34116202
Descripción
Test por Mallory Christ, actualizado hace más de 1 año
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Creado por Mallory Christ
hace alrededor de 3 años
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Pregunta 1
Pregunta
Which of the following systemic changes does diabetes cause?
Respuesta
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Delayed gastric emptying
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Altered airway anatomy
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Autonomic changes (such as decreased HR variability)
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Increased risk of wound infection
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Increased risk of nerve injury
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Development of hypothyroidism
Pregunta 2
Pregunta
Insulin therapy is 1 of the 6 predicators for a major adverse cardiac event (MACE) on the RCRI scale
Respuesta
- True
- False
Pregunta 3
Pregunta
Diabetic patients should take their prescribed sulfonyurea on the morning of surgery
Respuesta
- True
- False
Pregunta 4
Pregunta
When should an diabetic patient hold their prescribed metformin preoperatively?
Respuesta
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If they are completing a bowel prep before surgery
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If they have renal impairment
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If the fasting period is brief
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Both A & B
Pregunta 5
Pregunta
Preoperatively, diabetic patients should take their long acting insulin and hold their short acting insulin
Respuesta
- True
- False
Pregunta 6
Pregunta
Which of the following is important consideration for patients with hyperthyroidism who report dysphagia and dyspnea when lying flat?
Respuesta
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Ensure patient takes morning dose of thyroxine on the morning of surgery
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Be prepared to administer glucocorticoids intraoperatively
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Have a dose of magnesium drawn up in case the patient goes into Torsades
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Do NOT administer a paralytic to these patients
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All of the above
Pregunta 7
Pregunta
Your patient has Hashimoto thyroiditis. During your preop assessment, you notice they are bradycardic. What should you do?
Respuesta
-
Obtain labs (TSH & T4 levels) and proceed with surgery if they are normal
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Order a transesophogeal echocardiogram (TEE)
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Reschedule the surgery and refer them to their endocrinologist
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Proceed with surgery as this is a normal finding of Hashimotos
Pregunta 8
Pregunta
If your preoperative patient took glucocorticoids within the last _________, you should complete a thorough assessment (what steroid they took, for how long, if they tapered, etc) due to concern for development of adrenal insufficiency
Respuesta
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2 weeks
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1 month
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3 months
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1 year
Pregunta 9
Pregunta
20 mg prednisone per day is considered high dose glucocorticoids
Respuesta
- True
- False
Pregunta 10
Pregunta
Your patient has adrenal insufficiency and develops severe hypotension immediately after induction. What should you do?
Respuesta
-
Administer stress dose steroids
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Administer fluid boluses
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Start vasopressors immediately
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There is not a need to do anything as the hypotension will likely self resolve within minutes
Pregunta 11
Pregunta
What are symptoms of adrenal insufficiency?
Respuesta
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Fatigue
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Myalgias & arthralgias
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Nausea/vomiting & loss of appetite
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CNS stimulation & anxiety
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Weight gain
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Development of goiter
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Hypotension refractory to vasopressor therapy & fluid
Pregunta 12
Pregunta
In a patient with acromegaly, what assessment finding would indicate compression of the left recurrent laryngeal nerve?
Respuesta
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Severe hypertension
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Presence of a "buffalo hump"
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Voice hoarseness and stridor
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Narrowing of the subglottic opening
Pregunta 13
Pregunta
If a patient has a carcinoid tumor and develops carcinoid syndrome, what are their symptoms and where does the tumor drain?
Respuesta
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Symptoms are flushing, diarrhea, tachycardia, and bronchospasm. The tumor drains into portal circulation
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Symptoms are flushing, diarrhea, tachycardia, and bronchospasm. The tumor does NOT drain into portal circulation
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Symptoms are cold intolerance, constipation, and bradycardia. The tumor drains into portal circulation
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Symptoms are cold intolerance, constipation, and bradycardia. The tumor does NOT drain into portal circulation
Pregunta 14
Pregunta
What are the three symptoms of a pheochromocytoma?
Respuesta
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Headache
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Hypoglycemia
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Presence of a goiter
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Diaphoresis
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Bradycardia
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Tachycardia
Pregunta 15
Pregunta
Which of the following is an appropriate consideration for a patient with a pheochromocytoma?
Respuesta
-
Prepare to discharge patient home several hours after surgery
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Ensure patient is appropriately alpha blocked (with phenoxybenzamine) prior to operating
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Instruct patient to hold morning meds the day of surgery
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Continue octreotide drip throughout entire surgery
Pregunta 16
Pregunta
Your patient is confused, lethargic, and is having seizures. They are euvolemic and do not appear fluid overloaded, but their urine is concentrated. What do you suspect?
Respuesta
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Hyponatremia due to SIADH
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Hyponatremia due to diabetes insipidus
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Pheochromocytoma
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Adrenal insufficiency
Pregunta 17
Pregunta
At what rate should you correct hyponatremia?
Respuesta
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0.5 mEq/L/hr
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1 mEq/L/hr
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5 mEq/L/hr
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As quickly as possible to avoid neurologic injury
Pregunta 18
Pregunta
Hypoparathyroidism is the most common cause of hypercalcemia
Respuesta
- True
- False
Pregunta 19
Pregunta
Intraoperatively, your patient's labs come back showing a calcium of 3.5 mg/dL. Which is the most important consideration?
Respuesta
-
You will monitor the ECG closely for ST segment changes, T wave abnormalities, or a shortened QT interval
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You will aggressively treat the hypertension that is likely to ensue
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You will correct the calcium slowly to prevent neurological damage
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You will not plan on extubating this patient due to risk of laryngospasm
Pregunta 20
Pregunta
Your patient has a BMI of 37. What is their BMI classification?
Respuesta
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Normal
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Overweight
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Obese
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Severely obese
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Morbidly obese
Pregunta 21
Pregunta
What is the single biggest indicator of a difficult airway?
Respuesta
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BMI over 40
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Male gender
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Presence of metabolic syndrome
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Large neck circumference
Pregunta 22
Pregunta
For which condition would you want your patient on an octreotide drip going into surgery?
Respuesta
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Acromegaly
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Carcinoid tumor
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Pheochromocytoma
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Adrenal insufficiency
Pregunta 23
Pregunta
Your patient has a(n) __________ diagnosis. Prior to surgery, you must ensure they have a recent echocardiogram (within one year) to evaluate their ejection fraction due to risk of left ventricular hypertrophy.
Respuesta
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Pheochromocytoma
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Adrenal insufficiency
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Acromegaly
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Cushing Syndrome
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