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1
Q

Which nerve is at risk of injury when a face mask strap is used?

A

7

facial

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2
Q

What is the internal diameter of an anesthesia face mask connector?

A

22 mm

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3
Q

What observational assessment is the best means for assessing effectiveness of bag-and-mask ventilation?

A

chest rise

condensation

compliance

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4
Q

What is the appripriate starting rate for infusion of nitroglycerin?

A

0.5 mcg/kg/min

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5
Q

Which cardiac dysrhythmia most often produces inability of an NIBP machine to obtain systolic and diastolic blood pressure measurements?

A

A-fib

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6
Q

Why is a reservoir bag included as a component of an anesthesia breathing circuit?

A

Peak inspiratory flow demands

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7
Q

Below what MAC level will sevoflurane not increase heart rate?

A

MAC > 1.5

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8
Q

What prior surgical procedures represent a contraindication for IV catheter placement in an upper extremity?

For NIBP measurement in an upper extremity?

A

mastectomy w/ lymph node dissection

AV fistula

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9
Q

Comparing blood pressure measurements taken on an upper arm and the ipsilateral calf, how will the systolic and diastolic values compare?

A

If recumbant, systolic is increased

diastolic is decreased

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10
Q

Name one contraindication to hetastartch administration.

A

coagulopathies if delivery > 1 L / 24 hours

another is allergy reaction

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11
Q

What blocks 60-cycle interference?

A

band pass filter

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12
Q

When performing bag-and-mask ventilation in an adult, which fingers must be applied only to the bony rim of the mandible?

A

3 and 4

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13
Q

Time constant of gases and liquids

A

volume
flow

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14
Q

If IV catheter is in the SVC, where is it?

A

superior vena cava, joining of the left and right brachiocephalic venins to the right atrium

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15
Q

A 200 lb patient is breathing oxygen 2 L/min, air 3L/min, and sevoflurane 2.4% via ETT.

Vt is 600 ml , resp = 10 breaths/minute, FRC is 4000 ml

What is the time constant?

A

FRC
VA= (VT-VD)* RR

4000
(600-200)*10

1 min

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16
Q

If time constant = 1 minute, what percent change in inspired sevoflurance will have occurred at the end of the time comstant?

A

100 - 36.78 = 63%

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17
Q

How many time constants are required for a 95% change?

A

3 time constants

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18
Q

For a safe, cost effective preparation for an elective case, how many endotracheal tubes should be opened?

A

1

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19
Q

A 29 y/o woman is schedules to undergo BTL. What is BTL?

A

bilateral tubal ligation

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20
Q

What is the osmolarity of saline 3%?

A

308/0.9 * 3 = 1027 mOsm

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21
Q

What are the complications associated with excess administration of saline IVFs?

A

edema
pulmonary edema
electrolyte abnormalities

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22
Q

What are contraindications to administering lactated ringer’s solution?

A

low pH

lowers pH so causes acidosis
has Ca, lactate, K, Cl, Na
hypotonic at 273 mOsm/L

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23
Q

What are contraindications to using a NIBP cuff?

A

extremities with vascular abnormalities
dialysis shunts
IV lines

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24
Q

How do you size a BP cuff?

A

Width is 40% of arm circumference

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25
Q

How do you detect oxygen flow of a hand-operated, self-inflating bag?

A

listen at the distal end

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26
Q

What is the concentration of epinephrine?

A

1g/100,000ml

10 mcg

27
Q

What is the I, II, III, and IV Korotkoff sounds?

A

I = snap

II = murmur

III = thump

IV = muffle

28
Q

What is an hypo-osmolar crystalloid IV solution?

A

LR is slightly above

29
Q

During bag-mask verntilation, stay below what peak airway pressure to avoid insufflating the stomach?

30
Q

What is the affect of hypothermia on non-depolarizing neuromuscular blockers?

A

prolongs the blockade by decreasing metabolism

31
Q

What is the osmolarity of NS 3%?

A

308/0.9 * 3

1027mOsm

32
Q

What location is prone to infection regarding CVP catheters?

A

subclavian

33
Q

What does the acronym SVC mean?

A

superior vena cava

34
Q

What is the starting dosage rate of IV NTG infusion?

A

0.5 mcg/kg/min

35
Q

What is the distribution of LR 30 minutes after infusion?

A

1/3 remains in the plasma after 30 minutes

36
Q

Physical exam findings that would be a clue for difficult bag-mask ventilation?

A

edentulous

beard

micrognathism

37
Q

Reasons you are unable to bag-mask ventilate:

A

obstructing

bad seal

38
Q

How do you perioperatively manage a patient with pulmonary TB?

39
Q

How do you store drug vials?

40
Q

How do you increase IVF flow rate through an 18 gauge IV catheter?

A

raise the bag height

41
Q

What is the lung capacity involved in preoxygenation?

42
Q

During induction of anesthesia, what breath-to-breath end point are you trying to achieve with bag-mask ventilation?

43
Q

What is the correct action to be taken when a patient is being seen in preop clinic prior to elective knee arthroscopy is suspected of having active pulmonary tuberculosis?

A

delay the case until it clears

44
Q

Why is a reservoir bag included as a component of an anesthesia breathing circuit?

A

Meets peak inspiratory flow requirements

45
Q

Name the veins appropriate for insertion of a CVP catheter and list site-specific considerations (if any)?

A

femoral- DVT

EJV- hydrothorax

IJV- hydrothorax

cephalic

subclavian- PTX

basilic

46
Q

What attribute of CVP catheters is associated with increasing risk of infection?

A

number of lumens

47
Q

For vascular access procedures, a safe, effective alternative preparation for an iodine allergic patient would be?

A

chlorhexadine 4%

48
Q

Following IV injection of muscle relaxant, what is your temporal end-point for intubation during an RSI?

49
Q

Which muscle relaxant would you select in order to provide neuromuscular blockage during rapid-sequence induction of a patient with ESRD?

A

K normal: SUX, redose with CIS

K elevated: ROC, redose with CIS

50
Q

If aseptic technique is employed consistently, how long can a multidose drug vial continue to be used?

A

until expiration date

51
Q

An epinephrine infusion is connected to the main IVF tubing 4.25 ml from the IV catheter’s entry point into a CVP catheter. IVF flow rate is 120 ml/hr. When the epi infusion rate is decreased, how long will it take for there to be a 95% change in epi concentration in the SVC?

A

t = V / flow rate

4.25 ml / 2 ml/min = 2.125 min

52
Q

What is the Sellick maneuver?

A

RSI - cricoid pressure

53
Q

What IVFs contain magnesium?

A

Normosol

Plasmalyte 3mEq/L

54
Q

What are communicable disease risks for pregnant personnel?

A

look up

Cytomegalovirus?

55
Q

Where is the basilic vein?

A

medial side

56
Q

Where is the cephalic vein?

A

lateral side

57
Q

NIBP monitors display 3 blood pressure parameters: systolic, diastolic, and mean. Explain how each value is determined by the device. What will most likely happen to the reported BP values when the following conditions exist?

HTN
hypotension
sinus tachycardia
atrial fibrillation
ventricular fibrillation

A

HTN- get all 3
hypotension- get mean
sinus tachycardia- only mean
atrial fibrillation- only mean
ventricular fibrillation- get nothing

58
Q

What electrolytes are found in LR?

A

Na
Cl
K
Ca
Lactate

59
Q

What electrolytes are found in Plasma-Lyte?

A

Na
Cl
K
Mg

60
Q

Name the types of crystalloids:

A

D5W
0.9 Sodium Chloride
LR
Plasma-Lyte

61
Q

Name the types of colloid:

A

Hetastarch
Dextran
Albumin
3% Sodium Chloride
5% Sodium Chloride

62
Q

When do we replace fluids?

A

hourly requirements
insensible loss through open wound
“third spacing”
blood loss

63
Q

What are contraindications for placing peripheral IVs? (6)

A

massive edema
burns or injuries
abdominal trauma
areas of infection
indwelling fistula
side of mastectomy

Comp 5 Exam (2 decks)

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