspected,rSXrshouldrberpostponed
pts.rwhorhaverrecentlyrusedrnarcoticsrlikerheroinrmayrpresentrwithr"pinpoint"rpupils.rtheserpt.srarerinr therHughrriskrgrouprforrdiseaserlikerhepatitisrandrAIDS. mastectomyrpt.srwithrlymphrnoderdissections.r-rCORRECTrANSWER- sincertherlymphaticrchannelsrarerremoved,ranrimportantrpartrofrtherarmsrdrainagersystemrisrimpaired . thisrarmrshouldrnotrberusedrforrBP/IV. Whenritrhasrbeenrperformedrbilateral,ritrmayrbernecessaryrtorconsiderrveinsrinrtherfootrandrarthighrcuf frforrBP. threertypesrofrdrugsrthatrcounteractrtherbloodrclottingrfactorsrwhenritrcanrberharmfulrtorPt.sr- rCORRECTrANSWER- 1.rmedicationsrthatrantagonizertheractionsrofrbloodlettingrfactorsrproducedrinrtherliver.
- drugsrthatracceleratertheractivityrofrtherbody'srownranti-clottingrfactor.
- drugsrthatrinhibitrplateletradhesion. (aspirin,rclopidogrelr(plavix)randrticlopidiner(ticlid.)rtheyrexertrtheirreffectsrofrtherlifercyclerofrarcell,r( 7 - 10 rdays.) Heparinr-rCORRECTrANSWER-acceleratesrtherbodiesronranti-clottingrfactor.
- mustrberadministeredrintravenously.
- thereffectsrarerimmediaterandrwearsroffrrapidlyrasrsoonrasrthermedicationrisrdiscontinued.
- itrisridealrforrhemodialysisrwhenranticoagulationrisronlyrrequiredrforrtimerofrSX. ISIrInternationalrsensitivityrindex.r-rCORRECTrANSWER- ISIrdependsronrthermethodrofrtestingrusedrbyrtherlabrandrisrusedrtordeterminertherINR. Pt.srtakingrwarfarinrareroftenrmaintainedratranrINRrofr 2 - 3,rputtingrtherpt.ratrriskrforrprolongedrbleedingrduringrandrafterrsurgery. INRr-rCORRECTrANSWER-InternationalrNormalizedrRatior- rUsedrtorstandardizertherPTrsorthatrtherresultsrarerconsistent,rregardlessrofrtherwayrthertestrisrcompl
etedrinrdifferentrlabs. INRrIs.rpatientsrPT/rnormalrPT.
edrplateletsrbecomer"sticky"randradherertorthersiterofrthervesselrdamage.
2)rvascularrspasmr- rtherplateletsrwithinrtherplateletrplugrreleasersubstancesrthatrcausertherbloodrvesselrtorgorintorarspas mrandrconstrictrthervesselratrtherpointrofrinjuryr3)establishedrofrtherdefinitiverclot.rar"tissuerfactor"risr releasedrfromrtherinjuredrtissuerthatrstartsrarchainrreactionrthatrinvolvesrcalcium,rVitaminrK,randrso merproteinsrinrtherbloodrcalledr"clottingrfactors". therfinalrstepsrincludertherformationrofrfibrin,rwithrcreatesrarmeshraroundrRBCsrandrplateletsrtorestab lishrtherdefinitiverclot. obesityr-rCORRECTrANSWER-artotalrbodyrweightr20%rabovertheridealrbodyrweight. associatedrwithrdiabetes,rhypertension,rcardiovascularrdisease,rstroke,randrsleeprapnea. specialrconsiderationsrforrobeserpt.srinrOMS;r-rCORRECTrANSWER-- largerrBPrcuff,rtoorsmallrmayrproduceranrelevatedrBPrmeasurement.
- veinraccessrmayrberextremelyrdifficultrduertorabnormal/deepranatomicalrlandmarks.
- pt.srshouldrberTX'drinrupright/semirfowlerrpositionrtorreducercardiovascular/respiratoryrcompromise.
anrairwayradjunctrsuchrasrarnasopharyngealrairway,rtonguertractionrsuture,rorrLMArmayrberconsider ed. specialrconsiderationsrwhenrpreparingranrobeserpt.rforrSXr-rCORRECTrANSWER- userofrLArbecauserofrrespiratoryrandrcardiovascularrcompromiserinrtheserpt.srwhilersedated.
- airwayrmaintenancercanrberchallenging.rifrcompleterobstructionroccurs,rre- establishingranrairwayrcanrberextremelyrdifficult.
manyrobeserpt.srarersubjectrtorobstructiversleeprapnea.ritrisrassociatedrwithrcessationrofrairflowrforr morerthanr 10 rseconds.
- theserpt.srareralsorpronertordeveloprgastrointestinalrrelaxr(GERD)randraspiration. considerationsrforrpt.srinrlater3rdrtrimesterronrpregnancy?r-rCORRECTrANSWER-- Theruterusrisrveryrlarge,rsorreelingrtherpt.rmayrcausertheruterusrtorpressron/occludertherinferiorrvenarc ava.rthisrwillrpreventrbloodrfromrreturningrtortherheartrfromrtherabdomen;rproducingrthersamereffectsr asrsyncope. Ifrthisrhappens,rtherpt.rshouldrberpositionedronrherrsidereitherrflatrorrwithrherdedrslightlyrdown. precautionsrforrpregnancyr-rCORRECTrANSWER-- surgeryrshouldrberlimitedrinrnaturerandrperformedrunderrLArwheneverrpossible.
- inrgeneral,ritrisrbestrtorperformrSXrduringrther2ndrtrimesterrw/consultrwithrOB.
- thergreatestrsurgicalrandranestheticrriskroccursrduringr1strtrimesterrofrpregnancy. precautionsrregardingrseizurerdisordersronranrOMSrofficer-rCORRECTrANSWER-- rquestionrpt.srregardingrtherfrequencyrandrmagnituderofrtheirrseizures
- howrlongrsincerlastr"breakthrough"rseizurerinrspiterofrmedications.
cerebrovascularraccidentsr-CVAs (stroke)r-rCORRECTrANSWER- strokerisrarneurologicalrimpairmentrcausedrbyrardisruptionrofrbloodrsupplyrtorarregionrofrtherbrain. TransientrIschemicrAttackr(TIA)rminirstroker-rCORRECTrANSWER- arsuddenrneurologicalrlossrofrfunctionrwithrarcompleterrecoveryrwithinr 24 rhours. thertwortypesrofrstrokerandrwhatrcausesrthemr-rCORRECTrANSWER- ischemic:rduertoranroccludedrbloodrvesselr(85r%) hemorrhagic:rduertorarrupturedrartery/raneurysmr(15%) factorsrthatrpredisposeranrindividualrtorarcerebrovascularraccidentrmodifiablervs.runm odifiabler-rCORRECTrANSWER-modifiable
- smoking
- TIA
- heartrdisease
- diabetes
- increasedrRBC's
- sicklercellrdisorders unmodifiable
- genderr(male)
- age,r(55rorrolder)
- racer(AfricanrAmerican)
- HXrofrpriorrstroke
- hereditary recoveredrstrokerpt.srmayrretainranrelementrofr(blank1)randrmayrberpronertor(blankr2.)
- rCORRECTrANSWER-functionalrloss,rincludingrrespiratoryrcompromise. aspirationrduertorresidualrnumbnessrandrdecreasedrswallowingrreflex.rthisralsorrendersrthemrmorerp ronertorrespiratoryrobstruction. precipitatingreventsrforrseizuresrinclude;r-rCORRECTrANSWER--fatigue
- userofralcoholrorrintoxicants
- photicrlightrstimulation
- menstruation phaseronerofrargrandrMalrseizurer-rCORRECTrANSWER-therprodromalrphase
- severalrminutesrbeforertherseizure,rtherpt.rexperiencesranxiety/depression.
immediatelyrbefore,rtherpt.rexperiencesranr"aura"rlastingrarfewrseconds.ritrmayrconsistrofrarsensoryrst
imulation.
- immediatelyrfollowing,rpt.rlosesrconsciousness.rthererareroftenrmusclerjerks/epilepticrcry.
