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Basic exam q's

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rocsux

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Having trouble with these, would appreciate any help, thanks!

1. an induction dose of ketamine is most likely to:

a. have analgesia
b. preserve laryngeal reflexes

why is b wrong?

2. two hours after a laparoscopic cholecystectomy an obese 45 year old woman is receving intravenous patient-controlled analgesia with morphine. her sp02 is 92$ on RA. Why?

a. hypoventilation
b. impaired o2 diffusion
c. increased Dead Space
 
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Ronin786

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Having trouble with these, would appreciate any help, thanks!

1. an induction dose of ketamine is most likely to:

a. have analgesia
b. preserve laryngeal reflexes

why is b wrong?

2. two hours after a laparoscopic cholecystectomy an obese 45 year old woman is receving intravenous patient-controlled analgesia with morphine. her sp02 is 92$ on RA. Why?

a. hypoventilation
b. impaired o2 diffusion
c. increased Dead Space
For question 2, the patient is fat, just had laparoscopic surgery and is receiving a PCA while on RA. The answer is hypoventilation, with the hint being that she's hypoxic on RA (refer to the alveolar gas equation and how supplemental oxygen can prevent or mask hypercarbia related hypoxia). Impaired O2 diffusion is a rare cause of hypoxia outside of restrictive lung disease of the lung and the other differential of atelectasis is a form of pulmonary shunting rather than dead space.

This is a high yield review:
Respiratory complications in the postanesthesia care unit: A review of pathophysiological mechanisms
 
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