Morgan and Mikhail's Clinical
Anesthesiology exam questions with
answers
Cardiac pacemaker action potential:
Phase 0:
Phase 3:
Phase 4: - CORRECT ANSWERS ✔✔Phase 0: Depolarization.
Voltage gated Ca channels(L-type) are activated, Ca floods into cell.
Phase 3: Repolarization. Inactivation of Ca channels and increased
permeability to K+ (K+ leaves cell)
Phase 4: Pacemaker potential. Slow influx of Na and Ca from Funny
Na channels and T-type Ca channels.
,the shape of an arterial line wave form provides clues to several
hemodynamic variables:
Rate of Upstroke = ?
Rate of downstroke = ?
Exaggerated variations in size during respiratory cycle = ? -
CORRECT ANSWERS ✔✔Rate of Upstroke = contractility
Rate of downstroke = peripheral vascular resistance
,Exaggerated variations in size during respiratory cycle =
hypovolemia
CVC indications - CORRECT ANSWERS ✔✔- Monitoring central
venous pressure
- Administration of fluids to treat hypovolemia and shock
- Infusion of caustic drugs and TPN
- Aspiration of air emboli
- Insertion of transcutaneous pacing leads
- Gaining venous access in pts with poor peripheral veins.
CVC contraindications: - CORRECT ANSWERS ✔✔Relative: tumors,
clots, tricuspid valve vegetations that could be dislodged or
embolized during cannulation.
Subclavian CVC is relatively contraindicated in pts on what class of
medication? - CORRECT ANSWERS ✔✔Anticoagulants: due to
inability to provide direct compression in the event of an accidental
arterial puncture
Optimal placement of CVC catheter tip? - CORRECT ANSWERS
✔✔Just superior to or at the junction of the SVC and the right
atrium
, Left IJ CVC placement has an increased risk of this unique
complication? - CORRECT ANSWERS ✔✔Pleural effusion and
chylothorax
Risks of CVC placement? - CORRECT ANSWERS ✔✔- Line
infection/bloodstream infection
- Air or thrombus embolism
- Arrhythmia (catheter tip is in the RA or RV).
- Hematoma, thrombosis
- Pneumothorax, hemothorax, hydrothorax, chylothorax (left IJ
placement).
- Cardiac perforation with cardiac tamponade
- Trauma to nearby nerves and arteries
Central venous pressure (CVP) approximates pressure in which
chamber of the heart? - CORRECT ANSWERS ✔✔Right atrium
Very low CVP may indicate?
Very high CVP may indicate? - CORRECT ANSWERS ✔✔Volume
depleted pt
Anesthesiology exam questions with
answers
Cardiac pacemaker action potential:
Phase 0:
Phase 3:
Phase 4: - CORRECT ANSWERS ✔✔Phase 0: Depolarization.
Voltage gated Ca channels(L-type) are activated, Ca floods into cell.
Phase 3: Repolarization. Inactivation of Ca channels and increased
permeability to K+ (K+ leaves cell)
Phase 4: Pacemaker potential. Slow influx of Na and Ca from Funny
Na channels and T-type Ca channels.
,the shape of an arterial line wave form provides clues to several
hemodynamic variables:
Rate of Upstroke = ?
Rate of downstroke = ?
Exaggerated variations in size during respiratory cycle = ? -
CORRECT ANSWERS ✔✔Rate of Upstroke = contractility
Rate of downstroke = peripheral vascular resistance
,Exaggerated variations in size during respiratory cycle =
hypovolemia
CVC indications - CORRECT ANSWERS ✔✔- Monitoring central
venous pressure
- Administration of fluids to treat hypovolemia and shock
- Infusion of caustic drugs and TPN
- Aspiration of air emboli
- Insertion of transcutaneous pacing leads
- Gaining venous access in pts with poor peripheral veins.
CVC contraindications: - CORRECT ANSWERS ✔✔Relative: tumors,
clots, tricuspid valve vegetations that could be dislodged or
embolized during cannulation.
Subclavian CVC is relatively contraindicated in pts on what class of
medication? - CORRECT ANSWERS ✔✔Anticoagulants: due to
inability to provide direct compression in the event of an accidental
arterial puncture
Optimal placement of CVC catheter tip? - CORRECT ANSWERS
✔✔Just superior to or at the junction of the SVC and the right
atrium
, Left IJ CVC placement has an increased risk of this unique
complication? - CORRECT ANSWERS ✔✔Pleural effusion and
chylothorax
Risks of CVC placement? - CORRECT ANSWERS ✔✔- Line
infection/bloodstream infection
- Air or thrombus embolism
- Arrhythmia (catheter tip is in the RA or RV).
- Hematoma, thrombosis
- Pneumothorax, hemothorax, hydrothorax, chylothorax (left IJ
placement).
- Cardiac perforation with cardiac tamponade
- Trauma to nearby nerves and arteries
Central venous pressure (CVP) approximates pressure in which
chamber of the heart? - CORRECT ANSWERS ✔✔Right atrium
Very low CVP may indicate?
Very high CVP may indicate? - CORRECT ANSWERS ✔✔Volume
depleted pt
