10 Random Questions
Following pneumonectomy, a paralyzed patient being mechanically ventilated has the following arterial blood gas values: PaO2 71 mmHg, PaCO2 55 mmHg, pH 7.29. SvO2 is 45%. The most likely explanation for this SvO2 is
- (A) decreased red cell mass
- (B) high cardiac output
- (C) hypothermia
- (D) peripheral left-to-right arteriovenous shunt
- (E) ventilation / perfusion mismatch
A 39-year-old patient with insulin-dependent diabetes mellitus receives thiopental 250 mg and succinylcholine 80 mg and is ventilated with 0.75% isoflurane in oxygen. Arterial pressure decreases abruptly from 140/100 to 80/50 mmHg while heart rate remains unchanged at 70 bpm. Failure of heart rate to increase most likely results from
- (A) acute hypoglycemia
- (B) autonomic neuropathy
- (C) depression of sinus node function by thiopental
- (D) depression of the baroreflex response by isoflurane
- (E) ganglionic stimulation by succinylcholine
A 46-year-old man is scheduled for repair of an inguinal hernia. Six years ago, he had an episode of malignant hyperthermia during cholecystectomy. Which of the following is the most appropriate perioperative management?
- (A) Administration of a regional anesthetic
- (B) Administration of dantrolene orally for two days prior to surgery
- (C) Avoidance of all inhalational anesthetics except isoflurane
- (D) Avoidance of ester local anesthetics
- (E) Flushing the anesthesia machine with oxygen 10 L/min for a minimum of 12 hours
The hemodynamic changes shown would most likely result from infusion of
- (A) dopamine
- (B) epinepherine
- (C) dobutamine
- (D) norepinepherine
- (E) isoproterenol
Assignment of a patient to an ASA physical status category is used to
- (A) facilitate comparisons among different patient groups and institutions
- (B) guide the choice of anesthetic technique
- (C) permit accurate determination of charges for professional services
- (D) predict anesthetic risk
- (E) predict perioperative mortality
Which of the following is the most likely cause of the coronary steal phenomenon?
- (A) Idiopathic hypertrophic subaortic stenosis (IHSS)
- (B) Decreased cardiac contractility
- (C) Dilation of coronary arterioles
- (D) Dilation of epicardial coronary arteries
- (E) Increased systemic vascular resistance
A patient sustains cardiac arrest while being mechanically ventilated. Which of the following is the most likely effect on PetCO2?
- (A) Gradual increase with the duration of asystole
- (B) Maintenance of the prearrest value
- (C) Abrupt decrease below the prearrest value
- (D) Decrease when thoracic compression is started
- (E) Gradual decrease independent of the ventilator cycle
A 40-year-old woman has continuous nondermatomal burning pain of the distal foot four weeks after sustaining a metatarsal fracture. On examination, the foot is mildly swollen, tender, and cool. Which of the following statements concerning this condition is true?
- (A) A radiograph of the distal bones of the painful foot will show severe osteoporosis
- (B) A technetium scan of the distal joints of the painful foot will show decreased uptake
- (C) Early use of opioid analgesia will prevent progression of the symptoms
- (D) Intravenous phentolamine will relieve the pain
- (E) The chance of spontaneous recovery within eight weeks is greater than 80%
The cardiac rhythm illustrated appeared suddenly in an anesthetized patient. The most appropriate management is
- (A) administration of adenosine
- (B) administration of digoxin
- (C) administration of epinepherine
- (D) overdrive pacing
- (E) synchronous cardioversion
A 32-year-old man is scheduled for hernia repair. He underwent heart transplantation for cardiomyopathy five years ago. Which of the following findings is most likely?
- (A) Absence of coronary atherosclerosis
- (B) Biventricular hypokinesis on echocardiography
- (C) Down-regulation of cardiac beta-adrenergic receptors
- (D) Increased heart rate at rest
- (E) Right ventricular hypertrophy