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Comprehensive exam Spring 21 (retake) > Basic exam 1 > Flashcards

Basic exam 1 Flashcards

1
Q

What class ULBT is it when the Lower incisors cannot reach the vermilion border?

A

Class II

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2
Q

What class Mallampati is it when the soft palate and base of the uvula are visible?

A

Class III

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3
Q

What is visible for a Mallampati Class I?

A

the entire palatal arch, including the bilateral faucial pillars, are visible down to their bases.

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4
Q

What is visible for a Mallampati Class II?

A

the upper part of the faucial pillars and most of the uvula are visible.

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5
Q

What is visible for a Mallampati Class IV?

A

only the hard palate is visible.

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6
Q

Is the CRNA responsible for surgical incision?

A

No (obviously not)

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7
Q

First thing you do when you take pt. into the OR?

A

Place the pulse Ox.

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8
Q

What is the contraindication on extubating an obese patient who was a difficult intubation?

A

Deep extubation

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9
Q

Tell me the structures you pass through when doing a midline approach for an epidural?

A 
Skin
Subcutaneous Fat
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space
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10
Q

Tell me the structures you pass through when doing a midline approach for a Spinal?

A 
Skin
Subcutaneous Fat
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Dura Mater
Arachnoid membrane
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11
Q

A spinal is given and the patient has upper extremity weakness, numbness, hypotension, mydriasis, etc. An astute SRNA student would be prepared to?

A

Prepare to intubate

you have administered a high spinal it would seem

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12
Q

Conservative measures regarding treatment of a post dural puncture headache would include the following: (choose two)

A

Fluids
500mg caffeine
bed rest
analgesics

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13
Q

STOP BANG is used to assess?

A

OSA

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14
Q

Where is the subarachnoid space located?

A

Spinal space

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15
Q

The structure after supraspinous ligamentum?

A

intraspinous ligamentum

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16
Q

Name some factors that affect spinal anesthesia?

A

DOSE

type of needle

site of injection (dermatome level)

direction of the needle

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17
Q

Grandma comes in for surgery and takes xanax 2 mg TID. What do you give her?

A

give 2mg IV versed

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18
Q

A reassuring sign for an incisor distance is what?

A

equal to or greater than 3 cm in an adult

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19
Q

If you have an unsuccessful intubation attempt what is next?

A

Face mask ventilation

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20
Q

What is the most influential factor affecting the level of spinal anesthesia?

A

dosage amount (DOSE)

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21
Q

Bupivacaine 0.75% (plain) length of duration is?

A

120 minutes

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22
Q

NPO Time for infant Formula?

A

6 hours

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23
Q

The utility of a test depends on its sensitivity and specificity: (CHOOSE TWO)

A

Specific tests have a low rate of false-positive results, and Rarely identify an abnormality when one is not present.

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24
Q

What artery runs along lateral edge of the cricothyroid membrane

A

Superior thyroid artery

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25
Q

Describe what the compression during cricoid pressure is achieving in relation to the esophagus?

A

compression of the esophagus posteriorly upon the vertebrae (not the trachea)

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26
Q

Which nerves are the parasympathetic nerves?

A

III, VII, IX, X (3,7,9,10)

1973

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27
Q

How to check for laryngeal edema in PACU?

A

Suction the oral pharynx and deflate the ETT cuff to evaluate the ability to breathe around the ETT

28
Q

If your patient is shivering post-operatively which medication should be given?

A

Meperidine 12.5 mg IV

29
Q

What are the three endogenous catecholamines?

A

Epi
norepi
dopamine

30
Q

Do cholinergic drugs or anticholinergic drugs cause cardiac dysrhythmias?

A

anticholinergics

cholinergic DO NOT

31
Q

Does Robinol cause CNS depression/ toxicity?

A

No

32
Q

risk factors for PONV?

A 
Hx of PONV
Female
under the age of 50 
post op opioid use
nonsmoker
surgeries that include eye, middle ear, chole, gyno
Duration of surgery 
volatile anesthetic use
abd distention
33
Q

What can you do to assess for pharyngeal edema before extubating?

A

suction and then deflate the cuff

34
Q

How to calculate cut length of an ETT for a child?

A

age/2 then add 14 (cm)

4/2 = 2 +14 = 16cm

35
Q

How to calculate tube size for a child?

A

age/4 then add 4 (mm)

4/4 = 1 +4 =5mm

36
Q

Where is the MAC blade placed?

A

Vallecula

37
Q

BMI greater than 42 would make you what ASA status?

A

ASA 3

38
Q

Patient was drinking water, how long must you wait for surgery now?

A

2 hours

39
Q

Thyromental distance is desired to be?

A

greater than or equal to 3 FB from the mentum to the upper thyroid

40
Q

Injury after a subtotal thyroidectomy where you have hoarseness is caused by damage to (Pick 2)

A

Unilateral Recurrent Nerve Damage (Common)

Superior Laryngeal Nerve Damage (Rare)

41
Q

Laryngospasm physiologically is caused by?

A

innervation of the sensory nerve of SLN (internal SLN)

42
Q

OB epidural insertion level is?

A

L2 through L5

43
Q

How much pressure for cricoid pressure?

A

30 newtons

3-5 kg

44
Q

35 year old with A1C of 11.5 and has missed her doctor’s appointment last week. Presents to the hospital experiencing malaise, fatigue, fever. What should a vigilant SRNA do (this is an elective surgery)

A

Cancel the case after consulting with surgeon

45
Q

What are some common cardiac issues that may cause post-op complications? (choose 2)

A

Cr > 2.0

DM with insulin dependence

46
Q

What kind of patients are at risk for pulmonary complications?

A

ASA Class III

47
Q

What kind of patients are at risk for respiratory issues post-op? (choose 3)

A

Alcohol consumption

Smoking

High BMI

48
Q

When providing PPV via a facemask it is important to keep pressure below what?

A

20

49
Q

A 35 year old female informs you that she has a pseudocholinesterase deficiency. What medication
should you take out of your anesthetic plan?

A

Succinylcholine

50
Q

After a failed attempt at laryngoscopy, what should you do next according to the difficult airway algorithm?

A

BMV

51
Q

The rate of emergence from anesthesia is directly proportional to ____________ and inversely proportional to _________.

A

Alveolar ventilation

Blood solubility

52
Q

Recovery from anesthesia should be assessed when?

A

once at least 48 hours afterwards if still inpatient

53
Q

The larynx has how many cartilages?

A

9

54
Q

You are preparing to do a cricothyrotomy, the SRNA would describe the Superior thyroid artery to be found? (2)

A

Running along the lateral edge of the cricothyroid membrane.

Crossing the upper cricothyroid membrane

55
Q

A patient with unilateral recurrent laryngeal damage, this would display as?

A

paralysis of the ipsilateral vocal cord, causing deterioration in voice quality.

56
Q

Have a patient with deteriorating voice and difficulty breathing, O2 sat is dropping and is currently 90%, what are the two possible reasons for this?

A

Bilateral recurrent laryngeal nerve damage

Hypocalcemia

57
Q

Spinal cord in adults ends at?

A

L1-L2

58
Q

Why does shivering occur in relation to recovery time of specific systems?

A

The spinal cord will recover quicker than the brain.

59
Q

46 year old male who is transgender (male to female) undergoing an elective surgery, what testing is needed?

A

EKG

60
Q

Big girl who wants bigger boobies and had symptoms of DKA A1C of 11.7 and did not follow up with PCP, what do you do?

A

Consult with surgeon and cancel case

61
Q

Adult Larynx is located where?

A

C3-C6

62
Q

42 year old male having orthopedic surgery with a PMH of DVT, is he a low, medium, high or very high risk for DVT?

A

Very high risk

63
Q

What anti secretion medication does not cause CNS toxicity?

A

Robinol

64
Q 
What size LMA would you use for some who weighs the following weights?
<5kg
5-10kg
10-20kg
20-30kg
30-50kg
50-70kg
70-100kg
>100kg
A
  • 1 → <5 kg
  • 1.5 → 5-10 kg
  • 2 → 10-20 kg
  • 2.5 → 20-30 kg
  • 3 → 30-50 kg
  • 4 → 50-70 kg
  • 5 → 70-100 kg
  • 6 → >100 kg
65
Q

What medication has the greatest anti secretion effects?

A

scopolamine

66
Q

When you can see the epiglottis only what is your grade view?

A

grade III

67
Q

Increase in HR during anesthesia, what are your initial thought?

A

depth of anesthesia not adequate

what else could be increasing my HR (maybe pain)

Comprehensive exam Spring 21 (retake) (5 decks)

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