10 Random Questions
Which of the following statements concerning myasthenia gravis is true?
- (A) Neostigmine is inappropriate for antagonism of neuromuscular blockade
- (B) The number of acetylcholine receptors is decreased
- (C) Plasma cholinesterase concentration is decreased
- (D) The risk for malignant hyperthermia is increased
- (E) Succinylcholine is contraindicated
A 25-year-old man requires exploratory laparotomy following a motor vehicle accident. He is acutely intoxicated with alcohol. Which of the following is the most likely result of the alcohol ingestion?
- (A) Hyperdynamic circulation
- (B) Hyperglycemia
- (C) Hyperthermia
- (D) Increased respiratory depression from opioids
- (E) Increased sensitivity to neuromuscular blocking drugs
An 80-kg, 70-year-old woman is scheduled for a mastectomy. She has a history of congestive heart failure treated with digoxin 0.25 mg daily. Preoperative examination shows a sinus rhythm at 80 bpm and blood pressure of 110/70 mmHg. Laboratory studies show a serum potassium concentration of 4.2 mEq/L and a serum digoxin concentration of 1.5 mcg/ml. Five minutes after induction of general anesthesia, ventricular bigeminy is noted; blood pressure is 85/65 mmHg, SpO2 is 97%, and PetCO2, is 20 mmHg. Which of the following is the most appropriate management?
- (A) Administration of calcium chloride
- (B) Administration of ephedrine
- (C) Administration of lidocaine
- (D) Administration of potassium chloride
- (E) Decrease in ventilation
A 70-kg, 47-year-old man is undergoing a repeat coronary artery bypass graft. Following sternotomy, administration of heparin 300 units/kg for anticoagulation increases the activated coagulation time from a baseline of 135 sec to 210 sec. This finding is compatible with
- (A) antithrombin III deficiency
- (B) heparin-induced thrombocytopenia
- (C) normal response to this dose of heparin
- (D) increased sensitivity to heparin
- (E) von Willebrand's disease
A 75-year-old man received an uneventful epidural anesthetic for total knee arthroplasty. Twenty-four hours later he has a painless flaccid paralysis in both legs. This clinical presentation is most consistent with
- (A) adhesive arachnoiditis
- (B) anterior spinal artery thrombosis
- (C) epidural abscess
- (D) epidural hematoma
- (E) transverse myelitis
A 70-year-old man with stable angina is scheduled for cataract removal with a retrobulbar block. After injection of 5 ml of 0.75% bupivacaine, heart rate decreases from 90 to 55 bpm, and frequent premature ventricular contractions are noted on the EKG. These changes are most likely caused by
- (A) intravascular injection of bupivacaine
- (B) subarachnoid injection of bupivacaine
- (C) myocardial ischemia
- (D) oculocardiac reflex
- (E) retrobulbar hemorrhage
Which of the following is an advantage of a circle system over a Mapleson D system?
- (A) Better anesthetic conservation
- (B) Lower dead space
- (C) Lower circuit resistance
- (D) More efficient scavenging
- (E) More rapid changes in inspired gas concentration
Which of the following results in the greatest increase in right-to-left shunting in an infant with cyanotic heart disease?
- (A) Decreased pulmonary vascular resistance
- (B) Decreased systemic vascular resistance
- (C) Hemodilution
- (D) Increased heart rate
- (E) Myocardial depression
The ECG rhythm shown developed during cholecystectomy in a 62-year-old man who had a myocardial infarction and is taking atenolol. The drug of choice for treating this dysrhythmia is
- (A) atropine
- (B) bretylium
- (C) isoproterenol
- (D) lidocaine
- (E) procainamide
Compared with a person of normal weight, which of the following findings are most likely on pulmonary function testing of a patient with morbid obesity? (FVC, FEV/FVC, FRC, A-a DO2)?
- (A) Decreased, Normal, Decreased, Normal
- (B) Decreased, Normal, Decreased , Increased
- (C) Decreased, Normal, Normal, Increased,
- (D) Increased, Decreased, Normal, Increased
- (E) Increased, Decreased, Decreased, Increased