10 Random Questions
A patient has hoarseness after undergoing surgery involving the aortic arch. The most likely cause is an injury to which of the following nerves?
- (A) Glossopharyngeal
- (B) Left recurrent laryngeal
- (C) Right recurrent laryngeal
- (D) Left superior laryngeal
- (E) Right superior laryngeal
Twenty minutes after thiopental induction for femoral herniorrhaphy, a 34-year-old woman is breathing spontaneously and receiving nitrous oxide-oxygen (2 liters each) and enflurane 3% by face mask. Pulse is 90 bpm, blood pressure is 80/60 mmHg, end-tidal enflurane concentration is 2%, and end-tidal carbon dioxide tension is 48 mmHg. Which of the following is most likely to occur on skin incision?
- (A) Pupillary dilation
- (B) Laryngeal stridor
- (C) Gross muscular movement
- (D) Increased blood pressure
- (E) No response
A healthy 60-kg 52-year-old woman undergoing reduction mammoplasty is anesthetized with isoflurane and oxygen, and deliberate hypotension to 80/40 mmHg is induced with nitroprusside. Urine output through an indwelling urethral catheter has been 10 mL during the past hour. You should now
- (A) administer furosemide 40 mg intravenously
- (B) infuse normal saline solution until urine output reaches 35 mL/hr
- (C) administer dopamine at 3 mcg/kg/min
- (D) expect normal urine flow with restoration of normal blood pressure
- (E) discontinue nitroprusside administration
Mepivacaine 40 ml of a 1% solution with epinephrine 1:200,000 is injected into the brachial plexus sheath at the axilla after eliciting a paresthesia in the ulnar nerve distribution. Which of the following is most likely to remain intact?
- (A) Adduction of the thumb
- (B) Flexion at the wrist
- (C) Sensation of the lateral forearm
- (D) Sensation on the palmar surface of the lateral three and one half fingers
- (E) Sensation on the palmar surface of the medial one and one half fingers
A patient who is scheduled for a parathyroidectomy for a parathyroid adenoma has a preoperative serum calcium concentration of 13.5 mg/dl. The ECG shows no acute changes. The most appropriate preoperative management is administration of
- (A) calcitonin
- (B) hydrocortisone
- (C) intravenous saline solution
- (D) mannitol
- (E) potassium phosphate
Systemic hypothermia to 30°C is accompanied by
- (A) a shift to the right of the oxyhemoglobin dissociation curve
- (B) a decrease in carbon dioxide dissolved in plasma
- (C) a decrease in the glomerular filtration rate
- (D) an increase in MAC of volatile inhalation agents
- (E) low-voltage, high-frequency EEG pattern
The patient whose flow-volume loop is shown on the right most likely has
- (A) bronchial asthma
- (B) a fixed midtracheal tumor
- (C) nasal polyps
- (D) restrictive lung disease
- (E) vocal cord paralysis
Which of the following statements regarding latex allergy is true?
- (A) Diphenhydramine is the treatment of choice for latex-induced anaphylactic reaction
- (B) Hospital workers are at equal risk as the general population
- (C) It is more common in patients with frequent urethral catheterizations
- (D) Latex gloves can be rinsed free of antigens
- (E) Skin testing should be performed immediately after an acute reaction in the operating room
Normal pregnancy is associated with a decrease in each of the following EXCEPT
- (A) expiratory reserve volume
- (B) FEV1/FVC ratio
- (C) functional residual capacity
- (D) thoracic compliance
- (E) vital capacity
The following changes occur during posterior cervical fusion in the prone position under halothane and nitrous oxide anesthesia with mechanical ventilation: HR 78 --> 84 with frequent PVCs; BP 110/70 --> 90/50; EtCO2 4.5% --> 2.0%; EtN2 0.12% --> 4% The most appropriate next step is to
- (A) administer lidocaine intravenously
- (B) decrease ventilatory rate
- (C) discontinue halothane
- (D) lower the patient's head
- (E) inspect the ventilator bellows