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
A 35-year-old man has acute onset of low back pain, lower extremity weakness, and bladder dysfunction. He had a lumbar laminectomy two years ago. A myelogram shows disk herniation at L4-5. The most appropriate management is
- (A) bed rest
- (B) administration of a nonsteroidal anti-inflammatory agent
- (C) epidural administration of a corticosteroid
- (D) epidural administration of a local anesthetic
- (E) surgical decompression
Which of the following is the most likely effect of administration of magnesium sulfate in a patient with preeclampsia?
- (A) Decreased motor end-plate sensitivity to acetylcholine
- (B) Decreased uteroplacental blood flow
- (C) Increased platelet aggregation
- (D) Increased systemic vascular resistance
- (E) Inhibited acetylcholinesterase
To measure the contribution of intrapulmonary shunting to arterial hypoxemia, which of the following measurements are necessary? (Assume normal cardiac output and anatomy.)
- (A) PaC02 and PeC02
- (B) PaC02 and Pe02 while breathing pure oxygen
- (C) Pa02 and Pv02 while breathing pure oxygen
- (D) Pa02 while breathing both room air and pure oxygen
- (E) Pa02 and PaC02 while breathing room air
A burn is found at the site of the electrocautery pad. Which of the following is most likely?
- (A) The electrosurgical unit was in the bipolar mode
- (B) The electrocautery pad became partially detached
- (C) The electrosurgical unit ground wire was severed
- (D) The line-isolation monitor alarmed
- (E) The patient became grounded
An 88-kg man is anesthetized with 66% nitrous oxide, 33% oxygen, and 1% isoflurane using a circle system. Following tracheal intubation, the nitrous oxide flow is set at 1 L/min and the oxygen flow is set at 0.5 L/min. After two hours the oxygen monitor indicates a circuit oxygen concentration of only 25% despite the flows noted above. The most likely explanation for this discrepancy is
- (A) decrease of oxygen pipeline pressure to 20 psi
- (B) increase in the concentration of nitrous oxide in the circuit
- (C) inaccuracy of flowmeters at low flow rates
- (D) malfunction of the oxygen monitor
- (E) progressive hypothermia
A multigravid woman is receiving oxytocin by infusion for augmentation of labor. Fetal heart rate is 190 bpm with beat-to-beat variability of 6 to 8 bpm. The most appropriate immediate action would be to
- (A) continue observation
- (B) sample fetal scalp blood
- (C) discontinue oxytocics
- (D) administer a beta-adrenergic blocker to the mother
- (E) deliver the fetus
A full-term newborn has marked respiratory distress in the delivery room. Breath sounds are asymmetric and the abdomen is scaphoid. Which of the following maneuvers is most appropriate?
- (A) Hyperventilation with bag and mask
- (B) Intubation and ventilation with positive end-expiratory pressure
- (C) Intubation and ventilation with zero end-expiratory pressure
- (D) Bronchoscopy
- (E) Insertion of a chest tube
An sevoflurane vaporizer is filled with isoflurane and the vaporizer dial is set at 1%. Which of the following will occur?
- (A) Less than 1% isoflurane will be delivered
- (B) More than 1% isoflurane will be delivered
- (C) Thymol precipitation will prevent vaporization
- (D) The vaporizer bypass will not open
- (E) The vaporizer will be damaged
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