EDAIC Hepatic, Renal and Endocrine Anesthesia

Question 1

Which volatile anesthetic agent is considered MOST hepatotoxic and carries the highest risk of immune-mediated fulminant hepatic necrosis?

Accepted Answer

Halothane

Answer

Isoflurane

Answer

Sevoflurane

Answer

Desflurane

Question 2

In a patient with end-stage liver disease, the volume of distribution of highly protein-bound drugs is most likely to:

Accepted Answer

Increase due to hypoalbuminemia increasing free drug fraction

Answer

Decrease due to reduced hepatic blood flow

Answer

Remain unchanged

Answer

Decrease due to ascites reducing extracellular fluid

Question 3

The hepatic artery supplies approximately what percentage of total hepatic blood flow?

Accepted Answer

25%

Answer

10%

Answer

50%

Answer

75%

Question 4

During liver transplantation, the anhepatic phase is associated with which hemodynamic change?

Accepted Answer

Hypotension due to inferior vena cava (IVC) occlusion and reduced venous return

Answer

Increased cardiac output from portal hypertension relief

Answer

Hypertension from systemic vascular resistance increase

Answer

Tachycardia from sympathetic stimulation only

Question 5

Which coagulation abnormality is MOST commonly seen in advanced liver disease?

Accepted Answer

Decreased production of vitamin K-dependent factors II, VII, IX, X

Answer

Elevated factor VIII levels

Answer

Thrombocytosis from splenic sequestration reversal

Answer

Elevated fibrinogen

Question 6

Succinylcholine duration of action is prolonged in severe liver disease primarily because of:

Accepted Answer

Decreased plasma pseudocholinesterase production by the liver

Answer

Reduced renal clearance of succinylcholine

Answer

Accumulation of toxic metabolites

Answer

Increased acetylcholine receptor sensitivity