10 Random Questions
The ECG tracing shows
- (A) aberrant intraventricular conduction
- (B) acceleration of phase 4 depolarization of the sinus node
- (C) a compensatory pause
- (D) initiation of re-entrant supraventricular tachycardia
- (E) paroxysmal atrial fibrillation
A 67-year-old man undergoes spinal anesthesia with hyperbaric tetracaine 10 mg for transurethral resection of the prostate. At the end of the 50-minute procedure, the level of anesthesia is T6 and blood pressure is 120/70 mmHg. Within two minutes after transfer to a stretcher, the patient has nausea and blood pressure decreases to 76/42 mmHg. Which of the following is the most likely cause of the acute hypotension?
- (A) Acute congestive heart failure
- (B) Decreased venous return
- (C) Dilutional hyponatremia
- (D) Progression of sympathetic block
- (E) Unrecognized bladder perforation
A 65-kg man is scheduled for wrist surgery with intravenous regional anesthesia with 0.5% lidocaine 50 ml. Which of the following statements is true?
- (A) This anesthetic is contraindicated if the patient has sickle cell disease
- (B) Mottling of the skin after injection dictates abandonment of the technique
- (C) Tourniquet discomfort is an indication to inject more local anesthetic
- (D) Bupivacaine 0.5% could be substituted to prolong anesthesia
- (E) Epinephrine (1:400,000) should be added to prolong anesthesia
Which of the following is a side effect of beta-adrenergic blockade?
- (A) Cerebral vasodilation
- (B) Decreased left ventricular filling pressures
- (C) Hypokalemia
- (D) Increased airway resistance
- (E) Uterine relaxation
Which of the following statements concerning awareness (recall) during opioid anesthesia is true?
- (A) It is usually not associated with pain
- (B) It correlates well with intact auditory evoked responses
- (C) It is prevented if the dose of opioid blocks the hemodynamic response to stimuli
- (D) It is prevented if the dose of opioid is adequate to prevent movement without muscle relaxants
- (E) It is predicted by a specific EEG pattern
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
Which of the following is characteristic of the pharmacokinetics of alfentanil?
- (A) Clearance is greater than that of fentanyl
- (B) Elimination half-life is normal in patients with hepatic insufficiency
- (C) Protein binding is minimal
- (D) The majority of alfentanil in plasma is ionized
- (E) Volume of distribution is smaller than that of fentanyl
Compared with normal adults, which of the following characteristics of neonates best explains the more rapid inhalation induction in neonates?
- (A) Greater cardiac index
- (B) Greater metabolic rate
- (C) Greater perfusion of vessel-rich tissues
- (D) Greater ratio of alveolar ventilation to functional residual capacity
- (E) Less lean body mass
Each of the following is consistent with exposure to organophosphates EXCEPT
- (A) bronchodilation
- (B) muscle weakness
- (C) salivation
- (D) sweating
- (E) urinary retention
A patient becomes flushed, dyspneic, and hypotensive during transfusion of 1 unit of packed red blood cells in the PACU. After discontinuing the transfusion, the most appropriate next step is administration of
- (A) aminophylline
- (B) cimetidine
- (C) diphenhydramine
- (D) epinephrine
- (E) hydrocortisone