Anesthesia a comprehensive review 7th edition by
hall r chantigian no toc index mosby
, 1
Chapter 1
Anesthesia Equipment and Physics
DIRECTIONS (Questions 1 through 90): Each of the questions or incomplete statements in this section is
followed by answers or by completions of the statement, respectively. Select the ONE BEST answer or comple-
tion for each item.
1. A 58-year-old patient has severe shortness of breath and “wheezing.” On examination, it is found that the patient has
inspiratory and expiratory stridor. Further evaluation reveals marked extrinsic compression of the midtrachea by a
tumor. The type of airflow at the point of obstruction within the trachea is
A. Laminar flow
B. Orifice flow
C. Undulant flow
D. Stenotic flow
E. None of the above
2. Concerning the patient in question 1, administration of 70% helium in O2 instead of 100% O2 will decrease the
resistance to airflow through the stenotic region within the trachea because
A. Helium decreases the viscosity of the gas mixture
B. Helium decreases the friction coefficient of the gas mixture
C. Helium decreases the density of the gas mixture
D. Helium increases the Reynolds number of the gas mixture
E. None of the above
3. A 56-year-old patient is brought to the operating room (OR) for elective replacement of a stenotic aortic valve. An
awake 20-gauge arterial catheter is placed into the right radial artery and is then connected to a transducer located at
the same level as the patient’s left ventricle. The entire system is zeroed at the transducer. Several seconds later, the
patient raises both arms into the air such that his right wrist is 20 cm above his heart. As he is doing this, the blood
pressure (BP) on the monitor reads 120/80. What would this patient’s true BP be at this time?
A. 140/100 mm Hg
B. 135/95 mm Hg
, C. 120/80 mm Hg
D. 105/65 mm Hg
E. 100/60 mm Hg
1
4. An admixture of room air in the waste gas disposal system during an appendectomy in a paralyzed, mechanically ven-
tilated patient under general volatile anesthesia can best be explained by which mechanism of entry?
A. Venous air embolism
B. Positive pressure relief valve
C. Negative pressure relief valve
D. Soda lime canister
E. Ventilator bellows
5. The relationship between intra-alveolar pressure, surface tension, and the radius of an alveolus is described by
A. Graham’s law
B. Beer’s law
C. Newton’s law
D. Laplace’s law
E. Bernoulli’s law
6. A size “E” compressed-gas cylinder completely filled with N2O contains how many liters?
A. 1160 L
B. 1470 L
C. 1590 L
D. 1640 L
E. 1750 L
7. Which of the following methods can be used to detect all leaks in the low-pressure circuit of any contemporary anes-
thesia machine?
A. Oxygen flush test
B. Common gas outlet occlusion test
C. Traditional positive-pressure leak test
D. Negative-pressure leak test
E. No test can verify the integrity of all contemporary anesthesia machines
8. Which of the following valves prevents transfilling between compressed-gas cylinders?
A. Fail-safe valve
B. Pop-off valve
C. Pressure-sensor shutoff valve
D. Adjustable pressure-limiting valve
E. Check valve
9. The expression that for a fixed mass of gas at constant temperature, the product of pressure and volume is constant is
known as
A. Graham’s law
B. Bernoulli’s law
C. Boyle’s law
D. Dalton’s law
E. Charles’ law
10. The pressure gauge on a size “E” compressed-gas cylinder containing O2 reads 1600 psi. How long could O2 be deliv-
ered from this cylinder at a rate of 2 L/min?
A. 90 minutes
B. 140 minutes
, 4 Part 1 Basic Sciences
C. 250 minutes
D. 320 minutes
E. Cannot be calculated
11. A 25-year-old healthy patient is anesthetized for a femoral hernia repair. Anesthesia is maintained with isoflurane and
N2O 50% in O2 and the patient’s lungs are mechanically ventilated. Suddenly, the “low-arterial saturation” warning
signal on the pulse oximeter alarms. After the patient is disconnected from the anesthesia machine, he is ventilated
with an Ambu bag with 100% O2 without difficulty and the arterial saturation quickly improves. During inspection of
your anesthesia equipment, you notice that the bobbin in the O 2 rotameter is not rotating. This most likely indicates
A. The flow of N2O through the O2 rotameter
B. No flow of O2 through the O2 rotameter
C. A flow of O2 through the O2 rotameter that is markedly lower than indicated
D. A leak in the O2 rotameter above the bobbin
E. A leak in the O2 rotameter below the bobbin
12. The O2 pressure-sensor shutoff valve requires what O2 pressure to remain open and allow N2O to flow into the N2O
rotameter?
A. 10 psi
B. 25 psi
C. 50 psi
D. 100 psi
E. 600 psi
13. A 78-year-old patient is anesthetized for resection of a liver tumor. After induction and tracheal intubation, a 20-gauge
arterial line is placed and connected to a transducer that is located 20 cm below the level of the heart. The system is
zeroed at the stopcock located at the wrist while the patient’s arm is stretched out on an arm board. How will the arte-
rial line pressure compare with the true BP?
A. It will be 20 mm Hg higher
B. It will be 15 mm Hg higher
C. It will be the same
D. It will be 15 mm Hg lower
E. It will be 20 mm Hg lower
14. The second-stage O2 pressure regulator delivers a constant O2 pressure to the rotameters of
A. 4 psi
B. 8 psi
C. 16 psi
D. 32 psi
E. 64 psi
15. The highest trace concentration of N2O allowed in the OR atmosphere by the National Institute for Occupational
Safety and Health (NIOSH) is
A. 1 part per million (ppm)
B. 5 ppm
C. 25 ppm
D. 50 ppm
E. 100 ppm
16. A sevoflurane vaporizer will deliver an accurate concentration of an unknown volatile anesthetic if the latter shares
which property with sevoflurane?
A. Molecular weight
B. Viscosity
C. Vapor pressure
D. Blood/gas partition coefficient
E. Oil/gas partition coefficient
17. The portion of the ventilator (Ohmeda 7000, 7810, and 7900) on the anesthesia machine that compresses the bellows
is driven by
A. Compressed oxygen
B. Compressed air
C. Electricity alone
hall r chantigian no toc index mosby
, 1
Chapter 1
Anesthesia Equipment and Physics
DIRECTIONS (Questions 1 through 90): Each of the questions or incomplete statements in this section is
followed by answers or by completions of the statement, respectively. Select the ONE BEST answer or comple-
tion for each item.
1. A 58-year-old patient has severe shortness of breath and “wheezing.” On examination, it is found that the patient has
inspiratory and expiratory stridor. Further evaluation reveals marked extrinsic compression of the midtrachea by a
tumor. The type of airflow at the point of obstruction within the trachea is
A. Laminar flow
B. Orifice flow
C. Undulant flow
D. Stenotic flow
E. None of the above
2. Concerning the patient in question 1, administration of 70% helium in O2 instead of 100% O2 will decrease the
resistance to airflow through the stenotic region within the trachea because
A. Helium decreases the viscosity of the gas mixture
B. Helium decreases the friction coefficient of the gas mixture
C. Helium decreases the density of the gas mixture
D. Helium increases the Reynolds number of the gas mixture
E. None of the above
3. A 56-year-old patient is brought to the operating room (OR) for elective replacement of a stenotic aortic valve. An
awake 20-gauge arterial catheter is placed into the right radial artery and is then connected to a transducer located at
the same level as the patient’s left ventricle. The entire system is zeroed at the transducer. Several seconds later, the
patient raises both arms into the air such that his right wrist is 20 cm above his heart. As he is doing this, the blood
pressure (BP) on the monitor reads 120/80. What would this patient’s true BP be at this time?
A. 140/100 mm Hg
B. 135/95 mm Hg
, C. 120/80 mm Hg
D. 105/65 mm Hg
E. 100/60 mm Hg
1
4. An admixture of room air in the waste gas disposal system during an appendectomy in a paralyzed, mechanically ven-
tilated patient under general volatile anesthesia can best be explained by which mechanism of entry?
A. Venous air embolism
B. Positive pressure relief valve
C. Negative pressure relief valve
D. Soda lime canister
E. Ventilator bellows
5. The relationship between intra-alveolar pressure, surface tension, and the radius of an alveolus is described by
A. Graham’s law
B. Beer’s law
C. Newton’s law
D. Laplace’s law
E. Bernoulli’s law
6. A size “E” compressed-gas cylinder completely filled with N2O contains how many liters?
A. 1160 L
B. 1470 L
C. 1590 L
D. 1640 L
E. 1750 L
7. Which of the following methods can be used to detect all leaks in the low-pressure circuit of any contemporary anes-
thesia machine?
A. Oxygen flush test
B. Common gas outlet occlusion test
C. Traditional positive-pressure leak test
D. Negative-pressure leak test
E. No test can verify the integrity of all contemporary anesthesia machines
8. Which of the following valves prevents transfilling between compressed-gas cylinders?
A. Fail-safe valve
B. Pop-off valve
C. Pressure-sensor shutoff valve
D. Adjustable pressure-limiting valve
E. Check valve
9. The expression that for a fixed mass of gas at constant temperature, the product of pressure and volume is constant is
known as
A. Graham’s law
B. Bernoulli’s law
C. Boyle’s law
D. Dalton’s law
E. Charles’ law
10. The pressure gauge on a size “E” compressed-gas cylinder containing O2 reads 1600 psi. How long could O2 be deliv-
ered from this cylinder at a rate of 2 L/min?
A. 90 minutes
B. 140 minutes
, 4 Part 1 Basic Sciences
C. 250 minutes
D. 320 minutes
E. Cannot be calculated
11. A 25-year-old healthy patient is anesthetized for a femoral hernia repair. Anesthesia is maintained with isoflurane and
N2O 50% in O2 and the patient’s lungs are mechanically ventilated. Suddenly, the “low-arterial saturation” warning
signal on the pulse oximeter alarms. After the patient is disconnected from the anesthesia machine, he is ventilated
with an Ambu bag with 100% O2 without difficulty and the arterial saturation quickly improves. During inspection of
your anesthesia equipment, you notice that the bobbin in the O 2 rotameter is not rotating. This most likely indicates
A. The flow of N2O through the O2 rotameter
B. No flow of O2 through the O2 rotameter
C. A flow of O2 through the O2 rotameter that is markedly lower than indicated
D. A leak in the O2 rotameter above the bobbin
E. A leak in the O2 rotameter below the bobbin
12. The O2 pressure-sensor shutoff valve requires what O2 pressure to remain open and allow N2O to flow into the N2O
rotameter?
A. 10 psi
B. 25 psi
C. 50 psi
D. 100 psi
E. 600 psi
13. A 78-year-old patient is anesthetized for resection of a liver tumor. After induction and tracheal intubation, a 20-gauge
arterial line is placed and connected to a transducer that is located 20 cm below the level of the heart. The system is
zeroed at the stopcock located at the wrist while the patient’s arm is stretched out on an arm board. How will the arte-
rial line pressure compare with the true BP?
A. It will be 20 mm Hg higher
B. It will be 15 mm Hg higher
C. It will be the same
D. It will be 15 mm Hg lower
E. It will be 20 mm Hg lower
14. The second-stage O2 pressure regulator delivers a constant O2 pressure to the rotameters of
A. 4 psi
B. 8 psi
C. 16 psi
D. 32 psi
E. 64 psi
15. The highest trace concentration of N2O allowed in the OR atmosphere by the National Institute for Occupational
Safety and Health (NIOSH) is
A. 1 part per million (ppm)
B. 5 ppm
C. 25 ppm
D. 50 ppm
E. 100 ppm
16. A sevoflurane vaporizer will deliver an accurate concentration of an unknown volatile anesthetic if the latter shares
which property with sevoflurane?
A. Molecular weight
B. Viscosity
C. Vapor pressure
D. Blood/gas partition coefficient
E. Oil/gas partition coefficient
17. The portion of the ventilator (Ohmeda 7000, 7810, and 7900) on the anesthesia machine that compresses the bellows
is driven by
A. Compressed oxygen
B. Compressed air
C. Electricity alone
