Missed Prodigy Questions Sim Exam 1

Question 1

For every 1 degree CElesius that the core body temp decreases, the cerebral metabolic rate of O2 consumption decreases by

Answer 1

8%

Question 2

During a craniotomy, a pt’s BP decreases from 120/80 to 60/30. Which of the following would happen?
Cerebral vessels dilate or constrict and CBF would increase or decrease

Answer 2

Cerebral vessels would dilate and CBF would decrease

Question 3

Local anesthetic exist as

*weak acid or base
*positively or negatively charged amine group

Answer 3

Weak base with positively charged amine group

**Local anesthetics are positive :)

Question 4

A femoral nerve block will provide adequate anesthesia for which of the following procedures?
-excision of a mass on lateral thigh
-excision of a mass on medial thigh
-lower extremity adductor release procedure
-knee arthroscopy

Answer 4

KNEE ARTHROSCOPY

Question 5

What is the specific gravity of CSF?

Answer 5

1.004 - 1.009

Question 6

In relation to CSF, 2% lidocaine with a Specific gravity between 1.0004 and 1.0066 is:
-hypobaric
-isobaric
-hyperbaric

Answer 6

Hypobaric

Question 7

An HIV positive patient is taking a combination of zidovudine and corticosteroids. You know that this can place the patient at risk for

Answer 7

Respiratory muscle dysfunction

Question 8

What is the half life of carbon monoxide

Answer 8

4-6 hours

Question 9

The burning felt on injection of diazepam and lorazepam is due to

Answer 9

THE PRESERVATIVE PROPYLENE GLYCOL

Question 10

What is the earliest sign of graft function after liver transplantation surgery

Answer 10

Base deficit normalizes with rapid fresh frozen plasma administration

Question 11

Which of the following laboratory changes are most specific for hepatobiliary obstruction

Answer 11

5’ nucleotides elevation

Question 12

Which of the following interventions would be an appropriate initial treatment for the derangement in serum potassium cased by hyperaldosteronism?

Answer 12

Spironolactone

***Hyperaldosteronism = LOW POTASSIUM

Question 13

All of the following pathologies are associated with sarcoidosis except:
-cor pulmonale
-chronic extrinsic lung disease
-restrictive cardiomyopathy
-hypercalcemia

Answer 13

Chronic extrinsic lung disease
(It causes a chronic intrinsic lung disease!)

Question 14

MS is associated with which of the following?
-prolonged latency of evoked potentials
-excessive accumulation of myelin on the axon
-neuropathy due to demyelination of the peripheral nerves
-rapid progression in patients diagnosed after 35 years of age

Answer 14

Prolonged latency of evoked potentials

**demyelination of central nerves!

Question 15

Autonomic hyperreflexia would most likely produce
-cutaneous vasoconstriction above spinal cord lesion
-apnea
-hypotension
-vasoconstriction below the spinal cord lesion

Answer 15

-Vasoconstriction below spinal cord lesion

Question 16

Patients with CHF often exhibit
-hypermagnesemia
-hyperkalemia
-hypernatremia
-hyponatremia

Answer 16

-HYPONATREMIA

*due to activation of vasopressin system

Question 17

ANAPHYLACTIC reactions are related to prior sensitization by exposure to an antigen with production of antigen-specific
-IgA
-IgE
-IgG
-IgM

Answer 17

IgE

*IgE related to anaphylaxis

Question 18

A drug with high hepatic extraction ratio may exhibit a prolonged elimination half-life in an elderly patient because:
-hepatic mass decreases with age
-hepatic transaminase levels increase with age
-cytochrome p450 activity diminishes with age
-hepatic blood flow diminishes with age

Answer 18

-Hepatic blood flow diminishes with age

*hepatic mass DOES decrease with age but hepatic extraction ratio relies on hepatic blood flow not hepatic mass

Question 19

A patient with Type A blood has

-anti-A antibodies
-anti-B antibodies
-both
-neither

Answer 19

Anti-B antibodies

Question 20

Which of the following components of a CVP tracing would be absent in a patient with afib
-a wave
-c wave
-v wave
-x descent

Answer 20

A wave

Question 21

According to OSHA, OR personnel shouldn’t be exposed to more than how many parts per million of halogenated agent if nitrous oxide is also used?
-0.5
-2
-10
-25

Answer 21

0.5 ppm

*If nitrous oxide is not used, max exposure is 2 ppm

*max exposure to nitrous alone is 25 ppm

Question 22

A child presents to the ED with a dx of epiglottis. He is drooling, complains of sore throat, exhibits stridor. Your preop exam for this patient should include:
-thorough airway exam (mallampati and jaw opening included)
-CBC w/ diff
-CXR
-plan for inhalation induction

Answer 22

Plan for inhalation induction

*avoid airway exam to prevent additional swelling

Question 23

Which of the following respiratory parameters is decrease in elderly patients?
-alveolar surface area
-residual volume
-closing capacity
-Both A&B

Answer 23

-Alveolar surface area

*closing capacity increases, RV increases

Question 24

Which of the following conditions is not a component of HELLP syndrome?
-thrombocytopenia
-elevated liver enzymes
-hemolysis
-leukopenia

Answer 24

Thrombocytopenia

Question 25

At birth, the spinal cord extends to

Answer 25

L3

Question 26

During carotid endarterectomy, which of the following techniques for management of ventilation would be the most appropriate?
-mod hypocapnea
-mod hypercapnea
-normocarb to mild hypocapnia
-normocarb to mild hypercap

Answer 26

Maintain NORMOCARBIA to MILD HYPOcapnea

*hypercapnea can result in steal phenomenon

Question 27

Which of the following is not true regarding anesthesia during strabismus surgery?
-associated w/ increased risk of oculocardaic reflex
-associated w/ higher than normal risk of MH
-postop N/v occurs in majority of patients undergoing this procedure
-hyperventilation increases the risk for sudden bradycardia

Answer 27

hyperventilation increases the risk for sudden bradycardia

*hypoventilation will increase the risk

Question 28

Which of the following statements regarding pyloric stenosis is false

-can result in hypochloremic metabolic alkalosis
-preop hydration w/ crystalloid is appropriate
-associated persistent vomiting results in loss of hydrogen ions
-hypochloremia is a potential symptom

Answer 28

preop hydration w/ crystalloid is appropriate

*correction of fluid deficit requires a sodium chloride solution supplemented with potassium
LR should not be used

Question 29

Which of the following side effects is most likely to occur with use of intraoperative blood salvage (cell saver)?

-hyponatremia
-air embolism
-hyperkalemia
-fluid volume overload

Answer 29

Air embolism

Question 30

Which of the following changes are expected to occur in the elderly as part of the normal aging process? (Select 2)
-hepatic microsomal activity is decreased
-pulmonary collagen content increases
-renal blood flow decreases
-the A-a difference for oxygen decreases

Answer 30

-pulm collagen content increases
-renal blood flow decreases

*hepatic microsomal enzyme activity is well preserved
*A-a gradient increases

Question 31

Principal cells in the cortical collecting duct are primarily responsible for

-secreting renin
-secreting sodium
-acid-base regulation
-secreting potassium

Answer 31

Secreting potassium

Question 32

The physiologic characteristics of HPV include:

-onset and resolution relatively slow
-triggered by arterial hypoxemia
-may be inhibited by verapamil
-diffuse effect throughout the entire pulmonary vasculature

Answer 32

It may be inhibited by verapamil

**Triggered by ALVEOLAR hypoxia
-inhibited by calcium channel blockers, nitrated, Inhaled anesthetic

Question 33

What lab finding is most associated with hypoaldosteronism?

Answer 33

Hyperkalemia

**hyperkalemia in a patient with normal renal function suggests hypoaldosteronism

*pts also have hyponatremia

Question 34

Where in the nephron is the majority of sodium reabsorbed

Answer 34

Proximal convoluted tubule