10 Random Questions
A 6-year-old child with asthma begins wheezing during anesthesia with halothane and nitrous oxide in oxygen. A loading dose of aminophylline is administered followed by continuous infusion. Premature ventricular contractions appear on the ECG. The most appropriate management is to
- (A) administer fentanyl
- (B) discontinue aminophylline
- (C) increase exhalation time
- (D) increase the inspired concentration of halothane
- (E) switch the inhalational agent to isoflurane
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
Which of the following statements concerning neuroleptic malignant syndrome is true?
- (A) It does not respond to dantrolene therapy
- (B) It is inherited as an autosomal trait
- (C) It is not triggered by succinylcholine
- (D) It occurs after long-term use of L-dopa
- (E) The halothane-caffeine contracture test is negative in susceptible patients
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
- (A) administer thiopental
- (B) decrease left ventricular afterload
- (C) increase arterial blood pressure
- (D) replace the left ventricular vent
- (E) resume cardiopulmonary bypass
Which of the following time concentration curves would be expected in arterial blood following intravenous injection of indocyanine green dye in a 3-year-old child with a small ventricular septal defect?
Which of the following is the most appropriate initial management of a patient with hypotension secondary to sepsis?
- (A) Calcium chloride
- (B) Corticosteroids
- (C) Crystalloid infusion
- (D) Dopamine
- (E) Fresh frozen plasma
Arterial oxyhemoglobin desaturation develops more rapidly following apnea in a pregnant patient at term than in a nonpregnant patient with a large intra-abdominal tumor. Which of the following findings in pregnancy is the most likely cause?
- (A) Higher cardiac output
- (B) Higher oxygen consumption
- (C) Larger anatomic dead space
- (D) Smaller blood volume
- (E) Smaller functional residual capacity
An infant with congenital lobar emphysema is scheduled for thoracotomy. Which of the following should be included in the anesthetic management of this infant?
- (A) Helium-oxygen inspired gas mixture
- (B) Nitrous oxide administration
- (C) Positive pressure ventilation
- (D) Prophylactic placement of a chest tube
- (E) Spontaneous ventilation until the chest is opened
A 2-year-old child is hospitalized for exposure. Rectal temperature is 30°C. The most appropriate method of warming is to
- (A) apply radiant heat
- (B) increase ambient temperature to 28°C
- (C) use a heating blanket set at 39°C
- (D) warm and humidify inspired gases
- (E) warm intravenous fluids to 37°C
Two months ago a 68-year-old man with insulin-dependent diabetes mellitus had a transurethral resection of the prostate under spinal anesthesia with tetracaine plus epinephrine. He now has numbness and tingling in both feet and disturbance of gait. Physical examination demonstrates stocking-type hypesthesia of both feet and ankles. The most likely diagnosis is
- (A) anterior spinal artery syndrome
- (B) diabetic neuropathy
- (C) adhesive arachnoiditis
- (D) cauda equina syndrome
- (E) peripheral nerve injury from the lithotomy position