Anesthesia for Vascular and Endovascular Surgeries

1. A hypertensive woman is well controlled by amlodipine and quinapril, and she is planned for cholecystectomy. According to the American College of Cardiology/American Heart Association (ACC/AHA) Guidelines for Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery, her antihypertensive medications should be:

• Continued during the perioperative period

• Held on the morning of surgery

• Held for 24 hours before surgery

• Replaced by intravenous medications on day of surgery

• Reduced by 50% for 24 hours before surgery

1. A 70-year old man underwent coronary surgery with the aids of cardiopulmonary bypass and heparin. His chance of postoperative heparin-induced thrombocytopenia (HIT) is approximately

• 2%

• 20%

• 50%

• 80%

• 99%

The most effective medical therapy for atherosclerotic peripheral vascular disease is:

• Dipyridamole

• Urokinase

• Warfarin (Coumadin)

• Aspirin

• Smoking cessation

Most neurologic deficits after carotid endarterectomy are thought to result from:

• Concomitant contralateral carotid stenosis

• Prolonged carotid artery cross-clamp in the absence of shunt use

• Thromboembolism

• Perioperative vasospasm

• Inadequate intraoperative carotid artery perfusion pressure

The most important factor shown to be of clinical importance in preserving renal function during aortic cross-clamping is:

• Lisinopril

• Fenoldopam

• Dopamine

• Intravascular volume status

• A. Mannitol

The clamping of the thoracic aorta in aneurysm repair is followed by:

• Immediate hypotension

• Immediate hypertension

• Cardiac standstill

• No change

• Loss of blood pressure in the right arm

Ischemia from a right coronary artery lesion would most likely be evident on electrocardiographic lead:

• I

• II

• aVL

• V5

What is the most common presenting symptom of aortic dissection?

• Midscapular pain

• Anterior chest pain

• All of the above

• Described as “tearing in nature”above

The advantages of ultrasound-guided central venous catheter placement as compared to the landmark technique, include all of the following EXCEPT:

• Prevention of arterial injury

• Direct visualization of the target vessel

• Decreased time required for internal jugular vein catheterization

• Decreased number of attempts required

• Decreased overall complication rate

Structures that pass anteriorly to the trachea include all of the following EXCEPT:

• pulmonary artery

• thyroid isthmus

• innominate artery

• aortic arch