10 Random Questions
Following induction of anesthesia with sufentanil and pancuronium, a patient with left main coronary artery disease has a decrease in blood pressure from 110/70 to 60/40 mmHg. There is no change in heart rate or ECG. The most appropriate management of the hypotension is administration of
- (A) calcium chloride
- (B) ephedrine
- (C) epinephrine
- (D) isoproterenol
- (E) phenylephrine
Which of the following is most likely to decrease uterine tone?
- (A) Administration of isoflurane 1%
- (B) Administration of nitrous oxide 50%
- (C) Intravascular injection of 5 ml of 0.5% bupivacaine
- (D) Intravenous administration of ketamine 2 mg/kg
- (E) Paracervical block with 20 ml of 1% lidocaine
A 45-year-old man is scheduled for appendectomy under general anesthesia. He reports that for many years he has occasionally felt his heart "skip a beat." The ECG tracing shown was obtained one hour ago. Which of the following is the most appropriate next step?
- (A) Proceeding with induction of anesthesia
- (B) Administration of a loading dose of digoxin
- (C) Carotid sinus massage
- (D) Intravenous administration of atropine
- (E) Placement of a temporary pacemaker
A woman is undergoing a repeat cesarean delivery at term following a normal pregnancy. Anesthesia consists of thiopental 250 mg, succinylcholine infusion (180 mg in 20 minutes), nitrous oxide and oxygen (7:3 L/min) until delivery. Twenty minutes after the incision a floppy newborn with a 1-minute Apgar score of 5 is delivered. The most likely explanation for the infant's condition is
- (A) high serum thiopental concentration
- (B) high serum succinylcholine concentration
- (C) high serum nitrous oxide concentration
- (D) high serum glucose concentration
- (E) uterine hypoperfusion
A woman with chronic obstructive pulmonary disease is extubated and minimally responsive after isoflurane anesthesia. She is receiving oxygen 6 L/min through a face mask. Respirations are 10/min, PaO2 is 68 mmHg, PaCO2 is 54 mmHg, and pH is 7.28. The most likely cause of the respiratory acidemia is
- (A) blunted sensitivity to low pH in the medullary respiratory center
- (B) chronic carbon dioxide retention
- (C) decreased lung volume from supine positioning
- (D) depression of carotid body chemoreceptors by halothane
- (E) suppression of hypoxic ventilatory drive by supplemental oxygen
Which of the following best explains the decreased effect of hyperventilation on cerebral blood flow when PaCO2 decreases below 20 mmHg?
- (A) Maximal constriction of cerebral vessels
- (B) Decreased cerebral perfusion pressure
- (C) Decreased cerebral metabolic rate for oxygen
- (D) Increased cardiac output
- (E) Increased cerebrospinal fluid pressure
When compared with a healthy 30-year-old man, which of the following respiratory parameters is decreased in an otherwise healthy 80-year-old man?
- (A) Alveolar to arterial oxygen gradient
- (B) Lung compliance
- (C) Ratio of functional residual capacity to total lung capacity
- (D) Resting tidal volume
- (E) Ventilatory response to carbon dioxide
In a patient with hypovolemic shock, which of the following factors is the best measure of the overall balance between oxygen supply and demand?
- (A) Arterial oxygen content
- (B) PetO2
- (C) Mixed venous oxygen saturation
- (D) PaO2
- (E) Transcutaneous oxygen tension
The most common clinical viral infection following homologous blood transfusion is caused by
- (A) cytomegalovirus
- (B) Epstein-Barr virus
- (C) hepatitis B virus
- (D) human immunodeficiency virus
- (E) non-A, non-B hepatitis virus
In this diagram of a circle system, an increase in dead space is most likely to result from placement of the pressure relief valve at location
- (A) 1
- (B) 2
- (C) 3
- (D) 4
- (E) 5