10 Random Questions
A 35-year-old woman who takes a diuretic daily for chronic hypertension has a serum potassium concentration of 3.1 mEq/L on the morning of an elective hysterectomy. An EKG shows left ventricular hypertrophy. The most appropriate management is to
- (A) consult with a cardiologist before proceeding
- (B) initiate oral potassium replacement and proceed with the operation when potassium concentration is normal
- (C) initiate intravenous potassium replacement and proceed with the operation
- (D) initiate intravenous potassium replacement and proceed with the operation when potassium concentration is 4 mEq/L
- (E) proceed with the operation without intervention
The tracing indicates that the pacemaker generator is
- (A) malfunctioning
- (B) VVT sensing and capturing normally
- (C) VOO sensing and capturing normally
- (D) DVI sensing and capturing normally
- (E) VVI sensing and capturing normally
A 56-year-old woman with pulmonary fibrosis is scheduled for pneumonectomy. Which of the following parameters best predicts potential postoperative functional impairment?
- (A) Exercise tolerance
- (B) Flow-volume loop
- (C) Resting arterial blood gas values
- (D) Unilateral pulmonary artery occlusion pressure
- (E) Vital capacity and FEV,
Eight hours after abdominal surgery, a 51-year-old patient becomes increasingly somnolent. Epidural morphine 5 mg was administered immediately following the procedure. Postoperatively, respiratory rate has not decreased below 12/min and Sp02 has remained greater than 92%. Arterial blood gas analysis shows Pa02 80 mmHg, PaC02 82 mmHg, and pH 7.1. Which of the following is the most appropriate conclusion?
- (A) Analysis of the blood sample was delayed
- (B) The blood sample was venous rather than arterial
- (C) The patient is receiving supplemental oxygen
- (D) The pulse oximeter readings are falsely high
- (E) No treatment is required at this time
Compared with normal adults, which of the following characteristics of neonates best explains the more rapid inhalation induction in neonates?
- (A) Greater cardiac index
- (B) Greater metabolic rate
- (C) Greater perfusion of vessel-rich tissues
- (D) Greater ratio of alveolar ventilation to functional residual capacity
- (E) Less lean body mass
One hundred children who are to have strabismus surgery are enrolled in a research protocol. Fifty receive a new antiemetic and 50 receive a placebo preoperatively. Fifteen children in the treatment group and 37 children in the control group have nausea and vomiting postoperatively. Which of the following analyses is most appropriate for determining the statistical significance of the group differences?
- (A) Analysis of variance
- (B) Chi-square analysis
- (C) Linear regression and correlation coefficient
- (D) Student's t-test
- (E) Wilcoxon's rank sum test
A patient whose trachea is intubated develops partial airway obstruction two hours after induction of fentanyl, nitrous oxide, oxygen anesthesia. The anesthesiologist discontinues the nitrous oxide and controls ventilation, and there is gradual improvement during the next hour. No evidence of a respiratory disorder is found at the conclusion of the anesthetic. Which of the following is most likely?
- (A) The endotracheal tube was in the right mainstem bronchus
- (B) The patient had an unrecognized air embolism
- (C) The patient had a nitrous oxide pneumothorax
- (D) The endotracheal tube cuff narrowed the airway
- (E) The fentanyl induced chest rigidity
A 68-year-old woman who is receiving urokinase for deep venous thrombosis and pulmonary emboli requires emergency laparotomy for a bleeding gastric ulcer. Which of the following agents is most appropriate to reverse the effects of urokinase?
- (A) Cryoprecipitate
- (B) Factor VIII concentrate
- (C) Fresh frozen plasma
- (D) Platelets
- (E) Vitamin K
Which of the following statements concerning neuroleptic malignant syndrome is true?
- (A) It does not respond to dantrolene therapy
- (B) It is inherited as an autosomal trait
- (C) It is not triggered by succinylcholine
- (D) It occurs after long-term use of L-dopa
- (E) The halothane-caffeine contracture test is negative in susceptible patients
A multigravid woman is receiving oxytocin by infusion for augmentation of labor. Fetal heart rate is 190 bpm with beat-to-beat variability of 6 to 8 bpm. The most appropriate immediate action would be to
- (A) continue observation
- (B) sample fetal scalp blood
- (C) discontinue oxytocics
- (D) administer a beta-adrenergic blocker to the mother
- (E) deliver the fetus