10 Random Questions
A 100-kg, 42-year-old woman received enflurane and oxygen for clipping of an intracranial aneurysm lasting eight hours. In the first two postoperative hours, urine output is 2 liters. Serum sodium concentration is 152 mEq/L. Urine osmolality and central venous pressure are low. Which of the following is best used to establish the diagnosis?
- (A) Pulmonary artery occlusion pressure
- (B) Serum fluoride concentration
- (C) Serum osmolality
- (D) Response to antidiuretic hormone
- (E) Response to fluid restriction
A healthy, 18-year-old, 65-kg woman undergoing diagnostic laparoscopy is being monitored with a properly functioning and calibrated capnograph. The end-tidal carbon dioxide concentration is 6%, and the inspired carbon dioxide concentration is 1%. This may be caused by each of the following EXCEPT
- (A) malfunction of the expiratory valve in a circle system
- (B) low gas inflow with a Bain circuit
- (C) exhausted soda lime within a circle system
- (D) absorption of carbon dioxide from carbon dioxide laparoscopy
- (E) carbon dioxide in the fresh gas flow
When the inspired gas is changed from air to 20% oxygen and 80% nitrous oxide, PaO2 increases because
- (A) increased pulmonary artery pressure perfuses alveoli that previously enhanced dead space
- (B) nitrous oxide stimulates the respiratory center
- (C) rapid absorption of nitrous oxide increases alveolar oxygen concentration
- (D) replacement of nitrogen by nitrous oxide expands atelectatic alveoli
- (E) respiratory depression from nitrous oxide shifts the oxyhemoglobin dissociation curve
Compared with epidural administration of hydrophilic opioids, epidural administration of lipophilic opioids is associated with
- (A) earlier onset of pruritus
- (B) greater motor block when combined with local anesthetics
- (C) higher incidence of delayed respiratory depression
- (D) lesser sensitivity to reversal of analgesia by naloxone
- (E) slower onset of analgesia
The flow-volume loop indicated by the "X" is characteristic of
- (A) asthma
- (B) bronchiectasis
- (C) emphysema
- (D) pulmonary fibrosis
- (E) tracheal stenosis
The left ventricular function curve is from a young, healthy patient. If X represents the patient's myocardial function prior to anesthesia, the effect of 1 MAC of isoflurane at normocarbia is best represented by which of the following positions?
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
A woman has weakness of the right quadriceps and a decreased knee jerk reflex on the right one day after forceps delivery under epidural anesthesia. The most likely cause is
- (A) epidural hematoma
- (B) intrapelvic nerve trauma
- (C) lithotomy positioning
- (D) reaction to the preservative in the anesthetic solution
- (E) trauma from the epidural needle
A newborn infant is undergoing repair of gastroschisis. During closure of the abdominal wall, ventilatory pressures and central venous pressure increase markedly. The most appropriate management is to
- (A) administer a bronchodilator
- (B) decrease tidal volume and increase ventilatory rate
- (C) increase the neuromuscular block
- (D) increase the depth of anesthesia
- (E) ask the surgeon to reopen the abdomen
Two hours after a colon resection, a 60-year-old woman with adult-onset diabetes mellitus is somnolent and has a blood glucose concentration of 612 mg/dl. Which of the following findings are most likely? (Sodium, Osmolality, Intravascular volume)
- (A) 127, 280, High
- (B) 127, 310, High
- (C) 127, 330, Low
- (D) 140, 280, Normal
- (E) 140, 300, Low
A patient is placed in the prone jackknife position for lumbar subarachnoid injection of tetracaine 10 mg in 10 ml of preservative-free sterile water. Which of the following results is most likely?
- (A) Respiratory insufficiency
- (B) Sensory and motor block at T4-S1
- (C) Sensory and motor block at L1-S5
- (D) Sensory loss without motor block at L1-S5
- (E) Sensory and motor block at S3-S5