10 Random Questions
A patient has an anterior neck injury, hoarseness, labored respirations, subcutaneous emphysema, and laryngeal crepitus following a motor vehicle accident. Which of the following is the best method of securing the airway in this situation?
- (A) Blind nasotracheal intubation
- (B) Lightwand intubation
- (C) Retrograde wire-guided intubation
- (D) Tracheostomy
- (E) Transtracheal jet ventilation
The hemodynamic changes shown would most likely result from infusion of
- (A) dopamine
- (B) epinepherine
- (C) dobutamine
- (D) norepinepherine
- (E) isoproterenol
A 72-year-old man has massive venous hemorrhage during a radical prostatectomy. Blood pressure decreases from 110/60 to 75/30 mmHg and central venous pressure decreases from 12 to 4 mmHg. End-expiratory carbon dioxide tension decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to
- (A) apply positive end-expiratory pressure to the breathing circuit
- (B) attempt to aspirate air from the central venous catheter
- (C) expand intravascular volume
- (D) place the patient in the Trendelenburg position
- (E) turn the patient to the left lateral decubitus position
Which of the following is most likely to occur during mediastinoscopy?
- (A) Chylothorax
- (B) Compression of the innominate artery
- (C) Injury to the superior laryngeal nerve
- (D) Tracheal tear
- (E) Venous air embolism
A 66-year-old man with aortic regurgitation is brought to the operating room for aortic valve replacement after having received morphine, scopolamine premedication. PO2 is 40 mmHg in a sample of pulmonary artery blood drawn 10 minutes after the patient started breathing pure oxygen. This finding is compatible with
- (A) wedging of the catheter tip
- (B) left-to-right intracardiac shunt
- (C) increased intrapulmonary shunting
- (D) excessively depressed ventilation
- (E) normal cardiac output
Which of the following is the most likely effect of administration of magnesium sulfate in a patient with preeclampsia?
- (A) Decreased motor end-plate sensitivity to acetylcholine
- (B) Decreased uteroplacental blood flow
- (C) Increased platelet aggregation
- (D) Increased systemic vascular resistance
- (E) Inhibited acetylcholinesterase
A 76-year-old man has a leaking abdominal aortic aneurysm. His blood pressure and pulse have remained stable for 15 minutes at 90/60 mmHg and 130 bpm, respectively. His hemoglobin concentration is 11 g/dl, and the EKG shows a left bundle branch block. Induction of anesthesia should proceed
- (A) after a pulmonary artery catheter has been inserted and the pulmonary artery occlusion pressure is greater than 7 mmHg
- (B) when the pulse has decreased below 130 bpm from the rapid transfusion of blood
- (C) when systolic blood pressure has increased to more than 120 mmHg from the rapid infusion of lactated Ringer's solution
- (D) immediately on arrival in the operating room
- (E) when circulatory signs deteriorate or cease to improve with rapid volume expansion
A Fluotec vaporizer is set to administer halothane 4% using a fresh gas flow of 4 L/min. If the diluent gas flow is increased to 8 L/min, and at the same time the room temperature increases from 20 to 25°C, the approximate concentration of halothane delivered to the patient would be
- (A) 2%
- (B) 2.5%
- (C) 3%
- (D) 4%
- (E) 5%
A 20-year-old man involved in a motor vehicle accident is brought to the operating room for irrigation and debridement of open fractures of the femur and humerus. Cyanosis, decreased breath sounds on the left, increased peak airway pressure, and hypotension are noted after intubation of the trachea. The most likely cause is
- (A) aspiration
- (B) fat embolus
- (C) intubation of the right mainstem bronchus
- (D) tension pneumothorax
- (E) unilateral bronchospasm
Upon removal of the epidural catheter after uneventful labor and delivery in a 25-year-old primiparous woman, approximately 1.2 cm of the Teflon catheter is left behind in the epidural space. The patient is informed of the complication. The most appropriate management is
- (A) immediate surgical removal
- (B) prophylactic antibiotics
- (C) lumbar myelogram
- (D) monthly neurologic examinations
- (E) no intervention