Anesthesia|Latest 2025/2026
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A 2 year old child is rushed to the trauma room for a laparotomy after sustaining
multiple injuries in a MVA. The child arrives intubated and pharmacologically
paralyzed. The child is tachycardic, mild HoTN, and hypothermic. All of the
following may be consequences of unintended Intraoperative hypothermia
EXCEPT?
A. Decreased oxygen consumption
B. Increased metabolic rate
C. Systemic HoTN
D. Pulmonary HTN
E. Hypoglycemia - ANSWERS-B. Increased Metabolic Rate
Cold stress may cause hypoxia, acidosis, depletion of glycogen stores,
hypoglycemia, 316. pulmonary vasoconstriction and hypertension,shock,
disseminated intravascular coagulation,altered drug metabolism, and delayed
emer-gence.
,A newborn infant at 33 weeks gestational age presents for gastroschisis repair. In
preparing medications for this pt, all of the following are considerations that will
affect your medication selection EXCEPT?
A.Increased ventilatory depression from maternally administer opioids
B. Immature BBB
C. Lower protein availability for drug binding
D. Increased sensitivity to CNS toxicity of lido
E. Immature enzyme systems for drug metabolism - ANSWERS-D. IncreaSed
sensitivity to CNS toxicity of lido.
The preterm infant is particularly suscep- tible to maternally-administered drugs.
They have immature enzyme systems, an incom- plete bundle branch block, and
decreased protein for binding. The preterm infant metab- olizes both ester and
amide local anesthetics and is actually less sensitive to the CNS toxicity of
lidocaine than full-term infants.
A 3-week-old infant, born at 38 weeks gesta- tional age, weighing 4 kg, presents
for a Ladd's procedure. In order to request the appropriate amount of blood, you
would like to know the allowable blood loss for this patient. What is the blood
volume of this patient?
(A) 160mL
(B) 200mL
(C) 400mL
(D) 280mL
, (E) 320mL - ANSWERS-(E) The normal blood volume in a full term
infantis80mL/kg(4kg× 80mL/kg= 320 mL). A premature infant has a higher volume
per unit of weight, 90-100 mL/ kg.
A 6-year-old boy presents to the holding area for elective repair of an inguinal
hernia. He is a mild asthmatic and has not taken any daily asthma medications for
5 weeks. He is cur- rently wheezing throughout on physical exam. You inform the
mother that you will
(A) proceed with surgery without treatment
(B) postpone until tomorrow after 2 doses of montelukast
(C) refer the patient to his pediatrician for evaluation and treatment
(D) proceed with surgery after albuterol
(E) perform surgery with sedation and analgesia with local infiltration - ANSWERS-
C) The patient's caregivers have been non- compliant with asthma medications.
He clearly
is not at baseline nor optimized for elective surgery. The patient should be
referred to his pediatrician. He should be placed back on a maintenance dose of
montelukast for a mini- mum of 2 weeks. Sedation and analgesia with local
anesthesia is usually not a reasonable choice in this age group.
A 4-day-old, full term neonate presents for repair of imperforate anus. The baby
has no other abnormalities. All of the following are true regarding transitional
circulation in this patient EXCEPT
(A) the patient's pulmonary vascular resistance has decreased relative to the
pressures in utero
(B) the patient's pressures on the left side of the heart have increased relative to
the pressures in utero