Chapter 5 Review Questions
			
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