©SIRJOEL EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
Nagelhout Exam Questions And Answers
How much in advance should pts with complex medical conditions be evaluated? - Answers✔1
week prior to scheduled procedure
Objectives of the pre op interview: - Answers✔Ensure goals of pre op assessment are met
Provide pre op education to pt and family
Informed consent
Aquaint pt and family to surgical process
Eval pt social situation and support network
Motivate pt to comply to preventive care strategies
What familial tendencies for diseases should be investigated when they come up in pre op
interview? - Answers✔atypical plasmacholinesterase
MH
porphyria
glycogen storage diseases(glucose6phosphate dehyrogenase deficiency)
1|Page
, ©SIRJOEL EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
Intaoperative concerns regarding ACE inhibitors - Answers✔Hypotension w or w/o bradycardia
that may be refractory to pressors
Intraoperative concerns regarding diuretics - Answers✔Hypovolemia and hypokalemia
Intaoperative concerns regarding antidysrhytmics - Answers✔cardiac depression, prolonged
NMB
amiodarone-hypotension and atropine resistant bradycardia requiring pacing
INtraoperative concerns regarding MAOis - Answers✔HTN secondary to indirect acting
sympathomimetic drugs causing release of NE; excitatory state (from meperidine) or depressive
phenomena secondary to opioid administration
AVOIND KNOW TRIGGER SUCH as MEPERIDINE
Intraoperative concerns regarding TCAs - Answers✔a-adrenergic blocking activity and
potentiation of sympathomimetic effects of epi and NE, resulting in HTN crisis; card
arrhythmias; lowers seizure threshold
Intaoperative concerns regarding SSRI - Answers✔Serotoniergic potentitation with GI
symptoms, HA and agitation
Intraoperative concerns regarding lithium: - Answers✔T wave smoothing, vent arrhythmias,
myocarditis; sinus dysfunction can lead to extreme atropine resistant sinus brady cardia;
dehydration will lead to increases in lithium blood levels
2|Page
ALL RIGHTS RESERVED.
Nagelhout Exam Questions And Answers
How much in advance should pts with complex medical conditions be evaluated? - Answers✔1
week prior to scheduled procedure
Objectives of the pre op interview: - Answers✔Ensure goals of pre op assessment are met
Provide pre op education to pt and family
Informed consent
Aquaint pt and family to surgical process
Eval pt social situation and support network
Motivate pt to comply to preventive care strategies
What familial tendencies for diseases should be investigated when they come up in pre op
interview? - Answers✔atypical plasmacholinesterase
MH
porphyria
glycogen storage diseases(glucose6phosphate dehyrogenase deficiency)
1|Page
, ©SIRJOEL EXAM SOLUTIONS 2024/2025
ALL RIGHTS RESERVED.
Intaoperative concerns regarding ACE inhibitors - Answers✔Hypotension w or w/o bradycardia
that may be refractory to pressors
Intraoperative concerns regarding diuretics - Answers✔Hypovolemia and hypokalemia
Intaoperative concerns regarding antidysrhytmics - Answers✔cardiac depression, prolonged
NMB
amiodarone-hypotension and atropine resistant bradycardia requiring pacing
INtraoperative concerns regarding MAOis - Answers✔HTN secondary to indirect acting
sympathomimetic drugs causing release of NE; excitatory state (from meperidine) or depressive
phenomena secondary to opioid administration
AVOIND KNOW TRIGGER SUCH as MEPERIDINE
Intraoperative concerns regarding TCAs - Answers✔a-adrenergic blocking activity and
potentiation of sympathomimetic effects of epi and NE, resulting in HTN crisis; card
arrhythmias; lowers seizure threshold
Intaoperative concerns regarding SSRI - Answers✔Serotoniergic potentitation with GI
symptoms, HA and agitation
Intraoperative concerns regarding lithium: - Answers✔T wave smoothing, vent arrhythmias,
myocarditis; sinus dysfunction can lead to extreme atropine resistant sinus brady cardia;
dehydration will lead to increases in lithium blood levels
2|Page
