Boards Review: Anesthesia And Intraop Fluids And Iv Meds

Front 1

What surgical prep solution is contraindicated for use on the face?

Back 1

Hibiclens, caustic to eyes

Front 2

why are iodine solutions superior to chlorhexidine as surgical antiseptic

Back 2

chlorhexidine not effective against viruses and fungi

Front 3

which nasal spray has less cardiac toxicity: oxymetazoline or neosynephrine

Back 3

oxymetazoline

Front 4

which medication has been shown to decrease the catecholamine response during suspension laryngoscopy

Back 4

fentanyl

Front 5

what factors are responsible for transfusion-induced immunosuppression

Back 5

serum factors and fragmented debris from white blood cells and platelets

Front 6

what should be given to cancer patients who need a blood transfusion to minimize the immunosuppression

Back 6

washed RBCs

Front 7

what is the best time to begin prophylactic antibiotic therapy for elective surgery

Back 7

1hr prior to operation

Front 8

what are the daily maintenance fluid requirements of a healthy 60-kg woman

Back 8

2100cc

Front 9

what is a reliable alternative induction technique in a 5yr struggling child who refuses the mask and cannot be managed with IV bc of lack of accessible veins

Back 9

sedating IM injection of ketamine 3mg/kg

Front 10

what are the negative side effects of ketamine

Back 10

increased airway secretions
transient increase in intracranial pressure
audiotory/visual hallucinations

Front 11

what is the preferred anesthetic technique for bronchoscopy in adults

Back 11

modified endotracheal tube or jetting system used with a relaxant and controlled ventilation

Front 12

what is the preferred anesthetic technique for bronchoscopy in infants and children

Back 12

spontaneous respiration with inhalation anesthesia

Front 13

all of the inhaled anesthetics are bronchodilators except

Back 13

nitrous oxide

Front 14

which neuromuscular blocker's metabolism is independent of renal or liver failure

Back 14

cisatracurium

Front 15

shortly after induction of general anesthesia, the patient's body temp significantly rises, PVCs are noted on the ECG and skin becomes flushed. What is likely dx

Back 15

malignant hyperthermia

Front 16

symptoms of malignant hyperthermia

Back 16

masseter spasm
sustained muscle rigidity
myoglobinuria

Front 17

what is the mechanism of action behind malignant hyperthermia

Back 17

inhibition of calcium reuptake into the sarcoplasmic reticulum of skeletal muscle

Front 18

what is the treatment for malignant hyperthermia

Back 18

total body cooling
vigorous hydration
dantrolene

Front 19

90yo woman given morphine before bedside laryngoscopy RR drops to 6 and lips turn blue. What med should be given

Back 19

naloxone

Front 20

what is a complication of rapid administration of naloxone

Back 20

flash pulmonary edema

Front 21

what med is used to reverse benzodiazepines

Back 21

flumazenil 200ug over 15 seconds

Front 22

which anesthetic should be discontinued 15min prior to placing a TM graft

Back 22

nitrous oxide

Front 23

what is the mechanism of action of local anesthetic

Back 23

prevent increases in the permeability of nerve membranes to sodium ions

Front 24

what are two main classes of local anesthetic

Back 24

ester linkage
amide linkage

Front 25

how do ester vs amide differ in metabolism

Back 25

ester: metabolized in plasma by cholinesterase
amide: liver by P-450

Front 26

what local are amides?

Back 26

lidocaine
ropivacaine
bupivacaine

Front 27

which antiHTN prolongs the effect of regional anesthesia with amide anesthetics

Back 27

clonidine

Front 28

what are the toxic side effects of local

Back 28

CNS excitability or depression
myocardial depression
peripheral vasodilation
methemoglobinemia
allergic rxn

Front 29

which local anesthetic produces toxicity at the lowest dose

Back 29

tetracaine

Front 30

T/F: all locals are weak bases and produce vasodilation

Back 30

F: cocaine and ropivacaine

Front 31

which local anesthetics have been shown to induce methemoglobinemia

Back 31

prilocaine
benzocaine
lidocaine
procaine

Front 32

what is the treatment for methemoglobinemia

Back 32

slow IV infusion of 1% methylene blue

Front 33

what is max recommended dose of bupivacaine

Back 33

2-3mg/kg

Front 34

what is duration of action of bupivacaine

Back 34

3-10 hours

Front 35

T/F: bupivacaine has a depressant effect on cardiac contractility 4x of lidocaine

Back 35

True

Front 36

how does ropivacaine differ from bupivacaine

Back 36

ropivacaine has less potential for serious cardiotoxic reactions

Front 37

what is max dose of lidocaine in 60kg woman

Back 37

300mg without epi (4mg/kg)
420mg with epi (7mg/kg)

Front 38

how much epi in 1cc of 1:100,000 epi

Back 38

10ug

Front 39

where should local anesthetic be injected to block superior laryngeal nerve

Back 39

halfway between hyoid and thyroid cartilages

Front 40

where should local anesthetic be injected to anesthetize subglottis and preepiglottic space

Back 40

cricothyroid membrane
thyroid notch

Front 41

what makes midazolam useful in outpatient setting

Back 41

short onset of action, half-life 2-4hr

Front 42

which benzo is preferred in pts with liver disease

Back 42

lorazepam

Front 43

which a-agonist is 5-10x more potent than clonidine

Back 43

dexmedetomidine

Front 44

T/F: all opioids cause bradycardia

Back 44

F: meperidine

Front 45

what is the primary advantage of using remifentanil over fentanyl

Back 45

shorter onset and offset

Front 46

allergy to what substance is contraindication to propofol

Back 46

soy

Front 47

what are adverse effects of succinylcholine

Back 47

dysrhythmia
fasciculations
hyperkalemia

Front 48

which pts are more likely to have adverse rxns to succinylcholine

Back 48

closed-angle glaucoma
space-occupying intracranial lesions
crush injury

Front 49

what is inheritance pattern of pseudocholinesterase deficiency

Back 49

autosomal recessive

Front 50

what patient population might have a decreased amount of pseudocholinesterase

Back 50

those taking anticholinesterase meds for glaucoma or myasthenia gravis