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Fragen in diesem Quiz (30)
1A 67-yo with a Hodgkin's lymphoma on bleomycin to undergo a laparotomy.
Which of the following increase risk of pulmonary toxicity?- APEEP 10 cmH2O
- BTV 600 mL
- CPeak pressure 20 cmH2O
- DFiO2 0.80
25-year-old boy is admitted to the PACU after receiving GA for a MRI. The patient is screaming, kicking and not making eye contact. The PACU nurse cannot calm him down.
Which of the following would prevented this presentation?- ARectal acetaminophen
- BOndansetron
- CDexmedetomidine
- DGlycopyrrolate
340-year-old man receives a 0.7 mcg/kg bolus of dexmedetomidine over ten minutes before an intubation.
What will be the most likely effect from this dose of dexmedetomidine ?
- AApnea
- BBradycardia
- CIncreased salivation
- DNystagmus
460-year-old woman is oliguric after a bowel resection marked by intraoperative hypotension despite
aggressive Ringer's lactate administration. Her plasma sodium is 126 mEq/L.
Which one is the most probable cause for her oliguria?- AExcessive antidiuretic hormone
- BInadvertent ureteral ligation
- CExcessive Ringer's lactate administration
- DRenal artery occlusion
5Two days after returning from Colombia a 37-year-old man became ill with flu-like prodrome, mild fever and rash in the face and trunk, as well as ocular pain and arthralgia; The symptoms alleviated after a few days. Along with the serum sample, a urine sample was taken and identified as Zika virus. He had been evaluated now for paresthesia of the four limb extremities that evolved into ascendant muscular weakness.
Which of the following has been associated with Zika virus infection?
- AGuillain-Barré syndrome
- BVasculitic neuropathy
- CMyasthenia gravis
- DCauda equina syndrome
6A 75-yo man with CAD on aspirin and clopidogrel after a bare metal stent placement. He need ligation and stripping of painful varicose veins in his legs.
Which is the earliest time after stent placement that appropriate to discontinue clopidogrel for elective surgery?- A1 week
- B1 month
- C3 months
- D1 year
7A 72-kg patient receives GA in a semi-closed circle system with fresh gas flows of O2 0.4 L/min, N2O 0.4 L/min and desflurane 4%. After 90 minutes, the inspired FiO2, as measured by the oxygen analyzer in the circuit, is 33%.
Which of the following is likely explanation for the discrepancy between the delivered and inspired oxygen concentrations?- AExhausted CO2 absorber
- BIncorrectly calibrated O2 analyzer
- CDilution of delivered gases with desflurane
- DIncreased uptake of O2 as compared to N2O
8Which of the following changes in CV function is usually occur in a healthy extremely old patient compared to his status at young age?
- ADecrease in LVEDP
- BIncrease in systemic arterial compliance
- CDecrease in beta-receptor sensitivity to catecholamines
- DIncrease in left ventricular stroke volume
9A 33 yo woman is for a laparoscopic assisted hysterectomy under general anesthesia placed in the Trendelenburg position. Over the first 40 minutes, her SpO2 decreases to 86% with no change in vital signs, pulse oximeter waveform, or end tidal CO2.
Which of the following interventions is needed to treat her hypoxemia?- APerform a recruitment maneuver
- BDecrease the tidal volume
- CIncrease the expiratory time
- DPlace the operating table flat
10After knee replacement, a woman reports no pain relief after taking relatively large doses of codeine fPO. Which of the following pharmacodynamics problems with codeine is causing the inadequate analgesia?
- AExcessive renal excretion
- BIncreased metabolism
- CDecreased conversion to morphine
- DImpaired gastric absorption
11After complete reversal of rocuronium with neostigmine a full dose of succinylcholine was given for re-intubating . How this going to effect the duration of the succinylcholine-induced neuromuscular blockade?
- AUnknown
- BProlonged
- CShortened
- DUnchanged
12Pulse pressure variation will be most accurate indicator of hypovolemia with which of the following methods of ventilation ?
- ASpontaneous ventilation with continuous positive airway pressure
- BSpontaneous ventilation
- CPressure support ventilation
- DVolume control ventilation
13A 61-year-old woman with a serum creatinine of 2.2 mg/dL requires intravenous contrast for an interventional radiology procedure. Which one of the following interventions is proven to reduce his risk of renal failure from contrast-induced nephrotoxicity?
- AAdministration of methylprednisolone
- BEuvolemic hydration with normal saline
- CIntravenous infusion of mannitol
- DAvoidance of sevoflurane
14After an block placement, a previously healthy woman suffers a cardiac arrest. Which one of the following medications is appropriate to be used during local anesthetic systemic toxicity resuscitation?
- AVasopressin
- BMetoprolol
- CVerapamil
- DEpinephrine
15Which of the following anesthesia machine safety devices is only one that continuously monitors to detect a low-pressure leak when delivering an anesthetic?
- AOxygen analyzer
- BOne-way check valve
- CProportioning system
- DOxygen supply failure alarm
16A 63-year-old woman had a CABG five hours ago. She is intubated and mechanically ventilated. Her BP decreases to 65/45 mmHg with a HR of 120 bpm. His CVP is 19 mmHg, PAP is 25/20 mmHg, and PCWP is 20 mmHg. Which of the following TEE findings is more likely to be present in this patient?
- ADistended left ventricle
- BMitral valve prolapse
- CAkinetic right atrium
- DNormal left ventricular contractility
17Which of the following clinical scenarios does NOT constitute a sentinel event?
- AIntraoperative hemolytic transfusion reaction secondary to blood group mismatch
- BAcute postoperative hepatic failure in a patient with metastatic liver disease who underwent a liver resection
- CIntraoperative anaphylactic reaction to cefuroxime in a patient with history of major PCN allergy
- DUnanticipated postoperative death of a full term infant
18A 70-year-old woman with dementia received GA for a hysterectomy. After the operation her pain was treated with opioids and nonsteroidal anti-inflammatory drug (NSAID). Three days after surgery the patient develops delirium. Which of the following preoperative factors is the best predictor of her postoperative delirium?
- AHistory of dementia
- BGeneral anesthesia (GA)
- CNonsteroidal anti-inflammatory drug (NSAID)
- DFemale sex
19A 72-year-old woman develops arterial hypotension, bradycardia, and respiratory arrest immediately after undergoing a retrobulbar block using 5 mL of lidocaine for a vitrectomy, . Injection into which one of the following structures is responsible for her condition?
- AOphthalmic artery
- BOptic nerve sheath
- CMyopic staphyloma
- DEpiscleral space
20A 55-year-old woman with CAD would like to have a breast augmentation. She has been on aspirin and clopidogrel since placement of a drug-eluting stent (DES) two months ago. At what point after stent placement would it be very appropriate to consider stopping clopidogrel for elective surgery?
- ASix months
- BNine months
- CTwelve months
- DEighteen months
21A 43 yo man was admitted to the hospital six days earlier for an intracranial hemorrhage that required emergency evacuation. The patient was later extubated when his neurologic status improved. He has been receiving 0.9% normal saline since admission, and his sodium level has been gradually decreasing from 141mEq/L, the level at admission, to 121 mEq/L. The patient appears hypovolemic, with a blood pressure of 115/70 mm Hg and pulse of 90 beats per minute. His intake and outtake documentation reveals that his urine output has been 2 to 4 L/d despite a fluid restriction of <1.5 L/d that was initiated two days earlier. Workup reveals a low serum osmolarity of, a normal serum creatinine level, and high urine osmolarity. His brain natriuretic peptide (BNP) is elevated. Which of the following is NOT correct in differentiating syndrome of inappropriate antidiuretic hormone (SIADH) from cerebral salt wasting (CSW)?
- AIn both SIADH and CSWS, laboratory tests alone cannot easily differentiate because in both conditions, serum Na is low, plasma osmolality low, urine osmolality high, and urine Na high.
- BSerum uric acid is low in CSW, and high in SIADH
- CCSW is associated with negative fluid balance and clinical evidence of volume depletion, whereas in SIADH no negative fluid balance or volume depletion is seen
- DUrea/Creatinine ratio may increase in CSW and is normal in SIADH
22A 55-y-o man with NIDDM, HTN and Afib is scheduled for elective surgery. Which one of the following oral medications is appropriate for the patient to continue on the morning of surgery?
- ALisinopril
- BAtenolol
- CMetformin
- DCoumadin
23 A 65 yo male with a history of HTN and nicotine abuse complaint of severe chest pain, nausea, dyspnea and diaphoresis.
On examination, the patient is in moderate distress. His skin is warm and dry. BP is 98/64 mm Hg and pulse is regular at 63/min. There is an S4 gallop at the apex together with a grade 2/6 systolic ejection murmur. Neck veins are 4 cm above the clavicle at 30 degrees. Lungs are clear and the peripheral pulses are normal. His ECG is shown, below.
The patient received sublingual NTG, 3 mg of intravenous morphine sulfate, and ASA. Two minutes later, the patient's BP drops to 70/30 mm Hg. Pulse is 60/min.
Which of the following represents the most likely cause for his hypotension:
- APapillary Muscle dysfunction
- BCardiogenic shock
- CAcute inferior wall MI with right ventricular infarction
- DMyocardial rupture
24Which safety event is NOT considered sentinel event by The Joint Commission?
- AAbduction of any patient receiving care
- BRape of a visitor while on site at the practice
- CAny intrapartum maternal death
- DUnintended retention of a foreign object in a patient after a clinical determination
25A 64-yo woman is evaluated prior to THR. She takes losartan for HTN, simvastatin for hyperlipidemia, and metformin for T2D. She can climb a flight of stairs (4 METS). When she shovels snow in the winter she has to take breaks because she gets short of breath. Which one of the following actions is the more appropriate next step?
- APrescribe perioperative beta-blocker
- BProceed with surgery
- CSchedule pharmacologic stress test
- DDiscontinue simvastatin
26In which patients low flow anesthesia is NOT contraindicated?
- Aacute alcoholic intoxication
- Bdiabetic ketoacidosis
- Ccarbon monoxide poisoning
- Dchemotherapy with bleomycin
27A 55-yo woman with asthma for an endovascular aneurysm repair. She currently takes metoprolol and has an allergy to shellfish. Which one of the following is the predictor for an anaphylactic reaction to intravenous contrast media in this patient?
- AMale sex
- BHistory of asthma
- CMetoprolol treatment
- DShellfish allergy
28A 55-yo smoker undergoes laparotomy using GA with desflurane after awake intubation. Which one of the following factors would be responsible for a carboxyhemoglobin level of 22% in this patient after surgery?
- ADesiccated carbon dioxide (CO2) absorbent
- BIncompetent expiratory valve in anesthesia machine
- CUse of benzocaine spray for awake intubation
- DHeavy smoking preoperatively
29A 19-yo patient with Down syndrome will receive a GA for an cholecystectomy. Which one of the following findings is more likely to impair visualization of the vocal cords during direct laryngoscopy in this patient?
- AMidface hypoplasia
- BMacroglossia
- CMicrognathia
- DAtlanto-occipital fusion
30A patient receives 20 mg of IV morphine over the first 24 hours after an exploratory laparotomy and develops postoperative nausea and vomiting (PONV). Which one of the following is the most important opioid-related factor contributing to the risk of postoperative nausea and vomiting?
- AOpioid class
- BRoute of administration
- CCumulative dose
- DDosing interval
Informationen
- Beschreibung
- 2016
- Autor
- Mike Ru
- Sprache
- English
- Aufrufe
- 117
- Schlagwörter
- Bewertung
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