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JW: Adv Principles A > Unit 1 Module 1 (Exam 1) > Flashcards

Unit 1 Module 1 (Exam 1) Flashcards

1
Q

New year, new semster, new challenges.
Ready?

A

Slide 7

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2
Q

What was the population of the United States in 2022?

A. 330 million
B. 331.1 million
C. 350 million
D. 310.2 million

A

B. 331.1 million

Slide 8

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3
Q

By 2030, what percentage of the U.S. population is projected to be over 65 years old?

A. 17%
B. 18%
C. 20%
D. 25%

A

C. 20% (one out of five people)

In 2022 only 17.5% were over the age of 65

Slie 8

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4
Q

Which factor contributes to IV access difficulties in elderly orthopedic patients? Select 2

A. Overhydration
B. Frail skin
C. Improved vein elasticity
D. Enhanced skin integrity
E. Movable veins

A

B. Frail skin
E. Movable veins

Slide 9

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5
Q

Why are thrombus risks increased in elderly patients undergoing orthopedic procedures?

A. Frequent physical activity
B. Active lifestyle
C. Hyperhydration
D. Sedentary lifestyle

A

D. Sedentary lifestyle

Slide 9

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6
Q

Common comorbidities in elderly orthopedic patients include ______ and ______.

A. Coronary artery disease, anemia
B. Diabetes, enhanced immunity
C. Arthritis, overhydration
D. Hypertension, improved bone density

A

A. Coronary artery disease, anemia

Slide 9

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7
Q

Preoperative assessments for elderly patients should include questions about ______ therapy.

A. Antibiotic
B. Anticoagulant
C. Vitamin
D. Pain management

A

B. Anticoagulant

Slide 9

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8
Q

Intraoperative positioning challenges in elderly patients are often due to ______ and ______.

A. Blood pressure, oxygenation issues
B. Enhanced mobility, vascular health
C. Muscle flexibility, hydration levels
D. Joint stiffness, bone fragility

A

D. Joint stiffness, bone fragility

slide 9

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9
Q

Which hormone increases in osteoporosis, contributing to bone density loss?

A. Growth hormone
B. Parathyroid hormone
C. Insulin-like growth factor
D. Estrogen

A

B. Parathyroid hormone

Slide 11

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10
Q

What are common causes of osteoporosis and fractures? (Select 2)

A. Decreased parathyroid hormone
B. Decreased growth hormone
C. Postmenopausal
D. Increased vitamin D levels

A

B. Decreased growth hormone
C. Postmenopausal

Slide 11

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11
Q

What factors contribute to decreased bone density in osteoporosis?
(Select 2)

A. Insulin-like growth factors
B. Decreased parathyroid hormone levels
C. Decreased vitamin D levels
D. Premenopausal

A

A. Insulin-like growth factors
C. Decreased vitamin D levels

Slide 11

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12
Q

Which bones are commonly fractured in patients with osteoporosis? (Select 3)

A. Proximal femur
B. Humerus
C. Skull
D. Wrist
E. Cervical Spine

A

A. Proximal femur
B. Humerus
D. Wrist

Slide 12

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13
Q

The thoracic and lumbar spine are prone to ______ fractures in patients with osteoporosis.

A. Stress
B. Compression
C. Spiral
D. Greenstick

A

B. Compression

Vertebral compression fractures in the spine are treated with a minimally invasive procedure called kyphoplasty

Stress fractures are tiny cracks in a bone. They’re caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances, usually happen in the lower legs or feet.

Slide 12

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14
Q

Which medication is NOT used to manage osteoporosis?

A. Fosamax
B. Actonel
C. Osteona
D. Reclast
E. Boniva

A

C. Osteona - completely made up name by me :)

Slide 12

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15
Q

Osteoarthritis is characterized by a loss of ______ cartilage, leading to inflammation.

A. Articular
B. Elastic
C. Compact
D. Spongy

A

A. Articular

“Bone on bone”

Slide 13

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16
Q

______% of patients over 65 with osteoarthritis experience physical limitations due to pain.

A. 5
B. 8
C. 10
D. 15

A

B. 8

Slide 13

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17
Q

What are common symptoms of osteoarthritis? (Select 3)

A. Pain
B. Crepitus
C. Increased joint strength
D. Decreased mobility
E. Improved circulation

A

A. Pain
B. Crepitus
D. Decreased mobility

Slide 14

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18
Q

What is crepitus in the context of osteoarthritis?

A. Tendons breaking
B. A type of bone fracture
C. Joint laxity
D. A scraping or popping sound

A

D. A scraping or popping sound

Either it’s between bone and cartilage or bone and bone

Slide 14

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19
Q

Which medications are used to manage osteoarthritis symptoms? (Select 3)

A. Fosamax
B. Celebrex
C. Opioids
D. NSAIDs
E. Antibiotics

A

B. Celebrex
C. Opioids
D. NSAIDs

Slide 14

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20
Q

Heberden nodes in osteoarthritis are characterized by swelling of the:

A. Proximal interphalangeal joints
B. Distal interphalangeal joints
C. Wrist joints
D. Metacarpophalangeal joints

A

B. Distal interphalangeal joints

Slide 15

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21
Q

Bouchard nodes are associated with swelling and spurring of the ______ interphalangeal joints.

A. Distal
B. Wrist
C. Metacarpophalangeal
D. Proximal

A

D. Proximal

Slide 15

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22
Q

Non-pharmacologic treatments for osteoarthritis include ______ and ______ therapy to improve mobility and reduce joint pain.

A. Massage, opioid
B. Hydrotherapy, steroid
C. Surgical, NSAIDs
D. Acupuncture, occupational

A

D. Acupuncture, occupational

Slide 16

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23
Q

______ therapy and ______ are non-pharmacologic strategies used to manage osteoarthritis symptoms.

A. Weight loss, TENS
B. Physical, corticosteroids
C. Massage, NSAIDs
D. TENS, opioids

A

A. Occupational, TENS

Slide 16

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24
Q

TENS stands for ______ Electro Nerve Stimulation.

A. Transcutaneous
B. Transient
C. Temporary
D. Transitional

A

A. Transcutaneous

Slide 16

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25
Q

Which NSAID is commonly prescribed for osteoarthritis?

A. Ibuprofen
B. Celecoxib
C. Meloxicam
D. Acetaminophen

A

C. Meloxicam

(Castillos mom takes it)

slide 17

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26
Q

What is a key concern with overuse of topical treatments like Voltaren?

A. They do not provide effective pain relief.
B. They can cause peptic ulcer disease and systemic side effects.
C. They are not absorbed into the body.
D. They promote cartilage regrowth.

A

B. They can cause peptic ulcer disease and systemic side effects.

Slide17

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27
Q

Celecoxib is classified as a:

A. COX-2 inhibitor
B. NSAID
C. Topical analgesic
D. Chondroprotective agent

A

A. COX-2 inhibitor

slide 17

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28
Q

Intra-articular therapy involves:

A. Oral NSAIDs
B. Topical treatments
C. Steroid injections
D. Acupuncture

A

C. Steroid injections

Can cause GI symptoms

slide 17

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29
Q

______ and ______ are examples of chondroprotective agents used in osteoarthritis management.

A. Glucosamine, chondroitin
B. Celecoxib, Voltaren
C. Meloxicam, acetaminophen
D. Ibuprofen, steroids

A

A. Glucosamine, chondroitin

Stop at least 2 weeks prior to surgery

Can also inculde Garlic, Ginko

Slide 17

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30
Q

Rheumatoid arthritis is primarily characterized as a:
Select 2

A. Chronic disesase
B. Acute with localized cartilage destruction
C. Temporary autoimmune condition
D. Chronic adipose disease
E. Systemic inflammatory disease

A

A.Chronic disease
D. Systemic inflammatory disease

Slide 18

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31
Q

In rheumatoid arthritis, connective and ______ tissue inflammation leads to ______.

A. Synovial, bone erosion
B. Connective, joint repair
C. Muscle, ligament repair
D. Cartilage, increased mobility

A

A. Synovial, bone erosion

Slide 18

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32
Q

______ and ______ are progressive outcomes of untreated rheumatoid arthritis.

A. Muscle regeneration, ligament repair
B. Bone erosion, enhanced mobility
C. Synovial thickening, improved flexibility
D. Cartilage destruction, impaired joint integrity

A

D. Cartilage destruction, impaired joint integrity

Slide 18

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33
Q

Rheumatoid arthritis commonly affects the ______ and ______ joints, causing pain and stiffness.

A. Wrists, metacarpophalangeal
B. Knees, shoulders
C. Distal interphalangeal, proximal interphalangeal
D. Spine, hip

A

A. Wrists, metacarpophalangeal

Slide 19

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34
Q

Rheumatoid nodules are typically found:

A. On muscle surfaces and on flexor surfaces
B. Only on distal interphalangeal joints
C. Around tendons in the spine
D. Surrounding joints and on extensor surfaces

A

D. Surrounding joints and on extensor surfaces

Slide 19

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35
Q

What is a distinguishing feature of subcutaneous rheumatoid nodules compared to Heberden and Bouchard nodes?

A. They are nonspecific and not limited to certain joints.
B. They are always found on the distal interphalangeal joints.
C. They are always proximal to the wrist.
D. They are associated with cartilage regrowth.

A

A. They are nonspecific and not limited to certain joints.

Slide 19

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36
Q

Systemic symptoms of rheumatoid arthritis include ______, ______, and weakness.

A. Weight gain, insomnia
B. Fatigue, anorexia
C. Joint swelling, cartilage growth
D. Increased mobility, strength

A

B. Fatigue, anorexia

Slide 19

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37
Q

______ and ______ are lab tests that help confirm the diagnosis of rheumatoid arthritis.

A. Rheumatoid factor, anti-immunoglobulin antibody
B. C-reactive protein, calcium
C. Erythrocyte sedimentation rate, glucose
D. Hematocrit, hemoglobin

A

A. Rheumatoid factor, anti-immunoglobulin antibody

Slide 20

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38
Q

______ and ______ are tests used to monitor systemic inflammation in rheumatoid arthritis patients.

A. Anti-immunoglobulin antibody, calcium
B. Rheumatoid factor, hemoglobin
C. Erythrocyte sedimentation rate, C-reactive protein
D. Platelet count, creatinine

A

C. Erythrocyte sedimentation rate, C-reactive protein

Slide 20

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39
Q

Which first line medication is commonly administered as a stress dose prior to procedures for rheumatoid arthritis patients?

A. Acetaminophen
B. Hydrocortisone
C. Celecoxib
D. Ibuprofen

A

B. Hydrocortisone

Usually…hydrocortisone, dexamethasone, or another mineralcorticoid could be of lesser dose range.

Slide 21

40
Q

Methotrexate (MTX) is a ______ that helps suppress the immune system and is classified as a ______.

A. DMARD, first-line treatment
B. NSAID, pain reliever
C. Biologic agent, chondroprotective agent
D. Glucocorticoid, TNF inhibitor

A

A. DMARD, first-line treatment

Slide 21

41
Q

______ and ______ are biologic agents that target tumor necrosis factor (TNF) in rheumatoid arthritis treatment.

A. Infliximab (Remicade), Etanercept (Enbrel)
B. Methotrexate (MTX), Hydroxychloroquine
C. Sulfasalazine, Leflunomide
D. NSAIDs, opioids

A

A. Infliximab (Remicade), Etanercept (Enbrel)

Slide 21

42
Q

Sulfasalazine and leflunomide are classified as ______, which are commonly used to manage ______ in rheumatoid arthritis.

A. Opioids, joint mobility
B. Biologic agents, pain
C. NSAIDs, cartilage degeneration
D. DMARDs, inflammation

A

D. DMARDs, inflammation

Slide 21

43
Q

Preoperative evaluation for a rheumatoid arthritis patient should include ______ and ______ to assess for airway challenges.

A. Neck circumference, vocal resonance
B. Nasal airflow, jaw alignment
C. TMJ mobility, cervical spine range of motion
D. Glottic flexibility, shoulder extension

A

C. TMJ mobility, cervical spine range of motion

Slide 22

44
Q

Cricoarytenoid arthritis can cause ______ and ______, requiring careful airway management in rheumatoid arthritis patients.

A. Hoarseness, glottic narrowing
B. Jaw pain, spinal curvature
C. Nasal congestion, throat swelling
D. Vocal resonance, synovial fluid accumulation

A

A. Hoarseness, glottic narrowing

Slide 22

45
Q

What should be assessed preoperatively in rheumatoid arthritis patients with potential cervical spine instability? (Select 3)

A. Neck motion
B. Mouth opening
C. Voice changes
D. Vertebral artery perfusion
E. Cranial nerve function

A

A. Neck motion
B. Mouth opening
C. Voice changes

Slide 23

46
Q

Atlantoaxial instability in rheumatoid arthritis can cause displacement of the ____________ process, leading to ______ on the medulla and cervical spine during neck flexion.

A. Mastoid, narrowing
B. Odontoid, impingement
C. Transverse, decompression
D. Odontoid, stretching

A

A. Odontoid, impingement

Slide 23

47
Q

Atlantoaxial instability can lead to which of the following complications during neck flexion?

A. Compression of the vertebral artery
B. Widening of the spinal canal
C. Increased range of motion in the cervical spine
D. Improved glottic opening

A

A. Compression of the vertebral artery

Slide 23

48
Q

Atlantoaxial instability in rheumatoid arthritis can result in what type of symptoms? (Select 3)

A. Headache
B. Neck pain
C. Improved vertebral artery flow
D. Bladder and bowel dysfunction
E. Widened glottic opening

A

A. Headache
B. Neck pain
D. Bladder and bowel dysfunction

Slide 24

49
Q

What are symptoms does atlantoaxial instability in rheumatoid arthritis show? (Select 2.)

A. Dysconjugate gaze
B. Lower extremity paresthesia
C. Ringing in ears
D. Upper extremity paresthesia
E. Improved cervical range of motion

A

B. Lower extremity paresthesia
D. Upper extremity paresthesia

Slide 24

50
Q

______ and ______ are recommended interventions for evaluating cervical spine instability in rheumatoid arthritis.

A. Flexion X-rays, extension X-rays
B. Cervical MRI, lumbar CT
C. Thoracic ultrasound, neck traction
D. Bone densitometry, cranial X-rays

A

A. Flexion X-rays, extension X-rays

Castillo “This helps determine if we are going to do direct versus video, if we are going to do manual inline stabilization versus awake fibre optic laryngoscopy which could be the last resort of course.”

Slide 24

51
Q

Vertebral artery occlusion in rheumatoid arthritis can cause ______ and ______, requiring careful cervical spine assessment.

A. Increased reflexes, nausea
B. Hyperextension, increased blood flow
C. Joint instability, improved perfusion
D. Dysphagia, transient loss of consciousness

A

D. Dysphagia, transient loss of consciousness

Slide 25

52
Q

______ and ______ are the most common symptoms of vertebral artery occlusion in rheumatoid arthritis.

A. B. Increased neck flexibility, improved airway patency
B. Nausea and vomiting, blurred vision
C. Hyperreflexia, joint mobility
D. Paresthesia, reduced airway narrowing
Correct Answer: A

A

B. Nausea and vomiting, blurred vision

Slide 25

53
Q

What symptoms are associated with Sjögren’s syndrome in patients with rheumatoid arthritis? Select 3
A. Dry eyes
B. Moist skin
C. Decreased saliva production
D. Increased tear production
E. Chronic dryness of mucosal surfaces

A

A. Dry eyes
C. Decreased saliva production
E. Chronic dryness of mucosal surfaces

Make sure the patient’s eyes are covered, maybe put protective drops in

Slide 26

54
Q

Which pulmonary complications may occur in rheumatoid arthritis patients?
Select 2
A. Restrictive ventilation pattern
B. Diffuse interstitial fibrosis
C. Increased functional residual capacity
D. Bronchial hyperreactivity

A

A. Restrictive ventilation pattern
B. Diffuse interstitial fibrosis

Slide 26

55
Q

What vascular condition is associated with rheumatoid arthritis?

A) Thrombocytopenia
B) Vasculitis
C) Varicose veins
D) Peripheral arterial disease

A

B) Vasculitis

Slide 27

56
Q

Which cardiac condition is a potential complication of severe rheumatoid arthritis? Select 2

A) Atrial fibrillation
B) Pericarditis
C) Endocarditis
D) Caridac tamponade
E. Aortic stenosis

A

B) Pericarditis
D) Caridac tamponade

Slide 27

57
Q

Patients with rheumatoid arthritis have an increase risk of which gastrointestinal complication?

A) Peptic ulcers
B) Intestinal perforation
C) Constipation
D) Diverticulitis

A

A) Peptic ulcers

Slide 27

58
Q

What renal condition might develop in rheumatoid arthritis patients due to the disease or its treatments?

A) Renal calculi
B) Acute renal failure
C) Kidney insufficiency
D) Glomerulonephritis

A

C) Chronic kidney insufficiency

Slide 27

59
Q

What components are essential during a preoperative evaluation for an orthopedic procedure? (Select 3)

A. Pain level
B. Neurovascular assessment
C. Assessment of bony prominences
D. Preoperative medications
E. Joint involvement

A

A. Pain level
B. Neurovascular assessment
E. Joint involvement

slide 31

60
Q

What is a critical consideration when positioning a patient for orthopedic surgery?

A. Ensuring the patient’s body is immobilized postoperatively
B. Protecting nerve structures and bony prominences
C. Assessing range of motion preoperatively
D. Maintaining the patient’s pain level throughout the procedure

A

B. Protecting nerve structures and bony prominences

Surgical positioning / mobility - protect nerves with padding

Slide 31

61
Q

Why is it important to consider the type of anesthesia for orthopedic procedures? (Select 3)

A. To increase intraoperative nerve damage
B. To ensure the patient remains still during the procedure
C. To manage postoperative pain levels
D. To make the surgical team comfortable
E. To enhance patient comfort

A

B. To ensure the patient remains still during the procedure
C. To manage postoperative pain levels
E. To enhance patient comfort

Consider regional

Slide 31

62
Q

Why is it important to recognize that patients with emergent orthopedic injuries may have full stomachs?

A. To anticipate the need for rapid blood transfusion
B. To prevent the risk of aspiration during anesthesia induction
C. To ensure adequate padding during surgical positioning
D. To minimize the risk of thromboembolic events

A

D. To prevent the risk of aspiration during anesthesia induction

Slide 33

63
Q

What is a significant risk associated with pelvic fractures during surgery?

A. Pulmonary aspiration
B. Fat embolism syndrome
C. Retroperitoneal space bleeding
D. Respiratory depression

A

C. Retroperitoneal space bleeding

Pelvic fractures –> iliac artery –> retroperitoneal space bleeding.

Will need massive transfusion protocol

Slide 33

64
Q

Which condition is most likely to occur with long bone fractures?

A. Hemodynamic stability
B. Thromboembolic hypoxic respiratory failure
C. Retroperitoneal hemorrhage
D. Air embolism

A

B. Thromboembolic hypoxic respiratory failure

Long bone fractures –> bone marrow fat emboli –> venous circulation –> thromboembolic hypoxic respiratory failure

Slide 33

65
Q

What is the primary purpose of cricoid pressure during rapid sequence induction (RSI)?

A. To ensure preoxygenation is effective
B. To prevent aspiration during induction
C. To facilitate visualization of the vocal cords
D. To improve intubation success rates

A

B. To prevent aspiration during induction

Slide 34

66
Q

Preoxygenation at 100% during RSI should be performed for at least how many minutes?

A. 1 minute
B. 2 minutes
C. 3 minutes
D. 5 minutes

A

C. 3 minutes

Slide 34

67
Q

What are the key steps involved in rapid sequence induction (RSI)? (Select 2)

A. Giving Propofol and Vecuronium
B. Apnea ventilation
C. Application of the Sellick maneuver
D. Ventilating the patient prior to intubation

A

B. Apnea ventilation (Boyles law)
C. Application of the Sellick maneuver (cricoid pressure)

Slide 34

68
Q

The pressure applied during the Sellick maneuver should be approximately __________ pounds.

A. 10
B. 15
C. 18
D. 20

A

A. 10 (30 Newtons)

Slide 34

69
Q

Why is modified RSI controversial in trauma anesthesia?

A. It involves the use of different medications than standard RSI
B. It allows for ventilating the patient, increasing aspiration risk
C. It requires less preoxygenation time than standard RSI
D. It does not involve cricoid pressure

A

B. It allows for ventilating the patient, increasing aspiration risk

Castillo - A modified radical rapid sequence induction where they ventilate the patient, just like, oh, let’s just try with one breath and if we see
chest rise, then yes, we can ventilate.
So they call it modified RSI.”

70
Q

Induction medications for RSI in trauma patients often include __________ or etomidate.

A. Ketamine
B. Propofol
C. Midazolam
D. Fentanyl

A

A. Ketamine

Castillo - “…not propofol, because there could be bleeding or dehydration that has already occurred with the patient and we don’t want to bottom out their pressures”

Slide 34

71
Q

Which of the following muscle relaxant medications are most appropriate for induction during RSI anesthesia?

A. Propofol and rocuronium
B. Rocuronium and succinylcholine
C. Etomidate and midazolam
D. Propofol and vecuronium

A

B. Rocuronium and succinylcholine

Slide 34

72
Q

When should an LMA or Combitube be considered during trauma anesthesia?

A. After three failed intubation attempts
B. When the patient is unresponsive to muscle relaxants
C. During preoxygenation for rapid sequence induction
D. Before administering induction medications

A

A. After three failed intubation attempts

Slide 34

73
Q

What does MILI stand for in the context of trauma anesthesia and rapid sequence induction (RSI)?

A. Manual Inline Immobilization
B. Manual Inline Intubation
C. Mechanical Inline Immobilization
D. Modified Intubation and Laryngoscopy

A

A. Manual Inline Immobilization
(can also be MILS, S is for stabilization)
Stabilization of head, neck, and torso in the neutral position for those
Patients who have not been cleared

Slide 36

74
Q

Which of the following airway maneuvers is avoided during MILI to prevent cervical spine movement?

A. Direct laryngoscopy
B. Cricoid pressure
C. Jaw thrust
D. Apneic ventilation

A

C. Jaw thrust

Castillo - we can’t do jaw thrust
because it would flex the neck and can result in some cervical spine movement, which could be an aggravating component for this patient.

Slide 36

75
Q

How many clinicians are typically required to perform MILI effectively?

A. One
B. Two
C. Three
D. Four

A

C. Three

    • Stabilize and align head in neutral position without applying cephalad traction
    • Stabilize shoulders/cricoid pressure
    • Intubate

Slide 36

76
Q

What is a significant disadvantage of MILI during intubation?

A. Increased aspiration risk
B. Reduced oxygenation during preoxygenation
C. Higher likelihood of hyperextension injuries
D. Reduced visibility of the larynx

A

D. Reduced visibility of the larynx

Prepare for difficult airway

Slide 36

77
Q

Why are ACE inhibitors typically held the night before surgery?

A. To reduce the risk of perioperative hypertension
B. To prevent significant hypotension during anesthesia induction
C. To enhance the effects of anticoagulants
D. To reduce the risk of opioid-related side effects

A

B. To prevent significant hypotension during anesthesia induction

Slide 37

78
Q

Beta-blockers are typically __________ during the perioperative period to maintain cardiovascular stability.

A. Continued
B. Discontinued
C. Repaced
D. Doubled

A

A. Continued

Slide 37

79
Q

What are the risks associated with anticoagulant use in the preoperative period? (Select 2)

A. Increased risk of bleeding
B. Risk of hypotension
C. Delayed clotting time
D. Reduced oxygenation levels

A

A. Increased risk of bleeding
C. Delayed clotting time

Coumadin and LMWH

Slide 37

80
Q

Which medications may affect pain management during preoperative evaluation? (Select 2)

A. Coumadin
B. Opioids
C. NSAIDs
D. Beta-blockers

A

B. Opioids
C. NSAIDs

Slide 37

81
Q

Why is it critical to establish a baseline cognitive status during preoperative evaluation?

A. To identify patients with a history of substance abuse
B. To assess for age-related cardiovascular risks
C. To predict the likelihood of anesthesia-related hypotension
D. To monitor for potential postoperative delirium and confusion

A

D. To monitor for potential postoperative delirium and confusion

Slide 38

82
Q

Which factors increase the risk of postoperative delirium? (Select 3)

A. Advanced age
B. ETOH use or withdrawal
C. Preoperative dementia
D. Beta-blocker therapy
E. NSAID use

A

A. Advanced age
B. ETOH use or withdrawal
C. Preoperative dementia

Slide 38

83
Q

Which of the following are triggers for delirium in the perioperative period? (Select 3)

A. Pain
B. Hypoxemia
C. Hypertension
D. Hypovolemia
E. Cholinergic use
F. Hypervolemia

A

A. Pain
B. Hypoxemia
D. Hypervolemia

Slide 39

84
Q

Triggers for delirium include infection, __________ and ___________ and sleep deprivation

A. Hypocarbia, hypotension
B. Sleep deprivation, hypocarbia
C. Hypovolemia, pain
D. Hypercarbia, sleep deprivation

A

D. Hypercarbia, sleep deprivation

Slie 39

85
Q

Administration of __________ and __________ may increase the risk of postoperative delirium.

A. Benzodiazepines, anticholinergics
B. Opioids, beta-blockers
C. ACE inhibitors, NSAIDs
D. Benzodiazepines, beta-blockers

A

A. Benzodiazepines, anticholinergics

Slide 39

86
Q

What actions can anesthesia providers take to reduce the risk of postoperative delirium?

A. Optimize oxygenation
B. Avoid unnecessary benzodiazepine administration
C. Correct electrolyte imbalances preoperatively
D. Minimize postoperative pain
Correct Answers: A, B, C

A

All of the above

Slide 39

87
Q

Which symptoms should be assessed postoperatively to monitor for CNS changes? (Select 3)

A. Attention and awareness deficits
B. Muscle weakness and anxiety
C. Paranoia and hallucinations
D. Irritability and anxiety
E. Bradycardia and hypotension

A

A. Attention and awareness deficits
C. Paranoia and hallucinations
D. Irritability and anxiety

Slide 40

88
Q

Pre-operative evaluation

What happens to forced expiratory volume in one second (FEV₁) as part of the normal aging process?

A. It increases by 10% for each decade
B. It decreases by 10% for each decade
C. It remains constant throughout life
D. It decreases by 5% for each decade

A

B. It decreases by 10% for each decade

Slide 41

89
Q

Which age-related respiratory changes should anesthesia providers consider during preoperative evaluation? (Select 2)

A. Progressive decrease in PaO₂
B. Increased closing volume
C. Increase in FEV₁
D. Increased respiratory drive
E. Reduced total lung capacity

A

A. Progressive decrease in PaO₂
B. Increased closing volume

Slide 41

90
Q

Why is obesity a significant factor in preoperative respiratory evaluation?

A. It is strongly associated with obstructive sleep apnea
B. It increases the risk of bronchospasm
C. It leads to permanent lung damage
D. It causes immediate airway obstruction

A

A. It is strongly associated with obstructive sleep apnea

🛑 🔫

Slide 41

91
Q

According to ACC/AHA guidelines, when is preoperative cardiac testing necessary for intermediate-risk surgery?

A. Only when the patient has a history of coronary artery disease
B. When the results will change perioperative management
C. For all patients over the age of 65
D. If the patient has a history of smoking

A

B. When the results will change perioperative management

Slide 42

92
Q

Which is NOT a key consideration when evaluating cardiac risk preoperatively for intermediate-risk surgery? (Select 3)

A. Functional capacity
B. Presence of coronary stents
C. Antiplatelet medication management
D. Age over 65 as a sole determinant
E. Orthopedic disease

A

D. Age over 65 as a sole determinant

Slide 42

93
Q

What is the recommended target heart rate when using beta-blockers for high-risk cardiac patients?

A. Less than 100 bpm
B. Less than 90 bpm
C. Less than 80 bpm
D. Less than 70 bpm

A

C. Less than 80 bpm

Slide 43

94
Q

Which beta-blocker is most appropriate for immediate, short-term control of tachycardia in the operating room?

A. Labetalol
B. Metoprolol
C. Esmolol
D. Propranolol

A

C. Esmolol

Slide 42

95
Q

Why should beta-blockers be continued for patients already on them during the perioperative period?

A. To prevent rebound hypertension and tachycardia
B. To improve respiratory function during anesthesia
C. To reduce the risk of postoperative delirium
D. To manage anticoagulant effects

A

A. To prevent rebound hypertension and tachycardia

Slide 42

JW: Adv Principles A (13 decks)

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