SEE EXAM ANESTHESIA QOD QUESTIONS
AND ANSWERS
1. An action potential characterized by a spike followed by a plateau phase is seen in:
A. peripheral sensory nerve cells
B. peripheral motor nerve cells
C. striated skeletal muscle cells
D. cardiac muscle cells:
Answer: cardiac muscle cells
In contrast to the action potentials of nerve and skeletal muscle cells, the action potential of the cardiac myocyte is characterized by a
sharp spike followed by a plateau phase (2), which results from the opening of slower calcium channels.
pg. 345
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical
Books/McGraw-Hill Medical Publishing Division, 2013.
,2. Autonomic hyperreflexia:
A. is common with cord lesions below T8
B. can precipitate pulmonary edema
C. is not effectively prevented by regional anesthesia
D. can be prevented with adequate intraoperative sedation: Autonomichyperreflexia: Answer:
can precipitate pulmonary edema
Autonomic hyperreflexia should be suspected in patients with lesions above T5-8. Regional anesthesia and deep general anesthesia
are ettective in preventing autonomic hyperreflexia. Surgical stimulation in these patients without adequate anesthesia can result in
pulmonary edema, myocardial ischemia and cerebral hemorrhage.
pg. 927
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
3. During mediastinoscopy the risk of air embolization is greatest:
A. when the patient is supine
, B. during spontaneous ventilation
C. immediately after closure of the incision
D. in the postoperative period:
Answer: during spontaneous ventilation
Air embolization is seen with mediastinoscopy as a result of the 30o elevation of the head. This risk is increased if the patient is
spontaneously ventilating, secondary to the negative intrathoracic pressures generated during inhalation.
pp. 988-989
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012.
4. The formation of metanephrine is the result of::
Answer: catechol-O-methyltransferase metabolism of epinephrine
Catechol-O-methyltransferase (COMT) metabolizes epinephrine to metanephrine and norepinephrine to normetanephrine.
Subsequently, monamine oxidase (MAO) further metabolizes metanephrine and normetanephrine to vanillymandelic acid (VMA).
pg. 868
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
5. During the delivery of an anesthetic in the radiology department, full E-cylin- ders of
, nitrous oxide and oxygen are being used. If a 3:2 mixture of nitrous oxide:oxygen is
being delivered and the case has been proceeding for 60 minutes, the expected pressure
in the nitrous oxide E-cylinder is::
Answer: 745 - 750 PSIg
Nitrous oxide has a critical temperature of 37oC. This allow nitrous oxide to exist as a liquid at room temperature. Full E-cylinders of
nitrous oxide contain approximately 1590 L at a pressure of 745 psig. A sixty minute delivery of 3 L/min would result in a 180 L
consumption, and this would be inadequate to consume all the liquid nitrous oxide in the tank. As a result, there would be no change in
tank pressure.
pg. 622
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012.
6. A decrease in pseudocholinesterase activity has been associated with the use of:
(Select 3)
pancuronium
esmolol droperidol
vecuronium
metoclopramide
magnesium sulfate
AND ANSWERS
1. An action potential characterized by a spike followed by a plateau phase is seen in:
A. peripheral sensory nerve cells
B. peripheral motor nerve cells
C. striated skeletal muscle cells
D. cardiac muscle cells:
Answer: cardiac muscle cells
In contrast to the action potentials of nerve and skeletal muscle cells, the action potential of the cardiac myocyte is characterized by a
sharp spike followed by a plateau phase (2), which results from the opening of slower calcium channels.
pg. 345
Butterworth, JF, Mackey, DC, and Wasnick, JD. Morgan & Mikhail's Clinical Anesthesiology. New York: Lange Medical
Books/McGraw-Hill Medical Publishing Division, 2013.
,2. Autonomic hyperreflexia:
A. is common with cord lesions below T8
B. can precipitate pulmonary edema
C. is not effectively prevented by regional anesthesia
D. can be prevented with adequate intraoperative sedation: Autonomichyperreflexia: Answer:
can precipitate pulmonary edema
Autonomic hyperreflexia should be suspected in patients with lesions above T5-8. Regional anesthesia and deep general anesthesia
are ettective in preventing autonomic hyperreflexia. Surgical stimulation in these patients without adequate anesthesia can result in
pulmonary edema, myocardial ischemia and cerebral hemorrhage.
pg. 927
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
3. During mediastinoscopy the risk of air embolization is greatest:
A. when the patient is supine
, B. during spontaneous ventilation
C. immediately after closure of the incision
D. in the postoperative period:
Answer: during spontaneous ventilation
Air embolization is seen with mediastinoscopy as a result of the 30o elevation of the head. This risk is increased if the patient is
spontaneously ventilating, secondary to the negative intrathoracic pressures generated during inhalation.
pp. 988-989
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012.
4. The formation of metanephrine is the result of::
Answer: catechol-O-methyltransferase metabolism of epinephrine
Catechol-O-methyltransferase (COMT) metabolizes epinephrine to metanephrine and norepinephrine to normetanephrine.
Subsequently, monamine oxidase (MAO) further metabolizes metanephrine and normetanephrine to vanillymandelic acid (VMA).
pg. 868
Nagelhout, JJ, and Plaus, KL. Nurse Anesthesia. St. Louis: Elsevier, 2014.
5. During the delivery of an anesthetic in the radiology department, full E-cylin- ders of
, nitrous oxide and oxygen are being used. If a 3:2 mixture of nitrous oxide:oxygen is
being delivered and the case has been proceeding for 60 minutes, the expected pressure
in the nitrous oxide E-cylinder is::
Answer: 745 - 750 PSIg
Nitrous oxide has a critical temperature of 37oC. This allow nitrous oxide to exist as a liquid at room temperature. Full E-cylinders of
nitrous oxide contain approximately 1590 L at a pressure of 745 psig. A sixty minute delivery of 3 L/min would result in a 180 L
consumption, and this would be inadequate to consume all the liquid nitrous oxide in the tank. As a result, there would be no change in
tank pressure.
pg. 622
Longnecker, DE, Brown, DL, Newman MF and Zapol, WM. Anesthesiology. New York: McGraw Hill, 2012.
6. A decrease in pseudocholinesterase activity has been associated with the use of:
(Select 3)
pancuronium
esmolol droperidol
vecuronium
metoclopramide
magnesium sulfate
