10 Random Questions
A 5-year-old boy is to undergo microlaryngeal carbon dioxide laser vaporization of laryngotracheal papillomas under halothane administered through a small polyvinylchloride (PVC) endotracheal tube. The diluent gas mixture LEAST likely to support laser combustion of the PVC tube is
- (A) oxygen 40%, nitrous oxide 60%
- (B) oxygen 25%, nitrous oxide 75%
- (C) oxygen 30%, nitrogen 70%
- (D) oxygen 30%, helium 70%
- (E) oxygen 30%, air 70%
Which of the following provides the earliest indication of myocardial ischemia during general anesthesia?
- (A) Cardiac index
- (B) Mixed venous oxygen saturation
- (C) Pulmonary artery occlusion pressure
- (D) Regional ventricular wall motion
- (E) ST-segment depression on ECG
To measure the contribution of intrapulmonary shunting to arterial hypoxemia, which of the following measurements are necessary? (Assume normal cardiac output and anatomy.)
- (A) PaC02 and PeC02
- (B) PaC02 and Pe02 while breathing pure oxygen
- (C) Pa02 and Pv02 while breathing pure oxygen
- (D) Pa02 while breathing both room air and pure oxygen
- (E) Pa02 and PaC02 while breathing room air
The five curves shown represent the uptake of enflurane, desflurane, halothane, isoflurane, and nitrous oxide. Which uptake curve best depicts desflurane?
- (A) Curve A
- (B) Curve B
- (C) Curve C
- (D) Curve D
- (E) Curve E
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
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?
- (A) Anesthesia-induced block of nonshivering thermogenesis
- (B) Failure to use a warming blanket
- (C) Infusion of room-temperature crystalloid
- (D) Inhalation of room-temperature gases
- (E) Mixing of peripheral and central blood
Which of the following is most responsible for the duration of action of local anesthetics?
- (A) Concentration
- (B) Metabolism
- (C) Molecular weight
- (D) Tissue protein binding
- (E) Volume injected
When compared with a healthy 30-year-old man, which of the following respiratory parameters is decreased in an otherwise healthy 80-year-old man?
- (A) Alveolar to arterial oxygen gradient
- (B) Lung compliance
- (C) Ratio of functional residual capacity to total lung capacity
- (D) Resting tidal volume
- (E) Ventilatory response to carbon dioxide
Awakening after a single dose of thiopental is caused by redistribution from the brain primarily to which of the following sites?
- (A) Fat
- (B) Heart
- (C) Liver
- (D) Lung
- (E) Skeletal muscle
A 24-year-old man is undergoing induction of general anesthesia prior to appendectomy. During laryngoscopy, he regurgitates a large amount of bilious material. An endotracheal tube is inserted; aspiration shows bile-stained fluid. Which of the following is the most appropriate next step in management?
- (A) Infusion of a loading dose of aminophylline
- (B) Intravenous administration of broad-spectrum antibiotics
- (C) Lavage of the tracheobronchial tree with saline solution
- (D) Radiograph of the chest
- (E) Proceeding with the operation