Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
"Can't ventilate, can't intubate" scenario. What is the best way to secure the airway? - ANSWER
Requires an emergent surgical airway
a) surgical cricothyrotomy
b) transtracheal jet ventilation
tracheostomy and retrograde intubation are not considered emergent airways
Convert Fahrenheit to Celsius - ANSWER F= (C x 1.8) + 32
What are the best oxygen sources for transtracheal ventilation? - ANSWER High pressure O2 sources
(TTJV requires psi of at least 25)
1. jet ventilator attached to anesthesia machine
2. O2 tank with a pressure regulator set to 50 psi
3. O2 flush valve on the anesthesia machine
Low pressure O2 sources (self resuscitation bag or reservoir bag on the anesthesia machine) are not
used for TTJV because they cannot fill the lungs with adequate O2 flow
LA ranked from shortest DOA to longest DOA
a) procaine
b) lidocaine
c) chloroprocaine
d) bupivacaine
e) mepivacaine
,Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
f) tetracaine
g) ropivacaine - ANSWER shortest (lowest protein binding) : procaine, cholorprocaine (zero protein
binding)
intermediate: lidocaine, mepivacine
longest (most protein binding): bupivacaine, ropivacaine, tetracaine
In a cirlce system, work of breathing is primarily determined by which component of the system?
Think about Pouiselle's Law... - ANSWER Whatever answer choice gives you the smallest diameter-->
decreased radius/diameter increases resistance
ETT is likely the answer since it has the narrowest diameter out of the Y piece, unidirectional valves and
circuit tubing
In the 15 kg pediatric patient who experiences cardiac arrest, what is the first defibrillation shock set at?
What about the second attempt? - ANSWER first attempt: 2J/kg --> 30 J
second attempt if necessary: 4J/kg --> 60 J
Rank the following tests of neuromuscular function based on the % of receptors that can be occupied
when the desired response is achieved
TOF 4/4
double burst stimulation without fade
TV 5mL/kg
biting on tongue blade for longer than 5 seconds - ANSWER TV 5 mL/kg-- 80% of receptors still occupied
by NMBD
TOF 4/4 -- 70% of receptors still occupied by NMBD
,Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
double burst stimulation without fade -- 60% of receptors still occupied by NMBD
biting on tongue blade > 5 seconds -- 50% of receptors still occupied by NMBD (this is the most sensitive
test of reversal)
Surgery is needed within __ hours of spinal hematoma symptoms. If delayed for more than __ hours,
recovery is unlikely. - ANSWER 8 hours
surgical decompression needs to happen within 8 hours of spinal hematoma symptoms or recovery is
unlikely
2 causes of hypocalcemia in the operating room - ANSWER 1. administration of PRBCs (citrate binds
calcium)
2. hyperventilation (causes decreased ionized calcium because H+ ions get displaced from plasma
proteins and Ca takes its place)
Equation for therapeutic index (TI) - ANSWER LD50/ED50
Post synaptic nicotinic receptors are found at each of the following sites EXCEPT:
a) NMJ
b) SA node
c) autonomic ganglia
d) adrenal medulla - ANSWER B- muscarinic receptors and adrenergic (B1) receptors are at the SA node
Rank the following from most likely to least likely to cause a perioperative allergic reaction
muscle relaxants
antibiotics
latex
protamine/ blood products - ANSWER most likely: 1. muscle relaxants (50-60%)
, Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
2. latex (15%)
3. antibiotics (10-15%)
4. protamine/ blood products (<2-3%)
What dose of epi causes beta effects? - ANSWER low dose epi 0.01-0.03 mcg/kg/min --> beta effects
(B1= increased HR and contractility, B2= decreased SVR)
intermediate dose epi 0.03-0.15 mcg/kg/min --> mixed alpha and beta
high dose epi >0.15 mcg/kg/min --> alpha effects (increased SVR--> increased BP)
What is the first step of the soda lime reaction?
What are the final products of the soda lime reaction? - ANSWER First step:
CO2 + H2O --> H2CO3
(carbonic acid)
Final products:
CaCO3 + NaOH
(calcium carbonate and sodium hydroxide)
What is the Aldrete Score and what does it quantify? - ANSWER Quantifies recovery from anesthesia
Drug eluding stent vs metal stent
How long after stent placement should another surgery be delayed? - ANSWER DES: delay surgery for 6
months if possible
metal stent: delay surgery for a minimum of 30 days
Exam 154 correct solutions.
Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
"Can't ventilate, can't intubate" scenario. What is the best way to secure the airway? - ANSWER
Requires an emergent surgical airway
a) surgical cricothyrotomy
b) transtracheal jet ventilation
tracheostomy and retrograde intubation are not considered emergent airways
Convert Fahrenheit to Celsius - ANSWER F= (C x 1.8) + 32
What are the best oxygen sources for transtracheal ventilation? - ANSWER High pressure O2 sources
(TTJV requires psi of at least 25)
1. jet ventilator attached to anesthesia machine
2. O2 tank with a pressure regulator set to 50 psi
3. O2 flush valve on the anesthesia machine
Low pressure O2 sources (self resuscitation bag or reservoir bag on the anesthesia machine) are not
used for TTJV because they cannot fill the lungs with adequate O2 flow
LA ranked from shortest DOA to longest DOA
a) procaine
b) lidocaine
c) chloroprocaine
d) bupivacaine
e) mepivacaine
,Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
f) tetracaine
g) ropivacaine - ANSWER shortest (lowest protein binding) : procaine, cholorprocaine (zero protein
binding)
intermediate: lidocaine, mepivacine
longest (most protein binding): bupivacaine, ropivacaine, tetracaine
In a cirlce system, work of breathing is primarily determined by which component of the system?
Think about Pouiselle's Law... - ANSWER Whatever answer choice gives you the smallest diameter-->
decreased radius/diameter increases resistance
ETT is likely the answer since it has the narrowest diameter out of the Y piece, unidirectional valves and
circuit tubing
In the 15 kg pediatric patient who experiences cardiac arrest, what is the first defibrillation shock set at?
What about the second attempt? - ANSWER first attempt: 2J/kg --> 30 J
second attempt if necessary: 4J/kg --> 60 J
Rank the following tests of neuromuscular function based on the % of receptors that can be occupied
when the desired response is achieved
TOF 4/4
double burst stimulation without fade
TV 5mL/kg
biting on tongue blade for longer than 5 seconds - ANSWER TV 5 mL/kg-- 80% of receptors still occupied
by NMBD
TOF 4/4 -- 70% of receptors still occupied by NMBD
,Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
double burst stimulation without fade -- 60% of receptors still occupied by NMBD
biting on tongue blade > 5 seconds -- 50% of receptors still occupied by NMBD (this is the most sensitive
test of reversal)
Surgery is needed within __ hours of spinal hematoma symptoms. If delayed for more than __ hours,
recovery is unlikely. - ANSWER 8 hours
surgical decompression needs to happen within 8 hours of spinal hematoma symptoms or recovery is
unlikely
2 causes of hypocalcemia in the operating room - ANSWER 1. administration of PRBCs (citrate binds
calcium)
2. hyperventilation (causes decreased ionized calcium because H+ ions get displaced from plasma
proteins and Ca takes its place)
Equation for therapeutic index (TI) - ANSWER LD50/ED50
Post synaptic nicotinic receptors are found at each of the following sites EXCEPT:
a) NMJ
b) SA node
c) autonomic ganglia
d) adrenal medulla - ANSWER B- muscarinic receptors and adrenergic (B1) receptors are at the SA node
Rank the following from most likely to least likely to cause a perioperative allergic reaction
muscle relaxants
antibiotics
latex
protamine/ blood products - ANSWER most likely: 1. muscle relaxants (50-60%)
, Apex Mock Exams + Valley Pre-course
Exam 154 correct solutions.
2. latex (15%)
3. antibiotics (10-15%)
4. protamine/ blood products (<2-3%)
What dose of epi causes beta effects? - ANSWER low dose epi 0.01-0.03 mcg/kg/min --> beta effects
(B1= increased HR and contractility, B2= decreased SVR)
intermediate dose epi 0.03-0.15 mcg/kg/min --> mixed alpha and beta
high dose epi >0.15 mcg/kg/min --> alpha effects (increased SVR--> increased BP)
What is the first step of the soda lime reaction?
What are the final products of the soda lime reaction? - ANSWER First step:
CO2 + H2O --> H2CO3
(carbonic acid)
Final products:
CaCO3 + NaOH
(calcium carbonate and sodium hydroxide)
What is the Aldrete Score and what does it quantify? - ANSWER Quantifies recovery from anesthesia
Drug eluding stent vs metal stent
How long after stent placement should another surgery be delayed? - ANSWER DES: delay surgery for 6
months if possible
metal stent: delay surgery for a minimum of 30 days
