CE09

Question 1

Where to listen for aortic sounds

Answer 1

Right sternal border 2nd-3rd interspace

Question 2

In Preop Clinic, what is the most reasonable means to assess heart rate, basic rhythm, and pulse pressure?

Answer 2

Take patient’s pulse

Question 3

With which heart sound does the radial pulse correspond?

Answer 3

S1

Question 4

Which patients should receive preop pregnancy testing?

Answer 4

All with potential for child bearing

Question 5

What is MAC

Answer 5

Minimum alveolar concentration - anesthetic concentration required to prevent movement in response to a surgical stimulus in 50% of patients

Question 6

What is MAC bar

Answer 6

MAC required to block autonomic response to a surgical stimulus in 50% of patients

Question 7

What is MAC awake

Answer 7

MAC required to prevent appropriate response to command in 50% of subjects

Question 8

What is the most efficacious means for maintaining adult patient warmth

Answer 8

Convection

Question 9

What nerve is contiguous with the humerus for part of its passage through the upper arm?

Answer 9

Radial nerve

Question 10

How long does it take a drug injected into a vein in the ACF to reach systemic arterioles?

Answer 10

30 seconds

Question 11

Side effects of etomidate

Answer 11

• Myoclonus
• Burning
• Adrenal suppression

Question 12

Muscle relaxant exhibiting vagolytic activity

Answer 12

Pancuronium?

Question 13

Sympathomimetic with negligible effect on beta-2 adrenergic receptors

Answer 13

Norepi

Question 14

MAC-awake for desflurane

Answer 14

~2%

Question 15

Normal base excess

Answer 15

0

Question 16

Normal plasma bicarb

Answer 16

24

Question 17

Define macroglossia

Answer 17

Large tongue

Question 18

MOA of NTG

Answer 18

Causes the release of nitric oxide which vasodilates

Question 19

Reason for propofol’s white appearance

Answer 19

Scattering of light from lipid emulsion

Question 20

Contraindications for droperidol

Answer 20

• Parkinson’s

- Any long QT syndrome

Question 21

Hematocrit definition

Answer 21

Volume percentage of red blood cells in whole blood

Question 22

Layers of skin that you suture a CVP catheter to

Answer 22

Epidermis + dermis

Question 23

Disease assc. with click-murmur

Answer 23

Mitral valve prolapse

Question 24

Correct position for V5 lead

Answer 24

5th intercostal space anterior axillary line

Question 25

Side effects of meperidine

Answer 25

- Seizures | - Antimuscarinic effects

Question 26

Receptors that phenylephrine acts upon

Answer 26

Alpha 1

Question 27

Max flow rate from oxygen flush valve

Answer 27

75L/min

Question 28

Acronym SBO

Answer 28

Small bowel obstruction

Question 29

What type of diuretic is furosemide

Answer 29

Loop

Question 30

PERLA acronym

Answer 30

Pupils equal and reactive to light accommodation

Question 31

What is anisocoria

Answer 31

Unequal pupil sizes

Question 32

Assessing eye movements and reactivity to light is a test for which cranial nerves?

Answer 32

3, 4, 6

Question 33

What is PMI

Answer 33

Point of maximal impulse, the furthermost point from the sternum at which the cardiac impulse can be felt (apex beat)

Question 34

Which vasodilator can exhibit tachyphylaxis

Answer 34

Sodium nitroprusside

Question 35

Intraabdominal pressure in patient undergoing exploratory laparotomy

Answer 35

760mmHg (since abdomen is open to atmosphere)

Question 36

Which lymphatic vessel is at risk during left IJV cannulation?

Answer 36

Thoracic duct

Question 37

Normal PaCO2

Answer 37

35-45mmHg

Question 38

``` The following was obtained under room-air conditions: SaHbO 2 = 87% PaO 2 = 57 mmHg PaCO 2 = 57 mmHg pHa = 7.34 [Hb] = 17.8 gm/dl ``` What is this patient's state of oxygenation?

Answer 38

Hypoxemic - sat is 87%

Question 39

``` The following was obtained under room-air conditions: SaHbO 2 = 87% PaO 2 = 57 mmHg PaCO 2 = 57 mmHg pHa = 7.34 [Hb] = 17.8 gm/dl ``` What is this patient's cardiopulmonary oxygenating ability?

Answer 39

A-a gradient is 21. Need to know their age to determine if this is appropriate

Question 40

How to calculate appropriate A-a gradient based on age

Answer 40

1. 5 + 5torr per decade of life after 20 | 2. 4 + (age/4)

Question 41

``` The following was obtained under room-air conditions: SaHbO 2 = 87% PaO 2 = 57 mmHg PaCO 2 = 57 mmHg pHa = 7.34 [Hb] = 17.8 gm/dl ``` What is this patient's ventilatory status?

Answer 41

Hypoventilation because the PaCO2 is 57

Question 42

``` The following was obtained under room-air conditions: SaHbO 2 = 87% PaO 2 = 57 mmHg PaCO 2 = 57 mmHg pHa = 7.34 [Hb] = 17.8 gm/dl ``` What is this patient's acid-base state?

Answer 42

Acidic because the pH is 7.34

Question 43

Normal blood pH

Answer 43

7.35-7.45

Question 44

``` The following was obtained under room-air conditions: SaHbO 2 = 87% PaO 2 = 57 mmHg PaCO 2 = 57 mmHg pHa = 7.34 [Hb] = 17.8 gm/dl ``` What is this patient's acid-base condition?

Answer 44

Respiratory acidosis because the pH is low and PaCO2 is high

Question 45

What right-sided pressures are considered pulmonary hypertension?

Answer 45

Any pressures greater than 25mmHg

Question 46

Pulse pressure is used clinically as an indicator of...

Answer 46

Stroke volume

Question 47

Which diuretic poses a risk of hypokalemia

Answer 47

HCTZ - because K+ is wasted in the urine

Question 48

Normal PaO2

Answer 48

80-100

Question 49

Normal fibrinogen value

Answer 49

200-400mg/dL

Question 50

Physical signs associated with hypokalemia

Answer 50

- Weakness - Prolonged NMB - Ileus

Question 51

Reference point for coronary perfusion pressure

Answer 51

Tricuspid valve

Question 52

Reference point for cerebral perfusion pressure

Answer 52

External auditory meatus

Question 53

Dobutamine infusion dose

Answer 53

2-20mcg/kg/min

Question 54

Corticosteroid therapy can cause an increase in what lab value?

Answer 54

Blood glucose

Question 55

Calculation for BMI

Answer 55

Weight in kilograms/ height in meters squared

Question 56

BMI classification for underweight

Answer 56

Under 18.5

Question 57

Normal BMI range

Answer 57

18.5-25

Question 58

BMI classification for overweight

Answer 58

25-30

Question 59

BMI classification for obese

Answer 59

30-40

Question 60

BMI classification for morbidly obese

Answer 60

Over 40

Question 61

Actions of hydromorphone

Answer 61

Mu agonist

Question 62

Hepatic perfusion and oxygenation

Answer 62

- Consumes ~20% of O2 at rest | - Blood flow of 1-2L/minute

Question 63

Epinephrine infusion dosage

Answer 63

1-20 mcg/min OR .01-1 mcg/kg/min

Question 64

Drug infusion with photosensitivity

Answer 64

Nitroprusside