10 Random Questions
Which of the following statements concerning cerebral vasospasm following intracranial hemorrhage is true?
- (A) It is accompanied by paradoxical intracranial hypotension
- (B) It responds to nitroprusside therapy
- (C) It persists more than 48 hours after hemorrhage
- (D) It is exacerbated by intravascular volume expansion
- (E) It is confirmed by ST-T wave changes in the absence of myocardial ischemia
A 2-year-old child has cardiac arrest during an inguinal herniorrhaphy under general anesthesia administered during a Jackson-Rees system. The graph shows end-tidal PCO2 monitored from the tip of the endotracheal tube during cardiopulmonary resuscitation; minute ventilation is unchanged. Which of the following is the most likely cause of the change beginning at the arrow?
- (A) Decreased fresh gas flow
- (B) Inadequate chest compression
- (C) Increased dead space
- (D) Restoration of cardiac output
- (E) Sampling artifact
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
- (A) Maximum effect occurs one hour after injection
- (B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
- (C) Maximum effect occurs during the acute phase of the disease
- (D) The beneficial effect results primarily from sympathetic neurolysis
- (E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
An axillary block is administered to a 60-kg patient using 40 ml of 0.5% bupivacaine. Ten minutes after placement of the block, the patient has a seizure. Which of the following statements is true?
- (A) A low serum albumin concentration could have contributed to the occurrence of the seizure
- (B) CNS hypoperfusion is the most likely cause of the seizure
- (C) The seizure was probably secondary to an allergic reaction to the local anesthetic
- (D) The use of an equipotent dose of lidocaine rather than bupivacaine would have decreased the likelihood of
- the seizure
Which of the following statements about patient-controlled analgesia using opioids is true?
- (A) It is not associated with respiratory depression
- (B) It obviates loading doses
- (C) It requires a background opioid infusion to be effective
- (D) It requires intravenous administration to be effective
- (E) It requires less drug than intramuscular dosing for similar analgesia
Following completion of an ankle block, the patient reports intact sensation on the tips of the toes. Which of the following nerves was blocked inadequately?
- (A) Deep peroneal
- (B) Posterior tibial
- (C) Saphenous
- (D) Superficial peroneal
- (E) Sural
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?
- (A) Chest x-ray
- (B) Blood tranfusion
- (C) Subxiphoid pericardiocentesis
- (D) Fiberoptic bronchoscopy
- (E) Left chest needle thoracostomy
During induction of anesthesia, a patient is breathing isoflurane from a semiclosed circle absorber system. The temperature-compensated vaporizer is set to deliver isoflurane 1.5%. Which of the following will result in the lowest inspired concentration of isoflurane?
- (A) Doubling the length of circle system hoses
- (B) Decreasing the barometric pressure
- (C) Changing from rubber to plastic breathing hoses
- (D) Decreasing fresh gas flow
- (E) Exhaustion of the soda lime
A 50-year-old man with an 80 pack-year history of cigarette smoking has a forced expiratory volume in one second of 1.5 L and a forced vital capacity of 3.5 L. Which of the following statements concerning intraoperative anesthetic management is true?
- (A) An I:E ratio of 1:1 will improve carbon dioxide removal more than an I:E ratio of 1:2.5
- (B) Antagonism of neuromuscular block will most likely trigger acute bronchospasm
- (C) Functional residual capacity will increase during an acute exacerbation of bronchospasm
- (D) Induction with ketamine will increase airway resistance
- (E) Nitrous oxide is contraindicated
A 6-year-old child with asthma begins wheezing during anesthesia with halothane and nitrous oxide in oxygen. A loading dose of aminophylline is administered followed by continuous infusion. Premature ventricular contractions appear on the ECG. The most appropriate management is to
- (A) administer fentanyl
- (B) discontinue aminophylline
- (C) increase exhalation time
- (D) increase the inspired concentration of halothane
- (E) switch the inhalational agent to isoflurane