Mod9: April's Practice questions Flashcards
The transparent, anterior portion of the eye that permits light to enter is called the:
A. cornea
B. iris
C. ciliary body
D. retina
A. cornea
B. iris
C. ciliary body
D. retina
Mydrasis occurs during ____ activation while miosis occurs during _____ activation.
A. SNS, PNS
B.PNS, SNS
C. both SNS and PNS
A. SNS, PNS
B.PNS, SNS
C. both SNS and PNS
Topical administration of drugs act on the _________.
A. choroid
B. conjunctiva
C. sclera
D. ciliary body
A. choroid
B. conjunctiva
C. sclera
D. ciliary body
How many muscles move the eye within the globe?
A. 5
B. 6
C. 8
D. 10
A. 5
B. 6
C. 8
D. 10
Treatment of glaucoma includes (select two)
A. decreasing aqueous drainage
B. increasing aqueous production
C. increasing aqueous drainage
D. decreasing aqueous production
A. decreasing aqueous drainage
B. increasing aqueous production
C. increasing aqueous drainage
D. decreasing aqueous production
Select two class of medications that will decrease aqueous production
A. beta-blockers
B. anticholinesterases
C. carbonic anhydrase inhibitors
D. cholinergic agonist
A. beta-blockers
B. anticholinesterases
C. carbonic anhydrase inhibitors
D. cholinergic agonist
<strong>Beta-blockers</strong> and <strong>carbonic anhydrase</strong> inhibitors will decrease aqueous <u>production</u>
<strong>Anticholinesterases</strong> & <strong>cholinergic agonist</strong> increase aqueous humor <u>drainage</u> via PNS mediated miosis
Miosis/constriction promotes aqueous outflow
A. True
B. False
A. True
B. False
Normal intraocular pressure is:
A. 6-10 mmHg
B. 10-15 mmHg
C. 12-20 mmHg
D. 15-22 mmHg
A. 6-10 mmHg
B. 10-15 mmHg
C. 12-20 mmHg
D. 15-22 mmHg
Factors that increase intraocular pressure include all of the following except:
A. decrease in aqueous drainage
B. hypercarbia
C. decrease in CVP
D. coughing
A. decrease in aqueous drainage
B. hypercarbia
C. decrease in CVP
D. coughing
Succinylcholine will increase IOP ______ mmHg for 5-10 minutes.
A. 2-4
B. 5-10
C. 8-10
D. 10-12
A. 2-4
B. 5-10
C. 8-10
D. 10-12
Which drug will theoretically decrease IOP to the greatest extent?
A. sevoflurane
B. N2O
C. fentanyl
D. midazolam
A. sevoflurane
B. N2O
C. fentanyl
D. midazolam
The oculocardiac reflex, also referred to as the five and dime reflex, involves the trigeminal (V) nerve and the vagus (X) nerve. Which pathway does the vagus nerve take?
A. afferent
B. sensory
C. efferent
A. afferent
B. sensory
C. efferent
Which patient would you want to avoid giving a prophylactic dose of atropine to prevent OCR?
A. a 48 year old with COPD
B. a 60 year old with CAD
C. a 50 year old with HTN
D. a 75 year old with RA
A. a 48 year old with COPD
B. a 60 year old with CAD
C. a 50 year old with HTN
D. a 75 year old with RA
Topical or regional anesthesia for eye procedures may not be well tolerated in:
A. a patient who is able to lie flat
B. a patient who has a chronic cough
C. a patient who can lie flat
D. a patient who can tolerate their face being covered
A. a patient who is able to lie flat
B. a patient who has a chronic cough
C. a patient who can lie flat
D. a patient who can tolerate their face being covered
Which type of block is associated with less pain but a longer onset?
A. peribulbar
B. retrobulbar
C. facial nerve
D. none of the above
A. peribulbar
B. retrobulbar
C. facial nerve
D. none of the above
The most common complication from blocks in ophthalmic procedures is:
A. stimulation of OCR
B. retrobulbar hemorrhage
C. trauma to optic cranial nerve
D. intraarterial injection
A. stimulation of OCR
B. retrobulbar hemorrhage
C. trauma to optic cranial nerve
D. intraarterial injection
Complications associated with a facial nerve block include all of the following except:
A. laryngospasm
B. dysphagia
C. seizures
D. respiratory distress
A. laryngospasm
B. dysphagia
C. seizures
D. respiratory distress
Post retrobulbar syndrome can cause (select two)
A. LOC
B. laryngospasm
C. apnea
D. retrobulbar hemorrhage
A. LOC
B. laryngospasm
C. apnea
D. retrobulbar hemorrhage
Topical anesthesia can only be used for anterior chamber ophthalmic procedures.
A. True
B. False
A. True
B. False
Indications for general anesthesia for ophthalmic procedures include all of the following except:
A. severe claustrophobia
B. inability to communicate
C. inability to lie flat
D. procedures longer than 1 hour
A. severe claustrophobia
B. inability to communicate
C. inability to lie flat
D. procedures longer than 1 hour
Strabismus procedures have an increased risk of (select two)
A. post-op pain
B. PONV
C. bleeding
D. OCR
A. post-op pain
B. PONV
C. bleeding
D. OCR
Phacoemulsification is: (select two)
A. usually performed under regional anesthesia
B. usually performed under topical anesthesia
C. typically a no stitch procedure
D. involves a 10-12 mm incision
A. usually performed under regional anesthesia
B. usually performed under topical anesthesia
C. typically a no stitch procedure
D. involves a 10-12 mm incision
To prevent the accumulation of CO2 under facial drapes during a cataract procedure, the anesthetist should:
A. have HOB slightly elevated
B. maintain FGF >10 L/min
C. increase RR
D. keep the patient warm
A. have HOB slightly elevated
B. maintain FGF >10 L/min
C. increase RR
D. keep the patient warm
Select the correct sequence of duration of gas bubbles in vitreous cavity (from shortest to longest)
A. SF6 < air < C4F8 < C3F8
B. air < C4F8 < SF6 < C3F8
C. air < SF6 < C4F8 < C3F8
D. SF8 < air < C3F8 < C4F8
A. SF6 < air < C4F8 < C3F8
B. air < C4F8 < SF6 < C3F8
C. air < SF6 < C4F8 < C3F8
D. SF8 < air < C3F8 < C4F8
If air is used for an intraocular gas expansion, then how long must the patient wait before receiving N2O?
A. 3 days
B. 5 days
C. 10 days
D. 13 days
A. 3 days
B. 5 days
C. 10 days
D. 13 days
When the globe is open during a surgical procedure or following a traumatic injury:
A. patients are considered to have an empty stomach
B. there is a decrease in IOP
C. drainage of aqueous humor or extrusion of vitreous humor may occur through the wound
D. all of the above
A. patients are considered to have an empty stomach
B. there is a decrease in IOP
C. drainage of aqueous humor or extrusion of vitreous humor may occur through the wound
D. all of the above
Select two ways to prevent increases in IOP.
A. avoid direct pressure on globe
B. avoid increase in CVP
C. extubate awake
D. avoid deep levels of anesthesia
A. avoid direct pressure on globe
B. avoid increase in CVP
C. extubate awake
D. avoid deep levels of anesthesia
What two agents will increase IOP?
A. succinylcholine
B. rocuronium
C. ketamine
D. propofol
A. succinylcholine
B. rocuronium
C. ketamine
D. propofol
RSI with cricoid pressure should be used on a patient with an open globe injury.
A. True
B. False
A. True
B. False
Indications for a panendoscopy include (select two)
A. difficult intubation
B. diagnostic
C. removal of tonsils
D. removal of obstructive tumor
A. difficult intubation
B. diagnostic
C. removal of tonsils
D. removal of obstructive tumor
What premedication will help minimize secretions and facilitate airway visualization for a panendoscopy?
A. glycopyrrolate
B. atropine
C. scopolamine
D. metoclopramide
A. glycopyrrolate
B. atropine
C. scopolamine
D. metoclopramide
A succinylcholine drip is supplied in:
A. 100mg in 125 cc NS
B. 250 mg in 500 cc NS
C. 500 mg in 500 cc NS
D. 100 mg in 500 cc NS
A. 100mg in 125 cc NS
B. 250 mg in 500 cc NS
C. 500 mg in 500 cc NS
D. 100 mg in 500 cc NS
What drug would you want to avoid using in a panendoscopy?
A. remifentanil
B. propofol
C. esmolol
D. sufentanil
A. remifentanil
B. propofol
C. esmolol
D. sufentanil
What law explains why you would want to avoid using a microlaryngoscopy tube for too long?
A. Nerst
B. Ohm’s Law
C. Pousille’s Law
D. Lambert’s Law
A. Nerst
B. Ohm’s Law
C. Pousille’s Law
D. Lambert’s Law
Which anesthetic technique is best for a panendoscopy?
A. regional
B. TIVA
C. GETA
D. spinal
A. regional
B. TIVA
C. GETA
D. spinal
How long should expiration be with jet ventilation?
A. 1-2 seconds
B. 2-4 seconds
C. 4-6 seconds
D. 6 seconds
A. 1-2 seconds
B. 2-4 seconds
C. 4-6 seconds
D. 6 seconds
Inspirations with jet ventilation should last for 1-2 seconds and are delivered at ______ psi.
A. 30-60
B. 20-30
C. 40-50
D. 60-80
A. 30-60
B. 20-30
C. 40-50
D. 60-80
The “S” in LASER stands for:
A. simulated
B. stimulated
C. saturated
D. sequestered
A. simulated
B. stimulated
C. saturated
D. sequestered
Both manual and high frequency jet ventilation require TIVA.
A. True
B. False
A. True
B. False
YAG lasers:
A. can cause cornea damage, not retinal
B. produce long wavelengths
C. provide deeper tissue penetration
D. are more localized
A. can cause cornea damage, not retinal
B. produce long wavelengths
C. provide deeper tissue penetration
D. are more localized
To prevent eye injury from laser surgery, all of the following should be done except:
A. use lacrilube ointment to protect patient’s eyes
B. provide protective googles for everyone in OR
C. apply wet soaked gauze to the patient’s eyes
D. all of the above
A. use lacrilube ointment to protect patient’s eyes
B. provide protective googles for everyone in OR
C. apply wet soaked gauze to the patient’s eyes
D. all of the above
Select two ways to prevent an airway fire.
A. deliver FiO2 at 50% or greater
B. replace helium with N2O
C. limit laser intensity and duration
D. fill cuff with saline dyed methylene blue
A. deliver FiO2 at 50% or greater
B. replace helium with N2O
C. limit laser intensity and duration
D. fill cuff with saline dyed methylene blue
Select the correct sequence in the airway fire protocol
- stop ventilation and turn off O2
- Ventilate with 100% O2
- Remove ETT
- Reintubate
- Extinguish fire by placing ETT in H2O
- Assess airway damage
A. 1, 3, 4, 6, 5, 2
B. 1, 3, 5, 2, 4, 6
C. 1, 2, 5, 2, 6, 3
D. 1, 3, 2, 4, 5, 6
- stop ventilation and turn off O2
- Ventilate with 100% O2
- Remove ETT
- Reintubate
- Extinguish fire by placing ETT in H2O
- Assess airway damage
A. 1, 3, 4, 6, 5, 2
B. 1, 3, 5, 2, 4, 6
C. 1, 2, 5, 2, 6, 3
D. 1, 3, 2, 4, 5, 6
Patients undergoing a tonsillectomy and adenoidectomy are at an increased risk for (select two):
A. bacterial endocarditis
B. hyperventilation
C. re-bleeding
D. urinary retention
A. bacterial endocarditis
B. hyperventilation
C. re-bleeding
D. urinary retention
What are two ways to combat the pain associated with a tonsillectomy?
A. use of opioids intra-op
B. use of local anesthetics at surgical site
C. use of decadron to decrease inflammation
D. use of lidocaine during iduction
A. use of opioids intra-op
B. use of local anesthetics at surgical site
C. use of decadron to decrease inflammation
D. use of lidocaine during iduction
What is the correct positioning for a patient being transported to PACU post tonsillectomy?
A. supine with HOB elevated
B. prone
C. reverse Trendelenburg
D. lateral with head down
A. supine with HOB elevated
B. prone
C. reverse Trendelenburg
D. lateral with head down
Coughing during emergence from a tonsillectomy poses the greatest risk for:
A. aspiration
B. bucking
C. infection
D. postoperative bleeding
A. aspiration
B. bucking
C. infection
D. postoperative bleeding
Post-op pulmonary obstruction due to pulmonary edema can be treated with:
A. limiting O2
B. avoiding re-intubation
C. diuretics
D. early mobilization
A. limiting O2
B. avoiding re-intubation
C. diuretics
D. early mobilization
During a uvulopalatopharyngoplasty (UPPP), the surgeon is:
A. carving out redundant tissue
B. inserting an artificial pharynx
C. removing the uvula
D. all of the above
A. carving out redundant tissue
B. inserting an artificial pharynx
C. removing the uvula
D. all of the above
A.
B.
C.
D.
A.
B.
C.
D.
Methods to minimize blood loss and improve surgical field vision include (select two)
A. controlled hypotension
B. vasodilation
C. supine position
D. use of phenylephrine
A. controlled hypotension
B. vasodilation
C. supine position
D. use of phenylephrine
Extreme lateral rotation of the head in ear procedures can cause:
A. injury to the axillary nerve
B. injury to the brachial plexus
C. hypotension
D. C3-C4 subluxation in peds/RA
A. injury to the axillary nerve
B. injury to the brachial plexus
C. hypotension
D. C3-C4 subluxation in peds/RA
NDMR are strongly recommended in nasal and sinus procedures because the use of a rigid scope in the nose can cause bucking
A. True
B. False
A. True
B. False
HOB elevation in head and neck cancer surgeries place the patient at an increased risk for (best answer)
A. hypotension
B. VAE
C. bleeding
D. PONV
A. hypotension
B. VAE
C. bleeding
D. PONV
Select two types of drugs that should be avoided in head and neck cancer surgeries.
A. inhalation agents
B. opioids
C. NDMR
D. vasoconstrictiors
A. inhalation agents
B. opioids
C. NDMR
D. vasoconstrictiors
Select two complications from bilateral neck dissection (BLND)
A. postop bleeding
B. postop HTN
C. loss of hypoxic drive
D. hypocarbia
A. postop bleeding
B. postop HTN
C. loss of hypoxic drive
D. hypocarbia
Nasotracheal intubation is a contraindication in LeFort fractures because:
A. risk of meningitis
B. indirect mechanical damage to the brain
C. forces air into the skull
D. all of the above
A. risk of meningitis
B. indirect mechanical damage to the brain
C. forces air into the skull
D. all of the above
Ludwig’s angina:
A. is an airway emergency
B. AFOI is optional
C. is a lower airway obstruction
A. is an airway emergency
B. AFOI is optional
C. is a lower airway obstruction
