http://dx.doi.org/10.1016/j.rcae.2012.12.003

Questions and answers

Preguntas y respuestas

Fernando Raffán Sanabria<sup>ab,

a</sup> Professor, Universidad el Bosque and Universidad de los Andes, Bogotá, Colombia
^b Anesthesiologist and Intensivist, University Hospital Fundación Santa Fe de Bogotá

Corresponding author. Calle 119 # 7 - 75, Bogotá, Colombia. E-mail address: raffanmago@gmail.com

This section includes questions prepared on the basis of the contents of the articles published involume 40, number 4 of the Colombian Journal of Anesthesiology. Accept the challenge to test your reading comprehension and knowledge.

Instructions

This is amultiple-choice questionnaire. Please mark the appropria teanswer.

• 1. Risk factors associated to complications of radial artery cannulation include the following, except:

  • A. Prolonged time with an arterial line in place (over 72hours)

  • B. Catheter material

  • C. Use of vasoactive drugs

  • D. Female gender

• 2. In terms of catheterization of the radial artery, which of the following statements is true?

  • A. The puncture method (direct or transfixing) has not been associated to an increased risk of thrombosis

  • B. Arterial catheters inserted with the seldinger technique have shown a significant reduction in the incidence of ischemic complications when compared against the direct puncture technique, without using a guide

  • C. The cutting point that increases the risk of complications is being over 70 years old

  • D. Allen's test performed before the puncture is a good predictor of ischemia in the absence of vascular disease

• 3. Studies in patients undergoing myocardial revascularization have shown an increased development of hyperplasia, calcification and atheromatosis of the radial artery in patients with:

  • A. More than 50 years of age

  • B. Hypothyroidism

  • C. Alcoholism

  • D. Female gender

• 4. When considering the lesion from red cell storage, which of the following distractors is false:

  • A. Those stored for less than 14 days are called young

  • B. When units stored longer than 14 days are administered, mortality increases if the units are not leukoreduced

  • C. Trauma patients receiving units stored for over 2 weeks stay longer with mechanical ventilation in the ICU and exhibit a higher frequency of septic episodes

  • D. The storage lesion is associated with a decrease in 2-3 diphosphoglycerate and a significant increase in antioxidant release after the second week of storage

• 5. Fetal surgery is a rapidly progressing medical area; with regards to the development of pain pathways in the fetus, the following statement is false:

  • A. Peripheral pain receptors start developing during the seventh week of gestation

  • B. During the eighth week of gestation, the afferent fibers that communicate the peripheral receptors with the gelatinous substance start developing

  • C. The hypothalamic - pituitary adrenal cortex system becomes functional as of the the beginning of the third trimester

  • D. The serotonin - mediated descending inhibitory system of pain only develops after birth

• 6. In terms of intraoperative management during fetal surgery, fluid management has to be rational since the amount of fluid associated with pulmonary edema is above:

  • A. 500 cc

  • B. 1000 cc

  • C. 1500 cc

  • D. 2000 cc

• 7. With regards to the management of anesthesia for emergency cesarean section, a systematic literature review by Fuentes JB, Pinzón CE, Vasco M, report the following, except:

  • A. In a patient with epidural catheter for labor requiring extended anesthesia for cesarean section, the drug of choice is 2% lidocaine

  • B. Adding adrenalin to lidocaine decreases the latency of the local anesthetic agent

  • C. The use of bicarbonate as an adjuvant to 2% lidocaine decreases the latency and improves the quality of the block

  • D. The type of anesthesia delivered to the mother does not affect the long-term neonatal outcomes

• 8. Of the following definitions, which is inconsistent with the term massive transfusion

  • A. The need to transfuse more than 10 units in 24hours

  • B. The need to transfuse more than 4 units in one hour

  • C. Replacing more than 50% of the blood volume in 3hours

  • D. Using 5 units of red blood cells in 4hours

• 9. Referring to neuromuscular monitoring using blockers, which of the following statements is false

  • A. The recovery phase is defined as the start of the fourth response of the train of four and the establishment of the train of four ratio (T4/T1)

  • B. A simple stimulus is defined as the administration of supramaximum stimuli at a frequency ranging between 1 - 0.1Hz

  • C. The normalization of a train of four ratio of 0.8 against the baseline is considered to ensure adequate recovery of the neuromuscular block

  • D. Post-tetanic count is a useful tool for assessing deep blockade

• 10. The following echocardiographic parameters assess the right ventricular systolic function, except:

  • A. Displacement of the tricuspid ring

  • B. Change in the fractional area

  • C. Right Tei-index

  • D. Right Ventricular Systolic Work Index

Raffán F. Preguntas y respuestas. Rev. colomb. anestesiol. 2012:40(4).

Answers:

• 1. A

• 2. A

• 3. A

• 4. B

• 5. C

• 6. B

• 7. C

• 8. D

• 9. C

• 10. D