10 Random Questions
Following induction of general anesthesia, mask ventilation and the initial attempt at intubation is unsuccessful. Which of the following procedures is most appropriate?
(A) Administration of additional muscle relaxant
(B) Repeat attempt at intubation
(C) Fiberoptic intubation
(D) Retrograde intubation
(E) Cricothyroidotomy
Reveal Answer
BASIC
General
A patient with alcoholic cirrhosis, ascites, and gastrointestinal bleeding receives 4 units of red blood cells prior to anesthesia with isoflurane in oxygen for emergency exploratory laparotomy. After the peritoneum is opened and the fluid is drained, blood pressure decreases to 60/40 mmHg and SpO2 decreases to 90%. The most likely cause of the hypoxemia is
(A) acute myocardial ischemia
(B) decreased 2,3-diphosphoglycerate in transfused blood
(C) increased intrapulmonary shunting
(D) relative hypovolemia
(E) venous air embolism
Reveal Answer
ADVANCED
General
Maximum current is delivered to the myocardium by a countershock for defibrillation when
(A) paddle contact pressure is minimal
(B) petroleum jelly is used under the paddles
(C) previous countershocks of the same power have been attempted
(D) the patient is grounded securely
(E) the shock is applied at the end of inspiration
Reveal Answer
BASIC
Equipment & Physics
Which of the following decreases the clearance of atracurium?
(A) Administration of cimetidine
(B) Cholinesterase deficiency
(C) Hepatic insufficiency
(D) Hypothermia
(E) Renal insufficiency
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Left ventricular end-diastolic volume is most likely to be underestimated by pulmonary artery occlusion pressure in patients with
(A) acute myocardial ischemia
(B) aortic insufficiency
(C) mitral stenosis
(D) primary pulmonary hypertension
(E) tricuspid stenosis
Reveal Answer
ADVANCED
Cardiac
Compared with healthy nonhypertensive patients, in patients with untreated hypertension undergoing anesthesia and operation,
(A) cerebral ischemia may occur at higher blood pressures
(B) intravenous fluid should be restricted before induction
(C) left ventricular hypertrophy enhances compensation for intraoperative fluid loss
(D) responses to sympathetic stimulation are decreased
(E) the incidence of intraoperative hypotension is lower
Reveal Answer
ADVANCED
General
Compared with healthy persons, patients with myasthenic (Eaton-Lambert) syndrome have increased
(A) resistance to vecuronium
(B) response to neostigmine during reversal of muscle paralysis
(C) sensitivity to succinylcholine
(D) susceptibility to development of malignant hyperthermia
(E) weakness with repetitive activity
Reveal Answer
During halothane anesthesia with spontaneous ventilation, the most reliable sign of malignant hyperthermia is
(A) hypertension
(B) increased temperature
(C) increased minute ventilation
(D) muscle rigidity
(E) tachycardia
Reveal Answer
A 2-year-old child is hospitalized for exposure. Rectal temperature is 30°C. The most appropriate method of warming is to
(A) apply radiant heat
(B) increase ambient temperature to 28°C
(C) use a heating blanket set at 39°C
(D) warm and humidify inspired gases
(E) warm intravenous fluids to 37°C
Reveal Answer
ADVANCED
Pediatric
The concentration effect is greater with nitrous oxide than with the volatile anesthetics because nitrous oxide
(A) has a lower blood-gas partition coefficient
(B) has less effect on cardiac output (0 has lower lipid solubility
(D) is affected less by ventilation-perfusion mismatch
(E) is used in much higher concentrations
Reveal Answer