ENT Anesthesia

The two most frequent levels of obstruction during sleep in children with hypertrophied tonsils are:

• Soft palate and base of the tongue

• Base of the tongue and hard palate

• Base of the tongue and hyoid bone

• Hyoid bone and tip of epiglottis

• None

True in events leading to cor pulmonale, EXCEPT:

• Longstanding hypoxemia and hypercarbia

• Left-sided heart failure

• Increased airway resistance

• Pulmonary artery hypertension

• Pulmonary venule constriction

A thorough history-taking and physical examination is the basis for pre-operative evaluation for pediatric patients who will undergo ENT surgeries. The following may be present, EXCEPT:

• Sleep-disordered breathing

• Elongated face

• Prognathic mandible

• Retrognathic mandible

• High-arched palate

Component of STOP-BANG questionnaire:

• Sneezing

• Tremors

• Observation of restlessness during sleep

• Elevations in blood pressure

• Nighttime somnolence

Component of STBUR questionnaire:

• Snorting

• Sneezing

• Tremors

• Trouble concentrating in daytime activities

• Unrefreshed feeling after sleeping

Which of the following is TRUE:

• The long-term effects of OSAS are NOT limited to the airway

• Increased body mass index and obesity may lead to increased cognitive vulnerability

• Increased frequency of hyperactivity and increased levels of C-reactive protein

• None of the above

• All of the above

True about acute post-tonsillectomy pulmonary edema:

• Proposed mechanism is that during inspiration before adenotonsillectomy, the positive intrapleural pressure that is generated causes a decrease in venous return, diminishing pulmonary blood volume

• Pleural pressure in the healthy child with airway obstruction ranges from -2.5 cm to -10 cm H2O during inspiration

• Intrapleural pressure in the healthy child without airway obstruction can be as much as -30 cm H2O during inspiration

• The rapid relief of airway obstruction results in decreased airway pressure, an increase in venous return, an increase in pulmonary hydrostatic pressure, hyperemia, and finally pulmonary edema

• None of the above

The most common cause of stridor in infants:

• Cysts

• Tracheomalacia

• Laryngomalacia

• Choanal atresia

• Croup

Patients with a history of head and neck cancer may have undergone prior chemotherapy, which can affect specific organ systems, or radiation, which can lead to one of the following, rendering direct laryngoscopy difficult:

• Anatomic nasal obstruction reduce oropharyngeal cross-sectional area

• Fibrosis and ankylosis in the temporomandibular joint

• Anatomic imbalance between the upper airway soft tissue volume and craniofacial size

• Pharyngeal dilator muscles do not contract maximally

• All of the above

Systemic absorption of vasoconstrictive agents during functional endoscopic sinus surgery may cause:

• Hypertension

• Bradycardia

• Tachycardia

• Arrythmias

• All of the above