10 Random Questions
A 70-kg 78-year-old man undergoing small-bowel resection during anesthesia with isoflurane in oxygen becomes hypotensive and develops frothy pink sputum in the endotracheal tube. Heart rate is 50 bpm, blood pressure is 75/60 mmHg, pulmonary artery occlusion pressure is 22 mmHg, and cardiac output is 1.7 L/min. The most appropriate initial step in management is administration of which of the following?
- (A) Albumin
- (B) Digoxin
- (C) Dopamine
- (D) Esmolol
- (E) Nitroglycerin
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
At term which of the following would produce the greatest increase in uterine blood flow?
- (A) Increasing PaO2 to greater than 100 mmHg
- (B) Administering ritodrine intravenously
- (C) Administering halothane to 1 MAC
- (D) Administering magnesium sulfate intravenously
- (E) Increasing PaCO2 from 35 to 40 mmHg
Two days after total abdominal hysterectomy, a 54-year-old woman develops lethargy followed by seizures and coma. Laboratory studies show a serum sodium concentration of 108 mEq/L and serum osmolality of 225 mOsm/kg. The most appropriate next step in management is administration of which of the following?
- (A) Desmopressin
- (B) Furosemide only
- (C) Saline solution 0.9% only
- (D) Furosemide and saline solution 0.9%
- (E) Furosemide and saline solution 3%
A 75-year-old woman with significant carotid artery stenosis is scheduled for general anesthesia for repair of a fractured hip. Which of the following is the greatest disadvantage of using propofol as an induction agent in this patient?
- (A) Decreased arterial blood pressure
- (B) Pain during intravenous injection
- (C) Prolonged apnea after induction
- (D) Prolonged awakening
- (E) Prolonged elimination half-life
Uterine blood flow is
- (A) autoregulated in normal unanesthetized parturients
- (B) decreased by the addition of epinephrine 1:200,000 to lidocaine administered epidurally
- (C) decreased by intravenous infusion of ritodrine in unanesthetized parturients
- (D) increased by administration of magnesium sulfate to patients with preeclampsia
- (E) unchanged after paracervical injection of lidocaine without epinephrine
A middle-aged, 70-kg man with a brain tumor is scheduled for an elective craniotomy. Preoperatively, he is alert but papilledema is present. Anesthesia is induced with thiopental 300 mg and succinylcholine 100 mg, followed by tracheal intubation. Immediately following intubation vigorous bucking occurs. The best immediate management would be to
- (A) administer succinylcholine 100 mg intravenously
- (B) administer fentanyl 500 jug intravenously
- (C) hyperventilate with isoflurane 2%
- (D) administer thiopental 400 mg intravenously
- (E) hyperventilate and administer lidocaine 1 mg/kg intravenously
A 70-kg, 50-year-old man is scheduled for muscle flap closure of a decubitus ulcer over the sacrum. He has been quadriplegic at the level of C6-7 for six years. Which of the following is most likely to result from subarachnoid anesthesia with tetracaine 10 mg for this procedure?
- (A) Atrioventricular block
- (B) Decreased risk for autonomic dysreflexia
- (C) Impaired expiratory muscle function
- (D) Impaired inspiratory muscle function
- (E) Inadequate block of spastic movements
During a cardiac arrest with effective chest compression and positive-pressure ventilation, 50 mEq of sodium bicarbonate is administered. Which of the following is the most likely result?
- (A) Decreased mixed venous pH
- (B) Decreased SpO2
- (C) Increased PetCO2
- (D) Increased plasma lactate concentration
- (E) Increased serum potassium concentration
Which of the following would be most likely to result in neonatal depression when administered to a healthy parturient during an uncomplicated labor and vaginal delivery?
- (A) Nitrous oxide 60% in oxygen supplemented with halothane 0.5% for 10 minutes before delivery
- (B) Ketamine 20 mg intravenously 30 minutes before delivery
- (C) Meperidine 100 mg intramuscularly 2 hours before delivery
- (D) Thiopental 100 mg intravenously 30 minutes before delivery
- (E) Nitrous oxide 60% in oxygen supplemented with enflurane 0.7% for 10 minutes before delivery