Term
| Congenital heart diseases associate with right-to-left shunting include: (Select 3) |
|
Definition
(3): tricuspid atresia, hypoplastic left heart syndrome, tetralogy of Fallot
Right-to-left shunting (cyanotic) heart disease is associated with: Tetrology of Fallot, pulmonary atresia, triscupid atresia, transposition of the great vessels, truncus arteriosus, single ventricle, double-outlet ventricle, total anomalous pulmonary venous return and hypoplastic left heart.
With tricuspid atresia, blood can flow out of the right atrium only via a patent foramen ovale (PFO). A PDA or VSD is necessary for the blood to flow from the left ventricle to the pulmonary circulation.
pg. 1181
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
The recommended maximum leakage current allowed in operating room equipment is:
A) 5 microamps
B) 10 microamps
C) 1 milliamp
D) 5 milliamps |
|
Definition
10 μA has been established as the recommended maximum allowable leakage current. This amount of current is below the threshold of perception (1mA) as well as below the threshold for risk of microshock.
pg. 192
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
|
|
Term
Causes of normal-anion-gap acidosis include:
A) renal failure
B) starvation
C) diarrhea
D) lactic acidosis |
|
Definition
Causes of normal-anion-gap acidosis include: diarrhea
Normal-anion-gap acidosis is also called hyperchloremic acidosis and results from the selective loss of bicarbonate anion or the introduction of large amounts of chloride anion. Common causes include: diarrhea, hypoaldosteronism, renal tubular acidosis and increased intake of chloride containing acids sometimes found in hyperalimentation.
pg. 461
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
|
|
Term
Carbonic anhydrase inhibitors are used in the treatment of:
A) acute glaucoma
B) renal tubular acidosis
C) diarrhea induced acidosis
D) acidosis resulting from hypoventilation |
|
Definition
Carbonic anhydrase inhibitors are used in the treatment of: acute glaucoma
Carbonic anhydrase inhibitors decrease the ability of the kidneys to reabsorb bicarbonate, resulting a hyperchloremic acidosis. As a result, carbonic anhydrase inhibitors would be avoided in patients with acidosis, especially a normal-anionic-gap acidosis. Because bicarbonate is filtered by the ciliary process in the formation of aqueous humor, carbonic anhydrase inhibitors reduce the formation of aqueous humor and can be used to decrease intraocular pressure.
pg. 1211
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
|
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Term
Hypoxemia during one-lung anesthesia is most effectively treated by:
A) PEEP applied to the ventilated lung
B) continuous oxygen insufflation to the collapsed lung
C) changing tidal volume and rate
D) periodic inflation of the collapsed lung |
|
Definition
Hypoxemia during one-lung anesthesia is most effectively treated by: periodic inflation of the collapsed lung
The application of PEEP to the ventilated lung, changes in the ventilatory parameters and oxygen insufflation to the collapsed lung may offer marginal improvement in oxygenation. However, periodic inflation of the collapsed lung with oxygen, early ligation of the ipsilateral pulmonary artery and CPAP to the collapsed lung offer consistently effective improvement in oxygenation.
pp. 678-679
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, |
|
|
Term
Sympathetic blockade during acute herpes zoster has been shown to:
A) increase analgesic requirements
B) reduce the incidence of postherpetic neuralgia
C) increase the need for corticosteroid therapy
D) be an effective treatment for patients who have had postherpetic neuralgia for a number of years |
|
Definition
Sympathetic blockade during acute herpes zoster has been shown to: reduce the incidence of postherpetic neuralgia
Sympathetic blockade within 2 months of the onset of herpes zoster has been shown to significantly reduce analgesic requirements and reduce the incidence of postherpetic neuralgia. Once the neuralgia is established however, blocks are usually ineffective.
pp. 1540-1541
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012.
pg. 407
Morgan, GE, Mikhail, MS, and Murray, MJ. Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2006. |
|
|
Term
Branches of the femoral nerve anesthetized during an ankle block include the:
A) deep peroneal nerve
B) sural nerve
C) saphenous nerve
D) posterior tibial nerve |
|
Definition
Branches of the femoral nerve anesthetized during an ankle block include the: saphenous nerve
The saphenous nerve is the only branch of the femoral nerve innervating the foot. The four remaining nerves innervating the foot, the deep peroneal nerve, the posterior tibial nerve, the sural nerve and the superficial peroneal nerve, are all branches of the sciatic nerve.
pp. 1123-1124
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
Pulmonary complications from advanced hepatic disease with cirrhosis include:
A) an obstructive ventilatory defect
B) respiratory acidosis
C) increased intrapulmonary shunting
D) increased functional residual capacity |
|
Definition
Pulmonary complications from advanced hepatic disease with cirrhosis include: increased intrapulmonary shunting
Pulmonary manifestations associated with cirrhosis include: increased intrapulmonary shunting, decreased FRC, pleural effusions, restrictive ventilatory defect and respiratory alkalosis.
pg. 774 Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic agent (MAC) is:
A) echinacea
B) valerian
C) ginkgo
D) ephedra |
|
Definition
An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic agent (MAC) is: valerian
Both valerian and kava have been shown to have a GABA-mediated hypnotic effect and by this mechanism decrease MAC. Acute withdrawal after chronic use may result in an increase in MAC.
pg. 346t
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
pg. 585
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
|
|
Term
A decrease in pseudocholinesterase activity has been associated with the use of: (Select 3)
A) pancuronium
B) esmolol
C) droperidol
D) vecuronium
E) metoclopramide
F) magnesium sulfate
G) dantrolene
H) rocuronium |
|
Definition
A decrease in pseudocholinesterase activity has been associated with the use of: pancuronium, esmolol, metoclopramide
The following drugs have been associated with a decrease in pseudocholinesterase activity: echothiophate, pyridostigmine, neostigmine, phenelzine, cyclophosphamide, metoclopramide, esmolol, pancuronium and oral contraceptives. Although both dantrolene and magnesium may alter the effects of neuromuscular blockers, neither causes inhibition of pseudocholinesterase.
pg. 207
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medica |
|
|
Term
During the delivery of an anesthetic in the radiology department, full E-cylinders of nitrous oxide and oxygen are being used. If a 3:2 mixture of nitrous oxide:oxygen is being delivered and the case has been proceeding for 60 minutes, the expected pressure in the nitrous oxide E-cylinder is:
? # psig |
|
Definition
745 - 750 psig
Nitrous oxide has a critical temperature of 37oC. This allow nitrous oxide to exist as a liquid at room temperature. Full E-cylinders of nitrous oxide contain approximately 1590 L at a pressure of 745 psig. A sixty minute delivery of 3 L/min would result in a 180 L consumption, and this would be inadequate to consume all the liquid nitrous oxide in the tank. As a result, there would be no change in tank pressure.
pg. 622
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
|
|
Term
Characteristics of human immunodeficiency virus neuropathy include: (Select 2)
A) distal polyneuropathy
B) rapid sudden onset
C) proximal muscle weakness
D) allodynia
E) upper extremities most commonly involved
F) proximal to distal progression of symptoms |
|
Definition
distal polyneuropathy, allodynia
Symptomatic neuropathy occurs in 10% to 35% of patients who are seropositive for human immunodeficiency virus (HIV). The sensory neuropathies associated with HIV include distal sensory polyneuropathy and antiretroviral toxic neuropathy (ATN) secondary to the treatment. The clinical features of HIV sensory neuropathy typically include painful allodynia and hyperalgesia. The onset is gradual and most commonly involves the lower extremities. The neuropathy and dysesthesia progress from the distal to the more proximal structures. There is minimal subjective or objective motor involvement and this is generally limited to the intrinsic muscles of the foot.
pg. 1658
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
|
|
Term
An action potential characterized by a spike followed by a plateau phase is seen in:
A) peripheral sensory nerve cells
B) peripheral motor nerve cells
C) striated skeletal muscle cells
D) cardiac muscle cells |
|
Definition
An action potential characterized by a spike followed by a plateau phase is seen in: cardiac muscle cells
In contrast to the action potentials of nerve and skeletal muscle cells, the action potential of the cardiac myocyte is characterized by a sharp spike followed by a plateau phase (2), which results from the opening of slower calcium channels.
pg. 345
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
During an open reduction of an ankle fracture a capnogram with a symmetric square waveform was obtained (pic was formerly shown). This capnogram is associated with:
A) exhaustion of the carbon dioxide absorber
B) inadequate fresh gas flow
C) inadequate minute ventilation
D) a normal ventilatory pattern |
|
Definition
During an open reduction of an ankle fracture the capnogram below was obtained. This capnogram is associated with: a normal ventilatory pattern
This is a completely normal capnogram and shows no indication of rebreathing or hypoventilation.
pg. 246
Ehrenwerth, J, Eisenkraft, JB, and Berry, JM. Anesthesia Equipment Principles and Applications. St. Louis: Elsevier, 2013. |
|
|
Term
During mediastinoscopy the risk of air embolization is greatest:
A) when the patient is supine
B) during spontaneous ventilation
C) immediately after closure of the incision
D) in the postoperative period |
|
Definition
During mediastinoscopy the risk of air embolization is greatest: during spontaneous ventilation
Air embolization is seen with mediastinoscopy as a result of the 30o elevation of the head. This risk is increased if the patient is spontaneously ventilating, secondary to the negative intrathoracic pressures generated during inhalation.
pp. 988-989
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
|
|
Term
Autonomic hyperreflexia:
A) is common with cord lesions below T8
B) can precipitate pulmonary edema
C) is not effectively prevented by regional anesthesia
D) can be prevented with adequate intraoperative sedation |
|
Definition
Autonomic hyperreflexia: can precipitate pulmonary edema
Autonomic hyperreflexia should be suspected in patients with lesions above T5-8. Regional anesthesia and deep general anesthesia are effective in preventing autonomic hyperreflexia. Surgical stimulation in these patients without adequate anesthesia can result in pulmonary edema, myocardial ischemia and cerebral hemorrhage.
pg. 927
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
During placement of a lumbar epidural using a midline approach, the needle passes through the: (Select 3)
A) interspinous ligament
B) anterior longitudinal ligament
C) intervertebral disk
D) supraspinous ligament
E) ligamentum flavum
F) facet joint |
|
Definition
During placement of a lumbar epidural using a midline approach, the needle passes through the: supraspinous ligament, interspinous ligament, ligamentum flavum
Passing anteriorly from the skin to the epidural space are the following structures: skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, ligamentum flavum.
pp. 941-942
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
|
|
Term
Interpleural analgesia can be accomplished by placing local anesthetic:
A along the cephalad border of the T6 rib
B) immediately deep to the parietal pleura C) immediately deep to the visceral pleura
D) superficial to the internal intercostal muscle |
|
Definition
Interpleural analgesia can be accomplished by placing local anesthetic: immediately deep to the parietal pleura
Interpleural analgesia is accomplished by placing an catheter between the parietal and visceral pleura. A loss-of-resistance technique is most commonly used at the T6 to T8 intercostal spaces, or the catheter can be placed under direct vision by the surgeon. Pneumothorax is a significant complication if the needle or catheter penetrates the visceral pleura.
pg. 1069
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
|
|
Term
In the CVP trace below, the v wave is caused by:
A) atrial contraction
B) ventricular contraction
C) atrial filling
D) opening of the tricuspid valve |
|
Definition
In the CVP trace below, the v wave is caused by: atrial filling
In the normal CVP tracing, the a wave is due to atrial systole. The c wave coincides with ventricular contraction. The v wave is the result of atrial filling prior to the opening of the tricuspid valve. The x descent is thought to be due to the pulling down of the atrium by ventricular contraction. The y descent corresponds to the opening of the tricuspid valve.
pp. 298-300
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
The synthesis of acetylcholine from acetylcoenzyme A and choline is catalyzed by:
A) free acetate anion
B) choline acetyltransferase
C) acetyl cholinesterase
D) pseudocholinesterase |
|
Definition
The synthesis of acetylcholine from acetylcoenzyme A and choline is catalyzed by: choline acetyltransferase
The synthesis of acetylcholine occurs in the cholinergic nerve terminal. Acetyl Co-A and choline combine to form acetylcholine. This reaction is catalyzed by the enzyme choline acetyltransferase.
pg. 819
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
The primary causative factor in the development of persistent pulmonary hypertension (PPH) in the neonate is:
A) cystic fibrosis
B) pregnancy-induced hypertension
C) hypoxemia
D) right-to-left shunting through a patent ductus arteriosus |
|
Definition
The primary causative factor in the development of persistent pulmonary hypertension (PPH) in the neonate is: hypoxemia
Hypoxia or acidosis during the early neonatal period may predispose the infant to return to fetal circulation. This serious condition, previously known as persistent fetal circulation (PFC), is currently known as persistent pulmonary hypertension (PPH). Hypoxemia and/or acidosis promotes an increase in pulmonary vascular resistance which ultimately causes right to left shunting through the ductus arteriosus, foramen ovale, or both. Shunting causes continued hypoxemia, leading to a continued increase in pulmonary vascular resistance, and a vicious cycle ensues. Primary causes of hypoxemia in the neonate include pneumonia and meconium aspiration.
pp. 1163-1164
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
Electrocardiographic changes seen with hypokalemia include:
A) peaked T waves
B) increasingly prominent U waves
C) shortened PR interval with P wave inversion
D) decreased QRS amplitude |
|
Definition
Electrocardiographic changes seen with hypokalemia include: increasingly prominent U waves
Electrocardiographic changes seen with hypokalemia include:
T wave flattening/inversion
ST segment depression
increased P wave amplitude
prolongation of the P-R interval
increasingly prominent U waves
pg. 378, 1712
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013.
pg. 1125
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Deleterious effects of hypothermia include: (Select 2)
impaired renal function
right shift of the hemoglobin-oxygen saturation curve
irreversible platelet dysfunction
increased incidence of wound infection
increased postoperative protein anabolism |
|
Definition
Deleterious effects of hypothermia include: impaired renal function, increased incidence of wound infection
Deleterious effects of hypothermia include:
increased PVR
left shift of the hemoglobin-oxygen saturation curve
reversible platelet dysfunction
postoperative protein catabolism
altered mental status
impaired renal function
decreased drug metabolism
poor wound healing
increased incidence of infection
cardiac arrhythmias
pp. 1235-1236
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
Prior to pneumonectomy, split lung function testing is indicated in the patient with:
A) an FEV1 of 2.2 L
B) a PaCO2 of 49 mm Hg on room air
C) a PaO2 of 54 mm Hg on room air
D) a maximum VO2 of 21 mL/kg/min |
|
Definition
Prior to pneumonectomy, split lung function testing is indicated in the patient with: a PaCO2 of 49 mm Hg on room air
Split lung function testing is indicated in patients requiring pneumonectomy, but not meeting the recommended laboratory criteria. Current recommendations for patients requiring pneumonectomy are:
PaCO2 < 45 mm Hg
FEV1 > 2 L
Predicted postop FEV1 > 800 mL
Maximum VO2 > 15 mL/kg/min
FEV1/FVC > 50% of predicted
pp. 663-665
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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|
Term
Postintubation croup:
is secondary to inflammation of subglottic structures
is less common when cuffed endotracheal tubes are used
occurs most frequently in infants less than 4 months of age
is most often seen immediately upon extubation |
|
Definition
Postintubation croup: is secondary to inflammation of subglottic structures
Postintubation croup usually occurs at the level of the cricoid, since this is the narrowest part of the pediatric airway. Croup is less common with endotracheal tubes that are uncuffed and small enough to allow a gas leak at 10 - 25 cm H2O. Postintubation croup is associated with early childhood (1 - 4 years). Unlike laryngospasm, postintubation croup is seen some time after extubation, usually within 3 hours.
pp. 463-464
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
pg. 1231
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
|
|
Term
Closing capacity is defined as:
closing volume + expiratory reserve volume
functional residual capacity - residual volume
closing volume + residual volume
residual volume + expiratory reserve volume |
|
Definition
Closing capacity is defined as: closing volume + residual volume
Closing capacity is the lung volume at which airways begin to close and is defined as the closing volume + residual volume.
pg. 497
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
|
|
Term
Renal effects of nitrous oxide include:
decreased renal blood flow secondary to decreased cardiac output
decreased renal blood flow secondary to increased renal vascular resistance
increased renal blood flow secondary to sympathetic stimulation
increased glomerular filtration with increased reabsorption |
|
Definition
Renal effects of nitrous oxide include: decreased renal blood flow secondary to increased renal vascular resistance
Nitrous oxide appears to decrease renal blood flow by increasing renal vascular resistance. This results in decreased glomerular filtration and decreased urine output.
pg. 167
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
|
|
Term
The elimination half-life of a drug:
- is inversely proportional to the clearance
- is inversely proportional to the volume of distribution
- is directly proportional to clearance
- is shortest in drugs that are rapidly redistributed |
|
Definition
The elimination half-life of a drug: is inversely proportional to the clearance
The elimination half-life of a drug is proportional to the volume of distribution and inversely proportional to the rate of clearance.
pg. 165
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
|
|
Term
Correct statements concerning the use of antidepressants in pain management include:
analgesic effects require a higher dose than that needed for antidepression
analgesic effects appear to be secondary to the blockade of serotonin and norepinephrine reuptake
antidepressants are not effective in neuropathic pain
newer SSRIs are more effective analgesics than the older tricyclic antidepressants |
|
Definition
Correct statements concerning the use of antidepressants in pain management include: analgesic effects appear to be secondary to the blockade of serotonin and norepinephrine reuptake
Antidepressants demonstrate an analgesic effect at doses lower that those needed for antidepressant effect. Both actions appear secondary to the block of the reuptake of serotonin and norepinephrine. Older tricyclic antidepressants seem more effective analgesics than the newer SSRIs. Antidepressants are most useful in patients with neuropathic pain.
pg. 1055
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
|
|
Term
The body mass index (BMI) associated with morbid obesity is:
> 30
> 35
> 40
> 45 |
|
Definition
The body mass index (BMI) associated with morbid obesity is: > 40
Overweight and obesity are classified using the BMI. Overweight is defined as a BMI > 24, obesity as a BMI > 30, morbid obesity as a BMI > 40, super obesity as a BMI > 50 and super-super obesity as a BMI > 60. BMI is calculated with the following formula:
BMI = Weight (kg) / Height (meters)2
pg. 1050
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
The number of dichotomous divisions of the tracheobronchial tree from the trachea to the alveolar sacs is approximately:
(Enter numerical answer in box below. Click 'Next' when completed.)
divisions |
|
Definition
The number of dichotomous divisions of the tracheobronchial tree from the trachea to the alveolar sacs is approximately: 20 - 25
Dichotomous division, each branch dividing into two smaller branches, of the tracheobronchial tree is estimated to involve 20 - 25 divisions.
pg. 593
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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Term
A 42-year-old man is undergoing a thoracoscopy. During the procedure an 8-minute period of apneic oxygenation is required. If the patient's PaCO2 is 40 mm Hg, the expected PaCO2 at the end of the apneic period would be:
(Enter numerical answer in box below. Click 'Next' when completed.)
? mm Hg |
|
Definition
A 42-year-old man is undergoing a thoracoscopy. During the procedure an 8-minute period of apneic oxygenation is required. If the patient's PaCO2 is 40 mm Hg, the expected PaCO2 at the end of the apneic period would be: 67 to 74 mm Hg
The apneic oxygenation technique affords adequate oxygen delivery, but progressive respiratory acidosis limits the use of this technique to 10 - 20 minutes in most patients. Arterial PaCO2 rises 6 mm Hg in the first minute followed by a rise of 3 - 4 mm Hg during each subsequent minute. In this patient this will produce a 27 - 34 mm Hg increase, resulting in a PaCO2 of 67 to 74 mm Hg.
pg. 561
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
|
|
Term
The essential component of cardioplegia solutions is:
mannitol
magnesium
potassium
corticosteroid |
|
Definition
Your response is correct.
The essential component of cardioplegia solutions is: potassium
High concentrations of potassium (20 - 30 mEq/L) are used in cardioplegia solutions. These solutions result in an increase in extracellular potassium and reduce transmembrane potential. This progressively interferes with the normal sodium currents of depolarization and eventually the sodium channels are completely inactivated.
pg. 519
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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|
Term
During an anterior-posterior spinal fusion, in a 70-kg patient, the laboratory reports an intraoperative hematocrit of 21% with a hemoglobin of 7g/dL. Two units of packed red blood cells are administered over the course of 30 minutes. Upon completion of the transfusion, the anticipated hematocrit will be approximately:
(Enter numerical answer in box below. Click 'Next' when completed.)
% |
|
Definition
During an anterior-posterior spinal fusion, in a 70-kg patient, the laboratory reports an intraoperative hematocrit of 21% with a hemoglobin of 7g/dL. Two units of packed red blood cells are administered over the course of 30 minutes. Upon completion of the transfusion, the anticipated hematocrit will be approximately:
(Enter numerical answer in box below. Click 'Next' when completed.) 25 - 27%
A commonly used rule of thumb states that each unit of PRBCs increases the hemoglobin 1 g/dL and the hematocrit 2% to 3%.
pg. 396
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2013. |
|
|
Term
During an anterior-posterior spinal fusion, in a 70-kg patient, the laboratory reports an intraoperative hematocrit of 21% with a hemoglobin of 7g/dL. Two units of packed red blood cells are administered over the course of 30 minutes. Upon completion of the transfusion, the anticipated hematocrit will be approximately:
(Enter numerical answer in box below. Click 'Next' when completed.)
% |
|
Definition
During an anterior-posterior spinal fusion, in a 70-kg patient, the laboratory reports an intraoperative hematocrit of 21% with a hemoglobin of 7g/dL. Two units of packed red blood cells are administered over the course of 30 minutes. Upon completion of the transfusion, the anticipated hematocrit will be approximately:
(Enter numerical answer in box below. Click 'Next' when completed.) 25 - 27%
A commonly used rule of thumb states that each unit of PRBCs increases the hemoglobin 1 g/dL and the hematocrit 2% to 3%.
pg. 396
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2013. |
|
|
Term
A 46-year-old male is scheduled for an emergent laparotomy for small bowel obstruction. His history is complicated by the acute onset of hepatitis B four days earlier and he presents with significant scleral jaundice. The perioperative mortality in this patient is approximately:
2%
5%
10%
25% |
|
Definition
Your response is incorrect.
A 46-year-old male is scheduled for an emergent laparotomy for small bowel obstruction. His history is complicated by the acute onset of hepatitis B four days earlier and he presents with significant scleral jaundice. The perioperative mortality in this patient is approximately: 10%
Patients with acute hepatitis should have elective surgery postponed until the acute hepatitis has resolved. Studies indicate increased perioperative morbidity (12%) and mortality (10% with laparotomy) during acute hepatitis.
pp. 1315-1316
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Factors increasing the affinity of hemoglobin for oxygen include: (Select 2)
increased carbon dioxide levels
increased 2,3-DPG levels
increased pH
the presence of fetal hemoglobin
increased body temperature
the presence of hemoglobin-S |
|
Definition
Factors increasing the affinity of hemoglobin for oxygen include: increased pH, presence of fetal hemoglobin
Factors that increase the affinity of hemoglobin for oxygen would cause a leftward shift of the hemoglobin dissociation curve and a decrease in the P50. These factors include alkalosis, decreased CO2 levels, and decreased 2,3-DPG levels. Hemoglobin-S, found in patients with sickle cell disease, has a decreased affinity for oxygen. Fetal hemoglobin, however, has an increased affinity for oxygen to help in oxygen transfer from the mother to the fetus.
Download CoreNotes
pp. 603-604
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
|
|
Term
The maximum recommended occupational whole-body exposure to radiation is:
1 rem/year
5 rem/year
10 rem/year
20 rem/year |
|
Definition
The maximum recommended occupational whole-body exposure to radiation is: 5 rem/year
The intraoperative use of imaging equipment exposes anesthesia providers to ionizing radiation. The maximum recommended whole-body exposure to radiation is 5 rem/year.
pg. 65
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Absolute contraindications to the use of epidural anesthesia in the parturient include: (Select 2)
inability of the patient to cooperate
herniated lumbar disc
multiple sclerosis
patient refusal
history of previous cesarean section
aortic regurgitation |
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Definition
Absolute contraindications to the use of epidural anesthesia in the parturient include: inability of the patient to cooperate, patient refusal
Absolute contraindications to epidural anesthesia/analgesia in the parturient include infection over the injection site, coagulopathy, thrombocytopenia, marked hypovolemia, true local anesthetic allergy, patient refusal and inability of the patient to cooperate. Preexisting neurological disease and back disorders are relative contraindications. Patients with aortic regurgitation usually benefit from the reduction in afterload seen after neuraxial anesthesia.
pg. 849
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Physiologic derangements seen in the patient with scleroderma include:
(Select 3)
pulmonary hypertension
esophageal dysmotility
excessive oral secretions and salivation
myocardial fibrosis
hypotension
spastic quadraparesis |
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Definition
Physiologic derangements seen in the patient with scleroderma include: pulmonary hypertension, esophageal dysmotility, myocardial fibrosis
Scleroderma is an autoimmune disease with multi-organ involvement. It is characterized by excessive deposition of collagen and subsequent fibrosis of the skin and internal organs. Manifestations are most evident in the skin, but pulmonary, cardiac, vascular and renal involvement may also be present. Patients with scleroderma are frequently difficult intubations and are at high risk for aspiration. Systemic hypertension from renal disease is very common. Xerostomia and decreased lacrimation are a result of exocrine gland involvement.
pg. 636
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
An increase in the plasma concentration and a prolongation of the elimination half-life of etomidate is seen with the concomitant administration of:
midazolam
rocuronium
fentanyl
succinylcholine |
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Definition
An increase in the plasma concentration and a prolongation of the elimination half-life of etomidate is seen with the concomitant administration of: fentanyl
Fentanyl has been shown to increase the plasma level of etomidate as well as prolong the elimination half-life of the drug.
Download CoreNotes
pg. 185
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Disodium edetate or sodium metabisulfite is added to formulations of propofol to:
enhance drug solubility
adjust pH
inhibit bacterial growth
increase drug potency |
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Definition
Disodium edetate or sodium metabisulfite is added to formulations of propofol to: inhibit bacterial growth
Current formulations of propofol contain 0.005% disodium edetate or 0.025% sodium metabisulfite to help retard the rate of microorganism growth.
pg. 186
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
During emergent transtracheal jet ventilation using a 14 gauge catheter, generation of sufficient gas flow requires a driving pressure of:
20 cmH2O
50 cmH2O
25 psi
50 psi |
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Definition
During emergent transtracheal jet ventilation using a 14 gauge catheter, generation of sufficient gas flow requires a driving pressure of: 50 psi
After proper location of the catheter is confirmed by aspiration air, jet ventilation may be achieved with intermittent pulses of oxygen at 50 psi.
pg. 1237
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Sensory innervation of the trachea and larynx below the vocal cords is supplied by the:
internal laryngeal nerve
external laryngeal nerve
recurrent laryngeal nerve
glossopharyngeal nerve |
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Definition
Sensory innervation of the trachea and larynx below the vocal cords is supplied by the: recurrent laryngeal nerve
The vagus nerve provides sensation to the airway below the epiglottis. The superior laryngeal branch of the vagus divides into an external (motor) and internal (sensory) laryngeal nerve that provide sensory supply to the larynx between the epiglottis and the vocal cords. Another branch of the vagus, the recurrent laryngeal nerve, innervates the larynx below the vocal cords and trachea.
pg. 310
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
A 24-year-old female is scheduled for resection of a cerebral aneurysm. She has no other significant past medical history. Acceptable levels of hypotension would include a mean arterial pressure of:
20 - 30 mm Hg
35 - 45 mm Hg
50 - 60 mm Hg
90 - 100 mm Hg |
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Definition
A 24-year-old female is scheduled for resection of a cerebral aneurysm. She has no other significant past medical history. Acceptable levels of hypotension would include a mean arterial pressure of: 50 - 60 mm Hg
Healthy young individuals tolerate mean arterial pressures as low as 50 - 60 mm Hg without complications. Chronically hypertensive patients have altered autoregulation of cerebral blood flow and may tolerate a mean arterial pressure of no more than 20 - 30% below baseline.
pg. 262
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Correct statements concerning the use of benzodiazepines in the elderly include:
volume of distribution is increased
reduced pharmacodynamic sensitivity is observed
the elimination half-life of diazepam, but not midazolam, is increased
all of the above |
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Definition
Correct statements concerning the use of benzodiazepines in the elderly include: volume of distribution is increased
Aging increases the volume of distribution for all benzodiazepines, effectively prolonging their elimination half-lives. Enhanced pharmacodynamic sensitivity is also observed. The elimination half-lives of both diazepam and midazolam are increased.
pg. 895
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Concerning preoperative informed consent:
it should disclose only life-threatening complications
charges of assault and battery are possible if it is not obtained
oral consent is insufficient
it is not necessary if the procedure is done in an office setting |
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Definition
Concerning preoperative informed consent: charges of assault and battery are possible if it is not obtained
Any procedure performed without the patient's consent can constitute assault and battery. Oral consent may be sufficient, but written consent is advisable for medicolegal purposes. It is generally accepted that not all risks need to be detailed, but risks that are realistic and have resulted in complications in similar patients should be disclosed.
pp. 29-30
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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Term
The National Institute for Occupational Safety (NIOSH) recommends limiting the operating room concentration of nitrous oxide to:
0.5 ppm
5 ppm
25 ppm
50 ppm |
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Definition
The National Institute for Occupational Safety (NIOSH) recommends limiting the operating room concentration of nitrous oxide to: 25 ppm
NIOSH recommends limiting the room concentration of nitrous oxide to 25 ppm and halogenated agents to 2 ppm (0.5 ppm if nitrous oxide is also being used).
pp. 652-654
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012. |
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Term
The highest incidence of muscle pain following the use of succinylcholine is seen in:
infants
octogenarians
outpatients
pregnant patients |
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Definition
The highest incidence of muscle pain following the use of succinylcholine is seen in: outpatients
Myalgia following the use of succinylcholine is most commonly seen in females and outpatients. Pregnancy and extremes of age seem to be protective.
pg. 532
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
The cardiovascular effects of pancuronium are caused by: (Select 3)
vagal blockade
stimulation of cardiac muscarinic receptors
ganglionic stimulation
decreased catacholamine reuptake
direct myocardial stimulation
blockade of cardiac slow calcium channels
central thalamic stimulation |
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Definition
The cardiovascular effects of pancuronium are caused by: vagal blockade, ganglionic stimulation, decreased catecholamine reuptake
The cardiovascular effects of pancuronium are caused by the combination of vagal blockade and sympathetic stimulation. The latter is due to a combination of ganglionic stimulation, catecholamine release and decreased catecholamine reuptake.
pg. 537
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013.
pg. 217
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Anesthetic implications of multiple sclerosis include:
exacerbation induced by spinal anesthesia
exacerbation induced by epidural anesthesia
exacerbation of symptoms secondary to hypothermia
the presence of significant peripheral neuropathy causing severe hyperkalemia after succinylcholine administration |
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Definition
Anesthetic implications of multiple sclerosis include: exacerbation induced by spinal anesthesia
Spinal anesthesia has been reported to cause exacerbation of the disease. Epidural and other regional techniques appear to have no adverse effect, especially in obstetrics; however a lower concentration of local anesthetic should be used. Demyelinated nerve fibers are extremely sensitive to hyperthermia, but conduction is usually improved by mild hypothermia.
pg. 619
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Local anesthetics with the potential to form methemoglobin include: (Select 3)
EMLA topical anesthetic cream
bupivacaine
benzocaine
ropivacaine
prilocaine
mepivacaine |
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Definition
Local anesthetics with the potential to form methemoglobin include: EMLA topical anesthetic cream, prilocaine, benzocaine
EMLA cream contains both lidocaine and prilocaine. The metabolites of prilocaine can convert hemoglobin to methemoglobin. Benzocaine can also cause methemoglobinemia.
pg. 140
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
"Methemoglobin Risk with Benzocaine Containing Local Anesthetics"
URL: http://www.upstate.edu/uha/pharmacy/newsletters/kidstuff_06/kidstuff_05_06.pdf |
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Term
Ulnar nerve injury:
results in wrist drop and loss of sensation in the web space between the thumb and index finger
occurs more frequently in males
manifests itself in the immediate postoperative period
is most commonly seen in the patient with a BMI of less than 18 |
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Definition
Ulnar nerve injury: occurs more frequently in males
Three attributes which are highly associated with development of postoperative ulnar nerve injury are:
1) male sex - various reports suggest that 70 - 90% of patients with postoperative ulnar neuropathy are men
2) high body mass index - BMI > or = 38
3) prolonged postoperative bed rest.
Many patients with postoperative ulnar neuropathy have a high frequency of contralateral ulnar nerve dysfunction, suggestive of a pre-existing abnormality. Patients may not develop symptoms of ulnar neuropathy until more than 48 hours postoperatively. Wrist drop and loss of sensation of the web space between the thumb and index finger are associated with radial nerve injury.
pp. 809-810
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
The potency of local anesthetics increases as the:
lipid solubility increases
pKa increases
number of double bonds in the anesthetic molecule increases
molecular weight decreases |
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Definition
The potency of local anesthetics increases as the: lipid solubility increases
Local anesthetic potency correlates directly with lipid solubility. In general, lipid solubility increases with an increase in the total number of carbon atoms in the molecule and by adding a halogen to the aromatic ring.
pg. 129
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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Term
The age group with the highest minimum alveolar concentration (MAC) of desflurane is:
2 - 3 months
1 - 2 years
25 - 30 years
greater than 75 years |
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Definition
The age group with the highest minimum alveolar concentration (MAC) of desflurane is: 2 - 3 months
The two-to-three-months-of-age group represents the highest MAC requirement. MAC subsequently decreases with advancing age.
pg. 883
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
The loss of ventricular filling as a result of acute atrial fibrillation is approximately:
(Enter numerical answer in box below. Click 'Next' when completed.)
% |
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Definition
The loss of ventricular filling as a result of acute atrial fibrillation is approximately:
(Enter numerical answer in box below. Click 'Next' when completed.) 15-25%
Passive flow accounts for about 75 - 85% of ventricular filling. The remaining 15 - 25% occurs as a result of atrial contraction, which is lost during atrial fibrillation.
pg. 249
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
During surgical repair of a detached retina, 1 mL of sulfur hexafluoride is injected into the posterior chamber. If the patient is receiving 4% desflurane and a 2:1 ratio of N2O and O2, the pressure-volume relationship of the bubble will approximately:
decrease by one third
remain the same
double
triple |
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Definition
During surgical repair of a detached retina, 1 mL of sulfur hexafluoride is injected into the posterior chamber. If the patient is receiving 4% desflurane and a 2:1 ratio of N2O and O2, the pressure-volume relationship of the bubble will approximately: triple
A sulfur hexafluoride gas bubble is sometimes used to support the retina after detachment. Diffusion of nitrous oxide into the bubble will cause expansion as nitrous oxide equilibrates with the gas bubble. A sixty-seven percent nitrous oxide concentration will cause the bubble to triple in its pressure-volume relationship in about 30 minutes and may double the intraocular pressure (IOP). In addition, when nitrous oxide is discontinued, the bubble will return to normal size, causing a fall in IOP and possible extension of the retinal tear. For these reasons, it is recommended that nitrous oxide be discontinued at least 15 minutes prior to the injection of a posterior chamber bubble.
pg. 762
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Topically applied ophthalmic medications are absorbed:
as quickly as intravenous administration
more quickly than subcutaneous administration
only minutely, with insignificant clinical effect
directly into the central nervous system through the optic nerve foramen |
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Definition
Topically applied ophthalmic medications are absorbed: more quickly than subcutaneous administration
Topically applied ophthalmic medications are absorbed at a rate intermediate between intravenous and subcutaneous injection. Children and the elderly are at particular risk for the toxic effects of topically applied medications.
pg. 762
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Correct location of the catheter tip of a central venous line is in the:
superior vena cava
right atrium
right ventricle
pulmonary artery |
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Definition
Correct location of the catheter tip of a central venous line is in the: superior vena cava
The CVP catheter tip should not be allowed to migrate into the heart chamber to avoid arrhythmias and perforation.
pg. 103
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
The rhythm strip below is indicative of:
first degree block
second degree block, type I
second degree block, type II
bifascicular block |
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Definition
The rhythm strip below is indicative of: second degree block, type I
Second degree block, type I, shows a progressive lengthening of the PR interval with each cycle until a QRS complex is dropped. This type of block indicates AV nodal disease and associated bradycardia usually responds to the administration of atropine.
Download CoreNotes
pg. 1704
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Physiologic effects of electroconvulsive therapy (ECT) include an:
initial sympathetic response with sustained tachycardia
initial sympathetic discharge followed by a sustained parasympathetic response
initial parasympathetic discharge followed by a sustained sympathetic response
initial parasympathetic response with sustained bradycardia |
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Definition
Your response is incorrect.
Physiologic effects of electroconvulsive therapy (ECT) include an: initial parasympathetic discharge followed by a sustained sympathetic response
An initial parasympathetic discharge followed by a sustained sympathetic response is immediately seen after the induction of a seizure. Marked bradycardia with increased secretions can occur, which is then followed by hypertension and tachycardia. Patients scheduled for ECT are routinely given anticholinergic medication preoperatively.
pg. 1277
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014. |
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Term
Submit
A 76-year-old man is scheduled for a hemicolectomy. His past medical history is significant for third degree heart block treated with a permanent pacemaker. Problems with electrocautery use in this patient can be minimized by:
placing the grounding pad near the pacemaker
using infrequent bursts of longer duration
the use of a bipolar cautery
reducing the surface area of the return electrode |
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Definition
A 76-year-old man is scheduled for a hemicolectomy. His past medical history is significant for third degree heart block treated with a permanent pacemaker. Problems with electrocautery use in this patient can be minimized by: the use of a bipolar cautery
Electrical interference from the electrocautery can be interpreted by the pacemaker as myocardial activity and suppress pacemaker activity. These problems can be minimized by limiting use to short bursts, placing the grounding pad as far from the pacemaker as possible and using a bipolar cautery.
pg. 403
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
Submit
The most severe transfusion reactions are due to:
ABO incompatibility
Rh incompatibility
febrile reactions
non-ABO hemolytic reactions |
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Definition
The most severe transfusion reactions are due to: ABO incompatibility
The most severe transfusion reactions are due to ABO incompatibility. Naturally acquired antibodies can react against the transfused antigens, activate complement and result in intravascular hemolysis.
pg. 1172
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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Term
The perception of an ordinarily non-noxious stimulus as pain is referred to as:
allodynia
anesthesia dolorosa
dysesthesia
hyperalgesia |
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Definition
The perception of an ordinarily non-noxious stimulus as pain is referred to as: allodynia
Allodynia is the perception of non-noxious stimuli as pain. Dysesthesia is an unpleasant sensation without a stimulus. Hyperesthesia is an increased response to a mild stimulus. Anesthesia dolorosa is pain in an area that lacks sensation.
pp. 1649-1650
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Cholinesterase inhibitors that freely cross the blood-brain barrier include:
neostigmine
pyridostigmine
physostigmine
edrophonium |
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Definition
Cholinesterase inhibitors that freely cross the blood-brain barrier include: physostigmine
Physostigmine is a teritary amine and has a carbamate group, but no quaternary ammonium. Therefore, it is lipid soluble and is the only clinically available cholinesterase inhibitor that freely passes the blood-brain barrier.
pg. 383
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
The effects of barbiturates on ischemic areas of the brain include:
vasoconstriction
vasodilation
redirection of blood flow to the ischemic areas
redirection of blood flow away from ischemic areas |
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Definition
The effects of barbiturates on ischemic areas of the brain include: redirection of blood flow to the ischemic areas
Barbiturates cause cerebral vasoconstriction in normal areas. These agents tend to redistribute blood flow to ischemic areas in what is sometimes referred to as a reverse steal phenomenon or Robin Hood effect. Ischemic areas remain maximally dilated and unaffected by the barbiturate.
pg. 485
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
In patients with a history of hypertrophic cardiomyopathy, intraoperative management should include:
a nitroglycerine infusion
inotropic support
afterload reduction
maintenance of adequate preload |
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Definition
In patients with a history of hypertrophic cardiomyopathy, intraoperative management should include: maintenance of adequate preload
In patients with outflow obstruction, myocardial depression and maintenance of preload and afterload are desirable.
Download CoreNotes
pp. 1083-1084
Barash, PG, Cullen, BF, Stoelting, RK, Cahalan, MK, Stock, MC, and Ortega, R. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2013. |
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Term
Correct statements regarding cerebral metabolism include:
the brain can only utilize glucose as an energy source
forty percent of brain glucose consumption is anaerobically metabolized
hyperglycemia can reduce the damage from focal hypoxic injury
the adult brain consumes approximately 50 ml/min of oxygen |
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Definition
Correct statements regarding cerebral metabolism include: the adult brain consumes approximately 50 ml/min of oxygen
The adult brain consumes about 20% of the total body oxygen (50 ml/min). Neuronal cells normally utilize glucose as their energy source, but can also utilize ketone bodies and lactate. Hyperglycemia has been shown to worsen global and focal hypoxic brain injury.
pg. 576
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division, 2013. |
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