Miscellaneous topics 4

Question 1

A transverse abdominal plane block would be useful for all of the following procedures EXCEPT:
a. inguinal hernia repair
b. appendectomy
c. cystoscopy
d. kidney transplant

Answer 1

c. cystoscopy

Question 2

The TAP block targets the nerves of the

Answer 2

anterior and lateral abdominal wall

Question 3

The TAP block is best suited for abdominal procedures that involve the

Answer 3

T9 to L1 distribution

Question 4

The landmarks for the TAP block form the

Answer 4

triangle of Petit:
1. external oblique muscle
2. Latissimus dorsi muscle
3. iliac crest

Question 5

Potential complications of the TAP block include

Answer 5

peritoneal puncture
liver hematoma

Question 6

Abdominal wall structures organized from superficial to deep:

Answer 6

subcutaneous tissue–> external oblique muscle–> internal oblique muscle–> transverse abdominis muscle–> peritoneum

Question 7

Where should you inject for a TAP block?

Answer 7

between the internal oblique and the transverse abdominus

Question 8

_______________ is pain localized to a dermatome

Answer 8

neuralgia

Question 9

____________ is impaired nerve function

Answer 9

Neuropathy

Question 10

______________ is abnormal sensation described as pins and needles

Answer 10

Paresthesia

Question 11

___________ is abnormal and unpleasant sense of touch

Answer 11

Dysethesia

Question 12

__________ is no pain is sensed in response to a stimulus that produces pain

Answer 12

Analgesia

Question 13

___________ is pain due to a stimulus that does not normally produce pain

Answer 13

Allodynia

Question 14

______________ is a stimulus that is normally expected to produce pain

Answer 14

Algogenic

Question 15

The ________block is used to relieve postdural puncture headache

Answer 15

sphenopalatine

Question 16

The _________- is the only cranial nerve that is enveloped by the meningeal sheath and bathed in CSF

Answer 16

optic nerve

Question 17

Inadvertent local anesthetic injection into the optic sheath is a risk of a

Answer 17

retrobulbar block

Question 18

Regional blocks used for pain management include

Answer 18

thoracic paravertebral block
celiac plexus block
superior hypogastric plexus block

Question 19

The thoracic paravertebral block is used for

Answer 19

breast surgery
thoracotomy
rib fractures

Question 20

The celiac plexus block is used for the management of

Answer 20

cancer pain of the upper abdomen

Question 21

The superior hypogastric plexus block is used for the management of

Answer 21

cancer pain of the pelvic organs

Question 22

Complex regional pain syndrome is characterized by

Answer 22

neuropathic pain with autonomic involvement

Question 23

The key distinction between type 1 and type 2 complex regional pain syndrome is

Answer 23

type 2 is always preceded by nerve injury

Question 24

Pain modulation occurs in the

Answer 24

spinal cord

Question 25

These drugs can be used to treat chronic pain because they increase concentrations of norepinephrine and serotonin

Answer 25

antidepressants- tricyclics, SSRIs, SNRIs

Question 26

Risk factors for complex regional pain syndrome include

Answer 26

female gender previous trauma previous surgery

Question 27

Treatment for complex regional pain syndrome is

Answer 27

ketamine infusion memantine (an NMDA antagonist) gabapentin regional sympathetic blockade physical therapy steroids amitriptyline

Question 28

Complications of a celiac plexus block include

Answer 28

orthostatic hypotension retroperitoneal hematoma hematuria diarrhea AAA dissection back pain retrograde migration of the injectate

Question 29

The most common side effect of prophylactic antibiotics is

Answer 29

pseudomembranous colitis

Question 30

Allergic reactions are most commonly caused by

Answer 30

beta-lactam antibiotics

Question 31

Is there cross-reactivity between penicillin and cephalosporins?

Answer 31

rare-1%

Question 32

__________ and _____________ cephalosporins are associated with the lowest rate of cross-reactivity

Answer 32

3rd and 4th generation

Question 33

These antibiotics are contraindicated during pregnancy:

Answer 33

chloramphenicol erythromycin tetracyclines fluoroquinolones

Question 34

Giving vancomycin quickly can cause

Answer 34

histamine release & hypotension

Question 35

Vancomycin should be administered

Answer 35

at a rate of 10-15 mg/kg over 1 hour

Question 36

If a patient reports an allergy to PCN, they can receive

Answer 36

cephalosporin if the reaction was not IgE mediated (anaphylaxis, bronchospasm, urticaria) and did not produce exfoliative dermatitis (Stevens-Johnson syndrome)

Question 37

What are examples of aminoglycosides?

Answer 37

gentamycin streptomycin

Question 38

What are risks associated with aminoglycosides?

Answer 38

ototoxicity nephrotoxicity skeletal muscle weakness

Question 39

What are examples of tetracyclines?

Answer 39

doxycycline

Question 40

What are risks associated with doxycycline?

Answer 40

hepatotoxicity nephrotoxicity

Question 41

What are examples of macrolides?

Answer 41

erythromycin

Question 42

What are risks associated with macrolides?

Answer 42

P450 inhibition

Question 43

What are examples of fluoroquinolones?

Answer 43

ciprofloxacin levofloxacin moxifloxacin

Question 44

What are risks associated with fluoroquinolones?

Answer 44

GI intolerance tendonitis & tendon rupture

Question 45

What are risks associated with clindamycin?

Answer 45

skeletal muscle weakness allergic reaction

Question 46

What are risks associated with metronidazole?

Answer 46

peripheral neuropathy alcohol intolerance

Question 47

What are risks associated with vancomycin?

Answer 47

hypotension following rapid infusion (histamine) red man syndrome Stevens-Johnson syndrome

Question 48

Cephalosporins act by

Answer 48

disrupting bacterial cell wall synthesis (peptidoglycan)

Question 49

Vancomycin acts by

Answer 49

disrupting bacterial cell wall synthesis

Question 50

What is the antibiotic of choice for an active MRSA infection?

Answer 50

vancomycin