who selflessly pass on their values and knowledge to us
Department of Anesthesiology and Perioperative Medicine, Drexel University College of
Medicine, Philadelphia, Pennsylvania
Instructor, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts
General Hospital, Boston, Massachusetts
Edward A. Bittner, MD, PhD, FCCP, FCCM
Program Director, Critical Care Medicine-Anesthesiology Fellowship, Associate Director,
Surgical Intensive Care Unit, Assistant Professor of Anaesthesia, Harvard Medical
School, Massachusetts General Hospital, Department of Anesthesia, Critical Care, and
Pain Medicine, Boston, Massachusetts
Surgical Critical Care Fellow, Massachusetts General Hospital, Department of Anesthesia,
Critical Care, and Pain Medicine, Boston, Massachusetts
Thomas M. Halaszynski, DMD, MD, MBA
Associate Professor of Anesthesiology, Director of Regional Anesthesia/Acute Pain
Medicine, Department of Anesthesiology, Yale University School of Medicine, Yale
New Haven Hospital, New Haven, Connecticut
Anesthesia Chief Resident, Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts General Hospital, Boston, Massachusetts
Assistant Professor, Fellowship Director, Critical Care Anesthesiology, Department of
Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska
Clinical Instructor in Anesthesia, Massachusetts General Hospital, Boston, Massachusetts
Anesthesiologist, Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts General Hospital, Assistant Professor of Anaesthesia, Harvard Medical
Assistant Professor of Anesthesiology, Yale University School of Medicine, Yale New
Haven Hospital, New Haven, Connecticut
Staff Anesthesiologist, Cumberland Pain Management, Cumberland, Maryland
Assistant Professor, Department of Anesthesia, Critical Care, and Pain Medicine,
Massachusetts General Hospital, Boston, Massachusetts
Associate Clinical Professor, University of California, San Francisco (UCSF), Department
of Anesthesia and Perioperative Care, San Francisco, California
Department of Anesthesiology and Perioperative Medicine, Drexel University College of
Medicine, Philadelphia, Pennsylvania
Department of Anesthesia and Perioperative Medicine, Signature Healthcare Brockton
Hospital, Brockton, Massachusetts, Affiliate of Beth Israel Deaconess Medical Center,
Boston, Massachusetts (Former Faculty—Brigham and Women’s Hospital, Harvard
Ashish C. Sinha, MD, PhD, DABA
Vice Chairman, Anesthesiology & Critical Care, Drexel University College of Medicine,
Hahnemann University Hospital, Philadelphia, Pennsylvania
Department of Anesthesia, All India Institute of Medical Sciences, New Delhi, India
Clinical Fellow, Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, Massachusetts
Department of Anesthesiology and Perioperative Medicine, Drexel University College of
Medicine, Philadelphia, Pennsylvania
The practice of anesthesiology requires a solid foundation of knowledge. It is with extreme
pleasure that we introduce Lippincott’s Anesthesia Review: 1,001 Questions and Answers.
The book is designed to rapidly review anesthesiology to help residents pass the written
examinations taken during and after residency. The book is broadly divided into 21
chapters to cover almost all relevant topics tested. Each question is followed by four
possible answers, among which one is the best or most likely answer.
The editors acknowledge the work of all who have given their valuable time and effort
to complete this book. These include all authors, proofreaders (including Shilpa Shah,
MD), and the team at Lippincott Williams & Wilkins. We would also like to thank our
families for their support while we prepared this manuscript.
We hope that this review book proves to be a valuable educational resource for
anesthesia residents and young practitioners to help them pass the boards. For any
constructive suggestions, please contact us by email: Anes1001@outlook.com.
1. Perioperative Evaluation and Management
PREET SINGH, MANISH PUROHIT, ASHISH SINHA, AND PAUL SIKKA
YURIY BRONSHTEYN AND EDWARD BITTNER
DARREN HYATT, ALA NOZARI, AND EDWARD BITTNER
5. Fluid Management and Blood Transfusion
REBECCA KALMAN AND EDWARD BITTNER
7. Spinal and Epidural Anesthesia
DEPPU USHAKUMARI AND ASHISH SINHA
DEPPU USHAKUMARI AND ASHISH SINHA
14. Gastrointestinal, Liver, and Renal Diseases
16. Ophthalmic, Ear, Nose, and Throat Surgery
DAVID STAHL, DANIEL JOHNSON, AND EDWARD BITTNER
20. Postoperative Anesthesia Care
PAUL SIKKA AND THOMAS HALASZYNSKI
Perioperative Evaluation and Management
Preet Singh, Manish Purohit, Ashish Sinha, and Paul Sikka
1. Preoperative application of scopolamine patch to prevent postoperative nausea and
C. Patient with a blood pressure of 160/96 mm Hg
2. Which of the following drugs is least likely to be effective for prophylaxis for
postoperative nausea and vomiting?
3. Famotidine, when used for stress ulcer prophylaxis, must be avoided preoperatively
in which of the following patients?
A. Patients with replaced mitral valve on warfarin
B. Patients with idiopathic thrombocytopenic purpura (ITP) for splenectomy
C. Patients with achalasia cardia for esophageal myotomy
D. Patients with a history of coronary stenting on aspirin
4. Which of the following drugs antagonizes substance P in the central nervous system
and is used as premedication to prevent postoperative nausea and vomiting?
5. Which of the following predictors is likely to be associated with lower incidence of
perioperative nausea and vomiting?
B. Use of fentanyl for pain relief
C. Patients with a history of smoking
D. Patients undergoing laparoscopic surgery
6. All of the following have an antiemetic action, except
7. Cefazolin, as a component of perioperative antimicrobial prophylaxis for surgery,
must begin within what time before incision?
A. Simultaneously with incision
B. Within 30 minutes prior to incision
C. Within 60 minutes prior to incision
D. Within 120 minutes prior to incision
8. Vancomycin, as a component of perioperative antimicrobial prophylaxis for surgery,
must begin within what time before incision?
A. Simultaneously with incision
B. Within 30 minutes prior to incision
C. Within 60 minutes prior to incision
D. Within 120 minutes prior to incision
9. A 65-year-old male with a history of hypertension and diabetes presents to
emergency department with altered sensation with a likely subdural hematoma. To
assess his cardiorespiratory status, he is asked about his level of physical activity. If
he is capable of performing at least which of the following activities independently,
he is less likely to have significant cardiopulmonary ailment during surgery?
A. Walk to washroom on level floor
10. In preoperative assessment of patients, physical activity is graded in terms of
metabolic equivalents (METs). The value that corresponds to oxygen consumption
11. As per American Society of Regional Anesthesia (ASRA) guidelines, intravenous
infusion of unfractionated heparin should be stopped how long prior to a planned
12. For emergent surgery, anticoagulation produced by warfarin can be reversed by
C. Prothrombin complex concentrate
13. Neuraxial block is not contraindicated for patients on which of the following drugs?
B. Low-molecular-weight heparin
14. All of the following are risk factors for obstructive sleep apnea, except
15. A 70-year-old male, who is diabetic for the last 20 years, is scheduled for an
elective surgery. Which of the following is not a sign of autonomic diabetic
A. History of recurrent diarrhea
B. History of postural hypotension
C. History of recurrent constipation
D. History of urinary retention
16. Which of the following perioperative factors in patients undergoing dialysis prior to
surgery predicts the possibility of hypotension (due to increased volume removed)?
D. Change in pH after dialysis
17. A patient with a history of severe asthma is scheduled for an appendectomy. Which
of the following induction agents will cause the least respiratory depression?
18. Which of the following drugs can significantly prolong the QT interval on the ECG?
20. Effect of combined administration of midazolam and fentanyl is
D. Noncompetitively antagonistic
21. Preoperative anesthetic evaluation is likely to bring down the incidence of all the
22. For elective procedures, an anesthesia provider must obtain informed and preferably
A. Just prior to transferring the patient to the operating room for surgery
B. During preoperative anesthetic evaluation
C. At the same time that a surgeon obtains consent for the surgical procedure
D. Just prior to induction of anesthesia in the operating room
23. An optimal preoperative evaluation is designed
A. To screen for and properly manage comorbid conditions
B. To assess the risk of anesthesia and surgery and lower it
C. To identify patients who may require special anesthetic techniques or
24. ASA classification for risk stratification is validated for predicting preoperative
morbidity associated with the following, except
A. General or regional anesthesia
25. A healthy pregnant patient in labor has which of the following ASA classifications?
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