10 Random Questions
A previously healthy 46-year-old woman has severe substernal chest pain one hour after receiving morphine sulfate 10 mg intramuscularly for an elective cholecystectomy. Vital signs, SpO2, and findings on a five-lead ECG on the operating room monitor are within normal limits. Which of the following is the most appropriate next step?
- (A) Sublingual administration of nitroglycerin
- (B) Intravenous administration of butorphanol
- (C) Intravenous administration of naloxone
- (D) Cardiology consultation
- (E) Cancellation of surgery
The highest serum fluoride levels are seen following the administration of which of the following volatile anesthetics?
- (A) Desflurane
- (B) Enflurane
- (C) Halothane
- (D) Isoflurane
- (E) Sevoflurane
Coughing that occurs during awake intubation is prevented by local anesthetic block of which of the following nerves?
- (A) Glossopharyngeal
- (B) Hypoglossal
- (C) Recurrent laryngeal and glossopharyngeal
- (D) Recurrent laryngeal and superior laryngeal
- (E) Superior laryngeal and glossopharyngeal
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
- (A) acute myocardial ischemia
- (B) decreased 2,3-diphosphoglycerate in transfused blood
- (C) increased intrapulmonary shunting
- (D) relative hypovolemia
- (E) venous air embolism
A 70-kg man has stable 80% neuromuscular block induced with d-tubocurarine. Compared with neostigmine 3 mg, antagonism with edrophonium 70 mg will
- (A) be of shorter duration
- (B) be of slower onset
- (C) be less reliable
- (D) produce less change in heart rate
- (E) require more anticholinergic
Which of the following statements concerning anesthetic management for MRIs is true?
- (A) ECG wires are associated with patient burns
- (B) Mechanical ventilation of the lungs is not feasible
- (C) Monitors with ferromagnetic components may be used
- (D) Oxygen analysis of inspired gas is inaccurate
- (E) Pulse oximetry is not reliable near the MR scanner
Which of the following statements concerning variable decelerations of fetal heart rate is true?
- (A) It indicates compression of the umbilical cord
- (B) It indicates compression of the fetal head
- (C) It indicates prematurity
- (D) It is obliterated by atropine
- (E) It occurs normally following epidural anesthesia
Each of the following statements concerning the activated clotting time (ACT) is true EXCEPT:
- (A) The ACT is more sensitive than the activated partial thromboplastin time (APTT) to blood heparin concentration
- (B) The ACT is prolonged if the specimen is not warmed during the assay
- (C) The ACT should be greater than 300 sec before initiating cardiopulmonary bypass
- (D) Hypofibrinogenemia may prolong the ACT after cardiopulmonary bypass
- (E) Whole blood is used for measurement of the ACT
A 68-year-old man with stable angina treated with propranolol and nifedipine is scheduled for coronary artery bypass grafting. After induction with fentanyl and tracheal intubation, heart rate decreases to 40 bpm and blood pressure decreases to 70/40 mmHg. The ECG is shown. Which of the following is the most appropriate first step in management?
- (A) Infusion of isoproterenol
- (B) Administration of phenylephrine
- (C) Closed chest cardiopulmonary resuscitation
- (D) Defibrillation
- (E) Synchronized cardioversion
A 54-year-old man receives 25 ml of a 50% alcohol and 0.25% bupivacaine solution for celiac plexus block. During the next 20 minutes, blood pressure decreases from 130/75 mmHg to 85/55 mmHg. Which of the following is the most likely cause?
- (A) Intravascular injection
- (B) Retroperitoneal hemorrhage
- (C) Splanchnic vasodilation
- (D) Subarachnoid blockade
- (E) Tension pneumothorax