Welcome to your Test 11 Which of the following best describes the mechanism of action of propofol? GABA receptor agonist NMDA receptor antagonist Dopamine receptor antagonist Alpha-2 adrenergic receptor agonist None Which of the following is the most appropriate initial management for a patient who develops malignant hyperthermia during surgery? Administer dantrolene sodium Administer dantrolene sodium Increase oxygen flow Start cooling measures with ice baths None Which of the following local anesthetics has the longest duration of action? Lidocaine Bupivacaine Mepivacaine Prilocaine None In a patient with increased intracranial pressure (ICP), which anesthetic agent is most appropriate for induction? Ketamine Propofol Nitrous oxide Etomidate None Which of the following is the most common cause of perioperative anaphylaxis in the anaesthesia setting? Latex Antibiotics Muscle relaxants Local anesthetics None What is the major mechanism of action of midazolam as an anxiolytic and sedative in anaesthesia? GABA receptor potentiation Inhibition of serotonin reuptake Dopamine receptor blockade NMDA receptor antagonism None Which of the following is the most appropriate statement regarding the use of succinylcholine in patients with neuromuscular disorders? Succinylcholine should be avoided in patients with myasthenia gravis. Succinylcholine is safe for patients with Guillain-Barré syndrome. Succinylcholine can be used safely in patients with muscular dystrophy. Succinylcholine should be avoided in patients with myopathies, including None During the administration of general anesthesia, what is the primary effect of nitrous oxide on the cardiovascular system? Increased heart rate Increased blood pressure Decreased heart rate Decreased blood pressure None Which monitoring modality is considered the gold standard for confirming correct endotracheal tube placement during intubation? Capnography Pulse oximetry Auscultation Chest X-ray None Which of the following statements regarding the pharmacokinetics of local anesthetics is correct? The onset of action is faster for amides than esters. Esters have a longer half-life than amides. The metabolism of esters primarily occurs in the liver. Amides are more likely to cause allergic reactions than esters. None Which of the following is a potential side effect of high doses of opioids used in the perioperative setting? Hyperthermia Respiratory depression Hypertension Tachycardia None Which of the following statements is true regarding the use of nitroglycerin during anesthesia? Nitroglycerin increases myocardial oxygen demand. ) Nitroglycerin can cause profound hypotension, especially in hypovolemic patients. Nitroglycerin is contraindicated in patients with coronary artery disease. Nitroglycerin is primarily a venous vasoconstrictor. None Which of the following is the most common cause of postoperative hypoxemia in a patient who has undergone general anesthesia? Aspiration of gastric contents Pulmonary embolism Atelectasis Laryngospasm None Which of the following is the mechanism of action of desflurane? Inhibition of NMDA receptors Enhancement of GABA activity Inhibition of serotonin reuptake Enhancement of acetylcholine release None Which of the following is an adverse effect commonly associated with the use of etomidate for induction of anesthesia? Hypertension Myoclonus Hyperkalemia Respiratory depression None Which of the following is the most appropriate method for preventing postdural puncture headache (PDPH)? Administering a higher dose of epidural analgesia Avoiding the use of local anesthetics for spinal anesthesia Using a smaller gauge spinal needle Administering intravenous fluids immediately post-procedure None Which of the following conditions increases the risk of perioperative awareness during general anesthesia? Use of a high dose of opioids Use of volatile anesthetics only Use of muscle relaxants without adequate anesthetic depth Increased age of the patient None What is the primary reason for the use of vasopressors in patients under general anesthesia? To increase the myocardial oxygen demand To reverse the effects of opioid overdose To maintain adequate blood pressure and perfusion during anesthesia To prevent intraoperative bleeding None Which of the following is the most common complication associated with the placement of a central venous catheter (CVC)? Arterial puncture Pneumothorax Infection Air embolism None Which of the following factors would most likely result in an increased risk of local anesthetic toxicity? Rapid injection of large doses into a highly vascular area Use of a small volume of anesthetic with a high concentration Injection into a low vascularity area Use of an anesthetic with a low lipid solubility None A 65-year-old male with a history of hypertension and coronary artery disease is scheduled for an elective cholecystectomy. He has been on beta-blockers for the last 5 years. His vital signs show a blood pressure of 140/85 mmHg and a heart rate of 70 bpm. Which of the following is the most appropriate action regarding his beta-blocker therapy on the morning of surgery? Continue the beta-blocker as scheduled Discontinue the beta-blocker 24 hours prior to surgery Increase the dose of beta-blocker on the morning of surgery Give only half of the beta-blocker dose on the morning of surgery None A 30-year-old female with no significant medical history presents for an elective surgery under general anesthesia. After the induction, she is intubated with a size 7.0 endotracheal tube. Her vital signs are stable, and the surgical procedure begins. During the surgery, you notice the patient’s end-tidal CO2 suddenly drops to zero. What is the most likely cause of this sudden change? Malposition of the endotracheal tube Pulmonary embolism Hypoventilation Equipment malfunction None Which of the following anesthetic agents can cause severe arrhythmias, especially in patients with a history of heart disease? Propofol Isoflurane Halothane Ketamine None A 50-year-old male with a BMI of 40 presents for laparoscopic surgery. He is intubated under general anesthesia, and the surgery proceeds without complication. However, during recovery, the patient is noted to have oxygen desaturation despite adequate ventilation. What is the most likely cause of this postoperative hypoxemia? Atelectasis Aspiration pneumonia Pulmonary embolism Obesity hypoventilation syndrome None Which of the following is the most important factor to consider when selecting an anesthetic agent for a patient with severe asthma? The ability to cause bronchodilation The onset time of the drug The degree of cardiovascular depression caused The potential for respiratory depression None A 75-year-old female is undergoing a total hip replacement under general anesthesia. During the surgery, you notice that her blood pressure drops significantly despite adequate fluid resuscitation and the administration of phenylephrine. The anesthesiologist suspects autonomic dysfunction due to her age and comorbidities. What is the most likely underlying cause of the hypotension in this patient? Inadequate depth of anesthesia Cardiovascular decompensation Vasodilation due to anesthesia Adrenal insufficiency None Which of the following is the most appropriate management for a 45-year-old male who experiences severe bradycardia (heart rate 40 bpm) during the induction of anesthesia with propofol and succinylcholine? Administer atropine Administer epinephrine Give an additional dose of propofol Administer dopamine None A 60-year-old male with a history of diabetes mellitus presents for elective surgery. His blood glucose level is measured at 180 mg/dL on the day of surgery. He is taking insulin regularly. Which of the following is the best management strategy for his blood glucose on the day of surgery? Hold all insulin and provide glucose supplementation during surgery Administer a reduced dose of insulin and monitor glucose levels intraoperatively Give the usual dose of insulin and monitor glucose levels Administer intravenous insulin to keep glucose levels tightly controlled during surgery None Which of the following is the most appropriate action when a patient develops severe hypotension following the administration of spinal anesthesia? Administer fluids and consider vasopressors Increase the head of the bed Administer 100% oxygen and monitor Reposition the patient to a Trendelenburg position None A 60-year-old female is undergoing a laparotomy under general anesthesia. After induction with propofol and fentanyl, she develops a rash, facial swelling, and difficulty breathing. What is the most likely cause of this reaction? Anaphylaxis to propofol Anaphylaxis to fentanyl Allergic reaction to latex Anaphylaxis to muscle relaxants None A 45-year-old male with a history of well-controlled asthma presents for a routine elective surgery under general anesthesia. He is instructed to fast for 8 hours prior to the procedure. Upon arrival in the preoperative area, he mentions that he has not fasted for the required period. What is the best course of action in this situation? Delay the surgery and reschedule Proceed with surgery but adjust the anesthetic plan to minimize aspiration risk Provide additional sedation and delay the surgery for 2 hours Administer preoperative antiemetics and continue with the procedure None Which of the following is the best definition of "informed consent" in the context of anesthesia? The patient understands the risks of anesthesia and agrees to proceed without asking questions The anesthesiologist provides the patient with a full explanation of the risks, benefits, and alternatives and the patient voluntarily agrees to the plan The patient signs a document stating they are aware that anesthesia is a necessary part of surgery The patient acknowledges the anesthesiologist’s decision about the anesthesia plan without further discussion None Which of the following is an example of a Type I error in statistical analysis? Concluding that there is a significant difference between two treatment groups when no difference exists Concluding that there is no significant difference between two treatment groups when a difference exists Incorrectly assuming the sample size is too small for meaningful analysis Using a biased sample that does not represent the target population None In a situation where a patient who is unable to consent for themselves (e.g., due to being under general anesthesia) requires urgent treatment, what ethical principle justifies proceeding with treatment? Justice Autonomy Beneficence Non-maleficence None A 72-year-old female with a history of chronic kidney disease (stage 3) is scheduled for elective knee replacement surgery. Preoperative labs show a creatinine level of 2.2 mg/dL. What is the most important consideration for anesthesia management in this patient? Use of a volatile anesthetic with a low minimum alveolar concentration (MAC) Minimize the use of nephrotoxic drugs such as NSAIDs and contrast agents Use of regional anesthesia to avoid potential nephrotoxicity from general anesthetics Increased monitoring for hyperkalemia due to decreased renal clearance None Which of the following types of statistical tests would be most appropriate to compare the means of two independent groups in an anesthesiology research study? Paired t-test Chi-square test Unpaired t-test ANOVA None A 30-year-old female who is 24 weeks pregnant is scheduled for an emergency appendectomy under general anesthesia. After the procedure, she experiences severe nausea and vomiting. Which of the following anesthetic agents should be avoided to reduce the risk of aspiration and nausea in this patient? Sevoflurane Nitrous oxide Fentanyl Propofol None A 60-year-old male with metastatic cancer requires urgent surgery to correct a bowel obstruction. His prognosis is poor, and his family is insistent on proceeding with surgery. However, the patient has expressed his wish to not undergo further aggressive treatment. What should be the anesthesiologist's approach in this situation? Follow the family’s wishes and proceed with surgery Honor the patient's advance directive and not proceed with surgery Proceed with surgery and then discuss the patient's wishes afterward Refuse to proceed with surgery and refer the case to ethics committee None Which of the following is an example of a Type II error in statistical analysis? Concluding that a treatment has no effect when it actually does Concluding that a treatment is effective when it is not Overestimating the sample size needed for the study Conducting a test on a biased sample None A 55-year-old male undergoing an elective cardiac surgery is given a spinal anesthetic. He develops hypotension following the spinal block. What is the most appropriate first step in managing this hypotension? Administer phenylephrine Place the patient in the Trendelenburg position Increase the spinal anesthetic dose Administer intravenous fluids None A 70-year-old male with a history of chronic obstructive pulmonary disease (COPD) is scheduled for elective hip replacement under general anesthesia. His preoperative lung function test shows a forced expiratory volume (FEV1) of 55% of the predicted value. What is the most important consideration before proceeding with anesthesia? Use of a muscle relaxant with minimal cardiovascular effects Ensuring the patient is adequately preoxygenated before induction Administering corticosteroids to prevent bronchospasm Avoiding general anesthesia and opting for regional anesthesia None Which of the following is the most appropriate statistical test for comparing the incidence of complications between two independent groups in an anesthesiology study? Paired t-test Fisher’s exact test One-way ANOVA Chi-square test None You are caring for a 35-year-old woman with a history of severe allergic reactions to penicillin, which she disclosed prior to surgery. During the procedure, she requires an antibiotic, and the surgical team insists on using penicillin as it is the most effective option for preventing infection. What is the most ethically appropriate action? Administer the penicillin as prescribed, as the surgical team has determined it’s necessary ) Discuss with the team and propose an alternative antibiotic to minimize the risk of an allergic reaction Proceed with surgery and use penicillin without discussing the issue with the patient Refer the case to the hospital ethics committee for further review None A 40-year-old woman with no known allergies presents for an elective laparoscopic cholecystectomy under general anesthesia. After induction with propofol and fentanyl, the patient becomes hypotensive with a heart rate of 100 bpm. What is the most likely cause of the hypotension? Blood loss from the surgical site Myocardial infarction Vasodilation due to the anesthetic agents Tachycardia-induced hypotension None Which of the following is the most important aspect of ensuring informed consent for anesthesia? The patient understands the risks, benefits, and alternatives of anesthesia and voluntarily agrees The patient reads a consent form and signs it before the procedure The surgeon provides the patient with information about anesthesia, not the anesthesiologist The anesthesiologist explains the risks, but the patient is not required to understand the information None A 60-year-old male with a history of chronic hypertension and type 2 diabetes mellitus is scheduled for a major abdominal surgery under general anesthesia. He is currently taking an ACE inhibitor. Which of the following is the most appropriate approach regarding the ACE inhibitor on the day of surgery? Discontinue the ACE inhibitor 24 hours before surgery Continue the ACE inhibitor as scheduled Increase the dose of the ACE inhibitor prior to surgery Administer an additional dose of ACE inhibitor on the morning of surgery None Which of the following statements is true regarding the concept of statistical power in clinical studies? Power is the probability of failing to reject the null hypothesis when it is false Power is influenced by the sample size, effect size, and significance level Power is independent of the sample size Power refers to the likelihood of obtaining statistically significant results regardless of the hypothesis None A 50-year-old woman with metastatic breast cancer requires emergency surgery under general anesthesia. She has expressed a wish to avoid aggressive treatments due to her prognosis but is now unable to communicate because of her medical condition. What is the most appropriate course of action? Proceed with surgery as it is necessary to alleviate immediate suffering, even without explicit consent Respect her previous wishes and avoid performing the surgery Proceed with surgery and inform her family afterward Refer the case to the hospital’s ethics committee to make a decision None A 25-year-old female who is 8 weeks pregnant presents for a routine dental procedure under local anesthesia. After administering the local anesthetic, you notice the patient is anxious and begins to experience a feeling of faintness. What is the most likely cause of her symptoms? Vasovagal response Allergic reaction to the local anesthetic Hypotension from supine positioning Hyperventilation due to anxiety None Which of the following is the primary factor to consider when administering intravenous fluids to a patient under anesthesia? The patient's age and gender The type of surgery being performed The patient’s preoperative fasting status The patient’s current renal function status None Time's up
