1. The motor nerve supply to the intrinsic muscles of the larynx is the:
B.
2. Which is NOT a paired cartilage of the larynx?
A.
3. The maneuver NOT considered appropriate when positioning a patient for intubation using a Macintosh blade is to:
C.
4. The larynx is located at which level of the spine in the normal adult?
D.
5. Sensory innervation to the larynx is provided by the:
B.
6. The normal adult trachea is 9-10 mm in diameter. Obstruction, causing respiratory stridor at rest, is not evident until the diameter is reduced to:
A.
7. The cranial nerves that innervate the pharynx are the:
D.
8. You have just extubated your patient. Your patient exhibits a sudden onset tracheal tug and “rocking boat” respirations with no misting of the mask. The most probable cause of this respiratory pattern is:
B.
9. The first line of treatment employed when laryngospasm is suspected should be:
D.
10. Common causes of upper airway obstruction include all of the following EXCEPT:
C.
11. Which of the following procedures would mandate general endotracheal anesthesia?
D.
12. The nerve most commonly injured from anesthesia face masks with head straps is the:
A.
13. Your patient has a suspected difficult airway. You plan an awake nasal fiberoptic intubation. You would perform all of the following EXCEPT:
C.
14. After arriving in the recovery room your patient begins to exhibit signs of airway obstruction. You should:
C.
15. If an oral airway is the proper size and placed correctly it will:
C.
16. During tracheal intubation, the tip of the Macintosh blade should be placed:
C.
17. Your patient vomited on induction. After emergence and extubation your patient is tachycardic, tachypneic and confused with an O2 sat of 80%. You suspect gastric aspiration, the chest X ray is normal. The next appropriate therapeutic intervention would be:
B.
18. Your patient has a suspected tooth fragment aspiration. The most appropriate technique for airway management is:
D.
19. Complications of a mask induction include all of the following EXCEPT:
A.
20. Rapid sequence induction is INAPPROPRIATE if:
C.
21. Contraindications to nasal fiberoptic intubation in the patient with head and neck trauma include all of the following EXCEPT:
C.
22. Placement of an oral airway before adequate depth of anesthesia has been achieved may lead to:
C.
23. Your patient has a suspected difficult airway. You plan to mask induce to maintain spontaneous respirations. What actions can you take to optimize success?
D.
24. Which statement is correct regarding the LMA?
C.
25. Your patient presenting for surgery has severe TMJ ankyloses and cannot open her mouth enough to place dentures. You plan for an awake nasal fiberoptic intubation to preserve spontaneous respirations. Besides glycopyrolate and anesthetizing the nasal mucosa, which intervention can best facilitate awake nasal fiberoptic intubation?
a. anesthetize the pharyngeal branch of the glossopharyngeal nerve
b. anesthetize the recurrent laryngeal nerve
c. anesthetize the recurrent laryngeal nerve
d. administer 4% lidocaine for 20 minutes preoperatively via nebulizer
D
1. Which if the following is NOT a usual sign of hypoxemia?
D.
2. Cyanosis is produced by all of the following EXCEPT:
B.
3. The most sensitive muscle(s) to the paralyzing effect of neuromuscular blocking drugs are (is):
B.
4. Liquification of a gas:
B.
5. The normal cylinder pressure of nitrous oxide is:
A.
6. At a temperature of 21 degrees Celsius, oxygen will be stored as a:
A.
8. When monitoring the EtCO2, the most accurate measurement is obtained at which phase of the respiratory cycle?
B.
9. The best monitor of adequacy of ventilation is the:
B.
10. High peak inspiratory pressures may be caused by all of the following EXCEPT:
a. low pulmonary compliance
b. endotracheal tube kinking
c. high fresh gas flows
d. increased anesthetic depth
D
11. Successful endotracheal intubation is most readily confirmed by:
a. pulse oximetry
b. capnography
c. esophageal stethoscope
d. arterial wave form
/question>
B
12. Post tetanic facilitation is related to:
B.
13. After intubation, the patient exhibits lack of EtCO2 waveform and a slow decrease in oxygen saturation. One would suspect:
D.
14. Which of the following sites for temperature monitoring provide the LEAST accurate correlation to central core temperature?
C.
15. Ventilatory settings for patients with chronic obstructive pulmonary disease should include a (an):
C.
16. Indications for the placement of an arterial line include all of the following EXCEPT:
B.
17. Induced hypotension is requested by the surgeon in anticipation of heavy bleeding. Essential monitors include all EXCEPT:
B.
18. When placing a blood pressure cuff the anesthesia provider should:
C.
19. You are extracting teeth on a morbidly obese man who has a large neck, smokes two packs per day for 15 years and has known OSA. Baseline SaO2 was 96% and the patient was placed on oxygen at 3 liters via nasal cannula. Induction was carried out with 100 mcg of fentanyl and 5 mg of midazolam. You are placing a block when your assistant calls your attention that the patient appears to not be breathing and looks cyanotic. The SaO2 remains at 96%. What is the most likely explanation for this?
C.
20. All anesthesia machines are equipped with oxygen supply failure alarms that sound when:
C.
21. A safety system for small cylinders that prevents the wrong tank placed on the wrong yoke is called:
A.
1. Gastric emptying can be delayed by all of the following factors EXCEPT:
C.
2. An OR nurse who is six months pregnant crushed her foot under an operating table six hours ago and presents for surgery. She had had breakfast two hours before the accident. She should have rapid sequence induction as a gastric aspiration risk because she:
B.
3. The constant to be used when calculating blood volume for a healthy ASA I 70 kg male patient is:
B.
4. Your trauma patient is bleeding heavily. Your team decides to treat for DIC. Treatment would contain all of the following EXCEPT:
B.
5. Your patient has just underwent a tonsillectomy and is being emergently returned to the OR due to uncontrolled bleeding. You should plan for:
A.
6. Long term storage of blood causes:
C.
7. Your patient was thrown from a motorcycle, suffering a chest wall hematoma but no rib fractures. He presents for ORIF of his right ankle. He is healthy and has no other apparent injuries. Nitrous oxide administered to this patient will increase a risk for:
C.
8. The best crystalloid solution to infuse to a trauma patient who has suffered significant blood loss and will need multiple transfusions is:
A.
9. Persistent bleeding after massive blood transfusion is most commonly due to:
B.
10. You are on trauma call to see a young man with a 10% spontaneous pneumothorax. He is spontaneously breathing and not complaining of SOB. The BEST treatment is:
B.
11. Your trauma patient has a suspected C spine and basilar skull fracture. The patient must be intubated for airway protection. The BEST technique would be:
C.
12. Your multiple gunshot trauma patient was intubated in the ER and is brought to surgery for an emergency laparotomy. You note decreased breath sounds, distended neck veins, cyanosis, an SpO2 of 80 and tracheal deviation. You suspect:
C.
13. Massive transfusion of blood bank blood usually causes:
A.
14. In an emergency situation, which unit of blood is preferred?
B.
15. Your patient is undergoing general anesthesia and needs a blood transfusion. What is the FIRST sign of transfusion reaction?
C.
16. Intravenous solutions containing dextrose are to be avoided in patients with brain injury because:
A.
17. In an emergency, anesthesia or surgery may be done without consent if the adult patient presents or is brought to the hospital unconscious, unable to consent and life is in danger without medical intervention. This situation is called:
B.
18. Your ASA I trauma patient was in a motorcycle accident and is undergoing IM nail of his right femur. During reaming of the femoral canal the patient’s SaO2 and EtCO2 suddenly and precipitously drop. Administering a fluid bolus does nothing. You place the patient on 100% O2 but he is tachycardic and hypotensive now. The decision is made to abandon the surgery and transport the patient to the ICU intubated and on pressors. Which diagnostic test is best for the planning of treatment?
D.
19. Hemorrhage of greater than 20% of blood volume is associated with:
a. oliguria
b. confusion
c. hypotension
d. tachycardia
D
1. Depth of anesthesia may become more profound in the patient with chronic renal failure. Which is the LEAST likely reason for this?
A.
2. In a patient with coronary artery disease, the intraoperative event LEAST likely to cause myocardial infarction is:
D.
3. Your patient has mitral stenosis. Your primary goal when inducing anesthesia is to:
C.
4. Which characteristic is descriptive of Type II diabetes?
C.
5. All of the following are possible mediators of bronchial asthma EXCEPT:
A.
6. A morbidly obese patient presents difficulties in all of the following EXCEPT:
C.
7. An OR nurse who is six months pregnant crushed her foot under an operating table six hours ago and presents for surgery. She had had breakfast two hours before the accident. She should have rapid sequence induction as a gastric aspiration risk because she:
A.
8. Rheumatoid arthritis can present intubation challenged for all of the pathophysiological reasons EXCEPT:
B.
9. The most serious electrolyte abnormality for patients with chronic renal failure is:
D.
10. Ventilatory settings for patients with chronic obstructive pulmonary disease should include a (an):
B.
11. The most advantageous non-depolarizing muscle relaxant for patients with chronic renal failure is:
B.
12. The inhalational agent of choice for patients with chronic renal failure is:
D.
13. The safest intubation technique for an insulin dependent diabetic patient is:
D.
14. The LEAST advantageous inhalational agent for an asthmatic patient undergoing surgery is:
C.
15. Which of the following beta blockers would be most inadvisable to administer to an asthmatic patient?
D.
16. While under general anesthesia, the signs of hypoglycemia are likely to be confused with:
B.
17. If wheezing is noted after intubation the first intervention by the anesthesia provider should be:
A.
18. Your patient is a T4 spinal cord paraplegic undergoing a general anesthetic for repair of a complex mandible fracture. The surgery takes 4.5 hours, 2.5 hours longer than expected. No Foley catheter had been placed per your order due to anticipated short length of case. At case completion the anesthesia resident notices abrupt onset of hypertension and bradycardia. Skin flushing and sweating is evident and the patient’s eyes are mydriatic. The resident cannot find his attending. Your diagnosis most likely would be:
A.
19. Your patient has a history of moderate to severe coronary artery disease but must have teeth extracted before surgery. Which anesthetic agent should you AVOID?
B.
20. You have been called to the emergency department to stabilize a frontal sinus table fracture in a 47 year old patient very recently diagnosed with Grave’s Disease that has not begun any treatment for it. The patient also has hypertension and osteoarthritis she does not treat. Her only medication is furosemide which she rarely takes. She must go to surgery due to altered LOC from an accompanying epidural hematoma. In order to avoid life threatening anesthetic complications from her Grave’s Disease, what is the best pre-anesthetic treatment in this emergent situation?
A.
21. You are evaluating a 50 year old male patient for full mouth extraction and reduction of mandibular tori. Your patient denies any health history and chart review from his primary care provider is unremarkable. When you auscultate his chest, a high pitched blowing murmur heard at the apex is heard and this radiates to the left axilla and does not change with inspiration. You order a 12 lead EKG, which reads atrial fibrillation and LV hypertrophy. How would you plan perioperative anesthetic management for this patient?
C.
22. Your first patient of the day is morbidly obese and needs general anesthesia. You explain the risks and go to prepare your room. When planning ventilator settings you keep in mind that obese people with restrictive lung disease have which primary characteristic?
B.
23. When comparing respiratory physiology of obese patients, when compared to non-obese patients, which of the following statements is correct?
B.
24. Your 49 year old patient presents for removal of tooth 15-17 and wishes anesthesia. You examine her and hear a loud 4/6 murmur at the apex of her heart which radiates to the left axilla. You diagnose probable mitral regurgitation. Your perioperative anesthetic management should include the following?
a. decrease intravascular volume
b. decrease myocardial contractility
c. increase peripheral vascular resistance
d. increase heart rate
D
25. You are evaluating a patient with a history of moderate coronary artery disease for removal of multiple decayed teeth and tori before coronary stenting can be done. Of the following agents, which has the greatest potential for disrupting myocardial oxygen supply and demand?
a. fentanyl
b. ketamine
c. midazolam
d. propofol
B
7. The temperature monitoring site that most closely correlates to core body temperature is:
B.
1. To calculate the fluid deficit for a 10 kg child, which constant is the most appropriate?
D.
2. The narrowest part of a child’s trachea is the:
C.
3. The pediatric cardiac output is dependent primarily upon:
C.
4. Compared to the adult, anatomical differences the anesthesia provider will encounter when instrumenting the pediatric airway include all of the following EXCEPT:
D.
5. Infants maintain their body temperature predominantly by:
D.
6. A five kg infant has an hourly fluid requirement during anesthesia of approximately:
D.
7. The factor which will LEAST influence your pediatric patient to intraoperative hypothermia is:
C.
8. The factor responsible for increased succinylcholine requirements in the pediatric patient is:
C.
9. Which statement regarding physiologic differences between the pediatric and adult patient is FALSE?
D.
10. Which statement is CORRECT regarding airway anatomy of the infant?
C.
11. Characteristics of the normal infant upper airway include all of the following EXCEPT:
B.
12. Compared to adults, the uptake and distribution of inhalational agents in pediatric patients is more rapid because of:
C.
13. Strategies for minimizing heat loss in a pediatric patient include all of the following EXCEPT:
D.
14. You are providing anesthesia for a child with strabismus, and notice sudden onset bradycardia. You tell the surgeons to stop. What should be your NEXT BEST course of action?
C.
15. You are about to treat a healthy 14 year old who presents for extraction of a mobile tooth. She is extremely apprehensive and you plan a single IV anesthetic for her since the procedure will last about 30 seconds. Her parents report she is currently menstruating and suffered severe nausea and vomiting after general anesthesia for PE tubes when she was 8. Which of the following anesthetics would be best for this patient?
a. etomidate
b. ketamine
c. brevital
d. propofol
D
16. Right mainstem bronchus intubation of an infant may occur more easily than in an adult due to (choose the best answer):
a. the trachea is short
b. distance from lips to larynx is short
c. uncuffed endotracheal tubes can easily slip distally
d. the mainstem bronchi are less angulated in their relationship to the trachea
A
1. The average crystalloid fluid replacement for a patient undergoing a total hip replacement or bowel surgery should be estimated at:
C.
2. If blood loss is being replaced with crystalloid the ratio which should be used is:
A.
3. An estimate for the base intravenous fluid requirements for a normal healthy 70 kg ASA I adult patient undergoing minor surgery is:
A.
4. The constant to be used when calculating blood volume for a healthy ASA I 70 kg male patient is:
D.
5. To calculate the estimated red cell mass for any patient, the data required would include:
C.
6. Which of the following procedures is most likely to involve blood replacement?
A.
7. Ringer’s lactate contains all of the following ions EXCEPT:
D.
8. Transfusing one unit of packed red blood cells in a healthy 70 kg adult is expected to raise the Hgb by 1 gm/dl and the hematocrit:
B.
9. The best crystalloid solution to infuse to a trauma patient who has suffered significant blood loss and will need multiple transfusions is:
A.
10. Intravenous solutions containing dextrose are to be avoided in patients with brain injury because:
D.
11. Your patient is a healthy ASA I male weighing 70 kg presenting for surgery. He has been NPO for eight hours. What is his hourly IV fluid rate?
a. 60 cc/hr
b. 80 cc/hr
c. 110 cc/hr
d. 140 cc/hr
12. Your patient is a healthy ASA I male weighing 90 kg presenting for surgery. He has been NPO for eight hours. What is his estimated fluid deficit?
a. 1000 ccs
b. 1040 ccs
c. 1080 ccs
d. 1100 ccs
B
13. A previously healthy ASA I 70 kg man comes to your room as an RB after a shoulder stabbing which caused an estimated 2 liter blood loss. Which one of the following statements best applies to this patient?
a. His pulse pressures will be widened
b. his urinary output will be a the lower limits of normal
c. he will have tachycardia but no change in his systolic blood pressure
d. his systolic blood pressure will be decreased with a narrowed pulse pressure
D
14. Hemorrhage of greater than 20% of blood volume is associated with:
a. oliguria
b. confusion
c. hypotension
d. tachycardia
D
1. Depth of anesthesia may become more profound in the patient with chronic renal failure. Which is the LEAST likely reason for this?
C.
2. The primary site of most drug metabolism (or biotransformation) is the:
C.
3. If 50% of a drug is eliminated from the body in ten minutes, how many elimination half times are required for 95% elimination?
B.
4. To make 20 cc’s of epinephrine 1:200,000 from an ampule containing 1 cc of 1:1000 epinephrine, how many cc’s of epinephrine 1:1000 must be added to your saline diluent?
B.
5. Nausea and vomiting induced by morphine and its derivatives are side effects caused by:
D.
6. Meperidine is metabolized primarily in the:
B.
7. The respiratory rate after administration of ketamine is:
A.
8. The most common cardiac arrhythmia seen after administration of most narcotics (except meperidine) is:
C
9. How are the actions of ultra short acting barbituates such as brevital and propofol terminated?
a. metabolism
b. excretion
c. enzymatic activity
d. redistribution
B.
10. Succinylcholine is eliminated by:
D.
11. Ester local anesthetics are biotransformed in the:
C.
12. The earliest sign of local anesthetic systemic toxicity is:
D.
13. Because of a decrease in lean body mass and plasma proteins in the elderly, drugs that are mainly distributed to these compartments will show plasma levels that are:
A.
14. During a continuous intravenous infusion of a drug, the time to reach steady state level is controlled by the:
A.
15. Metoclopramide (Reglan) can cause extrapyramidal side effects if injected too rapidly. The endogenous neurotransmitter associated with this side effect is:
B.
16. Your patient has myasthenia gravis. What class of drugs should be avoided?
A.
17. The most advantageous non-depolarizing muscle relaxant for patients with chronic renal failure is:
C.
18. Your patient has severe allergies to multiple substances and uses an inhaler twice per day, and also has severe GERD that requires her to sit up for 30 minutes after meals and sleep upright. During sedation for full mouth extraction the patient experiences laryngospasm you cannot break with positive pressure ventilation. You elect to intubate the airway. Which paralytic is safest?
C.
19. Your healthy 18 year old male received 10 mg of midazolam, 50 mcg of fentanyl and 50 mg of propofol during a long extraction case. Emergence was prolonged and respirations are shallow with the SaO2 at 89% on 4L supplemental O2. You administer flumazenil 0.2 mg and naloxone 0.2 mg with immediate improvement in mentation and respiratory status. Thirty minutes later in recovery your assistant summons you due to the patient’s drowsiness and non-responsiveness to verbal commands. The SaO2 is 91% and respirations are shallow at 12 per minute. What is the best action to take in this situation?
A.
20. Your patient is a C6 quadriplegic on dialysis who fell from his wheelchair and sustained a mandible fracture. He is scheduled for the OR today for ORIF of the mandible. Your intern notes the morning serum potassium is 5.1. You and your CRNA clear the patient for surgery, but which muscle relaxant is BEST used in this case?
D.
21. Which anesthetic agent drug combination best balances out the potential adverse hemodynamic effects of each?
A.
22. You are treating a patient with a known active opiate addiction. You should:
A.
23. Your patient, a 66 year old male with a history of hypertension, coronary artery disease, and gout is in the PAR after a mandible advancement for OSA. The PAR is calling you as no anesthesia personnel are available. They patient has an elevated BP of 200/120, pulse 84, RR 16 and sat 99% on room air. The patient is sleeping comfortably, not in pain and has a foley catheter in place. What is the most appropriate medication to order?
C.
24. Which of the following statement pertaining to opioid induced chest wall rigidity is correct?
B.
25. You are evaluating a 42 year old patient for multiple tooth extractions. She is requesting anesthesia. Her history includes asthma controlled with Advair daily and albuterol which she uses twice per year. She also has a 1 pack per day for 30 years smoking habit, and takes Elavil (amitriptyline) for depression. Which anesthetic agent should be avoided for this patient?
a. fentanyl
b. ketamine
c. propofol
d. midazolam
B
1. If blood flow through both internal carotid arteries is compromised, cerebral circulation will depend on flow via the:
B.
2. Which of the following is NOT a functional characteristic of the carotid bodies?
A.
3. The two primary determinants of cardiac output are:
B.
4. The function of the cytochrome P-450 system in the liver is to:
B.
5. Functions of insulin in the body include all of the following EXCEPT:
C.
6. If a patient’s baseline MAP is 60, during surgery cerebral blood flow will be controlled by:
C.
7. The most important factor in the control of normal breathing is:
D.
8. Your patient is young and healthy. If induced hypotension is requested, your patient’s MAP can generally safely be reduced to:
B.
9. Which statement concerning the oculocardiac reflex is INCORRECT?
B.
10. Which is the most profound cerebral vasodilator?
B.
11. The process where cerebral blood vessels contract and expand to maintain a constant blood supply to the brain is called:
C.
12. You suspect the patient you are working up has hyperaldosteronism. Which laboratory value would be consistent with this?
C.
1. The most commonly injured peripheral nerve noted in anesthetized patients positioned supine is the:
A.
2. In an upright normal adult, lung ventilation is greatest, per unit volume, in:
C.
3. Oliguria in patients kept in the reverse Trendelenberg position for extended periods may be present because:
B.
4. The most common respiratory complication associated with the lateral position is:
C.
5. The nerve most commonly injured from anesthesia face masks with head straps is the:
B.
6. Which nerve is most commonly injured by improper traction on the angle of the mandible?
C.
7. The upper extremity nerves most commonly injured by stretching while under general anesthesia are the:
D.
1. Which characteristic is descriptive of Type II diabetes?
D.
2. Platelet function can best be determined by the following test:
D.
3. Which of the following responses would warrant further investigation if noted on a preoperative assessment?
A.
4. Perioperative steroid therapy needs to be considered if your patient has been on steroid therapy for more than:
B.
5. Which of the following preoperative tests would NOT be necessary when evaluating a healthy 24 year old male for ankle surgery who wishes spinal anesthesia?
A.
6. Where should the stethoscope be placed in order to best auscultate the mitral valve?
A.
7. A patient with severe systemic disease which limits functionality is an ASA classification:
D.
8. Rheumatoid arthritis can present intubation challenged for all of the pathophysiological reasons EXCEPT:
C.
9. The most serious electrolyte abnormality for patients with chronic renal failure is:
A.
10. Which pre-operative test is the best indicator of platelet function?
A.
11. Which one of these patients would be considered safe for a standard anesthetic induction according to current ASA guidelines for NPO status?
A.
12. Which patient is INAPPROPRIATE for an outpatient surgical procedure?
B.
13. Which of the following antihypertensives should be held day of surgery?
A.
14. Your patient has stable known coronary artery disease. You are ordering beta blockade for him preoperatively. Which statement below is correct?
B.
15. Your patient has hypertrophic cardiomyopathy. Which drug class should be avoided?
D.
16. Your patient is a well controlled hypertensive. Which class of antihypertensive medication would cause you to avoid the use of a local anesthetic with vasoconstrictor?
B.
17. You are working up a newly admitted patient for cataract surgery. He is a 70 year old male with a history of mitral stenosis. He presents with fatigue, exertional dyspnea and occasional chest pain. You observe JVD, peripheral edema and hepatosplenomegaly. In order to confirm if he is OK for surgery, what other diagnostic finding should you search for?
A.
18. Your 40 year old patient smokes a pack a day for 20 years and has a chronic productive cough present for six months of the year. What is the most likely process at work?
D.
19. You are evaluating a 72 year old male for extraction of teeth 3-6. His written medical history includes stable angina, CHF, well controlled type 2 diabetes and a coronary stent placed 3 months ago after an anterior MI 3 months ago. His medications are metoprolol and furosemide. You examine him and he reports no chest pain when climbing two flights of stairs. His heart sounds are normal and lungs reveal inspiratory bibasilar rales. What is your greatest concern when evaluating his surgical and anesthetic risk?
a. stable angina
b. MI and stent placement 3 months ago
c. congestive heart failure
d. type 2 diabetes
C
20. Your 17 year old asthmatic patient presents for extraction of all four third molars. He plays basketball three times per week and has an albuterol inhaler he uses twice per year on average. His pediatrician has ordered a PFT which indicates a FEV1/FVC of 85%. What preoperative treatment should you administer?
a. ipratropium MDI
b. nebulized racemic epinephrine
c. Advair MDI
d. No treatment
D
21. You are evaluating a 42 year old patient for multiple tooth extractions. She is requesting anesthesia. Her history includes asthma controlled with Advair daily and albuterol which she uses twice per year. She also has a 1 pack per day for 30 years smoking habit, and takes Elavil (amitriptyline) for depression. Which anesthetic agent should be avoided for this patient?
a. fentanyl
b. ketamine
c. propofol
d. midazolam
B
1. Hyperkalemia can be treated intraoperatively by all of these methods EXCEPT:
B.
2. An increased PaCO2 is most usually caused by:
C.
3. The most important factor in the control of normal breathing is:
B.
4. A patient with acute hypoventilation will exhibit blood gas values that reflect a:
B.
5. A patient with chronic renal failure on dialysis who is being mechanically ventilated is at risk for all of the following complications EXCEPT:
D.
6. Metabolic derangements in patients suffering from prolonged vomiting include:
C.
7. Complications of prolonged vomiting include all of the following EXCEPT:
B.
8. Your trauma patient is undergoing an ex lap. You draw an ABG and the results are as follows: pH 7.32, PaCO2 46, HCO3 23. This indicates:
A.
1. The most serious complication of hypothermia during the perioperative period is:
C.
2. All of the following will help reduce evaporative heat loss from the lungs under general anesthesia EXCEPT:
A.
3. The earliest observable sign for malignant hyperthermia is:
D.
4. The physical phenomenon responsible for most heat loss in the anesthetized patient during surgery is:
D.
5. The temperature monitoring site that most closely correlates to core body temperature is:
D.
6. If the anesthesia provider suspects malignant hyperthermia is occurring during surgery, the provider should do first:
C.
7. Which of the following sites for temperature monitoring provide the LEAST accurate correlation to central core temperature?
D.
8. A drug which should NEVER be administered to children with myotonia dystrophica is:
B.
9. All of the following can serve to maintain or increase a patient’s temperature intraoperatively EXCEPT:
C.
10. Your patient has Duchenne muscular dystrophy. Which anesthetic agent should NOT be used?
B.
11. Dantrolene sodium can only be mixed with:
D.
12. The factor which will LEAST influence your pediatric patient to intraoperative hypothermia is:
A.
13. A very early symptom of malignant hyperthermia in the child is:
A.
14. Strategies for minimizing heat loss in a pediatric patient include all of the following EXCEPT:
A.
15. Patient introperative hypothermia is best prevented by:
D.
16. Administering dry anesthetic gases and oxygen at room temperature with no humidifier via an endotracheal tube can lead to:
B.
17. A 21 year old patient with severe cerebral palsy will require general anesthesia with nasal intubation for multiple tooth extractions. Why is succinylcholine contraindicated for this patient?
A.
1. Diffusion hypoxia is a phenomenon associated with very rapid movement of which anesthetic agent from the blood to the lungs, producing a significant dilution of oxygen?
B.
2. The high incidence of shivering after anesthesia using isoflurane and sevoflurane is related to their:
D.
3. When the initial rapid absorption of nitrous oxide results in an increased alveolar concentration and faster uptake of another inhalational anesthetic, this is known as the:
B.
4. Liquification of a gas:
A.
5. Anesthetic gases are effective CNS depressants because of their high solubility in:
B.
6. Which of the following statements are FALSE regarding nitrous oxide?
D.
7. The safest anesthetic gas for use in a patient with cirrhosis of the liver is:
A.
8. Nitrous oxide will expand an endotracheal tube cuff because:
B.
9. Compared to adults, the uptake and distribution of inhalational agents in pediatric patients is more rapid because:
B.
10. Your patient was thrown from a motorcycle, suffering a chest wall hematoma but no rib fractures. He presents for ORIF of his right ankle. He is healthy and has no other apparent injuries. Nitrous oxide administered to this patient will increase a risk for:
C.
11. All of these factors contribute to the determination of the concentration of inhaled anesthetic gases in the body tissues EXCEPT:
C.
12. All of the following statements regarding uptake and distribution of drugs are correct EXCEPT:
D.
13. Volatile anesthetics depress respiratory drive by which of the following mechanisms?
D.
14. The inhalational agent considered to be most cerebrally protective is:
A.
15. Which of the following BEST describes the effects of desflurane on the cardiovascular system?
B.
16. Your elderly patient has a decreased MAC requirement?
a. true
b. false
A
1. The “excitement” phase of anesthesia is when stimulation of the patient can cause thrashing, coughing and laryngospasm in an unprotected airway. This is also known as stage:
C.
2. The gag and vomiting reflexes are lost in stage:
B.
3. The surgical stage of anesthesia is stage:
B.
4. A deep extubation should take place when the patient:
D.
5. You have just completed an ORIF of a mandible fracture and the mandible has been wired. Your preferred method of extubation is:
