Anesthesia Assessment and Etomidate Quiz
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Questions and Answers

Which of the following conditions is associated with a high Mallampati score?

  • Low blood pressure
  • Difficult intubation (correct)
  • Normal oxygen saturation
  • Low heart rate

    • What does the Thyromental distance (TMD) assess?

  • The distance from the thyroid cartilage to the mental prominence (correct)
  • The length of the patient’s neck
  • The distance from the chin to the collarbone
  • The distance from the upper lip to the lower lip

    • Which air assessment predictor assesses the ability to bite the upper lip?

  • Modified Mallampati score
  • Upper lip bite test (correct)
  • Tracheal deviation test
  • Thyromental distance

    • What is the typical threshold for a normal Thyromental distance?

    <p>7 cm</p> Signup and view all the answers

    What is the primary action of etomidate?

    <p>Hypnotic</p> Signup and view all the answers

    What is the typical induction dose of etomidate?

    <p>0.3 mg/kg</p> Signup and view all the answers

    In assessing a patient’s airway, which sign might indicate a difficult intubation?

    <p>Loose or chipped teeth</p> Signup and view all the answers

    Which of the following factors is not typically included in a pre-anesthesia assessment?

    <p>Type of clothing worn during surgery</p> Signup and view all the answers

    Which of the following is a significant adverse effect of etomidate?

    <p>Transient inhibition of adrenal steroid synthesis</p> Signup and view all the answers

    What is the primary route of excretion for etomidate after administration?

    <p>Urine</p> Signup and view all the answers

    What is the purpose of evaluating exercise tolerance during a pre-anesthesia assessment?

    <p>To assess overall physical fitness and risks</p> Signup and view all the answers

    Which of the following could be a complication that needs to be documented in previous anesthesia assessments?

    <p>PONV (Postoperative Nausea and Vomiting)</p> Signup and view all the answers

    What is the onset of action for etomidate after intravenous administration?

    <p>30 to 60 seconds</p> Signup and view all the answers

    Why is etomidate no longer administered by continuous infusion?

    <p>It risks sustained suppression of endogenous cortisol and aldosterone production</p> Signup and view all the answers

    Which statement about etomidate's metabolism is correct?

    <p>It is rapidly metabolized by hepatic and plasma esterases.</p> Signup and view all the answers

    In which patients is etomidate particularly ideal for use during induction?

    <p>Patients with significant cardiovascular disease</p> Signup and view all the answers

    What makes neonates and young infants obligate nasal breathers?

    <p>Soft tracheal cartilages</p> Signup and view all the answers

    Which anatomical feature is the narrowest part of the airway in infants?

    <p>Cricoid cartilage</p> Signup and view all the answers

    What is a significant physiological difference in the respiratory system of young children?

    <p>Lower lung compliance</p> Signup and view all the answers

    What should be maintained to prevent airway obstruction in infants?

    <p>Neutral or slightly extended head position</p> Signup and view all the answers

    Which condition is common in children aged 3 to 8 years that may lead to airway obstruction?

    <p>Adeno-tonsillar hypertrophy</p> Signup and view all the answers

    What characterizes the tidal volume in infants?

    <p>Relatively fixed volume</p> Signup and view all the answers

    What is a common complication in premature and ex-premature infants that requires monitoring post-surgery?

    <p>Apnoeas</p> Signup and view all the answers

    What anatomical difference decreases the ease of airway management in young children?

    <p>Long, U-shaped epiglottis</p> Signup and view all the answers

    Which of the following is a contraindication for the use of sevoflurane?

    <p>Severe hypovolemia</p> Signup and view all the answers

    What property of sevoflurane contributes to its effectiveness in inhalational induction?

    <p>Pleasant smell</p> Signup and view all the answers

    What effect does sevoflurane have on cardiovascular function?

    <p>Decreases myocardial O2 demand</p> Signup and view all the answers

    What is a risk associated with the degradation of sevoflurane by soda lime?

    <p>Compounds A formation</p> Signup and view all the answers

    Which characteristic makes sevoflurane particularly suitable for use in pediatric patients?

    <p>Rapid and smooth induction characteristics</p> Signup and view all the answers

    How does sevoflurane affect respiratory function?

    <p>Induces bronchodilatation</p> Signup and view all the answers

    What is a notable neurological effect of sevoflurane?

    <p>Reduces intraocular pressure</p> Signup and view all the answers

    Which effect is commonly associated with sevoflurane during emergence from anesthesia?

    <p>Emergence agitation</p> Signup and view all the answers

    What is the most common initial sign of cardiac toxicity associated with local anesthetics?

    <p>Hypotension</p> Signup and view all the answers

    Which class of drugs is recommended for the immediate management of seizures in local anesthetic systemic toxicity?

    <p>Benzodiazepines</p> Signup and view all the answers

    What can be administered if benzodiazepines are not available during seizure management?

    <p>Propofol or thiopental</p> Signup and view all the answers

    What is the primary focus of management during local anesthetic-induced cardiac arrest?

    <p>Restoring cardiac output</p> Signup and view all the answers

    How is lipid emulsion therapy theorized to help in cases of local anesthetic toxicity?

    <p>By drawing the anesthetic out of cardiac tissue</p> Signup and view all the answers

    What is the recommended initial bolus amount of 20% lipid emulsion for treatment in suspected toxicity cases?

    <p>1.5 mL/kg</p> Signup and view all the answers

    Which of the following is NOT a sign of cardiac toxicity from local anesthetics?

    <p>Fever</p> Signup and view all the answers

    What should be done if hemodynamic stability is not achieved after the initial lipid emulsion bolus?

    <p>Increase infusion rate to 0.5 mL/kg per minute</p> Signup and view all the answers

    What is one of the primary uses of nitrous oxide in medical practice?

    <p>Pain relief during childbirth</p> Signup and view all the answers

    Which of the following is a known characteristic of nitrous oxide?

    <p>It rapidly enters enclosed air-containing spaces</p> Signup and view all the answers

    What condition may result from the use of nitrous oxide at the end of surgery?

    <p>Diffusion hypoxia</p> Signup and view all the answers

    What is a notable effect of prolonged use of nitrous oxide?

    <p>Megaloblastic anemia</p> Signup and view all the answers

    How does nitrous oxide affect the cardiovascular system?

    <p>It mildly depresses myocardial function</p> Signup and view all the answers

    What percentage of xenon mixed with oxygen is considered to induce general anesthesia without side effects?

    <p>70% xenon and 30% oxygen</p> Signup and view all the answers

    What is a significant drawback of nitrous oxide exposure?

    <p>Interferes with DNA synthesis</p> Signup and view all the answers

    Which statement about nitrous oxide is inaccurate?

    <p>It is highly soluble in blood</p> Signup and view all the answers

    Study Notes

    Anesthesia 3rd Stage Study Notes

    • This is a teaching package for anesthesia techniques, 3rd stage, for the academic years 2023-2024.
    • The course covers preoperative assessment and premedication.

    Preoperative Assessment and Premedication

    • Preoperative assessment identifies comorbidities that may cause complications during and after surgery.
    • Elective procedures typically have a preoperative assessment 2–4 weeks before surgery.
    • Premedication involves medications to prepare the patient for anesthesia and optimize surgery conditions.
    • Specific patient needs depend on the patient and procedure.

    Goals of Preoperative Assessment

    • Establish a strong doctor-patient relationship
    • Plan the anesthetic technique
    • Screen and manage comorbidities
    • Assess and minimize anesthetic risks
    • Identify the need for specialized techniques
    • Identify the need for advanced postoperative care
    • Prepare the patient
    • Determine perioperative risk
    • Reduce patient anxiety
    • Obtain informed consent
    • The ASA physical classification (American Society of Anesthesiologists) helps assess patient risk before surgery.

    Minimum Preoperative Visit Components (ASA)

    • Medical, anesthetic, and medication history
    • Complete physical examination
    • Review of diagnostic data (ECG, labs, X-rays)
    • Assessment of ASA physical status
    • Formulation and discussion of the anesthetic plan

    ASA Physical Classification

    • ASA 1: Normal healthy patient
    • ASA 2: Mild systemic disease, no impact on daily life
    • ASA 3: Severe systemic disease, significant impact on daily life
    • ASA 4: Severe systemic disease, constant threat to life
    • ASA 5: Moribund, not expected to survive without surgery
    • ASA 6: Declared brain-dead patient—organ donor
    • E: Emergency surgery

    History

    • Medical problems (current and past)
    • Regular medications
    • Previous surgeries (date)
    • Family anesthesia history
    • Anesthesia problems in the family
    • Type of anesthesia
    • Pseudocholinesterase deficiency and malignant hyperpyrexia

    Physical Examination

    • Airway assessment
    • Heart and lungs assessment
    • Vital signs, including O2 saturation
    • Blood pressure, resting pulse, rate, rhythm
    • Respiration, rate, depth, and pattern at rest
    • Body temperature
    • Height and weight (BMI)
    • Other specific examinations depending on the individual patient and procedure

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    Related Documents

    Anesthesia 3rd Stage Lecture Notes PDF

    Description

    Test your knowledge on anesthesia assessments and specifically etomidate's pharmacology. This quiz covers key concepts like airway predictors, Thyromental distance, and the adverse effects of etomidate. Perfect for those studying anesthesiology or preparing for exams!

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