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Quizzes > Quizzes for Business > Healthcare

Thyroidectomy Anesthesia Knowledge Test: Take the Quiz

Sharpen Anesthesia Techniques for Thyroid Surgery

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art depicting elements related to Thyroidectomy Anesthesia Knowledge Test quiz

Step into this thyroidectomy anesthesia quiz to challenge and sharpen your preoperative assessment and airway management skills for thyroid surgery. Ideal for anesthesia students, residents, and seasoned clinicians seeking to refine their anesthesia knowledge test performance. The interactive assessment offers customizable questions that can be freely modified in our editor for personalized practice. For further study, explore the Neuro Anesthesia Knowledge Test or Dental Anesthesia Knowledge Assessment in our quizzes library.

Which preoperative laboratory test is most essential to assess thyroid function before thyroidectomy?
Serum amylase
Serum magnesium
Thyroid”stimulating hormone (TSH) level
Arterial blood gas
TSH is the primary screening test for thyroid function and guides perioperative management. Other tests do not directly reflect thyroid status.
What is the optimal neck position for anesthetic management during thyroidectomy?
Supine with neck extension and shoulder roll
Trendelenburg with head turned to the side
Prone with neutral neck
Lateral decubitus with slight flexion
Neck extension with a shoulder roll provides optimal surgical exposure and maintains a stable airway alignment. Other positions are not suitable for thyroid access.
Which nerve is most at risk of injury during thyroidectomy?
Spinal accessory nerve
Phrenic nerve
Recurrent laryngeal nerve
Hypoglossal nerve
The recurrent laryngeal nerve runs close to the thyroid gland lobes and is vulnerable during dissection. Injury can cause vocal cord paralysis.
What is the most common electrolyte disturbance after total thyroidectomy?
Hypermagnesemia
Hypocalcemia
Hypernatremia
Hypokalemia
Parathyroid glands can be inadvertently damaged or devascularized, leading to hypocalcemia. Other disturbances are less common.
Which airway device is most appropriate for airway control during thyroidectomy?
Oropharyngeal airway
Laryngeal mask airway
Cuffed endotracheal tube
Nasopharyngeal airway
A cuffed endotracheal tube secures the airway, protects against aspiration, and allows positive-pressure ventilation, which is required for thyroid surgery.
In hyperthyroid patients, which induction agent is preferred due to its minimal cardiovascular stimulation?
Ketamine
Propofol
Thiopental
Etomidate
Propofol has favorable cardiovascular profile with reduced sympathetic tone, making it ideal for hyperthyroid patients. Ketamine would increase heart rate and blood pressure.
How does hyperthyroidism affect the minimum alveolar concentration (MAC) of volatile anesthetics?
MAC becomes unpredictable
MAC is unchanged
MAC is increased
MAC is decreased
Hyperthyroidism increases baseline metabolic rate and sympathetic activity, raising MAC. This requires higher volatile agent concentrations for the same effect.
Which airway management technique is most appropriate for a patient with a large goiter causing tracheal deviation?
Blind nasal intubation
Standard laryngoscopy
Awake fiberoptic intubation
Supraglottic airway
Awake fiberoptic intubation maintains spontaneous ventilation and visualizes distorted anatomy, enhancing safety in tracheal deviation.
Which muscle relaxant is least appropriate if intraoperative recurrent laryngeal nerve monitoring is planned?
Vecuronium
Cisatracurium
Succinylcholine
Rocuronium
Succinylcholine produces fasciculations and prolonged depolarization, interfering with nerve monitoring signals. Nondepolarizing agents are preferred.
For a hyperthyroid patient, which medication is administered preoperatively to control heart rate and reduce thyroid hormone conversion?
Labetalol
Metoprolol
Propranolol
Atenolol
Propranolol controls heart rate and inhibits peripheral conversion of T4 to T3. Atenolol and metoprolol do not affect hormone conversion, and labetalol has less beta blockade.
Which change in anesthetic management is recommended for hypothyroid patients?
Reduce induction dose of anesthetics
Increase fluid administration drastically
Avoid all opioids
Increase MAC of volatile agents
Hypothyroid patients have reduced drug clearance and increased sensitivity, warranting lower induction doses. Their MAC is decreased, not increased.
What intraoperative monitoring tool uses electrodes built into the endotracheal tube to protect the recurrent laryngeal nerve?
Bispectral index (BIS) monitor
EMG endotracheal tube
Central venous pressure monitor
Train”of”four (TOF) stimulator
An EMG endotracheal tube has electrodes to detect laryngeal muscle activity and provides real”time recurrent laryngeal nerve monitoring. BIS and CVP do not monitor nerves.
Which postoperative analgesic strategy is most appropriate after thyroidectomy?
High”dose intravenous morphine alone
Multimodal analgesia with non”opioid and local infiltration
No analgesics to avoid sedation
Continuous epidural local anesthetic
Multimodal analgesia combining non”opioid agents and local infiltration reduces opioid requirements and side effects. Epidurals are not typically used for thyroidectomy.
How is postoperative hypocalcemia best managed if symptomatic after thyroidectomy?
Aggressive sodium intake
IV calcium gluconate
IV magnesium sulfate
High”dose vitamin D only
IV calcium gluconate provides immediate correction of symptomatic hypocalcemia. Vitamin D supports long”term absorption but is not for acute symptoms.
What physiologic mechanism explains the increased MAC requirement in hyperthyroid patients?
Elevated sympathetic tone and metabolic rate
Enhanced renal clearance of anesthetics
Increased plasma protein binding
Reduced cardiac output
Hyperthyroidism raises sympathetic activity and basal metabolism, increasing MAC. Protein binding and clearance changes are not primary drivers of MAC.
Which strategy allows continuous intraoperative monitoring of the recurrent laryngeal nerve?
Intermittent manual palpation of the nerve
BIS index monitoring
Visual inspection only
Continuous vagal nerve stimulation with EMG recording
Continuous vagal stimulation with EMG provides real”time feedback on nerve integrity. Visual inspection or palpation is intermittent and less sensitive.
During surgery, a patient develops hyperthermia, tachycardia, and hypertension despite adequate depth of anesthesia. What is the most likely cause?
Anaphylaxis
Malignant hyperthermia
Sepsis
Thyroid storm
Thyroid storm presents with hyperthermia, tachycardia, and hypertension intraoperatively in thyroid patients. Malignant hyperthermia includes muscle rigidity and acidosis, which differ.
How does hypothyroidism alter pharmacokinetics and anesthetic drug sensitivity?
Decreased sensitivity only
Increased clearance and decreased sensitivity
No change in clearance, increased sensitivity
Decreased clearance and increased sensitivity
Hypothyroidism slows metabolic clearance and increases central nervous system sensitivity, requiring dose reductions. Clearance is not increased.
What immediate intervention is required if a neck hematoma compresses the airway after thyroidectomy?
Increase FiO2 to 100%
Bolus of IV corticosteroids
Start noninvasive ventilation
Urgent surgical decompression of the wound
A neck hematoma that compromises the airway necessitates immediate surgical decompression. Oxygen and steroids may help but do not relieve mechanical compression.
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Learning Outcomes

  1. Identify key anesthetic considerations for thyroidectomy patients.
  2. Apply airway management protocols specific to thyroid surgery.
  3. Evaluate perioperative thyroid hormone impact on anesthesia care.
  4. Demonstrate neuromonitoring techniques to protect recurrent laryngeal nerves.
  5. Analyse anesthetic drug choices for hypo- and hyperthyroid conditions.
  6. Master postoperative pain and complication management strategies.

Cheat Sheet

  1. Optimize Thyroid Hormone Levels - Ensure your patient has reached a stable euthyroid state before surgery to minimize perioperative surprises and keep vital signs in check. Proper pre-op assessment and medication adjustments are your best friends here. OpenAnesthesia: Anesthesia for Thyroidectomy
  2. Be Ready for a Tricky Airway - A large thyroid mass can push on the larynx or trachea, making intubation a puzzle. Always have advanced airway tools and a backup plan at the bedside. PubMed: Difficult Airway Management
  3. Protect the Recurrent Laryngeal Nerve - Intraoperative neuromonitoring using special electrodes on the endotracheal tube helps you spot nerve irritation in real time, reducing vocal cord injury risk. It's like having a live GPS for nerve safety. OpenAnesthesia: Neuromonitoring Tips
  4. Watch for Postoperative Hypocalcemia - Low calcium often shows up 24 - 72 hours after total thyroidectomy, causing tingling, muscle cramps, or ECG changes. Early detection and supplementation keep those symptoms at bay. OpenAnesthesia: Hypocalcemia Management
  5. Consider LMA to Reduce Throat Pain - Swapping an endotracheal tube for a laryngeal mask airway can make postoperative sore throat milder and smooth out hemodynamic swings during induction. A small change with big comfort benefits! BMC Anesthesiology: LMA vs. ETT
  6. Stay Alert for Thyroid Storm - Hyperthyroid patients can explode into hypertension, tachyarrhythmias, and fevers if storm strikes. Keep beta blockers, fluids, cooling measures, and steroids on hand for an immediate response. OpenAnesthesia: Thyroid Storm Protocol
  7. Give Stress-Dose Steroids When Needed - Hypothyroid patients may harbor hidden adrenal insufficiency, so administering a hydrocortisone boost before surgery prevents hemodynamic collapse under stress. Think of it as adrenal insurance. OpenAnesthesia: Steroid Supplementation
  8. Use Short-Acting Muscle Relaxants - Agents like succinylcholine or low-dose rocuronium facilitate smooth intubation and wear off quickly to allow intraoperative neural monitoring without delaying emergence. Timing is everything! OpenAnesthesia: Muscle Relaxant Guide
  9. Employ Superficial Cervical Plexus Blocks - This regional block delivers targeted pain relief, slashes opioid needs, and keeps nausea on the run - making your patient happier in PACU. A little block goes a long way. OpenAnesthesia: Cervical Plexus Block
  10. Monitor for Postop Complications - Hemorrhage, laryngeal edema, and nerve injury can sneak up fast after thyroidectomy. Early recognition and swift intervention are your keys to preventing airway obstruction and serious sequelae. PMC: Thyroid Surgery Complications
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