GYN/Gu/Out-of-or/Anesthesia Complications Basics Quiz II

Always place a bite block with ECT - the seizure can cause the patient to bite through their tongue.

Wear the gray mask so you don't get HPV in your throat.

A distended bladder in a patient with spinal cord injury can cause autonomic hyper/dys-reflexia, which is a condition characterized by life-threatening hypertension. This increased blood pressure can lead to serious complications such as stroke, myocardial infarction (heart attack), and even death. Therefore, it is true that a distended bladder in a patient with spinal cord injury can cause life-threatening hypertension.

Flow is reduced to the leg by a pressure of 0.7 mmHg for each 1 cm above the level of BP measurement.

Glycine is an inhibitory neurotransmitter because it acts to reduce or inhibit the activity of neurons in the nervous system. It binds to specific receptors in the brain and spinal cord, allowing chloride ions to enter the neuron and hyperpolarize it. This hyperpolarization makes it more difficult for the neuron to reach its threshold and generate an action potential, effectively reducing the excitability of the neuron and inhibiting its activity. Therefore, glycine plays a crucial role in regulating neuronal activity and maintaining a balance between excitation and inhibition in the nervous system.

This is very true. Give 3-5% NaCl @

The blood supply to the cervix is primarily provided by the descending uterine artery. This artery arises from the internal iliac artery and runs along the lateral wall of the uterus. It gives off branches that supply blood to the cervix, as well as the uterus itself. The femoral artery supplies blood to the lower extremities, the inferior epigastric artery supplies blood to the abdominal wall, and the pudendal artery supplies blood to the external genitalia. Therefore, these arteries are not directly involved in supplying blood to the cervix.

The appropriate ASAs for out-of-OR procedures include ASA I, ASA II, and ASA III with stable comorbidities. This means that patients who are classified as ASA I (healthy) and ASA II (mild systemic disease) are suitable for out-of-OR procedures. Additionally, patients who are classified as ASA III (severe systemic disease) but have stable comorbidities can also undergo out-of-OR procedures. However, patients with ASA IV (severe systemic disease that is a constant threat to life) and ASA V (moribund patient not expected to survive without the procedure) are not considered appropriate for out-of-OR procedures.

The infusion should be slowly infused to prevent severe hypotension.

Contrast reaction treated like any allergic reaction - 02, bronchodilators, epinephrine, benadryl, corticosteroids.

Glycine (a non-essential amino acid) is metabolized to glycolytic acid and ammonia. Toxic levels of ammonia attribute to blindness that is resolved with normalized ammonia levels.

Hepatitis B is most common in healthcare personnel due to its transmission through blood products and body fluids. This is because healthcare personnel are at a higher risk of exposure to blood and body fluids in their line of work, such as through needlestick injuries or contact with contaminated surfaces. Hepatitis B is a viral infection that affects the liver and can cause serious health complications if left untreated. Therefore, healthcare personnel need to take precautions such as vaccination and following proper infection control measures to prevent the transmission of Hepatitis B.

Hepatitis C is the most common cause of non-alcoholic cirrhosis.

Irrigation should be:
Isotonic
Inexpensive
Non-electrolyte
Non-hemolytic
Transparent

Hyponatremia is a condition characterized by low levels of sodium in the blood. When hyponatremia occurs, it can lead to changes in the electrical activity of the heart, specifically affecting the QRS complex and ST segment on an electrocardiogram (ECG). In this case, the correct answer is "wide, elevation," indicating that hyponatremia can cause a widening of the QRS complex and an elevation of the ST segment on an ECG. These changes are important to recognize as they can indicate potential cardiac complications associated with hyponatremia.

The parasympathetic response of the bladder, as well as the internal and external sphincter, are innervated via the pudendal nerve. The pudendal nerve is responsible for controlling the voluntary muscles of the perineum, including those involved in urination. It originates from the sacral plexus and provides motor innervation to the external urethral sphincter, allowing for voluntary control over the release of urine. Therefore, the pudendal nerve is the correct answer in this context.

Communicate with the surgeon - many want to assess nerve function during axillary node dissection so a normal dose of roc can't be given (bovie too close to a nerve won't cause a reaction if paralyzed).

BPH, or benign prostatic hyperplasia, is a condition where the prostate gland enlarges and causes obstruction of the bladder neck. This obstruction can lead to various complications. GU infections can occur because the stagnant urine in the bladder provides a suitable environment for bacterial growth. Renal insufficiency can result from the chronic obstruction and increased pressure on the kidneys, leading to decreased kidney function. Bladder stones can form due to the prolonged presence of urine in the bladder, which can crystallize and form stones. Therefore, GU infections, renal insufficiency, and bladder stones are all potential complications of BPH.

It begins to increase after 40.

Hypotension and bradycardia secondary to vagal stimulation via the carotid bodies that can progress to cardiac arrest.
Although excessive bleeding is not a specific risk, venous embolism from the prolonged case with poor blood flow is a risk.

The placement of a bare-metal stent within 6 weeks or a drug-eluting stent within 1 year greatly increases the risk of peri-operative MI. This means that if a drug-eluting stent is placed within 1 year, there is a higher chance of experiencing a heart attack during or after the surgery. The longer the time interval after stent placement, the lower the risk of peri-operative MI.

The top three causes for anesthesia closed claims are death, nerve injury, and brain damage. This means that these are the most common outcomes that result in claims related to anesthesia. It is important for anesthesiologists to be aware of these risks and take necessary precautions to prevent such complications.

This prevents acardia.

The lithotomy position, which involves lying on the back with the legs elevated and flexed, can put pressure on the common peroneal nerve. This nerve runs along the outer side of the thigh and can be compressed or stretched in this position, leading to nerve injury. The obturator nerve, femoral nerve, and sciatic nerve are not typically affected by the lithotomy position.

All are correct! Up to 2 liters of irrigation fluid can be absorbed causing dilutional hyponatremia and fluid volume overload.

The hypogastric nerve enters the thoracolumbar (SNS) portion of the spinal cord (T11-L2 to L3) and supplies the sympathetic innervation of the bladder.

Likewise, decreases in female hormones (seen in menopause) have been associated with an increase in pain sensitivity.

The pelvic nerve is located at S2-3.
When RELAXED, the detrussor muscle allows the bladder to store urine. When it CONTRACTS, urination occurs.

Sensory to the vagina via the pudendal nerve (S2,3,4). Sympathetic via the hypogastric plexus (L1-L3) and parasympathetic via the sacral nerves.

Adequate regional anesthesia for most GU surgeries should encompass the T10 dermatome. This is because the T10 dermatome covers the region of the body where most of the genitourinary surgeries are performed. By targeting this specific dermatome with anesthesia, the surgeon can ensure that the patient does not experience pain or discomfort during the procedure.