Anesthesia Oral Boards

Question 1

Side effects of glucagon

Answer 1

Increased heart rate and transient hyperglycemia

Question 2

Rx for SIADH

Answer 2

Demeclocycline: inhibits renal action of ADH, induces diabetes insipidus

Question 3

Hypernatremia, urine osmolality 700-800 mosmol/L, urine Na less than 25 mEq/L

Answer 3

Unreplaced insensible loss or GI losses

Question 4

Hypernatremia, urine osmolality 700-800 mosmol/L, urine Na greater than 100 mEq/L

Answer 4

Sodium overload

Question 5

Hypernatremia, urine osmolality less than 300 mosmol/L

Answer 5

Diabetes insipidus

Question 6

Hyponatremia, plasma osmolality less than 275 mOsm/kg, urine osmolality less than than 100 mOsm/kg

Answer 6

Excessive water intake

Question 7

Hyponatremia, plasma osmolality less than 275 mOsm/kg, urine osmolality greater than than 100 mOsm/kg

Answer 7

Impaired renal diluting ability

Question 8

Hyponatremia, euvolemia

Answer 8

SIADH, postop pain/stress, diuretics, hypothyroidism

Question 9

Hyponatremia, hypovolemia, urine Na greater than 20 mEq/L

Answer 9

Renal solute loss: diuretics, Addison’s disease

Question 10

Hyponatremia, hypovolemia, urine Na less than 10 mEq/L

Answer 10

Non renal solute loss: GI losses, skin, insensible

Question 11

Hyponatremia, hypervolemia, urine Na greater than 20 mEq/L

Answer 11

Renal failure

Question 12

Hyponatremia, hypervolemia, urine Na less than 10 mEq/L

Answer 12

CHF, cirrhosis, nephrotic syndrome

Question 13

Clinical features of hypernatremia

Answer 13

Lethargy, confusion, irritability, coma, seizures, nausea, myoclonus, tremors, muscle weakness, intracerebral bleeding,

Question 14

Clinical features of hyponatremia

Answer 14

Asymptomatic: greater than 125
Anorexia, nausea, malaise: 120-125
Headache, lethargy, confusion, agitation, obtundation: 110-120
Stupor, seizures, coma: less than 110

Question 15

Drugs that cause hyperkalemia

Answer 15

Succinylcholine, beta blocker, ACE inhibitors, heparin, severe digitalis toxicity, cyclosporine

Question 16

Diagnosis of DKA

Answer 16

Serum ketones > 7 mmol, serum bicarbonate

Question 17

Labs to order when suspecting DKA

Answer 17

Urinalysis, glucose, electrolytes to determine anion gap, ABG, CBC to check for infection

Question 18

Treatment for DKA

Answer 18

IV fluids, insulin bolus then gtt, potassium as acidosis is corrected, antibiotics for sepsis

Question 19

Diagnosis and treatment of nonketotic hyperosmolar coma

Answer 19

Severe dehydration, no ketoacidosis, glucose very high like 1000 mg/dL, mental status changes.
Treatment: IVFs, insulin, dextrose, potassium

Question 20

Anesthetic considerations for diabetic patients

Answer 20

Renal dysfunction, increased risk of CAD and CVA and PVD, autonomic dysfunction: delayed gastric emptying, orthostatic hypotension, infection and poor wound healing, stiff joints

Question 21

Drugs that precipitate when mixed with barbiturates

Answer 21

Vecuronium, atracurium, midazolam, sufentanil, alfentanil

Question 22

Sevoflurane has potential for emergence delirium and can be switched to what agent after induction?

Answer 22

Isoflurane

Question 23

Sevoflurane given at flow rates less than 2 liters can cause what?

Answer 23

Formation of compound A with is nephrotoxic

Question 24

Which volatile agent has greatest risk of degrading to form carbon monoxide I extremely dry CO2 absorber?

Answer 24

Desflurane