GYN/Gu/Out-of-or/Anesthesia Complications Basics Quiz II

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  • 1/31 Questions

    A distended bladder in a patient with spinal cord injury can cause life-threatening hypertension that can lead to stroke, MI, and death, a phenomenon known as autonomic hyper/dys-reflexia.

    • True
    • False
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About This Quiz

This quiz assesses foundational knowledge in GYN\/GU and anesthesia complications, focusing on the bladder's innervation, sympathetic and parasympathetic responses, and impacts of conditions like BPH. It is essential for learners in medical fields, particularly those studying urology.

GYN/Gu/Out-of-or/Anesthesia Complications Basics Quiz II - Quiz

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  • 2. 

    Glycine is an ________________ neurotransmitter.

    • Excitatory

    • Inhibitory

    Correct Answer
    A. Inhibitory
    Explanation
    Glycine is an inhibitory neurotransmitter because it acts to reduce or inhibit the activity of neurons in the nervous system. It binds to specific receptors in the brain and spinal cord, allowing chloride ions to enter the neuron and hyperpolarize it. This hyperpolarization makes it more difficult for the neuron to reach its threshold and generate an action potential, effectively reducing the excitability of the neuron and inhibiting its activity. Therefore, glycine plays a crucial role in regulating neuronal activity and maintaining a balance between excitation and inhibition in the nervous system.

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  • 3. 

    A hypo-osmotic hyponatremia treated with a loop diuretic like furosemide will further drop the sodium due to Na+ wasting secondary to inhibition of Cl- reuptake.

    • YOU GOT IT!

    • NAH BRO!

    Correct Answer
    A. YOU GOT IT!
    Explanation
    This is very true. Give 3-5% NaCl @

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  • 4. 

    _____________ syndrome is progressive tissue swelling within a closed space which leads to severe circulatory insufficiency.  Occurs in the legs during lithotomy position but can occur in the hands and arms.

    • TURP

    • Compartment

    • Down's

    • Cushing's

    Correct Answer
    A. Compartment
    Explanation
    Flow is reduced to the leg by a pressure of 0.7 mmHg for each 1 cm above the level of BP measurement.

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  • 5. 

    ECT causes a seizure which:

    • Decreases CBF and ICP

    • Increases CBF and ICP

    Correct Answer
    A. Increases CBF and ICP
    Explanation
    Always place a bite block with ECT - the seizure can cause the patient to bite through their tongue.

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  • 6. 

    HPV can be spread via the airborne route during laser removal of condylomas.  

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Wear the gray mask so you don't get HPV in your throat.

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  • 7. 

    The parasympathetic response of the bladder, as well as the internal and external sphincter, are innervated via the ____________ nerve.

    • Pudendal nerve

    • Vagal nerve

    • Hypogastric nerve

    • Pelvic nerve

    Correct Answer
    A. Pudendal nerve
    Explanation
    The parasympathetic response of the bladder, as well as the internal and external sphincter, are innervated via the pudendal nerve. The pudendal nerve is responsible for controlling the voluntary muscles of the perineum, including those involved in urination. It originates from the sacral plexus and provides motor innervation to the external urethral sphincter, allowing for voluntary control over the release of urine. Therefore, the pudendal nerve is the correct answer in this context.

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  • 8. 

    Which irrigation fluid used for GU cases can cause toxic levels of ammonia to accumulate, leading to temporary blindness?

    • Water

    • Glycine

    • Sorbitol

    • Mannitol

    • Cytol (Sorbitol & Mannitol)

    Correct Answer
    A. Glycine
    Explanation
    Glycine (a non-essential amino acid) is metabolized to glycolytic acid and ammonia. Toxic levels of ammonia attribute to blindness that is resolved with normalized ammonia levels.

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  • 9. 

    Irrigation fluid should be:​ 

    • Isotonic

    • Inexpensive

    • Electrolyte-rich

    • Non-hemolytic

    • Opaque

    Correct Answer(s)
    A. Isotonic
    A. Inexpensive
    A. Non-hemolytic
    Explanation
    Irrigation should be:
    Isotonic
    Inexpensive
    Non-electrolyte
    Non-hemolytic
    Transparent

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  • 10. 

    Hyponatremia causes confusion, headache, ________ QRS, and ST ______________.

    • Narrow, elevation

    • Wide, elevation

    • Narrow, depression

    • Wide, depression

    Correct Answer
    A. Wide, elevation
    Explanation
    Hyponatremia is a condition characterized by low levels of sodium in the blood. When hyponatremia occurs, it can lead to changes in the electrical activity of the heart, specifically affecting the QRS complex and ST segment on an electrocardiogram (ECG). In this case, the correct answer is "wide, elevation," indicating that hyponatremia can cause a widening of the QRS complex and an elevation of the ST segment on an ECG. These changes are important to recognize as they can indicate potential cardiac complications associated with hyponatremia.

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  • 11. 

    The blood supply to the cervix is supplied via the:

    • Descending uterine artery

    • Femoral artery

    • Inferior epigastric artery

    • Pudendal artery

    Correct Answer
    A. Descending uterine artery
    Explanation
    The blood supply to the cervix is primarily provided by the descending uterine artery. This artery arises from the internal iliac artery and runs along the lateral wall of the uterus. It gives off branches that supply blood to the cervix, as well as the uterus itself. The femoral artery supplies blood to the lower extremities, the inferior epigastric artery supplies blood to the abdominal wall, and the pudendal artery supplies blood to the external genitalia. Therefore, these arteries are not directly involved in supplying blood to the cervix.

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  • 12. 

    Appropriate ASAs for Out-of-OR procedures include:

    • ASA I

    • ASA II

    • ASA III with stable comorbidities

    • ASA IV

    • ASA V

    Correct Answer(s)
    A. ASA I
    A. ASA II
    A. ASA III with stable comorbidities
    Explanation
    The appropriate ASAs for out-of-OR procedures include ASA I, ASA II, and ASA III with stable comorbidities. This means that patients who are classified as ASA I (healthy) and ASA II (mild systemic disease) are suitable for out-of-OR procedures. Additionally, patients who are classified as ASA III (severe systemic disease) but have stable comorbidities can also undergo out-of-OR procedures. However, patients with ASA IV (severe systemic disease that is a constant threat to life) and ASA V (moribund patient not expected to survive without the procedure) are not considered appropriate for out-of-OR procedures.

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  • 13. 
    During a D&C (dilation and curettage), 20-30 units of Pitocin may be added to 1 L of fluid and rapidly infused to help reduce bleeding via uterine contraction. - ProProfs

    During a D&C (dilation and curettage), 20-30 units of Pitocin may be added to 1 L of fluid and rapidly infused to help reduce bleeding via uterine contraction.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The infusion should be slowly infused to prevent severe hypotension.

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  • 14. 

    Nonionized media contrast has a lower osmolality than ionized media contrast and is less toxic to use.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Contrast reaction treated like any allergic reaction - 02, bronchodilators, epinephrine, benadryl, corticosteroids.

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  • 15. 

    Hepatitis _____ is most common in healthcare personnel due to its transmission through blood products and body fluids.  

    • A

    • B

    • C

    • Z

    Correct Answer
    A. B
    Explanation
    Hepatitis B is most common in healthcare personnel due to its transmission through blood products and body fluids. This is because healthcare personnel are at a higher risk of exposure to blood and body fluids in their line of work, such as through needlestick injuries or contact with contaminated surfaces. Hepatitis B is a viral infection that affects the liver and can cause serious health complications if left untreated. Therefore, healthcare personnel need to take precautions such as vaccination and following proper infection control measures to prevent the transmission of Hepatitis B.

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  • 16. 

    Hepatitis ___ is the most common cause of non-alcoholic cirrhosis.

    • A

    • B

    • C

    • D

    Correct Answer
    A. C
    Explanation
    Hepatitis C is the most common cause of non-alcoholic cirrhosis.

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  • 17. 
    The bladder's sympathetic response is provided by its innervation via the ____________ nerve (T11-L2 to L3). - ProProfs

    The bladder's sympathetic response is provided by its innervation via the ____________ nerve (T11-L2 to L3).

    • Pelvic nerve

    • Hypogastric nerve

    • Vagus nerve

    • Pudendal nerve

    Correct Answer
    A. Hypogastric nerve
    Explanation
    The hypogastric nerve enters the thoracolumbar (SNS) portion of the spinal cord (T11-L2 to L3) and supplies the sympathetic innervation of the bladder.

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  • 18. 
    The sensory, motor, and detrussor muscle of the bladder is supplied via the __________ nerve. - ProProfs

    The sensory, motor, and detrussor muscle of the bladder is supplied via the __________ nerve.

    • Hypogastric nerve

    • Pudendal nerve

    • Pelvic nerve

    • Vagal nerve

    Correct Answer
    A. Pelvic nerve
    Explanation
    The pelvic nerve is located at S2-3.
    When RELAXED, the detrussor muscle allows the bladder to store urine. When it CONTRACTS, urination occurs.

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  • 19. 

    Adequate regional anesthesia for most GU surgeries should encompass which dermatome?

    • T4

    • S2-3

    • T10

    • T7

    Correct Answer
    A. T10
    Explanation
    Adequate regional anesthesia for most GU surgeries should encompass the T10 dermatome. This is because the T10 dermatome covers the region of the body where most of the genitourinary surgeries are performed. By targeting this specific dermatome with anesthesia, the surgeon can ensure that the patient does not experience pain or discomfort during the procedure.

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  • 20. 

    BpH causes bladder neck obstruction and may lead to:

    • GU infections

    • Fistula formation

    • Renal insufficiency

    • Bladder stones

    Correct Answer(s)
    A. GU infections
    A. Renal insufficiency
    A. Bladder stones
    Explanation
    BPH, or benign prostatic hyperplasia, is a condition where the prostate gland enlarges and causes obstruction of the bladder neck. This obstruction can lead to various complications. GU infections can occur because the stagnant urine in the bladder provides a suitable environment for bacterial growth. Renal insufficiency can result from the chronic obstruction and increased pressure on the kidneys, leading to decreased kidney function. Bladder stones can form due to the prolonged presence of urine in the bladder, which can crystallize and form stones. Therefore, GU infections, renal insufficiency, and bladder stones are all potential complications of BPH.

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  • 21. 

    The prostate gland begins to increase in size after the age of 35.

    • YOU RIGHT!

    • YOU WRONG!

    Correct Answer
    A. YOU WRONG!
    Explanation
    It begins to increase after 40.

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  • 22. 

    The lithotomy position most commonly causes nerve injury to the:

    • Obturator nerve

    • Femoral nerve

    • Common peroneal nerve

    • Sciatic nerve

    Correct Answer
    A. Common peroneal nerve
    Explanation
    The lithotomy position, which involves lying on the back with the legs elevated and flexed, can put pressure on the common peroneal nerve. This nerve runs along the outer side of the thigh and can be compressed or stretched in this position, leading to nerve injury. The obturator nerve, femoral nerve, and sciatic nerve are not typically affected by the lithotomy position.

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  • 23. 

    Due to venous absorption of irrigation fluid, TURP syndrome can cause:

    • CHF and pulmonary edema

    • Hypotension

    • Hypertension & Bradycardia

    • Confusion and Restlessness

    Correct Answer(s)
    A. CHF and pulmonary edema
    A. Hypotension
    A. Hypertension & Bradycardia
    A. Confusion and Restlessness
    Explanation
    All are correct! Up to 2 liters of irrigation fluid can be absorbed causing dilutional hyponatremia and fluid volume overload.

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  • 24. 
    Extracorporeal shock wave lithotripsy should be delivered ________ msec after the R wave to prevent R-on-T phenomenon. - ProProfs

    Extracorporeal shock wave lithotripsy should be delivered ________ msec after the R wave to prevent R-on-T phenomenon.

    • 5

    • 10

    • 15

    • 20

    Correct Answer
    A. 20
    Explanation
    This prevents acardia.

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  • 25. 

    Increases in female hormones (such as in pregnancy) have been associated with a decrease in pain sensitivity.

    • THAT SOUNDS RIGHT!

    • NO DAT AIN'T TRUE!

    Correct Answer
    A. THAT SOUNDS RIGHT!
    Explanation
    Likewise, decreases in female hormones (seen in menopause) have been associated with an increase in pain sensitivity.

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  • 26. 

    Vaginal blood flow is derived from the uterine and _______________ arteries.

    • Femoral

    • Inferior mesenteric

    • Pudendal

    • Inferior epigastric epigastric

    Correct Answer
    A. Pudendal
    Explanation
    Sensory to the vagina via the pudendal nerve (S2,3,4). Sympathetic via the hypogastric plexus (L1-L3) and parasympathetic via the sacral nerves.

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  • 27. 

    The anesthesia plan for a mastectomy includes a normal induction sequence with rocuronium.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Communicate with the surgeon - many want to assess nerve function during axillary node dissection so a normal dose of roc can't be given (bovie too close to a nerve won't cause a reaction if paralyzed).

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  • 28. 

    Complications from radical lymph node dissection include:

    • Hypotension

    • Bradycardia

    • Venous air embolism (VAE)

    • Excessive bleeding

    Correct Answer(s)
    A. Hypotension
    A. Bradycardia
    A. Venous air embolism (VAE)
    Explanation
    Hypotension and bradycardia secondary to vagal stimulation via the carotid bodies that can progress to cardiac arrest.
    Although excessive bleeding is not a specific risk, venous embolism from the prolonged case with poor blood flow is a risk.

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  • 29. 

    Placement of a bare-metal stent within 6 weeks or a drug-eluting stent within ___________ greatly increase the risk of peri-operative MI.

    • 2 months

    • 6 months

    • 1 year

    • 18 months

    Correct Answer
    A. 1 year
    Explanation
    The placement of a bare-metal stent within 6 weeks or a drug-eluting stent within 1 year greatly increases the risk of peri-operative MI. This means that if a drug-eluting stent is placed within 1 year, there is a higher chance of experiencing a heart attack during or after the surgery. The longer the time interval after stent placement, the lower the risk of peri-operative MI.

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  • 30. 

    The top three causes for anesthesia closed claims are: 

    • Death

    • Myocardial Infarction

    • Nerve Injury

    • Brain Damage

    Correct Answer(s)
    A. Death
    A. Nerve Injury
    A. Brain Damage
    Explanation
    The top three causes for anesthesia closed claims are death, nerve injury, and brain damage. This means that these are the most common outcomes that result in claims related to anesthesia. It is important for anesthesiologists to be aware of these risks and take necessary precautions to prevent such complications.

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  • 31. 
    Greg said to know this chart.*Calcineurin inhibitors like cyclosporine and tacrolimus are used to prevent allograft rejection by inhibiting T-cell activation.* - ProProfs

    Greg said to know this chart.*Calcineurin inhibitors like cyclosporine and tacrolimus are used to prevent allograft rejection by inhibiting T-cell activation.*

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  • Mar 04, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 06, 2017
    Quiz Created by
    Mm223508
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