Anesthesia Hub -

10 Random Questions

A previously healthy, 60-kg, 17-year-old boy is undergoing emergency surgery for a gunshot wound involving the iliac vein. Ventilation is controlled with a tidal volume of 700 ml/breath, rate of 10/min, and peak inspiratory pressure of 30 cmH2O. Body temperature is normal. The most likely cause of an end-tidal carbon dioxide partial pressure of 16 mmHg is

(A) endobronchial intubation
(B) excessive expiratory time
(C) excessive tidal volume
(D) low cardiac output
(E) pulmonary aspiration

BASIC General

During induced hypotension for clipping of a cerebral aneurysm in a 20-degree head-up position, the arterial pressure transducer should be zero referenced at which level?

(A) External auditory meatus
(B) Midaxillary line at the fifth intercostal space
(C) Sternal notch
(D) Thyroid cartilage
(E) Top of the cranium

Which of the following is the primary factor regulating normal coronary blood flow?

(A) Aortic diastolic pressure
(B) Coronary perfusion pressure
(C) Heart rate
(D) Myocardial oxygen consumption
(E) Systolic wall tension

BASIC Cardiac

Which of the following drugs is contraindicated in patients with Parkinson's disease?

(A) Atropine
(B) Dopamine
(C) Droperidol
(D) Fentanyl
(E) Isoflurane

Which of the following is the most reliable indicator of adequate reversal of neuromuscular block?

(A) Inspiratory force equal to -30 cmH20
(B) Sustained head lift for 5 seconds
(C) Train-of-four ratio of 0.7
(D) Twitch height at 100% of control
(E) Vital capacity of 15 ml/kg

BASIC General

During anesthesia with nitrous oxide, oxygen, and a relaxant, the patient's lungs are being mechanically ventilated and there is a heated humidifier in the circuit. The most likely cause of an apparent increase in inspired oxygen concentration is

(A) a hole in the ventilator bellows
(B) backflow of fresh gas because of resistance in the humidifier
(C) decreased oxygen utilization by the patient
(D) heat damage to the oxygen sensor
(E) water condensation on the oxygen sensor

BASIC Equipment & Physics

Unilateral or bilateral diaphragmatic paralysis is a complication of each of the following EXCEPT

(A) surgical ligation of a patent ductus arteriosus
(B) use of pericardial ice-slush for topical cardiac hypothermia
(C) stellate ganglion block
(D) interscalene brachial plexus block
(E) C6 cervical fracture-dislocation

ADVANCED General

During laser microsurgery of the larynx, a rubber endotracheal tube wrapped with aluminum-foil tape starts to smolder and give off smoke. The first step is to

(A) suction the endotracheal tube
(B) add helium to the inspired gas mixture
(C) remove the endotracheal tube
(D) turn off the fresh gas flow
(E) pack a saline-soaked gauze sponge into the hypopharynx

Which of the following statements concerning opioid dependence in anesthesiologists is true?

(A) Mortality rate is high
(B) Deterioration of professional performance is an early sign
(C) Nalbuphine suppresses signs of withdrawal
(D) Naltrexone prevents relapse
(E) Sufentanil is detected by urine screening

A 72-year-old patient who takes levodopa and carbidopa is undergoing colon resection. Metoclopramide is administered preoperatively and anesthesia is maintained with proposal, fentanyl, and nitrous oxide, with vecuronium for muscle relaxation. Fifteen minutes after reversal of muscle relaxation with neostigmine and atropine and tracheal extubation, the patient has dyspnea and muscular rigidity. Which of the following is the most likely cause?

(A) Central anticholinergic syndrome
(B) Fentanyl-induced rigidity
(C) Inhibition of methionine synthetase by nitrous oxide
(D) Metoclopramide-induced dopamine antagonism
(E) Peripheral conversion of levodopa to dopamine

BASIC Pharmacology & Pharmacokinetics