10 Random Questions
Which of the following cardiovascular abnormalities is LEAST likely to be present in a patient with end-stage alcoholic cirrhosis?
- (A) Decreased myocardial contractility
- (B) High cardiac index
- (C) High mixed venous oxygen saturation
- (D) Increased peripheral vascular resistance
- (E) Low blood viscosity
A 40-year-old man is scheduled for emergency laparotomy for bowel obstruction. He is nauseated but has not vomited. Which of the following drugs administered intravenously preoperatively will decrease the risk for pulmonary aspiration?
- (A) Atropine
- (B) Droperidol
- (C) Metoclopramide
- (D) Ranitidine
- (E) None of the above
Which of the following is the most likely cause of the increased incidence of right ventricular failure in patients with morbid obesity?
- (A) Chronic hypoxia
- (B) Chronic silent pulmonary aspiration
- (C) Chronic silent subendocardial ischemia
- (D) Decreased vital capacity
- (E) Increased pulmonary blood flow
This flow-volume loop from a 57-year-old man is most consistent with which of the following conditions?
- (A) Bronchospasm
- (B) Decreased vital capacity
- (C) Myasthenia gravis
- (D) Narrowing of the upper airway
- (E) Pneumothorax
A 65-kg 70-year-old man in the PACU is breathing spontaneously at 20/min through an endotracheal tube connected to a T-piece with a fresh gas flow of 5 L/min. He has a tidal volume of 350 mL and an FiO2 of 0.5. SpO2 decreases from 98% to 84% over one hour, then improves to 92% with an FiO2 of 1.0. Which of the following is the most likely cause of the hypoxemia?
- (A) Decreased functional residual capacity
- (B) Increased dead space ventilation
- (C) Inhibition of hypoxic pulmonary vasoconstriction
- (D) Room air admixture during inspiration
- (E) Shivering
Following a right lower lobectomy, a patient develops a bronchopleural fistula and becomes hypoxic. He is orally intubated and mechanically ventilated with pure oxygen. PaO2 is 65 mmHg, PaCO2 is 70 mmHg, and pH is 7.25. Which of the following will produce the most favorable change in the blood gases?
- (A) Increasing ventilatory frequency
- (B) Increasing suction on the chest tube
- (C) Applying 10 cmH2O positive end-expiratory pressure
- (D) Using a double-lumen tube for differential ventilation
- (E) Starting negative-pressure ventilation
A Fluotec vaporizer is set to administer halothane 4% using a fresh gas flow of 4 L/min. If the diluent gas flow is increased to 8 L/min, and at the same time the room temperature increases from 20 to 25°C, the approximate concentration of halothane delivered to the patient would be
- (A) 2%
- (B) 2.5%
- (C) 3%
- (D) 4%
- (E) 5%
Which of the following statements concerning cardiovascular physiology in a healthy term neonate is true?
- (A) Heart rate is increased in response to hypoxemia
- (B) Heart rate increases reflexly in response to hypotension
- (C) Stroke volume increases in response to decreased systemic vascular resistance
- (D) Stroke volume increases in response to bradycardia
- (E) Stroke volume is near-maximal under resting conditions
A 38-year-old woman with hyperthyroidism is undergoing open reduction and internal fixation of a fractured humerus with isoflurane anesthesia. Intraoperatively her heart rate increases to 120 bpm with occasional premature ventricular contractions. The most appropriate therapy at this time is to
- (A) discontinue isoflurane
- (B) administer edrophonium
- (C) administer esmolol
- (D) administer lidocaine
- (E) administer propylthiouracil
Following maternal epidural injection, fetal exposure to chloroprocaine is lower than fetal exposure to bupivacaine for which of the following reasons?
- (A) Chloroprocaine is metabolized by plasma cholinesterase
- (B) Chloroprocaine is more protein bound
- (C) Chloroprocaine is not readily absorbed from the epidural space
- (D) The ionized fraction of chloroprocaine in the fetal circulation is smaller
- (E) The pKa of chloroprocaine is less than that of bupivacaine