Anesthesiology board review by Kerri M. Robertson, David J Lubarsky, Sudharma Ranasinghe

By Kerri M. Robertson, David J Lubarsky, Sudharma Ranasinghe

Why waste time guessing at what you must recognize for anesthesia in-service and board examination? Maximize your examination instruction time with this quick-hit query and resolution assessment. the original query and single-answer structure removes the guesswork linked to conventional multiple-choice Q&A experiences and reinforces in simple terms the proper solutions you will want to understand on examination day. Emphasis is put on distilling key evidence and medical pearls crucial for examination luck. This high-yield evaluation is ideal for severe, streamlined evaluation within the days and weeks sooner than your examination.

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How does the parasympathetic nervous system innervate its end-organs? The craniosacral outflow tracts extend out as long preganglionic fibers that synapse at ganglia that are near the effector organs. Short postganglionic fibers make the terminal connections to elicit the end-organ response.  What are the neurotransmitters of the sympathetic and parasympathetic nervous systems? Acetylcholine is used as the preganglionic neurotransmitter at the level of the ganglia in both the sympathetic and parasympathetic nervous systems.

What is dysautonomia? Autonomic dysfunction due to generalized, segmental or focal disorders of the central or peripheral nervous system. The most serious anesthetic risk is orthostatic hypotension. Dysautonomic crises triggered by stress are characterized by hypertension, tachycardia, abdominal pain, diaphoresis and vomiting.  What causes dysautonomia? Congenital, familial or acquired (infectious states, drugs or trauma). Each may lead to different signs or symptoms, depending on the location and degree of autonomic dysfunction.

Up to 12 hours.  What may delay gastric emptying? Idiopathic gastroparesis remains the most common cause of delayed gastric emptying. Diabetes mellitus, anorexia nervosa, gastric surgery, gastric outlet obstruction, obesity, stress from pain or anxiety, neurologic disorders, disease involving the gastric wall or nerves, drugs, such as opioids, and pregnancy. Long bone fractures are associated with incomplete gastric emptying for up to 24 hours.  Where is the vomiting center located? Medulla.  T/F: Nasogastric and gastric tubes increase the risk of aspiration.

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