The Internet Journal of Anesthesiology

Questions and Answers

by Olivier C. Wenker, M.D.

Part 8

Introduction: This site was created in order to stress your brain for a few minutes (3 questions) while surfing by. Every once in a while we will update this section with new questions and answers. This will give you the opportunity to check your knowledge in different anesthesiologic fields. If you would like to be informed whenever we update this section please subscribe for free as reader of  The Internet Journal of Anesthesiology. We will send you an e-mail message every time we add or update some of our pages.  

Disclaimer: One should keep in mind that the current opinion in Europe may differ from the one in Australia or in the U.S. Having an international readership, it might be difficult to satisfy everybody with the given answers or the suggestions for additional reading. In order to assure the accuracy of this section, all the questions and especially the answers will be reviewed by several international members of the editorial board. Nevertheless, it is difficult to ensure that all the information given is entirely accurate for all circumstances. The publishers disclaim any liability, loss, or damage occurred as consequence, directly or indirectly, of the use and application of any of the content of this section.

Question 1:

A 55 year old, 70 kg patient presents with the following ABG: pH 7.15, PaCO2 30 mmHg, and BE -11, HCO3 15 mmol/l

  • what kind of acid-base disturbance is presented?
  • what would be the dosage of sodium bicarbonate to correct this disturbance
  • what would be the dosage of THAM (Trihydroxymethylaminomethan)  to correct this disturbance

 

for an answer click here

 

Question 2:

Neuroanesthesia:

  • What is the intracranial blood volume in ml ?
  • What % of the cardiac output is delivered to the brain ?
  • What is the cerebral perfusion in ml/min ?

 

for an answer click here

 

Question 3:

What are the clinical signs (trias) of a cardiac tamponade ?

 

for an answer click here

 

 

 

 

 

 

 

 

 

 

Answers

Answer to Question 1:

  • metabolic acidosis
  • neg BE x 0.2 x kg = 11 x 0.2 x 70 = 154 mmol sodium bicarbonate
    (some authors prefer to multiply with 0.3 instead of 0.2)
  • neg BE x kg = 11 x 70 = 770 ml THAM

for next question (question 2) click here

 

 

 

 

 

 

 

 

 

Answer to Question 2:

  • 100 - 150 ml
  • 15 %
  • 50 ml/min/100g = 700 - 900 ml/min

 

for next question (question 3) click here

 

 

 

 

 

 

 

 

 

Answer to Question 3:

The clinical trias of cardiac tamponade consists of:

  1. increased CVP
  2. pulsus paradoxus
  3. distant heart sounds

 

 

back to question 1 click here

© Internet Scientific Publications, L.L.C., 1996 to 1998.

First Published: October 1996

The Internet Journal of Anesthesiology