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Anesthesia Jeopardy

Total questions: 29

Worksheet time: 13mins

Name
Class
Date
1.

Who can run the fastest out of these attendings?

a)
b)
c)
d)
2.

An 8-year-old male with a past medical history of Becker Muscular Dystrophy (BMD) undergoes induction of anesthesia with propofol, fentanyl, and succinylcholine.  He is successfully and uneventfully intubated.  An hour into the case he develops a wide QRS complex rhythm that degenerates into ventricular fibrillation with consequent loss of peripheral pulses, pulse oximetry, and ability to measure blood pressure via a non-invasive blood pressure cuff.  No changes are noted in peak airway or plateau pressures and breath sounds are noted bilaterally.  What is the MOST likely etiology of this rapid decline in hemodynamics?

a)

Anaphylaxis

b)

Malignant Hyperthermia

c)

Myocardial Infarction

d)

Rhabdomyolysis

3.

A 2-day-old boy born at 37 weeks gestation is scheduled for mandibular distraction. He has undergone evaluation for Pierre Robin sequence because of feeding difficulty and respiratory distress at birth. He has a nasopharyngeal airway in place and is receiving 2 L per minute of oxygen via nasal cannula. He has noticeable retractions and nasal flaring and his SpO2 is 94%. He does not have any other syndromic features. Which of the following airway management strategies is MOST appropriate in this patient?

a)

Induction with propofol and rocuronium then intubation with fiberoptic guidance.

b)

Mask induction with sevoflurance and oxygen followed by videolaryngoscopy

c)

Mask induction with sevoflurance, oxygen and nitrous oxide followed by direct laryngoscopy.

d)

Prophylactic tracheostomy under MAC sedation.

4.

Which of the following is TRUE regarding anesthetics during pregnancy?

a)

Early maternal benzodiazepine use is associated with fetal neural tube defects.

b)

Phenylephrine use during maternal anesthesia is associated with neonatal acidosis.

c)

The longer the fetus is exposed to volatile anesthetic, the higher the risk of teratogenic complication.

d)

Turning from the lateral to the supine position may decrease maternal cardiac output.

5.

Which of the following therapies is contraindicated in the setting of increased intracranial pressure following traumatic head injury?

a)

Barbiturate coma

b)

Head elevation

c)

High dose glucocorticoids

d)

Neuromuscular blockade

6.

Which of the following INCREASES the risk for development of post dural puncture headache following accidental dural puncture with an epidural needle?

a)

Female gender

b)

Morbid Obesity

c)

Needle with higher gauge number

d)

Scoliosis

7.

A 75-year-old patient is being evaluated for hypotension in the ICU after cardiac surgery.  The patient is extubated and breathing spontaneously with 6 LPM oxygen via nasal cannula.  Which of the following is the LEAST likely to be seen in the setting of cardiac tamponade?

a)

Increased right ventricular preload during inspiration.

b)

Right atrial collapse in late diastole and early systole.

c)

Right ventricular collapse in early diastole.

d)

Systemic blood pressure decrease by > 10mm Hg during expiration.

8.

A 76-year-old man presents to the chronic pain clinic for port site pain two months after video-assisted thoracoscopic surgery.  He reports severe burning pain at the surgical site.  Palpation of the site worsens the pain.  Which of the following best describes the pain?

a)

Somatic

b)

Myofascial

c)

Inflammatory

d)

Neuropathic

9.

Which of the following regarding carbon monoxide is correct?

a)

Carbon monoxide has 20 times greater affinity to hemoglobin than oxygen.

b)

Carbon monoxide poisoning is usually associated with a normal PaO2.

c)

Carbon monoxide poisoning produces a non-anion gap metabolic acidosis.

d)

Carbon monoxide poisoning primarily causes a rightward shift of the hemoglobin-oxygen dissociation curve.

e)

Carbon monoxide poisoning causes 2 wave pulse oximetry levels to read 85%.

10.

Which of the following BEST describes the difference between an arterial waveform recorded at the aortic arch compared to the radial artery?

a)

The aortic arterial waveform dicrotic notch is more delayed and slurred.

b)

The aortic arterial waveform has a less pronounced diastolic wave.

c)

The radial arterial waveform has a lower systolic pressure.

d)

The radial arterial waveform has a narrower pulse pressure.

11.

Which of the following is LEAST appropriate for managing traumatic brain injury in the intensive care unit?

a)

Maintain cerebral perfusion pressure between 50-70mm Hg.

b)

Maintain ICP < 20mm Hg.

c)

Maintain normothermia or mild hypothermia

d)

Maintain PaCO2 between 25-30mm Hg.

12.

This abnormal CVP waveform is MOST indicative of which of the following cardiac conditions?

a)

Atrial fibrillation

b)

AV dissociation

c)

AV sequential pacing

d)

Cardiac Tamponade

e)

Tricuspid Regurgitation

13.

Which of the following is NOT a sign of autonomic neuropathy in a diabetic patient?

a)

Resting tachycardia with loss of heart rate variability.

b)

Increased sweating

c)

Hypoglycemia unawareness

d)

Gastroparesis

e)

Impaired ventilatory responses

14.

A 33-year-old female is taken to the operating room for laparoscopic cholecystectomy.  During the surgery, the ventilator alarms indicating elevated pressures.  Both the peak inspiratory pressure and plateau pressure are increased.  Which of the following is MOST likely the cause?

a)

Bronchospasm

b)

Biting the ETT

c)

Kinked ETT

d)

CO2 insufflation

e)

Mucus Plug

15.

What structure is denoted by the arrow in the ultrasound image, which was obtained during an upper extremity regional anesthetic procedure?

a)

Subclavian vein

b)

Subclavian artery

c)

Brachial artery

d)

Axillary artery

16.

A 32-year-old woman underwent successful vaginal delivery with a labor epidural for analgesia. After delivery, the epidural catheter broke at the 5 cm mark when being removed. Which of the following imaging modalities would be the test of choice for finding the precise location of a retained epidural catheter fragment?

a)

Computed Tomography Scan

b)

Live Fluoroscopy Imaging

c)

Lumbar Plain Radiographs

d)

Magnetic Resonance Imaging

17.

Which of the following clinical findings is NOT associated with the diagnosis of ischemic optic neuropathy in the immediate post-operative period?

a)

Optic disc atrophy

b)

Painless visual loss

c)

Sluggish pupils

d)

Visual field deficits

18.

A 25-year-old G2P1 female is admitted at 30 weeks gestation in preterm labor.  She has a history of myasthenia gravis and her labor has been complicated by gestational diabetes.  Which of the following tocolytic agents is MOST likely to increase maternal blood glucose levels?

a)

Terbutaline

b)

Indomethacin

c)

Atosiban

d)

Magnesium Sulfate

e)

Nifedipine

19.

A 71-year-old man with end-stage renal disease undergoes hemodialysis prior to an elective surgery. Which of the following is MOST likely to occur as a result of the dialysis?

a)

Decreased serum bicarb concentration

b)

Decreased serum sodium concentration

c)

Increased serum glucose concentration

d)

Increased serum prealbumin concentration

20.

A 68-year-old man who underwent retinal detachment repair with intraocular perfluorocarbon injection one week ago now presents for urgent repair of an incarcerated umbilical hernia.  Which of the following anesthetic agents is contraindicated?

a)

Desflurane

b)

Midazolam

c)

Succinylcholine

d)

Nitrous oxide

21.

A 58-year-old male is undergoing right total knee arthroplasty.  He will be admitted overnight and spinal anesthesia is to be performed.  Which of the following is MOST likely true regarding spinal anesthesia?

a)

Spinal fentanyl primarily causes analgesia through ascent to the brain and action in the periaqueductal gray.

b)

Spinal fentanyl impairs afferent input through action at mu receptors in the substantia gelatinosa.

c)

Spinal morphine acts primarily by activation of presynaptic calcium channels in the substantia gelatinosa.

d)

Spinal morphine primarily works through systemic absorption and transfer to the brain.

22.

A patient with the preoperative electrocardiogram shown below develops intraoperative supraventricular tachycardia with a rate of 160 bpm. Which of the following medications is MOST appropriate for rate control?

a)

Adenosine

b)

Diltiazem

c)

Procainamide

d)

Labetalol

23.

An axillary block is performed for repair of a distal radius fracture under monitored anesthesia care.  During the procedure, the patient complains of pain in the lateral forearm.  To alleviate the patient’s pain, local anesthetic should be injected into which of the following muscles?

a)

Brachialis

b)

Coracobrachialis

c)

Pronator teres

d)

Brachioradialis

24.

Which of the following inhalation agents is LEAST likely to cause uterine relaxation during general anesthesia for cesarean section?

a)

Nitrous oxide

b)

Sevoflurane

c)

Desflurane

d)

Isoflurane

25.

Which of the following nerves are most likely affected by a transversus abdominis plane block?

a)

Ilioinguinal, Subcostal, Femoral cutaneous, Iliohypogastric

b)

Subcostal, Intercostal, Ilioinguinal, Iliohypogastric

c)

Subcostal, Intercostal, Ilioinguinal, Long thoracic

d)

Subcostal, Intercostal, Iliohypogastric, Thoracodorsal

26.

A 5-day-old infant in respiratory distress was intubated and started on mechanical ventilation.  The infant developed gastric distention, and nasogastric tube placement was unsuccessful.  The anesthesiologist noted that the expiratory volume was significantly lower than the inspiratory volume.  Which of the following is MOST likely to improve the patient's ventilation?

a)

Advance the ETT

b)

Increase Tidal Volume

c)

Place a gastrostomy tube

d)

Switch to LMA

e)

Increase I:E ratio

27.

During pulmonary function tests, which of the following is the minimum response to a bronchodilator challenge which indicates chronic bronchodilator therapy should be initiated?

a)

>5% FEV1 improvement

b)

>15% FEV1 improvement

c)

>5% TLC improvement

d)

>15% TLC improvement

28.

The anesthesiologist wishes to optimize intubation conditions for a patient who will undergo electroconvulsive therapy (ECT).  Which of the following intravenous drugs would be the LEAST appropriate for this patient, given the type of procedure being performed?

a)

Etomidate

b)

Glycopyrrolate

c)

Remifentanil

d)

Fentanyl

e)

Diltiazem

29.

Which of the following statements regarding muscle relaxant use in the pediatric population is TRUE?

a)

Bradycardia is common in children after their initial dose of rocuronium without atropine treatment.

b)

Duration of action of vecuronium is shortened in neonates due to their increased hepatic metabolism.

c)

Exaggerated hyperkalemia after succinylcholine administration is not seen in neonates with burn injuries.

d)

Infants require relatively larger doses of succinylcholine due to their relatively large volume of distribution.