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Colombian Journal of Anestesiology
Print version ISSN 0120-3347
Rev. colomb. anestesiol. vol.43 no.1 Bogotá Jan./Mar. 2015
Questions and answers
Preguntas y respuestas
Fernando Raffán Sanabria (MD)a,b
a Anesthesiologist and Intensivist, University Hospital Fundación Santa Fe de Bogotá, Colombia
b Professor, Universidad el Bosque and Universidad de los Andes, Bogotá, Colombia
This section includes questions prepared on the basis of the contents of the articles published in volume 42, number 4 of the Colombian Journal of Anesthesiology. Accept this challenge to test your reading comprehension and knowledge.
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With regard to the low fresh gas flow anesthetic technique, is it true that:
- Flows between 0.8 and 1.5 L/min are used.
- It is not recommended for procedures with sevofluo-rane lasting more than 3h.
- Is contraindicated in patients with severe hemolysis or massive transfusion.
- There are sevofluorane TCI devices that have shown that the time to achieve the target concentration is significantly longer than with 2 L/min flows.
ANSWER C
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According to the meta-analysis by González Cárdenas VH et al., when comparing remiphentanyl (R) against epidural anesthesia (EA) for pain management during labor, all of the following statements are true, except for:
- The correlation between the administration of (R) and good patient satisfaction is equivalent to the administration of (EA) and good satisfaction.
- The incidence of instrumented delivery is similar in both groups.
- The incidence of cesarean section is similar for both groups
- The probability of complications is significantly higher with (R) than with (EA).
ANSWER D
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In terms of airway management, the following statements are true:
- Around 60% or mayor complications occur during extubation or in the recovery room.
- Abnormal ventilation weaning rates are good predictors of extubation failure.
- There is evidence favoring the use of steroids 4 h prior to extubation in patients with suspicious upper airway edema.
- Difficult mask ventilation does not in itself predispose to a higher risk of difficult intubation.
ANSWER C
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Which of the following statements about leakage tests prior to extubation of a patient is true:
- A tidal volume difference with the inflated vs. the deflated cuff of at least 40% is the cut point suggesting a low probability of laryngeal edema.
- The cut point is a difference of >80 cc in adult patients, suggestive of a low probability of laryngeal edema.
- The leakage test has a high predictive value for post-extubation laryngeal stridor and the need to rein-tubate.
- In the absence of a leak or with leaks less than 110 cc, consider placing an exchanger for controlled and assisted extubation.
ANSWER D
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Which of the following statements is false regarding the use of thromboelastography (TEG)?:
- The enoxaparine activity may be evaluated with TEG.
- Patients receiving Isofluorane during anesthesia have a higher hypercoagulability index than those receiving TIVA anesthesia with propofol.
- TEG has been used to guide the administration of fibrinogen in postpartum hemorrhage.
- TEG allows for the detection of hypothermia-related coagulation disorders.
ANSWER B
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In young adults, the apparent strong ion difference is:
- A) 40-42 mEq/L
- 27-40 mEq/L
- 12-24mEq/L
- 8-12mEq/L
ANSWER A
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Lower glycemic levels and glycogen stores due to fasting result in all of the following, except for:
- Increased insulin secretion.
- Increased lipolysis.
- Fattyacids areoxidized inthe liverand produceketone bodies.
- Ketone bodies are converted into acetyl coenzyme A.
ANSWER A
-
Which of the following conditions relates to therapeutic hypothermia?
- Hypercalcemia
- Hypomagnesemia
- Hyperphosphatemia
- Hypoglycemia
ANSWER B
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With regard to the peripheral mechanisms associated to the onset of the complex regional pain syndrome, all of the following are true, except for:
- Axonal hypoxia.
- Vasoconstriction.
- Increased Endothelin-1 production.
- Decreased interleukines-6 (IL-6).
ANSWER D
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The estimated incidence of difficult intubation in preschool age children is of approximately:
- 0.1%
- 1%
- 3%
- 7%
ANSWER A
Reference
Raffan F. Questions and answers, Rev Colomb Anestesiol 2014;42:October-December (4). [ Links ]