Preop/Intra/postop

Question 1

Difficult intubation predictors?

Answer 1

Prominent upper incisors
Receding chin
Thyromental distance

Question 2

Mallampati sensitivity and specificity?

Answer 2

50%

More specific 90%

Question 3

Thyromental distance sensitivity?

Answer 3

Variable between 20-70%

Question 4

Functional statue classification?

Answer 4

1: cardiac disease without limitations
2: mild symptoms (sob/angina) with mild limitations during ordinary activity
3: marked limitation due to sx, comfortable only at rest
4: sever limitation, sx even at rest.

Question 5

Hypothermia/heat loss causes during

First hour of surgery …..
During surgery …..

Answer 5

Redistribution of heat from core periphery

Radiation

Question 6

Effect of hypothermia?

Answer 6

• increased Hct
• thrombocytopenia
• increased WBC
• hyperglycemia
• cold diuretics, decreased ADH
• shifts oxy-HB curve to left
• ABG: decreases PaO2 + PaCO2 and increases pH
• decreases MAC

Question 7

Most effective method in mgmt of post op shivering?

Answer 7

Skin surface warming with forced air warmer

Question 8

How much PaO2 and PaCO2 decreases during hypothermia?

Answer 8

By 5 mmHg and PACO2 decreases by 2 mmHg

Question 9

Coughing during induction increases risk of …. in patients with perforated eye injury

Answer 9

Expulsion of eye contact

Question 10

The use of pulse ox during MRI, increases risk of …

Answer 10

Burns

Question 11

MCC of anaphylaxis during anesthesia?

Answer 11

Nonsteroidal NMB (e.g. rocuronium)

Question 12

Patients allergic to latex are likely allergic to?

Answer 12

Banana
Pineapple 
Mango
Kiwi
Soy

Question 13

First step in event of airway fire during laser use?

Answer 13

Turn off gases and pull out ETT

Question 14

How to decrease airway fire during laser surgery?

Answer 14

• keep FiO2 below 0.3
• no N2O use
• use NS to inflate cuff instead of air
• use aluminum foil to cover the ETT
• use metallic ETT

The use of laser in general can cause ETT fire

Question 15

CO2 vs Nd: YAG laser

Answer 15

Nd: YAG has lager wavelength and deeper tissue penetration can cause thermal damage. Also associated with air embolism.

Question 16

Sudden bradycardia and asystole with decreased EtCO2 in lap surgery at time of insufflation can be due to?

Answer 16

CO2 embolism

Question 17

MCC of inability to pass PACU after MAC is

Answer 17

Inadequate wakefulness (over sedation)

Question 18

…. is a must for discharge from PACU after day surgery

Answer 18

Adult escort (ride)

Question 19

MCC of hypoxia in PCU

Answer 19

Atelectasis resulting in Rt to Lf shunt

Question 20

Most likely cause of flaccid lower extremities paralysis and back pain following epidural?

Answer 20

Epidural hematoma

Question 21

Common causes of unilateral blindness following spine surgery in prone position

Answer 21

Ischemic optic neuropathy

Central retinal artery occlusion

Acute closed angle glaucoma

Question 22

Aspiration mgmt?

Answer 22

Intubation > auction out ETT prior to positive pressure ventilation

Question 23

Cause of airway instruction in thyroidectomy

• immediately after extubation….
• few hrs after extubation….
• 24 hrs after extubation….

Answer 23

• tracheomalacia, bilateral vocal cord paralysis
• bleeding and hematoma
• hypocalcemia (due to laryngeal dysfunction)

Question 24

MCC of strider in first 30 min after extubation following parathyoidectomy?

Answer 24

Airway edema