10 Random Questions
A conscious patient has an acute subdural hematoma that will require surgical evacuation. Which of the following interventions to be carried out in the emergency department is most likely to decrease intracranial pressure?
- (A) Having the patient hyperventilate
- (B) Intravenous administration of an opioid
- (C) Intravenous administration of a corticosteroid
- (D) Intravenous administration of nitroprusside
- (E) Intravenous administration of furosemide
A 32-year-old woman is anesthetized for suboccipital craniotomy. During positioning, the capnograph shows an abrupt decrease in the slope of the expiratory upstroke. Which of the following is the most likely cause?
- (A) Air embolism
- (B) Incompetent expiratory valve
- (C) Incomplete neuromuscular block
- (D) Kinked endotracheal tube
- (E) Tracheal extubation
A patient has seizure activity 30 seconds after injection of 0.25% bupivacaine 2 ml with epinephrine 1:200,000 for stellate ganglion block. The most likely cause is
- (A) reaction to epinephrine in the anesthetic solution
- (B) anaphylactoid reaction to bupivacaine
- (C) subarachnoid injection of bupivacaine
- (D) peridural venous injection of bupivacaine
- (E) vertebral artery injection of bupivacaine
An obese, 70-year-old woman with a long history of tobacco abuse is awake and semirecumbent after uneventful anesthesia with isoflurane for a ventral hernia repair. During the first hour in the recovery room while breathing 50% oxygen by face mask, her arterial oxygen saturation decreases to 90% while other vital signs remain satisfactory. Which of the following is most likely to be effective in the management of this situation?
- (A) Intravenous doxapram
- (B) Racemic epinephrine by inhalation
- (C) Continuous positive airway pressure by mask
- (D) Reintubation of the trachea
- (E) Coughing
A 2-year-old child has cardiac arrest during an inguinal herniorrhaphy under general anesthesia administered during a Jackson-Rees system. The graph shows end-tidal PCO2 monitored from the tip of the endotracheal tube during cardiopulmonary resuscitation; minute ventilation is unchanged. Which of the following is the most likely cause of the change beginning at the arrow?
- (A) Decreased fresh gas flow
- (B) Inadequate chest compression
- (C) Increased dead space
- (D) Restoration of cardiac output
- (E) Sampling artifact
Which of the following statements concerning propofol is true?
- (A) Active metabolites can produce residual postoperative sedation
- (B) It causes less cardiovascular depression than an equivalent induction dose of thiopental
- (c) It causes less respiratory depression than an equivalent induction dose of thiopental
- (D) It has analgesic properties
- (E) The vehicle emulsion is associated with hypersensitivity reactions
A 2600-g neonate is to undergo surgical repair of a small gastroschisis. The infant is preoxygenated with 100% oxygen. Arterial hemoglobin desaturation is noted during laryngoscopy after a rapid-sequence induction. Which of the following is the most likely cause?
- (A) High fetal hemoglobin concentration
- (B) High ratio of oxygen consumption to functional residual capacity
- (C) Low functional residual capacity in milliliters per kilogram
- (D) Poor thoracic compliance
- (E) Patent ductus arteriosus
The most likely cause of bilateral fixed and dilated pupils after clipping of a basilar artery aneurysm is
- (A) preoperative administration of atropine
- (B) intraoperative infusion of trimethaphan
- (C) naloxone antagonism of opioid
- (D) persistent hypothermia
- (E) brain stem ischemia
Electrocautery units operate at frequencies between 300 kHz and 2 mHz to
- (A) avoid pacemaker interference
- (B) minimize ECG tracing interference
- (C) minimize the likelihood of ventricular fibrillation
- (D) optimize hemostasis
- (E) provide the best "cutting" current
In a patient who is to undergo clipping of a cerebral aneurysm, an advantage of isoflurane over nitroprusside for induction of hypotension is
- (A) better maintenance of cardiac output
- (B) better maintenance of cerebral blood flow
- (C) greater decrease in cerebral oxygen consumption
- (D) greater decrease in afterload
- (E) more rapid titration of systemic blood pressure