ANESTHESIA BOARD QUESTIONS EXAM REVIEW UPDATE

ANESTHESIA BOARD QUESTIONS 2023- 2024 EXAM REVIEW UPDATE The Bourbon pressure gauge can be used to calculate the cylinder volume for (Select 2 ). A- Nitrogen B- Helium C- Nitrous oxide D- Carbon Dioxide - ANS-A- Nitrogen B= Helium Both exist as a liquid. The Bourbon pressure gauge can be used to calculate the cylinder volume for (Select 2 ). A- Nitrogen B- Helium C- Nitrous oxide D- Carbon Dioxide - ANS-A- Nitrogen B= Helium Both exist as a liquid. Changes found in banked blood include: (Select 2) A- increased levels of 2,3-DPG B - a left shift of the hemoglobin dissociation curve C- decreased levels of potassium D- formation of microaggregates E- alkalosis secondary to the presence of citrate F- increased intracellular ATP stores G- thrombocytosis - ANS-B,D Changes occurring in banked blood include: Depletion of 2,3-DPG Depletion of intracellular ATP Oxidative damage Increased adhesion to vascular endothelium Altered cell morphology Accumulation of microaggregates Hyperkalemia (as high as 17.2 mEq/L) Absence of platelets (after 2 days of storage) Hemolysis Accumulation of proinflammatory products Changes found in banked blood include: (Select 2) A- increased levels of 2,3-DPG B - a left shift of the hemoglobin dissociation curve C- decreased levels of potassium D- formation of microaggregates E- alkalosis secondary to the presence of citrate F- increased intracellular ATP stores G- thrombocytosis - ANS-B,D Changes occurring in banked blood include: Depletion of 2,3-DPG Depletion of intracellular ATP Oxidative damage Increased adhesion to vascular endothelium Altered cell morphology Accumulation of microaggregates Hyperkalemia (as high as 17.2 mEq/L) Absence of platelets (after 2 days of storage) Hemolysis Accumulation of proinflammatory products Does "light" anesthesia promote wheezing? - ANS-Yes, if patint has a reactive airway. Does "light" anesthesia promote wheezing? - ANS-Yes, if patint has a reactive airway. The largest fraction of carbon dioxide in the blood is in the form of : A - carbamino compounds B- Bicarbonate C- Dissolved gas D- Carboxyhemoglobin - ANS-B The largest fraction of carbon dioxide in the blood is in the form of : A - carbamino compounds B- Bicarbonate C- Dissolved gas D- Carboxyhemoglobin - ANS-B Pulmonary changes associated with Duchenne's muscular dystrophy include: A-a restrictive ventilatory defect B-an obstructive ventilatory defect C-decreased pulmonary artery pressures D- increased residual volume - ANS-A- restrictive ventilatory defect The combination of marked kyphoscoliosis and degeneration of the respiratory muscles produces a severe restrictive ventilatory defect in patients with Duchenne's muscular dystrophy. Pulmonary hypertension is also commonly seen. Pulmonary changes associated with Duchenne's muscular dystrophy include: A-a restrictive ventilatory defect B-an obstructive ventilatory defect C-decreased pulmonary artery pressures D- increased residual volume - ANS-A- restrictive ventilatory defect The combination of marked kyphoscoliosis and degeneration of the respiratory muscles produces a severe restrictive ventilatory defect in patients with Duchenne's muscular dystrophy. Pulmonary hypertension is also commonly seen. A 46-year-old male is scheduled for an emergent laparotomy for small bowel obstruction. His history is complicated by the acute onset of hepatitis B four days earlier and he presents with significant scleral jaundice. The perioperative mortality in this patient is approximately: A-2% B- 5% C- 10% D- 25% - ANS-C- 10% Patients with acute hepatitis should have elective surgery postponed until the acute hepatitis has resolved. Studies indicate increased perioperative morbidity (12%) and mortality (10% with laparotomy) during acute hepatitis. A 46-year-old male is scheduled for an emergent laparotomy for small bowel obstruction. His history is complicated by the acute onset of hepatitis B four days earlier and he presents with significant scleral jaundice. The perioperative mortality in this patient is approximately: A-2% B- 5% C- 10% D- 25% - ANS-C- 10% Patients with acute hepatitis should have elective surgery postponed until the acute hepatitis has resolved. Studies indicate increased perioperative morbidity (12%) and mortality (10% with laparotomy) during acute hepatitis. An increase in intraocular pressure has been associated with: (select 3) A-nitrous oxide administration B-succinylcholine administration C-opioid administration D-hyperventilation E- laryngoscopy F- hypoxemia G-sevoflurane administration - ANS-B, E, F succinylcholine, laryngoscopy, hypoxemia. Succinylcholine increases intraocular pressure by 5 - 10 mm Hg for 5 - 10 minutes after administration. This increase is primarily the result of prolonged contracture of the extraocular muscles from the depolarizing effects of succinylcholine. Nitrous oxide, volatile anesthetic agents and opioids have been associated with a reduction in intraocular pressure. Hypoxemia, hypercarbia, hypertension, hypervolemia, laryngoscopy and intubation have all been shown to increase IOP. An increase in intraocular pressure has been associated with: (select 3) A-nitrous oxide administration B-succinylcholine administration C-opioid administration D-hyperventilation E- laryngoscopy F- hypoxemia G-sevoflurane administration - ANS-B, E, F succinylcholine, laryngoscopy, hypoxemia. Succinylcholine increases intraocular pressure by 5 - 10 mm Hg for 5 - 10 minutes after administration. This increase is primarily the result of prolonged contracture of the extraocular muscles from the depolarizing effects of succinylcholine. Nitrous oxide, volatile anesthetic agents and opioids have been associated with a reduction in intraocular pressure. Hypoxemia, hypercarbia, hypertension, hypervolemia, laryngoscopy and intubation have all been shown to increase IOP. In the pressure-volume loop below, cardiac work is best represented by: A-the area of the curve B-the slope of the line from points C to D C-the distance of the line from points C to D D-the slope of a line from points A to D - ANS-A-the area of the curve Cardiac work is the product of pressure and volume and is linearly related to myocardial oxygen consumption. Cardiac work is best represented by the area of the curve of a pressure-volume loop. In the pressure-volume loop below, cardiac work is best represented by: A-the area of the curve B-the slope of the line from points C to D C-the distance of the line from points C to D D-the slope of a line from points A to D - ANS-A-the area of the curve Cardiac work is the product of pressure and volume and is linearly related to myocardial oxygen consumption. Cardiac work is best represented by the area of the curve of a pressure-volume loop. Current anesthesia apparatus checkout recommendations suggest which of the following prior to every case? A-Check oxygen cylinder supply B-Check the carbon dioxide absorber C-Performance of a machine low-pressure leak test D-Calibration of the oxygen monitor - ANS-B- Check the carbon dioxide absorber Verification of the adequacy of the carbon dioxide absorber is suggested prior to every case. If the same anesthesia machine is being used by the same provider, E-cylinder pressure checks, machine low-pressure leak testing and calibration of the oxygen sensor need not be repeated after an initial check. Current anesthesia apparatus checkout recommendations suggest which of the following prior to every case? A-Check oxygen cylinder supply B-Check the carbon dioxide absorber C-Performance of a machine low-pressure leak test D-Calibration of the oxygen monitor - ANS-B- Check the carbon dioxide absorber Verification of the adequacy of the carbon dioxide absorber is suggested prior to every case. If the same anesthesia machine is being used by the same provider, E-cylinder pressure checks, machine low-pressure leak testing and calibration of the oxygen sensor need not be repeated after an initial check. A patient with diabetic ketoacidosis is scheduled for an emergent laparotomy. Which of the following best explains the decrease in serum potassium concentration that occurs in this patient following administration of insulin? A-Dilutional hypokalemia follows free water retention from decreased osmotic diuresis B-Extracellular potassium is actively transported with glucose into cells C-Insulin enhances renal excretion of potassium Continues...