Here you will find some questions drafted on the basis of the articles published in the Colombian Journal of Anesthesiology Vol. 40, No. 1. I accepted the challenge of putting your reading comprehension and knowledge to a test. Instructions A. If a, b, and c are true. B. If a and c are true. C. If b and d are true. D. If only d is true. E. If all are true. 1. When using epidural morphine for post-partum analgesia: a. The most frequent side effect is nausea. b. The analgesic effect is stronger in primiparous, than in multiparous patients. c. With a two to three milligram dose, the incidence of respiratory depression is around 4 %. d. The incidence of urinary retention is close to 5%. 2. In 2011 the Colombian Society of Anesthesiology prepared the recommendations for sedation by non-anesthesiologists that included: a. Profound propofol sedation may be administered as long as capnography is available. b. Continuous use of pulse-oximetry. c. The Midazolam - narcotics combination may be used. d. Propofol alone can be used if the level of sedation is I or II. 3. With regards to preoperative anemia and its impact on patients undergoing cardiovascular surgery: a. The WHO definition of anemia in women is a hemoglobin level below 12 mg %. b. The WHO definition of anemia in men is a hemoglobin level below 13 mg %. c. Red blood cells transfusion increases the number of adverse outcomes and reduces the survival in patients following cardiovascular surgery. d. Preoperative anemia is a risk factor for mortality and morbidity in cardiovascular surgery. 4. The meta-analysis published by Rincón D., and Benavides A, on intraoperative supplementary oxygen to reduce morbidity - mortality in general anesthesia showed: a. Oxygen administered with FIO2 >60% may decrease the incidence of operative site. b. The need for rescue antiemetic drugs and the incidence of unprogrammed ICU admissions are seriously affected by FIO2 > 60%. c. FIO2 values ranging from 30% and 80% have no influence on the incidence of atelectasis or postoperative pneumonia. d. Oxygen concentration > 60% irrefutably reduces the incidence of nausea and vomiting in abdominal surgery patients with excessive manipulation. 5. The recommendation for a patient with warfarin anticoagulation who will undergo surgery is: a. If the surgery can be postponed for 12 to 24 h administer 2.5 - 5 milligrams of Vitamin K I.V. and confirm a preoperative INR <1.5. b. In emergency non-deferrable surgery, administer Vitamin K and FFP (10 to 15 ml/k). c. If FFP is contraindicated, use prothrombin complex concentrate (PCC) at a dose of 25–50 IU /K. d. Use recombinant Factor VII if FFP is not available. 6. Which of the following surgical procedures are considered minimum bleeding risk with full anticoagulation (INR therapeutic value): a. Pacemaker implantation. b. Excisional biopsy. c. Posterior chamber eye surgery under local anesthesia. d. ERCP without sphincterotomy. 7. The clinical conditions requiring continuous warfarin anticoagulation are: a. Prosthetic heart valves. b. Chronic atrial fibrillation. c. History of venous or pulmonary thromboembolism. d. History of CVAs. 8. The following factors are considered for stratifying thromboembolic risk in chronic nonvalvular atrial fibrillation patients: a. High blood pressure. b. Diabetes Mellitus. c. > 75 years old. d. History of cerebrovascular events or transient ischemic attack. 9. The following statements are true with regards to sugammadex: a. Is a cyclodextrin that forms liposoluble inclusion complexes that engulf the molecule of rocuronium and direct it to be excreted in the bile. b. The recommended dose of sugammadex for reversal of moderate rocuromium block is 4ml/k. c. The dose of sugammadex for reversal of cisatracurium with a 0.5 TOF response if around 1 mg/K. d. Sugammadex may be used safely for reversing vecuronium. 10. The following statements are true with regards to the use of Dexmedetomidine (DMM) during labor: a. No grade I recommendations can currently be made for its use. b. Case reports suggest its potential use to assist in labor anesthesia when epidural anesthesia is contraindicated and other options have failed. c. It has been shown to result in high placental retention with a maternal-fetal index around 0.8. d. DMM may increase the frequency and amplitude of uterine contractions. References: Rev Colomb Anestesiol. 2012;40(1). Answers: 1. C. 2. C. 3. E. 4. B. 5. A. 6. C. 7. A. 8. E. 9. D. 10. E.
