455 General Anesthesia 2011 Exam

Front 1

without the use of a paralyzing agent. the earliest level at which an oral or nasal pharyngea; airway can be inserted is

Back 1

stage III plane 1

Front 2

without the use of a paralyzing agent. the earliest level at which an endotracheal tube is

Back 2

stage III plane 2

Front 3

without the use of a paralyzing agent. the earliest level at which surgery can be performed in

Back 3

stage III plane 1

Front 4

Actions of agents-
Propofol is usually used to produce

Back 4

general anesthesia

Front 5

Actions of agents-
with great care propofol can produce

Back 5

moderate or deep conscious sedation

Front 6

Actions of agents-
Romazicon is used

Back 6

to reverse the action of benzodiazepines

Front 7

Actions of agents-
Demeral is

Back 7

an opioid narcotic

Front 8

Actions of agents
demeral produces

Back 8

primarily analgesia and not used to produce sedation

Front 9

Actions of agents-
Nembutal is
used for

Back 9

a barbiturate

sedation

Front 10

Actions of agents-
Versed (midazolam) and valium(diazepam) are___

used primarily for

Back 10

benzodiazepines

the three levels of conscious sedation

Front 11

T or F the manouevre for respiratory obstruction during general anesthesia is the same as used for CPR airway management

Back 11

T

Front 12

When a CPR manouevre is not successful try a

oral or nasopharyngeal airway

Back 12

naso since you are working in the oral cavity

Front 13

If the nasopharyngeal airway is not successful then what should be tryed
if thats not successful then finally try

Back 13

LMA

an endotracheal tube

Front 14

what respiratory problem is allergic in nature

Back 14

asthma

Front 15

What is the most important question when someone has a hx of an MI

Back 15

when it occured since there is a 25% risk of a repeat MI if < 6 mo

Front 16

What are transdermal patches used for

Back 16

administration of cardic meds like nitroglycerine not for sedatives

Front 17

how are anestheic agents given

Back 17

orally, iv, rectally, nasally and im, not transdermal

Front 18

list the protective reflexes to the airway

Back 18

pharyngeal reflex and laryngeal reflex

NOT- spinal reflex is in response to pain and vomitting reflex causes vomitting as one passes through Stage II(not one which is per se related to airway

Front 19

How are IV agents metabolized

Back 19

by the liver to become water soluble to be excreted by kidneys

Front 20

what is the concern with nursing mother and anesthetics

Back 20

the depressing effect of the agfent is excreted in the milk and therefore depresses the infant

Front 21

when is a muscle relaxant used to paralyze a pt endotracheal intubation

Back 21

stage III plane 1

Front 22

If a muscle relaxant is not used to paralyze a pt endotracheal intubationwhat stage must you get the patient for the laryngeal reflex is lost

Back 22

stage III 2

Front 23

what is the paralyzing agent

Back 23

succinyl choline

Front 24

action of succinyl choline

what metabolizes it

Back 24

floods nueromuscular junction as long as its circulation

once not circulation cholinesterase removes it

Front 25

best initial guide to induction of anesthsia is

what stage

Back 25

loss of the lid reflex. occurs at
stage III plane 1

mask is place on nose

Front 26

when succinyl choline is not used respiration start to be lost at

Back 26

stage III plane 3 (intercostalis first then eventually as go deeper in plane 4 diaphragmatic

Front 27

closed system requires what___

consequence if not have above

Back 27

a co2 absorber so co2 does nto build up

result in malignant Hyperthermia but is not its cause

Front 28

what is the prinicipal effect of nitrous oxide

Back 28

analgeisa, it can produce light conscious sedation, it does not produce amnesia or hypnosis

Front 29

MAC of halogenated hydrocarbon is ___ when nitrous oxide is used with it
nitrous cause halogenated hydro to be more

Back 29

lowered

potent

Front 30

what blood gases does nitrous effect?

Back 30

nitrogen

Front 31

what do you do to prevent diffusion hypoxia

Back 31

breath 100% O2 at end of procedure

Front 32

if increase the conc of nitrous how does it relate to its effect

Back 32

faster or increase the rate of the effect

Front 33

effect of halogenated hydrocarbons on lungs

Back 33

cause bronchodilation

Front 34

effect of halogenated hydrocarbons on asthmatics

Back 34

good effect

Front 35

what halogenated hydrocarbon is hepatotoxic

Back 35

Halothane (fluothane) only when there is a preexisting liver dz

Front 36

what is the effect of narcotics on respiration

what is the bodies reponse

Back 36

depresses- by depressing the respiratory centers response to CO2 stimulation

trys to increase BP- eventualy exhausted BP will drop and life will cease

Front 37

what stages can propofol carry a patient into

Back 37

all stages of anesthesia

Front 38

when happens to the airspce when N2O is admin

side effect of this

Back 38

it expands

perm deafness with general anesthetic b/c of middle/inner ear gas expansion

Front 39

what is the problem with enteric conscious sedation

Back 39

almost impossible to titrate oral drugs and over dosage is a distinct poss ( resp and BP depression

Front 40

malignant hyperthermia is triggered by

Back 40

is genetic and by halogenated hydrocarbons and succinylcholine

Front 41

malignant hyperthermia caused by what mech

Back 41

uncontrolled relesae of Ca from muscle

Front 42

malignant hyperthermia treat with the use of what drug

Back 42

dantrolene

Front 43

how can you know in head of time if hyperthermia will occur

Back 43

muscle biopsy

Front 44

what halogenated hydrocarbon can precipitate seizures

Back 44

Ethrane (enflurane) be advoided in pt with epilepsy and seizures

Front 45

what drug are good for pt with seizures

Back 45

benzodiazepines

Front 46

what is nembutal
what is it used for

Back 46

a barbiturate
sedation - not for induction of anesthesia wont cary pt to stage III plane 1

Front 47

what is midazolam
what is it used for

Back 47

a benzodiazepine
sedation - not for induction of anesthesia wont cary pt to stage III plane 1

Front 48

during anesthic when BP drops and respiration are depressed first thing to do is

Back 48

stop admin anesthetic agent, give O2, trendelenberg positin, assist or control respir

Front 49

what is isoflurane
what is it used for

Back 49

halogenated hydrocarbon
a general anesthetic agent and can be used to induce and maintain the surgical levels of anesthesia

Front 50

what is demeral
what is it used for

Back 50

opioid narcotic which eleveates pain threshold
Not used to induce anesthesia

Front 51

what is seconal
what is it used for

Back 51

short acting barbituate
produces sedation or hypnosis(sleep)
Does not induce anesthesia

Front 52

what is Romazicon
what is it used for
1/2 life

Back 52

antagonist to benzodiazepines
1/2 life me be greater of less than the agent it is reversing

Front 53

what is contraindicated with acute intermittent porphyria

Back 53

pentothal

Front 54

what is pentothal effect on lungs

effect for asthmatics

Back 54

broncho constriction

contraindicated for asthma pt

Front 55

what has a faster emergence

pentothal or propofol

Back 55

propofol

Front 56

what has a greater predisposition for laryngeal spasms with foreign mat in pharynx

pentothal or propofol

Back 56

pentothal

propofol has less tendency to do that

Front 57

what is the shelf life of pentothal

Back 57

good it has a perservative

Front 58

what is the shelf life for propofol

Back 58

must be used within 12 hrs since bac start to grow in

Front 59

if pt not adequate handled with nitrous what should you do?

if not enough what should you do

if not enough what do you use

Back 59

IV moderate conscious sed with IV benzodiazepine

then deep conscious sedation with benzodiazepines and poss w/ narcotic to raise pain threshold

only then if unsucessful should a general be considered

Front 60

for enteral sedation what should u consider using

Back 60

nembutal or valium over midazolam since they are longer acting

Front 61

what dz affect cholinesterase

Back 61

atypical or pseudocholinase def

could take hours for spontaneous breathing to occur, anesthesiologist breaths for the pt

Front 62

if pt not a good candidate for nitrous then the easiest controll approach would be

Back 62

IV benzodiazepine with the N2O

Front 63

what is demeral

Back 63

opiod analgesic not a sedative per say

Front 64

use of propol guarded

Back 64

need much experience to keep pt sedated level withou going into the surgical levels

Front 65

second gas effect of nitorus of halogenated hydrocarbons is

Back 65

make halgenated hydrocarbons more potent less needs to be used

Front 66

is N2O flammable

Back 66

yes

Front 67

Dialysis pt should get procedure done on

Back 67

no-dialysis day

Front 68

dialysis pt are more prone to

Back 68

cardiac abnormalities due to K+ being off

Front 69

what would you expect to be more prevalent in diabetics

Back 69

BP and cardiac problems
esp type I

Front 70

when giving IV benzodiazepines to elderly antipated dosage should be ___ less than younger pt

Back 70

30%

Front 71

in elderly onset of response takes___ why

Back 71

longer there is less protein binding and slower liver detoxification.

less drug circualting

Front 72

what do you have to make sure you use when admin halogenated hydrocarbon for anesthesia

Back 72

capnograph and thermometer in addition to other monitors

due to malignant hyperthermia

Front 73

difficulity to inflate the chest is a sign of

Back 73

larungeal spasm which if often initiated by blood in the pharynx

Front 74

hyperventilation casues to respiartory drive

Back 74

to blow off CO2 (hypocapnea) which reduces respiratory drive.

Front 75

hypocapnea can lead to

Back 75

carpodedal tetany (spasm)