Tex-Wes-Reference_Guide Flashcards
In the Mallampati classification, what is visible in a Class II airway?
A) Only the soft palate
B) Soft palate, uvula, and fauces
C) Soft palate, fauces, uvula, and tonsillar pillars
D) Soft palate and base of the uvula only
Answer: B) Soft palate, uvula, and fauces
Rationale: A Class II airway allows visualization of the soft palate, fauces, and uvula but not the tonsillar pillars. This suggests a moderate level of difficulty for intubation, as not all structures are clearly visible.
In the Mallampati classification, what is visible in a Class I airway?
A) Only the soft palate
B) Soft palate, fauces, uvula, and tonsillar pillars
C) Soft palate and fauces only
D) Soft palate, uvula, and base of the tonsils
Answer: B) Soft palate, fauces, uvula, and tonsillar pillars
Rationale: Class I in the Mallampati classification indicates that the mouth is fully open and unobstructed, allowing visualization of the soft palate, fauces, uvula, and both anterior and posterior tonsillar pillars. This classification often correlates with easier intubation.
What is visible in a Class III Mallampati airway classification?
A) Only the soft palate
B) Soft palate and fauces
C) Soft palate and base of the uvula
D) Uvula and tonsillar pillars
Answer: C) Soft palate and base of the uvula
Rationale: In a Class III classification, only the soft palate and the base of the uvula are visible. This classification is associated with more challenging airway management because of limited visibility.
In a Class IV Mallampati classification, which structures are visible?
A) Only the soft palate
B) None of the oropharyngeal structures
C) Uvula and soft palate
D) Soft palate and tonsillar pillars
A) Only the soft palate
Which Mallampati class is associated with the easiest intubation?
A) Class I
B) Class II
C) Class III
D) Class IV
Answer: A) Class I
Rationale: Class I classification indicates the maximum visibility of airway structures, suggesting that intubation should be easier compared to other classes, which have progressively more restricted views
What is visible in a Grade I Cormack-Lehane classification?
A) Only the epiglottis
B) Only the arytenoids
C) Entire glottis, including the vocal cords
D) Only the soft palate
Answer: C) Entire glottis, including the vocal cords
Rationale: Grade I indicates a full view of the glottis opening, including the vocal cords. This is the easiest scenario for intubation, as all critical structures are clearly visible.
Which structures are visible in a Grade II Cormack-Lehane classification?
A) Entire glottis
B) Posterior portion of the glottis
C) Epiglottis only
D) No visible structures
Answer: B) Posterior portion of the glottis
Rationale: Grade II indicates that only the posterior portion of the glottis is visible, making intubation moderately difficult. The anterior glottis may not be seen, but the arytenoids are typically visible.
What is visible in a Grade III Cormack-Lehane view?
A) Epiglottis only, no glottis visible
B) Full view of the vocal cords
C) Posterior glottis and epiglottis
D) Entire glottis
Answer: A) Epiglottis only, no glottis visible
Rationale: Grade III is associated with a difficult airway because only the epiglottis is visible, and the glottis is not seen at all. This view typically requires advanced techniques for successful intubation.
What does a Grade IV Cormack-Lehane classification indicate?
A) Full glottis visualization
B) Visible posterior glottis
C) Only the epiglottis is seen
D) Neither the epiglottis nor the glottis is visible
Answer: D) Neither the epiglottis nor the glottis is visible
Rationale: Grade IV is the most challenging view, where neither the epiglottis nor the glottis can be visualized. This situation often requires alternative airway management techniques, such as video laryngoscopy or a surgical airway.
Which Cormack-Lehane grade is associated with the highest risk of difficult intubation?
A) Grade I
B) Grade II
C) Grade III
D) Grade IV
Answer: D) Grade IV
Rationale: Grade IV indicates the most limited view with no visualization of the epiglottis or glottis. This is considered a “cannot intubate, cannot ventilate” scenario and is associated with the highest risk of complications.
What does ASA Class I indicate about a patient’s health status?
A) The patient has severe systemic disease
B) The patient has mild systemic disease without functional limitations
C) The patient is a normal, healthy individual
D) The patient has severe systemic disease that is a constant threat to life
Answer: C) The patient is a normal, healthy individual
Rationale: ASA Class I represents a healthy patient with no systemic disease, indicating the lowest risk for complications during anesthesia.
Which description best fits ASA Class II?
A) A patient with severe systemic disease that is a constant threat to life
B) A patient with mild systemic disease and no functional limitations
C) A moribund patient who is not expected to survive without surgery
D) A patient who is brain-dead and undergoing organ donation
Answer: B) A patient with mild systemic disease and no functional limitations
Rationale: ASA Class II includes patients with mild systemic diseases (e.g., controlled diabetes or hypertension) that do not affect their daily activities.
What characterizes an ASA Class III patient?
A) A healthy individual
B) A patient with mild systemic disease and no functional limitations
C) A patient with severe systemic disease with some functional limitations
D) A patient with severe systemic disease that is a constant threat to life
Answer: C) A patient with severe systemic disease with some functional limitations
Rationale: ASA Class III is assigned to patients with severe systemic disease that limits daily activities (e.g., poorly controlled diabetes, angina). These patients have an increased risk during anesthesia.
What does ASA Class IV indicate about a patient’s condition?
A) A healthy patient with no systemic disease
B) A patient with severe systemic disease that is a constant threat to life
C) A patient with mild systemic disease and no functional limitations
D) A brain-dead patient undergoing organ donation
Answer: B) A patient with severe systemic disease that is a constant threat to life
Rationale: ASA Class IV patients have severe, life-threatening systemic diseases (e.g., advanced heart failure, end-stage renal disease), posing a high risk for anesthesia-related complications.
What is the definition of ASA Class V?
A) A healthy patient undergoing an elective procedure
B) A patient with mild systemic disease that is well-controlled
C) A moribund patient not expected to survive without surgery
D) A patient with severe systemic disease but no functional limitations
Answer: C) A moribund patient not expected to survive without surgery
Rationale: ASA Class V is reserved for patients in critical condition who are unlikely to survive without immediate surgical intervention.
For which patient is ASA Class VI designated?
A) A healthy individual scheduled for elective surgery
B) A patient with severe systemic disease that is life-threatening
C) A patient with mild systemic disease but no functional limitations
D) A brain-dead patient whose organs are being removed for donation
Answer: D) A brain-dead patient whose organs are being removed for donation
Rationale: ASA Class VI applies to brain-dead patients undergoing organ donation, reflecting their non-viable status rather than surgical risk.
What is the correct sequence of the 4 stages of anesthesia?
A) Analgesia, Excitement, Surgical Anesthesia, Overdose
B) Surgical Anesthesia, Analgesia, Excitement, Overdose
C) Overdose, Surgical Anesthesia, Excitement, Analgesia
D) Excitement, Analgesia, Surgical Anesthesia, Overdose
Answer: A) Analgesia, Excitement, Surgical Anesthesia, Overdose
Rationale: The stages proceed in order from initial induction (Analgesia), through a period of increased excitement, to a stable surgical anesthesia, and finally to an overdose stage if anesthesia is too deep.
During which stage of anesthesia is it safest to intubate the patient?
A) Stage 1 (Analgesia)
B) Stage 2 (Excitement)
C) Stage 3 (Surgical Anesthesia)
D) Stage 4 (Overdose)
Answer: C) Stage 3 (Surgical Anesthesia)
Rationale: Stage 3, Surgical Anesthesia, is characterized by stable respiration, absent reflexes, and relaxed muscles, making it the safest time for intubation.
Which of the following signs indicates that a patient has entered Stage 2 (Excitement) of anesthesia?
A) Regular breathing and fixed pupils
B) Agitation, irregular breathing, and increased muscle tone
C) Complete muscle relaxation and stable hemodynamics
D) Apnea and dilated pupils
Answer: B) Agitation, irregular breathing, and increased muscle tone
Rationale: Stage 2 (Excitement) is marked by hyperactive reflexes, irregular respiration, and involuntary movements. Intubation and extubation during this stage can trigger laryngospasm. Eyes might be darting around.
When is it appropriate to perform a deep extubation?
A) During Stage 1 (Analgesia)
B) During Stage 2 (Excitement)
C) During Stage 3 (Surgical Anesthesia)
D) During Stage 4 (Overdose)
Answer: C) During Stage 3 (Surgical Anesthesia)
Rationale: Deep extubation is performed while the patient is still under deep anesthesia (Stage 3) to avoid coughing, gagging, or laryngospasm. The patient should have adequate muscle relaxation and stable vitals.
Which sign indicates that the patient has entered Stage 4 (Overdose)?
A) Increased heart rate and blood pressure
B) Tachypnea and regular breathing pattern
C) Severe hypotension, apnea, and dilated, non-reactive pupils
D) Increased muscle tone and gag reflex
Answer: C) Severe hypotension, apnea, and dilated, non-reactive pupils
Rationale: Stage 4 (Overdose) is marked by significant CNS depression, including respiratory and cardiovascular collapse. This stage is life-threatening and requires immediate intervention.
What is the ideal stage for extubation when performing a standard awake extubation?
A) Stage 1 (Analgesia)
B) Stage 2 (Excitement)
C) Stage 3 (Surgical Anesthesia)
D) Fully awake and following commands (Stage 1 emergence)
Answer: D) Fully awake and following commands (Stage 1 emergence)
Rationale: Extubation is safest when the patient is fully awake, protecting their own airway and following commands (head lift). Extubation in Stage 2 (Excitement) can lead to complications like laryngospasm.
What physical sign might indicate that a patient is moving from Stage 2 (Excitement) to Stage 3 (Surgical Anesthesia)?
A) Gag reflex reappears
B) Pupils become dilated and non-reactive
C) Regular, rhythmic breathing resumes
D) Increased tear production
Answer: C) Regular, rhythmic breathing resumes- (eyes midline)
Rationale: The transition from Stage 2 to Stage 3 is marked by a return to regular breathing patterns, loss of reflexes, and muscle relaxation, indicating readiness for surgical procedures.
What is the normal range for arterial pH in a blood gas analysis?
A) 7.25 - 7.35
B) 7.35 - 7.45
C) 7.45 - 7.55
D) 7.55 - 7.65
Answer: B) 7.35 - 7.45
Rationale: The normal pH range in arterial blood is 7.35 to 7.45. A pH below this range indicates acidosis, while a pH above this range suggests alkalosis.
What is the normal PaCO₂ range in an arterial blood gas (ABG)?
A) 25 - 35 mmHg
B) 30 - 40 mmHg
C) 35 - 45 mmHg
D) 40 - 50 mmHg
Answer: C) 35 - 45 mmHg
Rationale: The normal partial pressure of carbon dioxide (PaCO₂) is 35-45 mmHg. Levels above this range indicate respiratory acidosis, while levels below suggest respiratory alkalosis.
What is the normal range for bicarbonate (HCO₃⁻) in a blood gas analysis?
A) 18 - 22 mEq/L
B) 22 - 26 mEq/L
C) 26 - 30 mEq/L
D) 30 - 34 mEq/L
Answer: B) 22 - 26 mEq/L
Rationale: Normal bicarbonate levels in blood gas analysis range from 22 to 26 mEq/L. Bicarbonate acts as a buffer to maintain pH balance in the body.
Which of the following represents a normal arterial PaO₂ value?
A) 60 - 70 mmHg
B) 70 - 80 mmHg
C) 80 - 90 mmHg
D) 90 - 100 mmHg
Answer: D) 90 - 100 mmHg
Rationale: The normal partial pressure of oxygen (PaO₂) in arterial blood is 90-100 mmHg. Values below this range may indicate hypoxemia.
What is the normal range for base excess (BE) in an ABG?
A) -4 to 0 mEq/L
B) -2 to 2 mEq/L
C) 0 to 4 mEq/L
D) 2 to 6 mEq/L
Answer: B) -2 to 2 mEq/L
Rationale: Base excess reflects the metabolic component of acid-base balance. A normal range of -2 to 2 mEq/L indicates balanced metabolic status.
What is the formula for calculating the oxygen consumption (VO₂)?
A) VO₂ = 5 x kg
B) VO₂ = 8 x kg
C) VO₂ = 10 x kg^(3/4)
D) VO₂ = 12 x kg^(3/4)
Answer: C) VO₂ = 10 x kg^(3/4)
Rationale: The formula for oxygen consumption (VO₂) is 10 x kg^(3/4). This accounts for metabolic rate and body weight.
What is the alveolar gas equation used to calculate PaO₂?
A) PAO₂ = (Hgb x 1.34 x SaO₂) + (PaCO₂ x 0.003)
B) PAO₂ = FiO₂ x (Pb - PH₂O) - PaCO₂/0.8
C) PAO₂ = (Pb - PaCO₂) / FiO₂
D) PAO₂ = HCO₃ / PaCO₂
Answer: B) PAO₂ = FiO₂ x (Pb - PH₂O) - PaCO₂/0.8
Rationale: The alveolar gas equation estimates the partial pressure of oxygen in the alveoli, accounting for atmospheric pressure (Pb), water vapor pressure (PH₂O), and PaCO₂.
Which formula correctly calculates the arterial oxygen content (CaO₂)?
A) CaO₂ = (Hgb x 1.34 x SaO₂) + (PaO₂ x 0.003)
B) CaO₂ = PaO₂ / FiO₂
C) CaO₂ = HCO₃ x PaCO₂
D) CaO₂ = Hgb / SaO₂
Answer: A) CaO₂ = (Hgb x 1.34 x SaO₂) + (PaO₂ x 0.003)
Rationale: The arterial oxygen content formula accounts for both oxygen bound to hemoglobin and dissolved oxygen in the plasma.
What is the normal range for arterial oxygen saturation (SaO₂) in a blood gas analysis?
A) 85% - 90%
B) 90% - 92%
C) 93% - 95%
D) 95% - 98%
Answer: D) 95% - 98%
Rationale: The normal range for SaO₂ is 95% to 98%. This value indicates the percentage of hemoglobin that is saturated with oxygen. Levels below 90% are typically considered hypoxemic and may require intervention.
What is the formula for calculating Mean Arterial Pressure (MAP)?
A) MAP = (SBP + DBP)/2
B) MAP = (SBP + 2 × DBP)/3
C) MAP = (DBP + 3 × SBP)/4
D) MAP = SBP - DBP
Answer: B) MAP = (SBP + 2 × DBP)/3
Rationale: The MAP formula averages the pressure throughout the cardiac cycle, giving more weight to the diastolic pressure because the heart spends more time in diastole.
What is the normal range for Cardiac Output (CO)?
A) 2 - 4 L/min
B) 4 - 8 L/min
C) 6 - 10 L/min
D) 8 - 12 L/min
Answer: B) 4 - 8 L/min
Rationale: Cardiac Output measures the volume of blood the heart pumps per minute. The normal range is 4-8 L/min, depending on the patient’s size and metabolic needs.
What is the normal range for Central Venous Pressure (CVP)?
A) 0 - 2 mmHg
B) 2 - 6 mmHg
C) 6 - 10 mmHg
D) 10 - 15 mmHg
Answer: B) 2 - 6 mmHg
Rationale: CVP reflects the pressure in the thoracic vena cava, indicating right atrial pressure. Normal values range from 2 to 6 mmHg (up to 12 in some sources), helping assess a patient’s volume status.
Which of the following represents a normal Cardiac Index (CI)?
A) 1.5 - 2.0 L/min/m²
B) 2.5 - 4.0 L/min/m²
C) 4.0 - 5.5 L/min/m²
D) 5.5 - 7.0 L/min/m²
Answer: B) 2.5 - 4.0 L/min/m²
Rationale: Cardiac Index adjusts Cardiac Output for body surface area (BSA), providing a more individualized assessment of heart function. The normal range is 2.5-4.0 L/min/m².
What is the normal range for Pulmonary Capillary Wedge Pressure (PCWP)?
A) 4 - 8 mmHg
B) 8 - 12 mmHg
C) 12 - 16 mmHg
D) 16 - 20 mmHg
Answer: B) 8 - 12 mmHg
Rationale: PCWP estimates left atrial pressure and is used to assess left ventricular function. Normal values are 8-12 mmHg.
Which value represents a normal Systemic Vascular Resistance (SVR)?
A) 200 - 500 dynes·sec/cm⁵
B) 500 - 800 dynes·sec/cm⁵
C) 700 - 1400 dynes·sec/cm⁵
D) 1400 - 1800 dynes·sec/cm⁵
Answer: C) 700 - 1400 dynes·sec/cm⁵
Rationale: SVR is a measure of the resistance the heart must overcome to pump blood through the systemic circulation. The normal range is 700-1400 dynes·sec/cm⁵.
What is the normal range for Ejection Fraction (EF)?
A) 30% - 40%
B) 40% - 50%
C) 50% - 60%
D) 55% - 70%
Answer: D) 55% - 70%
Rationale: Ejection Fraction measures the percentage of blood pumped out of the left ventricle with each heartbeat. Normal values range from 55% to 70%, indicating efficient heart function.
What is the Shock Index (SI) formula, and what does an SI > 1 indicate?
A) SI = (Heart Rate × SBP); SI > 1 indicates hypovolemia
B) SI = (SBP/DBP); SI > 1 indicates hypertension
C) SI = (Heart Rate/SBP); SI > 1 indicates increased morbidity and mortality
D) SI = (DBP/Heart Rate); SI > 1 indicates bradycardia
Answer: C) SI = (Heart Rate/SBP); SI > 1 indicates increased morbidity and mortality
Rationale: The Shock Index is calculated as Heart Rate divided by Systolic Blood Pressure (SBP). An SI > 1 suggests significant hemodynamic instability and increased risk of poor outcomes.
What is the normal range for Pulmonary Vascular Resistance (PVR)?
A) 50 - 250 dynes·sec/cm⁵
B) 50 - 350 dynes·sec/cm⁵
C) 100 - 400 dynes·sec/cm⁵
D) 200 - 500 dynes·sec/cm⁵
Answer: B) 50 - 350 dynes·sec/cm⁵
Rationale: PVR indicates the resistance in the pulmonary circulation and helps assess right ventricular afterload.
What is the normal range for Pulmonary Artery Pressure (PAP)?
A) Systolic: 15-30 mmHg, Diastolic: 5-15 mmHg, Mean: 10-15 mmHg
B) Systolic: 20-40 mmHg, Diastolic: 10-20 mmHg, Mean: 15-20 mmHg
C) Systolic: 25-50 mmHg, Diastolic: 15-25 mmHg, Mean: 20-30 mmHg
D) Systolic: 30-50 mmHg, Diastolic: 20-30 mmHg, Mean: 25-35 mmHg
Answer: A) Systolic: 15-30 mmHg, Diastolic: 5-15 mmHg, Mean: 10-15 mmHg
Rationale: PAP measures the pressure in the pulmonary artery, reflecting right ventricular function and pulmonary circulation status.
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What does a Shock Index (SI) greater than 1 indicate?
A) Decreased risk of morbidity and mortality
B) Increased volume status
C) Increased risk of morbidity and mortality
D) Normal hemodynamic stability
Answer: C) Increased risk of morbidity and mortality
Rationale: The Shock Index is calculated as Heart Rate divided by Systolic Blood Pressure. An SI > 1 suggests hemodynamic instability and may indicate shock.
What is a common cause of Sphincter of Oddi spasm during anesthesia?
A) Inhaled anesthetics
B) Propofol
C) Opioids
D) Local anesthetics
Answer: C) Opioids
Rationale: Opioids, particularly morphine and fentanyl, can cause spasm of the Sphincter of Oddi due to their effect on smooth muscle contraction, increasing biliary pressure.
Which opioid is least likely to cause Sphincter of Oddi spasm?
A) Morphine
B) Fentanyl
C) Meperidine
D) Hydromorphone
Answer: C) Meperidine
Rationale: Meperidine (Demerol) is less likely to cause Sphincter of Oddi spasm compared to other opioids. It is sometimes preferred for patients undergoing biliary procedures.
Which medication can be used to treat Sphincter of Oddi spasm intraoperatively?
A) Epinephrine
B) Nitroglycerin
C) Norepinephrine
D) Lidocaine
Answer: B) Nitroglycerin 50mcg IV
Rationale: Nitroglycerin, a smooth muscle relaxant, can help relieve Sphincter of Oddi spasm by reducing smooth muscle tone, lowering biliary pressure.
Which diagnostic sign might indicate a Sphincter of Oddi spasm during an ERCP procedure?
A) Decreased heart rate
B) Elevated biliary pressures
C) Hypotension
D) Increased gastric motility
Answer: B) Elevated biliary pressures
Rationale: During ERCP, increased biliary pressures may suggest a spasm of the Sphincter of Oddi, especially if the patient reports biliary colic symptoms.
What is the recommended IV dose of Glucagon for treating a Sphincter of Oddi spasm?
A) 0.5 mg
B) 1 mg
C) 2 mg
D) 4 mg
Answer: C) 2 mg
Rationale: Glucagon at a dose of 2 mg IV helps relax the smooth muscle of the Sphincter of Oddi, alleviating the spasm and reducing biliary pressure.
Which medication can be administered at a dose of 40 mcg IV to reverse the effects of opioids causing Sphincter of Oddi spasm?
A) Atropine
B) Naloxone
C) Nitroglycerin
D) Glucagon
Answer: B) Naloxone
Rationale: Naloxone, an opioid antagonist, is given at 40 mcg IV to counteract the opioid-induced increase in Sphincter of Oddi tone.
What is the IV dose of Atropine for treating Sphincter of Oddi spasm?
A) 0.1 mg
B) 0.2 mg
C) 0.5 mg
D) 1 mg
Answer: B) 0.2 mg
Rationale: Atropine at a dose of 0.2 mg IV may help alleviate Sphincter of Oddi spasm by reducing vagal stimulation and relaxing the smooth muscle.
Which of the following medications is NOT commonly used to treat Sphincter of Oddi spasm?
A) Glucagon
B) Nitroglycerin
C) Naloxone
D) Epinephrine
Answer: D) Epinephrine
Rationale: Epinephrine is not used for treating Sphincter of Oddi spasm. Instead, smooth muscle relaxants (e.g., Nitroglycerin) and opioid antagonists (e.g., Naloxone) are preferred.
What is the first step in managing a laryngospasm intraoperatively?
A) Administering succinylcholine
B) Applying positive pressure ventilation with 100% oxygen
C) Administering naloxone
D) Starting chest compressions
Answer: B) Applying positive pressure ventilation with 100% oxygen
Rationale: The initial treatment for laryngospasm involves applying continuous positive airway pressure (CPAP) with 100% oxygen to help open the airway and relieve the spasm. Turn APL valve up to 40-70mmHg.. DO NOT BAG
Which maneuver can be used to help relieve a laryngospasm by stimulating deep breaths?
A) Trendelenburg maneuver
B) Larson’s maneuver
C) Valsalva maneuver
D) Heimlich maneuver
Answer: B) Larson’s maneuver
Rationale: Larson’s maneuver involves firm pressure applied to the area behind the earlobe (mastoid process- larson’s Point), helping to break the laryngospasm by stimulating a deep breath and relaxing the vocal cords.
What is the recommended dose of succinylcholine for treating a severe laryngospasm?
A) 0.2 mg/kg IV
B) 0.5 mg/kg IV
C) 1 mg/kg IV
D) 0.1 mg/kg IV
Answer: D) 0.1 mg/kg IV or 10-20mg IV.. note that up to 1mg/kg has been reported to be given in extreme cases.
Rationale: Succinylcholine, a depolarizing neuromuscular blocker, is given at a dose of 0.1 mg/kg IV to quickly relax the vocal cords and resolve a severe laryngospasm.
If IV access is not available, what is the dose of succinylcholine that can be administered intramuscularly (IM) to treat laryngospasm?
A) 2 mg/kg IM
B) 4 mg/kg IM
C) 6 mg/kg IM
D) 10 mg/kg IM
Answer: B) 4 mg/kg IM
Rationale: When IV access is not established, succinylcholine can be administered intramuscularly at a dose of 4 mg/kg for effective treatment of laryngospasm.
Which of the following actions should be avoided during a laryngospasm to prevent worsening of the condition?
A) Deepening anesthesia
B) Suctioning the airway
C) Applying excessive force during positive pressure ventilation
D) Using jaw thrust
Answer: C) Applying excessive force during positive pressure ventilation
Rationale: Excessive force during positive pressure ventilation can worsen laryngospasm by increasing airway irritation. Gentle, controlled pressure should be used.
What is the estimated blood volume (EBV) for an adult male?
A) 50 mL/kg
B) 60 mL/kg
C) 70 mL/kg
D) 80 mL/kg
Answer: C) 70 mL/kg
Rationale: The EBV for an adult male is approximately 70 mL/kg. This estimation helps determine blood loss and fluid replacement needs during surgery.
What is the formula for calculating Allowable Blood Loss (ABL)?
A) ABL = (HCT_initial - HCT_final) × EBV / HCT_initial
B) ABL = (HCT_initial + HCT_final) × EBV / HCT_final
C) ABL = (HCT_initial × EBV) / (HCT_final + EBV)
D) ABL = HCT_initial × HCT_final / EBV
Answer: A) ABL = (HCT_initial - HCT_final) × EBV / HCT_initial
Rationale: This formula estimates the maximum allowable blood loss before requiring transfusion, based on changes in hematocrit and the patient’s estimated blood volume.
What is the approximate volume of blood in a fully soaked lap sponge?
A) 50 - 75 mL
B) 100 - 150 mL
C) 150 - 200 mL
D) 200 - 250 mL
Answer: B) 100 - 150 mL
Rationale: A fully soaked surgical lap sponge typically holds about 100-150 mL of blood. This estimation is used intraoperatively to gauge blood loss.
What fluid replacement ratio is typically used for crystalloid fluids in response to blood loss?
A) 1:1
B) 1:2
C) 1:3
D) 1:4
Answer: C) 1:3 (3mls of crystalloid for 1 ml blood)
Rationale: Crystalloid fluids are replaced at a 3:1 ratio for blood loss. This accounts for the distribution of crystalloids into the interstitial and intracellular compartments.
For a patient weighing 70 kg, what is the estimated blood volume (EBV)?
A) 3,500 mL
B) 4,200 mL
C) 5,000 mL
D) 6,000 mL
Answer: B) 4,200 mL
Rationale: Using the standard EBV for an adult male (70 mL/kg), the calculation is: 70 kg × 70 mL/kg = 4,200 mL.
Which of the following is an appropriate replacement fluid for blood loss when the patient is hemodynamically unstable?
A) D5W (5% dextrose in water)
B) Normal saline (0.9% NaCl)
C) Lactated Ringer’s solution
D) Packed red blood cells (PRBCs)
Answer: D) Packed red blood cells (PRBCs)
Rationale: PRBCs are used for blood replacement in cases of significant blood loss, especially when the patient is hemodynamically unstable, as they provide oxygen-carrying capacity.
What is a typical target final hematocrit (HCT_final) used in the ABL formula?
A) 10%
B) 20%
C) 30%
D) 40%
Answer: C) 30%
Rationale: The target final hematocrit is often set at 30%, which aligns with common transfusion guidelines and ensures a minimum safe level of hematocrit.
Using the patient’s information (EBV = 5,250 mL, HCT_initial = 45%), what is the ABL if the target hematocrit (HCT_final) is 30%?
A) 1,250 mL
B) 1,750 mL
C) 2,100 mL
D) 2,625 mL
Answer: B) 1,750 mL
Rationale: ABL = EBV × (HCT_initial - HCT_final) / HCT_initial = 5,250 mL × (45 - 30) / 45 = 1,750 mL.
In the context of the ABL calculation, why is it important to pre-calculate the number of surgical mops or gauze needed based on the estimated blood loss?
A) To ensure that the patient does not lose any blood
B) To provide an immediate visual indicator of when allowable blood loss is reached
C) To replace mops frequently during surgery
D) To prevent the need for suctioning blood
Answer: B) To provide an immediate visual indicator of when allowable blood loss is reached
Rationale: Calculating the number of mops or gauze helps alert the surgical team when the allowable blood loss has been exceeded, prompting timely decisions about blood transfusions.
For a patient weighing 60 kg with an initial hematocrit of 40%, what is the EBV if the patient is an adult female?
A) 3,600 mL
B) 3,900 mL
C) 4,200 mL
D) 4,500 mL
Answer: B) 3,900 mL
Rationale: Using the standard blood volume for an adult female (65 mL/kg), the calculation is: 60 kg × 65 mL/kg = 3,900 mL.
Using the above information, calculate the ABL if the target hematocrit (HCT_final) is 30%. Initial is 40% and EBV is 3,900mL.
A) 975 mL
B) 1,040 mL
C) 1,300 mL
D) 1,560 mL
Answer: A) 975 mL
3900 x (40 -30) / 40 = 975mL
What is the estimated blood volume (EBV) for a full-term neonate?
A) 65 mL/kg
B) 75 mL/kg
C) 85 mL/kg
D) 95 mL/kg
Answer: C) 85 mL/kg
Rationale: Full-term neonates have an estimated blood volume of 85 mL/kg due to their higher blood volume relative to body weight.
What is the recommended estimated blood volume (EBV) for a morbidly obese patient (BMI > 40)?
A) 50 mL/kg
B) 60 mL/kg
C) 70 mL/kg
D) 80 mL/kg
Answer: B) 60 mL/kg
Rationale: For morbidly obese patients, the EBV is reduced to 60 mL/kg to account for their increased body fat, which has lower blood volume per unit of weight.
Which fluid replacement ratio is used for crystalloids in response to blood loss?
A) 1:1
B) 2:1
C) 3:1
D) 4:1
Answer: C) 3:1
Rationale: Crystalloids (e.g., normal saline, lactated Ringer’s) are typically replaced at a 3:1 ratio because they distribute into both the intravascular and interstitial compartments.
What is the estimated blood volume (EBV) for a 10-year-old child?
A) 65-75 mL/kg
B) 70- 80 mL/kg
C) 65 - 85 mL/kg
D) 75- 85 mL/kg
A) 65-75 mL/kg
adult/child female is 65mL/Kg while the male is 75mL/Kg
Which replacement fluid has a 1:1 replacement ratio with blood loss? - select all
A) Crystalloids
B) Colloids
C) D5W (5% dextrose in water)
D) Albumin
Answer: B) Colloids, D) Albumin
Rationale: Colloids (e.g., albumin, hydroxyethyl starch) are replaced at a 1:1 ratio because they remain in the intravascular space, providing efficient volume expansion.
What is the EBV for a premature neonate?
A) 75 mL/kg
B) 80 mL/kg
C) 85 mL/kg
D) 95 mL/kg
Answer: D) 95 mL/kg
Rationale: Premature neonates have a higher estimated blood volume of 95 mL/kg due to their immature physiology and higher relative blood volume needs.
If a patient has lost 1,000 mL of blood, how much PRBC’s should be given to replace the loss?
A) 500 mL
B) 1,000 mL
C) 2,000 mL
D) 3,000 mL
Answer: A) 500 mL
Rationale: PRBC’s are replaced at a 0.5:1 ratio, so 1,000 mL of blood loss requires 500 mL of PRBC replacement.. If it was whole blood we would use 1:1 so 1000mL.
During surgery, you notice that there are 10 fully soaked 4 x 4 gauze pads and 3 fully soaked lap sponges. How much blood loss (Max) would you estimate based on this count?
A) 250 mL
B) 550 mL
C) 750 mL
D) 1,000 mL
Answer: B) 550 mL
Rationale: A fully soaked 4 x 4 gauze pad holds approximately 10 mL of blood, and a fully soaked lap sponge holds around 100-150 mL of blood. The calculation is:
10 gauze pads × 10 mL = 100 mL
3 lap sponges × 150 mL = 450 mL
Total estimated blood loss = 100 mL + 450 mL = 550 mL.
What is the maintenance fluid requirement for a 25 kg child using the 4-2-1 rule?
A) 35 mL/hr
B) 45 mL/hr
C) 55 mL/hr
D) 65 mL/hr
Answer: D) 65 mL/hr
Rationale: Using the 4-2-1 rule:
First 10 kg: 10 kg × 4 mL/kg/hr = 40 mL/hr
Next 10 kg: 10 kg × 2 mL/kg/hr = 20 mL/hr
Remaining 5 kg: 5 kg × 1 mL/kg/hr = 5 mL/hr
Total = 40 + 20 + 5 = 65 mL/hr
A 70 kg patient has been NPO for 8 hours. What is the estimated NPO fluid deficit?
A) 560 mL
B) 880 mL
C) 1,040 mL
D) 1,400 mL
Answer: B) 880 mL
Rationale: Calculate the maintenance rate first using the 4-2-1 rule:
First 10 kg: 10 kg × 4 mL/kg/hr = 40 mL/hr
Next 10 kg: 10 kg × 2 mL/kg/hr = 20 mL/hr
Remaining 50 kg: 50 kg × 1 mL/kg/hr = 50 mL/hr
Total = 40 + 20 + 50 = 110 mL/hr
NPO Deficit = 110 mL/hr × 8 hours = 880 mL
Which of the following is an appropriate fluid replacement strategy for evaporative losses in a patient undergoing major abdominal surgery?
A) 0-2 mL/kg/hr
B) 2-4 mL/kg/hr
C) 4-8 mL/kg/hr
D) 8-12 mL/kg/hr
Answer: C) 4-8 mL/kg/hr
Rationale: Major abdominal surgery is associated with significant evaporative and third-space fluid losses, typically replaced at a rate of 4-8 mL/kg/hr.
How would you replace the NPO deficit in a 60 kg patient during the first hour of surgery?
A) Replace the entire deficit in the first hour
B) Replace 25% of the deficit in the first hour
C) Replace 50% of the deficit in the first hour
D) Replace the deficit evenly over the entire surgery
Answer: C) Replace 50% of the deficit in the first hour
Rationale: The standard approach is to replace 50% of the NPO deficit in the first hour, followed by 25% in the second hour, and the remaining 25% in the third hour.
For a 30 kg child undergoing minor surgery, what would be the estimated evaporative fluid loss replacement?
A) 0 mL/hr
B) 30 mL/hr
C) 6 mL/hr
D) 120 mL/hr
Answer: B) 6 mL/hr
Rationale: For minor surgery, the replacement rate for evaporative losses is typically 0.2 mL/kg/hr. Using 30 kg × 0.2 mL/kg/hr = 6 mL/hr.
moderate evaporative Loss is 2-4mL/Kg/hr
What is the BMI range for a person classified as overweight?
A) 18.5 - 24.9 kg/m²
B) 25 - 29.9 kg/m²
C) 30 - 34.9 kg/m²
D) 35 - 39.9 kg/m²
Answer: B) 25 - 29.9 kg/m²
Rationale: The overweight category is defined by a BMI between 25 and 29.9 kg/m², indicating excess body weight.
Which BMI value classifies a person as morbidly obese (Obesity Class III)?
A) ≥ 30 kg/m²
B) ≥ 35 kg/m²
C) >35 kg/m²
D) ≥ 45 kg/m²
Answer: C) 35- 40 kg/m²
Rationale: A BMI of 35-40 kg/m² is classified as morbid obesity (Obesity Class III), associated with significant health risks.
A patient weighs 70 kg and is 1.75 m tall. What is their BMI?
A) 22.9 kg/m²
B) 24.5 kg/m²
C) 25.1 kg/m²
D) 27.8 kg/m²
Answer: A) 22.9 kg/m²
the calculation yields a BMI of 22.9 kg/m², which is within the normal weight range.
What is the classification for a BMI of 32 kg/m²?
A) Normal weight
B) Overweight
C) Obese
D) Morbidly Obese
Answer: C) Obese
Rationale: A BMI between 30 and 34.9 kg/m² falls into the Obesity Class I category
Which BMI range is associated with the lowest risk for health complications?
A) < 18.5 kg/m²
B) 18.5 - 24.9 kg/m²
C) 25 - 29.9 kg/m²
D) ≥ 40 kg/m²
Answer: B) 18.5 - 24.9 kg/m²
Rationale: The normal weight range (18.5 - 24.9 kg/m²) is associated with the lowest risk for obesity-related health issues.
What is the formula for calculating the Ideal Body Weight (IBW) for men according to your reference guide?
A) Height (cm) - 100
B) Height (cm) - 105
C) Height (cm) - 110
D) Height (cm) - 95
Answer: A) Height (cm) - 100 = kg
Rationale: The formula for men is
IBW=Height(cm)−100, reflecting typical body composition standards.
What is the formula for calculating the Ideal Body Weight (IBW) for women?
A) Height (cm) - 100
B) Height (cm) - 105
C) Height (cm) - 110
D) Height (cm) - 95
Answer: B) Height (cm) - 105
Using the formula from the spreadsheet, what is the IBW for a male patient who is 180 cm tall?
A) 70 kg
B) 75 kg
C) 80 kg
D) 85 kg
Answer: C) 80 kg
IBW=180cm−100=80kg.
Which rescue drug is used as an alpha and beta agonist for treating hypotension?
A) Labetalol
B) Ephedrine
C) Neosynephrine
D) Dopamine
Answer: B) Ephedrine
Rationale: Ephedrine acts on both alpha and beta receptors, making it effective for increasing blood pressure in cases of hypotension.
What is the standard dose of Neosynephrine (Phenylephrine) for treating hypotension?
A) 50 mcg
B) 75 mcg
C) 100 mcg
D) 150 mcg
Answer: C) 100 mcg
Rationale: The typical dose for Neosynephrine is 100 mcg, which acts as a potent alpha agonist to increase blood pressure by vasoconstriction.
What is the on-hand concentration of Ephedrine?
A) 5 mg/mL
B) 10 mg/mL
C) 25 mg/mL
D) 50 mg/mL
Answer: D) 50 mg/mL
Rationale: The on-hand concentration for Ephedrine is 50 mg/mL, allowing for easy dilution and administration of the standard 5 mg dose.
Which drug from the list is specifically used to treat hypertension?
A) Neosynephrine
B) Ephedrine
C) Labetalol
D) Norepinephrine
Answer: C) Labetalol
Rationale: Labetalol is a beta antagonist used to lower blood pressure in cases of hypertension.
What is the standard dose of Labetalol for treating hypertension?
A) 2.5 mg
B) 5 mg
C) 7.5 mg
D) 10 mg
Answer: B) 5 mg
Rationale: The standard dose for Labetalol is 5 mg, and it is typically administered as an intravenous push for acute blood pressure control.
What is the on-hand concentration of Neosynephrine?
A) 5 mg/mL
B) 10 mg/mL
C) 15 mg/mL
D) 20 mg/mL
Answer: B) 10 mg/mL
Rationale: Neosynephrine (Phenylephrine) is typically available in a concentration of 10 mg/mL. You will need to dilute.
What is the standard dose of Hydralazine for treating hypertension?
A) 5 mg
B) 10 mg
C) 15 mg
D) 20 mg
Answer: A) 5 mg
Rationale: The typical dose for Hydralazine is 5 mg, used for its arterial vasodilatory effects in managing elevated blood pressure.
What is the on-hand concentration of Hydralazine?
A) 5 mg/mL
B) 10 mg/mL
C) 15 mg/mL
D) 20 mg/mL
Answer: D) 20 mg/mL
Rationale: Hydralazine is available at an on-hand concentration of 20 mg/mL, allowing for accurate dosing in hypertensive crises
Which drug is a beta-blocker used for treating hypertension, with a typical dose of 10 mg?
A) Ephedrine
B) Esmolol
C) Neosynephrine
D) Labetalol
Answer: B) Esmolol
Rationale: Esmolol is a short-acting beta-blocker commonly used for acute hypertension, dosed at 10 mg.
What is the on-hand concentration of Esmolol?
A) 5 mg/mL
B) 10 mg/mL
C) 20 mg/mL
D) 40 mg/mL
Answer: B) 10 mg/mL
Rationale: Esmolol is provided at a concentration of 10 mg/mL, suitable for titrating doses during blood pressure management.
What is the normal hematocrit (Hct) range for females?
A) 35 - 45 g/dL
B) 37 - 47 g/dL
C) 40 - 50 g/dL
D) 42 - 52 g/dL
Answer: B) 37 - 47 g/dL
What is the normal hematocrit (Hct) range for males?
A) 37 - 47 g/dL
B) 40 - 50 g/dL
C) 42 - 52 g/dL
D) 45 - 55 g/dL
Answer: C) 42 - 52 g/dL
What is the normal hemoglobin (Hgb) range for females?
A) 12 - 14 g/dL
B) 13 - 15 g/dL
C) 14 - 16 g/dL
D) 15 - 16 g/dL
Answer: D) 15 - 16 g/dL
What is the normal hemoglobin (Hgb) range for males?
A) 12 - 14 g/dL
B) 13 - 17 g/dL
C) 14 - 18 g/dL
D) 15 - 20 g/dL
Answer: C) 14 - 18 g/dL
What is the normal white blood cell (WBC) count range?
A) 3,000 - 10,000/μL
B) 4,000 - 11,000/μL
C) 5,000 - 12,000/μL
D) 6,000 - 13,000/μL
Answer: B) 4,000 - 11,000/μL
What is the normal platelet (Plts) count range?
A) 100,000 - 400,000/μL
B) 120,000 - 450,000/μL
C) 150,000 - 450,000/μL
D) 200,000 - 500,000/μL
Answer: C) 150,000 - 450,000/μL
What is the normal potassium (K⁺) range?
A) 2.5 - 4.5 mEq/L
B) 3.0 - 5.0 mEq/L
C) 3.5 - 5.0 mEq/L
D) 4.0 - 5.5 mEq/L
Answer: C) 3.5 - 5.0 mEq/L
What is the normal magnesium (Mag) range?
A) 1.0 - 2.0 mEq/L
B) 1.5 - 2.5 mEq/L
C) 2.0 - 3.0 mEq/L
D) 2.5 - 3.5 mEq/L
Answer: B) 1.5 - 2.5 mEq/L
What is the normal calcium (Ca⁺⁺) range?
A) 7.5 - 9.5 mg/dL
B) 8.0 - 10.0 mg/dL
C) 8.5 - 10.5 mg/dL
D) 9.0 - 11.0 mg/dL
Answer: C) 8.5 - 10.5 mg/dL
What is the normal range for ionized calcium (Ionized Ca⁺⁺)?
A) 5.9 - 7.1 mmol/L
B) 1.1 - 1.3 mmol/L
C) 2.3 - 4.5 mmol/L
D) 2.5 - 3.7 mmol/L
Answer: B) 1.1 - 1.3 mmol/L
What is the normal phosphorus (Phos) range?
A) 1.0 - 2.0 mEq/L
B) 1.5 - 2.5 mEq/L
C) 1.8 - 2.6 mEq/L
D) 2.0 - 3.0 mEq/L
Answer: C) 1.8 - 2.6 mEq/L
What is the normal chloride (Cl⁻) range?
A) 95 - 105 mEq/L
B) 100 - 108 mEq/L
C) 102 - 112 mEq/L
D) 105 - 115 mEq/L
Answer: B) 100 - 108 mEq/L
What is the normal BUN (Blood Urea Nitrogen) range?
A) 5 - 15 mg/dL
B) 8 - 18 mg/dL
C) 10 - 20 mg/dL
D) 12 - 22 mg/dL
Answer: C) 10 - 20 mg/dL
What is the normal creatinine range?
A) 0.4 - 1.0 mg/dL
B) 0.6 - 1.3 mg/dL
C) 0.8 - 1.5 mg/dL
D) 1.0 - 2.0 mg/dL
Answer: B) 0.6 - 1.3 mg/dL
What is the normal albumin range?
A) 2.5 - 4.0 g/dL
B) 3.0 - 4.5 g/dL
C) 3.5 - 5.5 g/dL
D) 4.0 - 6.0 g/dL
Answer: C) 3.5 - 5.5 g/dL
What is the normal range for Prothrombin Time (PT)?
A) 10 - 12 sec
B) 11 - 14 sec
C) 15 - 18 sec
D) 19 - 22 sec
Answer: B) 11 - 14 sec
Rationale: PT measures the extrinsic pathway of coagulation, specifically assessing factors I (fibrinogen), II (prothrombin), V, VII, and X. It is crucial for monitoring patients on warfarin therapy. An elevated PT may indicate a bleeding risk and can be treated with fresh frozen plasma (FFP) or vitamin K.
What is the normal range for Partial Thromboplastin Time (PTT)?
A) 15 - 25 sec
B) 18 - 28 sec
C) 21 - 34 sec
D) 25 - 40 sec
Answer: C) 21 - 34 sec
Rationale: PTT evaluates the intrinsic and common pathways of coagulation, assessing factors I, II, V, VIII, IX, X, XI, and XII. It is used to monitor heparin therapy. Prolonged PTT may indicate the need for protamine administration if the patient is on heparin.
What is the normal value for the International Normalized Ratio (INR)?
A) 0.8
B) 1
C) 1.2
D) 1.5
Answer: B) 1
Rationale: INR standardizes PT values across different labs and is used to monitor warfarin therapy. An elevated INR indicates an increased risk of bleeding and may require reversal with vitamin K or FFP.
What is the normal range for Activated Clotting Time (ACT)?
A) 50 - 100 sec
B) 60 - 110 sec
C) 80 - 120 sec
D) 100 - 150 sec
Answer: C) 80 - 120 sec
Rationale: ACT is used to monitor high-dose heparin therapy, especially during cardiopulmonary bypass. Prolonged ACT may indicate excessive anticoagulation and can be treated with protamine.
What is the normal value for Fibrin Split Products (FSP)?
A) <5 μ/dL
B) <10 μ/dL
C) <15 μ/dL
D) <20 μ/dL
Answer: B) <10 μ/dL
Rationale: FSPs are fragments from the breakdown of fibrin, indicating active clot degradation. Elevated levels suggest disseminated intravascular coagulation (DIC) or thrombolysis and may require treatment with antifibrinolytic agents.
What is the normal range for fibrinogen?
A) 100 - 300 mg/dL
B) 160 - 450 mg/dL
C) 200 - 500 mg/dL
D) 250 - 600 mg/dL
Answer: B) 160 - 450 mg/dL
Rationale: Fibrinogen is a key factor in clot formation. Low fibrinogen levels may indicate liver disease or DIC and often require replacement with cryoprecipitate or FFP.
What is the normal range for plasminogen activity?
A) 50 - 100%
B) 60 - 120%
C) 62 - 130%
D) 70 - 140%
Answer: C) 62 - 130%
Rationale: Plasminogen is converted to plasmin, which helps break down clots. Low plasminogen levels can lead to poor clot resolution and may necessitate thrombolytic therapy.
What is the normal range for D-dimer levels?
A) <100 ng/dL
B) <150 ng/dL
C) <200 ng/dL
D) <250 ng/dL
Answer: D) <250 ng/dL
Rationale: D-dimer is a marker of fibrin degradation and is elevated in conditions with active clotting, such as DVT, PE, or DIC. High levels warrant further investigation and possible anticoagulation therapy.
What is the normal range for Thyroid Stimulating Hormone (TSH)?
A) 0.1 - 0.3 μ units/mL
B) 0.4 - 4.0 μ units/mL
C) 0.5 - 5.0 μ units/mL
D) 1.0 - 6.0 μ units/mL
Answer: B) 0.4 - 4.0 μ units/mL
Rationale: TSH regulates thyroid function. Elevated TSH suggests hypothyroidism, while low TSH indicates hyperthyroidism. Treatment may include thyroid hormone replacement or antithyroid medications.
What is the normal range for T3 (Triiodothyronine)?
A) 70 - 200 ng/dL
B) 80 - 210 ng/dL
C) 90 - 230 ng/dL
D) 100 - 250 ng/dL
Answer: C) 90 - 230 ng/dL
Rationale: T3 is an active thyroid hormone. Abnormal levels may indicate thyroid dysfunction and may require adjustments in thyroid hormone therapy.
What is the normal range for T4 (Thyroxine)?
A) 10 - 12 mg/dL
B) 13 - 15 mg/dL
C) 13 - 19 mg/dL
D) 15 - 20 mg/dL
Answer: B) 13 - 15 mg/dL
Rationale: T4 is a precursor to T3. Abnormal levels indicate thyroid dysfunction and may require hormone replacement or antithyroid treatment.
What is the normal range for SGOT (AST) and SGPT (ALT)?
A) <15 IU/L
B) <25 IU/L
C) <35 IU/L
D) <45 IU/L
Answer: C) <35 IU/L
Rationale: AST and ALT are liver enzymes. Elevated levels indicate liver damage and may require further investigation and management of liver function.
What is the normal range for Fibrin Degradation Products (FDP)?
A) <5 μ/mL
B) <8 μ/mL
C) <10 μ/mL
D) <12 μ/mL
Answer: C) <10 μ/mL
Rationale: FDPs are fragments produced from the breakdown of fibrin during fibrinolysis. Elevated levels indicate increased fibrin breakdown, commonly seen in disseminated intravascular coagulation (DIC) or active thrombolysis. Management may include addressing the underlying cause and possibly administering antifibrinolytics. like TXA or amicar
Which of the following agents is a known trigger for Malignant Hyperthermia (MH)?
A) Propofol
B) Halothane
C) Midazolam
D) Ketamine
Answer: B) Halothane
Rationale: Halothane is a potent volatile anesthetic known to trigger MH, along with other inhaled agents like isoflurane, sevoflurane, and desflurane, as well as succinylcholine.
Which muscle relaxant is a common trigger for Malignant Hyperthermia?
A) Rocuronium
B) Vecuronium
C) Succinylcholine
D) Atracurium
Answer: C) Succinylcholine
Rationale: Succinylcholine is a depolarizing neuromuscular blocker that can trigger MH by causing uncontrolled calcium release in skeletal muscles.
What is a hallmark early sign of Malignant Hyperthermia during surgery?
A) Bradycardia
B) Decreased ETCO2
C) Rapidly increasing ETCO2
D) Hypothermia
Answer: C) Rapidly increasing ETCO2
Rationale: An early sign of MH is a rapid rise in end-tidal CO2 (ETCO2), indicating increased metabolic activity and hypermetabolism in the body.
What is the initial treatment step if Malignant Hyperthermia is suspected?
A) Administer dantrolene immediately
B) Stop the triggering agent immediately
C) Give a diuretic
D) Administer propofol
Answer: B) Stop the triggering agent immediately
Rationale: The first step in managing MH is to immediately stop the administration of any triggering agents (volatile anesthetics and succinylcholine).
