10 Random Questions
Each of the following conditions is associated with autonomic hyperreflexia in patients with spinal cord injury EXCEPT
- (A) bradycardia
- (B) flushing below the level of injury
- (C) headache
- (D) sweating above the level of injury
- (E) systolic hypertension
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
A 57-year-old man with hepatocellular disease is scheduled to undergo a colectomy for colon cancer. Preoperative laboratory studies show a plasma albumin concentration of 2.4 g/dl (normal = 3.5 to 5.5 g/dl); prothrombin time is 16 sec (control 12 sec). Which of the following statements concerning the anesthetic management of this patient is true?
- (A) Atracurium will have a prolonged duration of action
- (B) The risk for perioperative hyperglycemia is increased
- (C) Mivacurium will have a shortened duration of action
- (D) The unbound fraction of thiopental will be increased
- (E) Vitamin K injection will normalize the prothrombin time
Each of the following drugs is a cause of central anticholinergic syndrome EXCEPT
- (A) amitriptyline
- (B) atropine
- (C) diphenhydramine
- (D) promethazine
- (E) ranitidine
The trend plot shows end-tidal gases measured during a radical neck dissection. The event occurring at A is most likely
- (A) acute hypotension
- (B) endobronchial intubation
- (C) kinking of the endotracheal tube
- (D) rupture of the endotracheal cuff
- (E) venous air embolism
A patient is undergoing exploration of a stab wound to the left side of the neck. On awake laryngoscopy, the left vocal cord is in midposition and the right vocal cord is abducted during inspiration. The most likely cause of these findings is trauma to which of the following structures on the left?
- (A) C7-8 nerve root
- (B) Stellate ganglion
- (C) Glossopharyngeal nerve
- (D) Superior laryngeal nerve
- (E) Vagus nerve
Prior to occlusion of any major pulmonary blood vessels during a thoracotomy, applying positive end-expiratory pressure to ventilation through the dependent lumen of a double-lumen tube and occluding the upper lumen of the tube will
- (A) increase blood flow to the dependent lung
- (B) increase the alveolar-arterial oxygen tension difference
- (C) override hypercarbic pulmonary vasoconstriction
- (D) improve the patient's oxygenation
- (E) increase the right ventricular dP/dt
A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?
- (A) Fluid overload with 5% dextrose in water
- (B) Inappropriate secretion of antidiuretic hormone
- (C) Increased free water clearance
- (D) Nephrogenic diabetes insipidus
- (E) Neurogenic diabetes insipidus
A 54-year-old woman who is scheduled to undergo emergency exploratory laparotomy takes warfarin sodium for anticoagulation. Prothrombin time is 19 sec (control 12 sec). Which of the following agents is most appropriate to reverse the effects of warfarin?
- (A) Cryoprecipitate
- (B) Desmopressin (DDAVP)
- (C) Factor IX concentrate
- (D) Fresh frozen plasma
- (E) Pooled factor VIII
Compared with healthy nonhypertensive patients, in patients with untreated hypertension undergoing anesthesia and operation,
- (A) cerebral ischemia may occur at higher blood pressures
- (B) intravenous fluid should be restricted before induction
- (C) left ventricular hypertrophy enhances compensation for intraoperative fluid loss
- (D) responses to sympathetic stimulation are decreased
- (E) the incidence of intraoperative hypotension is lower