10 Random Questions
A decreased dose of sodium thiopental is administered to patients in hypovolemic shock primarily because
- (A) acidosis increases the fraction of unionized drug
- (B) delivery of the drug to the brain is increased
- (C) hepatic clearance is decreased
- (D) thiopental is a myocardial depressant
- (E) thiopental is a venous dilator
Reveal answer
Following a vaginal hysterectomy in the lithotomy position under general anesthesia, a patient has numbness of the lateral aspect of the left calf and medial half of the dorsum of the left foot. On physical examination she has footdrop and the toes cannot be extended. Which nerve is most likely to be involved?
- (A) Common peroneal nerve
- (B) Deep peroneal nerve
- (C) Posterior tibial nerve
- (D) Saphenous nerve
- (E) Sciatic nerve
Reveal answer
Which of the following statements about thiopental is true?
- (A) Rapid uptake into maternal tissues limits its transfer to the fetus
- (B) Its short duration of action is due to its extensive binding to plasma proteins
- (C) Accumulation in fat leads to acute tolerance
- (D) Alkalinity of solution causes respiratory depression
- (E) Uptake into brain is slowed by respiratory acidosis
Reveal answer
The anesthetic concentration necessary to suppress responses to intubation without muscle relaxation is
- (A) Increased in pregnancy
- (B) increased by premedication with scopolamine
- (C) higher than the concentration required for skin incision
- (D) lower at high altitudes than at low altitudes
- (E) the same as that required for electrocautery of gut
Reveal answer
The acute onset of hypotension without a decrease in mixed venous oxygen saturation is most likely associated with the onset of
- (A) hemorrhage
- (B) myocardial infarction
- (C) pulmonary edema
- (D) pulmonary embolus
- (E) sepsis
Reveal answer
The figure describes the uptake of nitrous oxide 75% by individual tissue groups (VRG = vessel-rich group, MG = muscle group, FG = fat group) and their sum (total uptake, TU). Which set of labels accurately describes the curves?
- (A) 1- MG, 2- FG, 3- VRG, 4- TU
- (B) 1- VRG, 2- MG, 3- FG, 4- TU
- (C) 1- FG, 2- MG, 3- TU, 4- VRG
- (D) 1- TU, 2- FG, 3- MG, 4- VRG
- (E) 1- TU, 2- VRG, 3- MG, 4- FG
Reveal answer
A 62-year-old man, who had a myocardial infarction three years ago, complicated by congestive heart failure and renal failure, is undergoing a colectomy. A pulmonary artery catheter demonstrates a cardiac output higher than measurements recorded during a cardiac catheterization two months after the infarction. Which of the following most likely contributes to the increased cardiac output?
- (A) Creation of an arteriovenous fistula
- (B) Increased hemoglobin concentration from 10 to 12 g/dl
- (C) Stimulation of carotid body receptors
- (D) Transcutaneous nitroglycerin
- (E) Use of a beta-adrenergic blocker to prevent myocardial reinfarction
Reveal answer
A 62-year-old woman with obesity and type II diabetes mellitus is scheduled to undergo vitrectomy of the right eye. Five minutes after retrobulbar injection with 0.75% bupivacaine 4 ml and intravenous administration of fentanyl 50 ju-g and midazolam 1 mg, she is apneic and unresponsive. Which of the following is the most likely cause?
- (A) Fentanyl-midazolam interaction
- (B) Hypoglycemia
- (C) Intravenous bupivacaine
- (D) Retrobulbar hematoma
- (E) Subarachnoid bupivacaine
Reveal answer
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
Reveal answer
The most likely effect of a celiac plexus block for an abdominal operation is
- (A) bowel distention
- (B) hypotension
- (C) incisional analgesia
- (D) muscle relaxation
- (E) urinary retention
Reveal answer