Anesthesia Hub -

10 Random Questions

When the inspired gas is changed from air to 20% oxygen and 80% nitrous oxide, PaO2 increases because

(A) increased pulmonary artery pressure perfuses alveoli that previously enhanced dead space
(B) nitrous oxide stimulates the respiratory center
(C) rapid absorption of nitrous oxide increases alveolar oxygen concentration
(D) replacement of nitrogen by nitrous oxide expands atelectatic alveoli
(E) respiratory depression from nitrous oxide shifts the oxyhemoglobin dissociation curve

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

Assignment of a patient to an ASA physical status category is used to

(A) facilitate comparisons among different patient groups and institutions
(B) guide the choice of anesthetic technique
(C) permit accurate determination of charges for professional services
(D) predict anesthetic risk
(E) predict perioperative mortality

BASIC General

A 70-kg, 77-year-old man Is undergoing left nephrectomy with nitrous oxide, oxygen, fentanyl, and midazolam anesthesia. He has a 90 pack-year history of cigarette smoking and has chronic obstructive pulmonary disease. One hour after incision, expiratory wheezing occurs and peak Inspiratory pressure increases from 35 to 65 cmH20; end-tidal PCO2 is unchanged, but SpO2 decreases from 97% to 88%. The most likely cause is

(A) endobronchial intubation
(B) overinflation of the endotracheal tube cuff
(C) pneumothorax
(D) pulmonary edema
(E) pulmonary embolism

ADVANCED Respiratory & Critical Care General

A 5-year-old child undergoes strabismus correction during spontaneous ventilation with halothane 1.5%, nitrous oxide and oxygen 50%. Intravenous atropine 0.2 mg is administered after inhalation induction. Ten minutes after incision, heart rate decreases from 110 bpm to 40 bpm. Which of the following is the most likely cause?

(A) Administration of phenylephrine eyedrops
(B) Inadvertent external pressure on the carotid sinus
(C) Paradoxical response to a small dose of atropine
(D) Sinoatrial nodal depression by halothane
(E) Traction on an extraocular muscle

ADVANCED Pediatric

A 22-year-old woman at 33 weeks' gestation has abdominal pain and vaginal bleeding after sustaining blunt trauma to the abdomen. Heart rate is 125 bpm, blood pressure is 98/65 mmHg, and respiratory rate is 20/min. Fetal heart rate is 100 bpm. Which of the following is the most appropriate management?

(A) Conservative observation and monitoring if fetal immaturity is seen on ultrasound
(B) Increasing maternal blood pressure with a vasopressor
(C) Infusion of terbutaline
(D) Lumbar epidural anesthesia
(E) Urgent cesarean delivery

The rate of induction with inhalational agents is more rapid in neonates than adults because of a relatively increased

(A) cardiac output
(B) cerebral blood flow
(C) functional residual capacity
(D) metabolic rate
(E) minute ventilation

ADVANCED Pediatric

Following protamine administration, profound pulmonary hypertension is most likely initiated by release of

(A) epinephrine
(B) histamine
(C) leukotriene
(D) norepinephrine
(E) thromboxane

ADVANCED Pharmacology & Pharmacokinetics Cardiac

The EEG of a patient undergoing anesthesia with high-dose fentanyl would most likely show

(A) the same pattern seen with enflurane 0.5 MAC
(B) cessation of low-frequency activity
(C) accentuation of high-frequency activity
(D) uniform depression of all frequencies
(E) low-frequency, high-amplitude activity

Each of the following values is associated with acute tubular necrosis EXCEPT

(A) urine osmolality of 200 mOsm/L
(B) urine sodium concentration of 15 mEq/L
(C) urine specific gravity of 1.009
(D) urine/serum osmolality ratio of 1.2
(E) fractional excretion of sodium of 4%

BASIC General