CRNA
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,Carbonic Anhydrase Inhibitors are used in the treatment A. Acute glaucoma
of: The decrease the ability of the kidneys to reabsorb bicarbonate, resulting in
A. Acute glaucoma hypercholemic aciosis. As a result, carbonic anhydrase inhibitors would be
B. Renal tubular acidosis avoided in patients with acidosis, especially in a normal anion gap acidosis.
C. Diarrhea induced acidosis Bicarbonate is filtered by the ciliary process in the formation of aqueous humor,
D. Acidosis resulting from hypoventilation carbonic anydrase inhibitors reduce the formation of aqueous humor and can
decrease intraocular pressure.
Branches of the femoral nerve anesthetized during an C. Saphenous Nerve
ankle block include the: It's the only one to come from the femoral nerve. The other 3 are from the sciatic
A. Deep peroneal nerve nerve.
B. Sural nerve
C. Saphenous Nerve
D. Posterior Tibial Nerve
Pulmonary complications from advanced hepatic disease C. Increased intrapulmonary shunting
with cirrhosis include: pulmonary manifestations associated with cirrhosis include: increased
A. obstructive ventilatory defect intrapulmonary shunting, decreased FRC, pleural effusions, restrictive ventilatory
B. respiratory acidosis defect, and respiratory alkalosis
C. increased intrapulmonary shunting
D. increased function residual capacity
An anxiolytic herbal medication associated with a Valerian
decrease in the requirement of inhaled anesthetic agent both valerian and kava have been shown to have a GABA mediated hypnotic
(MAC) is: effect and by this mechanism can decreased MAC. Acute withdrawal after
echinacea chronic use may result in an increase in MAC
valerian
ginkgo
ephedra
A decrease in pseudocholinesterase activity has been pancuronium
associated with the use of: (Select 3) esmolol
pancuronium metaclopramide
esmolol
droperidol The following drugs have been associated with a decrease in
vecuronium pseudocholinesterase activity: ecothiopate, pyridostigmine, neostigmine,
metoclopramide phenelzine, cyclophosphamide, metaclopramide, esmolol, pancuronium, and oral
magnesium sulfate contraceptives. Although both dantrolene and magnesium may alter the effects of
dantrolene other neuromuscular blockers, neither causes inhibition of pesudocholinesterase
rocuronium
During the delivery of an anesthetic in the radiology 745-750psi
department, full E-cylinders of nitrous oxide are being
used. If a 3L/min:2L/min mixture of nitrous:oxygen is N20 has a critical temperature of 37 degrees C. The allow N20 to exist as a liquid
being delivered and teh case has been proceeding for 60 at room temperature. Full E-cylinders of N20 contain approx 1590L at a pressure
minutes, the expected pressure in the nitrous oxide e- of 745 psig. A sixty minute delivery of 3L/min would result in a 180L consumption,
cylinder is: this would be inadequate to consume all the liquid nitrous oxide in the tank. As a
result, there would be no change in tank pressure.
pg. 658 Barash, PG, Stoelting RK
The formation of metanephrine is the result of: A. catechol-O-methyltransferase metabolism of epinephrine.
A. catechol-O-methyltransferase metabolism of
epinephrine COMT metabolizes epi to metanephrine and norepi to normetanephrine.
B. catechol-O-methyltransferase metabolism of Subsequently MAO further metabolizes metanephrine and normetanephrine into
norepinephrine vanillymandelic acid (VMA).
C. monamine oxidase metabolism of epinephrine
D. monamine oxidase metabolism of norepinephrine
Characteristics of human immunodeficiency virus distal polyneuropathy, allodynia
neuropathy include: (select 2)
A. Distal polyneuropathy symptomatic neuropathy occurs in 10%-35% of patients who are seropositive for
B. Rapid sudden onset HIV. The sensory neuropathies associated with HIV include distal sensory
C. Proximal muscle weakness polyneuropathy and antiretroviral toxic neuropathy (ATN) secondary to the
D. Allodynia treatment. The clinical features of HIV sensory neuropathy typically include
E. Upper extremities most commonly involved painful allodynia and hyperalgesia. The onset is gradual and most commonly
F. Proximal to distal progression of symptoms involved the lower extremities. The neuropathy and dysesthesia progress from
the distal and more proximal structures. There is minimal subjective of objective
motor involvement and this is generally limited to the intrinsic muscles of the foot.
, An action potential characterized by a spike followed by D. In contrast to the action potentials of nerve and skeletal muscle cells, the
a plateau phase is seen in: action potential of the cardiac myocyte is characterized by a sharp spike followed
A. Peripheral sensory muscle cells by a plateau phase (2), which results from the opening slower calcium channels
B. peripheral motor nerve cells
C. stiated skeletal muscle cells
D. Cardiac cells
During mediastinoscopy the risk of air embolization is B. During spontaneous ventilation
greatest: Air embolization is seen with mediastinoscopy as a result of the 30 degree
A. when the patient is supine elevation of the head. The risk is increased if the patient is spontaneously
B. during spontaneous ventilation ventilation secondary to the negative intrathoracic pressures generated during
C. immediately after closure of the incision inhalation.
D. in the postoperative period
autonomic hyperreflexia B. Can precipitate pulmonary edema
A. Is common with cord lesions below T8 Autonomic hyperreflexia should be suspected in patients with lesions above T5-
B. Can precipitate pulmonary edema 8. Regional anesthesia and deep general anesthesia are effective in preventing
C. Is not effectively prevented by regional anesthesia autonomic hyperreflexia. Surgical stimulation in these patients without adequate
D. Can be prevented with adequate intraoperative anesthesia can result in pulmonary edema, myocardial ischemia and cerebral
sedation hemorrhage.
When placing an epidural with a midline approach, the B. Interspinous ligament
needle will pass through the: (select 3) C. Ligamentum flavum
A. Anterior longitudinal ligament E. Supraspinous ligament
B. Interspinous ligament
C. Ligamentum flavum
D. Facet joint
E. Supraspinous ligament
The primary causative factor in the development of C. Hypoxemia
persistent pulmonary hypertension (PPH) in the neonate Hypoxia or acidosis during the early neonatal period may predispose the infant to
is: return to fetal circulation. This serious condition, previously known as persistent
A. cystic fibrosis fetal circulation (PFC), is currently known as persistent pulmonary hypertension
B. Pregnancy induced hypertension (PPH). Hypoxemia and/or acidosis promotes an increase in pulmonary vascular
C. hypoxemia resistance which ultimately causes right to left shunting through the ductus
D. R to L shunting through a patent ductus arteriosus arteriosus, foramen ovale, or both. Shunting causes continued hypoxemia,
leading to a continued increase in pulmonary vascular resistance, and a vicious
cycle ensues. Primary causes of hypoxemia in the neonate include pneumonia
and meconium aspiration.
Electrocardiac changes seen with hypokalemia include: B. Increasing prominent U waves
A. peaked T waves Also T wave flattening/inversion
B. increasing prominent U waves ST segment depression
C. Shorted PR interval with P wave inversion Increased P wave amplitude
D. Decreased QRS amplitude prolongation of the PR interval
Dantrolene: (Select 2) B. Inhibits calcium ion release from the sarcoplasmic reticulum
A. depends on an extracellular mechanism to achieve C. Can also be used in the treatment of thyroid storm
muscle relaxation
B. inhibits calcium ion release from the sarcoplasmic Dantrolene hinds the the Ryr1 receptor and inhibits calcium ion release from the
reticulum sarcoplasmic reticulum. Dantrolene's effects are Intracellular and may result in
C. can also be used in the treatment of thyroid storm muscle weakness and ventilator insufficiency. The half-life of dantrolene is
D. therapy should not be repeated after an MH episode approx 6 hours. Dantrolene has also been used to treat neuroleptic malignant
has terminated syndrome and thyroid storm.
E. has a half-life of approximately 12 hours
Renal effects of nitrous oxide include: B. decreased renal blood flow secondary to increased renal vascular resistance
A. decreased renal blood flow secondary to decreased Nitrous Oxide appears to decrease renal blood flow by increasing vascular
cardiac output resistance. The results in decreased glomerular filtration and decreased renal
B. decreased renal blood flow secondary to increased output.
renal vascular resistance
C. increased renal blood flow secondary to sympathetic
stimulation
D. increased glomerular filtration with increased
reabsorption
The elimination half-time of a drug: A. Is inversely proportional to clearance
A. Is inversely proportional to clearance
B. Is inversely proportional to volume of distribution The elimination half-Tim ECF a drug is proportional to the volume of distribution
C. Is directly proportion to clearance and inversely proportional to the rate of clearance
D. Is shortest in drugs that are rapidly redistributed