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Clinical Entrance Exam > basics exam 1 > Flashcards

basics exam 1 Flashcards

1
Q

Lower incisors cannot reach the vermillion border.

name test and class

A

UBLT (upper bite lip test)

Class II

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2
Q

The soft palate and base of the uvula are visible.

Name test and class

A

Mallampati Test

Class III

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3
Q

CRNA responsible for a lot of things, but what are we NOT responsible for:

A

surgical incision

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4
Q

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

A

put on the pulse ox

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5
Q

what is the contraindication on extubating an obese patient who was difficult to intubate?

A

deep extubation

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6
Q

which structures does the needle follow after the ligamentum flavum in a spinal?

A

Dura Mater

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7
Q

A spinal is given and the pt has UE weakness, numbness, hypotension, mydriasis, etc.. An astute SRNA student would be prepared to:

A

INTUBATE

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8
Q

Conservative measures regarding tx of post dural puncture headache would include the following: (2)

A

Fluids
500 mg caffeine

(bed rest)

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9
Q

STOP BANG is used to assess:

A

OSA

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10
Q

Where is the subarachnoid space located?

A

spinal space

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11
Q

the structure after supraspinous ligamentum:

A

interspinous ligamentum

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12
Q

Factors affecting spinal anesthesia include:

A
  • DOSE
  • Needle type (“pencil-point” sprotte/whitacre , 25ga needle)
  • SITE of injection
  • the direction of the needle

(Patient characteristics: ht, position, gender; LA characteristics/baricity; vol of CSF)

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13
Q

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

A

2mg IV Versed

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14
Q

What is a reassuring sign of the intercisor test?

A

reassuring is equal or greater than 3

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15
Q

If you have an unsuccessful intubation attempt, what is next (as long as pt is stable):

A

Face mask ventilation

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16
Q

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

A

DOSAGE

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17
Q

Bupivacain 0.75% (plain) length of duration is:

A

120 mins

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18
Q

Ester action is prolonged in patients with atypical pseudocholinesterase and may cause hypersensitivity d/t the metabolic end product of ester called Paraaminobenzoic acid.

(Identify the esters)

A

Procaine
Chloroprocaine
Tetracaine

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19
Q

NPO time for infant formula:

A

6 hours

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20
Q

The utility of a test depends on its sensitivity and specificity:

*this was a select two but I think the dump got some things flip flopped.

A

SENSITIVE tests: have a low rate of false-positive results and rarely identify an abnormality when one is present.

SPECIFIC tests: have a low rate of false-positive results and rarely identify an abnormality when one is not present.

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21
Q

Runs along the lateral edge of the cricothyroid membrane:

A

Superior thyroid artery

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22
Q

Dermatome for Nipple line:

A

T4

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23
Q

Dermatome for Umbillicus:

A

T10

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24
Q

Which constituents of fluid are identical but vary in quantity (choose 3):

A
  • Plasma
  • Interstitial fluid
  • Intracellular fluid
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25
Q

Cricoid pressure is when (describe)

A

Compressing the esophagus back to the vertebrae (not the trachea)

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26
Q

Which nerves are the Parasympathetic nerves?

A

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

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27
Q

How do you 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

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28
Q

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

A

Meperidine 12.5 IV

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29
Q

What is not an endogenous catecholamine?

A

Dobutamine

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30
Q

Multimodal approach to perioperative therapy includes all of the following EXCEPT:

this question is pertains to spinal over GA or a combo use. Week 3 ppt

A

enhance the perioperative stress response

  • REDUCED stress response to surgery is an advantage.
  • also: Less blood loss, incidence of DVT, pulm/ cardiac complications, and better in ob b/c less meds to mother/fetus
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31
Q

Drugs that do NOT cause CNS depression/toxicity?

A

Cholinergic

anitcholinergic, hypothermia, pain will

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32
Q

Which patient is the most at risk for post op delirium?

A

17 yr old deaf male

  • also includes PTSD, dementia
33
Q

Which of the following does not cause CNS depression/toxicity?

A

Glycopyrrolate (robinol)

34
Q

Which of the following is at most risk of PONV?

A

<50 years old

  • female
  • hx of PONV
  • opioid use
  • motion sickness
35
Q

To assess for pharyngeal edema before extubating?

A

suction and then deflate the cuff

36
Q

Formula for ETT size =

A

[Age+ 4 ] / 4

37
Q

Formula for Cut Length =

A

[Age + 14] / 2

38
Q

Where is the MAC blade placed?

A

Vallecula

39
Q

ASA score for pt with BMI > 42

A

ASA 3

40
Q

Patient just told you they had some water before surgery, what do you do?

A

Wait 2 hours

41
Q

Thyromental distance is?

A

Greater than or equal to 3 fingerbreadths from the mentum to the upper thyroid

42
Q

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

A
  1. unilateral recurrent nerve damage (common)

2. Superior laryngeal nerve damage (rare)

43
Q

A laryngospasm is?

A

innervation of the sensory nerve of SLN (superior laryngeal nerve)
- internal SLN

44
Q

Cholinergics do not increase risk of

A

dysrhythmias

45
Q

OB Level of insertion:

A

L2-L5

46
Q

ASA for a moribound patient:

A

ASA 5

47
Q

How much pressure is required when performing Cricoid pressure?

A

30 newtons

48
Q

What is another name for cricoid pressure?

A

Sellick Maneuver

49
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?

A

Cancel the case after consulting with surgeon

*this is elective

50
Q

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

A
  1. Cr >2

2. DM with insulin dependence

51
Q

What ASA class is associated with a higher risk for pulmonary complications?

A

ASA III

52
Q

ASA III puts patients at risk for

A

pulmonary complications

53
Q

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

A
  1. alcohol consumption
  2. smoking
  3. high BMI
54
Q

Cardiopulmonary, renal function…. etc.

These are all part of what?

A

Pre-op assessment

55
Q

When providing oxygen via facemask, it is important to keep pressure below ___ to prevent gastric inflation.

A

20

56
Q

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

A

succinylcholine

57
Q

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

A

provide bag mask ventilation

58
Q

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

A
  • alveolar ventilation

- blood solubility

59
Q

The rate of emergence from anesthesia is directly proportional to ____ .

A

Alveolar ventilation

60
Q

The rate of emergence from anesthesia is inversely proportional to ____.

A

blood solubility

61
Q

Recovery from anesthesia should be assessed when?

A

once, at least 48hrs afterwards if still inpatient

62
Q

The larynx has how many cartilages?

A

9 - 3 paired, 3 unpaired

63
Q

what factors expose the patient to increased chances of PONV?

A

<50 years old (EXAM)

  • female
  • hx of PONV
  • opioid use
  • motion sickness
64
Q

You are preparing to do a cricothyrotomy, the SRNA would describe the Superior Thyroid artery to be found:

A

along the lateral edge of the cricothyroid membrane.

Crossing the upper cricothyroid membrane.

65
Q

A patient with deteriorating voice and difficulty breathing, O2sat is dropping and is currently 90%. What do you suspect? (2)

A
  1. Bilateral recurrent laryngeal nerve damage

2. hypocalcemia

66
Q

The spinal cord ends in adults at:

A

L1-L2

67
Q

46 yo. transgendered woman (man to woman) undergoing elective surgery. Necessary pre op testing?

A

EKG

*Dr Hammon stated that the correct answer was originally to get an EKG, but he would also accept it if you chose “no pre-op testing”

68
Q

Adult larynx is located where?

A

C3-C6

69
Q

40ish year old man is having surgery. PMH of DVT. Is he low/mod/high or very high risk for DVT?

A

VERY high risk

70
Q

What is true about the brain and spinal cord in regards to shivering?

A

the spinal cord will recover quicker than the brain

71
Q

Tell me LMA sizes:

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
72
Q

patient is 60 kg. what size LMA?

A

4

73
Q

What antisialogogue does not cause CNS toxicity?

A

glyco

74
Q

What medication has the greatest antisaligogue effects?

A

scopolamine

75
Q

In a picture of lining up the different axis’s….

Be able to identify the proper alignment for intubation.

A

Picture C (bottom left)

-OA, PA, LA all lined up

76
Q

Laryngoscopic Image given. identify the grade.

This image is a full view. All structures are visible. What grade would you give?

A

Grade 1

77
Q

Mallampati view for you to score.

Pilars, Uvula, Soft and Hard palate are all visible. What class is this?

A

Class 1

78
Q

You see an increased HR during anesthesia. What are your initial thoughts? (2)

A
  1. depth of anesthesia not adequate

2. what else could be increasing my HR?

Clinical Entrance Exam (21 decks)

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