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Chapter 5 Quiz

1) All BUT ONE of the following are true regarding malignant hyperthermia (MH). Indicate the exception:

  • a) Newer volatile anesthetics such as desflurane are not believed to trigger MH.
  • b) Nitrous oxide is safe. 
  • c) Dantrolene is the only therapeutic drug treatment.
  • d) Mortality is as high as 10% even with prompt treatment.

2) Which of the following is the first sign of a malignant hyperthemic reaction?

  • a) Hyperthermia
  • b) Hypercarbia
  • c) Tachycardia
  • d) Ventricular arrhythmias

3) Treatment of a malignant hyperthermia crisis includes ALL BUT ONE of the following. Indicate the exception:

  • a) Turning off the volatile anesthetic
  • b) Active cooling measures
  • c) Dantrolene
  • d) Beta blockers

4) Maternal hypotension in the supine position during pregnancy is most often due to:

  • a) Decreased blood volume
  • b) Decreased peripheral vascular resistance
  • c) Decreased hematocrit
  • d) Compression of the vena cava

5) ALL BUT ONE of the following represent relevant physiologic changes of pregnancy in the 40 week gestation parturient. Indicate the exception:

  • a) Decreased cardiac output
  • b) Delayed gastric emptying
  • c) Increased blood volume
  • d) Decreased anesthetic requirements

6) In the obstetrical patient in her third trimester, the supine position:

  • a) Should be avoided by placing a pillow under her knees.
  • b) Is detrimental due to the risk of causing excessive venous return to the right heart. 
  • c) Is harmful to the mother, but is harmless to the fetus
  • d) Is safe at 20 weeks of pregnancy.

7) ALL BUT ONE of the following are part of rational fasting guidelines for pediatric patients. Indicate the exception:

  • a) Solids up to 8 hours pre-op
  • b) Clear fluids up to 3 hours pre-op
  • c) Breast milk up to 4 hours pre-op
  • d) Formula up to 2 hours pre-op

8) The narrowest portion of the neonate’s airway is at the level of the:

  • a) Glottis
  • b) Cricoid
  • c) Trachea
  • d) Pharynx

9) The appropriate size endotracheal tube for a 4 year old child is:

  • a) 4.0
  • b) 4.5
  • c) 5.0
  • d) 6.0

10) ALL BUT ONE of the following represents attributes of the pediatric cardiovascular system. Indicate the exception:

  • a) Cardiac output is heart-rate dependent.
  • b) Hypoxemia is an important cause of bradycardia.
  • c) Blood volume is greater, relative to size.
  • d)Vagal responsiveness is under-developed.

11) Which ONE of the following is an explanation for rapid desaturation during apnea that is seen in the pediatric patient?

  • a) Increased functional residual capacity (FRC)
  • b) Increased oxygen consumption
  • c) Increased minute ventilation
  • d) Obligate nasal breathing

12) ALL BUT ONE are features of the pediatric airway compared to the adult. Indicate the exception:

  • a) Larynx situated higher
  • b) Larynx situated more anteriorly
  • c) Epiglottis shorter and less mobile
  • d) Narrowest part of the airway at the cricoid

13) The use of epidural analgesia for labour is likely to result in which ONE of the following:

  • a) Prolonged second stage
  • b) Increased risk of operative delivery
  • c) Neonatal depression
  • d) Maternal sedation

14) ALL BUT ONE of the following is a disadvantage of general anesthesia for Caesarian section. Indicate the exception:

  • a) Increased risk of aspiration in the pregnant patient
  • b) Increased anesthetic requirements
  • c) Exacerbation of uterine atony
  • d) Increased risk of awareness under anesthesia

15) Which ONE of the following is an accurate statement regarding the use of spinal anesthesia for Caesarian section?

  • a) Quick and easy in the setting of emergency Caesarian section
  • b) Associated with decreased maternal morbidity
  • c) Associated with increased neonatal depression
  • d) Presents less of a risk of maternal hypotension compared with general anesthesia

Answers: 1a, 2c, 3d, 4d, 5a, 6d, 7d, 8b, 9c, 10d, 11b,12c, 13a, 14b, 15b