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Question 1
Incorrect
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A 57-year-old woman has undergone a mitral valve repair and is experiencing a prolonged recovery in the cardiac intensive care unit. To aid in her management, a pulmonary artery catheter is inserted.
What is one of the calculated measurements provided by the pulmonary artery catheter?Your Answer: Pulmonary artery wedge pressure
Correct Answer: Cardiac output
Explanation:Measuring Cardiac Output and Pressures with a Pulmonary Artery Catheter
A pulmonary artery catheter can provide direct and derived measurements for assessing cardiac function. Direct measurements include right atrial pressure, right ventricular pressure, pulmonary artery pressure, pulmonary artery wedge pressure, core temperature, and mixed venous saturation. The catheter can also be used to calculate cardiac output using the method of thermodilution. This involves a proximal port with a heater and a distal thermistor that senses changes in temperature.
Pulmonary artery wedge pressure is a direct measurement that can be obtained with the catheter, reflecting left atrial filling. However, it may not always accurately reflect the pressure in the left atrium due to various factors. Right ventricular pressure is another direct measurement that can be obtained.
Central venous saturation is a direct measure in some machines with a built-in saturation measurement probe, while in others, samples can be taken via the distal port and measured using a gas machine. Overall, a pulmonary artery catheter can provide valuable information for monitoring cardiac output and pressures in critically ill patients.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 2
Correct
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What is the commonly used curved-blade laryngoscope in adult practice?
Your Answer: Macintosh
Explanation:Types of Laryngoscopes
Laryngoscopes are medical instruments used to visualize the larynx and facilitate intubation. There are several types of laryngoscopes, each with its own unique features. The Miller, Oxford, and Wisconsin laryngoscopes have straight blades, while the Macintosh and McCoy laryngoscopes have curved blades. The McCoy laryngoscope is typically used for difficult intubations, as its blade tip is hinged and can be operated by a lever mechanism on the handle. Overall, the choice of laryngoscope depends on the individual patient and the specific needs of the intubation procedure.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 3
Incorrect
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You are faced with a 60-year-old male patient who has a history of ischaemic heart disease (taking aspirin and clopidogrel) and reflux, and requires an emergency DHS for his neck of femur fracture. Despite administering a thiopentone and suxamethonium rapid sequence induction, you are unable to intubate the patient. You have attempted to reposition him, insert a bougie, and switch to a McCoy blade, but all efforts have been unsuccessful. The patient's oxygen saturation has dropped to 88%, and you are unable to ventilate him via a face mask due to his large face and thick beard. You are losing your seal and cannot achieve any tidal volume.
What would be your next step in managing this patient?Your Answer: Deliver 100% oxygen and wake the patient up
Correct Answer: Insert a laryngeal mask airway (LMA) and attempt to ventilate the patient
Explanation:Managing a ‘Can’t Intubate’ Scenario in a Patient with Neck of Femur Fracture
In a ‘can’t intubate’ scenario with a patient who has a neck of femur fracture, the priority is delivering oxygen. If attempts at intubation have been difficult and the patient is desaturating, the Difficult Airway Society recommends attempting ventilation with a laryngeal mask airway (LMA) as a temporary measure. If this fails and the patient continues to desaturate, an emergency cricothyrotomy is advised for urgent oxygen delivery. Using a videolaryngoscope to secure a definitive airway is not recommended if oxygenation is a priority. Similarly, attempting a fibreoptic intubation or using a long blade for further attempts at intubation can cause damage and swelling in the airway, leading to laryngospasm. Waking the patient up is also not advisable in this emergency situation, as neck of femur fractures have a high mortality rate if left untreated.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 4
Correct
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You are requested to evaluate a 75-year-old woman who underwent a left mastectomy yesterday to treat breast cancer. Her potassium level is low at 3.1 mmol/L (normal range is 3.5-4.9), but she is asymptomatic and currently having her lunch. She has a history of hypertension and takes a thiazide diuretic regularly. What would be the appropriate course of action?
Your Answer: Prescribe an oral potassium supplement
Explanation:Treatment for Mild Hypokalaemia
Mild hypokalaemia can be treated with oral supplementation. If a patient is able to eat, intravenous fluids are unnecessary. It is best to advise the patient to take oral supplements for a few days. Foods such as tomatoes and bananas contain high levels of potassium and could be offered as well. However, it is important to note that the maximum concentration of potassium that can be given via a peripheral line is 40 mmol/L. It is also important to avoid loop diuretics as they can make the patient’s potassium levels even lower. As long as the patient is asymptomatic and able to eat, mild hypokalaemia can be easily treated with oral supplementation.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 5
Correct
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A patient is brought into the Resuscitation Room. Paramedics were called after he was found face down, unconscious on the road. He smells strongly of alcohol. He has a nasopharyngeal airway in situ (inserted by the ambulance service). There are no visible injuries, except for a small abrasion on his left knee and another on his left shoulder. He is currently on 15 l of high-flow oxygen via a non-rebreather mask.
In which of the following scenarios is a nasopharyngeal airway indicated for an elderly patient?Your Answer: Seizures
Explanation:The Use of Nasopharyngeal Airways in Seizure Management
Nasopharyngeal airways are a valuable tool in managing patients with seizures. During a seizure, jaw rigidity can make it difficult to position an oropharyngeal airway, making a nasopharyngeal airway a better option. These airways are used to secure an open airway in patients with a decreased Glasgow Coma Scale (GCS) score and those who cannot tolerate an oropharyngeal airway due to an intact gag reflex. The correct size of the airway is chosen by sizing the width of the patient’s nostril to the circumference of the tube, and insertion is facilitated by using a water-based lubricant. However, nasopharyngeal airways should not be used in patients with a patent airway or those with basal skull fractures and coagulopathy.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 6
Correct
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You are requested to evaluate a 22-year-old man who had undergone an incision and drainage procedure for pilonidal abscess. The nursing staff is worried about his unusual behavior. He has admitted to social cannabis use in the past.
Upon arrival, you observe that he is forcefully sticking out his tongue and bending his neck to the left and right. His eyes are looking upwards, and his pupils are dilated. His blood glucose level is 5 mmol/L, and all routine observations are normal. He was given paracetamol and an anti-emetic ten minutes ago.
What is the most suitable course of treatment?Your Answer: Intravenous procyclidine
Explanation:Oculogyric Crisis
Oculogyric crisis is a type of acute dystonic reaction that is commonly associated with the use of neuroleptics and anti-emetic medications like metoclopramide. Unfortunately, the clinical spectrum of this condition is not well understood, which often leads to misdiagnosis as a psychogenic disorder. Symptoms of oculogyric crisis can occur suddenly or over several hours and may include restlessness, agitation, malaise, and a fixed stare. The most characteristic symptom is the upward deviation of the eyes, which may be sustained or accompanied by other eye movements like convergence or lateral deviation. Other associated symptoms may include neck flexion, mouth opening, tongue protrusion, and ocular pain. Fortunately, the symptoms of oculogyric crisis can be rapidly resolved with the use of medications like procyclidine.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 7
Incorrect
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How should neuropathic pain be managed?
Your Answer: The analgesic response to amitriptyline occurs after three to four weeks
Correct Answer: Anticonvulsants are prescribed in similar doses to the treatment of epilepsy
Explanation:Neuropathic Pain and Treatment Options
Neuropathic pain is a chronic condition that affects neuronal membrane excitability and often results in allodynia, hyperalgesia, and hyperpathia. Unlike nociceptive pain, neuropathic pain is less responsive to opioids and can be more difficult to treat. To manage this type of pain, coanalgesics such as antidepressants, anticonvulsants, and antiarrhythmics are commonly prescribed. Anticonvulsants are typically administered at similar doses and schedules as in the treatment of epilepsy. The analgesic response to mexiletine can be predicted by evaluating the improvement in pain after an intravenous lidocaine infusion. Amitriptyline, on the other hand, has a faster analgesic response than its antidepressant effect, with pain relief occurring within a week of treatment. Overall, managing neuropathic pain requires a multifaceted approach that may involve a combination of medications and other therapies.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 8
Incorrect
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Which of the following is not involved in managing chronic pain caused by cancer?
Your Answer: Carbamazepine
Correct Answer: Pinaverium
Explanation:Medications for Pain Relief in Various Conditions
Pinaverium is a medication that is commonly used to reduce the duration of pain in individuals with irritable bowel syndrome (IBS). On the other hand, carbamazepine is used to treat neuropathic pain that is associated with malignancy, diabetes, and other disorders. Clodronate is another medication that is used to treat malignant bone pain and hypercalcaemia by inhibiting osteoclastic bone resorption.
Corticosteroids are also used to treat pain caused by central nervous system tumours. These medications work by reducing inflammation and oedema, which in turn relieves the pain caused by neural compression. Nifedipine is another medication that is used to relieve painful oesophageal spasm and tenesmus that is associated with gastrointestinal tumours.
Lastly, oxybutynin is a medication that is used to relieve painful bladder spasm. Overall, these medications are used to treat pain in various conditions and can provide relief to individuals who are experiencing discomfort.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 9
Incorrect
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The following blood gas values were obtained on a different ventilated patient.
pH 7.4 (7.35-7.45)
pO2 95 mmHg (90-120)
Bicarbonate 22 mmol/L (23-26)
pCO2 30 mmHg (35-45)
What is the most appropriate explanation for these results?Your Answer: Mixed metabolic and respiratory acidosis.
Correct Answer: Respiratory alkalosis
Explanation:Respiratory Alkalosis: Causes and Effects
Respiratory alkalosis is a condition that occurs when a person hyperventilates, leading to a decrease in the partial pressure of carbon dioxide (PaCO2) in the alveoli. This decrease in PaCO2 causes an increase in the ratio of bicarbonate concentration (HCO3) to PaCO2, which in turn increases the pH of the blood. As a result, the patient may appear to have an alkalosis with a high pH of 7.5, low pCO2, and normal PO2. However, the body tries to compensate for this by lowering the bicarbonate concentration. This condition can be caused by a variety of factors, including anxiety, fever, hypoxia, and pulmonary disease. It can also be a side effect of certain medications or a result of high altitude. Treatment for respiratory alkalosis depends on the underlying cause and may include addressing the underlying condition, breathing techniques, or medication.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 10
Incorrect
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A 7-year-old girl is scheduled for an elective tonsillectomy. Your consultant has requested that you prepare all the airway equipment. What size of endotracheal tube (ETT) do you anticipate she will require?
Your Answer: 7.0 cuffed ETT
Correct Answer: 5.5 cuffed ETT
Explanation:Choosing the Correct Endotracheal Tube Size for an 8-Year-Old Child
When it comes to intubating an 8-year-old child, choosing the correct endotracheal tube (ETT) size is crucial. Cuffed ETTs are now considered safe for use in children, but not in neonates. To calculate the appropriate size of a cuffed ETT, use the formula (Child’s age/4) + 3.5. For an 8-year-old child, the correct size of a cuffed ETT would be 5.5 mm. If an uncuffed tube is preferred, use the formula (Child’s age/4) + 4 to calculate the tube size, which would be 6.0 mm for an 8-year-old child. It is important to note that using a cuffed tube offers more protection from aspiration. Avoid using a 4.5 mm cuffed ETT, as it is too small for an 8-year-old child.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 11
Correct
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A 98-year-old gentleman is admitted for an incarcerated hernia. He has a past medical history of chronic kidney disease stage 3, secondary to hypertension, and a background of transient ischaemic attacks (TIAs) and osteoarthritis of both knees.
He has four good twitches on train of four testing (normal response), following which reversal of his muscle relaxant was given. Intraoperatively, he received a total of 100 micrograms of fentanyl, 20 mg of morphine and 1 g of paracetamol for pain. He has an arterial line in situ. Blood gas prior to finishing the procedure showed a pH of 7.35, PaCO2 of 5.4 kPa, HCO3− of 21 mmol/l, with a blood sugar of 7.2.
You attempt to wean him off ventilation, but 20 minutes later he still does not want to breathe unsupported or wake up.
What should your next course of action be?Your Answer: Give naloxone 100 micrograms iv
Explanation:Medical Interventions for a Post-Operative Patient with Reduced Consciousness
When dealing with a post-operative patient with reduced consciousness, it is important to rule out any reversible causes before administering any medical interventions. In the case of opiate toxicity, administering naloxone, an opiate antidote, can reverse the effects of the opiates. However, if the patient’s reduced Glasgow Coma Scale score and lack of respiratory effort are not caused by hypoglycemia, giving intravenous glucose is not necessary. It is also important to consider the patient’s age and wait a little longer to rule out any reversible causes. Administering a second dose of muscle relaxant reversal is unlikely to help if the patient has adequate contraction on train of four testing. Lastly, before re-sedating the patient for a CT head, it is necessary to rule out any reversible causes such as opiate toxicity.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 12
Correct
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You are asked to see a patient on the high dependency unit following an elective repair of her abdominal aortic aneurysm. Her last haemoglobin was 75 g/L (130-180) and your consultant has told you to give her four units of blood urgently.
The nurse informs you that the patient's date of birth is incorrect on the blood she is about to give, although all other details are correct. The patient mentions that this has happened before. She has previously received six units of blood in theatre without any issues.
What course of action should you take?Your Answer: Stop the blood transfusion
Explanation:Importance of Correct Patient Identification in Transfusions
Transfusions are a crucial aspect of medical treatment, but incorrect patient identification of samples and blood products can lead to fatal consequences. In fact, it is the most common cause of death following transfusion. Therefore, it is essential to ensure that patient identification is accurate and consistent throughout the process.
If there are any inconsistencies or doubts about the patient’s identity, it is crucial to stop the transfusion immediately and inform the laboratory. This step can prevent serious harm or even death. It is better to err on the side of caution and take the necessary steps to ensure that the patient receives the correct blood product.
In emergency situations where blood is needed immediately, and there is uncertainty about the patient’s identity, group O negative blood may be used. However, this should only be a temporary solution until the patient’s identity is confirmed, and the appropriate blood product can be administered.
In conclusion, patient identification is a critical aspect of transfusions, and any errors or inconsistencies should be addressed immediately to prevent harm to the patient. It is better to take the necessary precautions and ensure that the patient receives the correct blood product, even if it means delaying the transfusion.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 13
Incorrect
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Before undergoing general anaesthesia, which regular medications need to be stopped?
Your Answer: Carbamazepine
Correct Answer: Phenelzine
Explanation:Medication Management in Perioperative Period
Phenelzine and tranylcypromine are monoamine oxidase inhibitors that need to be discontinued at least two weeks before elective surgery due to their potential life-threatening interactions with pethidine and indirect sympathomimetics. Additionally, they can prolong the action of suxamethonium by decreasing the concentration of plasma cholinesterase. Carbamazepine, an anticonvulsant, should be continued throughout the perioperative period. Gliclazide, a short-acting oral hypoglycemic, can be taken if the surgery’s anticipated duration is short.
Lisinopril, an angiotensin-converting enzyme inhibitor (ACEi), and digoxin, a cardiac glycoside, should be continued pre-operatively. Morphine sulfate tablets should also be continued pre-operatively, and a morphine infusion (PCA) should be considered for postoperative analgesia. Pyridostigmine is used in the management of myasthenia gravis and should be continued before minor surgery. However, if perioperative muscle relaxation is required, omitting one or more doses of pyridostigmine would allow a reduction in the dose of the muscle relaxant. Proper medication management in the perioperative period is crucial to ensure patient safety and optimal surgical outcomes.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 14
Correct
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To visualize the vocal cords, where should the tip of a Macintosh laryngoscope be inserted?
Your Answer: Into the vallecula
Explanation:Macintosh Laryngoscope: A Tool for Visualizing the Vocal Cords
The Macintosh laryngoscope is a medical instrument designed to aid in the visualization of the vocal cords. Its curved blade is specifically shaped to fit into the oral and oropharyngeal cavity. To use it, the blade is inserted through the right side of the mouth and gradually advanced, pushing the tongue to the left and out of view. The blade has a small bulbous tip that is intended to sit in the vallecula, a small depression between the base of the tongue and the epiglottis.
By lifting the laryngoscope up and forwards, the larynx is elevated, allowing for a clear view of the vocal cords. This tool is commonly used in medical settings, such as during intubation procedures or when examining the airway. Its design allows for a safe and effective way to visualize the vocal cords, aiding in the diagnosis and treatment of various medical conditions.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 15
Correct
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Which volatile agent was linked to the development of fulminant hepatitis after secondary exposure?
Your Answer: Halothane
Explanation:Halothane Hepatitis and Precautions
Halothane hepatitis is a condition that can range from minor liver function issues to severe liver failure. It occurs when liver damage appears within 28 days of exposure to halothane, after excluding other known causes of liver disease. About 75% of patients with halothane hepatitis have antibodies that react to halothane-altered antigens. Therefore, it is important to take precautions when using halothane.
Halothane should be avoided if there has been a previous exposure within three months, if there is a known adverse reaction to halothane, if there is a family history of adverse reactions, or if there is pre-existing liver disease. These precautions can help prevent the occurrence of halothane hepatitis and ensure the safety of patients. It is important to carefully consider the use of halothane and take necessary measures to avoid any potential harm.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 16
Incorrect
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A 26-year-old man on the Medical Ward develops status epilepticus. He is immediately attended by the Foundation Year One Doctor who notices that his airway has been compromised. The patient is immediately examined and found to be haemodynamically stable, with a history of hypertension and asthma. The anaesthetist immediately performs a rapid sequence induction and intubation (RSII) to clear the patient’s airway.
Which of the following inducing agents used in RSII is most likely to be used in this patient?Your Answer: Ketamine
Correct Answer: Propofol
Explanation:Common Inducing Anaesthetic Agents and Their Uses
Propofol, etomidate, ketamine, midazolam, and thiopental are all commonly used inducing anaesthetic agents with varying properties and uses.
Propofol is the drug of choice for RSII procedures in normotensive individuals without obvious cardiovascular pathology. It has amnesic, anxiolytic, anticonvulsant, and muscle relaxant properties, but no analgesic effects.
Etomidate provides haemodynamic stability without histamine activity and minimal analgesic effects. It is used in RSI procedures in patients with raised intracranial pressure and cardiovascular conditions, often in combination with fentanyl.
Ketamine is a non-competitive glutamate N-methyl-D-aspartate (NMDA) receptor blocker that produces dissociative anaesthesia. It can be used for induction of anaesthesia in patients with hypotension, status asthmaticus, and shock, but is avoided in hypertensive patients due to relative contraindications.
Midazolam is a benzodiazepine with anticonvulsive, muscle relaxant, and anaesthetic actions. At higher doses or in combination with other opioids, it induces significant cardiovascular and respiratory depression.
Thiopental is administered intravenously as an inducing anaesthetic agent or as a short-acting anaesthetic. It is also used as an anticonvulsant agent and to decrease intracranial pressure in neurosurgical procedures.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 17
Incorrect
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A 32-year-old cyclist, who was in a car accident, needs to have a central venous line (CVL) inserted. Which of the following statements is the most precise?
Your Answer: A CVL cannot be used for parenteral feeding
Correct Answer: CVL placement is required for the administration of adrenaline infusion
Explanation:Central Venous Lines: Placement, Uses, and Complications
Central venous lines (CVLs) are commonly used in medical settings for various purposes, including the administration of inotropes such as adrenaline, parenteral nutrition, blood products, fluids, and measurement of central venous pressures. However, the use of CVLs is not without risks and complications, which include local site and systemic infection, arterial puncture, haematomas, catheter-related thrombosis, air embolus, dysrhythmias, atrial wall puncture, lost guidewire, anaphylaxis, and chylothorax.
When it comes to the placement of CVLs, the site of choice is the subclavian vein, although the complication risk is higher. Femoral lines are more susceptible to infection due to the flora within the groin area. Consideration of the age of all lines should be made on daily review within the Intensive Care Unit/High Dependency Unit environment, as routine replacement of a CVL every fortnight is uncommon.
Lastly, a check radiograph for placement is recommended on insertion of both subclavian and internal jugular lines to confirm correct placement within the superior vena cava and to exclude a procedural pneumothorax. However, this does not need to be repeated on removal, as there are no needles or incisions involved in the removal of the line.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 18
Incorrect
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You are conducting a pre-assessment for a 28-year-old man who is scheduled to undergo a colectomy for treatment resistant ulcerative colitis. This will be his first surgery. Your intended anaesthetic plan involves using propofol and sevoflurane as induction agents and suxamethonium as a muscle relaxant. What aspects of the patient's medical history and condition would cause you to modify your anaesthetic plan?
Your Answer: The patient has a severe penicillin allergy
Correct Answer: The patient’s mother was ‘unable to move’ for 5 h after having an abdominal hysterectomy
Explanation:Considerations for Anesthesia in a Patient with Medical History
When administering anesthesia to a patient, it is important to take into account their medical history and any potential risk factors. Here are some considerations for a patient with specific medical history:
Anesthesia Considerations for a Patient with Medical History
– Prolonged Paralysis: If a patient has a family or personal history of prolonged paralysis after receiving suxamethonium, it may be necessary to consider using a different muscle relaxant during surgery.
– Asthma: Patients with asthma are at a higher risk of airway irritation during endotracheal intubation. However, in some surgeries, intubation is necessary and careful monitoring is required.
– Blood Pressure: While a blood pressure of 110/75 may be normal for a 26-year-old male, it is important to review the patient’s past blood pressure measurements to ensure that this is the case. Induction agents with profound cardiovascular effects should be avoided if the patient is in shock.
– Family History of Cardiac Arrest: If a patient has a family history of cardiac arrest, it is important to review the facts of the case and consider any independent risk factors that may have contributed to the event.
– Penicillin Allergy: While anesthesia agents do not contain penicillin, it is important to document any allergies in case the patient requires antibiotics after surgery. -
This question is part of the following fields:
- Anaesthetics & ITU
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Question 19
Correct
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What is the combination of ingredients in Hartmann's solution?
Your Answer: Sodium, chloride, potassium, calcium and lactate
Explanation:Hartmann’s Solution Composition and Metabolism
Hartmann’s solution, also known as lactated Ringer’s solution, is an intravenous fluid that is isotonic in nature. It contains various compounds, including sodium, chloride, potassium, calcium, and lactate. A litre of this solution contains 131 mmol of sodium, 111 mmol of chloride, 5 mmol of potassium, 2 mmol of calcium, and 29 mmol of lactate.
One of the unique features of Hartmann’s solution is the presence of lactate, which is metabolized by the liver to release bicarbonate. This process is important because bicarbonate would otherwise combine with calcium to form calcium carbonate, which can cause complications. Therefore, the metabolism of lactate helps to maintain the stability of the solution and prevent any adverse effects.
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This question is part of the following fields:
- Anaesthetics & ITU
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Question 20
Correct
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You are asked to take over a patient halfway through a case to relieve the consultant anaesthetist for a comfort break. The patient, who is 65 years old, has an endotracheal tube (ETT) in situ and is maintained on sevoflurane and ventilated at a rate of 14 breaths per minute, with a tidal volume of 600. You notice that the carbon dioxide (CO2) trace is high (ET 6.9) and increasing quite rapidly. The maxillofacial surgeon remarks that the patient’s jaw is quite tight and asks for more muscle relaxant. You check the patient’s temperature and find that it is high at 39.6 °C.
Which one of the following is your priority?Your Answer: Actively cool the patient, stop sevoflurane and give dantrolene
Explanation:Managing Malignant Hyperpyrexia: An Anaesthetic Emergency
Malignant hyperpyrexia is a life-threatening anaesthetic emergency triggered by inhalational anaesthetics and muscle relaxants in genetically susceptible individuals. It causes a hypermetabolic state, leading to increased CO2 production, oxygen consumption, heat production, metabolic and respiratory acidosis, hyperkalaemia, activation of the sympathetic nervous system, and disseminated intravascular coagulation.
Early signs include a rise in end-tidal CO2, rigid muscles, tachycardia, and tachypnoea. Treatment involves discontinuation of the triggering agent, rapid administration of dantrolene, active cooling, and treatment of hyperkalaemia. Dantrolene inhibits calcium release from the sarcoplasmic reticulum and reverses the hypermetabolic state.
It is important to inform the surgeon and stop the operation. Once the initial reaction is controlled, the patient will require transfer to the ICU and monitoring for 24-48 hours.
In contrast, giving more muscle relaxant or antibiotics is not recommended. Active management and stabilisation of the patient should precede discussion with the ICU. Malignant hyperpyrexia requires prompt recognition and management to prevent serious complications and death.
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This question is part of the following fields:
- Anaesthetics & ITU
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