10 Random Questions
The arterial waveform and EKG shown are from a 60-year-old man with uremia who is the PACU after hip surgery under general anesthesia. The patient is drowsy, extubated, and breathing easily. The most likely diagnosis is
- (A) hypovolemia
- (B) myocardial ischemia
- (C) nontension pneumothorax
- (D) pericardial tamponade
- (E) pulmonary embolus
Each of the following conditions can be accurately evaluated with transesophageal echocardiography EXCEPT
- (A) intimal tear at the aortic arch
- (B) intracardiac air
- (C) left atrial thrombus
- (D) patent foramen ovale
- (E) right atrial myxoma
Which of the following provides the earliest indication of myocardial ischemia during general anesthesia?
- (A) Cardiac index
- (B) Mixed venous oxygen saturation
- (C) Pulmonary artery occlusion pressure
- (D) Regional ventricular wall motion
- (E) ST-segment depression on ECG
Which of the following statements concerning nalbuphine is true?
- (A) It causes partial reversal of morphine-induced ventilatory depression
- (B) Analgesia is partially mediated by delta receptor agonism
- (C) Its antagonist effects are mediated at kappa receptors
- (D) Duration of action is significantly shorter than that of morphine
- (E) Ventilatory drive is not depressed
After termination of an inhalation anesthetic, patient-controlled analgesia will
- (A) be effective without a loading dose of opioid if started in the immediate postanesthetic period
- (B) be associated with greater analgesic requirements than conventional intramuscular opioid techniques
- (C) cause addiction or dependence to opioids if continued for more than 72 hours
- (D) produce less patient satisfaction than intermittent intravenous administration of opioids
- (E) show a diurnal variation in analgesic requirement
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
Transcutaneous electrical nerve stimulation is LEAST likely to be effective in which of the following pain syndromes?
- (A) Acute postoperative pain
- (B) Chronic pancreatitis
- (C) Myofascial syndrome
- (D) Phantom limb pain
- (E) Reflex sympathetic dystrophy
Five minutes after initiating one-lung ventilation using a double-lumen endobronchial tube, a 70-year-old patient has a decrease in Sp02 from 99% to 90%. Tidal volume and respiratory rate are unchanged. Fiberoptic bronchoscopy verifies appropriate positioning of the tube. Which of the following is the most likely cause of the desaturation?
- (A) Blood flow to the nondependent lung
- (B) Failure of hypoxic pulmonary vasoconstriction in the dependent lung
- (C) Inadequate filling of the bronchial cuff
- (D) Inadequate minute ventilation
- (E) Surgical manipulation of the nondependent lung
Brain death following prolonged barbiturate coma is best confirmed by
- (A) electroencephalography
- (B) cerebral angiography
- (C) neurologic examination
- (D) physostigmine trial
- (E) measurement of cortical evoked potentials
A 32-year-old man is scheduled for hernia repair. He underwent heart transplantation for cardiomyopathy five years ago. Which of the following findings is most likely?
- (A) Absence of coronary atherosclerosis
- (B) Biventricular hypokinesis on echocardiography
- (C) Down-regulation of cardiac beta-adrenergic receptors
- (D) Increased heart rate at rest
- (E) Right ventricular hypertrophy