10 Random Questions
A healthy 18-year-old youth is scheduled for an emergency operation for removal of a steel splinter from his right iris. Anesthesia is induced with thiopental and pancuronium and, following tracheal intubation, is maintained with nitrous oxide 2 liters, oxygen 2 liters, and halothane 1.5%. Conjunctival instillation of phenylephrine solution 10% increases blood pressure from 110/70 to 230/110 mmHg and decreases pulse from 70 to 46 bpm. The ECG shows a bigeminal pattern. The most appropriate treatment is to
- (A) administer lidocaine
- (B) administer atropine
- (C) administer propranolol
- (D) decrease halothane
- (E) administer nitroprusside
Which of the following statements concerning cerebral blood flow (CBF) during anesthesia is true?
- (A) CBF changes minimally when PaC02 increases from 30 to 40 mmHg
- (B) CBF changes minimally when P02 decreases from 160 to 100 mmHg
- (C) CBF is autoregulated when mean arterial pressure is 40 mmHg
- (D) CBF is coupled to cerebral metabolism during isoflurane anesthesia
- (E) CBF is unaffected by 1.2% isoflurane at a PaC02 of 40 mmHg
Failure of contrast material to enter the duodenum following intraoperative cholangiography is most likely related to administration of
- (A) butorphanol
- (B) fentanyl
- (C) halothane
- (D) nalbuphine
- (E) naloxone
Which Mapleson breathing circuit permits the LEAST amount of fresh gas inflow to prevent rebreathing during spontaneous ventilation?
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
The plasma concentration of an intravenously administered drug follows the two-compartment kinetic model shown in the graph. Which of the following events is illustrated by the decline in plasma concentration shown at Time #2?
- (A) Decreasing activity of the drug at its receptor site
- (B) Distribution from plasma to tissue
- (C) Elimination of the drug from plasma
- (D) Increasing volume of distribution
- (E) Redistribution from vessel-rich groups to vessel-poor groups
In a healthy 70-kg adult, which of the following is the most likely effect of intravenous administration of morphine 10 mg on ventilatory responses?
- (A) Increased response to hypoxia and decreased response to hypercarbia
- (B) Decreased response to hypercarbia and no change in response to hypoxia
- (C) Decreased response to both hypoxia and hypercarbia
- (D) No change in response to hypercarbia and decreased response to hypoxia
- (E) No change in response to hypoxia or hypercarbia
A 48-year-old woman with von Willebrand's disease is scheduled for a hysterectomy. The most appropriate initial preoperative therapy to decrease bleeding is administration of
- (A) cryoprecipitate
- (B) desmopressin (DDAVP)
- (C) fresh frozen plasma
- (D) platelets
- (E) vitamin K
A patient has a seizure within seconds after receiving a retrobulbar injection of 0.5% bupivacaine with epinephrine 1:200,000. Which of the following is the most likely cause?
- (A) Air embolism
- (B) Oculocardiac reflex
- (C) Ophthalmic artery injection
- (D) Retrobulbar hemorrhage
- (E) Subdural injection
A multiparous 24-year-old woman sustains an amniotic fluid embolism during general anesthesia. The LEAST likely clinical finding is
- (A) increased end-tidal carbon dioxide tension
- (B) increased uterine bleeding
- (C) jugular venous distention
- (D) ST and T wave abnormalities on ECG
- (E) wheezing
Two days after myocardial infarction involving the left anterior descending coronary artery, a patient's blood pressure decreases acutely from 125/80 to 70/40 mmHg, heart rate increases from 75 to 90 bpm, pulmonary artery pressure increases to 50/30 mmHg, and urine output decreases from 60 to 10 ml/hr. Thermodilution cardiac output has increased from 4 to 7 L/min. The most appropriate action is to
- (A) compare mixed venous oxygen saturation in the right atrium and pulmonary artery
- (B) draw blood for culture and start antibiotic therapy
- (C) start dopamine infusion in low dose
- (D) administer a fluid challenge
- (E) monitor peripheral capillary oxygenation by transcutaneous oximetry