Anästhesie final exam

15)) The most appropriate pre-treatment for a patient with hypotension due to sepsis is:

16)) 68 yo woman without history of previous diseases is admitted to emergency because of rapid breathlessness and pain in the chest. 3 days before the symptoms she came back from vacation in Mexico. What is the best course of action?

18)) patient with petrochanteric fracture of left femur, treated at ortho department for 2 weeks, stranded in bed. Doctor called you for a anesthesiologic consultation because the state of patient has worsen GCS from 15 to 13. On the examination patient has tachypnea 30/min, SBP 90 mmHg, crackles and single wheezes in lungs and 39 C fever.

19)).  In a patient in septic shock the right fluid therapy would be:

20)) for fast, in bed (and accurate) evaluation of volume status (volemia) of a patient at ER:

21)) Indication for V-V ECMO in acute respiratory failure are all below except:

22)) Fracture of the spinal cord may cause:

25)) pathophysiological changes observed in sepsis are :

26)) In patients with sepsis activation of tissue factor and impaired fibrinolysis may lead to:

27) The newest, full definition of septic shock is:

28)) Patient with chronic pulmonary obturation was admitted for operation. His AGB are pH = 7.35, PaCO2 = 48mmHg, HCO3 = 30 mmol/L. Based on those parameters we can say patient has:

31)) Patient who is pulmonary and cardiovascular efficient, without urethral catheter, hospitalized after surgery of abdominal injury, was diagnosed with septic fever. The doctors excluded infection of postsurgical wound, HAP and UTI. In case of suspected infection of blood due to central catheter (CLA-BSI)…(finish sentence)…

32)) To disinfect the skin in the procedure of inserting central venous catheter you choose:

33)) Choose the FALSE statement regarding the dose of adrenaline in anaphylactic shock:

34)) During resuscitation, the indication for administration of adrenaline is:

35)) Choose the indication of defibrillation:

36)) trouble with ventilating the patient and foreign bodies in the airway have been excluded, which of the following things can be helpful in ventilation with a mask?

37)) Choose the correct statement regarding constant EtCO2 monitoring during resuscitation:

38)) Which of the following does not belong to reversible causes of cardiac arrest:

39)) Depression of the circulatory system (cardiovascular depression) during induction of intravenous anaesthesia is usually caused by:

40)) Calculate the CPP (cerebral perfusion pressure) based on the following values:
HR: 75BPM BP: 120/80 mmHg (MAP 65) CVP: 15 mmHg ICP: 20 mmHg RR: 25 breaths per minute MV (minute volume): 10 l/min

42)) A pulse may be present in:

43)) Choose the incorrect sentence:

46))Which fluid is contraindicated in the treatment of sepsis:

47)). After diagnosing sepsis antibiotic should be given:

48)). What makes recognizing death due to cardiac reasons difficult?

49.)) Physiological effects of the positive intrathoracic pressures on the cardiovascular system are best characterized by:

50)) Parameters of lung protective ventilation are all expect:

51)) Measuring procalcitonin blood levels in patients at ICU is used in:

54)) Clinical state of a patient diagnosed with septic shock was assessed in the SOFA scale: 10 points at the admission to the ICU, 8 points on the second day, and 6 points on the fourth day. These results indicate:

55)) A 60 year old male patient at the ICU was in the cardiac arrest. 6 minutes of the CPR resulted in the restoration of the circulation.

The patient’s blood gas results: pH 7.18 ; PaCO2 62mmHg ; HCO3 17,5 mmol/L ; PaO2 65 mHg. They indicate:

56)) Which one of the following methods of anesthesia induction might be used in small children?

57)) How long before general anesthesia children should be on an empty stomach?

ACHTUNG! It’s actually (also in the ppt) 4h mothers milk and 2h clear fluids -> there’s no such answer!! —> if it’s on the exam, ask what they mean!!

58)). In a patient with fever, cough, rhonchi and rales over both lungs, increasing dyspnea and necessity of intubation despite ambulatory antibiotic therapy (amoxicillin with calvulanic acid) following diagnostic examinations should be done:

59)) A patient without relevant medical history, who was admitted to the ICU (from home) due to cardiopulmonary insufficiency with temperature of 39 C and purulent cough, was diagnosed with increased number of leukocytes, high PCT and CRP and left sided inflammatory changes in ?????

What antibiotic should be given empirically in community acquired pneumonia?

60)) A 54 year old female patient was admitted to the ICU from the Infectious Diseases Clinic due to cardiopulmonary and kidney insufficiencies during sepsis (with a suspicion of meningitis) without culture results conformation. What antibiotics should be given empirically?