10 Random Questions
The need for increased doses of nondepolarizing muscle relaxants in patients with extensive burns is best explained by
- (A) increased protein binding
- (B) hypermetabolism
- (C) increased glomerular filtration rate
- (D) proliferation of receptors on burned muscle
- (E) decreased volume of distribution
Compared with adults, neonates are more likely to become hypoxemic following anesthesia and extubation because of a relatively
- (A) higher rate of oxygen consumption
- (B) greater sensitivity to neuromuscular blockade
- (C) larger Vd/Vt ratio
- (D) lower blood pressure
- (E) smaller functional residual capacity
A 2.8-kg newborn undergoes repair of a moderate-sized omphalocele. Intravenous fluid is administered at 14 mL/hr. Forty-five minutes after beginning surgery and before reduction of the omphalocele, arterial blood pressure decreases from 80/40 to 55/30 mmHg. SaO2 is 98% at an FiO2 of 0.5. Breath sounds are equal bilaterally. Which of the following is the most likely explanation for the decrease in blood pressure?
- (A) Associated congenital cardiac defect
- (B) Compression of the lungs by the abdominal contents
- (C) Inadequate fluid administration
- (D) Pneumothorax
- (E) Sepsis
Which of the following is the most likely adverse effect of prolonged intravenous administration of nitroglycerin?
- (A) Cyanmethemoglobinemia
- (B) Hemolysis
- (C) Methemoglobinemia
- (D) Neutropenia
- (E) Thrombocytopenia
A 1-month-old infant becomes hypoxemic faster during apnea than an adult. Which of the following is the primary cause of this difference?
- (A) Functional residual capacity in an infant is half that of an adult
- (B) Metabolic rate in an infant is twice that of an adult
- (C) Resting PaO2 in an infant is lower than that in an adult
- (D) The number of alveoli in an infant is 12% the number in an adult
- (E) The hemoglobin dissociation curve in an infant is shifted to the right
To detect the delivery of a hypoxic gas mixture, the optimal location for an oxygen analyzer in this circle is
- (A) 1
- (B) 2
- (C) 3
- (D) 4
- (E) 5
A 72-year-old patient who takes levodopa and carbidopa is undergoing colon resection. Metoclopramide is administered preoperatively and anesthesia is maintained with proposal, fentanyl, and nitrous oxide, with vecuronium for muscle relaxation. Fifteen minutes after reversal of muscle relaxation with neostigmine and atropine and tracheal extubation, the patient has dyspnea and muscular rigidity. Which of the following is the most likely cause?
- (A) Central anticholinergic syndrome
- (B) Fentanyl-induced rigidity
- (C) Inhibition of methionine synthetase by nitrous oxide
- (D) Metoclopramide-induced dopamine antagonism
- (E) Peripheral conversion of levodopa to dopamine
A patient with uremia is scheduled for emergency surgery. Bleeding time is 18 minutes. The most appropriate initial treatment is
- (A) cryoprecipitate
- (B) desmopressin
- (C) fresh frozen plasma
- (D) platelets
- (E) vitamin K
Which of the following is a manifestation of preeclampsia?
- (A) Hypovolemia
- (B) Increased colloid osmotic pressure
- (C) Natriuresis
- (D) Resistance to catecholamines
- (E) Thrombocytosis
An infant is delivered by forceps following labor in which variable decelerations were noted. Amniotic fluid was clear. Initial evaluation shows a cyanotic, limp infant with a heart rate of 80 bpm, poor respiratory efforts, and grimacing in response to suctioning. The most appropriate method of resuscitation for this newborn is
- (A) vigorous tactile stimulation
- (B) bag and mask ventilation with oxygen
- (C) immediate endotracheal intubation
- (D) administration of sodium bicarbonate 1 mEq/kg
- (E) volume expansion with normal saline solution 10 mL/kg