Question Bank

Front 1

1) Laparoscopic surgery is

Back 1

is contraindicated after 23 weeks gestation

Front 2

2) During a laparoscopic surgery procedure, the greatest rate of rise of ETCO2 is the during?

Back 2

first 20 -30mins

Front 3

When the surgeon begins to insufflate the abdomen with carbon dioxide, the anesthesia provider should be vigilant to the possibility of vagally mediated reflexes. All are examples of these possible reflexes EXCEPT?

Back 3

Hypertension

Front 4

All of the following are discharge criteria for you patient who has MAC for their cataract surgery except?

Back 4

Be completely free of PONV

Front 5

Your patient is having a laparoscopic hernia repair. He complains of GERD for which he take Prilosec. Which is most appropriate for your patient?

Back 5

Bicitra 30ml and Reglan 10mg prior to induction.

Front 6

Know that PONV can be elevated in patient with a history of PONV and those receiving laparoscopy surgery, following are some medications that may help to relieve PONV?

Back 6

Ondansetron, Kytril and propofol

Front 7

Naloxone is?

Back 7

a competitive antagonist

Front 8

All of the following except ______ contribute to decrease in arterial oxygenation in lap surgery?

Back 8

Pulmonary dead space

Front 9

Which one of the following is not a common procedure performed via laparoscopy surgery?

Back 9

Endarectomy

Front 10

T/F. A head down position during laparoscopic surgery tends to shift the trachea downward, so that a trachea tube anchored at the mouth may migrate into the right mainstem bronchus?

Back 10

False

Front 11

An ________ is the functional unit of the liver and is defined by a portal tract in the middle and centrilobular veins at the periphery?

Back 11

Acinus

Front 12

You about to do a colonoscopy on your patient who weigh 92 kg and is 5’3”. She state she does not tolerate pain very well at all and is begging for you to please make sure she is completely asleep and does not experience any pain. Which of the following drugs would you not consider using on your patient?

Back 12

Dilaudid (colonoscopy is very short)

Front 13

13) Which of the following statements concerning ketorolac is true?

Back 13

it reversibly binds cyclooxygenase

Front 14

14) Manifestations of cirrhosis include?

Back 14

: hypoalbuminemia, hypokalemia, hypomagnesemia

Front 15

The portal vein brings blood from which organs?

Back 15

spleen, intestines and pancreas

Front 16

_______ represents the major route of cholesterol elimination?

Back 16

Bile acid

Front 17

The primary substance of bile is?

Back 17

bile salts

Front 18

The ______ is a cylindrically shaped unit that surrounds a central vein in a spokelike fashion?

Back 18

Lobule

Front 19

T/F. Hepatitis B requires the presence of Hepatitis D?

Back 19

False

Front 20

Which of the following type of hepatitis is generally not transmitted percutaneously?

Back 20

Hep A.

Front 21

21) Which of the following is generally elevated in a patient with hepatic encephalopathy?

Back 21

Ammonia

Front 22

22) Which of the following enzymes is most specific for the liver?

Back 22

Alanine aminotransferase (ALT)

Front 23

A patient is place in lithotomy position for a surgical procedure exhibits loss of dorsiflexion of the foot in the recovery area. This may indicate damage to the?

Back 23

common peroneal nerve.

Front 24

A patient is bleeding excessively after a routine TURP. Re-exploration discloses diffuse oozing. Some of the most appropriate managements would be administration of all EXCEPT?

Back 24

Desmopressin (all = PLT, FFP, Epsilon-aminocaproic acid, cryo)

Front 25

What is the appropriate dose for oral midazolam in pediatric patient?

Back 25

0.5-0.75mg/kg.

Front 26

Which of the drugs would be most appropriate to use while performing conscious sedation for CT scan where the patient needs to be absolutely still?

Back 26

Propofol

Front 27

Following induction and intubation of a patient with hypothyroidism, the blood pressure falls to 80/40mmHG. The most appropriate intervention for this patient would be to administer?

Back 27

Ephedrine 5mg IV

Front 28

Which of the following benzos is water soluble?

Back 28

midazolam

Front 29

Which of the following pharmacologic treatments would be contraindicated for use in treating hypertensive emergencies associated with encephalothy?

Back 29

Hydralazine

Front 30

Which of the following muscle relaxants would be most appropriate in a patient with a history of asthma?

Back 30

Cisatracurium

Front 31

What is the IM dose of succx for a two year old patient?

Back 31

4mg/kg

Front 32

All of the following are true of ketorolac IM except?

Back 32

augments plt aggregation

Front 33

Which of the following drugs causes steroid suppression?

Back 33

Etomidate

Front 34

Which of the following narcotics has the greatest lipid solubility?

Back 34

sufentanil

Front 35

Local anesthetics exist as?

Back 35

Weak bases with a positively charged amine group.

Front 36

Many neurotranmitters in the nervous system in the geriatric are reduced, however, the neurotransmitter ______ does not seem to be affected?

Back 36

Glutamate

Front 37

All fo the following are associated with an increase potential for perioperative morbidity and mortality. Select the factor that has the least impact on morbidity and mortality in the older adult?

Back 37

Chronological age

Front 38

Central sleep apnea is best described as?

Back 38

Regular respiratory rate despite physical obstruction.

Front 39

We know that the closing capacity in the geriatric patient is increased. Closing capacity is made up of which volumes?

Back 39

Residual volume and Closing volume

Front 40

Which of the following is false? Obese patient have?

Back 40

reduce metabolism

Front 41

Aspiration pneumonitis in the obese patient?

Back 41

the risk is increased due to high abdominal pressures.

Front 42

In an otherwise healthy, obese patient?

Back 42

Cardiac output is increased

Front 43

Of the following, pick the two that are correct:

Back 43

Biological aging manifests itself as loss of height, graying of hair, wrinkling of skin & Clinical age emphasizes that intrinsic as well as extrinsic factors contribute to the altered homeostasis in older adults.

Front 44

Diazepam in the elderly is a drug we should not take lightly. This is because diazepam?

Back 44

is highly protein bound, has a large volume of distribution & is lipophilic

Front 45

Motor innervation of the cricothyroid muscle is provided by?

Back 45

the external branch of the superior laryngeal nerve.

Front 46

A mediastinoscopy can result in decrease blood flow through which vessel?

Back 46

all the above (brachiocephalic, right subclavian, & right common carotid artery).

Front 47

When placing monitors on a patient presenting for mediatinoscopy which of the following is the appropriate arrangement?

Back 47

radial arterline line and O2 sat monitor on the right arm and the BP cuff on the left arm.

Front 48

The greatest risk for one lung ventilation is ______?

Back 48

hypoxemia

Front 49

After inserting a double lumen ETT you should inflate the bronchial cuff with?

Back 49

1-2ml of air

Front 50

After induction you inflate the tracheal and bronchial cuff of a left sided double lumen ETT. You then clamp the tracheal cuff. Next you listen to breath sounds. Which of the following is most accurate?

Back 50

Absence of breath sounds over the entire right lung and the left upper lobe indicates the tube is too far down the left bronchus.

Front 51

Pa>Pv>PA (zone 2): dead space is slightly diminished in favor of greater perfusion and the relationship between ventilation and perfusion is almost equal?

Back 51

False

Front 52

Myasthenic Syndrome (Eaton Lambert syndrome) is an autoimmune disorder with post junctional decrease Ach release. T/F?

Back 52

false

Front 53

53) Benzos exert their anti seizure effects by?

Back 53

Occupying a GABA receptor

Front 54

Which of the following drugs increase CBF, CMRO2 and ICP?

Back 54

Ketamine

Front 55

Reglan exerts its gastric prokinetic effects by?

Back 55

increase in cholinergic activity

Front 56

The presence of a Q wave on the electrocardiogram is considered pathologic when its duration exceeds?

Back 56

0.04 seconds

Front 57

The conducting fiber of the neuron is the _______?

Back 57

Axon

Front 58

If my CVP = 8 and my CPP = 87, what is my MAP?

Back 58

95

Front 59

The path of CSF is from the aqueduct of sylvius to the_______?

Back 59

4th ventricle

Front 60

Cushings Triad is a sign of ?

Back 60

Increased ICP (bradycardia, htn)

Front 61

Vasculature to ischemic areas remain maximally dilated while healthy areas constrict. This phenomenon is call?

Back 61

the robin hood or reverse steal phenomenon

Front 62

Which drug has the greatest decrease in CMRO2, but an even greater decrease in CBF?

Back 62

Thiopental

Front 63

Which of the following agents does not release histamine?

Back 63

cisatracurium

Front 64

Most anesthetics ____ latency and ____ amplitude

Back 64

INCREASE :DECREASE

Front 65

What position should a patient be placed if all measure fail when you are trying to treat a VAE?

Back 65

Left lateral Trendelenburg

Front 66

What factor does the intrinsic and extrinsic coagulation pathways meet?

Back 66

X

Front 67

What is the co-factor of the factor X?

Back 67

V

Front 68

What four factors up the intrinsic pathway?

Back 68

VII, VIII, IX, X

Front 69

A 15year old girl had a spinal fusion with Harrington rod instrumentation. On emergence the patient was unable to move her left lower extremity. In this patient, the proper course to follow when the loss of function is discovered is to?

Back 69

Re-explore immediately (if only D is correct).

Front 70

When performing an epidural, you would expect?

Back 70

sensory blockade to be approx. 2 segments higher than motor blockade.

Front 71

When performing a paramedian approach in a spinal anesthesia the first ligament you approach is the?

Back 71

Ligamentum Flavum

Front 72

Spinal anesthesia is also referred to as a subarachnoid block or intrathecal injection? T/F?

Back 72

True

Front 73

Which of following represents the correct way to perform an epidural blood patch for treatment of postdural headache?

Back 73

inject 15ml of autologous blood at one interspace below the level of the dura puncture.

Front 74

Epidural level and duration is dependent on?

Back 74

dose, volume and concentration

Front 75

Your patient is going to have an epidural placed for his procedure. He will also need to receive heparin. From what you know?

Back 75

The catheter should be removed 2-4hrs after last heparin dose.

Front 76

Which of the following statements is false?

Back 76

For a spinal anesthetic give 500ml of fluid immediately after injection of your local anesthetic.

Front 77

As you are facing your patient’s back and getting ready to perform a spinal anesthesia you the spinal coverings you will pass through will be in this order?

Back 77

Dura mater --- arachnoid mater--- pia mater

Front 78

Which of the following is true concerning A-gamma fibers?

Back 78

its size is 0.75 microns.

Front 79

What is the correct order of duration of the following local anesthetics that may be used for an epidural block? (shortest to longest)

Back 79

Chloroprocaine---lidocaine---bupivicaine---ropivicane

Front 80

Which of the following situations would warrant consideration of an alternative to neuraxial anesthesia for a laboring mother?

Back 80

Diagnosis of abruption placentae

Front 81

You are doing a an epidural anesthesia on a patient for a TURP. You going to be performing an epidural anesthesia. If you inject at the L4-5 level how much local anesthesia will you need?

Back 81

A) what is the ml/segment of LA you need? Ans: 1-2ml/segment
b) amount of LA needed? Ans: 7-14

Front 82

The illiohypogastric nerve arises from the first lumbar nerve and supplies the abdominal muscles and the skin of the lower part of the anterior abdominal wall. T/F?

Back 82

True

Front 83

The femoral nerve is lateral to the femoral vein; the femoral vein is lateral to the femoral artery; and the femoral artery is medial to the femoral vein. T/F?

Back 83

False

Front 84

The vitamin K dependent clotting factors for the newborn are?

Back 84

II, VII, IX, X

Front 85

The laryngeal location in a pediatric patient is at the level(s) of _____?

Back 85

C2-C4

Front 86

At one year of age the spinal cord extends to ____?

Back 86

L1

Front 87

88) In which age group would you need to praise the child for their cooperative behavior?

Back 87

Toddler

Front 88

If your patient is four years old you would use a size _____ ETT and the length of insertion would be ________?

Back 88

5, 15

Front 89

What size laryngoscope would you use for a 2 year old child?

Back 89

1.5

Front 90

In which condition does the child present with hypoglycemia, obesity and pulmonary hypertension?

Back 90

Prader-Willi syndrome

Front 91

The most common tracheoesophageal fistula is?

Back 91

IIIB

Front 92

The _______ line the sinusoids and are part of the monocyte-macrophage (reticuloendothelial) system. Their functions include phagocytosis, processing of antigens, as well as the release of various proteins and enzymes?

Back 92

Acinus

Front 93

A 46 year old man who takes clonidine for essential hypertension undergoes a 12-hour limb reimplantation under general anesthesia. Which of the following should be anticipated during the perioperative course?

Back 93

Decreased anesthetic requirement, post-operative HTN, Blunting of tachycardia with tracheal intubation, and Excessive postoperative drowsiness (all are correct).