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Surgical Anesthesiology > Surg Anes > Flashcards

Surg Anes Flashcards

1
Q

Which muscles relaxant block muscarinic receptors? Which is most potent?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium
A

Pancuronium

Galamine ++

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2
Q

Formula for length

A

length = (age/12) + 12

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3
Q

A Grade 3 score under Cormack and Lehane classification anticipates that intubation is:

a. not difficult
b. fairly severe
c. slightly difficult
d. impossible by direct laryngoscopy only

A

b. fairly severe

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4
Q

Mivacurium is a short actin benzylquinolinium compound that is hydrolyzed by plasma cholinesterase

T/F

A

True

is the is only non-depolarizer that is hydrolyzed by cholinesterase

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5
Q

MOA of NO

A

the activity of B12 dependent enzyme METHIONINE SYNTHETASE AND THYMIDYLATE SYNTHETASE > irreversible oxidation of the cobalt atom of Vitamin B12

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6
Q

Correct sequent of evolutions of anesthetic techniques:

Inhalation
Intravenous
Local and Regional
Neuromuscular blocking agents

A

Inhalations > Local and Regional > Intravenous > Neuromuscular blocking agents

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7
Q

methods of elimination of inhaled anesthetics

A

. Alveolus (most important)
. Biotransformation
. Transcutaneous loss

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8
Q

Mallampati Classification and which are easy or difficult

A

I - soft palate, fauces in front, uvula, pillars
II - soft palate, fauces in front, uvula (no pillars)
EASY

III - soft palate, base of uvula
IV - hard palate only
DIFFICULT

IV requires special equipment

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9
Q

Vasoconstrictors mixed with local anesthetics:

a. will form precipitates
b. will produce hypotension
c. vasoconstrict surrounding blood vessels
d. hasten absoroption
d. maximize toxicity

A

d. hasten absoroption

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10
Q

Lung sounds are heard after intubation only over the right lung of an adult patient. The ET tube is at 27 cm at the teeth. The most likely explanation for the finding is:

a. occlusion of the endotracheal tube
b. left-sided pneumothorax
c. right mainstream intubation
d. right-sided hypertympany

A

c. right mainstream intubation

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11
Q

Which of th sedative/hypnotic drugs is 2 to 3 times as potent as the standard drug with a rapid onset but shorting acting can be used as an inducing agent:

a. diazepam
b. lorazepam
c. midazolam
d. pentobarbital

A

a. midalzolam

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12
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

MIVACURIUM

A

Nicotine Receptors NONE
Cardinal Muscarinic Receptors NONE
Histamine Release +

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13
Q

What is the glottis location in newborns?

A

C3 to C4

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14
Q

Which non-polariser has laudinine as a metabolite?

A

Atracurium

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15
Q

Sellick”s maneuver is:

a. application of gentle pressure on the cricoid cartilage
b. occlusion of the esophagus and trachea
c. prevents aspiratioin of gastric contents
d. A and C only
e. all of the above

A

e. all of the above

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16
Q

An active metabolite of pipecuronium is laudanosine which is a CNS stimulant

T/F

A

False

An active metabolite of ANTRACURIUM is laudanosine which is a CNS stimulant

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17
Q

A 54 years old ASA 1, male is for thyriodectomy, the following should be requested EXCEPT:

a. CBC
b. FBS
c. ECG
d. CXR

A

d. CXR

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18
Q

Mivacurium is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

A

d. ischemic heart disease

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19
Q

Anesthetic plan is based on

a. current status of pertinent known medical problems
b. cardiac status
c. functional status
d. B and C
e. aota

A

e. all of the above

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20
Q

Cholingeric is

parasympathetic
sympathetic

A

parasympathetic

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21
Q

minimum alveolar concentration (MAC) decreased by

A 
. NO
. Premedication
. Age
. Acute alcohol intoxication
. Hypothermia
. Hypotension
. Hypercarbia
. Sympathetic decrease
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22
Q

Most nephrotixic of inhaled anesthetics

A

methoxyflurane

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23
Q

Most common complication seen immediately after extubation

a. coughing
b. sore throat
c. laryngospasm
d. accidental tooth extraction

A

c. laryngospasm

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24
Q

What is the most potent of the inhalation anesthetics

A

Isoflurane

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25
Q

What are the laboratory exam validity of the following

. hematocrit
. serum glucose/creatinine/BUN
. Liver function test
. ECG
. CXR
. Coagulation studies
A 
. Hematocrit (1mo)
. serum glucose/creatinine/BUN (1 mo)
. Liver function test (1 mo)
. ECG (6 months)
. CXR (6 months)
. Coagulation studies (1 week)
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26
Q

factors affecting inspiratory concentration

A

. Fresh gas flow rate
. Breathing circuit volume
. Circuit absorption

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27
Q

The following statement regarding Macintosh blade is true:

a. a straight blade with curve tip
b. less need for a stylet
c. greater exposure of glottis opening
d. less trauma to the teeth

A

d. less trauma to the teeth

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28
Q

Duration of Mivscurium vs Atracurium/Vecurium

A

1/3 of A/V

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29
Q

ASA IV patients have a mortality rate of

a. 10%
b. 20%
c. 50%
d. 40%

A

b. 20%

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30
Q

Question

A

Answer

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31
Q

A 51 years old, male uncontrolled diabetes mellitus, his perioperative risk for cardian complication based on patient-related preditors will be

a. Major
b. Intermediate
c. Moderate
d. MInor

A

b. Intermediate

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32
Q

What is the net effect of volatile anesthetics on cerebral blood flow

A

balance betweebetween a reduction in Cerebral Blood Flow caused by Cerebral Metabolic Rate suppression and augmentation of Cerebral Blood Flow caused by the direct cerebral vasodilation.

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33
Q

Succinylcholine acts at the presynaptic sites blocking the Na channels therefore impairing the release of acetylcholine

T/F

A

False

Syccinylcholine is a depolarizer. It mimics the action of Ach and there is persistent depolarization due to open channels. This prevent propogation of action potential.

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34
Q

Halothane, the 1st halogenated hydrocarbon inhalation anesthetic is associated with:

a. Van Poznok and Artusia
b. Shykys and Krants
c. Barash
d. Suckling

A

d. Suckling

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35
Q

Technique of airway management where a plastic catheter is inserted at the cricothyroid membrane and serves as a guide for the ETT:

a. Fiberoptic technique
b. transtracheal ventilation
c. rapid sequence intubation
d. retrograde intubation

A

d. retrograde intubation

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36
Q

Most common methods of confirming ETT placement EXCEPT:

a. visualization of the ETT entering the larynx
b. auscultation of the chest for breath sounds
c. chest motion during ventilation
d. chest x-ray

A

d. chest xray

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37
Q

A 69 years old male will undergo thyroidectomy, the anesthetic plan will consist of:

a. Cormack Lehane Class II
b. general anesthesia
c. regional anesthesia
d. sedation

A

b. general anesthesia

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38
Q

Persistent depolarization of succinylcholine is associated with leakage of potassium ions from the activation

A

True

is

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39
Q

The “first anesthesiologist”:

a. Snow
b. Wells
c. Long
d. Davy

A

a. Snow

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40
Q

The patient who will not require preoperative evaluation

a. 72 yo male for cataract extraction under local anesthesia
b. 26 yo female with uncontrolled hypertension for breast cyst exicision under sedation
c. 6 yo male for explore lap under general anesthesia
d. 33 year old male for appendectomy under spinal anesthesia

A

a. 72 yo male for cataract extraction under local anesthesia

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41
Q

The following are the advantages when using anticholinergic agent EXCEPT:

a. lessen airway secretion
b. vagolytic action
c. pyrexia

A

c. pyrexia

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42
Q

A 72 years old male is considered moderate risk for perioperative cardiac complication based on the surgical procedure if he will undergo:

a. appendectomy for ruptured appendix
b. carotid endarterectomy
c. explore lap for complete gut obstruction
d. reopen surgery due to massive bleeding after a thyroidectomy

A

b. carotid endarterectomy

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43
Q

A 33 years old make is scheduled for hemorrhoidectomy is classified as:

a. ASA II if he has labile hypertension
b. ASA IE if he is a normal healthy patient
c. ASA III if he is a diabetic and can only walk three meters
d. ASA IV if he has a good control of his hypertension

A

c. ASA III if he is a diabetic and can only walk three meters

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44
Q

Short neck may result in difficult intubation.

a. the laryngeal axis will not align with the pharyngeal axis
b. the pharyngeal axis will not align with the oral axis
c. the pharyngeal and laryngeal axes will not align with the oral axis
d. the laryngeal and oral axes will not align with the pharyngeal axis

A

a. the laryngeal axis will not align with the pharyngeal axis

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45
Q

The term “anesthesia” as narcotic-like effect was first described by:

a. Dioscorides
b. Holmes
c. Long
d. Morton

A

a. Dioscorides

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46
Q

Place in order rapid sequence induction

. assistant administers medication
. non-depolarizing MR may be administered
. patient is intubated and cuff is inflated
. pre-oxygenation for 3-5 min
. respiration is not assisted until the airway is secure

A

. pre-oxygenation for 3-5 min > . respiration is not assisted until the airway is secure > . non-depolarizing MR may be administered > . assistant administers medication > . patient is intubated and cuff is inflated

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47
Q

Liver function test is valid for:

a. 1 month
b. 2 months
c. 3 months
d. 6 months
e. 12 months

A

a. 1 month

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48
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

PIPERCURONLUM

A

Nicotine Receptors NONE
Cardinal Muscarinic Receptors NONE
Histamine Release

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49
Q

Pipercuronium is safely given in patients with ischemic heart disease

T/F

A

True

Replacement for Pancuronium where increased in HR has to be avoided
Ischemic Heart disease
Long term mechanical ventilation

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50
Q

Inidication for endotracheal intubation includes:

a. risk of pulmonary aspirations
b. intracranial or intrathoracic surgery
c. prolonged positive pressure ventilation
d. all are correct

A

d. all are correct

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51
Q

A 79 years old patient who will undergo phaco surgery for cataract.

A. take midazolam PO before leaving the house if he is anxious

b. requires no premedication
c. can drink coffee with milk up to 2 hours prior to the procedure
d. can take diphenhydramine if he has history of allergy

A

b. requires no premedication

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52
Q

Which muscles relaxant has histamine release?Which is most potent?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium
A

D-Tubocurarine +++
Metacurarine
Atracurium
Mivacurium

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53
Q

Anatomic differences of children from adults:

a. newborn head is large
b. larynx is more caudal
c. glottic opening is the narrowest point in the larynx
d. glottis is located at C5 level

A

a. newborn head is large

. larynx is more cephalad
. cricoid cartilage is the narrowest point in the larynx (adults - vocal cords)
. Glottis is C3 level

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54
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

D-TUBO CURANINE

A

Nicotine Receptors BLOCKS ++
Cardinal Muscarinic Receptors NONE
Histamine Release +++

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55
Q

The cardiovascular effects of pancuronium are attributed to the selective cardiac vagal blockage and activation of the sympathethis nervous system

T/F

A

True

is

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56
Q

An important element in successful intubation is to adjust the table so that the patients’s face is at the level of the anesthesiologist’s:

a. clavicle
b. breast
c. xiphoid
d. umbilicus
e. iliac crest

A

c. xiphoid

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57
Q

Factors predisposing to aspiration

A 
Emergency SX
Inadequate anesthesia
Abdominal pathology
Obesity
Opioid medication
Neurologic deficit
Lithotomy
Difficult intubation/airway
Reflux
Hiatal hernia
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58
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

SUCCINYLCHOLINE

A

Nicotine Receptors STIM
Cardinal Muscarinic Receptors STIM
Histamine Release RARE

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59
Q

Dissociative anesthetic:

a. ketamine HCl
b. NO
c. halothane
mivacurium

A

a. ketamine HCl

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60
Q

NMB interferes with the physiological sequence of neuromuscular transmission. They are also considered anesthetics.

T/F

A

False

interferes with physiological sequence of neuromuscular transmission

Not anesthetics

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61
Q

factor affecting alveolar concentration

A

. Solubility in the blood
. alveolar blood flow
. Partial pressure difference between alveolar gas and venous blood

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62
Q

A 69 years old male will undergo thyroidectomy. What laboratory exam must be done?

A. PT time

b. CXR
c. CBC
d. Urinalysis
e. ECG

A

c. CBC

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63
Q

Inflation of the ETT cuff is verified by

a. equal breath sounds
b. inflated pilot balloon
c. presence of waveform in capnograph
d. adequate oxygenation

A

b. inflated pilot balloon

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64
Q

Indication for ETT

A 
. pulonary aspiration
. head and neck
. prone, sitting, lateral during surgery
. airway abnormalities
. intracranial, intrathoracic, intra abdominal
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65
Q

Prolonged exposure of sevoflurane in human will cause (3)

A

proteinuria, enzymuria, glycosuria

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66
Q

The following are the determinants of the what type of pre-medication and dosage to be given to patients EXCEPT:

a. patient’s age and weight
b. ASA physical status classification
c. marital status
d. level of anxiety

A

c. marital status

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67
Q

Pancuronium is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

A

e. liver disease

68
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

Atracurium

A

Nicotine Receptors NONE
Cardinal Muscarinic Receptors NONE
Histamine Release +

69
Q

Techniques for orotracheal intubation includes the following:

a. height of the table should be at the anesthesiologists symphysis pubis
b. the laryngoscope handle is held by the right hand
c. the glottic opening is recognized by its triangular shape & pale white vocal cords
d. the ETT is advanced until the cuff is at the level of the vocal cords

A

c. the glottic opening is recognized by its triangular shape & pale white vocal cords

70
Q

The need for further cardiac evaluation is influenced by:

a. anesthetic technique
b. surgery type
c. laboratory examination
d. result of ECG

A

d. result of ECG

71
Q

Which muscles relaxant block nicotinic receptors? Which is most potent?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium
A

D-Tubocurarine ++

Metacurarine

72
Q

Pancuronium is contraindicated in which HR increase adverse diseases

A

Hypovolemia
Valvular Heart Disease
Coronary heart disease

73
Q

Non-depolarizers binds to postsynaptic receptors which prevent acetylcholine from activating sodium channels therefore depolarization cannot occur

T/F

A

True

is

74
Q

Onset of Succinylcholine

A

30-60 seconds; can intubate 3-5 min

75
Q

Adverse side effects of Succinylcholine

A 
Cardiac dysthymia 
Hyperkalemia
Myalgia
Myloglobinuria
Increase intragastric pressure
Increase intraoptical pressure
Increased intracranial pressure
Sustained skeletal muscle contraction (myotonia)
76
Q

Evolution of the practice of anesthesiology happened in:

a. England and USA
b. Japan and Germany
c. England and Spain
d. USA and Russia

A

a. England and USA

77
Q

Prolonged exposure of NO in human will cause

A

megaloblastic anemia

78
Q

Atracurium can be given to those with renal or hapatic disease.

T/F

A

True - metabolism happens in blood

79
Q

Ideal pre-operative interview EXCEPT:

a. reassuring
b. via cell phone
c. unhurried and tactful
d. at least within 24 hours prior to operations

A

b. via cell phone

80
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

VECURONIUM

A

Nicotine Receptors NONE
Cardinal Muscarinic Receptors NONE
Histamine Release NONE

81
Q

MOA of non-depolarisers

A

1) block post synaptic receptor not allowing Ach to activate Na channels
2) block pre-synap sites to block Na channels which impairs the release of Ach

82
Q

Blunt baroreceptor reflex associated with

A

halothane

83
Q

minimum alveolar concentration (MAC) increased by

A

. Age (highest at 6 mo)
. Chronic alcohol abuse
. Sympathetic increase (drugs)
. Hypermetabolic states

84
Q

No depressant drugs before surgery for the following (4)

A

little physiologic reserve
head injury
hypovolemia
extremes of age

85
Q

Lower limit autoregulation pressure

A

50 mmHg

86
Q

Cormack and Lehane classification based on

A

views obtained at laryngoscopy

87
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

PANCURONIUM

A

Nicotine Receptors NONE
Cardinal Muscarinic Receptors BLOCK +
Histamine Release NONE

88
Q

Arrange in chronological order the following steps

a. visualization of the glottic opening
b. Sellick’s maneuver
c. insertion of geudel airway
d. insertion of endotracheal tube
e. locating the epiglottis

A

locating the epiglottis > visualization of the glottic opening > Sellick’s maneuver > insertion of endotracheal tube > insertion of geudel airway

89
Q

Normal mouth opening in an adult:

a. 20 mm
b. 40 mm
c. 20 cm
d. 40 cm

A

b. 40 mm

90
Q

Succinylcholine is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

A

c. burn patients

91
Q

Block / Stimulate / No Effect

Nicotine Receptors
Cardinal Muscarinic Receptors
Histamine Release

METACURINE

A

Nicotine Receptors BLOCKS
Cardinal Muscarinic Receptors NONE
Histamine Release ++

92
Q

What is the mean arterial pressure range?

A

65 to 150 mmHg

93
Q

Vecuronium is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

A

a. renal disease

94
Q

Instrument used to prevent patients from biting the tube and obstructing their own airway:

a. stylet
b. cuff
c. guedel airway
d. laryngeal mask

A

c. guedel airway

95
Q

What type of cardiac dysarthria does succincholine illicit?

A

Sinus brachycardia
Sinus arrest
Junctional rhythm

96
Q

Atracurium is contraindicated in

a. renal disease
b. status asthmaticus
c. burn patients
d. ischemic heart disease
e. liver disease

A

b. status asthmaticus

97
Q

A medical prodecure wherein a tube is placed into the trachea through the mouth:

a. retrograde intubartion
b. nasotracheal intubation
c. orotracheal intubation

A

c. orotracheal intubation

98
Q

A 6 years old female for tonsilectomy came for follow-up, She has fever, wheezing, and significant nasal discharge.

a. do a repear CBC
b. determine if the pathology is viral
c. postpone surgery
d. give atropine for premedication to dry secretions

A

c. postpone surgery

99
Q

The most important goal of preoperative evaluation is:

a. risk reduction
b. cost reduction
c. efficiency promotion
d. patient preparation

A

a. risk reduction

100
Q

Patients of extreme ages are classified as:

a. ASA I
b. ASA II
c. ASA III
d. ASA IV
e. ASA V

A

c. ASA III

101
Q

retrograde intubation uses what forceps?

A

Magill

102
Q

Which muscle relaxants stimulates muscarinic receptors?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium
A

succinylcholine

103
Q

Low cholinesterase activity associated with

A

Pregnancy
Severe liver disease
Anti-cholinesterase drug

104
Q

Penington forumula for ID abvoe and below 6 yo

A

<6
ID = (age/3) + 3.5

> 6
ID = (age/4) + 4.5

105
Q

Development of hypodermic needle and syringe is credited to:

a. Wood
b. Ore
c. Burkhardt
d. Fischer

A

a. Wood

106
Q

An example of opioid which can be given as premedication is:

a. oxycodone
b. ketoroiac
c. gabapentine
d. loratidine

A

a. oxycodone

107
Q

Computer the ET size of a 6 year old year old 20 kg using the Penington formula:

a. 5.0 mm
b. 5.5 mm
c. 6.0 mm
d. 6.5 mm

A

d. 6.5

108
Q

What is a short acting benzylquinolinium?

A

Mivacarium

109
Q

Blocked of the conscious perception of pain:

a. amnesia
b. relaxation
c. analgesia
d. obtundation

A

c. analgesia

110
Q

Coagulation studies are indicated in patients

a. prolonged intake of warfarin
b. use of NSAIDS for 5 days
c. history of dengue fever
e. hep A infection 5 years ago

A

a. prolonged intake of warfarin

111
Q

Noted the use of nitrous oxide for analgesia and surgery:

a. Soubeian
b. Davy
c. Guthrie
d. Simpson

A

b. Davy

112
Q

The narrow point of the pediatric larynx is

A

criocoid cartilage

113
Q

In case of inability to ventilate and intubate, the airways equipment to be used is the

a. oral airway
b. nasal airway
c. laryngeal mask
d. ETT

A

b. nasal airway

114
Q

The following are the commonly used monitors in the operating room EXCEPT:

a. non-invasive blood pressure apparatus
b. pulse monitor
c. electrocardiagram
d. central venous pressure monitor

A

d. central venous pressure monitor

115
Q

How is Atracurium metabolised?

A

Hoffman elimination

Ester hydrolysis

116
Q

The best time to extubate the patient is during

a. Emergence
b. awake
c. laryngospasm
d. accidental tooth extraction

A

a. Emergence

117
Q

Most reliable method of confirming ETT placement:

a. fiberoptic bronchoscopy
b. chest x-ray
c. capnography
d. auscultation on breath sounds

A

c. capnography

118
Q

Two weeks prior to surgery, laboratory and diagnostic exams show normal results.

A. a repeat prothrombin time will be requested

b. if a patient has chronic anemia, a repeat Hgb is done
c. pre-operative chest x-rays among elderly always required
d. physiologic age for ECG is > 50 years old

A

A. a repeat prothrombin time will be requested (valid for 1 week)

. Hematocrit - 1 month
. Serum glucose/creatinine/BUN - 1 month
. ECG - 6 months
. CXRs - 6 months
. Coagulation studies - 1 week
119
Q

The absence of waveform in the capnograph wiehn the ETT is inserted will require

a. increase oxygenation
b. re-intubation
c. adjustment of the ETT
d. inflation of the pilot balloon

A

c. adjustment of the ETT

120
Q

Which muscle relaxants stimulates nicotinic receptors?

Succinylcholine
D-Tubocurarine
Metacurarine
Pancuronium
Galamine
Atracurium
Mivacurium
A

succinylcholine

121
Q

The glottis opening is in the level of the 4th to 6th first cervical vertebrae in

a. infant
b. toddler
c. child
d. adult

A

d. adult

122
Q

Cerebral Perfusion Pressure equation

A

MAP - ICP

123
Q

What is the result if Vecurium is given with opioids?

A

Brachycardia

124
Q

What are the long acting depolarisers?

A

Pancuronium

Pipecuronium

125
Q

A 41 years old male was referred to the Anesthesia Service for scheduled Colonoscopy.

A. ASA Class III if hypertention is controlled

b. E is added for Elective procedure
c. ASA Class I if he has no-comorbid conditions
d. ASA Class II if he has uncontrolled DM

A

c. ASA Class I if he has no-comorbid conditions

126
Q

Succinylcholine causes an increase in intraocular pressure which is secondary to contraction of tonic myofibrils and dilation of choroidal blood vessels

T/F

A

True

is

127
Q

Which of the following statements is related to rapid sequence induction?

a. pre-oxygenation for 3-5 minutes
b. application of cricoid pressure
c. used in patients with full stomach
d. A and B only
e. all of the above

A

e. all of the above

128
Q

what is second gas effect?

A

A high concentration of gas will augment not only its own uptake but that of a concurrently administered volatile anesthetic

129
Q

Discovered nitrous oxide and oxygen:

a. Hickman
b. Priestly
c. Morton
d. Newton

A

b. Priestly

130
Q

What is the basis of the Mallampati classification system?

A

visualization of the oropharynx

131
Q

Physiological responses to ETT

A

. cardiovascular and sympathoadrenal responses

. increased intracranial pressure

132
Q

Most widely used classification of laryngeal view using direct laryngoscopy:

a. Mallamparti
b. Water’s
c. Cormack and Lehande
d. Samson-Young

A

c. Cormack and Lehande

Mallamparti only uses a light source; Cormack and Lehande uses laryngoscopy

133
Q

Preoperative evaluation prior to intubation will allow the anatomic assessment of the following EXCEPT:

a. dental state
b. mandibular opening
c. TMJ
d. presence of hypertention

A

d. presence of hypertension

134
Q

Using the Penington Formula, computer for the approximate ET size of a 5 yo child:

a. 4.0 - 4.5 mm
b. 4.5 - 5.0 mm
c. 5.0 - 5.5 mm
d. 5.5 - 6.0 mm

A

c. 5.0 - 5.5 mm

<6.5 yo: (age years/3) + 3.5
>6.6 yo: (age years/4) + 4.5

135
Q

ASA class mortality rates ASA Class 1-5

A 
1 < .08
2. <0.4
3. <4.3
4. <23
5 <51
136
Q

Vecuronium is a monoquartenacy steroidal analogue of pancuronium which is devoid of vagolytic effects

T/F

A

True

is

137
Q

Laryngoscope basic 3 types

A

Macintosh, Jackson or Wisconsin, Miller

138
Q

In 1885, he injected cocaine in the nerve tracts:

a. William T. Morton
b. William Holstad
c. August Bier
d. Carl Koller

A

c. August Bier

139
Q

What nondepolarizer is hydrolysed by plasma cholinesterase

A

Mivacurium

140
Q

Equipments used in endotracheal intubation includes the following EXCEPT:

a. endotracheal tube
b. laryngoscope
c. suction machine
d. mechanical ventilator

A

d. mechanical ventilator

141
Q

factors that will speed up anesthesia induction

A

. High inspired partial pressure of the anesthetic
. High minute ventilation
. A low volume breathing circuit
. High fresh gas flow
. A low solubility of anesthetic to tissue
. A low cardiac output
. A small alveolar to venous partial pressure

142
Q

Compute for the length of of ET (alveolar ridge to the tip of the tube) for 6 year old 20kg:

a. 13 cm
b. 14 cm
c. 15 cm
d. 16 cm

A

c. 15 cm

length = (age/2) + 12

143
Q

Fasting period for the following

Clear liquids 
Breast milk 
Infant formula 
Nonhuman milk 
Solid food 
Fatty or fried food
A 
Clear liquids 2
Breast milk 4
Infant formula 6
Nonhuman milk 6
Solid food 6
Fatty or fried food 8
144
Q

Which of the following is a high pressure, low residual volume cuff?

a. Murphy
b. Magill
c. Miller
d. Macintosh

A

a. Murphy

145
Q

What forceps are used in orotracheal intubation?

A

Magill

146
Q

What is the cerebral blood flow?

A

50 ml/100 mg / min

147
Q

The focus of history and PE is

a. brain
b. GI tract
c. heart
d. liver

A

c. heart

148
Q

“Sniffing” position includes:

a. elevate the head with pads under the occiput by 20 cms
b. flex the head at the atlanto-occipital joint
c. aligns the oral, pharyngeal and laryngeal axes
d. all are correct

A

c. aligns the oral, pharyngeal and laryngeal axes

149
Q

In the 2011 ASA Practice Guidelines for Preoperative Fasting

a. black coffee is not an example of clear liquid
b. friend rice and bacon prolongs gastric emptying time
c. mild can be given to an infact up to 2 hours prior to anesthesia
d. the current recommendation is that PPI can be administer routinely

A

b. friend rice and bacon prolongs gastric emptying time

150
Q

Pre-operative visit includes the following important matters EXCEPT:

a. physical status classification
b. informed consent
c. drug intake
d. financial status

A

d. financial status

151
Q

Metabolite of sevoflurane

A

acyl halide

152
Q

The laryngoscope shoud be held in ____ hand and the blade inserted on the ____ side of the mouth:

a. right, right
b. left, left
c. right, left
d. left, right

A

d. left, right

153
Q

What are the intermediate acting nondepolarizers?

A

Atracurium
Vecorunium
Mivacurium

154
Q

Formula for ETT size

A

size = (age/4) + 4

155
Q

Routine CXR is not indicated in

a. presence of fever and cough in 6 month old male
b. lung surgery
c. 32 yo for appendectomy
d. COPD pt

A

c. 32 yo appendectomy

156
Q

Steps in chemical regulation

A

increase neural activity > increase cerebral metabolic rate > release glutamate > NO synthesis > cerebral vasodilation

157
Q

Pre-operative medication is given in the following condition:

a. out-patient
b. in-patient cancer sugery
c. elderly patient
d. hypovolemic patient

A

b. in-patient cancer sugery

158
Q

A 69 years old make will undergo thyroidectomy. What is the rationale for the request of the lab exam

a. patient’s age
b. possibility of bleeding due to surgery
c. presence of uti
d. A and B
e. aota

A

a. patient’s age

159
Q

Mallampati score when only the soft palte and base of the uvula are visible is:

a. Class 1
b. Class 2
c. Class 3
d. Class 4

A

c. Class 3

160
Q

Physiologic responses to ETT intubation include the following:

a. increase in heart rate
b. increase in blood presure
c. increase in intracranial pressure
d. all are correct

A

d. all are correct

161
Q

What pH put pratients at risk for pulmonary aspiration

A

25mL residual gastric volume of pH <2.5

162
Q

Match laryngoscope type to shape

Jackson/Wisconsin
Macintosh
Miller

curved
straight
straight with curved lip

A

Jackson/Wisconsin - straight
Macintosh - curved
Miller - straight with curved lip

163
Q

Conclusion of pre-anesthetic visit to a 27 years old female with cholelithiasis EXCPET:

a. assign physica status of patient
b write anesthetic plan
c. order pre-medication
d. request additional laboratory work-up
d. none
A

d. request additional laboratory work-up

164
Q

Basic tools of an anesthesiologist EXCEPT:

a. laryngoscope
b. stethoscope
c. Magil’s forcep
d. opthalmoscope

A

d. opthalmoscope

165
Q

How to reduce risk of PONV

A 
. Avoid GA by the use of RA
. Prefer propofol infusions
. Avoid NO
. Avoid volatiel anesthetics
. Minimize perioperative opioids
. Adequate hydration
166
Q

The feature is characteristic of adult larynx:

a. epiglottis is less rigid, longer and narrower
b. the narrowest part is the glottis
c. the angle between the glottis and epiglottis is more acute
d. the aryepiglattic folds are closer to the midline

A

b. the narrowest part is the glottis

167
Q

Fasting period before an elective surgery in an ASA I young adult should be:

a. 4 hours
b. 6 hours
c. 8 hours
d. 10 hours

A

c. 8 hours

Surgical Anesthesiology (1 decks)

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