Miscellaneous topics 3

Question 1

Causes of drug-induced hyperpyrexia include:

Answer 1

malignant hyperthermia
neuroleptic malignant syndrome
serotonin syndrome
anticholinergic poisoning

Question 2

Neuroleptic malignant syndrome is caused by

Answer 2

dopamine depletion

Question 3

Serotonin syndrome is caused by

Answer 3

an excess 5-HT activity

Question 4

Anticholinergic poisoning is caused by

Answer 4

excess ACh blockade

Question 5

Methylene blue has ______________ inhibiting properties

Answer 5

MAO-A

Question 6

Methylene blue can increase the risk of

Answer 6

serotonin syndrome in patients taking other serotonergic drugs

Question 7

Treatment for serotonin syndrome is

Answer 7

cyproheptadine

Question 8

Treatment for anticholinergic poisioning is

Answer 8

physostigmine

Question 9

Treatment for neuroleptic malignant syndrome is

Answer 9

bromocriptine, dantrolene

Question 10

What are causes of sympathomimetic syndrome?

Answer 10

amphetamines
cocaine

Question 11

What are key features of sympathomimetic syndrome?

Answer 11

agitation
hallucinations
arrhythmias
myocardial ischemia

Question 12

What are treatments for sympathomimetic syndrome

Answer 12

vasodilators
labetalol
supportive care

Question 13

What is the cause of tricyclic antidepressant overdose?

Answer 13

tricyclic antidepressants- amitriptyline, nortriptyline

Question 14

What are the key features of tricyclic antidepressant overdose?

Answer 14

hypotension
decreased LOC/coma
polymorphic VT

Question 15

What are the treatments for tricyclic antidepressant overdose?

Answer 15

magnesium
serum alkalization
supportive care

Question 16

What drugs can cause serotonin syndrome?

Answer 16

SSRIS, SNRIs, MAOIs, MDMA (ecstasy), methylene blue, meperidine, fentanyl

Question 17

Key features of serotonin syndrome include

Answer 17

akathisia
mydriasis
tremor
AMS
clonus
muscle rigidity

Question 18

Key features of anticholinergic syndrome are

Answer 18

red, hot dry skin
mydriasis
delirium

Question 19

Causes of neuroleptic malignant syndrome are

Answer 19

dopamine antagonists- haloperidol, metoclopramide, chlorpromazine, risperidone or withdrawal from dopamine agonists

Question 20

Key features of neuroleptic malignant syndrome include

Answer 20

bradykinesia
decreased LOC/coma
rhabdomyolysis
myoglobinuria
acidosis
ANS instability
normal pupils

Question 21

MAOIs combine with _________ increase the risk of serotonin syndrome.

Answer 21

meperidine or ephedrine

Question 22

SSRIs combined with _________ increase the risk of serotonin syndrome.

Answer 22

meperidine or fentanyl

Question 23

Identify the statements that BEST represents the anesthetic considerations for ophthalmic surgery.
a. intraocular perfusion pressure equals MAP-CVP
b. Aqueous humor is reabsorbed by the ciliary process
c. hypocarbia increases intraocular pressure
d. nitrous oxide is contraindicated for 10 days after a sulfur hexafluoride bubble is placed

Answer 23

d. nitrous oxide is contraindicated for 10 days after sulfur hexafluoride bubble is placed

Question 24

IOP is determined by

Answer 24

the choroidal blood volume
aqueous fluid volume
extraocular muscle tone

Question 25

Normal IOP is

Answer 25

10-20 mmHg

Question 26

Factors that increase IOP include

Answer 26

hypercarbia hypoxemia increased CVP increased MAP laryngoscopy Trendelenburg position

Question 27

An increased IOP in a patient with an open globe injury can

Answer 27

cause permanent blindness

Question 28

What paralytic is recommended for the patient with an open eye injury?

Answer 28

succinylcholine is okay to use in a patient with an open eye injury and a full stomach rocuronium 1.2 mg/kg is also a suitable option

Question 29

Succinylcholine increases IOP by

Answer 29

5-15 mmHg for up to 10 minutes

Question 30

Glaucoma is caused by a

Answer 30

chronically elevated IOP that leads to retinal artery compression

Question 31

IOP is reduced by

Answer 31

drugs that reduce aqueous humor production or facilitate aqueous humor drainage

Question 32

Unique anesthetic considerations for strabismus surgery include

Answer 32

increased risk of PONV & activation of the oculocardiac reflex (bradycardia)

Question 33

Nitrous oxide is contraindicated for __________ after a patient undergoes sulfur hexafluoride bubble placement

Answer 33

7-10 days

Question 34

Intraocular perfusion pressure equation is

Answer 34

IPP= MAP-IOP

Question 35

Aqueous humor is produced by

Answer 35

the ciliary process

Question 36

Aqueous humor is reabsorbed by the

Answer 36

canal of schlemm

Question 37

Factors that decrease IOP include

Answer 37

hypocarbia decreased CVP decreased MAP volatile anesthetics nitrous oxide nondepolarizing NMB propofol opioids benzodiazepines hypothermia

Question 38

Anticholinergics ______________ IOP

Answer 38

do not increase

Question 39

LMA placement and/or removal ____________ IOP

Answer 39

has a minimal effect on

Question 40

What drug can be used to facilitate aqueous humor drainage?

Answer 40

echothiphate

Question 41

Echothiophate can prolong the duration of

Answer 41

succinylcholine and ester-type local anesthetics

Question 42

How long does N2O need to be avoided with silicone oil?

Answer 42

0 days

Question 43

How long does N2O need to be avoided with an air bubble?

Answer 43

5 days

Question 44

How long does N2O need to be avoided with perfluoropropane?

Answer 44

30 days

Question 45

What causes open-angle glaucoma?

Answer 45

sclerosis of the trabecular meshwork. impairs aqueous humor drainage

Question 46

What causes closed-angle glaucoma?

Answer 46

closure of the anterior chamber; creates a mechanical outflow obstruction