10 Random Questions
The adult oxyhemoglobin dissociation curve will resemble that of the fetus in the presence of
- (A) increased 2,3-diphosphoglycerate concentration
- (B) chronic anemia
- (C) hyperthermia
- (D) metabolic alkalemia
- (E) hyperkalemia
A 20-year-old man involved in a motor vehicle accident is brought to the operating room for irrigation and debridement of open fractures of the femur and humerus. Cyanosis, decreased breath sounds on the left, increased peak airway pressure, and hypotension are noted after intubation of the trachea. The most likely cause is
- (A) aspiration
- (B) fat embolus
- (C) intubation of the right mainstem bronchus
- (D) tension pneumothorax
- (E) unilateral bronchospasm
A normal adult is receiving general anesthesia via a standard circle system and controlled ventilation. Mass spectrometer data are shown. Which event is most compatible with these data?
- (A) Endobronchial intubation
- (B) Hemorrhagic shock
- (C) Incompetent expiratory valve
- (D) Substantial decrease in fresh gas flow
- (E) Venous air embolism
Five minutes after intrathecal administration of tetracaine 12 mg in hyperbaric solution, a 60-year-old man has a weak hand grasp. Respirations are normal, heart rate has decreased from 80 to 45 bpm, and blood pressure has decreased from 150/80 to 90/50 mmHg. The most appropriate management at this time is
- (A) administration of atropine
- (B) administration of ephedrine
- (C) administration of phenylephrine
- (D) placement of the patient in the head-down position
- (E) observation
The primary determinant of the duration of an intravenous regional block sufficient to provide surgical anesthesia of an upper extremity is
- (A) duration of tourniquet inflation
- (B) capacitance of the venous system of the extremity
- (C) local anesthetic agent injected
- (D) volume of anesthetic solution injected
- (E) method of exsanguinating the arm
Halothane
- (A) has no effect on reflex hypoxic pulmonary vasoconstriction
- (B) protects the myocardium from beta-adrenergic stimulation
- (C) has a direct, negative chronotropic effect on the sinoatrial node
- (D) metabolites decrease renal concentrating ability
- (E) is unsafe for use with epinephrine-containing local anesthetics
You are asked to evaluate a 2000-g male infant three hours after vaginal delivery because of a respiratory rate of 50/min, pulse rate of 115 bpm, and the following arterial blood gas values while breathing room air: PaO2 64 mmHg, PaCO2 43 mmHg, and pH 7.33. His mother received meperidine 75 mg two hours before delivery. Appropriate management includes
- (A) administration of naloxone 50 mcg intramuscularly
- (B) increasing the FiO2 to 0.4
- (C) intubation and mechanical ventilation at an FiO2 of 0.5
- (D) administration of oxygen 50% with 5 cm H2O continuous positive airway pressure
- (E) observation, with no action at present
At extubation performed one week after nasotracheal intubation, each of the following is likely to occur EXCEPT
- (A) upper airway obstruction
- (B) aspiration after extubation
- (C) ulceration of vocal cords
- (D) tracheal stenosis
- (E) sinusitis
A patient receives an emergency transfusion of three units of O, Rh-negative blood for profuse hemorrhaging. If his blood type is AB, Rh-negative, which of the following is most appropriate for continuing transfusion?
- (A) AB, Rh-negative whole blood
- (B) B, Rh-negative whole blood
- (C) O, Rh-negative whole blood
- (D) A, Rh-negative erythrocytes
- (E) O, Rh-negative erythrocytes
A 27-year-old man with chronic renal failure is to undergo revision of an arteriovenous graft. He insists on general anesthesia. Hemodialysis was completed two hours ago, and serum potassium concentration is now 5 mEq/L. Which of the following statements concerning anesthetic management of this patient is true?
- (A) Enflurane is contraindicated
- (B) Succinylcholine is contraindicated
- (C) Neostigmine will be required in larger than usual dosage
- (D) The duration of action of atracurium will be prolonged
- (E) The duration of action of propofol will be unchanged