ABA Emergency Response Procedures 4

Question 1

A patient develops pulseless electrical activity (PEA) intraoperatively. Which mnemonic summarizes the reversible causes to address immediately?

Accepted Answer

5Hs and 5Ts (Hypovolemia, Hypoxia, Hydrogen ion, Hypo/hyperkalemia, Hypothermia; Tension pneumothorax, Tamponade, Toxins, Thrombosis pulmonary, Thrombosis coronary)

Answer

The 5Hs and 5Ts mnemonic from ACLS identifies all reversible causes of PEA that must be systematically evaluated and treated during resuscitation.

Question 2

During a laparoscopic procedure, end-tidal CO2 abruptly rises to 80 mmHg and SpO2 drops to 78% with decreased breath sounds on the left. The MOST likely cause is:

Accepted Answer

Pneumothorax from trocar injury

Answer

Trocar injury to the pleura during laparoscopy can cause pneumothorax, presenting with unilateral decreased breath sounds, rising ETCO2, and hypoxia.

Question 3

A patient receiving a blood transfusion develops fever, chills, flank pain, and hemoglobinuria 15 minutes into the transfusion. What is the FIRST step?

Accepted Answer

Stop the transfusion immediately and maintain IV access with normal saline

Answer

Acute hemolytic transfusion reaction requires immediately stopping the transfusion and maintaining IV access to treat hypotension and prevent renal failure from free hemoglobin.

Question 4

After induction with succinylcholine, a patient's potassium rises from 4.2 to 7.8 mEq/L causing tall peaked T-waves. Which patient population is at highest risk for this hyperkalemic response?

Accepted Answer

Patients with burn injury more than 48 hours old or denervation injuries

Answer

Upregulation of extrajunctional acetylcholine receptors after burns (>24–48 h) or denervation (spinal cord injury, stroke) causes massive potassium efflux with succinylcholine.

Question 5

During a carotid endarterectomy under general anesthesia, the patient suddenly develops ST-segment elevation in leads II, III, and aVF. The most appropriate immediate action is:

Accepted Answer

Notify the surgeon to abort the procedure; optimize coronary perfusion pressure

Answer

Intraoperative inferior STEMI requires immediate notification of the surgical team and hemodynamic optimization (MAP >70) to maintain coronary perfusion while arranging emergent intervention.

(ABA) American Board of Anesthesiology Practice Test

(ABA) American Board of Anesthesiology Practice Test

ABA Emergency Response Procedures 4