10 Random Questions
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
Preoperative administration of an alpha-adrenergic blocker for 10 days to patients with pheochromocytoma will decrease
- (A) episodic tachycardia
- (B) hyperglycemia
- (C) hypovolemia
- (D) nasal stuffiness
- (E) postural hypotension
Two days after coronary artery bypass grafting, a 62-year-old man remains sedated, tracheally intubated, and mechanically ventilated with full neuromuscular block. Over the next three hours, Pa02 decreases from 90 to 70 mmHg at an Fl02 of 0.7, peak inspiratory pressure measured proximally in the ventilatory circuit increases from 40 to 66 cmH20, and plateau pressure remains unchanged at 30 cmH20. Which of the following is the most likely cause of these changes?
- (A) Adult respiratory distress syndrome
- (B) Bronchial mucus plugging
- (C) Left ventricular failure
- (D) Lobar pneumonia
- (E) Tension pneumothorax
Each of the following increases arterial to end-tidal carbon dioxide tension difference EXCEPT
- (A) addition of positive-end expiratory pressure
- (B) deliberate hypotension
- (C) endobronchial intubation
- (D) hypovolemia
- (E) pulmonary embolism
In patients with reflex sympathetic dystrophy affecting the arm, which of the following findings indicates a therapeutic block?
- (A) Bradycardia
- (B) Contralateral nasal congestion
- (C) Hoarseness
- (D) Increased skin temperature
- (E) Ipsilateral Horner's syndrome
A healthy patient is receiving general endotracheal anesthesia with nitrous oxide 4 L/min, oxygen 2 L/min, and isoflurane 1% with spontaneous ventilation. The inspiratory breathing hose becomes disconnected from the inspiratory valve. The earliest alarm will be produced by
- (A) a pulse oximeter with finger probe set to alarm at 60% saturation
- (B) a mass spectrometer set to alarm when no breath is detected for 30 seconds
- (C) an oxygen analyzer mounted on the inspiratory valve outlet and set to alarm at 25% oxygen concentration
- (D) a capnograph sensor at the Y-piece that alarms when end-tidal carbon dioxide tension is greater than 60
- mmHg
Which of the following is the greatest disadvantage of pressure-cycled ventilation?
- (A) Increased I:E ratio
- (B) Increased mechanical dead space
- (C) Increased risk for barotrauma
- (D) Variable respiratory rates
- (E) Variable tidal volumes
A 26-year-old woman has weakness on extension of the right knee one day after uneventful vaginal delivery under spinal anesthesia with lidocaine. The most likely cause is
- (A) femoral nerve injury from thigh abduction
- (B) obturator nerve injury from obstetric forceps
- (C) peroneal nerve compression from the leg support
- (D) saphenous nerve injury from the stirrups
- (E) chemical arachnoiditis following the spinal anesthetic
A multi-orifices right heart catheter is being positioned by EKG control prior to sitting craniotomy. The EKG tracing is obtained between the distal tip of the catheter and the right arm lead. The most appropriate next step is to
- (A) leave the catheter in place
- (B) advance the catheter 2 to 3 cm
- (C) withdraw the catheter 2 to 3 cm
- (D) remove the catheter completely
- (E) change polarity of the EKG
A 50-year-old man is scheduled to undergo emergency craniotomy for evacuation of an epidural hematoma. His Glasgow Coma Scale score is 6; heart rate is 54 bpm, and blood pressure is 190/110 mmHg. The most appropriate initial management is administration of which of the following agents?
- (A) Atropine
- (B) Mannitol
- (C) Nimodipine
- (D) Sodium nitroprusside
- (E) Thiopental