Mod10: April's Practice questions Flashcards
Where should the kidney rest be placed in the lateral position to prevent compression of the IVC?
A. under iliac crest
B. above iliac crest
C. under the 12th rib
D. lateral to the kidneys
A. under iliac crest
B. above iliac crest
C. under the 12th rib
D. lateral to the kidneys
What will increase in the head down position?
A. FRC
B. CV
C. Vt
D. lung capacities
A. FRC
B. CV (Closing Volume )
C. Vt
D. lung capacities
The closing capacity is the volume in the lungs at which its smallest airways, the respiratory bronchioles, collapse.
Closing capacity= closing volume + residual volume
The alveoli lack supporting cartilage and so depend on other factors to keep them open
Valsalva maneuver should be delivered at what pressure?
A. 10-20 cmH2O
B. 20-30 cmH2O
C. 30-40 cmH2O
D. 40-50 cmH2O
A. 10-20 cmH2O
B. 20-30 cmH2O
C. 30-40 cmH2O
D. 40-50 cmH2O
Valsalva maneuvers may cause a decrease in (select two)
A. VR
B. FRC
C. CV
D. BP
A. VR
B. FRC
C. CV
D. BP
Supine positioning causes an increase in all of the following except:
A. right atrial filling pressure
B. CO
C. VR
D. HR
A. right atrial filling pressure
B. CO
C. VR
D. HR
Under anesthesia and mechanical ventilation, the dependent lung:
A. has better ventilation than the independent lung
B. has better perfusion than the independent lung
C. has better ventilation compared to spontaneous breathing
D. has better ventilation and perfusion than the independent lung
A. has better ventilation than the independent lung
B. has better perfusion than the independent lung
C. has better ventilation compared to spontaneous breathing
D. has better ventilation and perfusion than the independent lung
All are causes of postop visual loss (PLV) except:
A. hypertension
B. excessive blood loss
C. ischemic optic neuropathy
D. central retinal arterial occlusion
A. hypertension
B. excessive blood loss
C. ischemic optic neuropathy
D. central retinal arterial occlusion
The most commonly injured nerve in the arm is the ________ nerve.
A. radial
B. median
C. ulnar
D. brachial
A. radial
B. median
C. ulnar
D. brachial
Elderly patients with a hip fracture may have to be placed in what position for a spinal placement?
A. lateral
B. prone
C. sitting
D. supine
A. lateral
B. prone
C. sitting
D. supine
Compression of the abdomen on a Wilson frame table can cause (select two)
A. decrease in FRC
B. decrease in VR
C. increase in BP
D. decrease in HR
A. decrease in FRC
B. decrease in VR
C. increase in BP
D. decrease in HR
What must have adequate padding to prevent nerve injury on a Fracture Table?
A. perineal post
B. back rest
C. abdomen
D. neck
A. perineal post
B. back rest
C. abdomen
D. neck
For every 1 cm rise of the head in the beach chair position, there is a 0.75 mmHg drop in blood pressure
A. True
B. False
A. True
B. False
Blood pressure in the brain is about ________ lower than blood pressure in the arm in the beach chair position.
A. 8-24 mmHg
B. 12-16 mmHg
C. 8-10 mmHg
D. 20-24 mmHg
A. 8-24 mmHg
B. 12-16 mmHg
C. 8-10 mmHg
D. 20-24 mmHg
Select three risk associated with the use of a pneumatic tourniquet.
A. bleeding
B. pain
C. low RR
D. metabolic changes
E. bradycardia
F. pulmonary embolism
A. bleeding
B. pain
C. low RR
D. metabolic changes
E. bradycardia
F. pulmonary embolism
Insufflation pressure for a pneumatic tourniquet placed on the arm should be:
A. equal to SBP
B. 100 mmHg above baseline of SBP
C. 50 mmHg above baseline of DBP
D. 50 mmHg above baseline of SBP
A. equal to SBP
B. 100 mmHg above baseline of SBP
C. 50 mmHg above baseline of DBP
D. 50 mmHg above baseline of SBP
Using a pneumatic tourniquet for longer than two hours places the patient at risk for (select two):
A. transient muscle dysfunction
B. untreatable pain
C. peripheral nerve damage
D. alkalosis
A. transient muscle dysfunction
B. untreatable pain
C. peripheral nerve damage
D. alkalosis
Bleeding during tourniquet pain is commonly due to intramedullary blood flow in long bones.
A. True
B. False
A. True
B. False
The deflation of the tourniquet can cause an increase in all except:
A. heart rate
B. EtCO2
C. blood pressure
D. serum lactate
A. heart rate
B. EtCO2
C. blood pressure
D. serum lactate
What fibers are responsible for burning and aching pain?
A. A-delta fibers
B. beta fibers
C. D fibers
D. C fibers
A. A-delta fibers
B. beta fibers
C. D fibers
D. C-fibers
Under what anesthetic condition is the patient least likely to experience tourniquet pain?
A. General
B. spinal
C. epidural
D. IV regional
A. General
B. spinal
C. epidural
D. IV regional
If bone cement is absorbed systemically, what would you expect to see? (select two)
A. increase in SVR
B. vasoconstriction
C. vasodilation
D. CV instability
A. increase in SVR
B. vasoconstriction
C. vasodilation
D. CV instability
Select two ways to minimize effects associated with bone cement syndrome.
A. restrict fluids
B. increase FiO2 prior to cementing
C. maintain FiO2 < 30%
D. maintain adequate IV volumes
A. restrict fluids
B. increase FiO2 prior to cementing
C. maintain FiO2 < 30%
D. maintain adequate IV volumes
Select three signs and symptoms of a fat embolism under anesthesia
A. decreased PA pressures
B. bradycardia
C. tachycardia
D. ST changes
E. hypoxia
F. hypocarbia
A. decreased PA pressures
B. bradycardia
C. tachycardia
D. ST changes
E. hypoxia
F. hypocarbia
An increase in the A-a gradient means:
A. not as much oxygen is leaving from the blood to the alveoli
B. not as much oxygen is not leaving from the alveoli to the blood
C. both A and B
A. not as much oxygen is leaving from the blood to the alveoli
B. not as much oxygen is leaving from the alveoli to the blood
C. both A and B
An increase in the A-a gradient will cause:
A. hypoxia
B. respiratory acidosis
C. decreased lung compliance
A. hypoxia
B. respiratory acidosis
C. decreased lung compliance
What laboratory finding would you expect to find in a patient with a fat embolism?
A. decreased serum lipase
B. decreased H/H
C. prolonged clotting time
D. increased serum K
A. decreased serum lipase
B. decreased H/H
C. prolonged clotting time
D. increased serum K
The triad of a fat embolism (dyspnea, confusion and petechiae) is seen how long after a long bone fracture?
A. 24 hours
B. 48 hours
C. 72 hours
D. 5 days
A. 24 hours
B. 48 hours
C. 72 hours
D. 5 days
What position holds the greatest risk for VAE?
A. supine
B. sitting
C. prone
D. lateral
A. supine
B. sitting
C. prone
D. lateral
Venous air embolisms cause an increase in (select two)
A. dead space
B. blood pressure
C. ETCO2
D. ETN2
A. dead space
B. blood pressure
C. ETCO2
D. ETN2
Late signs of a venous air embolism include all of the following except:
A. decrease in ETCO2
B. cyanosis
C. tachycardia
D. Mill Wheel murmur
A. decrease in ETCO2
B. cyanosis
C. tachycardia
D. Mill Wheel murmur
•Late signs
•Hypotension
•Tachycardia
•Cardiac dysrhythmias
•Cyanosis
•“Mill wheel” murmur
Select two ways to manage a VAE intra-op.
A. FiO2 100%
B. compress neck veins
C. right lateral decubitus position
D. restrict volume/fluids
A. FiO2 100%
B. compress neck veins
C. right lateral decubitus position
D. restrict volume/fluids
Risk factors for a thromboembolic event include (select three)
A. minor infection
B. age > 60
C. immobile < 4 days
D. previous DVT
E. obesity
F. no use of oral contraceptives
A. minor infection
B. age > 60
C. immobile < 4 days
D. previous DVT
E. obesity
F. no use of oral contraceptives
Risk factors:
Severe infection - > 60 y/o - Tourniquet use
Immobile > 4 days - Previous miscarriage
Oral contraceptives - Previous DVT
Hypotension with increased CVP indicates:
A. hypoxia
B. tachycardia
C. RV failure
D. LV failure
A. hypoxia
B. tachycardia
C. RV failure
D. LV failure
The blood gas in a patient with a PE would show:
A. severe hypoxemia with respiratory alkalosis
B. mild hypoxemia with respiratory alkalosis
C. mild hypoxemia with respiratory acidosis
D. hypoxemia with respiratory acidosis
A. severe hypoxemia with respiratory alkalosis
B. mild hypoxemia with respiratory alkalosis
C. mild hypoxemia with respiratory acidosis
D. hypoxemia with respiratory acidosis
The gold standard for diagnosing a PE is:
A. CXR
B. spiral CT
C. V/Q scan
D. pulmonary angiography
A. CXR
B. spiral CT
C. V/Q scan
D. pulmonary angiography
Pulmonary embolisms only come from DVTs or from within the lungs themselves.
A. True
B. False
A. True
B. False
Select two contraindications for thrombolytic therapy.
A. PE
B. GI bleed 3 months ago
C. recent surgery
D. active bleeding
A. PE
B. GI bleed 3 months ago
C. recent surgery
D. active bleeding
Select a disadvantage to regional anesthesia.
A. increased PONV
B. increased risk for thromboembolism
C. increased risk for falls
D. increased blood loss
A. increased PONV
B. increased risk for thromboembolism
C. increased risk for falls
D. increased blood loss
Neuraxial anesthesia will decrease:
A. factor VIII
B. von Willebrand factor
C. stress hormones
D. all of the above
A. factor VIII
B. von Willebrand factor
C. stress hormones
D. all of the above
INR must be less than what value in order to proceed with regional anesthesia?
A. 1.5
B. 2.0
C. 2.5
D. 1.0
A. 1.5
B. 2.0
C. 2.5
D. 1.0
Patients on antiplatelet therapy are at risk for what under regional anesthesia?
A. spinal or epidural hematoma
B. hypotension
C. DIC
D. all of the above
A. spinal or epidural hematoma
B. hypotension
C. DIC
D. all of the above
All are branches of the sciatic nerve except:
A. femoral nerve
B. popliteal nerve
C. saphenous nerve
D. common peroneal nerve
A. femoral nerve
B. popliteal nerve
C. saphenous nerve
D. common peroneal nerve
The saphenous nerve is a terminal branch of the femoral nerve and the only innervation of the foot not a part of the sciatic system
Seven total nerves must be blocked in order to perform an ankle procedure under regional anesthesia.
A. True
B. False
A. True
B. False
Five nerves supply sensation to the foot:
- Saphenous nerve (only one Not part of the sciatic system)
- Deep peroneal nerve
- Common peroneal nerve
- Superficial peroneal nerve
- Posterior tibial nerve
Which patient would you avoid performing a supraclavicular block on?
A. 80 year old with HTN
B. 50 year old with COPD
C. 45 year old obesity
D. 20 year old with anemia
A. 80 year old with HTN
B. 50 year old with COPD
C. 45 year old obesity
D. 20 year old with anemia
An axillary block will block:
A. forearm
B. hand
C. elbow
D. all of the above
A. forearm
B. hand
C. elbow
D. all of the above
What type of muscle pain might the patient complain of with an infraclavicular block?
A. neck muscles
B. pectoralis
C. biceps
D. trapezoids
A. neck muscles
B. pectoralis
C. biceps
D. trapezoids
Blocking of the femoral nerve will block:
A. anterior aspect of thigh and knee, medial aspect of leg
B. foot and ankle
C. foot and lower part of the leg
D. ankle and distal toe
A. anterior aspect of thigh and knee, medial aspect of leg
B. foot and ankle
C. foot and lower part of the leg
D. ankle and distal toe
Select two ways to minimize blood loss in hip fracture repairs.
A. volatile agents
B. beta-blockers
C. induced hypertensive technique
D. opioids
A. volatile agents
B. beta-blockers
C. induced hypertensive technique
D. opioids
TXA and amicar work by:
A. competitively inhibiting the binding site of plasminogen
B. inhibiting serine protease
C. inhibiting coagulation
A. competitively inhibiting the binding site of plasminogen
B. inhibiting serine protease
C. inhibiting coagulation
The most common viral infection associated with blood product administration is:
A. CMV
B. HIV
C. HPV
D. HCB
A. CMV
B. HIV
C. HPV
D. HCB
Acute normovolemic hemodilution is the process of collecting the patient’s blood weeks before the planned procedure
A. True
B. False
A. True
B. False
Nonimmune-mediated transfusion reactions include all of the following except:
A. transfusion-associated CV overload
B. posttransfusion purpura
C. metabolic derangements
D. iron overload
A. transfusion-associated CV overload
B. posttransfusion purpura
C. metabolic derangements
D. iron overload
EPO administration pre-op would be indicated for:
A. a renal failure patient
B. COPD
C. CAD
D. hypotension
A. a renal failure patient
B. COPD
C. CAD
D. hypotension
If a patient comes in with a long bone injury, what type of spinal cord injury would you be concerned about?
A. cervical
B. thoracic
C. lumbar
D. sacral
A. cervical
B. thoracic
C. lumbar
D. sacral
Transection above T1 will cause
A. paraplegia
B. diaphragmatic paralysis
C. quadriplegia
D. decrease in respiratory function
A. paraplegia
B. diaphragmatic paralysis
C. quadriplegia
D. decrease in respiratory function
The most common cause of death for a C4 injury is:
A. MI
B. stroke
C. respiratory failure
A. MI
B. stroke
C. respiratory failure
Select three criteria that must be met in order to clear a cervical spine injury.
A. fully alert
B. no drugs or alcohol
C. minor neck pain
D. possible head injury
E. lethargic but following commands
F. no neck pain
A. fully alert
B. no drugs or alcohol
C. minor neck pain
D. possible head injury
E. lethargic but following commands
F. no neck pain
Blind nasal intubations for acute spinal cord injuries are contraindicated in what condition?
A. LeFort fractures
B. thoracic fractures
C. increased ICP
D. active bleeding
A. LeFort fractures
B. thoracic fractures
C. increased ICP
D. active bleeding
Spinal cord shock last for:
A. 5-10 days
B. 1 week
C. 1-3 weeks
D. 1 month
A. 5-10 days
B. 1 week
C. 1-3 weeks
D. 1 month
What would you expect the heart rate to be in a patient experiencing spinal cord shock?
A. 40-60 bpm
B. 60-70 bpm
C. 80-100 bpm
D. 100-120 bpm
A. 40-60 bpm
B. 60-70 bpm
C. 80-100 bpm
D. 100-120 bpm
What induction agent would benefit a patient experiencing spinal cord shock?
A. propofol
B. etomidate
C. thiopental
D. ketamine
A. propofol
B. etomidate
C. thiopental
D. ketamine
At what point can you no longer use succinylcholine after a SCI?
A. 6 hours
B. 18 hours
C. 24 hours
D. 48 hours
A. 6 hours
B. 18 hours
C. 24 hours
D. 48 hours
_______ activity occurs above the lesion in autonomic hyperreflexia, while _____ activity occurs below.
A. SNS, PNS
B. PNS, SNS
C. SNS, SNS
D. PNS, PNS
A. SNS, PNS
B. PNS, SNS
C. SNS, SNS
D. PNS, PNS
If using precedex during a procedure that involves use of the wake up test, what is the loading dose?
A. 0.6 mcg/kg over 10 minutes
B. 0.8 mcg/kg over 10 minutes
C. 1.0 mcg/kg over 10 minutes
D. 1.2 mcg/kg over 10 minutes
A. 0.6 mcg/kg over 10 minutes
B. 0.8 mcg/kg over 10 minutes
C. 1.0 mcg/kg over 10 minutes
D. 1.2 mcg/kg over 10 minutes
________ latency or ________ amplitude means that the patient is less responsive to stimulation.
A. increased, decreased
B. increased, increased
C. decreased, increased
D. decreased, decreased
A. increased, decreased
B. increased, increased
C. decreased, increased
D. decreased, decreased
Select two factors that would alter SSEP.
A. hypertension
B. hypotension
C. hyperthermia
D. hypercarbia
A. hypertension
B. hypotension
C. hyperthermia
D. hypercarbia
Inhalation agents will increase both latency and amplitude
A. True
B. False
A. True
B. False
Regional anesthesia for the repair of a shaft humeral fracture is most likely to cause damage to which nerve?
A. brachial
B. axillary
C. ulnar
D. radial
A. brachial
B. axillary
C. ulnar
D. radial
What regional techniques are commonly used for surgery to the upper arm and shoulder? (select two)
A. interscalene
B. supraclavicular
C. infraclavicular
D. brachial
A. interscalene
B. supraclavicular
C. infraclavicular
D. brachial
All are the major nerves of the brachial plexus except:
A. axillary
B. median
C. ulnar
D. radial
A. axillary
B. median
C. ulnar
D. radial
The interscalene block usually leaves the ______ nerve unblocked.
A. median
B. ulnar
C. radial
D. peroneal
A. median
B. ulnar
C. radial
D. peroneal
If using the axillary approach for an elbow, distal humerus or proximal forearm, what nerve should you be aware of that will not be blocked?
A. median
B. muscular
C. musculocutanous
D. maxillary
A. median
B. muscular
C. musculocutanous
D. maxillary
A pneumothorax after regional anesthesia to the forearm is typically seen:
A. 4-8 hours after discharge
B. 2 hours after discharge
C. 6-12 hours after discharge
D. 12-24 hours after discharge
A. 4-8 hours after discharge
B. 2 hours after discharge
C. 6-12 hours after discharge
D. 12-24 hours after discharge
What block would not be effective for wrist surgery?
A. beir block
B. axillary approach
C. interscalene
D. supraclavicular
A. beir block
B. axillary approach
C. interscalene
D. supraclavicular
How long can a continuous brachial plexus block catheter be left in?
A. 2 days
B. 2-4 days
C. 4-7 days
D. 2 weeks
A. 2 days
B. 2-4 days
C. 4-7 days
D. 2 weeks
Only patients who received motor blockade to the upper extremities can be discharged right away.
A. True
B. False
A. True
B. False
What lab would you want to order before a hip arthroplasty?
A. type and cross
B. type and screen
C. electrolytes
D. platelets
A. type and cross
B. type and screen
C. electrolytes
D. platelets
What type of local anesthetic is appropriate for a hip procedure? (select two)
A. isobaric
B. hyperbaric
C. hypobaric
A. isobaric
B. hyperbaric
C. hypobaric
What two blocks are needed to block the entire leg for an ACL repair?
A. lumbar plexus block
B. common peroneal nerve block
C. sciatic nerve block
D. saphenous serve block
A. lumbar plexus block
B. common peroneal nerve block
C. sciatic nerve block
D. saphenous serve block
All of the following cause vasoconstriction/vasospasm except:
A. hyperthermia
B. hypotension
C. hypothermia
D. decreased perfusion presure
A. hyperthermia
B. hypotension
C. hypothermia
D. decreased perfusion presure
