Anesthesia

Question 1

Plavix and ASA management periop

Answer 1

Stop both 5 days preop, continue ASA if within 6months of stent

Question 2

Sudden vfib upon induction after crush/burn/spinal cord injury, med

Answer 2

Succinylcholine

Question 3

Initial tx seizures, why

Answer 3

Ativan, more rapid onset than diazepam with longer half life than versed

Question 4

Cyanosis, hypoxia, without cardiopulmonary dysfunction, dx and tx

Answer 4

Methemoglobinemia, remove agent, O2, observe

Question 5

Succinylcholine SE

Answer 5

Malignant hyperthermia, hyperkalemia

Question 6

Ketamine SE

Answer 6

Tachycardia

Question 7

Propofol SE

Answer 7

HypoT, infusion syndrome (brady to asystole with acidosis or rhabdo in children)

Question 8

Etomidate SE

Answer 8

Adrenal insufficiency

Question 9

Meperidine SE

Answer 9

Seizures

Question 10

Perioral numbness/tingling, tinnitus, seizures, dx and tx

Answer 10

Local anesthetic toxicity, lipid emulsion therapy 1.5mL/kg 20% over 1min followed by 0.25mL/kg/min

Question 11

Most effective smoking cessation tx

Answer 11

Varenicline 4wks prior to sx

Question 12

Factors that decrease MAC

Answer 12

Older age, metabolic acidosis, hypothermia

Question 13

Initial sign of local anesthetic toxicity

Answer 13

Dizziness

Question 14

Sudden brady and mill wheel murmur, tx

Answer 14

Steep Tburg, aspirate CVC

Question 15

Tachy, arrhythmia, febrile, acidosis after induction, dx and tx

Answer 15

Malignant Hyperthermia, Dantrolene (stop anesthetic/sx and administer O2)

Question 16

Revised Cardiac Risk Index Components and score

Answer 16

Ischemic HD, CHF, CVA, DM, CKD, intraperitoneal/thoracic sx each 1pt; 3pts >11% risk cardiac death, MI, arrest

Question 17

ET tube position

Answer 17

2fm above carina 20-23cm from incisors

Question 18

Meperidine metabolism and toxic metabolite

Answer 18

Renal, Normeperidine

Question 19

Best predictor opioid toxicity

Answer 19

Respiratory rate <12

Question 20

IV anesthetic that decreases intracranial pressure, antiemetic effects, metabolized by liver

Answer 20

Propofol

Question 21

Revised Cardiac Risk Index risk factors

Answer 21

Cerebrovascular Dz
CHF
Cr >2
DM
Ischemic HD
Intraabdominal/intrathoracic sx

Question 22

Response to CO2 pneumoperitoneum; MOA

Answer 22

Bradycardia (vagal stretch)
Hypotension (decreased CO from IVC compression)

Question 23

New-onset harsh, continuous murmur intraop; next step

Answer 23

Air embolism ->Left lateral decubitus and Trendelenburg, aspirate via central line