10 Random Questions
The best premedication regimen for a known active narcotic addict would include
- (A) secobarbital
- (B) diazepam
- (C) nalbuphine
- (D) morphine
- (E) droperidol
Which of the following is most likely to decrease uterine tone?
- (A) Administration of isoflurane 1%
- (B) Administration of nitrous oxide 50%
- (C) Intravascular injection of 5 ml of 0.5% bupivacaine
- (D) Intravenous administration of ketamine 2 mg/kg
- (E) Paracervical block with 20 ml of 1% lidocaine
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
- (A) discontinue halothane
- (B) adminster ephedrine 10 mg intravenously
- (C) administer digoxin one half of his daily dose intravenously
- (D) administer sodium chloride 100 mL of 3%
- (E) do none of the above
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?
- (A) Atracurium will have a prolonged duration of action
- (B) The risk for perioperative hyperglycemia is increased
- (C) Mivacurium will have a shortened duration of action
- (D) The unbound fraction of thiopental will be increased
- (E) Vitamin K injection will normalize the prothrombin time
A 70-kg patient is anesthetized for a craniotomy in the sitting position. Minute ventilation through a circle system is 15 L/min; PetC02 is 65 mmHg. Which of the following is the most likely cause of the increased PetC02?
- (A) Inadequate flow of fresh gas
- (B) Incompetent expiratory valve
- (C) Intubation of the right mainstem bronchus
- (D) Light anesthesia
- (E) Venous air embolism
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
- (A) anaphylactic reaction
- (B) bronchospasm
- (C) myocardial infarction
- (D) pulmonary embolism
- (E) unreplaced blood loss
A 45-year-old woman with mitral stenosis is scheduled for elective mitral valve replacement. Two minutes after tracheal intubation, she develops atrial fibrillation with a ventricular response rate of 150 bpm and a decrease in blood pressure to 75/45 mmHg. Which of the following is the most appropriate first step in management?
- (A) Increasing the concentration of enflurane
- (B) Increasing the infusion rate of lactated Ringer's solution
- (C) Intravenous administration of digoxin
- (D) Intravenous administration of propranolol
- (E) Electrical cardioversion
During controlled ventilation, which of the following will cause an increase in end-tidal carbon dioxide tension with a normal waveform on the capnograph?
- (A) Bronchospasm
- (B) Rapid blood loss
- (C) Ventricular fibrillation
- (D) Endobronchial migration of the endotracheal tube
- (E) Release of a thigh tourniquet
Which of the following statements concerning postspinal headache is true?
- (A) Cerebrospinal fluid leukocytosis occurs
- (B) Intravenous caffeine therapy is more effective than epidural blood patch
- (C) The incidence decreases with age
- (D) The incidence is higher in males than in females of all ages
- (E) The incidence is the same after single or multiple dural punctures
Two days after myocardial infarction involving the left anterior descending coronary artery, a patient's blood pressure decreases acutely from 125/80 to 70/40 mmHg, heart rate increases from 75 to 90 bpm, pulmonary artery pressure increases to 50/30 mmHg, and urine output decreases from 60 to 10 ml/hr. Thermodilution cardiac output has increased from 4 to 7 L/min. The most appropriate action is to
- (A) compare mixed venous oxygen saturation in the right atrium and pulmonary artery
- (B) draw blood for culture and start antibiotic therapy
- (C) start dopamine infusion in low dose
- (D) administer a fluid challenge
- (E) monitor peripheral capillary oxygenation by transcutaneous oximetry