Sun31October0735PM 11

Hypertension one hour following a laparotomy may be due to:

True / False

Malignant Hyperpyrexia Correct

Urinary retention Correct

Hypoxia Incorrect answer selected

Hypocapnia Correct

Inadequate analgesia Correct

Explanation

The most common cause of postoperative hypertension is inadequately controlled pain. Hypercapnia due to alveolar hypoventilation can cause hypertension (not hypocapnia). This may be due to respiratory depression following a general anaesthetic or opioids used for analgesia. A full bladder due to urinary retention or a blocked catheter can also cause agitation and pain.

Diffusion hypoxia is a feature of an anaesthetic involving nitrous oxide and supplementary oxygen should be given to patients for about 20 minutes as the residual nitrous oxide diffuses into the alveoli. Hypertension can accompany diffusion hypoxia or any cause of hypoxia.

Malignant hyperpyrexia (MH) is an inherited disease (autosomal dominant) affecting skeletal muscle contraction and metabolism. It follows exposure to triggering agents, particularly volatile anaesthetic agents and suxamethonium. It is a life-threatening condition which usually presents early during an anaesthetic but can be delayed for several hours. Features include:

cardiovascular instability

cyanosis

hypercapnia

hyperkalaemia, and

hyperthermia.

Answer Statistics

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Average score: 79.70%

Times answered: 263