Apex kwAnesthesia for Surgical Procedures
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Domain Exams
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The patient should be breathing a high FiO2 to treat V/Q mismatch.
Intercostal nerve blocks 2 levels above and below the incision is sufficient.
(Lung deflation should not be attempted when performing the surgical procedure under local
anesthesia.) You are providing local anesthesia for a VATS for minor transthoracic biopsy.
What statements are TRUE about this approach to the case? (Select 2)
-The patient should be breathing a high FiO2 to treat V/Q mismatch.
-Intercostal nerve blocks 2 levels above and below the incision is sufficient.
-Direct intravascular arterial pressure should be monitored.
-Insufflating gas into the thorax will assist with poor lung deflation.
14 G, 4 cm peripheral venous
(When selecting an IV catheter for rapid infusion, the 2 most important considerations include the
diameter and length of the catheter. Poiseuille says that flow is directly proportional to the radius
raised to the 4th power. Because of this, changes in radius yield a far more significant effect than
changes in catheter length. It's a mistake to assume that you'll always get better flow with a
central line versus a peripheral catheter. A potential benefit of longer catheters is that they may be
less likely to get dislodged.) What is the MOST effective choice in a venous catheter for use in
patients requiring the rapid infusion of resuscitation fluids?
-14 G, 12 cm central venous
-16 G, 3 cm peripheral venous
-16 G, 20 cm multi-port central venous
-14 G, 4 cm peripheral venous
Portal vein puncture
Cardiac dysrhythmias
Pneumothorax
(During a TIPS procedure, the shunt is introduced via the jugular vein, threaded through the right
atrium through the inferior vena cava and to the hepatic vein. A lot can happen here.
Pneumothorax or IJ injury can occur during catheter placement. Passage through the RA can
cause cardiac dysrhythmias. If the portal vein is punctured rather than cannulated, hemorrhage
can occur.) Complications of the TIPS procedure that may require anesthesia support include:
(Select 3)
-Portal vein puncture
-Hypothermia
-Cardiac dysrhythmias
-Hypophosphatemia
-Venous air embolism
, Apex kwAnesthesia for Surgical Procedures
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Domain Exams
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-Pneumothorax
Vasodilators
(The immediate cardiovascular response to aortic cross-clamping is an increase in afterload and
myocardial work. The most appropriate treatment is the administration of vasodilators with the
goal of decreasing SVR and cardiac work.) What is the MOST appropriate to use in response to
aortic cross-clamping?
-Volume expansion
-Vasopressors
-Beta blockers
-Vasodilators
Monopolar Is a monopolar or bipolar bovie more likely to cause problems?
Elevation of the HOB
Total IV anesthesia
Mucosal vasoconstriction
(Standard measures to reduce blood loss and maintain a clear visual field for the surgeon include
the use of topical vasoconstrictors and elevation of the head of the bed. Barash reports 2 studies
that demonstrate less blood loss with TIVA compared with inhaled anesthesia.) Which
methods are recommended to reduce blood loss during endoscopic sinus surgery? (Select 3)
-Controlled hypothermia
-Perioperative beta blockade
-Elevation of the head of the bed
-Minimize intravascular volume
-Total IV anesthesia
-Mucosal vasoconstriction
Hypertension and tachycardia
(An aneurysm is most likely to burst when the patient is hypertensive (think law of Laplace), and
myocardial ischemia is most likely to occur when the heart rate is rapid.) Anesthetic
management of a thoracic aneurysm repair should focus on avoidance of:
-Hypotension and tachycardia
-Hypertension and bradycardia
-Hypertension and tachycardia
-Hypotension and bradycardia
15-30 minutes
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Domain Exams
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The patient should be breathing a high FiO2 to treat V/Q mismatch.
Intercostal nerve blocks 2 levels above and below the incision is sufficient.
(Lung deflation should not be attempted when performing the surgical procedure under local
anesthesia.) You are providing local anesthesia for a VATS for minor transthoracic biopsy.
What statements are TRUE about this approach to the case? (Select 2)
-The patient should be breathing a high FiO2 to treat V/Q mismatch.
-Intercostal nerve blocks 2 levels above and below the incision is sufficient.
-Direct intravascular arterial pressure should be monitored.
-Insufflating gas into the thorax will assist with poor lung deflation.
14 G, 4 cm peripheral venous
(When selecting an IV catheter for rapid infusion, the 2 most important considerations include the
diameter and length of the catheter. Poiseuille says that flow is directly proportional to the radius
raised to the 4th power. Because of this, changes in radius yield a far more significant effect than
changes in catheter length. It's a mistake to assume that you'll always get better flow with a
central line versus a peripheral catheter. A potential benefit of longer catheters is that they may be
less likely to get dislodged.) What is the MOST effective choice in a venous catheter for use in
patients requiring the rapid infusion of resuscitation fluids?
-14 G, 12 cm central venous
-16 G, 3 cm peripheral venous
-16 G, 20 cm multi-port central venous
-14 G, 4 cm peripheral venous
Portal vein puncture
Cardiac dysrhythmias
Pneumothorax
(During a TIPS procedure, the shunt is introduced via the jugular vein, threaded through the right
atrium through the inferior vena cava and to the hepatic vein. A lot can happen here.
Pneumothorax or IJ injury can occur during catheter placement. Passage through the RA can
cause cardiac dysrhythmias. If the portal vein is punctured rather than cannulated, hemorrhage
can occur.) Complications of the TIPS procedure that may require anesthesia support include:
(Select 3)
-Portal vein puncture
-Hypothermia
-Cardiac dysrhythmias
-Hypophosphatemia
-Venous air embolism
, Apex kwAnesthesia for Surgical Procedures
kw kwkw kwkw kwkw
Domain Exams
kwkw kwkw
-Pneumothorax
Vasodilators
(The immediate cardiovascular response to aortic cross-clamping is an increase in afterload and
myocardial work. The most appropriate treatment is the administration of vasodilators with the
goal of decreasing SVR and cardiac work.) What is the MOST appropriate to use in response to
aortic cross-clamping?
-Volume expansion
-Vasopressors
-Beta blockers
-Vasodilators
Monopolar Is a monopolar or bipolar bovie more likely to cause problems?
Elevation of the HOB
Total IV anesthesia
Mucosal vasoconstriction
(Standard measures to reduce blood loss and maintain a clear visual field for the surgeon include
the use of topical vasoconstrictors and elevation of the head of the bed. Barash reports 2 studies
that demonstrate less blood loss with TIVA compared with inhaled anesthesia.) Which
methods are recommended to reduce blood loss during endoscopic sinus surgery? (Select 3)
-Controlled hypothermia
-Perioperative beta blockade
-Elevation of the head of the bed
-Minimize intravascular volume
-Total IV anesthesia
-Mucosal vasoconstriction
Hypertension and tachycardia
(An aneurysm is most likely to burst when the patient is hypertensive (think law of Laplace), and
myocardial ischemia is most likely to occur when the heart rate is rapid.) Anesthetic
management of a thoracic aneurysm repair should focus on avoidance of:
-Hypotension and tachycardia
-Hypertension and bradycardia
-Hypertension and tachycardia
-Hypotension and bradycardia
15-30 minutes
