Quiz
Anesthesia Question of the Day 2
Fragen in diesem Quiz (48)
1A 73-year-old woman taking warfarin for chronic atrial fibrillation is brought to the operating room for evacuation of a spontaneous left temporal intracerebral hematoma with uncal herniation syndrome. Her INR is 3.8. Her platelet count and hematocrit are normal. What is the recommended medical therapy for reversing her coagulopathy?
- ACryoprecipitate
- B4-Factor prothrombin complex concentrate (PCC)
- CFresh frozen plasma
- DVitamin K
2The incidence of headache with inadvertent dural puncture during epidural anesthesia is decreased:
- Awith decreasing age
- Bby keeping the patient supine for more than 12 hours following puncture
- Cwith the use of fluid, instead of air, for loss of resistance
- Dby inserting the needle with the bevel aligned perpendicular to the long axis of the meninges
3All of the following statements are true about hypoxic pulmonary vasoconstriction (HPV) EXCEPT:
- AHPV is a local response of bronchiolar artery smooth muscle in underventilated areas of the lung
- BHPV is responsible for most lung perfusion redistribution during one-lung ventilation
- CHPV occurs in areas of the lung with low alveolar oxygen pressure
- DHPV allows the lung to maintain optimal ventilation/perfusion matching
4Factors decreasing physiologic dead space include:
- Athe supine position
- Banticholinergic agents
- Cincreasing age
- Demphysema
5A 64-year-old, 73 kilogram male with a 50 pack-year smoking history is scheduled to undergo a lobectomy for a right upper lobe mass. You have placed a left-sided double lumen endotracheal tube, and you would like to confirm proper placement. Which of the following findings would suggest that your double-lumen endotracheal tube has entered the right main bronchus by accident?
- AInflate tracheal cuff, ventilate tracheal lumen, bilateral lung breath sounds
- BInflate bronchial cuff, inflate tracheal cuff, ventilate tracheal lumen, right lung breath sounds
- CInflate bronchial cuff, ventilate bronchial lumen, left lung breath sounds
- DInflate bronchial cuff, ventilate bronchial lumen, right lung breath sounds
6The development of transient neurologic symptoms (TNS) after spinal anesthesia is MOST associated with which of the following local anesthetics?
- ABupivacaine
- BLidocaine
- CPrilocaine
- DTetracaine
7Selective adrenergic stimulation of the β2-receptor results in:
- Aincreased heart rate
- Bincreased insulin secretion
- Cdetrusor muscle contraction
- Dpupillary constriction
8A patient with a severe traumatic brain injury is emergently brought to the operating room for evacuation of a parenchymal hematoma causing uncal herniation. The neurosurgeon requests that you limit systolic blood pressure to < 160 mmHg but keep cerebral perfusion pressure > 60mmHg. Currently, blood pressure is 190/100 mmHg and ICP is 25 mmHg. What antihypertensive agent will avoid a further increase in intracranial pressure?
- AHydralazine
- BMinoxidil
- CNitroglycerin
- DNicardipine
9Hormones released by the neurohypophysis include: (Select 2)
- Athryotropin
- Bgrowth hormone
- Carginine vasopressin
- Dadrenocorticotropic hormone
- Efollicle stimulating hormone
- Foxytocin
- Gprolactin
- Hluteinizing hormone
10A 50-year-old woman presents for lumbar spine surgery. Vital signs include blood pressure 210/130 mmHg. She appears comfortable but somewhat anxious. The anesthesiologist is concerned that this is a hypertensive emergency. What is the MOST appropriate next step in her management?
- AApply nitroglycerin paste to the chest wall and proceed to surgery
- BCancel surgery and send the patient to the emergency room
- CProceed with surgery without further consideration
- DQuestion the patient regarding history of hypertension and antihypertensive therapies
11At 10,000 feet elevation (atmospheric pressure is 520 mm Hg), oxygen 100 mL/min is bubbled through a vaporizer containing an anesthetic with a vapor pressure of 260 mmHg. This mixture is added to a fresh gas flow of 5 L/min. The delivered anesthetic concentration is:
- A0.25%
- B0.5%
- C1%
- D2%
12Pancreatic somatostatin producing cells in the Islets of Langerhans are:
- Aalpha cells
- Bbeta cells
- Cgamma cells
- Ddelta cells
13Pancreatic somatostatin producing cells in the Islets of Langerhans are:
- Aalpha cells
- Bbeta cells
- Cgamma cells
- Ddelta cells
14The recommended maximum leakage current allowed in operating room equipment is:
- A5 μA
- B10 μA
- C1 mA
- D5 mA
15In a coagulopathic patient, the risk of bleeding after a paravertebral blockade is MOST similar to which other form of regional anesthesia?
- AAxillary block
- BBier block
- CEpidural block
- DSupraclavicular block
16Which of the following changes would MOST likely result in increased coronary artery perfusion in a patient with aortic stenosis?
- ADecreased systemic diastolic pressure
- BIncreased systemic vascular resistance
- CIncreased left ventricular diastolic pressure
- DTachycardia
17Causes of normal-anion-gap acidosis include:
- Arenal failure
- Bstarvation
- Cdiarrhea
- Dlactic acidosis
18A 62-year-old man has had CABG surgery and develops atrial fibrillation in the ICU afterward. He is administered an amiodarone loading dose with a planned maintenance dose to follow. Which of the following hemodynamic effects is MOST likely to occur during the acute bolus phase?
- ADecreased systemic vascular resistance
- BDecreased pulmonary vascular resistance
- CIncreased systemic vascular resistance
- DIncreased pulmonary vascular resistance
19The area of myocardium most vulnerable to ischemia is the:
- Aleft ventricular epicardium
- Bright ventricular epicardium
- Cleft ventricular subendocardium
- Dright ventricular subendocardium
20Hypoxemia during one-lung anesthesia is most effectively treated by:
- APEEP applied to the ventilated lung
- Bcontinuous oxygen insufflation to the collapsed lung
- Cchanging tidal volume and rate
- Dperiodic inflation of the collapsed lung
21Which of the following antibiotics is nephrotoxic?
- AQuinolones
- BRifampin
- CVancomycin
- DAll of the above
22Which of the following statements regarding open surgical versus percutaneous tracheostomies is MOST likely true?
- AOpen tracheostomies are associated with fewer major complications
- BOpen tracheostomies are associated with fewer infectious complications
- CPercutaneous tracheostomies are associated with fewer major complications
- DThere is no difference in the incidence of major complications
23Sympathetic blockade during acute herpes zoster has been shown to:
- Aincrease analgesic requirements
- Breduce the incidence of postherpetic neuralgia
- Cincrease the need for corticosteroid therapy
- Dbe an effective treatment for patients who have had postherpetic neuralgia for a number of years
24Sympathetic blockade during acute herpes zoster has been shown to:
- Aincrease analgesic requirements
- Breduce the incidence of postherpetic neuralgia
- Cincrease the need for corticosteroid therapy
- Dbe an effective treatment for patients who have had postherpetic neuralgia for a number of years
25Branches of the femoral nerve anesthetized during an ankle block include the:
- Adeep peroneal nerve
- Bsural nerve
- Csaphenous nerve
- Dposterior tibial nerve
26A 35-year-old woman complains of chest pain on her seventh postpartum day. EKG reveals STEMI in anterior leads and a regional wall motion abnormality is appreciated on TTE. An angiogram reveals LCA dissection and the diagnosis of acute MI secondary to spontaneous coronary artery dissection (SCAD) is made. What is the incidence of SCAD in pregnant patients with MI?
- A27%
- B17%
- C7%
- D0.7%
27Pulmonary complications from advanced hepatic disease with cirrhosis include:
- Aan obstructive ventilatory defect
- Brespiratory acidosis
- Cincreased intrapulmonary shunting
- Dincreased functional residual capacity
28A patient with a large mediastinal tumor presents for excision of the mass. CT scan shows a mass of 14 x 10 cm causing about 40% tracheal compression and moderate compression of the superior vena cava (SVC) and other mediastinal structures. The heart is displaced laterally and an apical impulse is felt just medial to the anterior axillary line. The patient is asymptomatic with no signs of SVC syndrome. Which of the following is the MOST common mechanism of hemodynamic collapse under general anesthesia in this patient?
- AIncreased afterload
- BDecreased preload
- CVentilation-perfusion mismatch
- DRhythm abnormalities
29An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic agent (MAC) is:
- Aechinacea
- Bvalerian
- Cginkgo
- Dephedra
30A 23-year-old primiparous woman in spontaneous labor is monitored with continuous fetal heart monitors. The cardiotocograph shows a baseline fetal heart rate of 110/min with moderate variability. There are no accelerations over a period of 20 minutes and no early decelerations. This tracing falls under which of the following categories?
- ACategory I
- BCategory II
- CCategory III
- DCategory IV
31The formation of metanephrine is the result of:
- Acatechol-O-methyltransferase metabolism of epinephrine
- Bcatechol-O-methyltransferase metabolism of norepinephrine
- Cmonamine oxidase metabolism of epinephrine
- Dmonamine oxidase metabolism of norepinephrine
32A 35-year-old man who had right ankle ORIF under general anesthesia after sciatic-saphenous nerve blockade develops right foot drop postoperatively. Which nerve is most likely injured?
- APeroneal nerve
- BTibial nerve
- CSaphenous nerve
- DSural nerve
33Which of the following is MOST true regarding a pediatric patient with a URI and the risk of anesthesia?
- AAirway reactivity has been demonstrated to occur in the lab, but has not been definitively shown to occur
- BIncreased incidence of adverse airway events have been demonstrated in children to last for 2-4 weeks after the URI
- CThe best approach is to cancel all children with a URI presenting for elective surgery
- DThere are no known affects of a URI on the lower airways
34Characteristics of human immunodeficiency virus neuropathy include: (Select 2)
- Adistal polyneuropathy
- Brapid sudden onset
- Cproximal muscle weakness
- Dallodynia
- Eupper extremities most commonly involved
- Fproximal to distal progression of symptoms
35An action potential characterized by a spike followed by a plateau phase is seen in:
- Aperipheral sensory nerve cells
- Bperipheral motor nerve cells
- Cstriated skeletal muscle cells
- Dcardiac muscle cells
36Patient risk factors associated with the development of perioperative peripheral nerve injuries include all of the following EXCEPT:
- ADiabetes mellitus
- BHypertension
- CFemale sex
- DTobacco abuse
37Autonomic hyperreflexia:
- Ais common with cord lesions below T8
- Bcan precipitate pulmonary edema
- Cis not effectively prevented by regional anesthesia
- Dcan be prevented with adequate intraoperative sedation
38Mannitol may be administered during surgical clipping of an aneurysm to decrease brain water and thus brain bulk. The peak effect of mannitol occurs approximately:
- A5 – 10 minutes after the infusion begins
- B15 – 20 minutes after the infusion begins
- C30 – 45 minutes after the infusion begins
- DAbout 1 hour after the infusion begins
39Renal effects of nitrous oxide include:
- Adecreased renal blood flow secondary to decreased cardiac output
- Bdecreased renal blood flow secondary to increased renal vascular resistance
- Cincreased renal blood flow secondary to sympathetic stimulation
- Dincreased glomerular filtration with increased reabsorption
40What are the primary anatomic landmarks for a fascia iliaca block?
- AAnterior superior iliac spine and pubic tubercle
- BAnterior superior iliac spine and greater trochanter of femur
- CIliac crest and pubic tubercle
- DPosterior superior iliac spine and greater trochanter of femur
41The dibucaine number:
- Ais normally less than 60%
- Bis a quantitative assessment of pseudocholinesterase activity
- Cis inversely proportional to pseudocholinesterase function
- Dreflects inhibition of pseudocholinesterase by dibucaine
42A 45-year-old morbidly obese man with a medical history of hypertrophic cardiomyopathy presents for ear surgery. He has an ejection fraction of 65% on transthoracic echocardiography. After induction of general anesthesia, his blood pressure is 78/40 mmHg with a regular heart rate of 80 bpm. Which of the following is the MOST appropriate initial intervention?
- AEphedrine 20 mg IV
- BEpinephrine 30 mcg IV
- CEsmolol 50 mg IV
- DPhenylephrine 100 mcg IV
43Chronic aortic regurgitation results in all the following EXCEPT:
- ADecreased aortic diastolic pressure
- BIncreased stroke volume
- CDecreased LV end diastolic pressure
- DIncreased LV mass
44Release of aldosterone by the adrenal cortex is stimulated by: (select 3)
- Aangiotensin I
- Bangiotensin II
- Chypokalemia
- Dpituitary ACTH
- Econgestive heart failure
- Fhypervolemia
45The most common complication of thoracic paravertebral nerve block is:
- Ahypotension
- Bsubarachnoid injection
- Cpneumothorax
- Dintravascular injection
46A 55-year-old woman with an infected automatic cardioverter-defibrillator (AICD) lead presents for removal. During the course of the procedure she develops acute profound, refractory hypotension that progresses to cardiovascular collapse and pulseless electrical activity. Which of the following is the MOST appropriate intervention at this time?
- AAdministration of epinephrine to increase blood pressure
- BNeedle thoracostomy to treat pneumothorax
- CThoracotomy to evacuate pericardial effusion
- DTranscutaneous pacing to increase heart rate
47Which of the following drugs is NOT a cell cycle inhibitor?
- AAzathioprine
- BMycophenolate mofetil
- COrtho Kung T3 (OKT3)
- DSirolimus
48According to the Modified Glasgow Coma Scale, a moderate head injury is associated with a score of:
- A13 - 15
- B9 - 12
- C6 - 9
- Dless than 6
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- Quiz am Anesthesia Question of the Day 2, erstellt von thomasina413 am 10/08/2014.
- Autor
- thomasina413
- Sprache
- English
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