10 Random Questions

Which of the following is the most common cause of coagulopathy occurring during massive blood transfusion?

(A) Decreased serum fibrinogen concentration
(B) Decreased serum ionized calcium concentration
(C) Dilutional thrombocytopenia
(D) Disseminated intravascular coagulation
(E) Hypothermia

Reveal answer

Neuro

The most likely cause of bilateral fixed and dilated pupils after clipping of a basilar artery aneurysm is

(A) preoperative administration of atropine
(B) intraoperative infusion of trimethaphan
(C) naloxone antagonism of opioid
(D) persistent hypothermia
(E) brain stem ischemia

Reveal answer

Pediatric OB

Which of the following statements regarding fetal heart rate patterns is true?

(A) Early decelerations suggest umbilical cord compression
(B) Fetal heart rates between 160 and 180 bpm are normal
(C) Fetal heart rate unaffected by uterine contraction suggests fetal well-being
(D) Late decelerations indicate inadequate uteroplacental perfusion
(E) Variable decelerations indicate need for urgent delivery

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General

A 27-year-old man with a one-month history of quadriplegia at a C6 level is given general anesthesia for cystoscopy. During the cystoscopy, blood pressure suddenly increases to 220/120 mmHg. Further evaluation is most likely to show

(A) atrial fibrillation (ventricular rate 100 bpm)
(B) paroxysmal atrial tachycardia (150 bpm)
(C) sinus bradycardia
(D) piloerection above the level of C6
(E) sweating above the level of C6

Reveal answer

Maternal hyperventilation will result in

(A) increased umbilical blood flow
(B) decreased affinity of maternal hemoglobin for oxygen
(C) decreased maternal and fetal cardiac output
(D) increased placental transfer of oxygen
(E) increased fetal cerebral blood flow

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General

During anesthesia with nitrous oxide and isoflurane in a 70-kg, 25-year-old patient, airway resistance would be decreased by

(A) a decrease in lung volume
(B) insertion of a 9-mm endotracheal tube
(C) administration of atropine
(D) neuromuscular block with d-tubocurarine
(E) movement of the patient from the supine to the sitting position

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Pharmacology & Pharmacokinetics

The highest serum fluoride levels are seen following the administration of which of the following volatile anesthetics?

(A) Desflurane
(B) Enflurane
(C) Halothane
(D) Isoflurane
(E) Sevoflurane

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Neuro

Which of the following is most likely to be effective in the treatment of clinically evident cerebral vasospasm occurring after subarachnoid hemorrhage?

(A) Administration of nimodipine
(B) Administration of thiopental
(C) Decreasing cerebral perfusion pressure
(D) Hypercarbia
(E) Hypocarbia

Reveal answer

Pediatric Neuro

A 4-month-old child undergoing a craniectomy for craniosynostosis is anesthetized with nitrous oxide and halothane. Suddenly the systolic blood pressure decreases from 75 to 30 mmHg, and the PetCO2 decreases from 35 to 6 mmHg. Which of the following maneuvers is LEAST likely to have a beneficial effect?

(A) Administration of a fluid bolus
(B) Administration of a vasopressor
(C) Application of positive end-expiratory pressure
(D) Discontinuation of nitrous oxide
(E) Flooding the surgical wound with saline solution

Reveal answer

Regional & Pain

A 58-year-old woman with rheumatoid arthritis and hyperactive gag reflex requires awake intubation prior to cervical spine stabilization. Which of the following regional nerve blocks is most appropriate?

(A) Deep cervical plexus
(B) Glossopharyngeal nerve
(C) Hypoglossal nerve
(D) Superior laryngeal nerve
(E) Trigeminal nerve

Reveal answer