10 Random Questions
A 40-year-old woman with chronic renal failure is undergoing revision of an arteriovenous shunt with general anesthesia. The capnographic waveform was obtained during spontaneous ventilation 20 minutes after administration of succinylcholine and tracheal intubation. Which of the following is the most likely cause of these findings?
- (A) Leaking endotracheal cuff
- (B) Channeling of soda lime
- (C) Light anesthesia
- (D) Metabolic acidosis
- (E) Residual neuromuscular block
Two hours after coronary artery bypass grafting, a 60-year-old man has a heart rate of 140 bpm and blood pressure of 80/60 mmHg. Cardiac index is 1.5 L/min/m2. Central venous pressure is 23 mmHg with large a-waves in the right atrial pressure tracing. A pulsus paradoxus of 6 mmHg is noted. Which of the following is the most likely diagnosis?
- (A) Atrial flutter
- (B) Cardiac tamponade
- (C) Hypovolemia
- (D) Junctional tachycardia
- (E) Tension pneumothorax
Evaluation of a postoperative neurologic deficit discloses inability to oppose the thumb and little finger, weakness of abduction of the thumb, and loss of flexion of the distal phalanx of the index finger. This problem is most likely related to
- (A) paresthesia occurring during an interscalene brachial plexus block
- (B) attempted radial artery cannulation at the wrist
- (C) inadequate padding under the elbow
- (D) attempted venipuncture in the antecubital fossa
- (E) abduction of the upper humerus against an "ether screen"
Hyperkalemia in response to the administration of an intubating dose of succinylcholine is associated with each of the following disorders EXCEPT
- (A) poliomyelitis
- (B) multiple sclerosis
- (C) hemiplegia
- (D) acute cervical cord transection
- (E) familial periodic paralysis
Each of the following conditions can be accurately evaluated with transesophageal echocardiography EXCEPT
- (A) intimal tear at the aortic arch
- (B) intracardiac air
- (C) left atrial thrombus
- (D) patent foramen ovale
- (E) right atrial myxoma
Desflurane at a stable alveolar concentration of 7%
- (A) causes bradycardia
- (B) decreases cerebrovascular resistance
- (C) degrades in soda lime
- (D) increases systemic vascular resistance
- (E) stimulates the respiratory centers
Which of the following statements concerning relationships among alveolar pressure, volume, and surface tension is true?
- (A) Surface tension of surfactant decreases as alveolar volume decreases
- (B) Surface tensions of water and of surfactant behave similarly as volume decreases
- (C) Changes in alveolar surface tension with volume are the same during expansion as during contraction
- (D) Pressure in the alveolus is inversely related to surface tension
- (E) Pressure in the alveolus is directly related to alveolar radius
In a patient who has undergone cholecystectomy, which of the following is the most likely pulmonary effect of systemically administered opioids?
- (A) Decreased Qs/Qt
- (B) Decreased dead space
- (C) Restored vital capacity
- (D) Restored functional residual capacity
- (E) Shift of the carbon dioxide response curve to the right
The plasma concentration of an intravenously administered drug follows the two-compartment kinetic model shown in the graph. Which of the following events is illustrated by the decline in plasma concentration shown at Time #2?
- (A) Decreasing activity of the drug at its receptor site
- (B) Distribution from plasma to tissue
- (C) Elimination of the drug from plasma
- (D) Increasing volume of distribution
- (E) Redistribution from vessel-rich groups to vessel-poor groups
Following a right lower lobectomy, a patient develops a bronchopleural fistula and becomes hypoxic. He is orally intubated and mechanically ventilated with pure oxygen. PaO2 is 65 mmHg, PaCO2 is 70 mmHg, and pH is 7.25. Which of the following will produce the most favorable change in the blood gases?
- (A) Increasing ventilatory frequency
- (B) Increasing suction on the chest tube
- (C) Applying 10 cmH2O positive end-expiratory pressure
- (D) Using a double-lumen tube for differential ventilation
- (E) Starting negative-pressure ventilation