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Colombian Journal of Anestesiology

Print version ISSN 0120-3347

Rev. colomb. anestesiol. vol.46 no.3 Bogotá July/Sept. 2018

https://doi.org/10.1097/cj9.0000000000000074 

Questions and answers

Questions and answers

Fernando Raffán-Sanabriaa  b 

a Anesthesiologist - intensivist, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

b Professor, Universidad del Bosque and Universidad de los Andes, Bogotá, Colombia.

1) Chronic Thromboembolic Pulmonary Disease (CTEPH) is a major cause of severe pulmonary hypertension and right ventricular dysfunction. Which of the following statements is false?1

  1. the incidence reported of CTEPH in patients with acute pulmonary thromboembolism (PTE) ranges from 0.6% to 4%, approximately.

  2. CTEPH is the single curable cause of PHT with surgical management through pulmonary endarterectomy.

  3. The estimated survival is of 20% when the mean pulmonary arterial pressure (mPAP) is > 40mmHg and of 2% for mPAP >50mmHg.

  4. Several groups suggest that every patient should be a candidate for surgery, if the source of the PHT is thromboembolic.

2) Which of the following electrolytic disorders is more frequent among hospitalized patients?2

  1. Hypomagnesemia.

  2. Hyperchloremia.

  3. Hyponatremia.

  4. Hypopotassemia.

3) Based on blood sodium levels, hyponatremia may be classified as severe hyponatremia when the levels are within the following range2:

  1. 125-129 mEq/L.

  2. 120-124 mEq/L.

  3. <125 mEq/L.

  4. < 115 mEq/L.

4) The following statements have been reported with regards to the use of Dipyrone (metamizol)3:

  1. A Cochrane analysis of the use of Dipyrone (metamizol) for various indications (acute postoperative pain, acute pain from renal colic, and primary acute headaches) has shown an adequate short-term safety profile.

  2. The International Aplastic Anemia Study (IAAS) revealed a global annual incidence of agranulocytosis of around 6 cases per million, and a mortality rate of 0.5 per million.

  3. Kotter, in a systematic review and meta-analysis of adverse events associated with the use of metimazol, in around 4000 patients with short-term Dipyrone use of less than two weeks, did not report any agranulocytosis or associated deaths.

  4. All of the above.

5) Post-anesthesia arousal, delirium, and agitation are all terms interchangeably used within the context of pediatric anesthesia. Which of the following factors has been considered a genuine risk factor?4

  1. Head and neck surgery.

  2. Age under 5 years old.

  3. Use of halogenated compounds.

  4. All of the above.

6) The Sugarbaker procedure - cytoreductive surgery and hyperthermic intraperitoneal chemotherapy - is the treatment of choice for the management of patients with all of the following diagnosis, except for5:

  1. Peritoneal mesothelioma.

  2. Peritoneal pseudomyxoma.

  3. Peritoneal carcinoma due to primary ovarian tumors.

  4. Peritoneal carcinoma due to primary pancreatic tumors.

7) Which of the following agents used in hyperthermic intraperitoneal chemotherapy is associated with pulmonary hypertension as an adverse effect?5

  1. Doxorubicin.

  2. Mitomycin C.

  3. Fluorouracil.

  4. Gemcitabine.

8) With regards to the use of dantrolene for the management of malignant hyperthermia, the following recommendations are true, except for6:

  1. The initial dose is 2.5mg/Kg of weight.

  2. Each dantrolene vial comes with 3g of mannitol and sodium hydroxide, and should be reconstituted in dextrose in distilled water or in normal saline solution.

  3. Shake the vial vigorously until a clear and uniform solution is obtained.

  4. Continue the administration until the signs and symptoms resolve, or after completing 10mg/Kg.

9) In which of the following surgical interventions is an epidural block between T6 and T10 recommended?7

  1. Nephrectomy.

  2. Colectomy.

  3. Hysterectomy.

  4. A and B are true.

10) Neurological patients in the ICU often present with hyponatremia with cerebral salt-wasting (CSW) or inappropriate antidiuretic hormone secretion (SIADH). Which of the following characteristics are not present in CSW?2

  1. Excessive sodium loss.

  2. Decreased blood levels of uric acid and urea nitrogen that are co-transported with sodium.

  3. Volume depletion.

  4. A and B.

Answers

  1. C.

  2. C.

  3. C.

  4. D.

  5. D.

  6. D.

  7. B.

  8. B.

  9. A.

  10. B.

References

1. Cruz-Suárez GA, Castro-Pérez JA, Echavarría-Vásquez JD, Bolivar-Giraldo IC, Echeverri-Saldarriaga S, Ariza F. Endarterectomía pulmonar en un centro cardiovascular colombiano, experiencia y principales desenlaces. Rev Colomb Anestesiol 2018;46:103-108. [ Links ]

2. Rocha-Rivera HF, Javela-Rugeles JD, Barrios-Torres JC, Montalvo-Arce C, Tovar-Cardozo JH, Tejada-Perdomo JH. Incidencia de hiponatremia postoperatoria en pacientes neuroquirurgicos en un hospital del sur colombiano. Rev Colomb Anestesiol 2018;46:109-117. [ Links ]

3. González-Cárdenas VH, Laverde-Gaona LA, Cabarique-Serrano SH, Cháves-Rojas N, Reina-Sierra JA, Infante JS, et al. Análisis de la incidencia de eventos adversos relacionados a aplicación de dipirona. Rev Colomb Anestesiol 2018;46:125-131. [ Links ]

4. González-Cardenas VH, Munar-González FD, Pinzón-Villazon IL, Cabarique-Serrano SH, Burbano-Paredes CC, Cháves-Rojas N, et al. Estudio del delirium y dolor agudo postoperatorio pediátrico en cirugías de bajo riesgo quirúrgico. Rev Colomb Anestesiol 2018;46:132-139. [ Links ]

5. Escobar B, Medina-Piedrahita P, Gómez-Henao P, Higuera-Palacio A, García-Mora M, Ruiz-Villa JO, et al. Cirugíacitorreductiva y quimioterapia intraperitoneal hipertérmica: Conceptos importantes para el anestesiólogo. Rev Colomb Anestesiol 2018;46:140-149. [ Links ]

6. Giraldo-Gutiérrez DS, Arrendo-Verbel MA, Rincón-Valenzuela DA. Reconstitución del dantroleno: descripción de un modelo de simulación en hipertermia maligna. Reporte de caso. Rev Colomb Anestesiol 2018;46:160-166. [ Links ]

7. Ariza F, Rodriguez-Mayoral H, Villarreal K. Analgesia epidural en cirugía abdominal mayor: pros, contras y puntos sin resolver mas allá del control del dolor. Rev Colomb Anestesiol 2018;46:183-184. [ Links ]

How to cite this article: Raffán-Sanabria F. Questions and answers. Rev Colomb Anestesiol. 2018;46:268-269.

Funding comment The author has no funding to disclose.

Conflicts of interest The author has no conflicts of interest to disclose.

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License

 
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