OB
To ensure adequate surgical anesthesia for a cesarean delivery performed under spinal anesthesia, sensory blockade must reach which dermatomal level?
T4
Narrowest part of pediatric airway
cricoid cartilage
A 100 kg patient has successfully separated from cardiopulmonary bypass following cardiac surgery. The surgical team requests reversal of systemic anticoagulation. The patient received a total of 30,000 units of heparin during bypass.
How much protamine should be administered to reverse the heparin effect?
300 mg
A 1:200,000 mixture of epi corresponds with what concentration in mcg/mL
5 mcg/mL
Max FiO2 that can be delivered by a nasal cannula
0.45
A patient at 36 weeks’ gestation presents with new-onset hypertension. Blood pressure is 156/98 mm Hg. Urinalysis shows 2+ protein, and platelet count and liver enzymes are normal.
Which of the following is the most likely diagnosis?
Preeclampsia
Level of larynx in peds
C3/C4
A patient presents with hypotension, jugular venous distention, and muffled heart sounds. Bedside ultrasound suggests cardiac tamponade. What ECG findings is most commonly associated with cardiac tamponade?
Electrical alternans
Primary determinant of LA potency
lipid solubility
SSEP waveform changes most consistent with spinal cord ischemia (amplitude and latency)
decreased amplitude and increased latency
34-year-old patient at 39 weeks gestation presents for an elective cesarean delivery. During the preoperative assessment, the certified anesthesiologist assistant reviews the following laboratory values:
Which of the following laboratory findings is abnormal in a term pregnant patient?
INR
What percentage of a term newborn’s total body weight consists of water?
75%
When preparing for a bilateral orthopedic knee surgery, you have been battling hypotension since induction, treating with small phenylephrine boluses. The operating room assistant raises both legs for site prep. Suddenly your hypotension issues have resolved.
What is indicated by this pressure change?
Hypovolemia
You have already given Oxytocin which was ineffective. What med would you additionally give to an asthmatic woman to increase uterine tone?
Methergine
During a strabismus repair on a 10-year-old patient, your attending reminds you to have medication immediately available to treat the oculocardiac reflex that may occur with traction on the extraocular muscles.
Which class of drug should be readily available?
Muscarinic antagonist
A pregnant patient with a history of Eisenmenger syndrome presents for cesarean delivery. What complication is this patient at highest risk for during the peripartum period?
Right heart failure
APGAR stands for
Appearance, Pulse, Grimace, Activity, Respiration
A patient with critical aortic stenosis is undergoing induction for aortic valve replacement. Immediately after induction, the patient becomes hypotensive.What physiologic changes is most poorly tolerated in severe aortic stenosis?
Decreased systemic vascular resistance
What drug can cause resistance (decreased block) to NDMRs?
Phenytoin
You are called to the ICU to assist with airway management for a 3-year-old child with a high fever, inspiratory stridor, tachypnea, and marked sternal retractions. The patient is sitting upright, leaning forward, drooling, and appears anxious.
Which of the following is the most likely cause of this presentation?
Epiglottitis
A 32-year-old patient undergoes emergency cesarean delivery for placental abruption under general anesthesia. Near the end of the case, the patient suddenly develops profound hypotension, severe hypoxemia, and markedly increased peak inspiratory pressures. The surgeon reports diffuse oozing from the surgical field.
Which of the following is the most likely cause of this acute deterioration?
Amniotic Fluid Embolism
A 3-year-old child weighing 17 kg presents with hemorrhage and a hemoglobin of 6.3 g/dL. You would like to raise the hemoglobin to 8.3 g/dL using packed red blood cells.
Approximately how much packed red blood cells should be administered?
170 mL
In pediatrics, 10 mL/kg of packed RBCs raises hemoglobin by approximately 2 g/dL.
Hemoglobin increase needed:
8.3 − 6.3 = 2 g/dL
Required transfusion:
10 mL/kg × 17 kg = 170 mL
A 64-year-old patient with severe chronic mitral regurgitation is undergoing general anesthesia for elective abdominal surgery. Shortly after induction, the blood pressure decreases to 85/50 mmHg and the heart rate is 58 bpm. TEE confirms severe MR with no other acute pathology. What medication would most likely worsen the degree of mitral regurgitation?
Administration of phenylephrine
An increased risk for local anesthetic toxicity during administration of amide local anesthetic is most commonly seen in which of the following patients?
Cirrhosis
An 11-year-old patient (weight 40 kg) presents for revision posterior spinal fusion for scoliosis. Significant blood loss is anticipated. The surgical team requests that red blood cell transfusion be initiated if the hematocrit decreases below 24%. The current hematocrit is 30%.
What is the allowable blood loss for this case before transfusion is indicated?
560 mL
Allowable blood loss (ABL) is calculated as: estimated blood volume (EBV) × (starting hematocrit − lowest acceptable hematocrit) ÷ starting hematocrit. Standard EBV values by age group are approximately:
Using an EBV of 70 mL/kg for this 11-year-old child gives a total blood volume of 2,800 mL, and an ABL of 2,800 × (30 − 24) ÷ 30 = 560 mL.