A patient who is a 72 year old male presents for his implant surgery. He has a history of an MI 6 years ago with angioplasty and a stent. He tells you that... [Show More] he stopped his aspirin a week ago (not instructed by his physician but he just did that on his own). Before you start, he complains of a vague chest pain, almost like indigestion, but it is radiating to his left arm. He is also diaphoretic (sweating). Your diagnosis (what is causing it) for this patient is:
Angina, possible heart attack (MI)
The safest time to extract a "bad tooth" on pregnant patient is:
Second trimester
A patient is experiencing a laryngospasm (spasm of the vocal cords). The correct sequence for the treatment of this is:
Stop, pack off site, suction, positive pressure oxygen, succinylcholine
Drugs (PO, IM or IV) given to patients are usually metabolized (broken down) in the body by what organ:
Liver
A pediatric airway is different than an adult airway in that:
Kids have a larger tongue and a conical shaped airway
Your patient is a relatively difficult anesthetic: he is morbidly obese with a short neck, recessed lower jaw, and Mallampatti score of VI. You're struggling to chin him. You've already put in a nasal pharyngeal airway. What else might you try before you intubate him?
Laryngeal-Mask-Airway
A laryngospasm (spasm of the vocal cords) a disorder of the:
Upper airway
Which monitor gives the most information about ventilation?
Capnograph
The most frequent anatomical cause of airway obstruction is the:
Tongue
A patient with Type II (non-insulin dependent) diabetes would typically be taking pills to control their blood glucose (blood sugars) and to control their diabetes.
True
The classification of drugs used to relieve pain are called:
Narcotics
The most common cardiac rhythm seen on the EKG for an adult patient in cardiac arrest is?
Ventricular Fibrillation
Which of the follow general drug categories are used to treat someone who is experiencing an asthma "attack":
Beta Agonists
The Mallampatti Classification system is used by Oral & Maxillofacial Surgeons to assess the airway of patients. This classification allows your surgeon to have an idea if this patient will have a difficult airway. You have the patient open their mouth and stick out their tongue. You do not see any part of the uvula and can only see part of the soft palate. This patient has a Mallampatti classification of:
IV
A patient comes in for the removal of a tooth. Which of these medical conditions would require this patient to take an antibiotic premedication one hour prior to removal of that tooth.
Prosthetic Heart Valve ( i.e. Aortic Valve replacement )
Insulin converts:
Glucose to Glycogen
The pneumonic MONA stands for:
Morphine, Oxygen, Nitroglycerin, Aspirin
Indications for patients to be on anticoagulation (blood thinner) medicines are:
-Stroke (CVA)
-Pulmonary Embolism (PE)
-History of blood clots in the leg (DVT or VTE)
The left side of the heart carries deoxygenated blood.
False
As patients undergo anesthesia, they pass through different stages of anesthesia. According to the American Society of anesthesiology, surgery is usually performed in what stage of anesthesia?
Stage 3
Stimulation of the Sympathetic Nervous System will result in:
Increased heart rate, increased blood pressure
You just finished removing 4 wisdom teeth on a 20 year old male. He received quite a bit of anesthetic agents. Specifically, 200 mg of Propofol, 8 mg of Versed, 200 umg of Fentanyl. He has been in recovery for about 15 minutes when the alarm on the pulse oximeter goes off. You check on him and find him unarousable, ashen colored with a respiratory rate of 8 which is very slow breathing. What drugs would you consider giving him?
Flumazenil (Romazicon) and Narcan (Naloxone)
You are checking in the next patient who is a 50 year old male. He is really nervous about the procedure. You confirm the surgical plan and then notice that he's avoiding eye contact, appears very pale, nearly grey and is sweating. He suddenly "passes out". Your diagnosis is:
Syncope (vasovagal)
You have a patient that is a 17 year old female who is undergoing the removal of all 4 wisdom teeth. During the surgery, you hear a high pitched crowing sound. You look down and her chest and abdomen and "not in sync" when she is breathing. Her oxygen saturation begins to fall rapidly. Your diagnosis and treatment are:
Laryngospasm; Positive pressure oxygen & Succinylcholine if needed
The classifications of drugs used to relax patients or reduce anxiety are called:
Benzodiazepines
There are two main categories of local anesthetics used in dentistry. The most common category of local anesthetic used in Oral & Maxillofacial Surgery is an:
Amide
You have a patient that is a 17 year old female who is undergoing the removal of all 4 wisdom teeth. She has a history of asthma which was more prevalent as a child, not so much now. During the surgery, you hear a wheezing sound and her oxygen saturation begins to fall. Your diagnosis and treatment are:
Bronchospasm; Give inhaler & Epinephrine if needed
The agent that is used to reverse (reversal agent) the effects of Midazolam (Versed) is:
Romazicon (Flumazenil)
Your patient arrives for a 1:30 pm surgery. (1:30 pm in the afternoon). He admits he was so thirsty he had a sip of water at 1:00 pm so he has been NPO (nothing by mouth) for only 30 minutes. He assures you it was just a sip of water and nothing more. You tell him:
Its ok to proceed but we must wait 1.5 hours
Your patient is an 82 year old female with a history of coronary artery disease, angina and a previous myocardial infarction (MI) 5 years ago. She has an abscessed painful molar that needs extraction. She wants to be mildly sedated for the procedure. Midway through, you notice the EKG suddenly looks like a wavy, chaotic undulating line. You check the leads and they are all correct. You feel for a pulse, and there is NO PULSE. Your first actions would be to
Defibrillate with an AED, Start CPR and call 911
The difference between a myocardial infarction and angina is:
Myocardial infarction indicates death or necrosis of the heart muscle
How many hours before Surgery dose the American Society of Anesthesiology recommends no food? (NPO guidelines)
6
You are doing a bicuspid extractions on a 20 year old male under a general anesthetic. He doesn't seem that "deep" because he keeps moving his tongue all over the place. The "chinner" notices that the pulse oximeter measurement is dropping and that his chest shows paradoxical rocking. You stop the procedure, pack off the site, and suction him out very well. Next you to try to give him positive pressure ventilation but this is unsuccessful. There is no crowing sound. You count the teeth on the tray, and although you did 4 extractions, you can only find 3 teeth. Your doctor quickly looks with the laryngoscope, sees the tooth, but cannot get it out. The saturation is now down to 42 and the patient is beginning to appear ashen (blue). Your next step is:
Perform crycothyrotomy (surgical airway)
A patient has stopped breathing. What is the main primary physiological mechanism that will restart this patients breathing (respirations)?
Excess of carbon dioxide (CO2)
The Trachea (wind pipe) branches into the right and left main stem bronchus. A patient is undergoing general anesthesia in your office to remove a tooth. The patient aspirates the tooth (i.e. tooth is going into the lungs).Which lung would you guess the tooth will end up in?
Right Lung
A patient has been sedated for a tooth extraction in your office. While the patient is under general anesthesia the patient starts to vomit. The correct sequence of treatment for this patient is:
Roll this patient on their right side, suction, and full face mask oxygen
When you compare the ventricles of the heart to the atria of the heart. The walls of the ventricle are thicker than the atria.
True
The QRS complex in the EKG represents:
Ventricular depolarization
Angina (chest pain) is potentially reversible.
True
The most concerning signs and symptoms of an acute anaphylactic reaction are:
Airway edema & Circulatory collapse [Show Less]
