10 Random Questions
A 29-year-old man who has been nasotracheally intubated for two weeks following a motor vehicle accident has a fever (39C) and a constant headache. Leukocyte count is 18,000/mm3. The most likely cause is
- (A) fractured nasal septum
- (B) retropharyngeal abscess
- (C) maxillary sinusitis
- (D) meningitis
- (E) rhinovirus infection
A 39-year-old patient with insulin-dependent diabetes mellitus receives thiopental 250 mg and succinylcholine 80 mg and is ventilated with 0.75% isoflurane in oxygen. Arterial pressure decreases abruptly from 140/100 to 80/50 mmHg while heart rate remains unchanged at 70 bpm. Failure of heart rate to increase most likely results from
- (A) acute hypoglycemia
- (B) autonomic neuropathy
- (C) depression of sinus node function by thiopental
- (D) depression of the baroreflex response by isoflurane
- (E) ganglionic stimulation by succinylcholine
The duration of action of an induction dose of thiopental is determined primarily by its
- (A) rate of elimination
- (B) rate of metabolism
- (C) redistribution from brain to fat
- (D) redistribution from brain to muscle
- (E) hepatic extraction
Desflurane is delivered using a vaporizer that contains internal heaters because
- (A) heat decreases the drug's viscosity
- (B) heat reduces thermal loss in the patient
- (C) heat increases the drug's oil-gas partition coefficient
- (D) heat prevents fluctuations of vapor pressure
- (E) it does not vaporize adequately at room temperature
Which of the following statements concerning carbon monoxide poisoning is true? A 38-year-old woman with a large goiter has undergone subtotal thyroidectomy. Airway obstruction is noted immediately after extubation despite normal vocal cord function on laryngoscopy. Which of the following is the most likely explanation?
- (A) Arytenoid dislocation
- (B) Hematoma
- (C) Hypocalcemia
- (D) Recurrent laryngeal nerve injury
- (E) Tracheomalacia
The cardiovascular effects of an inhalational anesthetic are evaluated in 10 normal volunteers in the awake resting state and after 15 minutes of constant inspired concentration. Results were analyzed by t-test for paired data and are presented below as mean +/- standard deviation. Based on these data, which of the following conclusions is most valid?
- (A) A decrease in cardiac output would have been evident if more subjects were included in the study
- (B) The anesthetic decreases mean arterial pressure
- (C) The anesthetic does not cause cardiac depression
- (D) The anesthetic is unsafe for patients with coronary after disease
- (E) There is a 95% to 100% chance that the anesthetic increases heart rate
Alveolar partial pressure of an inhaled anesthetic rises more rapidly in a parturient at term than in a nonpregnant woman because
- (A) functional residual capacity is decreased
- (B) PaC02 is decreased
- (C) uptake of inhaled agents by tissues is decreased
- (D) cardiac output is increased
- (E) physiologic dead space is increased
During prolonged labor, a fetal scalp blood sample shows a PO2 of 21 mmHg, a PCO2 of 46 mmHg, and a pH of 7.35. These findings suggest
- (A) fetal hypoxemia
- (B) maternal hypoventilation
- (C) sampling of venous blood
- (D) miscalibration of the oxygen electrode
- (E) no abnormality
Mismatching of ventilation to perfusion in the lung is greatest in which of the following situations?
- (A) Awake patient, spontaneous ventilation, lateral decubitus position
- (B) Anesthetized patient, controlled ventilation, supine position
- (C) Anesthetized patient, controlled ventilation, lateral decubitus position
- (D) Anesthetized patient, controlled ventilation, sitting position
- (E) Anesthetized patient, spontaneous ventilation, prone position
Which of the following factors is LEAST likely to affect serum ionized calcium concentration following blood transfusion?
- (A) Age of blood transfused
- (B) Amount of blood transfused
- (C) Body temperature
- (D) Serum pH
- (E) Rate of transfusion