Perioperative Patient Management Flashcards
7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Perioperative Patient Management flashcards as text
A patient receiving a thoracic epidural infusion of 0.1% bupivacaine with fentanyl develops hypotension (BP 78/42) and bradycardia (HR 44). The FIRST intervention should be:
Answer: IV fluid bolus, ephedrine or phenylephrine, and atropine if bradycardia persists
High thoracic sympathectomy from epidural spread causes hypotension and bradycardia managed with fluids, vasopressors, and atropine; intralipid is reserved for systemic local anesthetic toxicity.
During a carotid endarterectomy under general anesthesia, the surgeon asks you to increase blood pressure after carotid cross-clamping. The TARGET MAP should typically be:
Answer: 20% above the patient's baseline MAP
During carotid cross-clamping, maintaining MAP 20% above baseline helps perfuse the hemisphere via collaterals and is the standard approach.
A previously healthy 4-year-old child (18 kg) is extubated after an uneventful tonsillectomy. In PACU, SpO₂ is 88% with inspiratory stridor. The MOST appropriate immediate intervention is:
Answer: Administer nebulized racemic epinephrine and dexamethasone
Post-extubation croup (subglottic edema) is treated first with nebulized racemic epinephrine and dexamethasone; reintubation is reserved for failure of conservative measures.
Which intraoperative finding on a transesophageal echocardiogram is MOST consistent with acute left ventricular failure?
Answer: Dilated LV with global hypokinesis and elevated E/e' ratio
Dilated LV with global hypokinesis and elevated E/e' ratio on TEE indicates impaired systolic function and elevated filling pressures consistent with acute LV failure.
A patient with obstructive sleep apnea (AHI 45) is recovering from laparoscopic Roux-en-Y gastric bypass. Which postoperative analgesic strategy is MOST appropriate?
Answer: Multimodal analgesia with NSAIDs, acetaminophen, and regional techniques to minimize opioid use
OSA patients are highly sensitive to opioid-induced respiratory depression; multimodal opioid-sparing strategies with continuous monitoring are the standard of care.
Intraoperative hyperthermia (temperature 39.8°C), muscle rigidity, masseter spasm, and rising ETCO₂ in a 17-year-old 30 minutes after succinylcholine administration suggests:
Answer: Malignant hyperthermia
The triad of hyperthermia, masseter rigidity, and hypercarbia after triggering agents (succinylcholine, volatile anesthetics) is the classic presentation of malignant hyperthermia.
Which of the following best describes the anesthetic management priority for a patient with a known difficult airway presenting for elective surgery?
Answer: Awake fiberoptic intubation with topical anesthesia and sedation before induction
In a known difficult airway, awake fiberoptic intubation preserves spontaneous ventilation and airway patency, making it the gold-standard first-line approach for elective cases.