Principles III, Exam 4 |93 Verified
Questions With Correct Answers.,.
What is the most prominent clinical manifestation of bone cement implantation
syndrome? - AnswerPulmonary Hypertension (increased pulmonary vascular
resistance).
Which of the following are clinical manifestations of bone cement implantation
syndrome?
A. Hypoxia
B. Hypotension
C. Arrhythmias (including heart block and sinus arrest)
D. Decreased cardiac output - Answerall are s/s of bone cement implantation.
-intramedullary HTN (from bone cement) can cause embolization of fat, bone marrow,
cement and air into venous channels.
-systemic absorption of a residual monomer can produce vasodilation and decreased
SVR
Emboli most frequently occur during the insertion of a femoral prosthesis for hip
arthroplasty. Treatment strategies include what two actions? - Answer1. increase
inspired O2 prior to cementing
2. monitoring to maintain euvolemia
Regarding a tourniquet, inflation pressure is usually set approximately ___________
mmHg higher than the patients baseline SBP. - Answer100mmHg higher than the
patient's baseline SBP
____________ ______________ invariably and immediately relieves tourniquet pain
and associated hypertension. - AnswerCuff deflation
True or false
Tourniquet deflation is the only factor that eliminates tourniquet pain with resolution
within 30 minutes. - AnswerTrue.
Tourniquet deflation is the only factor that eliminates tourniquet pain
Prolonged inflation (>2hr) routinely leads to transient muscle _____________ from
ischemia and may produce ____________ or permanent ____________
____________ damage. - Answer-dysfunction
-rhabdomyolysis
, -peripheral nerve damage
Fat emboli syndrome is less frequent and classically presents within 72 hours following
long bone or pelvic fracture, with the triad: - Answer1. dyspnea
2. confusion
3. petechiae
Petechiae on chest, upper extremities, axillae and conjunctiva are suggestive of what
diagnosis? - AnswerFat embolism syndrome
What coagulation abnormalities are also seen with fat embolism syndrome? -
Answerthrombocytopenia
or
prolonged clotting times
The classic symptoms of fat emboli occur how many days after the precipitating event?
- Answer1-3 days
Under GA
-decrease in ET CO2
-decrease in PaO2
-increase in pulmonary artery pressure
-ST segment changes (ischemic appearing cx)
-R sided heart strain
are all signs of - AnswerFat emboli syndrome under general anesthesia.
True or false:
Concerning fat emboli syndrome, hypotension will occur and require treatment with
vasopressors.
Pulmonary hypertension will occur requiring treatment with vasodilators. -
AnswerTrue.
Hypotension tx with pressor
Pulm. HTN tx with vasodilator
_________ and _________ can cause morbidity and mortality following orthopedic
operations on the pelvis and lower extremities. - AnswerDVT and PE
Which of the following are risk factors for DVT?
Questions With Correct Answers.,.
What is the most prominent clinical manifestation of bone cement implantation
syndrome? - AnswerPulmonary Hypertension (increased pulmonary vascular
resistance).
Which of the following are clinical manifestations of bone cement implantation
syndrome?
A. Hypoxia
B. Hypotension
C. Arrhythmias (including heart block and sinus arrest)
D. Decreased cardiac output - Answerall are s/s of bone cement implantation.
-intramedullary HTN (from bone cement) can cause embolization of fat, bone marrow,
cement and air into venous channels.
-systemic absorption of a residual monomer can produce vasodilation and decreased
SVR
Emboli most frequently occur during the insertion of a femoral prosthesis for hip
arthroplasty. Treatment strategies include what two actions? - Answer1. increase
inspired O2 prior to cementing
2. monitoring to maintain euvolemia
Regarding a tourniquet, inflation pressure is usually set approximately ___________
mmHg higher than the patients baseline SBP. - Answer100mmHg higher than the
patient's baseline SBP
____________ ______________ invariably and immediately relieves tourniquet pain
and associated hypertension. - AnswerCuff deflation
True or false
Tourniquet deflation is the only factor that eliminates tourniquet pain with resolution
within 30 minutes. - AnswerTrue.
Tourniquet deflation is the only factor that eliminates tourniquet pain
Prolonged inflation (>2hr) routinely leads to transient muscle _____________ from
ischemia and may produce ____________ or permanent ____________
____________ damage. - Answer-dysfunction
-rhabdomyolysis
, -peripheral nerve damage
Fat emboli syndrome is less frequent and classically presents within 72 hours following
long bone or pelvic fracture, with the triad: - Answer1. dyspnea
2. confusion
3. petechiae
Petechiae on chest, upper extremities, axillae and conjunctiva are suggestive of what
diagnosis? - AnswerFat embolism syndrome
What coagulation abnormalities are also seen with fat embolism syndrome? -
Answerthrombocytopenia
or
prolonged clotting times
The classic symptoms of fat emboli occur how many days after the precipitating event?
- Answer1-3 days
Under GA
-decrease in ET CO2
-decrease in PaO2
-increase in pulmonary artery pressure
-ST segment changes (ischemic appearing cx)
-R sided heart strain
are all signs of - AnswerFat emboli syndrome under general anesthesia.
True or false:
Concerning fat emboli syndrome, hypotension will occur and require treatment with
vasopressors.
Pulmonary hypertension will occur requiring treatment with vasodilators. -
AnswerTrue.
Hypotension tx with pressor
Pulm. HTN tx with vasodilator
_________ and _________ can cause morbidity and mortality following orthopedic
operations on the pelvis and lower extremities. - AnswerDVT and PE
Which of the following are risk factors for DVT?
