10 Random Questions
A 5-month-old infant with tetralogy of Fallot is scheduled for elective inguinal herniorrhaphy. Which of the following would require the operation to be postponed?
- (A) Current propranolol therapy
- (B) Hematocrit of 65%
- (C) History of "tet spells"
- (D) Patent ductus arteriosus
- (E) Room air oxygen saturation of 82%
During repair for coarctation of the aorta in a healthy 13-year-old patient, right radial artery pressure increases from 100/60 to 105/70 mmHg after the aorta is cross clamped. This most likely indicates that
- (A) collateral blood flow has decreased the hemodynamic consequences of cross-clamping
- (B) left ventricular hypertrophy has decreased left ventricular compliance
- (C) spinal cord blood flow is impaired
- (D) the coarctation has decreased aortic diameter less than 50%
- (E) the coarctation involves the origin of the right subclavian artery
Which of the following is a known effect of propofol?
- (A) Decreased amplitude of somatosensory evoked potentials
- (B) Induction of malignant hyperthermia
- (C) Inhibition of cytochrome P450
- (D) Initiation of porphyria
- (E) Suppression of adrenocortical function
During an otherwise uneventful nitrous oxide-sevoflurane anesthetic in a spontaneously breathing patient, 85% nitrous oxide is accidently administered, resulting in a PO2 of 48 mmHg. Which of the following would be expected?
- (A) Tachycardia
- (B) Sweating
- (C) Tachypnea
- (D) Hyperactive EEG
- (E) None of the above
A 38-year-old woman with B-positive blood requires immediate blood transfusion during abdominal hysterectomy. No B-positive blood is available; O-negative blood is used. Three minutes after starting transfusion of packed red blood cells, the patient develops tachycardia, bronchospasm, and hypotension. Which of the following is the most likely cause?
- (A) Anaphylactic reaction to donor IgA
- (B) Bacterial contamination of transfused blood
- (C) Hemolysis resulting from ABO incompatibility
- (D) Hypocalcemia
- (E) IgG-mediated reaction to Rh antigens
A 32-year-old man who is addicted to opioids complains of pain in the PACU one hour after fixation of a mandibular fracture. He has received intravenous morphine 30 mg during the past hour. The most appropriate management is
- (A) continued intravenous administration of morphine until the pain resolves
- (B) intravenous administration of nalbuphine in 5-mg increments until the pain resolves
- (C) intramuscular administration of hydroxyzine 75 mg
- (D) evaluation for entrapment of the mandibular nerve
- (E) evaluation for drug-seeking behavior
Thirty-six hours after primary repair of meningomyelocele, a term newborn has frequent periods of apnea lasting 25 seconds and associated with oxygen desaturation to 80%. The most likely explanation is
- (A) hyperglycemia
- (B) loss of cerebrospinal fluid
- (C) obstructive hydrocephalus
- (D) residual anesthetic effect
- (E) normal postoperative events
Physiologically, coronary blood flow relates most directly to
- (A) cardiac work
- (B) systolic blood pressure
- (C) myocardial oxygen consumption
- (D) heart rate
- (E) mean arterial pressure
Which Mapleson breathing circuit shown in the illustration permits the LEAST amount of fresh gas inflow to prevent rebreathing during spontaneous ventilation?
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
Each of the following parameters of cerebral perfusion and metabolism is approximately equal to 50 EXCEPT
- (A) cerebral oxygen consumption in ml O2/min for a normal adult
- (B) lower limit of mean arterial pressure for cerebral autoregulation in mmHg
- (C) normal cerebral blood flow in ml /100 g tissue/min
- (D) PaO2 at which cerebral blood flow increases
- (E) PaCO2 at which cerebral blood flow doubles