132 questions match your search.


A 30-year-old man receives spinal anesthesia to the level of T4. Ten minutes later, heart rate and blood pressure abruptly decrease to 30 bpm and 60/25 mmHg, respectively. The most appropriate management is administration of which of the following drugs?

BASIC General Regional & Pain

A patient who is scheduled for a gastrectomy had abnormal liver function tests for four days following a prior cholecystectomy. In your consultation note, you should

BASIC General

A patient being mechanically ventilated in the ICU requires wound debridement twice daily. Each of the following agents would be appropriate for induction of brief general anesthesia EXCEPT

BASIC General

A patient has decreased lung compliance and hypoxemia after a 30-minute episode of laryngospasm following extubation. The most likely cause is

BASIC Respiratory & Critical Care General

One hundred children who are to have strabismus surgery are enrolled in a research protocol. Fifty receive a new antiemetic and 50 receive a placebo preoperatively. Fifteen children in the treatment group and 37 children in the control group have nausea and vomiting postoperatively. Which of the following analyses is most appropriate for determining the statistical significance of the group differences?

BASIC General

If a patient with excessive bleeding during exploratory laparotomy has a normal activated clotting time, the LEAST likely cause of the bleeding is

BASIC General

Preoperative evaluation of a patient who has marked malnutrition will demonstrate each of the following EXCEPT

BASIC General

Which of the following is the most likely cause of the increased incidence of right ventricular failure in patients with morbid obesity?

BASIC Respiratory & Critical Care General

A 57-year-old man with hepatocellular disease is scheduled to undergo a colectomy for colon cancer. Preoperative laboratory studies show a plasma albumin concentration of 2.4 g/dl (normal = 3.5 to 5.5 g/dl); prothrombin time is 16 sec (control 12 sec). Which of the following statements concerning the anesthetic management of this patient is true?

BASIC General

A 70-kg 78-year-old man undergoing small-bowel resection during anesthesia with isoflurane in oxygen becomes hypotensive and develops frothy pink sputum in the endotracheal tube. Heart rate is 50 bpm, blood pressure is 75/60 mmHg, pulmonary artery occlusion pressure is 22 mmHg, and cardiac output is 1.7 L/min. The most appropriate initial step in management is administration of which of the following?

BASIC Pharmacology & Pharmacokinetics General

During general anesthesia, a patient has the acute onset of atrial fibrillation with rapid ventricular response and hypotension to 50 mmHg systolic. The most appropriate treatment is

BASIC General

Which of the following phenomena is primarily responsible for the decrease in core body temperature that commonly occurs during the first hour of general anesthesia?

BASIC General

During rapid-sequence induction prior to an emergency surgical procedure, a 20-year-old patient vomits gastric contents containing particulate matter. An endotracheal tube is easily inserted and ventilation with pure oxygen is initiated. Despite the presence of bilateral breath sounds, SpO2 is 90%. Which of the following is the most appropriate next step?

BASIC Respiratory & Critical Care General

Which of the following is an effect of magnesium sulfate at the neuromuscular junction?

BASIC General

Which of the following is the most appropriate treatment of methemoglobinemia prior to emergency surgery?

BASIC General

A 64-year-old, 87-kg woman in good general health is undergoing a right knee arthroplasty while in the supine position with general anesthesia consisting of enflurane 2% and nitrous oxide 50% in oxygen. She is breathing spontaneously through a 7-mm endotracheal tube. During the first 30 minutes of the procedure, the arterial oxygen saturation measured by pulse oximetry decreases from 98% to 92%. The most likely cause of the desaturation is

BASIC Respiratory & Critical Care General

An obese, 35-year-old man had an episode of coughing followed by vomiting during induction of anesthesia for arthroscopy of the left knee. Intense wheezing developed bilaterally over five minutes. PaO2 is 60 mmHg, PaCO2 is 42 mmHg, and pH is 7.35. Optimal management following intubation of the trachea includes

BASIC General

A 45-year-old man is scheduled for appendectomy under general anesthesia. He reports that for many years he has occasionally felt his heart "skip a beat." The ECG tracing shown was obtained one hour ago. Which of the following is the most appropriate next step?

BASIC General Cardiac

Which of the following will result in the largest change in oxygen content?

BASIC General

A previously healthy, 60-kg, 17-year-old boy is undergoing emergency surgery for a gunshot wound involving the iliac vein. Ventilation is controlled with a tidal volume of 700 ml/breath, rate of 10/min, and peak inspiratory pressure of 30 cmH2O. Body temperature is normal. The most likely cause of an end-tidal carbon dioxide partial pressure of 16 mmHg is

BASIC General

The most common early indication of drug dependence in an anesthesiologist is

BASIC General

Statistical analysis of 20 patients shows a mean cardiac output (CO) of 5 L/min with a standard deviation of 1 L/min. The distribution pattern in the sample population is normal. Which of the following is the most appropriate conclusion?

BASIC General

A 26-year-old man who sustained multiple trauma undergoes open reduction and internal fixation of bilateral tibial-fibular fractures during anesthesia with isoflurane. nitrous oxide, and oxygen with positive pressure ventilation. During the procedure, the patient has sudden onset of hypotension, jugular venous distention, deviation of the trachea to the right, and decreased ventilatory compliance. Isoflurane is discontinued and 100% oxygen is administered. Which of the following is the most appropriate next step in management?

BASIC General

During laser microsurgery of the larynx using an endotracheal tube, a fire occurs in the airway. Which of the following is the most appropriate initial management?

BASIC Equipment & Physics General

The trend plot shows end-tidal gases measured during a radical neck dissection. The event occurring at A is most likely

BASIC Equipment & Physics Respiratory & Critical Care General

Addition of 20 cmH2O positive end-expiratory pressure to a patient receiving controlled mechanical ventilation decreases cardiac output and left ventricular function by

BASIC Respiratory & Critical Care General Cardiac

An unconscious adult patient is being ventilated through an esophageal obturator airway (EOA) in the emergency department. In the absence of cervical spine injury, which of the following is appropriate?

BASIC Equipment & Physics General

The patient at LEAST risk of pulmonary aspiration of gastric contents during induction of anesthesia is

BASIC General

Each of the following changes is expected with deliberate hypothermia EXCEPT

BASIC General Cardiac

A 30-year-old woman is undergoing laparoscopic tubal ligation. Thirty minutes after induction of general anesthesia, arterial oxygen saturation has decreased to 89%. Arterial blood gases at an FiO2 of 1.0 are PaO2 63 mmHg and PaCO2 40 mmHg; PetCO2 is 32 mmHg. Which of the following is the most likely cause?

BASIC Respiratory & Critical Care General

A bilateral superior laryngeal nerve block performed to facilitate fiberoptic intubation will provide anesthesia of the

BASIC General Regional & Pain

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

BASIC General

Which of the following remains normal in an otherwise healthy patient with obesity?

BASIC General

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

BASIC General

Which of the following factors is LEAST predictive of postoperative cardiac complications?

BASIC General

Which of the following processes is primarily responsible for the decrease in core body temperature that occurs during the first hour of general anesthesia?

BASIC General

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

BASIC General

During induction of anesthesia, a 56-year-old man with small bowel obstruction vomits a large quantity of undigested food particles and presumably aspirates. After instituting ventilation with pure oxygen, the most appropriate management is to

BASIC 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

BASIC General

During induction of anesthesia in a 70-year-old man with aortic stenosis, the blood pressure decreases from 140/ 80 to 70/45 mmHg as the cardiac rhythm changes from normal sinus at 70 bpm to junctional at 120 bpm. The most appropriate initial therapy would be

BASIC Pharmacology & Pharmacokinetics General Cardiac

An obese, 70-year-old woman with a long history of tobacco abuse is awake and semirecumbent after uneventful anesthesia with isoflurane for a ventral hernia repair. During the first hour in the recovery room while breathing 50% oxygen by face mask, her arterial oxygen saturation decreases to 90% while other vital signs remain satisfactory. Which of the following is most likely to be effective in the management of this situation?

BASIC Respiratory & Critical Care General

The mortality rate of patients given drug A is 12% (8 of 66) and the mortality rate of patients given drug B is 15% (10 of 66). Which of the following tests is most appropriate to compare these mortality rates?

BASIC General

Ten minutes after induction of anesthesia with thiopental and isoflurane but before incision, a patient's nasopharyngeal temperature has decreased to 35.4°C. Which of the following contributed most to this decrease in temperature?

BASIC General

A 78-year-old man who is scheduled for an inguinal hernia repair has a preoperative ECG showing left bundle branch block. He has had no symptoms of cardiovascular disease. This ECG finding most likely indicates

BASIC General

During controlled ventilation, which of the following will cause an increase in end-tidal carbon dioxide tension with a normal waveform on the capnograph?

BASIC General

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

BASIC General

A patient is undergoing exploration of a stab wound to the left side of the neck. On awake laryngoscopy, the left vocal cord is in midposition and the right vocal cord is abducted during inspiration. The most likely cause of these findings is trauma to which of the following structures on the left?

BASIC General

Which of the following statements best describes the decrease in functional residual capacity that accompanies the induction of general anesthesia?

BASIC Respiratory & Critical Care General

A 25-year-old man requires exploratory laparotomy following a motor vehicle accident. He is acutely intoxicated with alcohol. Which of the following is the most likely result of the alcohol ingestion?

BASIC Pharmacology & Pharmacokinetics General

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

BASIC Transfusions & Fluids General

Which of the following must be considered during perioperative management of a patient on long-term lithium therapy?

BASIC Pharmacology & Pharmacokinetics General

The ECG tracing shows

BASIC General

The acute onset of hypotension without a decrease in mixed venous oxygen saturation is most likely associated with the onset of

BASIC General

A 28-year-old patient has severe laryngospasm after extubation of the trachea following general anesthesia. Administration of 100% oxygen using continuous positive airway pressure does not improve symptoms. SpO2 is 75%. Which of the following is the most appropriate immediate management?

BASIC General

Which of the following statements about the standard error of the mean (SE) is true?

BASIC General

The ECG strip shown is recorded as a patient with a permanent transvenous DDD pacemaker enters the operating room. These changes indicate that the pacemaker is

BASIC General Cardiac

Intraoperative heat loss in an unclothed, undraped patient is caused primarily by

BASIC General

The human immunodeficiency virus (HIV)

BASIC General

When evaluating a screening test, which of the following is the most appropriate term for the proportion of patients with a disease who have a positive test result?

BASIC General

A 60-kg, 70-year-old man requires open reduction and internal fixation of an intertrochanteric fracture sustained 24 hours ago. Serum creatinine concentration is 1 mg/dl and blood urea nitrogen concentration is 40 mg/dl. The most likely cause of these findings is

BASIC General

Which of the following is the best initial treatment of anaphylaxis that occurs during general anesthesia?

BASIC Pharmacology & Pharmacokinetics General

Which of the following is the most appropriate initial management of a patient with hypotension secondary to sepsis?

BASIC Respiratory & Critical Care General

A morbidly obese patient is to undergo gastric stapling during general anesthesia. Following preoxygenation and induction, the oxygen saturation decreases after 40 seconds of laryngoscopy and attempted intubation. The rapid onset of arterial desaturation is most likely due to

BASIC General

Twenty minutes after thiopental induction for femoral herniorrhaphy, a 34-year-old woman is breathing spontaneously and receiving nitrous oxide-oxygen (2 liters each) and enflurane 3% by face mask. Pulse is 90 bpm, blood pressure is 80/60 mmHg, end-tidal enflurane concentration is 2%, and end-tidal carbon dioxide tension is 48 mmHg. Which of the following is most likely to occur on skin incision?

BASIC General

Which of the following is described by the standard deviation during analysis of the results of a clinical study?

BASIC General

The most likely cause of this capnographic tracing obtained just after laryngoscopy and intubation is

BASIC Equipment & Physics General

A 50-year-old man with alcoholism and jaundice is scheduled to undergo umbilical herniorrhaphy. An increase in which of the following best indicates impaired synthetic hepatic function?

BASIC General

The EKG rhythm shown developed during cholecystectomy in a 62-year-old man who had a myocardial infarction and is taking atenolol. The drug of choice for treating this arrhythmia is

BASIC Pharmacology & Pharmacokinetics General

A 40-year-old man is undergoing open reduction and internal fixation of a fractured femur. During anesthesia with fentanyl, sevoflurane, and oxygen, heart rate decreases to 20 bpm and 6 premature ventricular contractions per minute are noted. No pulse is detected. The most appropriate next step is to

BASIC General

A 65-year-old patient with hypertrophic cardiomyopathy has chest pain prior to induction of anesthesia. Pulse is 80 bpm and blood pressure is 130/80 mmHg. The ECG (V5) shows sinus rhythm and new ST-segment depression. The most appropriate management is administration of

BASIC General Cardiac

Which of the following is the most effective treatment of shivering following general anesthesia?

BASIC General

Which of the following is the most common initial sign of hemolytic transfusion reaction during general anesthesia?

BASIC Transfusions & Fluids General

A 36-year-old woman who undergoes peritoneal dialysis for chronic renal failure requires emergency surgical exploration for bowel obstruction. Serum creatinine concentration is 9.8 mg/dl and BUN concentration is 124 mg/dl. The most likely abnormality of coagulation is

BASIC General

An adult patient with atrial fibrillation develops pulseless ventricular tachycardia wfiile undergoing synchronized electirical cardioversion. Which of the following is the most appropriate management?

BASIC General Cardiac

Left ventricular subendocardial perfusion pressure is best estimated by the difference between

BASIC General

A 77-year-old woman is still intubated and breathing spontaneously following a total hip replacement. The muscle relaxant has been reversed. Tidal volume is 400 ml, end-tidal carbon dioxide tension is 45 mmHg, and SpO2 is 98% at an FiO2 of 1.0. On transfer from the operating table to the gurney, heart rate increases from 65 to 100 bpm and blood pressure decreases from 130/80 to 80/50 mmHg. End-tidal carbon dioxide tension is 30 mmHg and SpO2 is 94%. The most likely diagnosis is

BASIC General

Hypothermia to 29°C will decrease

BASIC General

A middle-aged, 70-kg man with a brain tumor is scheduled for an elective craniotomy. Preoperatively, he is alert but papilledema is present. Anesthesia is induced with thiopental 300 mg and succinylcholine 100 mg, followed by tracheal intubation. Immediately following intubation vigorous bucking occurs. The best immediate management would be to

BASIC General Neuro

A 65-year-old man has a history of alcohol abuse. Which of the following preoperative serum concentrations would provide the best assessment of synthetic hepatic function?

BASIC General

Following induction of general anesthesia, mask ventilation and the initial attempt at intubation is unsuccessful. Which of the following procedures is most appropriate?

BASIC General

The primary purpose of denitrogenation prior to anesthetic induction is to

BASIC Respiratory & Critical Care General

A previously healthy 46-year-old woman has severe substernal chest pain one hour after receiving morphine sulfate 10 mg intramuscularly for an elective cholecystectomy. Vital signs, SpO2, and findings on a five-lead ECG on the operating room monitor are within normal limits. Which of the following is the most appropriate next step?

BASIC Pharmacology & Pharmacokinetics General

A patient develops jaundice one week after undergoing laparoscopic cholecystectomy during halothane anesthesia. Laboratory studies show an increased serum alkaline phosphatase concentration, a mildly increased serum aspartate aminotransferase concentration, and a markedly increased conjugated bilirubin fraction. Which of the following is the most likely diagnosis?

BASIC Pharmacology & Pharmacokinetics General

A patient with cirrhosis presenting for liver transplantation is likely to exhibit each of the following EXCEPT

BASIC General

Which of the following is the most likely cause of a decrease in end-tidal carbon dioxide tension during general anesthesia with a constant minute ventilation?

BASIC Respiratory & Critical Care General

Administration of 200 mEq of sodium bicarbonate during cardiopulmonary resuscitation is associated with

BASIC General

A 30-year-old woman undergoes thyroidectomy under general endotracheal anesthesia. Immediately after extubation while breathing spontaneously, she has laryngospasm that resolves after 60 seconds of continuous positive airway pressure applied by face mask. In the PACU, she develops shortness of breath, tachypnea, hypoxemia, and rales. Which of the following is the most likely diagnosis?

BASIC General

Which of the following complications is more likely to occur during cannulation of the left internal jugular vein than during cannulation of the right internal jugular vein?

BASIC General

Which of the following is most likely to increase hepatic blood flow during general anesthesia?

BASIC General

Each of the following statements about the anatomy of the autonomic nervous system is true EXCEPT:

BASIC General

A 48-year-old woman with von Willebrand's disease is scheduled for a hysterectomy. The most appropriate initial preoperative therapy to decrease bleeding is administration of

BASIC Transfusions & Fluids General

Which of the following findings would be considered normal in the EEG of an adult?

BASIC Pharmacology & Pharmacokinetics General Cardiac

Each of the following structures may participate in causing acute bradycardia during strabismus surgery EXCEPT the

BASIC Pediatric General

Which of the following abnormalities in serum is most likely to result from intraoperative discontinuation of parenteral hyperalimentation?

BASIC Transfusions & Fluids General

Which of the following is the most common initial manifestation of malignant hyperthermia?

BASIC General

A healthy 60-kg 52-year-old woman undergoing reduction mammoplasty is anesthetized with isoflurane and oxygen, and deliberate hypotension to 80/40 mmHg is induced with nitroprusside. Urine output through an indwelling urethral catheter has been 10 mL during the past hour. You should now

BASIC General

A 30-year-old man who is undergoing laparotomy and resection of a large kidney tumor has a decrease in SpO2 from 100% to 92% and an increase in peak airway pressure from 20 to 35 cm H2O. Plateau pressure is unchanged at 18 cm H2O. Which of the following is the most likely cause?

BASIC Equipment & Physics Respiratory & Critical Care General

Which of the following is increased in patients with chronic anemia?

BASIC General

Following transfusion of packed red blood cells during general anesthesia, the patient's blood pressure decreases, heart rate and temperature increase, and hemoglobinuria and diffuse oozing are observed. Which of the following is the most appropriate first step in management?

BASIC Transfusions & Fluids General

A patient with a fasting blood glucose concentration of 100 mg/dl undergoes a four-hour operation under general anesthesia without intraoperative administration of glucose. On emergence the most likely finding will be

BASIC General

Which of the following statements regarding latex allergy is true?

BASIC General

During a cardiac arrest with effective chest compression and positive-pressure ventilation, 50 mEq of sodium bicarbonate is administered. Which of the following is the most likely result?

BASIC Respiratory & Critical Care General

A patient has severe hypotension, bronchospasm, and edema of the upper airway after injection of radiocontrast medium during cerebral angiography. The most appropriate immediate treatment is administration of

BASIC Pharmacology & Pharmacokinetics General

An EKG shows ventricular tachycardia in a patient with a heart rate of 160 bpm and a blood pressure of 90/60 mmHg. The best initial therapeutic maneuver prior to cardioversion is

BASIC General Cardiac

The cardiovascular effects of an inhalational anesthetic are evaluated in 10 normal volunteers in the awake resting state and after 15 minutes of constant inspired concentration. Results were analyzed by t-test for paired data and are presented below as mean +/- standard deviation. Based on these data, which of the following conclusions is most valid?

BASIC General

Which of the following combinations of hemoglobin, blood gases, and cardiac output provides the greatest delivery of oxygen to tissue? (Hb, PaO2, SaO2, CO)

BASIC General

A 46-year-old man is scheduled for repair of an inguinal hernia. Six years ago, he had an episode of malignant hyperthermia during cholecystectomy. Which of the following is the most appropriate perioperative management?

BASIC General Regional & Pain

A 30-year-old, 70-kg woman with mitral stenosis is scheduled for elective laparoscopic sterilization. Preoperatively she is taking digoxin and an unknown medication for chronic mental depression. The EKG demonstrates atrial fibrillation. Heart rate is 68 bpm. Anesthesia is induced with thiopental followed by nitrous oxide 50%, halothane 0.75%, and a continuous succinylcholine infusion. The ventilator is set to deliver a minute volume of 5 liters through an endotracheal tube. As the carbon dioxide is being insufflated into the abdomen, the blood pressure is noted to be elevated (150/100 mmHg) and ventricular bigeminy is present. The most appropriate therapy is to

BASIC General

A 70-year-old man who underwent bilateral carotid endarterectomies two years ago is to undergo anesthesia and surgery. The denervation of the carotid bodies is likely to result in

BASIC General

A patient receiving mechanical ventilation with oxygen 60% postoperatively has a PaO2 of 160 mmHg and a PaCO2 of 38 mmHg. One hour later, with mechanical ventilation unchanged, the PaO2 is 150 mmHg and PaCO2 is 48 mmHg. The most likely cause of these changes is

BASIC Respiratory & Critical Care General

Systemic hypothermia to 30°C is accompanied by

BASIC Respiratory & Critical Care General

Which of the following is the most reliable indicator of adequate reversal of neuromuscular block?

BASIC General

During acute normovolemic hemodilution in an adult, which of the following compensatory mechanisms is most important in maintaining tissue oxygenation?

BASIC General

Pseudocholinesterase

BASIC General

A 28-year-old woman undergoes total thyroidectomy. The left recurrent laryngeal nerve is transected during the procedure. Which of the following findings is most likely postoperatively?

BASIC General

Pulsus paradoxus is commonly seen during anesthesia in patients with each of the following conditions EXCEPT

BASIC General Cardiac

Initiation of positive pressure mechanical ventilation is LEAST likely to decrease cardiac output in patients with which of the following conditions?

BASIC Respiratory & Critical Care General

A patient is in sinus rhythm but has no pulse during cardiopulmonary resuscitation. There is marked resistance to positive pressure ventilation and breath sounds are difficult to hear bilaterally. The endotracheal tube is clearly in the trachea. The most appropriate next step in management is to

BASIC General

During a reoperative total hip arthroplasty requiring transfusion of 8 units of packed red blood cells, blood begins to ooze from the operative field and intravenous catheter sites. Urine is pink. The most likely cause is

BASIC Transfusions & Fluids General

Which of the following results in decreased mixed venous oxygen saturation?

BASIC Respiratory & Critical Care General

A 72-year-old man has massive venous hemorrhage during a radical prostatectomy. Blood pressure decreases from 110/60 to 75/30 mmHg and central venous pressure decreases from 12 to 4 mmHg. End-expiratory carbon dioxide tension decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to

BASIC General

Each of the following decreases hepatic blood flow EXCEPT

BASIC Pharmacology & Pharmacokinetics General

Pulsus paradoxus is commonly seen during anesthesia in patients with each of the following conditions EXCEPT

BASIC Respiratory & Critical Care General

Which of the following findings on the left is most likely to be associated with an increased risk of complications with cannulation of the left internal jugular vein compared with cannulation of the right internal jugular vein?

BASIC General

As part of a preoperative evaluation, a patient had a thallium scan showing a 'cold spot' over the left ventricle that occurs with moderate exercise and disappears at rest. This most likely indicates

BASIC General Cardiac

Which of the following cardiovascular abnormalities is LEAST likely to be present in a patient with end-stage alcoholic cirrhosis?

BASIC General

A patient with uremia is scheduled for emergency surgery. Bleeding time is 18 minutes. The most appropriate initial treatment is

BASIC General Transfusions & Fluids

Which of the following statements concerning awareness (recall) during opioid anesthesia is true?

BASIC General

A 68-year-old man who is scheduled for outpatient cystoscopy has non-insulin-dependent diabetes mellitus controlled with glipizide (Glucatrol) 5 mg twice daily. He has had nothing to eat since awakening this morning and has not taken glipizide today. His blood glucose level is 185 mg/dl. Before proceeding, the most appropriate management is to administer

BASIC Pharmacology & Pharmacokinetics General

In a patient with ventricular fibrillation refractory to repeated attempts at defibrillation and epinephrine administration, the most appropriate management is administration of

BASIC General Cardiac

In clinical anesthesia practice, the term "informed consent" is best described as a legal concept in which patients

BASIC General

In a patient with hypovolemic shock, which of the following factors is the best measure of the overall balance between oxygen supply and demand?

BASIC Respiratory & Critical Care General