Review Questions Flashcards
Anaphylactic reactions are related to prior sensitization by exposure to an antigen with production of antigen specific ___________.
- IgE antibodies
Antibodies are specific proteins called __________ that can recognize and bind to a specific antigen.
- immunoglobulins
What types of patients have a compromised immune system?
- chemotherapy
- HIV
- one month old infant
Irritant or contact dermatitis accounts for the majority of latex reactions and is caused by what type of reaction?
- T-cell mediated reactions
What are the molecules capable of stimulating an immune response called?
- antigens
Irritant or contac dermatitis accounts for the majority of latex allergies and is caused by what?
T-cell mediated reactions
Order from of highest to lowest or most common culprits of allergic reactions
#1 muscle relaxants #2 Latex #3 antiobiotics #4 opioids
Aftet induction of anesthesia in the OR your pt experiences hives,flushing, and extensive hupotension, and high peak inspiratory pressures. List 3 interventions
Epinephrine
Benadryl/pepcid
IVF bolus
After incidental needlestick with HIV contaminated needle the incidence of seeoversion is ____
0.3%
Approximately 7 minutes aftet induction of general anesthesia with propofol, fentanyl, lidocaine, rocuronium and successful intubation your patient becomes severely hypotensive and tachycardic. You notice increase in peak airway pressures, a drop in oxygen saturation, and urticaria on the chest and abdomen. Which would you do first?
Administer 50-100mcg epinephrine IV
Which patient populations have the high risk of latex reactions
All of the above
- children with spina bifida
- people with urogenital abnormalities
- people with multiple food allergies
- people with history of atopy
- people with allergies to bananas, avocados, and kiwis
You are performing a cystoscopy on a chronic alcoholic patient who exhibits signs of cirrhosis including ascites. What are two anesthetic considerations that should be made
- Avoid placement of an NG/OG tube
- Placement of an ETT
Which consideration needs to be made for a patient undergoing the Ivor-Lewis procedure for esophagectomy with a thoracic approach?
One lung ventilation
A patient with pancreatic disease is likely to exhibit all of the following EXCEPT?
- Diabetes Insipidus
Will show ileus, hyper/hypoglycemia, electrolyte disorders
You are preparing a patient from the ICU for a projected 8 hour esophagectomy. The patient is receiving TPN. What do you do with the TPN?
Continue TPN throughout the procedure
Which of the following medications used in the patient with GERD will increase gastric volume?
Sodium bicitrate
Which of the following would not be expected change to occur during insufflation for a laparoscopic procedure?
Increased TV
Will see decreased FRC, decreased venous return, increased peak airway pressure
A patient scheduled for surgery for upper esophageal cancer. Intraoperative concerns for the patient include all of the following except:
- Anastomosis leak
Intraoperative concerns are hemorrhage, injury to RLN, injury to tracheobronchial tree
During a carotid endarterectomy the cerebral oximetry reading on the operative side begins to fall to more than 20% baseline. Which of the interventions are appropriate? (Select 3)
A. Decreasing respiratory rate B. Administer a vasodilator C. Asking the surgeon to infiltrate the region with local anesthetic D. Administer glycopyrrolate E. Administer a vasopressor F. Asking the surgeon to place a shunt
A. Decreasing respiratory rate
E. Administering a vasopressor
F. Asking the surgeon to place a shunt
A major risk with the aortic cross-clamp during open AAA is paraplegia. The paraplegia is most likely caused by?
A. Declamping shock syndrome
B. Clamping of the iliac artery
C. Hyperperfusion of the basilar artery
D. Spinal cord ischemia
D. Spinal cord ischemia
The law of Laplace is associated with aneurysm wall tension. As the diameter increases, what happens to the wall tension?
A. Remains unchanged
B. Increases
C. Decreases
D. All of the above
B. Increases
You are called emergently to the ICU for the patient you dropped off following a carotid endarterectomy 2 hours ago. Upon enetering the room, the patient is in obvious respiratory distress with swelling on the operative side of the neck. Your first action is?
A. Placement of ETT
B. Placing the patient on BiPAP
C. Calling the OR to let them know you will be going back to the OR
D. Decreasing the BP
A. Placement of an ETT