Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anaesthesiology > 8th June 2023 - Variant 2 > Flashcards

8th June 2023 - Variant 2 Flashcards

1
Q

A 17-year-old boy develops pulmonary edema after resolution of postoperative laryngospasm. While breathing 100% oxygen, SpO2 is 80%.

Which of the following is the most appropriate management?

A. Administration of albuterol
B. Positive-pressure ventilation
C. Infusion of nitroglycerin
D. Administration of furosemide

A

D. Administration of furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The use of epidural analgesia for labour is likely to result in which one of the following:

A. Prolonged second stage
B. Increased risk of operative delivery
C. Neonatal depression
D. Maternal sedation

A

A. Prolonged second stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which one of the following structures is NOT encountered during direct laryngoscopy?

A.Vallecula
B. Cricoid cartilage
C. Epiglottis
D. Arytenoid cartilage

A

B. Cricoid cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of these patients is NOT at increased risk of aspiration?

A. A pregnant patient (32 weeks gestation) who has been NPO (nil per os) for 10 hours

B. A patient with fractured femur who has been NPO since the accident 12 hours ago

C. A healthy patient with appendicitis

D. A healthy patient who had 8 ounces of clear tea 4 hours pre-operatively

A

D. A healthy patient who had 8 ounces of clear tea 4 hours pre-operatively

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The maintenance fluid requirement for an 80 kg man using the 4-2-1 rule is:

A. 100 ml/hr
B. 120 ml/hr
C. 150 ml/hr
D. 170 ml/hr

A

B. 120 ml/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the following anesthetic agents does NOT trigger malignant hyperthermia?

A. Halothane
B. Isoflurane
C. Suxamethonium
D. Thiopental

A

D. Thiopental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

** Which of the following about Hypoxemic Respiratory Failure is NOT correct?

A. most commonly it is caused be V/Q mismatch

B. it may be cause by low partial pressure of inspired O2 (PIO2) and diffusion impairment

C. hypoventilation cannot cause hypoxemia

D. pneumonia, ARDS, pulmonary edema can lead to intrapulmonary shunt

A

C. hypoventilation cannot cause hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Maternal hypotension in the supine position during pregnancy is most often due to:

A. decreased hematocrit
B. decreased peripheral vascular resistance
C. compression of the vena cava
D. decreased blood volume

A

C. compression of the vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

** Which drug is used for the treatment of life-threatening bupivacaine toxicity?

A. Intralipid
B. Lidocaine infusion
C. Metoprolol
D. Sodium nitroprusside

A

A. Intralipid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

** What does GCS=9 points E2M5V2 mean?

A. Opens eye on verbal stimulation, localizes pain, inappropriate words

B. Opens eye to pain, withdraw from pain, inappropriate words

C. Opens eye to speech, localizes pain, inappropriate words

D. Opens eye to pain, localizes pain, incomprehensive words

A

D. Opens eye to pain, localizes pain, incomprehensive words

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In septic shock:

A) peripheral hypothermia is associated with a good prognosis

B) the patients usually have an increased cardiac output

C) the patients usually have a depleted circulating volume

D) the causative organisms are always Gram-negative

E) antibiotics should not be given before blood culture results are available

A

B) the patients usually have an increased cardiac output

C) the patients usually have a depleted circulating volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of acute anaphylaxis includes:

A. IM adrenaline
B. H1 and H2 antagonists
C. hydrocortisone
D. IM chlorpromazine
E. crystalloids

A

A. IM adrenaline
B. H1 and H2 antagonists
C. hydrocortisone
E. crystalloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spinal anaesthesia for fractured neck of femur repair compared with general anaesthesia:

A. decreases mortality

B. reduces hospital stay

C. decreases the incidence of thromboembolism

D. provides better immediate postoperative pain relief

E. decreases intraoperative blood loss

A

B. reduces hospital stay

C. decreases the incidence of thromboembolism

D. provides better immediate postoperative pain relief

E. decreases intraoperative blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Blood pressure measured by an automatic non-invasive method:

A. may over-read at high pressure
B. may over-read at low pressure
C. is affected by arrhythmias
D. may cause ulnar nerve damage
E. cuff width does not affect the measurement

A

B. may over-read at low pressure
C. is affected by arrhythmias
D. may cause ulnar nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which of the following criteria are part of the qSOFA (Quick SOFA) Score?

A. Altered mental status
B. Systolic blood pressure < 100mmHg
C. Leucocytes > 11G/L
D. SpO2 < 92%
E. Respiratory rate > 22 bpm

A

A. Altered mental status
B. Systolic blood pressure < 100mmHg
E. Respiratory rate > 22 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pulmonary hypertension is caused by:

A. multiple pulmonary emboli
B. mitral stenosis
C. chronic obstructive airways disease
D. volatile anaesthetic agents
E. ascent to high altitude

A

A. multiple pulmonary emboli
B. mitral stenosis
C. chronic obstructive airways disease
E. ascent to high altitude

17
Q

In acute cardiac tamponade there is:

A. muffled heart sounds
B. hypotension
C. bradycardia
D. distended jugular veins
E. cyanosis and cold extremities.

A

A. muffled heart sounds
B. hypotension
D. distended jugular veins
E. cyanosis and cold extremities.

18
Q

** Which of the following statements about intravenous anesthetics are correct?

A. Induction agent with the most stable cardiovascular profile is Propofol

B. Thiopental suppresses adrenal steroid synthesis

C. Psychomimetic reaction on emergence may occur with Ketamine

D. Ketamine has analgesic properties

E. Upper airway reflexes are best suppressed by Propofol

A

A. Induction agent with the most stable cardiovascular profile is Propofol

B. Thiopental suppresses adrenal steroid synthesis

D. Ketamine has analgesic properties

19
Q

Oxygen toxicity to the lung is due to:

A. inspired oxygen (FiO2) above 0.6
B. prolonged exposure
C. increased arterial partial pressure of oxygen
D. the effect of oxygen on pulmonary vessels
E. unhumidified oxygen

A

A. inspired oxygen (FiO2) above 0.6
B. prolonged exposure
D. the effect of oxygen on pulmonary vessels

20
Q

Concerning postoperative nausea and vomiting:

A. it is more common in women than men

B. the incidence is 80% with general anaesthesia

C. it is more common with thiopentone than with propofol

D. butyrophenones can decrease the incidence

E. it is more common with ear surgery

A

A. it is more common in women than men

C. it is more common with thiopentone than with propofol

D. butyrophenones can decrease the incidence

E. it is more common with ear surgery

21
Q

[CASE 1]

A 45-year old male patient that has had a motor vehicle accident is transported to the emergency department. He has a head and chest trauma. On admission he is unresponsive, pain stimulation leads to opening of the eyes and flexion of the upper extremities, with no verbal response. His pupils are dilated with normal reaction towards light. He has jugular vein distention.

After being provided with 8l/min oxygen via face mask his SpO2 is 88% and decreasing. His HR is decreasing rapidly from 130 to 50bpm and his blood pressure is 70/30mmHg.

On auscultation there is no breathing in the right hemithorax.

A) What is the most likely cause of the rapidly deteriorating condition?

B) What will your treatment strategy consist of?

C) How would you asses the patients’ neurological status?

A

A) Cause of the Rapidly Deteriorating condition is DUE to: RIGHT-Sided TENSION Pneumothorax w/ Mediastinal Shift TO Left, causing CARDIAC TAMPONADE

B) Treatment: Fluid Resuscitation / Emergency Needle THORACOSTOMY / CT for Head Trauma

C)
Eyes = To Pain (2)
Verbal = Unresponsive (1)
Motor = Flexion Withdrawal (4) == GCS 7

22
Q

[CASE 2]

A 22-year-old man comes to the emergency department because he has had fever, elevated blood glucose level, and confusion during the past three hours.

Pulse rate is 140/min, respirations are 30/min, and blood pressure is 80/50 mmHg.

Physical examination shows dry mucous membranes and delayed capillary refill.

Laboratory studies show serum potassium level of 5.2 mmol/L and serum glucose level of 26 mmol/L.

Arterial blood gas analysis shows pH of 7.0.

The patient is intubated and mechanically ventilated. After initial infusion of 30mL/kg crystalloid a new ABG is obtained.

A) Interpret the ABG.
B) What is the most likely cause?
C) Suggest a treatment plan

A

A) Px has Metabolic Acidosis w/ Respiratory Compensation; Also Hypoxaemic

B) DUE to Diabetic Ketoacidosis, DUE to HIGH Glucose + LOW Bicarbonate levels; A Ketone DRIP TEST would confirm Dx

C) Treatment:
- CORRECT the Acidosis w/ Insulin + IV Fluids
- REPLACE Calcium + Potassium
- TROMETHAMINE Injection to correct Metabolic Acidosis

23
Q

[WRITING I] GENERAL anesthesia – definition, components, types.

A

DEF = GENERAL Anaesthesia is the CONTROLLED + REVERSIBLE Induction of a State of Unconsciousness

Characterised by
- Analgesia / Amnesia / Hypnosis / Muscle Relaxation + STABLE Autonomic Regulation

3 COMPONENTS
1) TOTAL INHALATION Anaesthesia = Volatile Compounds, which are HIGHLY Lipid Soluble

2) TOTAL INTRAVENOUS Anaesthesia (TIVA) = Non-Volatile

3) BALANCE Anaesthesia

24
Q

[WRITING II] COMPLICATIONS of epidural and spinal anesthesia – prophylaxis and treatment.

A

COMPLICATIONS
- Puncture of the DURA MATER, can result in POST-OP Headache

  • Epidural / Spinal Haematoma
  • Epidural Abscess
  • TOTAL Spinal A = Cause Hypotension / Apnoea / Coma
  • HIGH Spinal A = Cause Hypotension / Bradycardia / Resp Distress

PROPHYLAXIS / TREATMENT
- For POST-OP Headaches = Rehydration + NSAIDs

  • For Resp Distress = Mechanical Ventilation
  • For Hypotension = Haemodynamic Support w/ VASOPRESSORS
  • For Urinary VOIDING = Use Urinary Catheters
25
Q

[WRITING III] HEMORRHAGIC SHOCK – definition, etiology, pathogenesis, clinical presentation.

A

DEF = A Form of HYPOVOLEMIC SHOCK, where SEVERE Blood loss, leads to INADEQUATE 02 Delivery at Cellular Level, potentially leading to DEATH!

ETIOLOGY
- Trauma
- Maternal Hemorrhage
- GI Hemorrhage
- Peri-operative Hemorrhage

PATHOGENESIS
1. Blood loss causes INADEQUATE 02 Delivery, ACTIVATING HOMEOSTATIC Mechs to PRESERVE Perfusion

2. Cellular Level = HS occurs when 02 Delivery FAILS to meet 02 DEMAND for Aerobic Metabolism - BECOMING ANAEROBIC instead

  1. Lactic Acid + Inorganic Phosphates ACCUMULATE DUE to 02 DEBT

4. FAILURE of supplying ATP to tissues , hence Homeostasis FAILS and CELL DEATH OCCURS

  1. Tissue Level = HYPOVOLEMIA + VC causes HYPOPERFUSION, and END-ORGAN DAMAGE to Vital Organs - causing MODS

CFs
- Cold, clammy hands (Inadequate T Perfusion)
- Oliguria / Anuria (Kidneys)
- Drowsiness (Brain)
- Tachycardia / Sweating
- Metabolic Acidosis

26
Q

[WRITING IV] Definition and classification of ALKALOSIS

A

DEF = An EXTREMELY ALKALINE Condition of the Body Fluids / Tissues

CLASSIFICATION
- Respiratory Alkalosis = pC02 is LESS than 35mmHg

  • Metabolic Alkalosis = Bicarbonate (HC03-) is MORE than 26 mmol / L

Anaesthesiology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions