SEE EXAM Anesthesia QOD NEWEST 2025 ACTUAL
EXAM WITH COMPLETE 450 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ | GUARANTEED PASS
A previously healthy 78-year-old woman sustains a left femur fracture and is in the
operating room undergoing a left femur intramedullary rod placement. During
bone reaming her blood pressure acutely drops from 130/70 mmHg to 90/45
mmHg, her heart rate increases from 80 to 115 bpm, and her SpO2 falls to 88%.
Which of the following signs is MOST specific for fat embolism?
a. Decreased hemoglobin
b. PaO2 75 mmHg on 100% oxygen
c. Petechial rash on upper body
d. Left ventricular dilation
c (Petechial rash on upper body
This scenario in the operating room is most concerning for fat embolism. In
patients who are having orthopedic surgery with long bone trauma/reaming, fat
embolism is very common, occurring in 3-10% of orthopedic trauma patients.
Common signs under general anesthesia include hypoxia, increased alveolar-
arterial oxygen gradient, tachycardia and a petechial rash on the upper portion
of the body. Petechiae only occur in 20-50% of patients but are considered to be
diagnostic. In general as the fat particles move to the right side of the heart they
can lodge in the pulmonary vascular bed but eventually travel through the left
,side of the heart to the brain. They produce local ischemia and inflammation.
Pulmonary compliance decreases, pulmonary arterial hypertension occurs and
cardiac output declines. This leads to the picture of right-sided heart failure,
whereby the right side of the heart dilates and is unable to pump blood to the
left side of the heart. Thus, systemic blood pressure drops. If a TEE is available in
this scenario, it would likely reveal some embolic particles in the right side of
the heart and pulmonary arteries, and the right ventricle may even be dilated.
The alveolar arterial oxygen gradient is a nonspecific sign that there is some
type of shunt physiology ongoing. These are helpful signs but may also occur as
a result of air or pulmonary thromboembolic embolism. The upper body
petechial rash is considered to be diagnostic.)
Which of the following is the BEST option for treating hypotension related to
arrhythmia during venous cannula placement prior to institution of
cardiopulmonary bypass for the patient undergoing coronary artery bypass graft
surgery?
a. Cardioversion
b. Discontinuation of mechanical stimulation
c. Phenylephrine
d. Volume replacement
b (Discontinuation of mechanical stimulation
For cardiopulmonary bypass to be instituted, an arterial cannula is placed in the
ascending aorta and venous cannulae are placed in the right atrium to drain
deoxygenated blood from the patient. This blood is directed to the bypass circuit
where it is oxygenated and CO2 is eliminated. Blood is then returned to the
,patient via the arterial cannula in the aorta. During placement of the venous
cannula in the right atrium, surgical manipulation can and often does trigger
arrhythmias: the most common being atrial fibrillation. Cessation or limited
mechanical stimulation is recommended if arrhythmias occur. Often, this alone
corrects the problem. Other maneuvers that may be successful include giving a
fluid bolus, titrating vasoactive medications and cardioversion.)
A patient's blood type is to be determined. No agglutination is seen when the
patient's blood is mixed with Anti-A antibody or Anti-B antibody. Agglutination is
seen when the patient's blood is mixed with Anti-D antibody. Which ABO blood
type PRBCs would be acceptable to administer to this patient?
a. A positive
b. AB positive
c. B positive
d. O positive
d
(O positive
Many antigens are present on the surface of red blood cells. A and B antigens
are capable of causing an antibody response that results in fatal intravascular
hemolysis, whereas reaction of the D antigen with its antibody can cause
hemolytic disease of the newborn. Red blood cells exist with one of 3 clinically
important states: A antigen only, B antigen only, or neither the A or the B
antigen. When a type and screen is performed, antibodies towards the A and B
, antigens are mixed with the patient's blood to check for agglutination, which
will occur when the patient's blood contains the appropriate antigen. In the case
above, no agglutination occurs with the mixture of either Anti-A or Anti-B
antibodies to the patient's serum, indicating that the red blood cells do not have
either A or B antigen on their surfaces (type O). Agglutination does occur with
Anti-D antibody, however, so the Rh type of the patient is "positive," hence the
patient is Type O positive. Because this patient has Type O positive blood, they
must receive Type O blood. Because they do have the D antigen, though, they
can receive either Rh positive or Rh negative blood.)
Carotid bodies located at the bifurcation of the common carotid artery MOST
respond to which of the following parameters to control ventilation?
a. pH
b. PaO2
c. PaCO2
d. SaO2
b (PaO2
Chemical control of ventilation occurs via the peripheral and central
chemoreceptors. Peripheral chemoreceptors consist of the carotid and aortic
bodies. These chemoreceptors respond primarily to a decrease in PaO2. Neural
activity increases when PaO2 falls below 100 mmHg, but a substantially
recognizable increase in minute ventilation may not be seen until the PaO2
drops below 65 mmHg. The carotid bodies serve to influence largely the
ventilatory effects of a decrease in PaO2 by increasing respiratory rate and tidal
volume. The aortic bodies predominantly affect the circulatory effects of a
EXAM WITH COMPLETE 450 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ | GUARANTEED PASS
A previously healthy 78-year-old woman sustains a left femur fracture and is in the
operating room undergoing a left femur intramedullary rod placement. During
bone reaming her blood pressure acutely drops from 130/70 mmHg to 90/45
mmHg, her heart rate increases from 80 to 115 bpm, and her SpO2 falls to 88%.
Which of the following signs is MOST specific for fat embolism?
a. Decreased hemoglobin
b. PaO2 75 mmHg on 100% oxygen
c. Petechial rash on upper body
d. Left ventricular dilation
c (Petechial rash on upper body
This scenario in the operating room is most concerning for fat embolism. In
patients who are having orthopedic surgery with long bone trauma/reaming, fat
embolism is very common, occurring in 3-10% of orthopedic trauma patients.
Common signs under general anesthesia include hypoxia, increased alveolar-
arterial oxygen gradient, tachycardia and a petechial rash on the upper portion
of the body. Petechiae only occur in 20-50% of patients but are considered to be
diagnostic. In general as the fat particles move to the right side of the heart they
can lodge in the pulmonary vascular bed but eventually travel through the left
,side of the heart to the brain. They produce local ischemia and inflammation.
Pulmonary compliance decreases, pulmonary arterial hypertension occurs and
cardiac output declines. This leads to the picture of right-sided heart failure,
whereby the right side of the heart dilates and is unable to pump blood to the
left side of the heart. Thus, systemic blood pressure drops. If a TEE is available in
this scenario, it would likely reveal some embolic particles in the right side of
the heart and pulmonary arteries, and the right ventricle may even be dilated.
The alveolar arterial oxygen gradient is a nonspecific sign that there is some
type of shunt physiology ongoing. These are helpful signs but may also occur as
a result of air or pulmonary thromboembolic embolism. The upper body
petechial rash is considered to be diagnostic.)
Which of the following is the BEST option for treating hypotension related to
arrhythmia during venous cannula placement prior to institution of
cardiopulmonary bypass for the patient undergoing coronary artery bypass graft
surgery?
a. Cardioversion
b. Discontinuation of mechanical stimulation
c. Phenylephrine
d. Volume replacement
b (Discontinuation of mechanical stimulation
For cardiopulmonary bypass to be instituted, an arterial cannula is placed in the
ascending aorta and venous cannulae are placed in the right atrium to drain
deoxygenated blood from the patient. This blood is directed to the bypass circuit
where it is oxygenated and CO2 is eliminated. Blood is then returned to the
,patient via the arterial cannula in the aorta. During placement of the venous
cannula in the right atrium, surgical manipulation can and often does trigger
arrhythmias: the most common being atrial fibrillation. Cessation or limited
mechanical stimulation is recommended if arrhythmias occur. Often, this alone
corrects the problem. Other maneuvers that may be successful include giving a
fluid bolus, titrating vasoactive medications and cardioversion.)
A patient's blood type is to be determined. No agglutination is seen when the
patient's blood is mixed with Anti-A antibody or Anti-B antibody. Agglutination is
seen when the patient's blood is mixed with Anti-D antibody. Which ABO blood
type PRBCs would be acceptable to administer to this patient?
a. A positive
b. AB positive
c. B positive
d. O positive
d
(O positive
Many antigens are present on the surface of red blood cells. A and B antigens
are capable of causing an antibody response that results in fatal intravascular
hemolysis, whereas reaction of the D antigen with its antibody can cause
hemolytic disease of the newborn. Red blood cells exist with one of 3 clinically
important states: A antigen only, B antigen only, or neither the A or the B
antigen. When a type and screen is performed, antibodies towards the A and B
, antigens are mixed with the patient's blood to check for agglutination, which
will occur when the patient's blood contains the appropriate antigen. In the case
above, no agglutination occurs with the mixture of either Anti-A or Anti-B
antibodies to the patient's serum, indicating that the red blood cells do not have
either A or B antigen on their surfaces (type O). Agglutination does occur with
Anti-D antibody, however, so the Rh type of the patient is "positive," hence the
patient is Type O positive. Because this patient has Type O positive blood, they
must receive Type O blood. Because they do have the D antigen, though, they
can receive either Rh positive or Rh negative blood.)
Carotid bodies located at the bifurcation of the common carotid artery MOST
respond to which of the following parameters to control ventilation?
a. pH
b. PaO2
c. PaCO2
d. SaO2
b (PaO2
Chemical control of ventilation occurs via the peripheral and central
chemoreceptors. Peripheral chemoreceptors consist of the carotid and aortic
bodies. These chemoreceptors respond primarily to a decrease in PaO2. Neural
activity increases when PaO2 falls below 100 mmHg, but a substantially
recognizable increase in minute ventilation may not be seen until the PaO2
drops below 65 mmHg. The carotid bodies serve to influence largely the
ventilatory effects of a decrease in PaO2 by increasing respiratory rate and tidal
volume. The aortic bodies predominantly affect the circulatory effects of a
