Missed Prodigy Questions Sim Exam 1 Flashcards

1
Q

For every 1 degree CElesius that the core body temp decreases, the cerebral metabolic rate of O2 consumption decreases by

A

8%

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2
Q

During a craniotomy, a pt’s BP decreases from 120/80 to 60/30. Which of the following would happen?
Cerebral vessels dilate or constrict and CBF would increase or decrease

A

Cerebral vessels would dilate and CBF would decrease

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3
Q

Local anesthetic exist as

*weak acid or base
*positively or negatively charged amine group

A

Weak base with positively charged amine group

**Local anesthetics are positive :)

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4
Q

A femoral nerve block will provide adequate anesthesia for which of the following procedures?
-excision of a mass on lateral thigh
-excision of a mass on medial thigh
-lower extremity adductor release procedure
-knee arthroscopy

A

KNEE ARTHROSCOPY

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5
Q

What is the specific gravity of CSF?

A

1.004 - 1.009

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6
Q

In relation to CSF, 2% lidocaine with a Specific gravity between 1.0004 and 1.0066 is:
-hypobaric
-isobaric
-hyperbaric

A

Hypobaric

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7
Q

An HIV positive patient is taking a combination of zidovudine and corticosteroids. You know that this can place the patient at risk for

A

Respiratory muscle dysfunction

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8
Q

What is the half life of carbon monoxide

A

4-6 hours

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9
Q

The burning felt on injection of diazepam and lorazepam is due to

A

THE PRESERVATIVE PROPYLENE GLYCOL

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10
Q

What is the earliest sign of graft function after liver transplantation surgery

A

Base deficit normalizes with rapid fresh frozen plasma administration

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11
Q

Which of the following laboratory changes are most specific for hepatobiliary obstruction

A

5’ nucleotides elevation

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12
Q

Which of the following interventions would be an appropriate initial treatment for the derangement in serum potassium cased by hyperaldosteronism?

A

Spironolactone

***Hyperaldosteronism = LOW POTASSIUM

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13
Q

All of the following pathologies are associated with sarcoidosis except:
-cor pulmonale
-chronic extrinsic lung disease
-restrictive cardiomyopathy
-hypercalcemia

A

Chronic extrinsic lung disease
(It causes a chronic intrinsic lung disease!)

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14
Q

MS is associated with which of the following?
-prolonged latency of evoked potentials
-excessive accumulation of myelin on the axon
-neuropathy due to demyelination of the peripheral nerves
-rapid progression in patients diagnosed after 35 years of age

A

Prolonged latency of evoked potentials

**demyelination of central nerves!

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15
Q

Autonomic hyperreflexia would most likely produce
-cutaneous vasoconstriction above spinal cord lesion
-apnea
-hypotension
-vasoconstriction below the spinal cord lesion

A

-Vasoconstriction below spinal cord lesion

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16
Q

Patients with CHF often exhibit
-hypermagnesemia
-hyperkalemia
-hypernatremia
-hyponatremia

A

-HYPONATREMIA

*due to activation of vasopressin system

17
Q

ANAPHYLACTIC reactions are related to prior sensitization by exposure to an antigen with production of antigen-specific
-IgA
-IgE
-IgG
-IgM

A

IgE

*IgE related to anaphylaxis

18
Q

A drug with high hepatic extraction ratio may exhibit a prolonged elimination half-life in an elderly patient because:
-hepatic mass decreases with age
-hepatic transaminase levels increase with age
-cytochrome p450 activity diminishes with age
-hepatic blood flow diminishes with age

A

-Hepatic blood flow diminishes with age

*hepatic mass DOES decrease with age but hepatic extraction ratio relies on hepatic blood flow not hepatic mass

19
Q

A patient with Type A blood has

-anti-A antibodies
-anti-B antibodies
-both
-neither

A

Anti-B antibodies

20
Q

Which of the following components of a CVP tracing would be absent in a patient with afib
-a wave
-c wave
-v wave
-x descent

A

A wave

21
Q

According to OSHA, OR personnel shouldn’t be exposed to more than how many parts per million of halogenated agent if nitrous oxide is also used?
-0.5
-2
-10
-25

A

0.5 ppm

*If nitrous oxide is not used, max exposure is 2 ppm

*max exposure to nitrous alone is 25 ppm

22
Q

A child presents to the ED with a dx of epiglottis. He is drooling, complains of sore throat, exhibits stridor. Your preop exam for this patient should include:
-thorough airway exam (mallampati and jaw opening included)
-CBC w/ diff
-CXR
-plan for inhalation induction

A

Plan for inhalation induction

*avoid airway exam to prevent additional swelling

23
Q

Which of the following respiratory parameters is decrease in elderly patients?
-alveolar surface area
-residual volume
-closing capacity
-Both A&B

A

-Alveolar surface area

*closing capacity increases, RV increases

24
Q

Which of the following conditions is not a component of HELLP syndrome?
-thrombocytopenia
-elevated liver enzymes
-hemolysis
-leukopenia

A

Thrombocytopenia

25
Q

At birth, the spinal cord extends to

A

L3

26
Q

During carotid endarterectomy, which of the following techniques for management of ventilation would be the most appropriate?
-mod hypocapnea
-mod hypercapnea
-normocarb to mild hypocapnia
-normocarb to mild hypercap

A

Maintain NORMOCARBIA to MILD HYPOcapnea

*hypercapnea can result in steal phenomenon

27
Q

Which of the following is not true regarding anesthesia during strabismus surgery?
-associated w/ increased risk of oculocardaic reflex
-associated w/ higher than normal risk of MH
-postop N/v occurs in majority of patients undergoing this procedure
-hyperventilation increases the risk for sudden bradycardia

A

hyperventilation increases the risk for sudden bradycardia

*hypoventilation will increase the risk

28
Q

Which of the following statements regarding pyloric stenosis is false

-can result in hypochloremic metabolic alkalosis
-preop hydration w/ crystalloid is appropriate
-associated persistent vomiting results in loss of hydrogen ions
-hypochloremia is a potential symptom

A

preop hydration w/ crystalloid is appropriate

*correction of fluid deficit requires a sodium chloride solution supplemented with potassium
LR should not be used

29
Q

Which of the following side effects is most likely to occur with use of intraoperative blood salvage (cell saver)?

-hyponatremia
-air embolism
-hyperkalemia
-fluid volume overload

A

Air embolism

30
Q

Which of the following changes are expected to occur in the elderly as part of the normal aging process? (Select 2)
-hepatic microsomal activity is decreased
-pulmonary collagen content increases
-renal blood flow decreases
-the A-a difference for oxygen decreases

A

-pulm collagen content increases
-renal blood flow decreases

*hepatic microsomal enzyme activity is well preserved
*A-a gradient increases

31
Q

Principal cells in the cortical collecting duct are primarily responsible for

-secreting renin
-secreting sodium
-acid-base regulation
-secreting potassium

A

Secreting potassium

32
Q

The physiologic characteristics of HPV include:

-onset and resolution relatively slow
-triggered by arterial hypoxemia
-may be inhibited by verapamil
-diffuse effect throughout the entire pulmonary vasculature

A

It may be inhibited by verapamil

**Triggered by ALVEOLAR hypoxia
-inhibited by calcium channel blockers, nitrated, Inhaled anesthetic

33
Q

What lab finding is most associated with hypoaldosteronism?

A

Hyperkalemia

**hyperkalemia in a patient with normal renal function suggests hypoaldosteronism

*pts also have hyponatremia

34
Q

Where in the nephron is the majority of sodium reabsorbed

A

Proximal convoluted tubule