Anesthesia Board Question of the Day

Question 1

The therapeutic range of lithium in the plasma is between:

Answer 1

0.8 and 1.0 mEq/L

Morgan and Mikhail, pg 658

Question 2

In the fetus, the percentage of cardiac output directed to the placenta is approximately:

Answer 2

50%

Morgan and Mikhail, pg 884

Question 3

The adrenal gland, mineralocorticoids are secreted by the:

Answer 3

Zona glomerulosa

Question 4

The area of myocardium most vulnerable to ischemia is the:

Answer 4

Left Ventricular Subendocardium

Question 5

The incidence of headache with inadvetent dural puncture during epidural anesthesia is decreased:

Answer 5

With the use of fluid instead of air, for loss of resistance

Question 6

The primary causative factor in the development of persistent pulmonary hypertension (PPH) in the neonate is:

Answer 6

Hypoxemia

Question 7

The Dibucaine number:

Answer 7

Reflects inhibition of pseudocholinesterase by dibucaine

Question 8

The body mass index (BMI) associated with morbid obesity is:

Answer 8

> 40

Question 9

The body mass index (BMI) associated with overweight is:

Answer 9

> 24

Question 10

The body mass index (BMI) associated with obesity is:

Answer 10

> 30

Question 11

The body mass index (BMI) associated with super obesity is:

Answer 11

> 50

Question 12

The body mass index (BMI) associated with super super obesity is:

Answer 12

> 60

Question 13

How do you calculate body mass index:

Answer 13

Weight (kg) / Height (meter)^2 = BMI

Question 14

The most common complication of thoracic paravertebral nerve block is:

Answer 14

-PNEUMOTHORAX

Pneumothorax is the most common complication of paravertebral clock and a chest radiograph is needed upon completion of the block. Other complications include subarachnoid injection, epidural injection, intravascular injection, and hypotension.

Question 15

The incidence of chronic active hepatitis following infection with the hepatitus C virus is approximately: 
10
25
50
75

Answer 15

50%

Question 16

The incidence of chronic active hepatitis following infection with hepatitus B virus is approximately:

Answer 16

3-10%

Question 17

In the pressure-volume loop, cardiac work is best represented by:

Answer 17

-The suprerior portion of the pressure volume loop, which usually is curved.

Question 18

Current anesthesia apparatus checkout recommendations suggest to check out what before every case?

Answer 18

-Check the carbon dioxide absorber

Question 19

Concerning preoperative informed consent:

a: It should disclose only life-threatening complications
b: Charges of assault and battery are possible if it is not obtained
c: oral consent is insufficient
d: It is not necessary if the procedure is done in an office setting

Answer 19

b: Charges of assault and battery are possible if it is not obtained

Question 20

The highest incidence of muscle pain following the use of succinylcholine is seen in:

a. infants
b. octogenarians
c. outpatients
d. pregnant patients

Answer 20

-Outpatients

Question 21

The cardiovascular effets of pancuronium are caused by:

a. vagal blockade
b. stimulation of cardiac muscarinic receptor
c. ganglionic stimulation
d. decreased catacholamine reuptake
e. direct myocardial stimulation
f. blockade of cardiac slow calcium channels
g. central thalamic stimulaiton

Answer 21

a. vagal blockade
c. ganglionic stimulation
d. decreased catacholamine reuptake

Question 22

Ulnar nerve injury:

a. Results in wrist drop and loss of sensation in the web space between the thumb and index finger
b. occurs more frequently in males
c. manifests itself in the immediate postoperative period
d. is most commonly seen in the patient with a BMI of less than 38

Answer 22

b. occurs more frequently in males

Three attributes which are highly associated with development of post operative 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 with a BMI >= 38
3) prolonged postoperative bed rest

Question 23

A full term, 4.2 kg neonate is scheduled for a thoracotomy for resection of congenital lobar emphysema. The infant’s starting hematocrit is 48%. Estimated allowable blood loss to maintain a hematocrit at or above 38% is:

Answer 23

The full term neonate has approximately 85 ml/kg total blood volume. Therefore:
4.2 kg x 85 ml/kg = 357 ml (blood volume)
MABL = Blood Volume x Hct (starting) - Hct (final) /
Hct (average) : 357 mL x (48 - 38) / 43 = 83 mL

Question 24

Hormones released by the neurohypophysis include: (Select two)

Answer 24

• Oxytocin
• Arginine vasopressin

The neurohypophysis is another term for the posterior pituitary gland. The hormones of the neurohypophysis, oxytocin and arginine vasopressin (Vasopressin, ADH), are synthesized in the hypothalamus and stored in the posterior pituitary. Stimulus for the release of arginine vasopressin arises from osmoreceptors in the hypothalamus that sense an increase in plasma osmolality.

Question 25

An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic agent (MAC) is:

Answer 25

Valerian

Rationale: Both valerian and kave 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.