10 Random Questions
Following a vaginal hysterectomy in the lithotomy position under general anesthesia, a patient has numbness of the lateral aspect of the left calf and medial half of the dorsum of the left foot. On physical examination she has footdrop and the toes cannot be extended. Which nerve is most likely to be involved?
- (A) Common peroneal nerve
- (B) Deep peroneal nerve
- (C) Posterior tibial nerve
- (D) Saphenous nerve
- (E) Sciatic nerve
A 54-year-old man receives 25 ml of a 50% alcohol and 0.25% bupivacaine solution for celiac plexus block. During the next 20 minutes, blood pressure decreases from 130/75 mmHg to 85/55 mmHg. Which of the following is the most likely cause?
- (A) Intravascular injection
- (B) Retroperitoneal hemorrhage
- (C) Splanchnic vasodilation
- (D) Subarachnoid blockade
- (E) Tension pneumothorax
The short clinical duration of action of a single dose of fentanyl is a result of its
- (A) small volume of distribution
- (B) large volume of distribution
- (C) low lipid solubility
- (D) rapid redistribution
- (E) short elimination half-life
During postoperative indirect laryngoscopy, the vocal cords appear symmetric during quiet breathing and approximate to the left of midline during phonation. The most likely cause is
- (A) pure abductor paralysis of the left cord
- (B) pure abductor paralysis of the right cord
- (C) abductor and adductor paralysis of the left cord
- (D) abductor and adductor paralysis of the right cord
- (E) adductor paralysis of both cords
A 55-year-old woman who is scheduled to undergo carotid endarterectomy has a history of essential hypertension and chronic obstructive pulmonary disease. Over a 30-minute period beginning one hour after induction of general anesthesia, Sp02 decreases from 99% to 95%. During that time, she has received fentanyl 100 mcg, isoflurane 1%, nitrous oxide 49.5%, oxygen 49.5%, and a nitroglycerin infusion to maintain blood pressure at approximately 160/95 mmHg. Which of the following is the most likely cause for the decline in oxygen saturation?
- (A) Decreased cardiac output
- (B) Increased dead space ventilation
- (C) Inhibition of hypoxic pulmonary vasoconstriction
- (D) Mainstem intubation
- (E) Second gas effect
Each of the following statements concerning norepinephrine is true EXCEPT:
- (A) Extraneuronal uptake is important in the termination of its activity
- (B) It is formed from dopamine
- (C) Its release is facilitated by ephedrine
- (D) Its uptake is affected by cocaine
- (E) It has minimal beta2-adrenergic activity
A 50-year-old patient is undergoing craniotomy for clipping of a cerebral aneurysm with isoflurane, nitrous oxide, and fentanyl anesthesia. At the time of aneurysm exposure, the EEG shows burst suppression. Which of the following is the most likely cause?
- (A) Cerebral ischemia
- (B) Cerebral vasospasm
- (C) Fentanyl effect
- (D) Isoflurane effect
- (E) Petit mal seizure activity
During axillary brachial plexus anesthesia, motor block frequently precedes sensory block because of
- (A) conduction velocity of motor fibers
- (B) myelination of motor fibers
- (C) size of motor fibers
- (D) presence of septa between motor fibers
- (E) peripheral location of motor fibers in the nerve bundle
The trend plot shows end-tidal gases measured during a radical neck dissection. The event occurring at A is most likely
- (A) acute hypotension
- (B) endobronchial intubation
- (C) kinking of the endotracheal tube
- (D) rupture of the endotracheal cuff
- (E) venous air embolism
A 45-year-old man with chronic liver failure is scheduled for liver transplantation. Which of the following preoperative findings is most likely?
- (A) Hypoxemia
- (B) Increased platelet count
- (C) Increased systemic vascular resistance
- (D) Increased serum factor VIII concentration
- (E) Metabolic alkalosis