Surg Anes Flashcards by Frankie Aguinot

Which muscles relaxant block muscarinic receptors? Which is most potent?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium

Pancuronium

Galamine ++

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Formula for length

length = (age/12) + 12

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A Grade 3 score under Cormack and Lehane classification anticipates that intubation is:

a. not difficult
b. fairly severe
c. slightly difficult
d. impossible by direct laryngoscopy only

b. fairly severe

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Mivacurium is a short actin benzylquinolinium compound that is hydrolyzed by plasma cholinesterase

T/F

True

is the is only non-depolarizer that is hydrolyzed by cholinesterase

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MOA of NO

the activity of B12 dependent enzyme METHIONINE SYNTHETASE AND THYMIDYLATE SYNTHETASE > irreversible oxidation of the cobalt atom of Vitamin B12

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Correct sequent of evolutions of anesthetic techniques:

Inhalation
Intravenous
Local and Regional
Neuromuscular blocking agents

Inhalations > Local and Regional > Intravenous > Neuromuscular blocking agents

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methods of elimination of inhaled anesthetics

. Alveolus (most important)
. Biotransformation
. Transcutaneous loss

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Mallampati Classification and which are easy or difficult

I - soft palate, fauces in front, uvula, pillars
II - soft palate, fauces in front, uvula (no pillars)
EASY

III - soft palate, base of uvula
IV - hard palate only
DIFFICULT

IV requires special equipment

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Vasoconstrictors mixed with local anesthetics:

a. will form precipitates
b. will produce hypotension
c. vasoconstrict surrounding blood vessels
d. hasten absoroption
d. maximize toxicity

d. hasten absoroption

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Lung sounds are heard after intubation only over the right lung of an adult patient. The ET tube is at 27 cm at the teeth. The most likely explanation for the finding is:

a. occlusion of the endotracheal tube
b. left-sided pneumothorax
c. right mainstream intubation
d. right-sided hypertympany

c. right mainstream intubation

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Which of th sedative/hypnotic drugs is 2 to 3 times as potent as the standard drug with a rapid onset but shorting acting can be used as an inducing agent:

a. diazepam
b. lorazepam
c. midazolam
d. pentobarbital

a. midalzolam

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Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

MIVACURIUM

Nicotine Receptors NONE
Cardinal Muscarinic Receptors NONE
Histamine Release +

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What is the glottis location in newborns?

C3 to C4

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Which non-polariser has laudinine as a metabolite?

Atracurium

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Sellick”s maneuver is:

a. application of gentle pressure on the cricoid cartilage
b. occlusion of the esophagus and trachea
c. prevents aspiratioin of gastric contents
d. A and C only
e. all of the above

e. all of the above

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An active metabolite of pipecuronium is laudanosine which is a CNS stimulant

T/F

False

An active metabolite of ANTRACURIUM is laudanosine which is a CNS stimulant

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A 54 years old ASA 1, male is for thyriodectomy, the following should be requested EXCEPT:

a. CBC
b. FBS
c. ECG
d. CXR

d. CXR

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Mivacurium is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

d. ischemic heart disease

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Anesthetic plan is based on

a. current status of pertinent known medical problems
b. cardiac status
c. functional status
d. B and C
e. aota

e. all of the above

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Cholingeric is

parasympathetic
sympathetic

parasympathetic

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minimum alveolar concentration (MAC) decreased by

. NO
. Premedication
. Age
. Acute alcohol intoxication
. Hypothermia
. Hypotension
. Hypercarbia
. Sympathetic decrease

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Most nephrotixic of inhaled anesthetics

methoxyflurane

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Most common complication seen immediately after extubation

a. coughing
b. sore throat
c. laryngospasm
d. accidental tooth extraction

c. laryngospasm

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What is the most potent of the inhalation anesthetics

Isoflurane

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What are the laboratory exam validity of the following ``` . hematocrit . serum glucose/creatinine/BUN . Liver function test . ECG . CXR . Coagulation studies ```

``` . Hematocrit (1mo) . serum glucose/creatinine/BUN (1 mo) . Liver function test (1 mo) . ECG (6 months) . CXR (6 months) . Coagulation studies (1 week) ```

factors affecting inspiratory concentration

. Fresh gas flow rate . Breathing circuit volume . Circuit absorption

The following statement regarding Macintosh blade is true: a. a straight blade with curve tip b. less need for a stylet c. greater exposure of glottis opening d. less trauma to the teeth

d. less trauma to the teeth

Duration of Mivscurium vs Atracurium/Vecurium

1/3 of A/V

ASA IV patients have a mortality rate of a. 10% b. 20% c. 50% d. 40%

b. 20%

Question

Answer

A 51 years old, male uncontrolled diabetes mellitus, his perioperative risk for cardian complication based on patient-related preditors will be a. Major b. Intermediate c. Moderate d. MInor

b. Intermediate

What is the net effect of volatile anesthetics on cerebral blood flow

balance betweebetween a reduction in Cerebral Blood Flow caused by Cerebral Metabolic Rate suppression and augmentation of Cerebral Blood Flow caused by the direct cerebral vasodilation.

Succinylcholine acts at the presynaptic sites blocking the Na channels therefore impairing the release of acetylcholine T/F

False Syccinylcholine is a depolarizer. It mimics the action of Ach and there is persistent depolarization due to open channels. This prevent propogation of action potential.

Halothane, the 1st halogenated hydrocarbon inhalation anesthetic is associated with: a. Van Poznok and Artusia b. Shykys and Krants c. Barash d. Suckling

d. Suckling

Technique of airway management where a plastic catheter is inserted at the cricothyroid membrane and serves as a guide for the ETT: a. Fiberoptic technique b. transtracheal ventilation c. rapid sequence intubation d. retrograde intubation

d. retrograde intubation

Most common methods of confirming ETT placement EXCEPT: a. visualization of the ETT entering the larynx b. auscultation of the chest for breath sounds c. chest motion during ventilation d. chest x-ray

d. chest xray

A 69 years old male will undergo thyroidectomy, the anesthetic plan will consist of: a. Cormack Lehane Class II b. general anesthesia c. regional anesthesia d. sedation

b. general anesthesia

Persistent depolarization of succinylcholine is associated with leakage of potassium ions from the activation

True is

The "first anesthesiologist": a. Snow b. Wells c. Long d. Davy

a. Snow

The patient who will not require preoperative evaluation a. 72 yo male for cataract extraction under local anesthesia b. 26 yo female with uncontrolled hypertension for breast cyst exicision under sedation c. 6 yo male for explore lap under general anesthesia d. 33 year old male for appendectomy under spinal anesthesia

a. 72 yo male for cataract extraction under local anesthesia

The following are the advantages when using anticholinergic agent EXCEPT: a. lessen airway secretion b. vagolytic action c. pyrexia

c. pyrexia

A 72 years old male is considered moderate risk for perioperative cardiac complication based on the surgical procedure if he will undergo: a. appendectomy for ruptured appendix b. carotid endarterectomy c. explore lap for complete gut obstruction d. reopen surgery due to massive bleeding after a thyroidectomy

b. carotid endarterectomy

A 33 years old make is scheduled for hemorrhoidectomy is classified as: a. ASA II if he has labile hypertension b. ASA IE if he is a normal healthy patient c. ASA III if he is a diabetic and can only walk three meters d. ASA IV if he has a good control of his hypertension

c. ASA III if he is a diabetic and can only walk three meters

Short neck may result in difficult intubation. a. the laryngeal axis will not align with the pharyngeal axis b. the pharyngeal axis will not align with the oral axis c. the pharyngeal and laryngeal axes will not align with the oral axis d. the laryngeal and oral axes will not align with the pharyngeal axis

a. the laryngeal axis will not align with the pharyngeal axis

The term "anesthesia" as narcotic-like effect was first described by: a. Dioscorides b. Holmes c. Long d. Morton

a. Dioscorides

Place in order rapid sequence induction . assistant administers medication . non-depolarizing MR may be administered . patient is intubated and cuff is inflated . pre-oxygenation for 3-5 min . respiration is not assisted until the airway is secure

. pre-oxygenation for 3-5 min > . respiration is not assisted until the airway is secure > . non-depolarizing MR may be administered > . assistant administers medication > . patient is intubated and cuff is inflated

Liver function test is valid for: a. 1 month b. 2 months c. 3 months d. 6 months e. 12 months

a. 1 month

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release PIPERCURONLUM

Nicotine Receptors NONE Cardinal Muscarinic Receptors NONE Histamine Release

Pipercuronium is safely given in patients with ischemic heart disease T/F

True Replacement for Pancuronium where increased in HR has to be avoided Ischemic Heart disease Long term mechanical ventilation

Inidication for endotracheal intubation includes: a. risk of pulmonary aspirations b. intracranial or intrathoracic surgery c. prolonged positive pressure ventilation d. all are correct

d. all are correct

A 79 years old patient who will undergo phaco surgery for cataract. A. take midazolam PO before leaving the house if he is anxious b. requires no premedication c. can drink coffee with milk up to 2 hours prior to the procedure d. can take diphenhydramine if he has history of allergy

b. requires no premedication

Which muscles relaxant has histamine release?Which is most potent? ``` Succinylcholine D-Tubocurarine Metacurarine Pancuronium Galamine Atracurium Mivacurium ```

D-Tubocurarine +++ Metacurarine Atracurium Mivacurium

Anatomic differences of children from adults: a. newborn head is large b. larynx is more caudal c. glottic opening is the narrowest point in the larynx d. glottis is located at C5 level

a. newborn head is large . larynx is more cephalad . cricoid cartilage is the narrowest point in the larynx (adults - vocal cords) . Glottis is C3 level

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release D-TUBO CURANINE

Nicotine Receptors BLOCKS ++ Cardinal Muscarinic Receptors NONE Histamine Release +++

The cardiovascular effects of pancuronium are attributed to the selective cardiac vagal blockage and activation of the sympathethis nervous system T/F

True is

An important element in successful intubation is to adjust the table so that the patients's face is at the level of the anesthesiologist's: a. clavicle b. breast c. xiphoid d. umbilicus e. iliac crest

c. xiphoid

Factors predisposing to aspiration

``` Emergency SX Inadequate anesthesia Abdominal pathology Obesity Opioid medication Neurologic deficit Lithotomy Difficult intubation/airway Reflux Hiatal hernia ```

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release SUCCINYLCHOLINE

Nicotine Receptors STIM Cardinal Muscarinic Receptors STIM Histamine Release RARE

Dissociative anesthetic: a. ketamine HCl b. NO c. halothane mivacurium

a. ketamine HCl

NMB interferes with the physiological sequence of neuromuscular transmission. They are also considered anesthetics. T/F

False interferes with physiological sequence of neuromuscular transmission Not anesthetics

factor affecting alveolar concentration

. Solubility in the blood . alveolar blood flow . Partial pressure difference between alveolar gas and venous blood

A 69 years old male will undergo thyroidectomy. What laboratory exam must be done? A. PT time b. CXR c. CBC d. Urinalysis e. ECG

c. CBC

Inflation of the ETT cuff is verified by a. equal breath sounds b. inflated pilot balloon c. presence of waveform in capnograph d. adequate oxygenation

b. inflated pilot balloon

Indication for ETT

``` . pulonary aspiration . head and neck . prone, sitting, lateral during surgery . airway abnormalities . intracranial, intrathoracic, intra abdominal ```

Prolonged exposure of sevoflurane in human will cause (3)

proteinuria, enzymuria, glycosuria

The following are the determinants of the what type of pre-medication and dosage to be given to patients EXCEPT: a. patient's age and weight b. ASA physical status classification c. marital status d. level of anxiety

c. marital status

Pancuronium is contraindicated in a. renal disease b. status asthmaticus c. burn patients d. ischemic heart disease e. liver disease

e. liver disease

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release Atracurium

Nicotine Receptors NONE Cardinal Muscarinic Receptors NONE Histamine Release +

Techniques for orotracheal intubation includes the following: a. height of the table should be at the anesthesiologists symphysis pubis b. the laryngoscope handle is held by the right hand c. the glottic opening is recognized by its triangular shape & pale white vocal cords d. the ETT is advanced until the cuff is at the level of the vocal cords

c. the glottic opening is recognized by its triangular shape & pale white vocal cords

The need for further cardiac evaluation is influenced by: a. anesthetic technique b. surgery type c. laboratory examination d. result of ECG

d. result of ECG

Which muscles relaxant block nicotinic receptors? Which is most potent? ``` Succinylcholine D-Tubocurarine Metacurarine Pancuronium Galamine Atracurium Mivacurium ```

D-Tubocurarine ++ | Metacurarine

Pancuronium is contraindicated in which HR increase adverse diseases

Hypovolemia Valvular Heart Disease Coronary heart disease

Non-depolarizers binds to postsynaptic receptors which prevent acetylcholine from activating sodium channels therefore depolarization cannot occur T/F

True is

Onset of Succinylcholine

30-60 seconds; can intubate 3-5 min

Adverse side effects of Succinylcholine

``` Cardiac dysthymia Hyperkalemia Myalgia Myloglobinuria Increase intragastric pressure Increase intraoptical pressure Increased intracranial pressure Sustained skeletal muscle contraction (myotonia) ```

Evolution of the practice of anesthesiology happened in: a. England and USA b. Japan and Germany c. England and Spain d. USA and Russia

a. England and USA

Prolonged exposure of NO in human will cause

megaloblastic anemia

Atracurium can be given to those with renal or hapatic disease. T/F

True - metabolism happens in blood

Ideal pre-operative interview EXCEPT: a. reassuring b. via cell phone c. unhurried and tactful d. at least within 24 hours prior to operations

b. via cell phone

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release VECURONIUM

Nicotine Receptors NONE Cardinal Muscarinic Receptors NONE Histamine Release NONE

MOA of non-depolarisers

1) block post synaptic receptor not allowing Ach to activate Na channels 2) block pre-synap sites to block Na channels which impairs the release of Ach

Blunt baroreceptor reflex associated with

halothane

minimum alveolar concentration (MAC) increased by

. Age (highest at 6 mo) . Chronic alcohol abuse . Sympathetic increase (drugs) . Hypermetabolic states

No depressant drugs before surgery for the following (4)

little physiologic reserve head injury hypovolemia extremes of age

Lower limit autoregulation pressure

50 mmHg

Cormack and Lehane classification based on

views obtained at laryngoscopy

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release PANCURONIUM

Nicotine Receptors NONE Cardinal Muscarinic Receptors BLOCK + Histamine Release NONE

Arrange in chronological order the following steps a. visualization of the glottic opening b. Sellick's maneuver c. insertion of geudel airway d. insertion of endotracheal tube e. locating the epiglottis

locating the epiglottis > visualization of the glottic opening > Sellick's maneuver > insertion of endotracheal tube > insertion of geudel airway

Normal mouth opening in an adult: a. 20 mm b. 40 mm c. 20 cm d. 40 cm

b. 40 mm

Succinylcholine is contraindicated in a. renal disease b. status asthmaticus c. burn patients d. ischemic heart disease e. liver disease

c. burn patients

Block / Stimulate / No Effect Nicotine Receptors Cardinal Muscarinic Receptors Histamine Release METACURINE

Nicotine Receptors BLOCKS Cardinal Muscarinic Receptors NONE Histamine Release ++

What is the mean arterial pressure range?

65 to 150 mmHg

Vecuronium is contraindicated in a. renal disease b. status asthmaticus c. burn patients d. ischemic heart disease e. liver disease

a. renal disease

Instrument used to prevent patients from biting the tube and obstructing their own airway: a. stylet b. cuff c. guedel airway d. laryngeal mask

c. guedel airway

What type of cardiac dysarthria does succincholine illicit?

Sinus brachycardia Sinus arrest Junctional rhythm

Atracurium is contraindicated in a. renal disease b. status asthmaticus c. burn patients d. ischemic heart disease e. liver disease

b. status asthmaticus

A medical prodecure wherein a tube is placed into the trachea through the mouth: a. retrograde intubartion b. nasotracheal intubation c. orotracheal intubation

c. orotracheal intubation

A 6 years old female for tonsilectomy came for follow-up, She has fever, wheezing, and significant nasal discharge. a. do a repear CBC b. determine if the pathology is viral c. postpone surgery d. give atropine for premedication to dry secretions

c. postpone surgery

The most important goal of preoperative evaluation is: a. risk reduction b. cost reduction c. efficiency promotion d. patient preparation

a. risk reduction

Patients of extreme ages are classified as: a. ASA I b. ASA II c. ASA III d. ASA IV e. ASA V

c. ASA III

retrograde intubation uses what forceps?

Magill

Which muscle relaxants stimulates muscarinic receptors? ``` Succinylcholine D-Tubocurarine Metacurarine Pancuronium Galamine Atracurium Mivacurium ```

succinylcholine

Low cholinesterase activity associated with

Pregnancy Severe liver disease Anti-cholinesterase drug

Penington forumula for ID abvoe and below 6 yo

<6 ID = (age/3) + 3.5 >6 ID = (age/4) + 4.5

Development of hypodermic needle and syringe is credited to: a. Wood b. Ore c. Burkhardt d. Fischer

a. Wood

An example of opioid which can be given as premedication is: a. oxycodone b. ketoroiac c. gabapentine d. loratidine

a. oxycodone

Computer the ET size of a 6 year old year old 20 kg using the Penington formula: a. 5.0 mm b. 5.5 mm c. 6.0 mm d. 6.5 mm

d. 6.5

What is a short acting benzylquinolinium?

Mivacarium

Blocked of the conscious perception of pain: a. amnesia b. relaxation c. analgesia d. obtundation

c. analgesia

Coagulation studies are indicated in patients a. prolonged intake of warfarin b. use of NSAIDS for 5 days c. history of dengue fever e. hep A infection 5 years ago

a. prolonged intake of warfarin

Noted the use of nitrous oxide for analgesia and surgery: a. Soubeian b. Davy c. Guthrie d. Simpson

b. Davy

The narrow point of the pediatric larynx is

criocoid cartilage

In case of inability to ventilate and intubate, the airways equipment to be used is the a. oral airway b. nasal airway c. laryngeal mask d. ETT

b. nasal airway

The following are the commonly used monitors in the operating room EXCEPT: a. non-invasive blood pressure apparatus b. pulse monitor c. electrocardiagram d. central venous pressure monitor

d. central venous pressure monitor

How is Atracurium metabolised?

Hoffman elimination | Ester hydrolysis

The best time to extubate the patient is during a. Emergence b. awake c. laryngospasm d. accidental tooth extraction

a. Emergence

Most reliable method of confirming ETT placement: a. fiberoptic bronchoscopy b. chest x-ray c. capnography d. auscultation on breath sounds

c. capnography

Two weeks prior to surgery, laboratory and diagnostic exams show normal results. A. a repeat prothrombin time will be requested b. if a patient has chronic anemia, a repeat Hgb is done c. pre-operative chest x-rays among elderly always required d. physiologic age for ECG is > 50 years old

A. a repeat prothrombin time will be requested (valid for 1 week) ``` . Hematocrit - 1 month . Serum glucose/creatinine/BUN - 1 month . ECG - 6 months . CXRs - 6 months . Coagulation studies - 1 week ```

The absence of waveform in the capnograph wiehn the ETT is inserted will require a. increase oxygenation b. re-intubation c. adjustment of the ETT d. inflation of the pilot balloon

c. adjustment of the ETT

Which muscle relaxants stimulates nicotinic receptors? ``` Succinylcholine D-Tubocurarine Metacurarine Pancuronium Galamine Atracurium Mivacurium ```

succinylcholine

The glottis opening is in the level of the 4th to 6th first cervical vertebrae in a. infant b. toddler c. child d. adult

d. adult

Cerebral Perfusion Pressure equation

MAP - ICP

What is the result if Vecurium is given with opioids?

Brachycardia

What are the long acting depolarisers?

Pancuronium | Pipecuronium

A 41 years old male was referred to the Anesthesia Service for scheduled Colonoscopy. A. ASA Class III if hypertention is controlled b. E is added for Elective procedure c. ASA Class I if he has no-comorbid conditions d. ASA Class II if he has uncontrolled DM

c. ASA Class I if he has no-comorbid conditions

Succinylcholine causes an increase in intraocular pressure which is secondary to contraction of tonic myofibrils and dilation of choroidal blood vessels T/F

True is

Which of the following statements is related to rapid sequence induction? a. pre-oxygenation for 3-5 minutes b. application of cricoid pressure c. used in patients with full stomach d. A and B only e. all of the above

e. all of the above

what is second gas effect?

A high concentration of gas will augment not only its own uptake but that of a concurrently administered volatile anesthetic

Discovered nitrous oxide and oxygen: a. Hickman b. Priestly c. Morton d. Newton

b. Priestly

What is the basis of the Mallampati classification system?

visualization of the oropharynx

Physiological responses to ETT

. cardiovascular and sympathoadrenal responses | . increased intracranial pressure

Most widely used classification of laryngeal view using direct laryngoscopy: a. Mallamparti b. Water's c. Cormack and Lehande d. Samson-Young

c. Cormack and Lehande Mallamparti only uses a light source; Cormack and Lehande uses laryngoscopy

Preoperative evaluation prior to intubation will allow the anatomic assessment of the following EXCEPT: a. dental state b. mandibular opening c. TMJ d. presence of hypertention

d. presence of hypertension

Using the Penington Formula, computer for the approximate ET size of a 5 yo child: a. 4.0 - 4.5 mm b. 4.5 - 5.0 mm c. 5.0 - 5.5 mm d. 5.5 - 6.0 mm

c. 5.0 - 5.5 mm <6.5 yo: (age years/3) + 3.5 >6.6 yo: (age years/4) + 4.5

ASA class mortality rates ASA Class 1-5

``` 1 < .08 2. <0.4 3. <4.3 4. <23 5 <51 ```

Vecuronium is a monoquartenacy steroidal analogue of pancuronium which is devoid of vagolytic effects T/F

True is

Laryngoscope basic 3 types

Macintosh, Jackson or Wisconsin, Miller

In 1885, he injected cocaine in the nerve tracts: a. William T. Morton b. William Holstad c. August Bier d. Carl Koller

c. August Bier

What nondepolarizer is hydrolysed by plasma cholinesterase

Mivacurium

Equipments used in endotracheal intubation includes the following EXCEPT: a. endotracheal tube b. laryngoscope c. suction machine d. mechanical ventilator

d. mechanical ventilator

factors that will speed up anesthesia induction

. High inspired partial pressure of the anesthetic . High minute ventilation . A low volume breathing circuit . High fresh gas flow . A low solubility of anesthetic to tissue . A low cardiac output . A small alveolar to venous partial pressure

Compute for the length of of ET (alveolar ridge to the tip of the tube) for 6 year old 20kg: a. 13 cm b. 14 cm c. 15 cm d. 16 cm

c. 15 cm length = (age/2) + 12

Fasting period for the following ``` Clear liquids Breast milk Infant formula Nonhuman milk Solid food Fatty or fried food ```

``` Clear liquids 2 Breast milk 4 Infant formula 6 Nonhuman milk 6 Solid food 6 Fatty or fried food 8 ```

Which of the following is a high pressure, low residual volume cuff? a. Murphy b. Magill c. Miller d. Macintosh

a. Murphy

What forceps are used in orotracheal intubation?

Magill

What is the cerebral blood flow?

50 ml/100 mg / min

The focus of history and PE is a. brain b. GI tract c. heart d. liver

c. heart

"Sniffing" position includes: a. elevate the head with pads under the occiput by 20 cms b. flex the head at the atlanto-occipital joint c. aligns the oral, pharyngeal and laryngeal axes d. all are correct

c. aligns the oral, pharyngeal and laryngeal axes

In the 2011 ASA Practice Guidelines for Preoperative Fasting a. black coffee is not an example of clear liquid b. friend rice and bacon prolongs gastric emptying time c. mild can be given to an infact up to 2 hours prior to anesthesia d. the current recommendation is that PPI can be administer routinely

b. friend rice and bacon prolongs gastric emptying time

Pre-operative visit includes the following important matters EXCEPT: a. physical status classification b. informed consent c. drug intake d. financial status

d. financial status

Metabolite of sevoflurane

acyl halide

The laryngoscope shoud be held in ____ hand and the blade inserted on the ____ side of the mouth: a. right, right b. left, left c. right, left d. left, right

d. left, right

What are the intermediate acting nondepolarizers?

Atracurium Vecorunium Mivacurium

Formula for ETT size

size = (age/4) + 4

Routine CXR is not indicated in a. presence of fever and cough in 6 month old male b. lung surgery c. 32 yo for appendectomy d. COPD pt

c. 32 yo appendectomy

Steps in chemical regulation

increase neural activity > increase cerebral metabolic rate > release glutamate > NO synthesis > cerebral vasodilation

Pre-operative medication is given in the following condition: a. out-patient b. in-patient cancer sugery c. elderly patient d. hypovolemic patient

b. in-patient cancer sugery

A 69 years old make will undergo thyroidectomy. What is the rationale for the request of the lab exam a. patient's age b. possibility of bleeding due to surgery c. presence of uti d. A and B e. aota

a. patient's age

Mallampati score when only the soft palte and base of the uvula are visible is: a. Class 1 b. Class 2 c. Class 3 d. Class 4

c. Class 3

Physiologic responses to ETT intubation include the following: a. increase in heart rate b. increase in blood presure c. increase in intracranial pressure d. all are correct

d. all are correct

What pH put pratients at risk for pulmonary aspiration

25mL residual gastric volume of pH <2.5

Match laryngoscope type to shape Jackson/Wisconsin Macintosh Miller curved straight straight with curved lip

Jackson/Wisconsin - straight Macintosh - curved Miller - straight with curved lip

Conclusion of pre-anesthetic visit to a 27 years old female with cholelithiasis EXCPET: ``` a. assign physica status of patient b write anesthetic plan c. order pre-medication d. request additional laboratory work-up d. none ```

d. request additional laboratory work-up

Basic tools of an anesthesiologist EXCEPT: a. laryngoscope b. stethoscope c. Magil's forcep d. opthalmoscope

d. opthalmoscope

How to reduce risk of PONV

``` . Avoid GA by the use of RA . Prefer propofol infusions . Avoid NO . Avoid volatiel anesthetics . Minimize perioperative opioids . Adequate hydration ```

The feature is characteristic of adult larynx: a. epiglottis is less rigid, longer and narrower b. the narrowest part is the glottis c. the angle between the glottis and epiglottis is more acute d. the aryepiglattic folds are closer to the midline

b. the narrowest part is the glottis

Fasting period before an elective surgery in an ASA I young adult should be: a. 4 hours b. 6 hours c. 8 hours d. 10 hours

c. 8 hours

Surg Anes Flashcards

(167 cards)