10 Random Questions
A 28-year-old patient has severe laryngospasm after extubation of the trachea following general anesthesia. Administration of 100% oxygen using continuous positive airway pressure does not improve symptoms. SpO2 is 75%. Which of the following is the most appropriate immediate management?
- (A) Laryngeal mask airway
- (B) Lidocaine
- (C) Racemic epinephrine
- (D) Succinylcholine
- (E) Cricothyroidotomy
Coughing that occurs during awake intubation is prevented by local anesthetic block of which of the following nerves?
- (A) Glossopharyngeal
- (B) Hypoglossal
- (C) Recurrent laryngeal and glossopharyngeal
- (D) Recurrent laryngeal and superior laryngeal
- (E) Superior laryngeal and glossopharyngeal
A 68-year-old man with stable angina treated with propranolol and nifedipine is scheduled for coronary artery bypass grafting. After induction with fentanyl and tracheal intubation, heart rate decreases to 40 bpm and blood pressure decreases to 70/40 mmHg. The ECG is shown. Which of the following is the most appropriate first step in management?
- (A) Infusion of isoproterenol
- (B) Administration of phenylephrine
- (C) Closed chest cardiopulmonary resuscitation
- (D) Defibrillation
- (E) Synchronized cardioversion
A 64-year-old, 87-kg woman in good general health is undergoing a right knee arthroplasty while in the supine position with general anesthesia consisting of enflurane 2% and nitrous oxide 50% in oxygen. She is breathing spontaneously through a 7-mm endotracheal tube. During the first 30 minutes of the procedure, the arterial oxygen saturation measured by pulse oximetry decreases from 98% to 92%. The most likely cause of the desaturation is
- (A) decreased functional residual capacity
- (B) diffusion hypoxia
- (C) hypercarbia
- (D) increased airway resistance produced by the endotracheal tube
- (E) inhibition of hypoxic pulmonary vasoconstriction
A 69-year-old man is confused and agitated one hour after preoperative intramuscular administration of scopolamine for awake fiberoptic laryngoscopy. SpO2 measured by pulse oximetry is 97%. Which of the following drugs is most appropriate for treatment of the change in mental status?
- (A) Fentanyl
- (B) Flumazenil
- (C) Midazolam
- (D) Neostigmine
- (E) Physostigmine
A 46-year-old patient who abuses intravenous drugs develops acute aortic valvular insufficiency from bacterial endocarditis. Which of the following statements concerning pressures measured through a pulmonary artery catheter is true?
- (A) Pulmonary artery occlusion pressure will underestimate left ventricular end-diastolic pressure
- (B) Pulmonary artery oxygen saturation will overestimate mixed venous oxygen saturation
- (C) Thermodilution cardiac output determination will overestimate cardiac output
- (D) Right ventricular end-diastolic pressure will equal left ventricular end-diastolic pressure
- (E) The pulmonary artery occlusion pressure trace will most likely have large V waves
A 65-year-old man is disoriented and has a headache and nausea in the recovery room 30 minutes after transurethral resection of the prostate with glycine irrigation performed under spinal anesthesia. Heart rate is 50 bpm and blood pressure is 180/110 mmHg. Which of the following is LEAST likely?
- (A) Decreased serum osmolality
- (B) Serum sodium concentration 132 mEq/L
- (C) Increased serum ammonia concentration
- (D) Bibasilar rales
- (E) Jugular venous distention
Which of the following is the most important function of temperature compensation in anesthetic vaporizers?
- (A) Compensation for changes in the specific heat of the anesthetic during vaporization
- (B) Delivery of diluent gas at a constant temperature regardless of flow rate
- (C) Increase of bypass flow when the vaporizer is cooled by high fresh gas flow
- (D) Maintenance of constant anesthetic vapor output over a range of vaporizer temperatures
- (E) Maintenance of constant vapor concentrations at low flow rates
Severe nausea and vomiting in the PACU is most effectively treated with a drug that acts as an antagonist at which of the following receptors?
- (A) Alpha-adrenergic
- (B) Beta-adrenergic
- (C) Dopamine
- (D) GABA
- (E) Glutamate
A 40-year-old woman has continuous nondermatomal burning pain of the distal foot four weeks after sustaining a metatarsal fracture. On examination, the foot is mildly swollen, tender, and cool. Which of the following statements concerning this condition is true?
- (A) A radiograph of the distal bones of the painful foot will show severe osteoporosis
- (B) A technetium scan of the distal joints of the painful foot will show decreased uptake
- (C) Early use of opioid analgesia will prevent progression of the symptoms
- (D) Intravenous phentolamine will relieve the pain
- (E) The chance of spontaneous recovery within eight weeks is greater than 80%