152 questions match your search.

Which of the following findings is most likely in patients with acute transection of the spinal cord at the level of C6?

ADVANCED General Neuro

Following blunt trauma to the chest, a patient has tachycardia, hypotension, and markedly distended neck veins. Each of the following is expected EXCEPT

ADVANCED General Cardiac

A 56-year-old woman with pulmonary fibrosis is scheduled for pneumonectomy. Which of the following parameters best predicts potential postoperative functional impairment?

ADVANCED Respiratory & Critical Care General

A 65-year-old man with essential hypertension well controlled around 140/90 mmHg with hydrochlorothiazide is scheduled for right colectomy for carcinoma. Preoperative EKG and all laboratory values are normal except for a hematocrit of 29% and serum potassium level of 3.2 mEq/L. Central venous pressure (CVP) measured from an internal jugular catheter inserted before induction of anesthesia is 7 mmHg. Ten minutes after induction with thiopental 200 mg followed by enflurane 3% in nitrous oxide and oxygen (50% each), blood pressure decreases suddenly from 110/70 to 80/50 mmHg with heart rate unchanged at 78 bpm. CVP is now 20 mmHg and the EKG demonstrates a midjunctional rhythm. After discontinuing the enflurane, the most appropriate action would be to

ADVANCED General

Two hours after sustaining extensive burns of the head, neck and chest in a house fire, a patient has stridor and difficulty breathing. The most appropriate management is

ADVANCED General

A 50-year-old woman develops stridor 10 hours after undergoing thyroidectomy. The most appropriate management is administration of which of the following drugs?

ADVANCED Respiratory & Critical Care General

During induction of general anesthesia in a patient with a supraglottic tumor, both intubation and subsequent ventilation via a face mask are impossible. A cricothyroidotomy is performed with a 16-gauge intravenous catheter. Which of the following statements is true?

ADVANCED Equipment & Physics Respiratory & Critical Care General

A 67-year-old man is undergoing total hip replacement under general anesthesia. He had a permanent endocardial VVI pacemaker placed two years ago for complete heart block, and since arrival in the operating room has been paced continuously. Use of the electrocautery causes the pacemaker to malfunction intermittently. The most appropriate management is to

ADVANCED General Cardiac

During laser excision of vocal cord polyps in a 5-year-old boy, dark smoke suddenly appears in the surgical field. The trachea is intubated and anesthesia is being maintained with halothane, nitrous oxide, and oxygen. The most appropriate initial step is to

ADVANCED Equipment & Physics General Pediatric

A patient with chronic paraplegia (T4 level) is undergoing cystoscopy and removal of bladder calculi without anesthesia. After 10 minutes, blood pressure is 240/100 mmHg and pulse is 50 bpm. The most appropriate management is administration of

ADVANCED General

During transurethral resection of the prostate, intravascular absorption of glycine irrigant most commonly produces

ADVANCED General

DC shocks of 200 joules applied directly to the heart are likely to

ADVANCED General

Compared with healthy nonhypertensive patients, in patients with untreated hypertension undergoing anesthesia and operation,

ADVANCED General

You are called to anesthetize a patient for an emergency pericardial window for a large pericardial effusion. Which of the following drugs is most appropriate for initiation of anesthesia?

ADVANCED General Cardiac

A 19-year-old college student is brought to the emergency department cyanotic and incoherent. Respiratory rate is 48/min, pulse is 140 bpm, and blood pressure is 140/85 mmHg. The only history obtainable is that he was at a party and suddenly felt sick. Cyanosis persists despite administration of pure oxygen by mask. A venous blood sample is chocolate-brown. The action most beneficial to the patient is to

ADVANCED General

Which of the following is the most appropriate initial therapy for acute pulmonary hypertension with right ventricular dysfunction and severe systemic hypotension that occurs during anesthesia?

ADVANCED General

Following pneumonectomy, a paralyzed patient being mechanically ventilated has the following arterial blood gas values: PaO2 71 mmHg, PaCO2 55 mmHg, pH 7.29. SvO2 is 45%. The most likely explanation for this SvO2 is

ADVANCED Respiratory & Critical Care General

Which of the following statements concerning myasthenia gravis is true?

ADVANCED General

Which of the following is the most likely effect of infrarenal cross clamping of the aorta without pharmacologic manipulation?

ADVANCED General

A 70-kg 61-year-old patient undergoes a four-hour resection of an abdominal aortic aneurysm during anesthesia with fentanyl and enflurane. Infrarenal clamping is required during the procedure. Twelve hours after the procedure, urine output is 15 ml/hr with a fractional sodium excretion of 6%. Which of the following is the most likely cause?

ADVANCED General

A 70-year-old patient is shivering and has chest pain in the PACU following a cholecystectomy. Heart rate is 120 bpm, and blood pressure is 220/120 mmHg. SpO2 is 97% at an FiO2 of 0.4. An ECG shows ST-T wave changes, which are not affected by intravenous administration of nitroglycerin. Which of the following is the most appropriate next step?

ADVANCED General Cardiac

Patients with acute alcohol intoxication are at increased risk for each of the following complications of general anesthesia EXCEPT

ADVANCED General

A patient has a decrease in heart rate from 80 to 50 bpm and a decrease in blood pressure from 140/90 to 60/40 mmHg while in the recovery room after adrenalectomy for pheochromocytoma. The most appropriate treatment is administration of

ADVANCED General

The tracing indicates that the pacemaker generator is

ADVANCED General Cardiac

A 70-kg, 50-year-old man is scheduled for muscle flap closure of a decubitus ulcer over the sacrum. He has been quadriplegic at the level of C6-7 for six years. Which of the following is most likely to result from subarachnoid anesthesia with tetracaine 10 mg for this procedure?

ADVANCED General Regional & Pain

A 55-year-old man who is scheduled to undergo carotid endarterectomy (CEA) has a persistent myocardial filling defect at three hours on a dipyridamole-thallium scan. Which of the following statements is correct?

ADVANCED General Cardiac

Which of the following statements best describes testing for susceptibility to malignant hyperthermia (MH)?

ADVANCED General

A 69-year-old woman with mitral stenosis and atrial fibrillation is scheduled for mitral valve replacement and removal of a left atrial thrombus. After administration of pancuronium, heart rate increases to 140 bpm and blood pressure decreases to 70/40 mmHg. Which of the following is the LEAST appropriate treatment?

ADVANCED General Cardiac

A 32-year-old man is scheduled for hernia repair. He underwent heart transplantation for cardiomyopathy five years ago. Which of the following findings is most likely?

ADVANCED General Cardiac

Each of the following is an effect of electroconvulsive therapy EXCEPT

ADVANCED General

Four days after mitral valve replacement, a 49-year-old, 70-kg woman who has had oliguric renal failure since the operation requires insertion of a Schribner shunt for hemodialysis. Her BUN concentration is 104 mg/dl, serum creatinine is 9.3 mg/dl, serum sodium is 130 mEq/L, and serum potassium is 6.7 mEq/L. During the operation under local anesthesia, diazepam 7.5 mg and morphine 10 mg are administered intravenously to control agitation. Five minutes later while she is sleeping quietly, unifocal premature ventricular contractions appear at a rate of 10 per minute on the ECG monitor. The most appropriate therapy is to

ADVANCED General Cardiac

During cardiopulmonary resuscitation (CPR) in an adult, external chest compression is being performed at the rate of 90/min with 2 inches of sternal depression and a compression-relaxation ratio of 20:80. The most appropriate action is to

ADVANCED General

A 36-year-old woman develops acute airway obstruction 24 hours after total thyroidectomy. The most likely cause is

ADVANCED General

Which of the following is most likely in a 30-year-old patient with untreated hypothyroidism?

ADVANCED General

Each of the following is a recognized complication during a transurethral resection for which glycine is used as an irrigant EXCEPT

ADVANCED Pharmacology & Pharmacokinetics General

A 45-year-old patient with chronic alcoholism develops jaundice four days after a cholecystectomy under halothane/morphine general anesthesia. Bilirubin and alkaline phosphatase are elevated, but ALT is only slightly above normal. All values were within normal limits preoperatively. The most likely cause of jaundice is

ADVANCED General

Nitroprusside therapy for hypertension should be discontinued in the presence of

ADVANCED General Cardiac

A 75-year-old man is confused, restless and disoriented two days after an aortic aneurysm repair. Serum sodium concentration is 112 mEq/L, serum osmolality is low, and urine is hypertonic. The most appropriate treatment is

ADVANCED General

A 75-year-old, 60-kg man with moderately disabling heart failure secondary to ischemic heart disease is undergoing a transurethral prostatic resection under halothane-nitrous oxide anesthesia. Resection time is 30 minutes, and fluid replacement has been lactated Ringer's solution 500 mL. Although heart rate is unchanged, the arterial pressure monitor used because of his cardiac condition has changed from A to B over the last 15 minutes. The most appropriate management is to

ADVANCED General

Which of the following physiologic changes occurs with immersion in water during extracorporeal shock wave lithotripsy?

ADVANCED 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?

ADVANCED General

Which of the following statements concerning carbon monoxide poisoning is true?

ADVANCED Respiratory & Critical Care General

Each of the following would be expected in an otherwise healthy 165-kg woman undergoing cholecystectomy EXCEPT

ADVANCED General

A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of

ADVANCED General

During a right lower lobe resection, SpO2 decreases from 99% to 70% after institution of one-lung ventilation. FiO2 is 1.0. The most appropriate management is to

ADVANCED General

Which of the following postoperative treatments decreases the risk for deep venous thrombosis?

ADVANCED General

Each of the following improves coagulation in patients with uremia EXCEPT

ADVANCED Pharmacology & Pharmacokinetics General

In a patient undergoing liver transplantation, sodium bicarbonate and calcium chloride are administered immediately before reperfusion of the transplanted liver to counteract

ADVANCED General

A 25-year-old woman undergoes a difficult open cholecystectomy during anesthesia with isoflurane, nitrous oxide, fentanyl, and vecuronium. Five units of blood are administered intraoperatively. Two days later, the patient has mildly increased serum transaminase concentrations and markedly increased alkaline phosphatase and direct bilirubin concentrations. Which of the following is the most likely cause?

ADVANCED General

A 120-kg 56-year-old man undergoing gastrectomy during anesthesia with fentanyl and isoflurane has a PetCO2 of 35 mmHg and a PaCO2 of 50 mmHg. His FEV,/FVC ratio is 80% of predicted. Heart rate is 120 bpm and arterial blood pressure is 80/40 mmHg. Which of the following is the most likely cause of the difference in PaCO2 and PetCO2?

ADVANCED Respiratory & Critical Care General

Six hours after coronary artery bypass grafting, a pulmonary artery catheter oximeter shows a mixed venous hemoglobin oxygen saturation of 50%. This value may result from each of the following EXCEPT

ADVANCED General

A 70-kg man with ischemic heart disease is undergoing abdominal aortic aneurysm resection. At the time of infrarenal cross-clamping, 0.2-mV ST-segment depression appears on lead V5 of the ECG. Hemodynamic changes occurring at the same time are shown below. Systemic blood pressure 90/50 --> 150/90; Heart rate 80 --> 95; PAp 20/10 --> 45/24; Mean pulmonary artery occlusion pressure (mmHg) 10 --> 23; Cardiac output (L/min) 4.5 --> 3.2. Ischemia would be decreased by restoring the pre-clamp level of each of the following EXCEPT

ADVANCED General

The preanesthetic ECG trace (lead II) shown from a 32-year-old woman suggests

ADVANCED 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. PetC02 decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to

ADVANCED General

Which of the following statements concerning autonomic hyperreflexia after spinal cord transection is true?

ADVANCED General

Each of the following statements concerning the activated clotting time (ACT) is true EXCEPT:

ADVANCED General Cardiac

Which of the following is a complication of glycine used for irrigation during transurethral resection of the prostate?

ADVANCED General

A patient with alcoholic cirrhosis, ascites, and gastrointestinal bleeding receives 4 units of red blood cells prior to anesthesia with isoflurane in oxygen for emergency exploratory laparotomy. After the peritoneum is opened and the fluid is drained, blood pressure decreases to 60/40 mmHg and SpO2 decreases to 90%. The most likely cause of the hypoxemia is

ADVANCED General

Two months ago a 68-year-old man with insulin-dependent diabetes mellitus had a transurethral resection of the prostate under spinal anesthesia with tetracaine plus epinephrine. He now has numbness and tingling in both feet and disturbance of gait. Physical examination demonstrates stocking-type hypesthesia of both feet and ankles. The most likely diagnosis is

ADVANCED General Regional & Pain

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

ADVANCED Respiratory & Critical Care General

An endobronchial Robertshaw tube is inserted for resection of a midesophageal tumor under isoflurane, oxygen, pancuronium anesthesia. Forty minutes into a planned two-hour resection, arterial blood gas values are reported as PO2 45 mmHg, PCO2 45 mmHg, and pH 7.33. Ten minutes earlier, the values were PO2 210 mmHg, PCO2, 41 mmHg, and pH 7.39. The first action should be to

ADVANCED General

When used for irrigation during transurethral resection of the prostate, glycine 1.5% is associated with each of the following EXCEPT

ADVANCED General

A 72-year-old woman is somnolent one day after left carotid endarterectomy. She has smoked 2 packs of cigarettes daily for 50 years. Six weeks ago, she underwent right carotid endarterectomy. At this time, arterial blood gases while breathing room air are PO2, 45 mmHg, PCO2, 60 mmHg, and pH 7.30. Which of the following is the most likely cause of the increased PCO2?

ADVANCED 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

ADVANCED General

A 26-year-old patient with multiple trauma is admitted to the intensive care unit postoperatively. The early development of polyuria, hypotension, low urine sodium excretion, high serum osmolality, and normal serum creatinine concentration is best explained by

ADVANCED General

During transurethral resection of the prostate under spinal anesthesia with a sensory level to T10, a patient has sudden onset of sharp upper abdominal pain and nausea. Arterial blood pressure increases from 120/80 to 150/90 mmHg; the patient becomes diaphoretic. Which of the following is the most likely diagnosis?

ADVANCED General

Which of the following situations is most likely related to paraplegia following repair of a descending thoracic aortic aneurysm?

ADVANCED General

Which of the following perioperative interventions decreases the risk for renal insufficiency in patients undergoing aortic aneurysm repair?

ADVANCED General

Each of the following statements about pheochromocytoma is true EXCEPT:

ADVANCED General

A 15-year-old previously healthy boy is scheduled for a celiotomy to relieve an acute intestinal obstruction. A rapid sequence induction is used. Anesthesia is maintained with a balanced technique including nitrous oxide and oxygen (5L:2L), meperidine, and pancuronium. Because of abdominal distention and the high pressure required for inflation of the lungs, a nasogastric tube is inserted. The abdomen remains distended, but compliance improves dramatically. At this time the patient is cyanotic, PaO2 is 48 mmHg, PaCO2 is 52 mmHg, and pH is 7.29. Nitrous oxide is discontinued. The most important therapeutic measure is to

ADVANCED General

A patient undergoes thoracotomy in the lateral decubitus position. Which of the following maneuvers is most likely to increase PaO2 during one-lung ventilation?

ADVANCED Respiratory & Critical Care General

A patient who had liver transplantation two years ago now requires general anesthesia for ENT surgery. Minimal rejection has occurred on a regimen of cyclosporine and prednisone. Which of the following is most likely?

ADVANCED General

You are called to a witnessed cardiac arrest where cardiopulmonary resuscitation is being performed. After successful intubation, arterial blood gas values are PaO2 86 mmHg, PaCO2 63 mmHg, and pH 7.25 at an FiO2 of 1.0. The most appropriate management at this time is to

ADVANCED Respiratory & Critical Care General

Which of the following is the LEAST likely cause of a prolonged prothrombin time?

ADVANCED General

An elderly man has an acute dissection of the descending thoracic aorta. Which of the following antihypertensive therapies is most likely to extend the dissection?

ADVANCED General

A 76-year-old man has a leaking abdominal aortic aneurysm. His blood pressure and pulse have remained stable for 15 minutes at 90/60 mmHg and 130 bpm, respectively. His hemoglobin concentration is 11 g/dl, and the EKG shows a left bundle branch block. Induction of anesthesia should proceed

ADVANCED General

A 70-year-old man who has just undergone an abdominal aortic aneurysm repair under halothane anesthesia develops hypertension, dyspnea, and cyanosis shortly after awakening in the recovery room. Administration of furosemide 20 mg intravenously improves the cyanosis within 10 minutes. This immediate effect of furosemide is best explained by

ADVANCED Pharmacology & Pharmacokinetics General

An 80-kg, 70-year-old woman is scheduled for a mastectomy. She has a history of congestive heart failure treated with digoxin 0.25 mg daily. Preoperative examination shows a sinus rhythm at 80 bpm and blood pressure of 110/70 mmHg. Laboratory studies show a serum potassium concentration of 4.2 mEq/L and a serum digoxin concentration of 1.5 mcg/ml. Five minutes after induction of general anesthesia, ventricular bigeminy is noted; blood pressure is 85/65 mmHg, SpO2 is 97%, and PetCO2, is 20 mmHg. Which of the following is the most appropriate management?

ADVANCED General

A patient with moderate hypothyroidism and unstable angina requires urgent coronary artery bypass grafting. Which of the following is most appropriate before proceeding with the operation?

ADVANCED General

Bronchospasm occurring during anesthesia in a patient with an ileal carcinoid is best treated by administration of

ADVANCED General

A 38-year-old woman with hyperthyroidism is undergoing open reduction and internal fixation of a fractured humerus with isoflurane anesthesia. Intraoperatively her heart rate increases to 120 bpm with occasional premature ventricular contractions. The most appropriate therapy at this time is to

ADVANCED General

A 64-year-old man with diabetes mellitus well controlled with NPH insulin undergoes lower extremity revascularization. Following administration of protamine 10 mg, the patient has facial flushing and blood pressure of 60/30 mmHg. The most appropriate initial step in management is administration of which of the following drugs?

ADVANCED Pharmacology & Pharmacokinetics General

A 23-year-old man who is receiving his first anesthetic has not resumed spontaneous ventilation two hours after receiving succinylcholine. The train-of-four monitor shows no twitch response. Which of the following is the most likely cholinesterase genotype in this patient?

ADVANCED Pharmacology & Pharmacokinetics General

During enflurane anesthesia for colectomy in a 75-year-old man with sepsis, urine output decreases to 10 ml/hr. Heart rate is 120 bpm, blood pressure is 100/50 mmHg, central venous pressure is 10 mmHg, and pulmonary artery occlusion pressure is 15 mmHg. The most appropriate management at this time is to

ADVANCED General

Hypomagnesemia is associated with

ADVANCED General Cardiac

A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of

ADVANCED General

The use of glycine as irrigating solution during transurethral resection of the prostate could be associated with each of the following EXCEPT

ADVANCED General

In patients with head trauma, which of the following factors results in a return of arterial pH toward normal levels after two days of mechanical hyperventilation?

ADVANCED General Neuro

A 45-year-old man with chronic liver failure is scheduled for liver transplantation. Which of the following preoperative findings is most likely?

ADVANCED General

Reduction of fire hazards during laser surgery of the airway is best accomplished by use of

ADVANCED Equipment & Physics General

A 40-year-old woman with Graves' disease is undergoing thyroidectomy with 1% isoflurane, 60% nitrous oxide, and oxygen. During surgical manipulation of the thyroid, temperature increases to 38.5°C, heart rate to 160 bpm, and blood pressure to 150/100 mmHg. The most appropriate initial treatment is to

ADVANCED General

A healthy 57-year-old man with a ureteral calculus is scheduled for immersion extracorporeal shock wave lithotripsy. Which of the following statements is true?

ADVANCED Equipment & Physics General

A 50-year-old man who takes aspirin and nifedipine is scheduled for thoracotomy with one-lung ventilation. Which of the following is associated with the greatest risk for intraoperative hypoxemia?

ADVANCED Respiratory & Critical Care General

A 90-kg, 59-year-old man with chronic obstructive pulmonary disease is undergoing laparotomy. Mechanical ventilation is being carried out with a fresh gas flow of 2 L/min at a rate of 16/min and tidal volume of 900 ml; I:E ratio is 1:2.5. PaCO2 remains greater than 50 mmHg. Preoperative PaCO2, was normal. Which of the following is the most appropriate next step?

ADVANCED Respiratory & Critical Care General

During one-lung ventilation, each of the following affects hypoxic pulmonary vasoconstriction in the nonventilated lung EXCEPT

ADVANCED Respiratory & Critical Care General

Two days after total abdominal hysterectomy, a 54-year-old woman develops lethargy followed by seizures and coma. Laboratory studies show a serum sodium concentration of 108 mEq/L and serum osmolality of 225 mOsm/kg. The most appropriate next step in management is administration of which of the following?

ADVANCED Respiratory & Critical Care General

Compared with a normal child, which of the following is expected during inhalation induction in a child with a 2:1 left-to-right intracardiac shunt?

ADVANCED General Pediatric

Which of the following factors is the major cause of hypotension following release of the infrarenal aortic cross-clamp during aortic reconstruction?

ADVANCED General

During right upper lobectomy and one-lung ventilation with a double-lumen endotracheal tube, the PaO2 decreases to 40 mmHg. The PaCO2 is 39 mmHg. Which of the following is most appropriate?

ADVANCED General Respiratory & Critical Care

A 70-year-old man undergoes cross clamping of the aorta for repair of an abdominal aneurysm. Which of the following methods is most appropriate for decreasing hypotension associated with removal of the cross clamp?

ADVANCED General

Which of the following complications is the primary cause of neurologic deficit following carotid endarterectomy?

ADVANCED General

Which of the following statements concerning absorption of irrigation fluid during transurethral resection of the prostate is true?

ADVANCED General

A 75-year-old man with aortic stenosis and coronary artery disease has a preinduction heart rate of 68 bpm and blood pressure of 125/70 mmHg. After induction of anesthesia with fentanyl, midazolam, and pancuronium, heart rate is 90 bpm and blood pressure is 85/45 mmHg. ECG shows a new ST-segment elevation in lead II. Which of the following is the most appropriate initial management?

ADVANCED General

At a body temperature of 30°C, resistance to blood flow increases because of

ADVANCED General

Which of the following statements concerning neuroleptic malignant syndrome is true?

ADVANCED General

Which of the following statements concerning carbon monoxide poisoning is true? A 38-year-old woman with a large goiter has undergone subtotal thyroidectomy. Airway obstruction is noted immediately after extubation despite normal vocal cord function on laryngoscopy. Which of the following is the most likely explanation?

ADVANCED General

A 64-year-old patient with chronic obstructive pulmonary disease sustained fractures of ribs 4 through 8 on the left one hour ago. Examination shows agitation, heart rate of 120 bpm, respiratory rate of 30/min, and blood pressure of 180/100 mmHg. PaO2 is 70 mmHg and PaCO2 is 35 mmHg on room air. Radiographs of the chest show no abnormalities. Which of the following is the most appropriate immediate management?

ADVANCED General Regional & Pain

A patient is bleeding excessively after routine transurethral resection of the prostate. Re-exploration discloses diffuse oozing. The most appropriate management is administration of

ADVANCED General

A patient is undergoing thoracotomy in the lateral position. Five minutes after initiation of one-lung ventilation using a double-lumen tube and 100% oxygen, SpO2 decreases from 100% to 65%. Which of the following is the most appropriate initial step in management?

ADVANCED Respiratory & Critical Care General

A 50-year-old patient undergoes subtotal thyroidectomy for Graves' disease. In the immediate postoperative period, he has marked hoarseness but no stridor. The most likely cause of the hoarseness is trauma to the

ADVANCED General

In the absence of coronary artery disease, isoflurane-induced vasodilation and tachycardia are beneficial hemodynamic goals for which of the following cardiac diseases?

ADVANCED General Cardiac

A previously healthy 28-year-old woman scheduled for laparoscopic tubal ligation becomes, agitated and refuses to undergo the procedure after being brought to the operating room. This behavior most likely resulted from preoperative administration of

ADVANCED Pharmacology & Pharmacokinetics General

Which of the following pre-existing conditions predisposes to new-onset third-degree heart block during pulmonary artery catheterization?

ADVANCED General Cardiac

A 40-year-old patient has pain following injection of 8 ml of thiopental 2.5% through a right radial artery catheter. His hand remains pink. Which of the following is the most appropriate next step?

ADVANCED General

A 35-year-old woman undergoes a one-hour abdominal liposuction procedure under general anesthesia. During the procedure, 2000 ml of crystalloid is administered and 800 ml of fatty tissue is extracted. Thirty minutes postoperatively, blood pressure is 75/40 mmHg and heart rate is 100 bpm; SpO2 is 94% on room air. Which of the following is the most likely cause of these findings?

ADVANCED Transfusions & Fluids General

Which of the following is the best method of pacing to improve cardiac output in a patient with third-degree heart block?

ADVANCED General Cardiac

A 30-year-old man is brought to the emergency department after being rescued from a house fire. With the trachea intubated and FiO2 at 1.0, arterial blood gas values are PaO2 495 mmHg, PaCO2 28 mmHg, and pH 7.28. Hemoglobin saturation measured by co-oximeter is 50%. The most appropriate next step is to

ADVANCED General

Following extubation after nasotracheal intubation for seven days, a 35-year-old man has fever, facial pain, nasal stuffiness, and purulent nasal secretions. The most likely cause is

ADVANCED General

A patient who is paraplegic secondary to spinal cord transection at T3 develops bradycardia and facial flushing during a nephrectomy under general anesthesia with nitrous oxide, fentanyl, and atracurium. The most likely cause of this response is

ADVANCED General

A patient has hoarseness after undergoing surgery involving the aortic arch. The most likely cause is an injury to which of the following nerves?

ADVANCED General Regional & Pain

During insufflation of the peritoneal cavity with carbon dioxide at the start of laparoscopy, heart rate increases to 140 bpm, blood pressure decreases to 70/40 mmHg, and a loud murmur is heard through the esophageal stethoscope. The most appropriate immediate step is to

ADVANCED General

A 70-year-old man with mild hypertension and aortoiliac occlusive disease is undergoing aortofemoral bypass grafting. Which of the following interventions is most effective in maintaining renal perfusion during infrarenal aortic clamping?

ADVANCED General

Which of the following statements concerning neuroleptic malignant syndrome is true?

ADVANCED Pharmacology & Pharmacokinetics General

A 19-year-old man is undergoing inguinal herniorrhaphy. He is anesthetized with a spinal block supplemented with midazolam and fentanyl. During the procedure, he has sudden loss of consciousness, profound hypotension, and bradycardia; systolic pressure is 40 mmHg and heart rate is 30 bpm. Cardiopulmonary resuscitation is started. The most appropriate next step is administration of

ADVANCED General

A 20-year-old woman with poorly controlled diabetes mellitus is scheduled for urgent drainage of an abdominal abscess. She received an initial dose of regular insulin 10 units followed by regular insulin 5 units/hr for the past five hours. Laboratory studies show serum sodium concentration 128 mEq/L, potassium 5.4 mEq/L, chloride 80 mEq/L, and glucose 750 mg/dl. The most appropriate perioperative management is

ADVANCED General

A 68-year-old man has signs of a coagulopathy after receiving 10 units of packed erythrocytes during emergency repair of a leaking abdominal aortic aneurysm. The most likely cause is

ADVANCED Transfusions & Fluids General

The syndrome of inappropriate ADH secretion is characterized by

ADVANCED General

A 35-year-old woman with systemic lupus erythematosus is admitted to the critical care unit following sudden onset of severe chest pain. Examination shows tachycardia, hypotension, pulmonary edema, and a blowing systolic murmur in the left parasternal region. The most appropriate management is

ADVANCED General

A 63-year-old man with a history of congestive heart failure and left ventricular dilation is scheduled for carotid endarterectomy. During carotid cross-clamping, the surgeon requests that systolic blood pressure be increased from 100 to 160 mmHg. Compared with an identical patient with normal left ventricular size, what is the effect of this change in blood pressure on this patient's myocardial oxygen consumption?

ADVANCED General Cardiac

Each of the following conditions is a complication of mediastinoscopy EXCEPT

ADVANCED General

Preoperative administration of an alpha-adrenergic blocker for 10 days to patients with pheochromocytoma will decrease

ADVANCED General

Unilateral or bilateral diaphragmatic paralysis is a complication of each of the following EXCEPT

ADVANCED General

A 58-year-old man with a history of angina is undergoing resection of an abdominal aortic aneurysm under morphine, nitrous oxide, d-tubocurarine anesthesia. Just before removal of the aortic cross-clamp, heart rate is 74 bpm, blood pressure is 115/70 mmHg, and pulmonary artery occlusion pressure is 7 mmHg. Immediately after removal of the cross-clamp, heart rate increases to 120 bpm, blood pressure decreases to 80/55 mmHg, and pulmonary artery occlusion pressure decreases to 3 mmHg. The V5 lead on the EKG demonstrates sudden ST-segment depression and T-wave inversion. Initial therapy should be

ADVANCED General

Which of the following is the most sensitive indicator of impending renal failure following trauma?

ADVANCED General

Five minutes after initiating one-lung ventilation using a double-lumen endobronchial tube, a 70-year-old patient has a decrease in Sp02 from 99% to 90%. Tidal volume and respiratory rate are unchanged. Fiberoptic bronchoscopy verifies appropriate positioning of the tube. Which of the following is the most likely cause of the desaturation?

ADVANCED General Respiratory & Critical Care

A patient who is scheduled for emergency laparotomy for bowel obstruction has had oliguria for three hours. She has had hypertension for 10 years. Which of the following laboratory findings would indicate preoperative fluid challenge?

ADVANCED General

During laser excision of a vocal cord polyp, the tracheal tube ignites. Which of the following is the most appropriate next step?

ADVANCED Equipment & Physics General

A man with alcoholic cirrhosis and a hemoglobin concentration of 10 g/dl has an intraoperative PaO2 of 75 mmHg at an FiO2 of 0.5. Which of the following is the most likely cause of the low PaO2?

ADVANCED General

When methylmethacrylate is inserted into the femur, each of the following may occur EXCEPT

ADVANCED General

Following a right lower lobectomy, a patient develops a bronchopleural fistula and becomes hypoxic. He is orally intubated and mechanically ventilated with pure oxygen. PaO2 is 65 mmHg, PaCO2 is 70 mmHg, and pH is 7.25. Which of the following will produce the most favorable change in the blood gases?

ADVANCED Respiratory & Critical Care General

A 39-year-old patient with insulin-dependent diabetes mellitus receives thiopental 250 mg and succinylcholine 80 mg and is ventilated with 0.75% isoflurane in oxygen. Arterial pressure decreases abruptly from 140/100 to 80/50 mmHg while heart rate remains unchanged at 70 bpm. Failure of heart rate to increase most likely results from

ADVANCED 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

ADVANCED Respiratory & Critical Care General

Which of the following statements regarding carbon monoxide poisoning is true?

ADVANCED Respiratory & Critical Care General

Each of the following conditions is associated with autonomic hyperreflexia in patients with spinal cord injury EXCEPT

ADVANCED General

After the first 70 minutes of a transurethral resection of the prostate, a 70-year-old man becomes confused and has tachycardia, hypertension, and shortness of breath. Serum sodium concentration is 116 mEq/L. After informing the surgeon that the procedure should be terminated as soon as possible, the most appropriate next step would be to

ADVANCED General

A patient is scheduled for right pneumonectomy. A left-sided double-lumen endobronchial tube is inserted. After the endobronchial side is clamped and both cuffs are inflated, breath sounds are heard only on the left. Which of the following is the most likely cause?

ADVANCED General Respiratory & Critical Care

A 33-year-old woman is scheduled for emergency appendectomy under general anesthesia. She has hypertrophic cardiomyopathy and has had two episodes of syncope in the past year. Which of the following statements concerning anesthetic management is true?

ADVANCED General Cardiac

A 65-year-old man is disoriented and has a headache and nausea in the recovery room 30 minutes after transurethral resection of the prostate with glycine irrigation performed under spinal anesthesia. Heart rate is 50 bpm and blood pressure is 180/110 mmHg. Which of the following is LEAST likely?

ADVANCED General

During liver transplantation, venovenous bypass from the femoral and portal veins to the axillary vein during cross-clamping of the inferior vena cava

ADVANCED General

Pulmonary artery occlusion pressure

ADVANCED Equipment & Physics General Cardiac

During isoflurane anesthesia, a 45-year-old patient with chronic asthma has wheezing, prolonged expiration, sinus tachycardia of 120 bpm, and premature ventricular contractions. Preoperative medication included cromolyn and theophylline. The most appropriate treatment is to administer

ADVANCED General

A 68-year-old man has a permanent DVI pacemaker that has been functioning appropriately. Which of the following is most likely to cause conversion to VOO pacing?

ADVANCED General Cardiac