Anesthesia Basics

Question 1

What are absolute contraindications to ECT?

Answer 1

Pheochromocytoma, recent stroke, recent intracranial surgery, intracranial mass lesion, recent MI, unstable cervical spine

MI stands for myocardial infarction.

Question 2

What is the mechanism of action of Droperidol?

Answer 2

Dopamine-2 receptor antagonist

Question 3

What is myasthenic syndrome associated with?

Answer 3

Small-cell carcinoma of the lung

Question 4

What type of muscle weakness do patients with myasthenic syndrome commonly experience?

Answer 4

Proximal limb weakness

Question 5

How do patients with myasthenic syndrome respond to exercise?

Answer 5

Improvement in strength

Question 6

Are patients with myasthenic syndrome sensitive or resistant to succinylcholine?

Answer 6

Sensitive

Question 7

What happens to muscle strength in myasthenia gravis with continued use?

Answer 7

Fatigue occurs

Question 8

What is the cause of myasthenia gravis?

Answer 8

Autoimmune process involving antibodies against postsynaptic acetylcholine receptors

Question 9

What is the effect of myasthenia gravis on the total number of functioning acetylcholine receptors?

Answer 9

Decrease

Question 10

What types of muscle weakness do myasthenia gravis patients commonly experience?

Answer 10

Extraocular, bulbar, and facial muscle weakness

Question 11

Are myasthenia gravis patients sensitive or resistant to depolarizing muscle relaxants?

Answer 11

Resistant

Question 12

Are myasthenia gravis patients sensitive or resistant to nondepolarizing muscle relaxants?

Answer 12

Sensitive

Question 13

What is cerebral perfusion pressure (CPP)?

Answer 13

The difference between cerebral blood flow (CBF) and intracranial pressure (ICP) or central venous pressure (CVP), whichever is greater.

Question 14

How can CPP be increased?

Answer 14

By either increasing CBF or decreasing ICP.

Increasing CBF can be achieved by raising the patient’s mean arterial pressure.

Question 15

Fill in the blank: CPP is the difference between CBF and _______.

Answer 15

ICP or CVP, whichever is greater.

Question 16

What factors can influence cerebral perfusion pressure?

Answer 16

Cerebral blood flow (CBF) and intracranial pressure (ICP).

Question 17

What does the modified Aldrete score assess?

Answer 17

• Activity
• Breathing
• Circulation
• Consciousness
• Oxygen saturation

Each factor is individually graded on a scale of 0-2, providing a composite score of 10 possible points.

Question 18

List the five components of PADSS.

Answer 18

• Vital signs
• Activity level
• Nausea and vomiting
• Pain
• Surgical bleeding

These components are assessed to determine patient readiness for discharge.

Question 19

What are the respiratory changes associated with obesity?

Answer 19

• Increased work of breathing
• Increased oxygen consumption
• Increased carbon monoxide diffusion capacity
• Decreased expiratory reserve volume
• Decreased functional residual capacity
• Decreased tidal volume

These changes impact the overall respiratory function in individuals with obesity.

Question 20

True or false: In patients with obesity, mechanical ventilation decreases oxygen consumption dedicated to respiratory work by approximately 15%.

Answer 20

TRUE

This indicates the efficiency of mechanical ventilation in reducing the respiratory workload.

Question 21

What happens to total and pulmonary blood volume in patients with obesity?

Answer 21

Increased

This increase compensates for the higher oxygen demand related to excess adipose tissue.

Question 22

Patients with obesity typically have high cardiac output. True or false?

Answer 22

TRUE

This is part of the body’s response to increased oxygen demand.

Question 23

What is elevated left ventricular end-diastolic pressure associated with in patients with obesity?

Answer 23

Increased oxygen demand

This is a compensatory mechanism due to excess adipose tissue.

Question 24

In patients with obesity, ventilator responses to hypoxia and hypercapnia are often _______.

Answer 24

attenuated

This means that their bodies have a reduced response to low oxygen and high carbon dioxide levels.

Question 25

What is the response level for Minimal Sedation Anxiolysis?

Answer 25

Normal response to verbal stimulation ## Footnote This level indicates that the patient can respond normally to verbal cues.

Question 26

What characterizes Moderate Sedation (Conscious Sedation)?

Answer 26

Purposeful response to verbal or tactile stimulation ## Footnote Patients at this level are awake and can respond to stimuli.

Question 27

Define the response for Deep Sedation.

Answer 27

Purposeful response to repeated or painful stimulation ## Footnote Patients may not be fully aware but can respond to significant stimuli.

Question 28

What is the response level for General Anesthesia?

Answer 28

Unarousable even with painful stimulus ## Footnote This indicates a complete lack of response to any external stimuli.

Question 29

What is the order of **systemic absorption** for nerve blocks from highest to lowest?

Answer 29

* Blood (Bier block) (highest) * Intercostal * Caudal * Epidural * Brachial plexus * Subcutaneous (lowest) ## Footnote This order indicates how quickly anesthetic agents enter the bloodstream from different nerve block sites.

Question 30

What is the sustained intraabdominal pressure required for a diagnosis of abdominal compartment syndrome?

Answer 30

>20 mm Hg ## Footnote This pressure must be associated with the development of new organ dysfunction or failure.

Question 31

What is the sustained pressure for a diagnosis of intraabdominal hypertension?

Answer 31

≥12 mm Hg ## Footnote This diagnosis does not require the presence of organ dysfunction.

Question 32

What conditions can result in **muscular rigidity**?

Answer 32

* Serotonin syndrome * Neuroleptic malignant syndrome ## Footnote Neither condition results from exposure to succinylcholine or volatile anesthetics like malignant hyperthermia.

Question 33

What is **serotonin syndrome** caused by?

Answer 33

An increase in serotonin at the synaptic cleft due to combining medications that increase serotonin ## Footnote Patients will present with rigidity, hyperthermia, myoclonus, hyperreflexia, nausea, vomiting, and diarrhea.

Question 34

List the **symptoms** of serotonin syndrome.

Answer 34

* Rigidity * Hyperthermia * Myoclonus * Hyperreflexia * Nausea * Vomiting * Diarrhea ## Footnote These symptoms result from an increase in serotonin levels.

Question 35

What causes **neuroleptic malignant syndrome**?

Answer 35

The use of antipsychotics ## Footnote Symptoms include mental status change, hyperthermia, rigidity, and dysautonomia.

Question 36

What distinguishes **neuroleptic malignant syndrome** from serotonin syndrome?

Answer 36

Neuroleptic malignant syndrome does not have hyperreflexia ## Footnote Both conditions present with rigidity and hyperthermia but differ in hyperreflexia.