10 Random Questions
Which of the following additives accelerates the onset of lidocaine axillary block without shortening duration?
- (A) Carbon dioxide
- (B) Dextran
- (C) Dextrose
- (D) Epinephrine
- (E) Hyaluronidase
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
A 34-year-old man is undergoing appendectomy during spinal anesthesia with T2 sensory blockade. Approximately 15 minutes after the injection of bupivacaine 15 mg, heart rate decreases to 34 bpm and blood pressure decreases to 70/40 mmHg. Which of the following is the most likely cause?
- (A) Baroreceptor stimulation
- (B) Bupivacaine cardiotoxicity
- (C) Hypovolemia
- (D) Thoracic sympathetic blockade
- (E) Vasovagal reflex
A 70-kg, 46-year-old man is undergoing clipping of a cerebral aneurysm with nitrous oxide, opioid, relaxant anesthesia. He is otherwise healthy. As the surgeons are about to enter the dura, the brain is noted to be tense and bulging. Heart rate is 100 bpm and mean arterial pressure is 90 mmHg. PaO2 is 120 mmHg, PaCO2 is 23 mmHg, and pH is 7.50. Which of the following should be done immediately?
- (A) Hyperventilation to a PaCO2 of 15 to 20 mmHg
- (B) Administration of furosemide 20 mg intravenously
- (C) Administration of mannitol 0.5 g/kg
- (D) Administration of thiopental 250 mg in increments
- (E) Addition of halothane 1% to deepen anesthesia
A 60-kg, 70-year-old man requires open reduction and internal fixation of an intertrochanteric fracture sustained 24 hours ago. Serum creatinine concentration is 1 mg/dl and blood urea nitrogen concentration is 40 mg/dl. The most likely cause of these findings is
- (A) acute tubular necrosis
- (B) chronic renal insufficiency
- (C) dehydration
- (D) obstruction of the bladder outlet
- (E) recent gastrointestinal hemorrhage
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
The tracing indicates that the pacemaker generator is
- (A) malfunctioning
- (B) VVT sensing and capturing normally
- (C) VOO sensing and capturing normally
- (D) DVI sensing and capturing normally
- (E) VVI sensing and capturing normally
When compared with diazepam, midazolam
- (A) metabolites contribute more significantly to the sedative effect
- (B) elimination is less dependent on hepatic metabolism
- (C) has more predictable action after intramuscular administration
- (D) produces less respiratory depression
- (E) produces less hypotension during induction of anesthesia with opioids
A rapid shallow ventilatory pattern is most energy efficient for a patient who
- (A) has a low ratio of forced expiratory volume in one second to vital capacity (FEV^VC)
- (B) has a high ratio of tidal volume to vital capacity, and diminished vital capacity
- (C) has increased pulmonary compliance
- (D) is using the accessory muscles of respiration
- (E) has increased airway resistance
Which of the following should be included in the preoperative management of a 12-year-old patient with Duchenne muscular dystrophy who is unable to ambulate?
- (A) Determination of serum creatine kinase concentration
- (B) Determination of serum potassium concentration
- (C) Liver function profile
- (D) Echocardiography
- (E) Dantrolene prophylaxis