MODERATE SEDATION COURSE 2021 November 11, 2021 0 Uncategorized Load QuizSave QuizThis quiz consists of 10 questions. Each question, you are required to provide 3 responses with an answer True [T] or False [F]. In total, you are required to provide 30 responses. To pass this quiz, you will need to answer correctly to 25 out of the 30 responses. Please note that you have only up to 3 attempts to pass the quiz. Your information 1. Please assess the following scenario: During insertion of the endoscope, the patient is noted to have noisy breathing and Sp02 revealed a dropped from baseline 99% to 93%.a. Procedure can continue but examination should be hastened True Falseb. Sedation should be deepened to provide more comfort to the patient True Falsec. Laryngospasm is a potential complication True False2. Regarding drug use in sedationa. When used in a healthy 60 year old female with BMI 18, an initial dose of midazolam 4mg and fentanyl 75 mcg given over 2 min is safe True Falseb. In patients struggling during endoscopy, further top up with midazolam 1mg can be given every 1 minute until the patient is calm True Falsec. If the patient is not achieving adequate sedation despite standard doses, the IV cannula should be checked for possible extravasation True False3. Regarding the right selection of patients for moderate sedation in gastroscopy. The following patients are considered suitable for endoscopist-directed sedation:a. A 65 year male with well controlled diabetes mellitus and a Mallampati score of II True Falseb. A 35 year old male BMI 40, with a history of snoring and a Mallampati score III True Falsec. A 70 year old female admitted for giddiness and hypotension after several bouts of hematemesis True False4. Regarding a patient who had completed the procedure and is in recovery rooma. After flumazenil was provided to patient for reversal, the endoscopist should review the patient before discharge True Falseb. The patient with a blood pressure BP 80/40 mmHg and HR 100/min can be safely discharged without review if otherwise alert True Falsec. Patients who have undergo sedation can be allowed to drive home if they fulfil the hospital ‘fitness for discharge’ True False5. The following are important aspects of safe monitoringa. The endoscopist is primarily responsible for the safe monitoring of patient during endoscopy True Falseb. Head tilt chin lift and jaw thrust should be performed in the presence of hypoxia True Falsec. Ephedrine can be used to counteract the hypotensive effects of sedatives True False6. Please assess the following scenario:A 50 year old male, ASA II, weighing 55kg, Mallampati score II, was given the following initial doses of sedative drugs. Midazolam 2 mg and Fentanyl 37.5 mcg prior to a routine gastroscopya. His sedation level should not be deepened within the first 2 minutes of initial drugs administered True Falseb. If he is struggling during insertion of the scope, an add-on dose of propofol 40mg can be given to rapidly deepen his sedation True Falsec. If his pulse oximeter reads 92% during the procedure and there is noisy breathing, head tilt chin lift and jaw thrust should be given True False7. Regarding procedure room assessmenta. ‘Time out’ can be performed for an anxious patient after a small ‘calming’ dose of midazolam is given True Falseb. IV access should be maintained throughout the entire procedure True Falsec. Supplemental oxygen is recommended for all receiving moderate sedation unless there are specific contraindications True False8. Regarding drug use in sedationa. The standard initial dose for a healthy 50 year old patient weighing 53kg is as follows: midazolam 2mg and fentanyl 37.5 mcg True Falseb. Patients who received topical lignocaine spray can be allowed to eat immediately after completion of gastroscopy if they did not receive sedation True Falsec. Respiratory depression is a major side effect of midazolam True False9. Regarding drug use in sedationa. Due to the synergistic effect of sedatives and narcotics used in combination, individual drug doses should be reduced True Falseb. The initial dose of Propofol alone sedation for a 65 year old patient (ASA I, 60kg) undergoing OGD is 80-100mg over 1 min True Falsec. The initial dose of naloxone to reverse respiratory depression in opioid over-sedation is 0.02-0.2mg and can be repeat every 2-3min True False10. In assessing your patients for risk of sedationa. Uvula is well-visualised with a Mallampati score of III True Falseb. A focused examination revealing rhonchi in the lungs during assessment should prompt further work up/treatment before elective scope True Falsec. A patient with uncontrolled hypertension is classified as ASA 2 True False3 out of 2You have reached the end of the quiz. To review your answer from the previous page, click the previous button. If you are ready to submit your quiz, click the submit button. Thank you. Time is Up! Time's up
