10 Random Questions
A 48-year-old woman underwent a posterior fossa craniotomy in the sitting position. Monitoring included precordial Doppler, arterial blood pressure, central venous pressure (CVP), and urine output. Furosemide was used intraopera-tively for cerebral decompression, and the operation was uneventful. In the recovery room, she was awake with stable vital signs when the CVP suddenly increased from 6 to 25 mmHg without any change in blood pressure. Shortly thereafter, premature ventricular contractions are noted. After administering lidocaine 1 mg/kg intravenously, the most appropriate action is to
- (A) position the patient head down, right side up and aspirate the CVP catheter
- (B) withdraw the CVP catheter 5 cm
- (C) infuse potassium chloride rapidly
- (D) administer furosemide
- (E) ask the neurosurgeon to reevaluate the patient immediately
Which of the following is the most reliable indicator of antagonism of nondepolarizing neuromuscular block sufficient for airway protection?
- (A) Clinically assessed ulnar nerve train-of-four ratio of 0.75
- (B) Peak negative pressure of 25 cmH2O
- (C) End-tidal PC02 of 40 mmHg during spontaneous ventilation
- (D) Sustained head lift for 5 seconds
- (E) Vital capacity of 15 ml/kg
A patient with moderate hypothyroidism and unstable angina requires urgent coronary artery bypass grafting. Which of the following is most appropriate before proceeding with the operation?
- (A) Initiation of epinephrine infusion
- (B) Intramuscular administration of a barbiturate
- (C) Intravenous administration of triiodothyronine (T3)
- (D) Intravenous administration of thyroxine (T4)
- (E) Treatment of myocardial ischemia
Which of the following statements concerning relationships among alveolar pressure, volume, and surface tension is true?
- (A) Surface tension of surfactant decreases as alveolar volume decreases
- (B) Surface tensions of water and of surfactant behave similarly as volume decreases
- (C) Changes in alveolar surface tension with volume are the same during expansion as during contraction
- (D) Pressure in the alveolus is inversely related to surface tension
- (E) Pressure in the alveolus is directly related to alveolar radius
At equipotent doses, which of the following opioids is most likely to migrate cephalad in cerebrospinal fluid after epidural administration?
- (A) Fentanyl
- (B) Hydromorphone
- (C) Meperidine
- (D) Morphine
- (E) Sufentanil
A mechanically ventilated newborn infant is undergoing gastroschisis repair during halothane anesthesia. Based on the right radial artery catheter tracing shown, which of the following is the most appropriate conclusion?
- (A) The abdomen has not yet been incised
- (B) The anesthetic should be changed from halothane to isoflurane
- (C) The ductus arteriosus is still open
- (D) The infant is hypovolemic
- (E) The tidal volume is inadequate
The primary purpose of denitrogenation prior to anesthetic induction is to
- (A) blunt hypoxic pulmonary vasoconstriction
- (B) improve ventilation and perfusion matching
- (C) increase contribution of second gas effect to rate of induction
- (D) increase oxygen reserve in the functional residual capacity
- (E) maximize arterial oxygen content
Which of the following statements concerning fetal hemoglobin is true?
- (A) It makes up less than 50% of the total hemoglobin in the neonate
- (B) It has less affinity for oxygen than adult hemoglobin
- (C) It binds with greater affinity to 2,3-DPG than adult hemoglobin
- (D) It shifts the oxyhemoglobin dissociation curve to the left
- (E) It has a P50 of 27 mmHg
A 27-month-old, 14-kg infant with intestinal obstruction is anesthetized with nitrous oxide at 1 L/min, oxygen at 0.4 L/min, and halothane at 0.8% using a Bain circuit. Ventilation is controlled at a rate of 30/min. The child's temperature is 39°C, and the PaCO2 is 65 mmHg. Which of the following is most likely?
- (A) Malignant hyperthermia
- (B) Low gas inflow rate
- (C) Low respiratory rate
- (D) Pulmonary aspiration of gastric contents
- (E) Inaccurate flowmeters
A 25-year-old woman is admitted to the hospital in the early stages of labor at term. Initial hematocrit is 33%. Which of the following is the most likely cause of the hematocrit value?
- (A) Decreased erythropoietin activity
- (B) Destruction of erythrocytes by the placenta
- (C) Early placental abruption
- (D) Increased plasma volume
- (E) Iron deficiency