Anesthesia Quiz from Core Concepts

Questions and Answers

After the administration of phenylephrine, which hemodynamic responses do you most expect in a heart transplant patient?

HR no change, BP no change

HR no change, BP increased (correct)

HR decreased, BP no change

HR decreased, BP increased

The arteria radicularis magna, or artery of Adamkiewicz, most commonly arises from?

T4 - T8

L2 - L4

L4 - S1

T8 - L2 (correct)

Which of the following medications should be avoided in the treatment of a woman with congenital long QT syndrome experiencing torsades de pointe?

Esmolol

Amiodarone (correct)

Magnesium sulfate

Calcium chloride

Which coronary artery do you most expect to be occluded in a patient with nausea, diaphoresis, and bradycardia showing echocardiogram findings of right ventricular ischemia?

Right coronary artery Signup and view all the answers

Which of the following monitoring modalities is most important in the setting of tricyclic antidepressant (TCA) poisoning?

Electrocardiogram Signup and view all the answers

Which of the following is most often associated with carbon monoxide poisoning?

Cyanide toxicity Signup and view all the answers

After an accidental needle stick with a contaminated needle, which of the following viruses carries the highest risk of transmission?

Hepatitis B Signup and view all the answers

Which of the following has not been definitely shown to reduce central line infection rates?

Routine dressing changes Signup and view all the answers

Disodium edentate or sodium metabisulfite is added to formulations of propofol to:

Inhibit bacterial growth Signup and view all the answers

During emergent transtracheal jet ventilation using a 14 gauge catheter, generation of sufficient gas flow requires a driving pressure of:

50 psi Signup and view all the answers

Sensory innervation of the trachea and larynx below the vocal cords is supplied by the:

Recurrent laryngeal nerve Signup and view all the answers

Correct statements concerning the use of benzodiazepines in the elderly include:

Volume of distribution is increased Signup and view all the answers

The National Institute for Occupational Safety (NIOSH) recommends limiting the operating room concentration of nitrous oxide to:

25 ppm Signup and view all the answers

The highest incidence of muscle pain following the use of succinylcholine is seen in:

Outpatients Signup and view all the answers

The cardiovascular effects of pancuronium are caused by: (Select 3)

Ganglionic stimulation Signup and view all the answers

Anesthetic implications of multiple sclerosis include:

Exacerbation induced by spinal anesthesia Signup and view all the answers

Local anesthetics with the potential to form methemoglobin include: (Select 3)

Prilocaine Signup and view all the answers

Ulnar nerve injury:

Occurs more frequently in males Signup and view all the answers

The potency of local anesthetics increases as the:

Lipid solubility increases Signup and view all the answers

A decrease in cerebral blood flow is seen after the administration of:

Propofol Signup and view all the answers

The age group with the highest minimum alveolar concentration (MAC) of desflurane is:

2 - 3 months Signup and view all the answers

The loss of ventricular filling as a result of acute atrial fibrillation is approximately:

15-25% Signup and view all the answers

During surgical repair of a detached retina, the pressure-volume relationship of the bubble will approximately:

Triple Signup and view all the answers

During pregnancy, the minimum alveolar concentration (MAC):

Decreases throughout the pregnancy Signup and view all the answers

Physiologic effects of electroconvulsive therapy (ECT) include an:

Initial parasympathetic discharge followed by a sustained sympathetic response Signup and view all the answers

The postretrobulbar block apnea syndrome:

Is associated with unconsciousness Signup and view all the answers

A 76-year-old man is scheduled for a hemicolectomy. Problems with electrocautery use in this patient can be minimized by:

The use of a bipolar cautery Signup and view all the answers

The most severe transfusion reactions are due to:

ABO incompatibility Signup and view all the answers

Intracranial hypertension is defined as a sustained increase in intracranial pressure (ICP) above:

15 mm Hg Signup and view all the answers

The rapid shallow breathing index (RSBI) should be:

Less than 100 Signup and view all the answers

The perception of an ordinarily non-noxious stimulus as pain is referred to as:

Allodynia Signup and view all the answers

Cholinesterase inhibitors that freely cross the blood-brain barrier include:

Physostigmine Signup and view all the answers

Ninety percent of congenital diaphragmatic hernias occur:

Through the left posterolateral foramen Signup and view all the answers

During fetal monitoring, Type III decelerations are thought to be related to:

Umbilical cord compression Signup and view all the answers

Pathophysiologic factors affecting the anesthetic management of patients with hypothyroidism include:

Difficulty with intubation and airway management Signup and view all the answers

The most frequent manifestation of sickle cell disease is:

Pain Signup and view all the answers

Reactants that are regenerated during the absorption of carbon dioxide by soda lime include:

Sodium hydroxide Signup and view all the answers

The effects of barbiturates on ischemic areas of the brain include:

Redirection of blood flow to the ischemic areas Signup and view all the answers

In patients receiving vecuronium, the greatest augmentation of neuromuscular blockade is seen with the use of:

Desflurane Signup and view all the answers

Local anesthetic solutions that are isobaric with the cerebrospinal fluid include: (Select 2)

Lidocaine 2% in normal saline Signup and view all the answers

A fresh E-cylinder of oxygen contains how many liters?

660 liters Signup and view all the answers

The most appropriate anesthetic technique for an 82-year-old female with moderate aortic stenosis is:

Opioid-based general anesthesia Signup and view all the answers

What effect does the addition of nitrous oxide have on the concentration of desflurane during inhalation anesthesia?

Decrease in desflurane concentration Signup and view all the answers

The formation of active metabolites has NOT been associated with the use of which drug?

Rocuronium Signup and view all the answers

The rate of seroconversion after exposure of mucous membranes to HIV-infected blood is approximately:

0.09% Signup and view all the answers

A decrease in cholinesterase activity has been associated with which condition?

Burns Signup and view all the answers

Hormones released by the neurohypophysis include: (Select 2)

Oxytocin Signup and view all the answers

Congenital heart diseases associated with right-to-left shunting include: (Select 3)

Tetralogy of Fallot Signup and view all the answers

The recommended maximum leakage current allowed in operating room equipment is:

10 μA Signup and view all the answers

Hypoxemia during one-lung anesthesia is most effectively treated by:

Periodic inflation of the collapsed lung Signup and view all the answers

Sympathetic blockade during acute herpes zoster has been shown to:

Reduce the incidence of postherpetic neuralgia Signup and view all the answers

The expected pressure in the nitrous oxide E-cylinder after 60 minutes of use in a 3:2 mixture is:

745 - 750 psig Signup and view all the answers

The formation of metanephrine is the result of:

Catechol-O-methyltransferase metabolism of epinephrine Signup and view all the answers

Characteristics of human immunodeficiency virus neuropathy include: (Select 2)

Allodynia Signup and view all the answers

During placement of a lumbar epidural using a midline approach, which structures does the needle pass through? (Select 3)

Interspinous ligament Signup and view all the answers

Prior to pneumonectomy, split lung function testing is indicated in the patient with:

A PaCO2 of 49 mm Hg on room air Signup and view all the answers

Postintubation croup:

Is secondary to inflammation of subglottic structures Signup and view all the answers

Physiologic derangements seen in the patient with scleroderma include: (Select 3)

Pulmonary hypertension Signup and view all the answers

Basal metabolic oxygen consumption in a 20-kg patient is approximately:

95 mL/min Signup and view all the answers

During emergent transtracheal jet ventilation using a 14 gauge catheter, generation of sufficient gas flow requires a driving pressure of:

50 psi Signup and view all the answers

Acceptable levels of hypotension in a 24-year-old female scheduled for cerebral aneurysm resection would include a mean arterial pressure of:

50 - 60 mm Hg Signup and view all the answers

Topically applied ophthalmic medications are absorbed:

More quickly than subcutaneous administration Signup and view all the answers

Which of the following is NOT a contraindication to activated charcoal in the setting of suspected aspirin poisoning?

Two hours since ingestion Signup and view all the answers

Which of the following is MOST true regarding acetaminophen poisoning?

5% of acetaminophen is excreted in the urine Signup and view all the answers

During pregnancy, the minimum alveolar concentration (MAC):

Decreases throughout the pregnancy Signup and view all the answers

Correct location of the catheter tip of a central venous line is in the:

Superior vena cava Signup and view all the answers

Which of the following is NOT a potential treatment for salicylate poisoning?

Administration of a reversible COX-inhibitor Signup and view all the answers

Physiologic effects of electroconvulsive therapy (ECT) include an:

Initial parasympathetic discharge followed by a sustained sympathetic response Signup and view all the answers

A 70-year-old man with a DDD-R pacemaker should have it reprogrammed to which of the following during an anterior cervical discectomy?

Discontinue R function Signup and view all the answers

During hip replacement surgery, cardiopulmonary changes associated with the application of acrylic bone cement include: (Select 3)

Hypoxemia secondary to fat embolization Signup and view all the answers

Maternal mortality associated with amniotic fluid embolization is:

Greater than 50% Signup and view all the answers

Absolute contraindications to electroconvulsive therapy (ECT) include:

Increased intracranial pressure Signup and view all the answers

The primary mechanism of intraoperative heat loss resulting in hypothermia is:

Radiation Signup and view all the answers

Sinus arrhythmia:

Causes an increase in heart rate with inspiration Signup and view all the answers

Of the following, the block associated with the highest blood level of local anesthetic per volume injected is the:

Intercostal block Signup and view all the answers

A 34-year-old female is undergoing tumescent liposuction of the abdomen and flanks. Peak serum levels of local anesthetic from the tumescent solution are most commonly seen in:

12 to 14 hours Signup and view all the answers

A 82-year-old female is scheduled for a total hip replacement under spinal anesthesia. Current recommendations regarding the dosing of enoxaparin state that the drug be:

Held for 10 - 12 hours prior to the spinal anesthetic Signup and view all the answers

Safety features that prevent filling of the vaporizer with an incorrect agent include:

Agent-specific keyed filling ports Signup and view all the answers

A person acting as an amicus curiae:

Is not a party to the litigation Signup and view all the answers

The first nurse anesthetist to be appointed to a university medical school faculty was:

Alice Maude Hunt Signup and view all the answers

Inhaled agents from highest vapor pressure to lowest are:

Nitrous Oxide, Des, Iso, Sevo Signup and view all the answers

Reduction of heart rate seen with the administration of opiates is mediated through the:

Mu receptors Signup and view all the answers

The effects of 60-Hz current on a human for 1 second match the current to the physiologic effect.

Perception Threshold = 1 mAmp Let-Go Current = 15 mAmp Microshock Risk = 100 micro-amps V Fib = 200 mAmp Signup and view all the answers

Mortality after liposuction procedures most commonly is the result of:

Pulmonary embolism Signup and view all the answers

Heart rate:

Decreases with increasing age Signup and view all the answers

Pulmonary effects of β2-adrenergic stimulation include: (Select 2)

Decreased bronchial secretions Signup and view all the answers

Nervous system changes seen in the pregnant patient at term include: (Select 2)

Increased sensitivity to local anesthetics Signup and view all the answers

Clinical signs of tension pneumothorax include:

Neck vein distention Signup and view all the answers

Portal hypertension leads to the development of portal-systemic venous collateral channels. These collateral sites commonly include the:

Hemorrhoidal veins Signup and view all the answers

As compared to hygroscopic heat-moisture exchangers, hydrophobic heat-moisture exchangers:

Are more effective filters of pathogens Signup and view all the answers

A nonselective α-antagonist used in the preoperative preparation of a patient with pheochromocytoma is:

Phenoxybenzamine Signup and view all the answers

The portion of the nephron responsible for concentration of urine via the countercurrent mechanism is the:

Loop of Henle Signup and view all the answers

Postoperative ulnar nerve injury:

Occurs more frequently in males Signup and view all the answers

In contrast to patients undergoing on-pump coronary artery bypass grafting (CABG), patients undergoing off-pump CABG:

Usually require relatively high mean arterial pressures during distal anastomoses grafting Signup and view all the answers

The single greatest cause of mortality in the patient with sickle cell disease is a result of:

Acute chest syndrome Signup and view all the answers

The line isolation monitor:

Monitors the integrity of the isolated power system Signup and view all the answers

Electrolyte containing irrigation solutions are avoided during transurethral resection of the prostate because they:

Interfere with the use of the cautery Signup and view all the answers

The use of nonionic gadolinium contrast media during MRI:

Is commonly associated with nausea Signup and view all the answers

The speed in an inhalation induction is slowed by right-to-left shunting. The change in the rate of induction is LEAST pronounced when using:

Isoflurane Signup and view all the answers

Study Notes

Propofol Formulation

Current propofol formulations include 0.005% disodium edentate or 0.025% sodium metabisulfite to inhibit bacterial growth.

Transtracheal Jet Ventilation

Sufficient gas flow during emergent transtracheal jet ventilation using a 14 gauge catheter requires a driving pressure of 50 psi.

Sensory Innervation of Airway

The recurrent laryngeal nerve, a branch of the vagus nerve, supplies sensory innervation to the trachea and larynx below the vocal cords.

Benzodiazepines and the Elderly

In the elderly, benzodiazepine volume of distribution increases, enhancing pharmacodynamic sensitivity, and increases the elimination half-lives of both diazepam and midazolam.

NIOSH Recommendations for Nitrous Oxide

NIOSH recommends limiting operating room nitrous oxide concentration to 25 ppm.

Succinylcholine Myalgia

Succinylcholine use is most likely to result in muscle pain in outpatients, with pregnancy and extremes of age showing protective effects.

Pancuronium Cardiovascular Effects

Pancuronium's cardiovascular effects arise from vagal blockade, ganglionic stimulation, and decreased catecholamine reuptake.

Multiple Sclerosis Anesthesia Considerations

Spinal anesthesia may exacerbate multiple sclerosis, while epidural and regional techniques are generally safe with lower anesthetic concentrations.

Methemoglobinemia in Local Anesthetics

Local anesthetics potentially forming methemoglobin include EMLA cream, prilocaine, and benzocaine.

Ulnar Nerve Injury Risk Factors

Ulnar nerve injury is more prevalent in males, high BMI patients, and can happen >48 hours postoperatively, associated with wrist drop.

Potency of Local Anesthetics

Potency of local anesthetics increases with lipid solubility, which is enhanced by a rise in carbon atoms or halogen addition to the molecule.

Cerebral Blood Flow and Anesthetics

Propofol decreases cerebral blood flow; inhalational agents like isoflurane and ketamine increase it.

Minimum Alveolar Concentration (MAC)

The highest MAC of desflurane is seen in infants aged 2-3 months, which decreases with age.

Atrial Fibrillation Effects

Acute atrial fibrillation results in a 15-25% loss of ventricular filling due to the absence of atrial contraction.

Sulfur Hexafluoride in Retina Surgery

Injection of sulfur hexafluoride gas into the posterior chamber during retina surgery can cause its pressure-volume to triple when N2O is present.

MAC during Pregnancy

The minimum alveolar concentration decreases throughout pregnancy, reducing by 40% at term.

Electroconvulsive Therapy (ECT) Effects

ECT causes an initial parasympathetic discharge followed by a sustained sympathetic response, leading to increased heart rate.

Postretrobulbar Block Apnea Syndrome

This syndrome is potentially caused by local anesthetic injection into the optic nerve sheath, leading to unconsciousness and apnea.

Electrocautery Use in Pacemaker Patients

To minimize electrocautery issues during procedures on patients with pacemakers, using a bipolar cautery is recommended.

Transfusion Reactions

The most severe transfusion reactions are attributed to ABO incompatibility, resulting in intravascular hemolysis.

Intracranial Hypertension Definition

Intracranial hypertension is defined as sustained ICP above 15 mm Hg.

Rapid Shallow Breathing Index (RSBI)

An RSBI of less than 100 is predictive of successful weaning from mechanical ventilation.

Allodynia

Allodynia refers to the perception of harmless stimuli as painful.

Cholinesterase Inhibitors

Physostigmine is the only cholinesterase inhibitor that can cross the blood-brain barrier due to its lipid solubility.

Congenital Diaphragmatic Hernias

90% of congenital diaphragmatic hernias occur through the left posterolateral foramen (Bochdalek).

Fetal Monitoring and Decelerations

Type III (variable) decelerations in fetal monitoring are primarily associated with umbilical cord compression.

Hypothyroidism in Anesthesia

Patients with hypothyroidism face intubation challenges due to potential anatomical changes like enlarged tongues or goiter.

Sickle Cell Disease Symptoms

Pain is the most frequent manifestation of sickle cell disease, caused by tissue ischemia.

Reactants in CO2 Absorption by Soda Lime

During CO2 absorption, sodium hydroxide is regenerated along with water.

Barbiturates and Ischemia

Barbiturates can redirect blood flow to ischemic areas of the brain, contributing to a reverse steal phenomenon.

Cerebral Blood Flow and Oxygen Tension

Brain blood flow significantly increases in response to hypoxemia and remains stable with hyperoxia.

Vecuronium Augmentation

The greatest augmentation of neuromuscular blockade with vecuronium occurs with desflurane as the inhalation agent.

Acrylic Bone Cement During Hip Surgery

Use of acrylic bone cement during hip replacement can lead to hypotension and hypoxemia due to cement absorption and embolization risks.

Amniotic Fluid Embolization Mortality

The maternal mortality rate associated with amniotic fluid embolism exceeds 50%.

ECT Contraindications

Increased intracranial pressure is an absolute contraindication for ECT; recent myocardial infarction is a significant relative contraindication.

Intraoperative Heat Loss Mechanisms

Radiation accounts for about 40% of intraoperative heat loss, followed closely by convection.### Card 37: Sinus Arrhythmia
Sinus arrhythmia is characterized by increased heart rate during inspiration and decreased during expiration.
It is a normal cardiac rhythm influenced by cyclic changes in vagal tone, primarily mediated through sympathetic innervation of the AV node.
Associated with ischemia of the SA node, and is a principal cause of premature atrial contractions.

Card 38: Local Anesthetic Blood Levels

The intercostal block is associated with the highest blood levels of local anesthetic per volume injected.
Blood concentration of local anesthetic depends on the total volume and concentration injected, with intercostal blocks showing significantly high levels.

Card 39: Tumescent Liposuction

Peak serum levels of local anesthetic typically occur 12 to 14 hours post-tumescent solution injection.
Tumescent solution contains normal saline, epinephrine, and lidocaine, with serum lidocaine levels declining over the following 6 to 14 hours.

Card 40: Enoxaparin Dosing

Enoxaparin should be held for 10 to 12 hours prior to spinal anesthesia due to the increased risk of spinal hematoma.
This recommendation aligns with guidelines from the American Society for Regional Anesthesia and Pain Medicine.

Card 41: Vaporizer Safety Features

Modern vaporizers utilize agent-specific keyed filling ports to prevent incorrect agent filling.
The pin index safety system is used for e-cylinders, while the diameter index safety system also enhances safety against errors.

Card 42: Amicus Curiae

An amicus curiae, or 'friend of the court,' is not a party in litigation and may provide expert testimony or file a brief to assist the court.

Card 43: First Nurse Anesthetist in Academia

Alice Maude Hunt was the first nurse anesthetist appointed to a university medical school faculty in 1922 at Yale University.
She is known for pioneering the use of nitrous oxide and oxygen anesthesia.

Card 44: Inhaled Agents

Inhaled agents ranked from highest to lowest vapor pressure: Nitrous Oxide, Desflurane, Isoflurane, Sevoflurane.

Card 45: Opiate Effects on Heart Rate

Reduction of heart rate due to opiate administration is mediated through mu receptors.

Card 46: Effects of 60-Hz Current

1 mAmp corresponds to perception threshold.
15 mAmp represents let-go current.
100 micro-amps indicate microshock risk.
200 mAmp can induce ventricular fibrillation.

Card 47: Liposuction Mortality Causes

The leading cause of mortality post-liposuction is pulmonary embolism, accounting for 23.1% of related deaths.

Card 48: Age and Heart Rate

Heart rate typically decreases with advancing age, reflecting intrinsic SA node function.
Enhanced vagal activity through M2 cholinergic receptors contributes to this decline.

Card 49: β2-Adrenergic Stimulation Effects

Stimulation of β2-adrenergic receptors leads to decreased bronchial secretions and bronchodilation.
Sympathetic system has minimal impact on pulmonary vascular tone.

Card 50: Nervous System Changes in Pregnancy

Pregnant women at term exhibit increased sensitivity to local anesthetics and decreased cerebrospinal fluid volume.
Other noted changes include increased epidural space potential volume and altered anesthetic spread.

Card 51: Clinical Signs of Tension Pneumothorax

Key signs include contralateral absence of breath sounds, hyperresonance, and neck vein distention indicates tension pneumothorax.

Card 52: Portal Hypertension Collateral Channels

Common collateral channels due to portal hypertension include hemorrhoidal veins, gastroesophageal veins, and periumbilical veins.

Card 53: Types of Heat-Moisture Exchangers

Hydrophobic HMEs are more effective in filtering pathogens compared to hygroscopic HMEs, which can retain more heat and moisture effectively.

Card 54: Pheochromocytoma Management

Phenoxybenzamine, a nonselective α-antagonist, is recommended for preoperative management of patients with pheochromocytoma.

Card 55: Nephron Function in Urine Concentration

The loop of Henle is critical for urine concentration via the countercurrent mechanism in the renal medullary interstitium.

Card 56: Ulnar Nerve Injury Risk

Postoperative ulnar nerve injury is more prevalent in males, with risk factors that also include high BMI and prolonged bed rest.

Card 57: Off-Pump CABG Characteristics

Off-pump CABG often necessitates higher mean arterial pressures during distal anastomoses, as opposed to standard CABG procedures.

Card 58: Sickle Cell Disease Mortality

Acute chest syndrome represents the most significant mortality risk for patients with sickle cell disease.

Card 59: Line Isolation Monitor Function

The line isolation monitor oversees the integrity of isolated power systems within medical environments, mitigating microshock risks.

Card 60: Irrigation Solutions in Prostate Surgery

Electrolyte-containing irrigation solutions are avoided during transurethral resection of the prostate as they can interfere with cautery.

Card 61: Gadolinium Contrast in MRI

Gadolinium contrast used in MRI is commonly associated with nausea but does not emit ionizing radiation nor has frequent allergic reactions.

Card 62: Inhalation Induction Factors

The rate of induction is least affected by isoflurane during right-to-left shunting due to its high blood/gas solubility.

Card 63: Isobaric Local Anesthetics

Bupivacaine 0.75% in normal saline and lidocaine 2% in normal saline are isobaric with cerebrospinal fluid.

Card 64: E-Cylinder Capacity

A fresh E-cylinder of oxygen holds about 660 liters of oxygen and is pressurized to approximately 1900 psi.

Card 65: Anesthetic Technique for Aortic Stenosis

An opioid-based general anesthesia technique is preferred for patients with mild to moderate aortic stenosis to minimize cardiac risks.

Card 66: Effects of Nitrous Oxide on Desflurane

Adding nitrous oxide to a desflurane mixture reduces the concentration of desflurane delivered due to increased gas viscosity.

Card 67: Neuromuscular Blockade Metabolites

Rocuronium is not associated with the formation of active metabolites, unlike vecuronium and pancuronium.

Card 68: HIV Exposure Risks

The seroconversion risk from mucous membrane exposure to HIV is approximately 0.09%, significantly lower than direct percutaneous exposure.

Card 69: Cholinesterase Activity Influencers

Decreased cholinesterase activity is linked to burns, while increased activity may be observed with obesity and alcoholism.### Hormones and the Neurohypophysis
Neurohypophysis refers to the posterior pituitary gland.
Key hormones include oxytocin and arginine vasopressin (vasopressin, ADH).
Hormones are synthesized in the hypothalamus and stored in the posterior pituitary.
Arginine vasopressin release is triggered by osmoreceptors detecting increased plasma osmolality.

Congenital Heart Diseases with Right-to-Left Shunting

Right-to-left shunting heart diseases are cyanotic and include:
- Tricuspid atresia
- Hypoplastic left heart syndrome
- Tetralogy of Fallot
In tricuspid atresia, blood flow from the right atrium is possible only through a patent foramen ovale (PFO).
A patent ductus arteriosus (PDA) or ventricular septal defect (VSD) is necessary for blood flow from the left ventricle to the pulmonary circulation.

Leakage Current Standards

Maximum allowable leakage current for operating room equipment is 10 μA.
This level is below the perception threshold and minimizes the risk of microshock.

Treatment for Hypoxemia during One-Lung Anesthesia

Most effective treatment is periodic inflation of the collapsed lung.
Other methods such as PEEP and oxygen insufflation may provide marginal improvements.

Sympathetic Blockade in Herpes Zoster

Effective in reducing the incidence of postherpetic neuralgia when applied within two months of onset.
Associated with decreased analgesic requirements.

Nitrous Oxide E-Cylinder Pressure after Usage

Expected pressure after 60 minutes of delivering a 3:2 nitrous oxide to oxygen mixture is 745 - 750 psig.
Nitrous oxide exists as a liquid at room temperature, and full cylinders contain about 1590 L at a pressure of 745 psig.

Metanephrine Formation

Formed through catechol-O-methyltransferase metabolism of epinephrine.
Metanephrine and normetanephrine are further metabolized by monoamine oxidase (MAO) to vanillymandelic acid (VMA).

Characteristics of HIV Neuropathy

Commonly features distal polyneuropathy and painful allodynia.
Occurs in 10% to 35% of seropositive patients, usually progressing from distal to proximal.

Lumbar Epidural Needle Pathway

Needle passes through the following structures to reach the epidural space:
- Supraspinous ligament
- Interspinous ligament
- Ligamentum flavum

Indications for Split Lung Function Testing

Indicated if a patient scheduled for pneumonectomy has a PaCO2 level of 49 mm Hg on room air.
Recommended criteria include FEV1 > 2 L and maximum VO2 > 15 mL/kg/min.

Postintubation Croup

Results from inflammation of subglottic structures, typically seen in early childhood.
More common with uncuffed endotracheal tubes and occurs within hours post-extubation.

Physiologic Effects in Scleroderma

Notable effects include pulmonary hypertension, esophageal dysmotility, and myocardial fibrosis.

Estimating Basal Metabolic Oxygen Consumption

In a 20-kg patient, basal metabolic oxygen consumption is approximately 95 mL/min.

Transtracheal Jet Ventilation Requirements

Requires a driving pressure of 50 psi using a 14 gauge catheter.

Acceptable Hypotension during Aneurysm Resection

Mean arterial pressure of 50 - 60 mm Hg is tolerable in healthy young individuals.

Absorption of Ophthalmic Medications

Topically applied medications are absorbed more quickly than through subcutaneous administration.

Activated Charcoal Contraindications

Bowel obstruction and bowel perforation are contraindications; however, having ingested the substance more than two hours ago is not a contraindication.

Acetaminophen Poisoning Facts

Acetaminophen accounts for around 90% of acute hepatic failure cases in the US.
Only 5% of acetaminophen is excreted in urine.

Changes in Minimum Alveolar Concentration (MAC) During Pregnancy

MAC decreases throughout pregnancy, by as much as 40% by term.

Central Venous Line Catheter Tip Location

Correct catheter tip placement is in the superior vena cava.

Treatments for Salicylate Poisoning

Sodium bicarbonate, hemodialysis, and activated charcoal are acceptable treatments.
Administration of a reversible COX-inhibitor should be avoided.

Physiological Response to Electroconvulsive Therapy (ECT)

Initial parasympathetic discharge followed by sustained sympathetic response occurs post-seizure induction.

Pacemaker Adjustment for Surgery

In patients with DDD-R pacemakers, it is advisable to discontinue the R function to avoid unwanted tachycardia caused by surgical stimuli.

Expected Hemodynamic Response Post-Phenylephrine During Heart Transplantation

Expected outcome is an increase in blood pressure with no change in heart rate due to denervation of the heart.

Arteria Radicularis Magna Origin

Commonly arises from T8 to L2 and supplies blood to the anterior spinal artery.

Treatment for Torsades de Pointe

Amiodarone should be avoided in treating arrhythmia in patients with congenital long QT syndrome due to its effect of prolonging the QT interval.

Right Coronary Artery Occlusion Symptoms

Symptoms indicating RCA occlusion include nausea, diaphoresis, bradycardia, and echocardiogram findings of right ventricular ischemia.

Monitoring in Tricyclic Antidepressant (TCA) Poisoning

Electrocardiogram monitoring is crucial due to potential life-threatening cardiac effects.

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Description

Test your knowledge on the core concepts of anesthesia with this quiz. Questions cover drug formulations, including propofol and various additives, as well as their purposes in clinical practice. It's an essential tool for students and professionals in the field of anesthesia.