ACE 2014-11a

Question 1

Things to do within 3 hours of severe sepsis:

Answer 1

Measure lactate
Blood cultures prior to atbx
Broad spectrum atbx
30 mL/kg of crystalloid

Question 2

Plexus block to relieve visceral pelvic pain

Answer 2

Superior hypogastric plexus block

Question 3

Occurrence of spontaneous bleeding in patients with HIT

Answer 3

Rare

Question 4

Medications that induce p450 system

Answer 4

Carbamazepine
Dexamethasone
Modafinil
Omeprazole
St. John's wort

Question 5

Transfusion associated graft vs host disease occurs most commonly in what age group?

Answer 5

Patients over age 60 yrs, developing 1-6 weeks after transfusion

Question 6

Induction drug associated with increased seizure duration for ECT

Answer 6

Etomidate

Question 7

Preop test that is best predictor of post thoracotomy morbidity and mortality

Answer 7

VO2: Maximal oxygen consumption
< 12mL/kg/min = 7x risk
< 1 flight of stairs = < 10mL/kg/min
5 flights = > 20mL/kg/min

Question 8

Traditional cutoff for preop paCO2 level for pulmonary resection

Answer 8

paCO2 > 69 mmHg

Question 9

Single most important cause of morbidity and mortality in patients with subarachnoid hemorrhage who survive initial bleed

Answer 9

Delayed cerebral ischemia, presenting 3-14 days after initial bleed

Question 10

Only drug demonstrating benefit to subarachnoid hemorrhage patient

Answer 10

Nimodipine

Question 11

Adrenergic agonist that is metabolized by lungs

Answer 11

Norepinephrine

Question 12

Mechanism of fenoldopam

Answer 12

Selective dopamine type 1 receptor agonist that decreases renal vascular resistance and increases renal blood flow

Question 13

Only intervention with documented efficacy in resolving the inability to ventilate with opioid induced rigidity

Answer 13

administration of neuromuscular blocking drugs

Question 14

Single most important stimulus for hypoxic pulmonary vasoconstriction

Answer 14

PAO2, partial pressure of oxygen at the alveoli

Question 15

Drugs to treat wide complex SVT associated with WPW

Answer 15

Lidocaine, amiodarone, procainamide

Question 16

Why is aspirin contraindicated in patients with hyperthyroidism

Answer 16

It inhibits binding of thyroid hormone and can increase levels of free t4 and t3

Question 17

Conditions that increase carbon monoxide diffusion capacity

Answer 17

Exercise, asthma, polycythemia, pulmonary hemorrhage, left to right intracardiac shunting

Question 18

What causes exacerbation of multiple sclerosis (MS) symptoms?

Answer 18

Increased body temperature, emotional and physiological stress

Question 19

Pretreatment with what medication may decrease frequency of abnormal movements during induction?

Answer 19

Fentanyl

Question 20

Only consistent method to prevent dementia or postop cognitive dysfunction (POCD)

Answer 20

Identifying patients at risk preoperatively with geriatric consultation

Question 21

Cherry red colored blood occurs when carbon monoxide levels are greater than?

Answer 21

40%

Question 22

Treatment of choice for thrombotic thrombocytopenic purpura (TTP)

Answer 22

Plasma exchange

Question 23

Why is succinylcholine contraindicated with Guillain-Barré syndrome (GBS) patients?

Answer 23

Hyperkalemia risk is increased due to proliferation of post synaptic receptors

Question 24

Cyclosporine most commonly causes toxicity in what organ?

Answer 24

Kidneys