10 Random Questions
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
- (A) administer dexamethasone
- (B) administer penicillin G
- (C) perform bronchoscopy
- (D) ventilate with positive end-expiratory pressure 15 cmH2O
- (E) proceed with the anesthesia plan if the tracheal pH is greater than 2.5
Compared with fentanyl, alfentanil is characterized by
- (A) greater volume of distribution
- (B) greater lipid solubility
- (C) less protein binding
- (D) faster redistribution
- (E) longer terminal elimination phase
Severe nausea and vomiting in the PACU is most effectively treated with a drug that acts as an antagonist at which of the following receptors?
- (A) Alpha-adrenergic
- (B) Beta-adrenergic
- (C) Dopamine
- (D) GABA
- (E) Glutamate
Compared with healthy persons, patients with myasthenic (Eaton-Lambert) syndrome have increased
- (A) resistance to vecuronium
- (B) response to neostigmine during reversal of muscle paralysis
- (C) sensitivity to succinylcholine
- (D) susceptibility to development of malignant hyperthermia
- (E) weakness with repetitive activity
The most likely cause of this capnographic tracing obtained just after laryngoscopy and intubation is
- (A) esophageal intubation
- (B) partial obstruction of the endotracheal tube
- (C) pulmonary embolus
- (D) insertion of an endotracheal nasogastric tube
- (E) mild bronchospasm
Addition of 20 cm H2O positive end-expiratory pressure to a patient receiving controlled mechanical ventilation decreases cardiac output and left ventricular function by
- (A) increasing right ventricular preload
- (B) increasing right ventricular afterload
- (C) increasing left ventricular preload
- (D) increasing left ventricular afterload
- (E) producing myocardial ischemia
A 5-year-old child undergoes strabismus correction during spontaneous ventilation with halothane 1.5%, nitrous oxide and oxygen 50%. Intravenous atropine 0.2 mg is administered after inhalation induction. Ten minutes after incision, heart rate decreases from 110 bpm to 40 bpm. Which of the following is the most likely cause?
- (A) Administration of phenylephrine eyedrops
- (B) Inadvertent external pressure on the carotid sinus
- (C) Paradoxical response to a small dose of atropine
- (D) Sinoatrial nodal depression by halothane
- (E) Traction on an extraocular muscle
An 8-kg, 1-year-old child has a measured blood loss of 50 ml during the first two hours of a rectal pull-through operation. Preoperative hematocrit was 31%. Balanced saline solution 150 ml has been administered for replacement. Urine output has been 2 ml for the last hour, heart rate is 160 bpm, and blood pressure is 40/15 mmHg. The most appropriate fluid therapy is,
- (A) 25% albumin
- (B) balanced salt solution
- (C) balanced salt solution and mannitol
- (D) 5% dextrose in 0.45% saline solution
- (E) packed red blood cells
During direct intra-arterial measurement of blood pressure
- (A) the mean arterial pressure will be unaffected by small air bubbles in the system
- (B) an underdamped system will overestimate the mean arterial pressure
- (C) an underdamped system will overestimate the diastolic pressure
- (D) long tubing from the catheter to the transducer will tend to decrease resonance in the system
- (E) calibration of the transducer by opening a stopcock to air at the sternal angle will overestimate the mean
The alveolar concentrations of anesthetics increase more rapidly in children than in adults because of a greater
- (A) blood volume (per kg body mass)
- (B) cardiac index
- (C) MAC
- (D) ratio of alveolar ventilation to functional residual capacity
- (E) tidal volume (per kg body mass)