1 What are the cardiovascular adaptations to pregnancy? Increased progesterone levels associated with pregnancy are presumed to increase the production of nitric oxide and prostacyclin. This is coupled with a decreased response to catecholamines and angiotensin, resulting in vasodilation. The…
1 What is the incidence of congenital heart disease? Congenital heart disease (CHD) is the most common type of birth defect. Although a variable range can be found in the literature, a reasonable estimate of the incidence is one in…
1 Compare and contrast the adult and pediatric airways. Compared with adults, children have larger heads, shorter necks, smaller nares, and larger tongues. Infants and neonates are obligate nose breathers. They have a large tongue, which can obstruct the airway…
1 Why are neonates and preterm infants at increased anesthetic risk? Pulmonary factors. Differences in the neonatal airway, including large tongue and occiput, floppy epiglottis, small mouth, and short neck predispose infants to upper airway obstruction. The more premature the…
1 How is alcohol absorbed and metabolized? Alcohol is absorbed across the gastrointestinal mucosa, more so in the small intestine than in the stomach. It enters into the portal vein and proceeds to the liver, where it is metabolized. Most…
1 Define obesity. Obesity is defined using the body mass index (BMI) ( Table 49.1 ). BMI=MassHeight2(kgm2) BMI = Mass Height 2 kg m 2 Table 49.1 Classification of Body Mass Index Body Mass Index Classification ≤ 18.5 Underweight 18.5–25…
1 Review the thyroid hormone laboratory tests. Thyroid hormone laboratory tests include: Total thyroxine (T 4 ) level Total triiodothyronine (T 3 ) level—formed from the peripheral conversion of T 4 Thyroid-stimulating hormone (TSH) level—formed in anterior pituitary Resin T…
1 Describe the principal types of diabetes mellitus. Type 1 diabetes mellitus: An autoimmune disorder in which destruction of the insulin-producing beta cells in the pancreatic islets results in the inability to produce insulin. Onset is more common in children…
1 What is amyotrophic lateral sclerosis and its anesthetic considerations? Also known as Lou Gehrig disease , amyotrophic lateral sclerosis (ALS) is a disease of both upper and lower motor neurons resulting from degeneration of alpha motor neurons in the…
1 What is malignant hyperthermia (MH) and its underlying defect? Malignant hyperthermia is a disastrous and sudden syndrome evoked by the administration of triggering anesthetic agents, including volatile anesthetics and depolarizing neuromuscular blocking agents. Unfortunately, there is no distinct phenotype…