10 Random Questions
When treating reflex sympathetic dystrophy of an arm, which of the following is the best indicator of a successful sympathetic blockade?
- (A) A pinprick sensory deficit in the distribution of C6
- (B) A 5°C increase in the temperature of the skin of the hand
- (C) An accentuated psychogalvanometric response in the forearm
- (D) An ipsilateral positive Horner's syndrome
- (E) Decreased temperature sensation in the hand
A patient has pain in the left thoracic wall associated with metastatic rib lesions. An intrathecal neurolytic block with 6% phenol in glycerin is planned for pain relief. Prior to performing the block, the patient should be placed in which of the following positions?
- (A) Left lateral semisupine
- (B) Right lateral semisupine
- (C) Left lateral semiprone
- (D) Right lateral semiprone
- (E) Prone
Which Mapleson breathing circuit shown in the illustration permits the LEAST amount of fresh gas inflow to prevent rebreathing during spontaneous ventilation?
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
During a craniotomy for a supratentorial tumor, a 28-year-old man receives isoflurane 0.75% in nitrous oxide 70% and oxygen. Ventilation is controlled to maintain PaCO2 at 25 mmHg. Nasopharyngeal temperature is 35.8°C. While the dura mater is open, the surgeon complains that the brain is bulging. The most appropriate management at this time is to
- (A) decrease the inspired isoflurane concentration to 0.5%
- (B) hyperventilate further to decrease PaCO2 to 20 mmHg
- (C) discontinue nitrous oxide
- (D) administer thiopental
- (E) administer additional muscle relaxants
Cessation of smoking on the day prior to an operation is associated with a perioperative
- (A) decrease in carbon monoxide in blood
- (B) improvement in ciliary beating in the airways
- (C) decrease in sputum volume
- (D) decrease in the need for postoperative ventilatory support
- (E) decrease in the risk of deep vein thrombosis
Which of the following is the most reliable indicator of adequate reversal of neuromuscular block?
- (A) Inspiratory force equal to -30 cmH20
- (B) Sustained head lift for 5 seconds
- (C) Train-of-four ratio of 0.7
- (D) Twitch height at 100% of control
- (E) Vital capacity of 15 ml/kg
Each of the following conditions causes resistance to nondepolarizing neuromuscular blockade EXCEPT
- (A) chronic severe infections
- (B) major burns
- (C) myotonia congenita
- (D) prolonged immobilization
- (E) upper motor neuron injury
When evaluating a screening test, which of the following is the most appropriate term for the proportion of patients with a disease who have a positive test result?
- (A) Accuracy
- (B) Incidence
- (C) Selectivity
- (D) Sensitivity
- (E) Specificity
Epinephrine is less effective in prolonging epidural anesthesia with bupivacaine than epidural anesthesia with lidocaine because
- (A) peak bupivacaine concentrations are decreased less than peak lidocaine concentrations
- (B) the acidic pH of epinephrine decreases the concentration of the nonionized bupivacaine
- (C) bupivacaine produces more vasoconstriction than lidocaine
- (D) the duration of action of bupivacaine is independent of local blood flow
- (E) bupivacaine antagonizes the vasoconstrictor activity of epinephrine
When inspired anesthetic gases are humidified
- (A) most particles 1 to 2 microns in size are deposited in the trachea
- (B) respiratory epithelial cilia become less active
- (C) alveolar water vapor pressure is unchanged
- (D) respiratory heat loss is abolished
- (E) sterilization of breathing apparatus is mandatory