A 49-year old patient presents for removal of tooth #15 under general anesthesia. His
clinical examination is significant for IV/VI holosystolic murmur heard at the apical
area and radiates to the left axilla. The perioperative management should include
which of the following?
A. Decrease intravascular volume
B. Decrease myocardial contractility
C. Increase peripheral vascular resistance
D. Increase heart rate.
Give this one a try later!
, D. Increase heart rate
A holosystolic murmur heard at the apex and radiating to the left axilla is
consistent with mitral regurgitation. The perioperative goals of managing
mitral regurgitation are to promote forward flow by decreasing afterload
and to maintain a normal to slightly increased heart rate.
Barbiturates have which of the following effects on the myocardium?
A. Directly sensitize the myocardium to arrhythmias
B. Directly increase myocardial contractility
C. Indirectly increase heart rate by inducing venodilation
D. Indirectly increase myocardial contractility
Give this one a try later!
C.
Barbiturates have no effect on myocardial sensitization. They decrease
myocardial contractility. Reflex tachycardia is common after an induction
does of barbiturate to compensate for the vasodilatation.
The efficiency of gaseous exchange in the elderly decreases as a result of:
A. a decrease in the closing volume.
B. a reduced alveolar surface area.
C. a decreased alveolar capillary membrane thickness.
D. a decreased V/Q ratio.
Give this one a try later!
B. a reduced alveolar surface area.
In the elderly there is an increase in the closing volume, an increase in the
alveolar capillary membrane thickness and an increase in the V/Q
, (ventilation/perfusion) ratio. The gaseous exchange is decreased because
of reduced alveolar surface area.
A 64 year-old female presents for removal of tooth number 30 under general
anesthesia. Her past medical history is significant for rheumatic heart disease, and
subsequent mitral valve stenosis. The preoperative management of this patient would
include which of the following?
A. Decrease intravascular volume
B. Increase intravascular volume
C. Maintain a slower heart rate
D. Maintain a faster heart rate
Give this one a try later!
The principal hemodynamic goals of managing patients with mitral stenosis
are to maintain a slower to normal sinus rhythm and to avoid tachycardia,
larger increases in cardiac output, and both hypovolemia and fluid
overload by judicious fluid therapy.
Which of the following neuromuscular blockers requires little if any dosage change in
the elderly patient?
A. Pancuronium
B. Vecuronium
C. Cisatracurium
D. Mivacurium
Give this one a try later!
C.
Cisatracurium is the neuromuscular blocker that is metabolized by Hoffman
degeneration and organ-independent elimination. This process is non-
enzymatic and occurs spontaneously and thus needs little if any change in
the routine does in the elderly. Also the clinical effect is not prolonged.
Pancuronium is dependent on renal function and excretion which
decreases with age. Vecuronium is dependent on hepatic function which
clinical examination is significant for IV/VI holosystolic murmur heard at the apical
area and radiates to the left axilla. The perioperative management should include
which of the following?
A. Decrease intravascular volume
B. Decrease myocardial contractility
C. Increase peripheral vascular resistance
D. Increase heart rate.
Give this one a try later!
, D. Increase heart rate
A holosystolic murmur heard at the apex and radiating to the left axilla is
consistent with mitral regurgitation. The perioperative goals of managing
mitral regurgitation are to promote forward flow by decreasing afterload
and to maintain a normal to slightly increased heart rate.
Barbiturates have which of the following effects on the myocardium?
A. Directly sensitize the myocardium to arrhythmias
B. Directly increase myocardial contractility
C. Indirectly increase heart rate by inducing venodilation
D. Indirectly increase myocardial contractility
Give this one a try later!
C.
Barbiturates have no effect on myocardial sensitization. They decrease
myocardial contractility. Reflex tachycardia is common after an induction
does of barbiturate to compensate for the vasodilatation.
The efficiency of gaseous exchange in the elderly decreases as a result of:
A. a decrease in the closing volume.
B. a reduced alveolar surface area.
C. a decreased alveolar capillary membrane thickness.
D. a decreased V/Q ratio.
Give this one a try later!
B. a reduced alveolar surface area.
In the elderly there is an increase in the closing volume, an increase in the
alveolar capillary membrane thickness and an increase in the V/Q
, (ventilation/perfusion) ratio. The gaseous exchange is decreased because
of reduced alveolar surface area.
A 64 year-old female presents for removal of tooth number 30 under general
anesthesia. Her past medical history is significant for rheumatic heart disease, and
subsequent mitral valve stenosis. The preoperative management of this patient would
include which of the following?
A. Decrease intravascular volume
B. Increase intravascular volume
C. Maintain a slower heart rate
D. Maintain a faster heart rate
Give this one a try later!
The principal hemodynamic goals of managing patients with mitral stenosis
are to maintain a slower to normal sinus rhythm and to avoid tachycardia,
larger increases in cardiac output, and both hypovolemia and fluid
overload by judicious fluid therapy.
Which of the following neuromuscular blockers requires little if any dosage change in
the elderly patient?
A. Pancuronium
B. Vecuronium
C. Cisatracurium
D. Mivacurium
Give this one a try later!
C.
Cisatracurium is the neuromuscular blocker that is metabolized by Hoffman
degeneration and organ-independent elimination. This process is non-
enzymatic and occurs spontaneously and thus needs little if any change in
the routine does in the elderly. Also the clinical effect is not prolonged.
Pancuronium is dependent on renal function and excretion which
decreases with age. Vecuronium is dependent on hepatic function which
