Download Anesthesia Final Exam

Anesthesia Final Exam
1) For a patient who is chronically taking the following medications, which two should be withheld on
the day of surgery?
a)
b)
c)
d)
Lasix
Metoprolol
Glucophage
Theodur
2) A 51 year old poorly controlled insulin dependent diabetic who is obese (320 lbs.) and is having a
debridement of a diabetic foot ulcer would be given which of the following ASA Physical Status
Classification?
a)
b)
c)
d)
e)
I
2
3
4
4E
3) Which of the following characteristics correlate with the potential for a different intubation?
a)
b)
c)
d)
e)
f)
Mallimpatie class 3
Thromental distance less than 6 cm
Poor extension of neck
Receding mandible
Protruding incisors, short neck
All of the above
4) If you are having difficulty in ventilating a patient and a foreign body has been ruled out which of the
following maneuvers may assist you in mask ventilation?
a)
b)
c)
d)
e)
f)
Head tilt jaw lift
Oral airway
Nasopharyngeal airway
LMA
Call for help
All of the above
5) What is the correct size tube to place in a normal 4 year old?
a)
b)
c)
d)
6.5 cuffed
3.5 cuffed
5.0 uncuffed
8.0 uncuffed
6) Where should a 6.0 endotracheal tube be taped?
a)
b)
c)
d)
19cm at the lips
13cm at the lips
16cm at the lips
18cm at the lips with confirmation by auscultation
ANESTHESIA FINAL EXAM
7) What disease states will cause an increase in Sv02?
a)
b)
c)
d)
e)
Sepsis
Cirrhosis
Hypothermia
SNP toxicity
All of the above
8) Which is the best indicator of ischemia?
a)
b)
c)
d)
e)
ST segment changes
Regional wall molion abnormalities
Increase filling pressures
Decreased EF%
None of the above
9) On which post-operative day is the highest incidence of myocardial infarction?
a)
b)
c)
d)
e)
one
six
three
four
seven
10) What is the definition cardiac output (CO)?
a)
b)
c)
d)
e)
CO = (BP) (HR)
CO = (HR) (SVR)
CO(BP)(SVR)
CO=(HR)(SV)
CO=(BP)(SV)
11) What is the Definition of Stroke Volume?
a)
b)
c)
d)
e)
LVEDP—LVEDV
LVESV—LVEDV
LVEDV—LVESV
LVESV—LVEDV
None of the above
12) The LMA (Laryngeal mask airway) is contraindicated in all of the following except?
a)
b)
c)
d)
e)
Pregenancy
Bronchospasm
Obesity
Diabetes
Recent Trauma
13) True or False. (circle one) The curved laryngoscope blade (Macintosh) is designed to compress the
epiglottis, lifting it anteriorly to visualize the larynx.
14) True or False. (circle one) The hinged connection of a folding laryngoscope is specifically designed to
act as a lever and the maxilla as a fulcrum to facilitate intubation.
15) True or False. (circle one) The “sniffing” position results in flexion of the atlanto occipital joints and
extension of the cervical spine.
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ANESTHESIA FINAL EXAM
16) The short duration of effect, seen with induction agents such as Thiopental and Propofol is due to
which of the following?
a)
b)
c)
d)
The rapid metabolism by the plasma cholinesterase.
The rapid elimination by the kidneys
The short Alpha half life due to redistribution.
Evaporation from high minute ventilation.
17) Which induction agent is most appropriate in an individual with a poor ejection fraction NYHA Ill
going for an emergency laparoscopic cholecystectomy?
a)
b)
c)
d)
e)
Propofol
Etomidate
Thiopental
Ketamine
Methohexital
18) Which of the following reduces the cerebral blood flow and cerebral metabolic rate the most and
should be considered when inducing a patient with increased intracerebral pressure?
a)
b)
c)
d)
Halothane
Etomidate
Thiopental
Ketamine
19) True or False. (circle one) A pregnant woman is rarely considered a full stomach due to their
increased caloric requirements.
20) Which is the first maneuver performed when a supine parturient suddenly becomes nauseated?
a)
b)
c)
d)
Give 10mg of metoclopramide,iv
Place in trendelenburg and give Odonstarone 4mg iv
Position in left uterine displacement and check a blood pressure
Order 100mg of rectal Tigan and place an oral gastric tube.
21) The anesthetic requirements are greatly (Increased, Decreased) in a pregnant patient. (circle one)
22) Which nerve roots need to be blocked to produce analgesia during the 1st stage labor?
a)
b)
c)
d)
T2—S1
T10-L1
S2—S4
Ti0—S4
23) At what site do local anesthetics work?
a)
b)
c)
d)
Na + Channels located on the inside of the lipid nerve membrane.
At the muscuranic acetylcholine receptors located at the neuromuscular junction.
K+ Channels located at the nerve end plate.
No specific site but its mechanism relies on temporary neural toxicity.
24) How many (mg) are ther in 20cc of ¼% Marcaine?
a)
b)
c)
d)
5mg of Xylocaine
50mg of Bupivicaine
50mg of Procaine
250 mg of Marcaine
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ANESTHESIA FINAL EXAM
25) What is the toxic dose of Bupivicaine per kilogram?
a)
b)
c)
d)
e)
I
2
30
3
7
26) What is a contraindication for a spinal anesthetic?
a)
b)
c)
d)
e)
Patient refusal
Infection at the site of needle insertion
Severe aortic stenosis
Coagulopathy
All of the above
27) An Infants cardiac output is most dependent on which of the following?
a)
b)
c)
d)
Stroke Volume
Heart rate
SVR
Contractility
28) The maintenance rate for IV fluids in a 3 year old boy weighing 24kg is which of the following?
a)
b)
c)
d)
24cc/hr
51cc/hr
64cc/hr
48cc/hr
29) Children will desaturate at a faster rate than adults primarily due to which of the following?
a)
b)
c)
d)
Smaller lung mass
Greater Oxygen consumption in relation to body mass
Faster Respiratory rate
Smaller FRC
30) The standards of care for a General Anesthetic include which of the following?
a)
b)
c)
d)
e)
Monitoring of oxygenation
Monitoring of ventilation
Monitoring of circulation
Monitoring of temperature
All of the above
31) Which of the following is the most important factor in determining proper placement of your
endotracheal tube?
a)
b)
c)
d)
e)
Pulse oximetry
End tidal C02
Peak inspiratory pressure
Tidal volume and Rate set on the ventilator
Auscultation
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ANESTHESIA FINAL EXAM
32) Pulse oximetry may be interfered by which of the following?
a)
b)
c)
d)
e)
Fluorescent lights
Cold appendage
Movement
Carbon monoxide poisoning
All of the above
33) Halothane and Sevoflorane are both used for mask inductions in children due to which of the
following?
a)
b)
c)
d)
Least pungent to inhale
Least cardiotoxic
Greatest analgesic effect
Earlier emergence
34) True or False. (circle one) MAC represents the Minimal Alveolar Concentration of an inhaled
anesthetic which inhibits skeletal movement in response to an noxious stimulus in 50% of patients.
35) What is the principle property that effects the speed of induction and emergence of an inhalation
agent?
a)
b)
c)
d)
Blood Gas Solubility Coefficient
Molecular weight
Baricity
Vapor pressure
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