Carbonic Anhydrase Inhibitors are used in the treatment of:
A. Acute glaucoma
B. Renal tubular acidosis
C. Diarrhea induced acidosis
D. Acidosis resulting from hypoventilation - ANSWERA. Acute glaucoma
The decrease the ability of the kidneys to reabsorb bicarbonate, resulting in hypercholemic aciosis. As a
result, carbonic anhydrase inhibitors would be avoided in patients with acidosis, especially in a normal
anion gap acidosis. Bicarbonate is filtered by the ciliary process in the formation of aqueous humor,
carbonic anydrase inhibitors reduce the formation of aqueous humor and can decrease intraocular
pressure.
Branches of the femoral nerve anesthetized during an ankle block include the:
A. Deep peroneal nerve
B. Sural nerve
C. Saphenous Nerve
D. Posterior Tibial Nerve - ANSWERC. Saphenous Nerve
It's the only one to come from the femoral nerve. The other 3 are from the sciatic nerve.
Pulmonary complications from advanced hepatic disease with cirrhosis include:
A. obstructive ventilatory defect
B. respiratory acidosis
C. increased intrapulmonary shunting
D. increased function residual capacity - ANSWERC. Increased intrapulmonary shunting
pulmonary manifestations associated with cirrhosis include: increased intrapulmonary shunting,
decreased FRC, pleural effusions, restrictive ventilatory defect, and respiratory alkalosis
An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic
agent (MAC) is:
,echinacea
valerian
ginkgo
ephedra - ANSWERValerian
both valerian and kava have been shown to have a GABA mediated hypnotic effect and by this
mechanism can decreased MAC. Acute withdrawal after chronic use may result in an increase in MAC
A decrease in pseudocholinesterase activity has been associated with the use of: (Select 3)
pancuronium
esmolol
droperidol
vecuronium
metoclopramide
magnesium sulfate
dantrolene
rocuronium - ANSWERpancuronium
esmolol
metaclopramide
The following drugs have been associated with a decrease in pseudocholinesterase activity: ecothiopate,
pyridostigmine, neostigmine, phenelzine, cyclophosphamide, metaclopramide, esmolol, pancuronium,
and oral contraceptives. Although both dantrolene and magnesium may alter the effects of other
neuromuscular blockers, neither causes inhibition of pesudocholinesterase
During the delivery of an anesthetic in the radiology department, full E-cylinders of nitrous oxide are
being used. If a 3L/min:2L/min mixture of nitrous:oxygen is being delivered and teh case has been
proceeding for 60 minutes, the expected pressure in the nitrous oxide e-cylinder is: - ANSWER745-
750psi
N20 has a critical temperature of 37 degrees C. The allow N20 to exist as a liquid at room temperature.
Full E-cylinders of N20 contain approx 1590L at a pressure of 745 psig. A sixty minute delivery of 3L/min
,would result in a 180L consumption, 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. 658 Barash, PG, Stoelting RK
The formation of metanephrine is the result of:
A. catechol-O-methyltransferase metabolism of epinephrine
B. catechol-O-methyltransferase metabolism of norepinephrine
C. monamine oxidase metabolism of epinephrine
D. monamine oxidase metabolism of norepinephrine - ANSWERA. catechol-O-methyltransferase
metabolism of epinephrine.
COMT metabolizes epi to metanephrine and norepi to normetanephrine. Subsequently MAO further
metabolizes metanephrine and normetanephrine into vanillymandelic acid (VMA).
Characteristics of human immunodeficiency virus neuropathy include: (select 2)
A. Distal polyneuropathy
B. Rapid sudden onset
C. Proximal muscle weakness
D. Allodynia
E. Upper extremities most commonly involved
F. Proximal to distal progression of symptoms - ANSWERdistal polyneuropathy, allodynia
symptomatic neuropathy occurs in 10%-35% of patients who are seropositive for HIV. The sensory
neuropathies associated with HIV include distal sensory polyneuropathy and antiretroviral toxic
neuropathy (ATN) secondary to the treatment. The clinical features of HIV sensory neuropathy typically
include painful allodynia and hyperalgesia. The onset is gradual and most commonly involved the lower
extremities. The neuropathy and dysesthesia progress from the distal and more proximal structures.
There is minimal subjective of objective motor involvement and this is generally limited to the intrinsic
muscles of the foot.
An action potential characterized by a spike followed by a plateau phase is seen in:
A. Peripheral sensory muscle cells
, B. peripheral motor nerve cells
C. stiated skeletal muscle cells
D. Cardiac cells - ANSWERD. 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 slower calcium channels
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 - ANSWERB. During spontaneous ventilation
Air embolization is seen with mediastinoscopy as a result of the 30 degree elevation of the head. The
risk is increased if the patient is spontaneously ventilation secondary to the negative intrathoracic
pressures generated during inhalation.
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 - ANSWERB. Can precipitate pulmonary
edema
Autonomic hyperreflexia should be suspected in patients with lesions above T5-8. Regional anesthesia
and deep general anesthesia are effective in preventing autonomic hyperreflexia. Surgical stimulation in
these patients without adequate anesthesia can result in pulmonary edema, myocardial ischemia and
cerebral hemorrhage.
When placing an epidural with a midline approach, the needle will pass through the: (select 3)
A. Anterior longitudinal ligament
B. Interspinous ligament
C. Ligamentum flavum
D. Facet joint
E. Supraspinous ligament - ANSWERB. Interspinous ligament
A. Acute glaucoma
B. Renal tubular acidosis
C. Diarrhea induced acidosis
D. Acidosis resulting from hypoventilation - ANSWERA. Acute glaucoma
The decrease the ability of the kidneys to reabsorb bicarbonate, resulting in hypercholemic aciosis. As a
result, carbonic anhydrase inhibitors would be avoided in patients with acidosis, especially in a normal
anion gap acidosis. Bicarbonate is filtered by the ciliary process in the formation of aqueous humor,
carbonic anydrase inhibitors reduce the formation of aqueous humor and can decrease intraocular
pressure.
Branches of the femoral nerve anesthetized during an ankle block include the:
A. Deep peroneal nerve
B. Sural nerve
C. Saphenous Nerve
D. Posterior Tibial Nerve - ANSWERC. Saphenous Nerve
It's the only one to come from the femoral nerve. The other 3 are from the sciatic nerve.
Pulmonary complications from advanced hepatic disease with cirrhosis include:
A. obstructive ventilatory defect
B. respiratory acidosis
C. increased intrapulmonary shunting
D. increased function residual capacity - ANSWERC. Increased intrapulmonary shunting
pulmonary manifestations associated with cirrhosis include: increased intrapulmonary shunting,
decreased FRC, pleural effusions, restrictive ventilatory defect, and respiratory alkalosis
An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic
agent (MAC) is:
,echinacea
valerian
ginkgo
ephedra - ANSWERValerian
both valerian and kava have been shown to have a GABA mediated hypnotic effect and by this
mechanism can decreased MAC. Acute withdrawal after chronic use may result in an increase in MAC
A decrease in pseudocholinesterase activity has been associated with the use of: (Select 3)
pancuronium
esmolol
droperidol
vecuronium
metoclopramide
magnesium sulfate
dantrolene
rocuronium - ANSWERpancuronium
esmolol
metaclopramide
The following drugs have been associated with a decrease in pseudocholinesterase activity: ecothiopate,
pyridostigmine, neostigmine, phenelzine, cyclophosphamide, metaclopramide, esmolol, pancuronium,
and oral contraceptives. Although both dantrolene and magnesium may alter the effects of other
neuromuscular blockers, neither causes inhibition of pesudocholinesterase
During the delivery of an anesthetic in the radiology department, full E-cylinders of nitrous oxide are
being used. If a 3L/min:2L/min mixture of nitrous:oxygen is being delivered and teh case has been
proceeding for 60 minutes, the expected pressure in the nitrous oxide e-cylinder is: - ANSWER745-
750psi
N20 has a critical temperature of 37 degrees C. The allow N20 to exist as a liquid at room temperature.
Full E-cylinders of N20 contain approx 1590L at a pressure of 745 psig. A sixty minute delivery of 3L/min
,would result in a 180L consumption, 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. 658 Barash, PG, Stoelting RK
The formation of metanephrine is the result of:
A. catechol-O-methyltransferase metabolism of epinephrine
B. catechol-O-methyltransferase metabolism of norepinephrine
C. monamine oxidase metabolism of epinephrine
D. monamine oxidase metabolism of norepinephrine - ANSWERA. catechol-O-methyltransferase
metabolism of epinephrine.
COMT metabolizes epi to metanephrine and norepi to normetanephrine. Subsequently MAO further
metabolizes metanephrine and normetanephrine into vanillymandelic acid (VMA).
Characteristics of human immunodeficiency virus neuropathy include: (select 2)
A. Distal polyneuropathy
B. Rapid sudden onset
C. Proximal muscle weakness
D. Allodynia
E. Upper extremities most commonly involved
F. Proximal to distal progression of symptoms - ANSWERdistal polyneuropathy, allodynia
symptomatic neuropathy occurs in 10%-35% of patients who are seropositive for HIV. The sensory
neuropathies associated with HIV include distal sensory polyneuropathy and antiretroviral toxic
neuropathy (ATN) secondary to the treatment. The clinical features of HIV sensory neuropathy typically
include painful allodynia and hyperalgesia. The onset is gradual and most commonly involved the lower
extremities. The neuropathy and dysesthesia progress from the distal and more proximal structures.
There is minimal subjective of objective motor involvement and this is generally limited to the intrinsic
muscles of the foot.
An action potential characterized by a spike followed by a plateau phase is seen in:
A. Peripheral sensory muscle cells
, B. peripheral motor nerve cells
C. stiated skeletal muscle cells
D. Cardiac cells - ANSWERD. 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 slower calcium channels
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 - ANSWERB. During spontaneous ventilation
Air embolization is seen with mediastinoscopy as a result of the 30 degree elevation of the head. The
risk is increased if the patient is spontaneously ventilation secondary to the negative intrathoracic
pressures generated during inhalation.
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 - ANSWERB. Can precipitate pulmonary
edema
Autonomic hyperreflexia should be suspected in patients with lesions above T5-8. Regional anesthesia
and deep general anesthesia are effective in preventing autonomic hyperreflexia. Surgical stimulation in
these patients without adequate anesthesia can result in pulmonary edema, myocardial ischemia and
cerebral hemorrhage.
When placing an epidural with a midline approach, the needle will pass through the: (select 3)
A. Anterior longitudinal ligament
B. Interspinous ligament
C. Ligamentum flavum
D. Facet joint
E. Supraspinous ligament - ANSWERB. Interspinous ligament
