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7835 Exam III (minus Module 8) > Mod8: April's Practice questions > Flashcards

Mod8: April's Practice questions Flashcards

1
Q

A type and cross should be ordered if the patient is expected to lose large amounts of blood.

A. True

B. False

A

A. True

B. False

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2
Q

The toxic pulmonary side effects of bleomycin include (select two)

A. restrictive changes

B. obstructive changes

C. increased FRC

D. decreased FRC

A

A. restrictive changes

B. obstructive changes

C. increased FRC

D. decreased FRC

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3
Q

Match the following chemotherapy drugs to its respective systemic toxic effect:

___. cardiotoxic

___.nephrotoxic

___. Pulmonary fibrosis

A.cisplastin

B.doxorubicin

C.bleomycin

A

_B__. cardiotoxic

_A__.nephrotoxic

_C_. Pulmonary fibrosis

A.cisplastin

B.doxorubicin

C.bleomycin

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4
Q

Ordering electrolytes would be most appropriate for a patient with what preexisting morbidities?

A. a patient receiving anticoagulation therapy

B. an immunosuppressed patient

C. A patient with renal disease and taking diuretics

D. a patient with CHF and COPD

A

A. a patient receiving anticoagulation therapy

B. an immunosuppressed patient

C. A patient with renal disease and taking diuretics

D. a patient with CHF and COPD

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5
Q

One would anticipate which issue to occur in an extremely anxious patient?

A. hypotension

B. decreased gastric emptying

C. decreased anesthetic requirements

D. all of the above

A

A. hypotension

B. decreased gastric emptying

C. decreased anesthetic requirements

D. all of the above

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6
Q

Elevation of the legs in the lithotomy position can cause:

A. hypotension

B. acute decrease in VR

C. decrease in MAP

D. exacerbation of CHF

A

A. hypotension

B. acute decrease in VR

C. decrease in MAP

D. exacerbation of CHF

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7
Q

What ventilatory changes should be made to prevent barotrauma/hypercarbia? (select 2)

A. decrease RR

B. increase RR

C. decrease Vt

D. increase Vt

A

A. decrease RR

B. increase RR

C. decrease Vt

D. increase Vt

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8
Q

A vulvectomy is:

A. the process of dilating the cervix and removing contents of the uterus

B. the removal of the uterus though the vagina

C. the removal of entire vulva

D. the removal of pelvic organs effected by a malignancy

A

A. the process of dilating the cervix and removing contents of the uterus

B. the removal of the uterus though the vagina

C. the removal of entire vulva

D. the removal of pelvic organs effected by a malignancy

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9
Q

A dilation and curettage requires what sensory level block?

A. T10

B. T11

C. T12

D. L4

A

A. T10

B. T11

C. T12

D. L4

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10
Q

A hysterectomy requires what sensory level block?

A. T10

B. T11

C. T4-T6

D. T2-T4

A

A. T10

B. T11

C. T4-T6

D. T2-T4

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11
Q

At what point of gestation is a woman considered a full stomach?

A. >10 weeks

B. >12 weeks

C. >16 weeks

D. >20 weeks

A

A. >10 weeks

B. >12 weeks

C. >16 weeks

D. >20 weeks

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12
Q

What is the correct dose of Ergonovine to help stop bleeding after delivery?

A. 20-30 U added to 1L IVF

B. 2.0 mg IM/SQ

C. 0.2 mg IV

D. 0.2 mg IM/SQ

A

A. 20-30 U added to 1L IVF

B. 2.0 mg IM/SQ

C. 0.2 mg IV

D. 0.2 mg IM/SQ

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13
Q

What would cause the anesthetist to be suspicious of a uterine rupture post-op? (select 2)

A. hypotension

B. severe back pain

C. severe abdominal pain

D. referred shoulder pain

A

A. hypotension

B. severe back pain

C. severe abdominal pain

D. referred shoulder pain

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14
Q

Select two concerns with the use of lasers.

A. OR fires

B. high sensory block required

C. vaporization of viral particles

D. potential for large blood loss

A

A. OR fires

B. high sensory block required

C. vaporization of viral particles

D. potential for large blood loss

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15
Q

CO2 beams are more precise than YAG beams in laser fulgurations.

A. True

B. False

A

A. True

B. False

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16
Q

The preferred approach for a hysterectomy is:

A. abdominal

B. midline incision

C. vaginal

D. bikini incision

A

A. abdominal

B. midline incision

C. vaginal

D. bikini incision

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17
Q

Younger patients receiving spinal or epidural anesthesia for a hysterectomy are an increased risk for:

A. bleeding

B. post-op pain

C. hypotension

D. post dural puncture headache

A

A. bleeding

B. post-op pain

C. hypotension

D. post dural puncture headache

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18
Q

Muscle relaxation is required for:

A. abdominal hysterectomy

B. vaginal hysterectomy

C. both

D. neither

A

A. abdominal hysterectomy

B. vaginal hysterectomy

C. both

D. neither

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19
Q

If a surgeon injects a vasopressor into the submucosa to minimize blood loss, what should you be on the look out for?

A. hypotension

B. reflexive bradycardia

C. reflexive tachycardia

D. bleeding

A

A. hypotension

B. reflexive bradycardia

C. reflexive tachycardia

D. bleeding

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20
Q

Sources of fluid deficits include (select three)

A. HTN

B. NPO guidelines

C. emesis due to a bowel obstruction

D. tachycardia

E. hypothermia

F. sequestration of water/electrolytes into abdominal structures

A

A. HTN

B. NPO guidelines

C. emesis due to a bowel obstruction

D. tachycardia

E. hypothermia

F. sequestration of water/electrolytes into abdominal structures

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21
Q

Signs of decreased peripheral perfusion due to hypovolemia include all of the following except:

A. increased skin temperature

B. skin mottling

C. dry mucous membranes

D. decreased skin turgor

A

A. increased skin temperature

B. skin mottling

C. dry mucous membranes

D. decreased skin turgor

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22
Q

What Hct value is a reflection of a patient having very concentrated serum?

A. 60%

B. 30%

C. 25%

D. 45%

A

A. 60%

B. 30%

C. 25%

D. 45%

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23
Q

Diarrhea causes metabolic ________ while vomiting causes metabolic _________.

A. acidosis, alkalosis

B. alkalosis, acidosis

C. acidosis, acidosis

D. alkalosis, alkalosis

A

A. acidosis, alkalosis

B. alkalosis, acidosis

C. acidosis, acidosis

D. alkalosis, alkalosis

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24
Q

Not all patients undergoing abdominal surgery are considered to have a full stomach.

A. True

B. False

A

A. True

B. False

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25
Q

Blocks of the T2-T4 sensory level will cause:

A. decreased minute to minute ventilation

B. paralysis of intercostal muscles

C. prevention of shoulder pain

D. all of the above

A

A. decreased minute to minute ventilation

B. paralysis of intercostal muscles

C. prevention of shoulder pain

D. all of the above

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26
Q

Regional anesthesia can cause unopposed PNS activity. How can this be reversed?

A. ensure adequate fluid status

B. proper patient positioning

C. administering glycopyrrolate

D. ensuring complete muscle relaxation

A

A. ensure adequate fluid status

B. proper patient positioning

C. administering glycopyrrolate

D. ensuring complete muscle relaxation

27
Q

Longer cases or cases with significant bowel exposure are expected to have ______ ml/kg/hr of evaporative fluid loss.

A. 8-10

B. 10-12

C. 12-15

D. 10-15

A

A. 8-10

B. 10-12

C. 12-15

D. 10-15

28
Q

Causes of 3rd spacing include all of the following except:

A. burns

B. infection

C. obstruction

D. ascites

A

A. burns

B. infection

C. obstruction

D. ascites

29
Q

Abrupt drainage of ascites can cause acute hypotension due to:

A. an increase of intra-abdominal pressure

B. a reduction in VR

C. bleeding

D. all of the above

A

A. an increase of intra-abdominal pressure

B. a reduction in VR

C. bleeding

D. all of the above

30
Q

How many twitches are recommended that relaxants be titrated to in order to provide adequate relaxation for abdominal closure?

A. 1

B. 2

C. 3

D. 4

A

A. 1

B. 2

C. 3

D. 4

31
Q

The use of what anesthetic gas is contraindicated in abdominal procedures?

A. N2O

B. NO

C. CO2

D. NO2

A

A. N2O

B. NO

C. CO2

D. NO2

32
Q

What prostanoid causes hemodynamic changes due to bowel manipulation?

A. prostaglandin H1a

B. prostaglandin F2a

C. prostaglandin F1a

D. all of the above

A

A. prostaglandin H1a

B. prostaglandin F2a

C. prostaglandin F1a

D. all of the above

33
Q

Hypothermia due to convection can be caused by what air flow rates in the OR?

A. 5-10 room volume changes/hr

B. 10-15 room volume changes/hr

C. 15-20 room volume changes/hr

D. 20-25 room volume changes/hr

A

A. 5-10 room volume changes/hr

B. 10-15 room volume changes/hr

C. 15-20 room volume changes/hr

D. 20-25 room volume changes/hr

34
Q

Select three physiological changes associated with hypothermia (select 3)

A. increased SVR

B. decreased SVR

C. decreased CBF

D. decreased O2 consumption

E. increased MAC

F. decreased blood viscosity

A

A. increased SVR

B. decreased SVR

C. decreased CBF

D. decreased O2 consumption

E. increased MAC

F. decreased blood viscosity

35
Q

Select two treatment options for intraoperative hiccups.

A. decrease depth of anesthesia

B. increase depth of neuromuscular blockade

C. administer chlorpromazine

D. administer metoclopramide

A

A. decrease depth of anesthesia

B. increase depth of neuromuscular blockade

C. administer chlorpromazine

D. administer metoclopramide

36
Q

Carcinoid tumors secrete all of the following vasoactive substances except:

A. serotonin

B. kalikrein

C. melatonin

D. histamine

A

A. serotonin

B. kalikrein

C. melatonin

D. histamine

37
Q

Serotonin causes ________ while histamine causes _________.

A. vasodilation, vasoconstriction

B. vasoconstriction, vasodilation

C. vasoconstriction, bronchodilation

D. vasodilation, bronchoconstriction

A

A. vasodilation, vasoconstriction

B. vasoconstriction, vasodilation

C. vasoconstriction, bronchodilation

D. vasodilation, bronchoconstriction

38
Q

What is the name of the urinary serotonin metabolite that is elevated in patients with Carcinoid tumors?

A. indoleacetic acid

B. 1,2-hydroxyindoleacetic acid

C. 4-hydroxyindoleacetic acid

D. 5-hydroxyindoleacetic acid

A

A. indoleacetic acid

B. 1,2-hydroxyindoleacetic acid

C. 4-hydroxyindoleacetic acid

D. 5-hydroxyindoleacetic acid

39
Q

What treatment of carcinoid tumors will reduce the release of vasoactive tumor products?

A. serotonin antagonist

B. surgical resection

C. somatostatin

D. histamine antagonist

A

A. serotonin antagonist

B. surgical resection

C. somatostatin

D. histamine antagonist

40
Q

Administration of which agent may activate kallikrein?

A. propofol

B. epinephrine

C. morphine

D. atracurium

A

A. propofol

B. epinephrine

C. morphine

D. atracurium

41
Q

Disadvantages of laparoscopic procedures include (select two)

A. increased stress response

B. increased risk for PONV

C. longer hospital stays

D. longer operating time

A

A. increased stress response

B. increased risk for PONV

C. longer hospital stays

D. longer operating time

42
Q

Which gas (for insufflation) has the greatest risk of embolization?

A. CO2

B. helium

C. O2

D. air

A

A. CO2

B. helium

C. O2

D. air

43
Q

Trendelenburg is used for _______ abdominal laparoscopic procedures while reverse Trendelenburg is used for ________ abdominal laparoscopic procedures.

A. lower, upper

B. upper, lower

C. both upper and lower, lower

D. lower, lower

A

A. lower, upper

B. upper, lower

C. both upper and lower, lower

D. lower, lower

44
Q

Immediate CV effects from insufflation of the abdomen include (select two)

A. Increased VR

B. decreased VR

C. Increased SVR

D. decreased CVP

A

A. Increased VR

B. decreased VR

C. Increased SVR

D. decreased CVP

45
Q

The direct effect of CO2 absorption from insufflation is increased SNS stimulation

A. True

B. False

A

A. True

B. False

46
Q

Select two regional circulatory changes that occur due to CO2 insufflation.

A. decreased CBF/ICP

B. decreased RBF/GFR

C. decreased femoral vein blood flow

D. respiratory alkalosis

A

A. decreased CBF/ICP

B. decreased RBF/GFR

C. decreased femoral vein blood flow

D. respiratory alkalosis

47
Q

The displacement of the diaphragm cephalad causes all of the following to decrease except:

A. FRC

B. lung volumes

C. PIP

D. pulmonary compliance

A

A. FRC

B. lung volumes

C. PIP

D. pulmonary compliance

48
Q

What ventilatory change can be made to counteract hypercarbia due to CO2 insufflation?

A. decrease RR

B. increase RR

C. increase Vt

D. add PEEP

A

A. decrease RR

B. increase RR

C. increase Vt

D. add PEEP

49
Q

Reverse Trendelenburg causes a decrease in all of the following except:

A. preload

B. MAP

C. CO

D. FRC

A

A. preload

B. MAP

C. CO

D. FRC

50
Q

Trendelenburg causes a decrease in all of the following except:

A. pulmonary compliance

B. TLC

C. preload

D. FRC

A

A. pulmonary compliance

B. TLC

C. preload

D. FRC

51
Q

Contraindications for laparoscopic procedures include all of the following except:

A. decreased ICP

B. CHF

C. coagulopathy

D. severe COPD

A

A. decreased ICP

B. CHF

C. coagulopathy

D. severe COPD

52
Q

Referred shoulder pain cannot be blocked by regional anesthesia

A. True

B. False

A

A. True

B. False

53
Q

When the pneumoperitoneum is released, what ventilatory change should you consider making?

A. increase RR

B. decrease Vt

C. decrease RR

D. decrease PEEP

A

A. increase RR

B. decrease Vt

C. decrease RR

D. decrease PEEP

54
Q

Patients with preexisting cardiopulmonary disease may show an increase in ETCO2 despite being hypercarbic due to:

A. increased shunting

B. decrease in ventilation

C. increased alveolar deadspace

D. increase in lung perfusion

A

A. increased shunting

B. decrease in ventilation

C. increased alveolar deadspace

D. increase in lung perfusion

55
Q

What can decrease the incidence of PONV with laparoscopic procedures?

A. neostigmine

B. TIVA

C. inhalation agents

D. MAC

A

A. neostigmine

B. TIVA

C. inhalation agents

D. MAC

56
Q

What can help reduce the incidence of referred shoulder pain due to diaphragmatic irritation? (select two)

A. remove as much CO2 as possible at the end of the case

B. controlling pain intraoperatively with opioids only

C. intraperitoneal instillation of 20 ml of 0.25% bupivacaine between the liver and diaphragm

D. allowing for greater stretching of the intra-abdominal cavity

A

A. remove as much CO2 as possible at the end of the case

B. controlling pain intraoperatively with opioids only

C. intraperitoneal instillation of 20 ml of 0.25% bupivacaine between the liver and diaphragm

D. allowing for greater stretching of the intra-abdominal cavity

57
Q

Gastric distention is to NGT as:

A. adhesions are to foley

B. concealed bleeding is to adhesions

C. bladder distention is to foley

D. none of the above

A

A. adhesions are to foley

B. concealed bleeding is to adhesions

C. bladder distention is to foley

D. none of the above

58
Q

Excessive IntraAbdominalPressure (IAP) > _____ mmHg can lead to cardiovascular complications.

A. 16

B. 18

C. 20

D. 25

A

A. 16

B. 18

C. 20

D. 25

59
Q

Subcutaneous emphysema can occur due to:

A. inadvertent intraperitoneal insufflation

B. sudden decrease in ETCO2

C. decreased area for CO2 diffusion

D. inadvertent extraperitoneal insufflation

A

A. inadvertent intraperitoneal insufflation

B. sudden decrease in ETCO2

C. decreased area for CO2 diffusion

D. inadvertent extraperitoneal insufflation

60
Q

Pneumothrorax and pneumomediastinum can be diagnosed by all of the following observations except:

A. decreased SaO2

B. unexpected hypercarbia

C. increased peak airway pressures

D. profound hypertension

A

A. decreased SaO2

B. unexpected hypercarbia

C. increased peak airway pressures

D. profound hypertension

61
Q

Select two treatments for a venous gas embolism.

A. hyperventilate

B. slow down gas insufflation

C. increase inhalation agent

D. immediately release pneumoperitoneum

A

A. hyperventilate

B. slow down gas insufflation

C. increase inhalation agent

D. immediately release pneumoperitoneum

62
Q

Two effects of the steep Trendelenburg position for robotic procedures include:

A. decreased VR

B. edema

C. decreased FRC

D. decreased CO2

A

A. decreased VR

B. edema

C. decreased FRC

D. decreased CO2

63
Q

If a leak is present after you decrease the cuff on the patient’s ETT, then edema is still present and the ETT must remain in place until fluid balance is corrected.

A. True

B. False

A

A. True

B. False

7835 Exam III (minus Module 8) (21 decks)

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