Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:
Read the article by Treschan and Peters entitled “The vasopressin system: Physiology and clinical strategies” on page 599 of this issue.
Review the questions and other required information for CME program completion (published in both the print and online journal).
When ready, go to the CME Web site: http://www.asahq.org/journal-cme. Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.
The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education programs for physicians.
The American Society of Anesthesiologists designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.
Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.
Learning Objectives: After reading this article, participants should have a better understanding of the pharmacology and clinical uses of vasopressin.
Authors –Tanja A. Treschan, M.D., and Jürgen Peters, M.D.
Grants or research support: None
Consultantships or honoraria: None
The article authored by Drs. Treschan and Peters was supported solely from institutional and/or departmental sources.
Question Writer –Peter L. Bailey, M.D.
Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.
Based on the article by Treschan and Peters entitled “The vasopressin system: Physiology and clinical strategies”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=105&issue=3&spage=599&part=fulltextin the September issue of Anesthesiology, choose the one correct answer for each question:
1. Which of the following statements concerning arginine vasopressin (AVP) is most likely true?
A. AVP is synthesized in the posterior pituitary gland.
B. AVP is released into the circulation only in response to certain stressful stimuli.
C. AVP can be considered one of the stress hormones.
D. AVP and antidiuretic hormone are different substances.
2. Which of the following statements concerning AVP is most likely true?
A. All vasopressin receptors utilize the same intracellular signaling pathway.
B. The half-life of AVP is long enough to make its infusion unnecessary during clinical use.
C. Stimulation of vasopressin receptor subtype V2 in collecting duct cells of the kidney increases water uptake.
D. Vasopressin receptor subtype V1 is only found on vascular smooth muscle.
3. Which of the following statements concerning desmopressin and/or AVP is most likely true?
A. AVP is released into the circulation in response to decreases in osmotic pressure.
B. Diabetes insipidus can be caused by a lack of AVP release associated with various pathologic conditions.
C. Desmopressin affects vasopressin receptor subtype V1.
D. Desmopressin must be administered intravenously.
4. Which of the following statements concerning the hemodynamic effects of vasopressin is most likely true?
A. AVP plays an important role in blood pressure control under normal physiologic conditions.
B. AVP administration results in more vasoconstriction in the systemic than in the pulmonary circulation.
C. Even low doses of exogenous AVP cause severe hypertension in normal healthy volunteers.
D. AVP administration causes vasodilatation in the cutaneous circulation.
5. Which of the following statements concerning hemostasis is most likely true?
A. In general, stress hormones have an anticoagulant effect.
B. Nasal administration of desmopressin is recommended when treating bleeding disorders.
C. Desmopressin is not associated with the risk of arterial thrombosis.
D. AVP increases von Willebrand factor levels.
6. Which of the following statements concerning the treatment of severe hypotension is most likely true?
A. Terlipressin is the preferred AVP-type analog for the treatment of severe perioperative hypotension in patients at risk for coronary artery disease.
B. The risks of adverse effects related to AVP-induced vasoconstriction are not dose related.
C. A variety of severe hypotensive disorders may be effectively treated with intravenous vasopressin.
D. Vasopressin is contraindicated in drug-induced anaphylactic shock.