32 Questions
According to the table, which group of hypertensive patients had the highest incidence of perioperative hypertensive episodes?
Treated/rendered normotensive patients
What is the primary risk factor for hypotension in hypertensive patients undergoing surgery?
All of the above
Why is transient hypotension during the perioperative period particularly dangerous for hypertensive patients?
All of the above
What is the recommended approach for beta blocker therapy in hypertensive patients undergoing surgery?
Continue beta blockers throughout the perioperative period
Which of the following questions should be asked regarding a hypertensive patient's antihypertensive medication use before surgery?
All of the above
What is the recommended approach for diuretic therapy in hypertensive patients undergoing surgery?
Both b and c
What is the primary mechanism of cardiac tamponade?
Pressure imposed by the pericardium impairing diastolic filling
Which of the following is NOT a symptom related to compression of adjacent structures in pericardial effusion and cardiac tamponade?
Tachycardia
What is a classic physical finding of cardiac tamponade?
Beck's Triad
Why can general anesthesia and positive-pressure ventilation be dangerous in hemodynamically significant cardiac tamponade?
They can lead to hypotension
What is a crucial goal of anesthetic management in cardiac tamponade?
Maintaining sinus rhythm
Which diagnostic modality is preferred for confirming the presence of cardiac tamponade?
Echocardiography
What is the primary goal in the obstetric management of primary pulmonary hypertension?
Maintain optimal mechanical coupling of the RV and the pulmonary circulation
What is the main cause of maternal mortality in cases of primary pulmonary hypertension during labor and the early postpartum period?
Right heart failure
Which vasodilators are used to determine responsiveness in patients with primary pulmonary hypertension?
Prostacyclin, NO, adenosine, prostaglandin E1
What is one of the effects of laparoscopy on patients with primary pulmonary hypertension?
Increased right heart filling pressure
What is the purpose of calculating pulmonary vascular resistance (PVR) in patients with primary pulmonary hypertension?
To determine responsiveness to vasodilators
What is a significant risk factor for hypoxemia in patients with pulmonary hypertension?
Increased oxygen extraction during exertion
In the treatment of primary pulmonary hypertension, what role do calcium channel blockers play?
Decrease pulmonary vascular resistance
What technique is preferred during labor and delivery for patients with primary pulmonary hypertension?
Epidural analgesia
Which condition results from right-to-left shunting through a patent foramen ovale in pulmonary hypertension?
Hypoxemia
What can transient pressurization of chest during thoracic procedures potentially lead to in patients with pulmonary hypertension?
Elevated pulmonary vascular resistance
Which of the following statements about pericarditis following a myocardial infarction (MI) is correct?
The acute presentation occurs 1-3 days after a transmural MI.
Which of the following is NOT a typical treatment for acute pericarditis?
Immunosuppressive drugs
Which form of relapsing pericarditis is NOT mentioned in the text?
Chronic
Which of the following statements about cardiac tamponade is correct?
It is dependent on the size and acuity of the pericardial effusion.
Which of the following is a characteristic of constrictive pericarditis?
The pericardium becomes a rigid shell due to inflammation and scarring
What is the primary treatment for constrictive pericarditis?
Stripping of the pericardium, which may require cardiopulmonary bypass
Which of the following is a potential complication associated with pericardial laceration?
Cardiac herniation, which would be managed similarly to cardiac tamponade
What is the primary goal of anesthetic management in cases of constrictive pericarditis?
Maintaining heart rate, contractility, systemic vascular resistance, and venous return
Which of the following is a characteristic of commotio cordis?
It is caused by a high-impact chest injury during ventricular repolarization
What is the recommended treatment for commotio cordis?
Immediate defibrillation
Test your knowledge on the risks associated with general anesthesia in hypertensive patients, including preoperative blood pressure, perioperative hypertensive episodes, and postoperative cardiac complications. Explore the Hines Surgical/Anesthetic Risk factors and their implications for hypertensive patients undergoing elective surgery.
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