10 Random Questions
During uncomplicated mask induction with halothane and 50% nitrous oxide in oxygen in a 6-month-old infant with a large ventricular septal defect and valvular pulmonic stenosis, SpO2 decreases from 85% (room air) to 60%; heart rate is 100 bpm and blood pressure is 62/40 mmHg. The most appropriate management is to
- (A) administer atropine
- (B) administer phenylephrine
- (C) administer propranolol
- (D) increase anesthetic depth
- (E) intubate the trachea
A radial artery catheter is to be used for blood pressure measurement during a sitting craniotomy. When zeroing the transducer, which of the following describes the best levels for placement of the transducer and opening of the system to air? (Transducer, Opening to Air)
- (A) Head Wrist
- (B) Head Head
- (C) Head Heart
- (D) Heart Heart
- (E) Heart Wrist
Infants with untreated pyloric stenosis are at increased risk for each of the following EXCEPT
- (A) congenital heart disease
- (B) dehydration
- (C) hypokalemia
- (D) increased gastric acidity
- (E) metabolic alkalosis
A patient has sudden cardiopulmonary arrest five minutes after retrobulbar block with 0.75% bupivacaine 2 ml with hyaluronidase for ophthalmologic surgery. No premonitory changes were noted on the pulse oximeter. The most likely cause is
- (A) allergic reaction to hyaluronidase
- (B) direct cardiac toxicity
- (C) oculocardiac reflex
- (D) intravenous injection of local anesthetic
- (E) subarachnoid injection of local anesthetic
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
A patient receiving propranolol and nifedipine is scheduled for elective coronary artery bypass surgery. During induction with fentanyl and oxygen, heart rate decreases from 52 to 36 bpm and blood pressure decreases from 130/85 to 80/50 mmHg. Administration of atropine 2 mg intravenously has no effect. The most appropriate treatment at this time is administration of
- (A) epinephrine
- (B) pancuronium
- (C) naloxone
- (D) phenylephrine
- (E) calcium chloride
Which of the following statements concerning use of temperature-corrected blood gas measurement (pH-stat) during hypothermic cardiopulmonary bypass is true?
- (A) Blood gas analysis is performed at the patient's temperature
- (B) Carbon dioxide should not be added to the bypass circuit
- (C) The carbon dioxide content of the patient's blood is greater than it would be without temperature correction
- (D) The incidence of postoperative neurologic deficits is increased compared with the alpha-stat method
- (E) The patient's temperature should be maintained above 25°C
A 2.8-kg 8-hour-old infant undergoes laparotomy for a ruptured omphalocele. Following primary closure of the abdominal wall, arterial blood gases are PaO2 40 mmHg (FiO2 0.6), PaCO2 55 mmHg, and pH 7.1. Blood pressure is 30/20 mmHg. After increasing the FiO2, the most appropriate action would be to
- (A) obtain a radiograph of the chest immediately
- (B) withdraw the endotracheal tube 1 cm
- (C) assess the patient for coexisting congenital heart disease
- (D) administer lactated Ringer's solution 15 ml/kg
- (E) ask the surgeon to reopen the wound
Following protamine administration, profound pulmonary hypertension is most likely initiated by release of
- (A) epinephrine
- (B) histamine
- (C) leukotriene
- (D) norepinephrine
- (E) thromboxane
During a cardiac arrest with effective chest compression and positive-pressure ventilation, 50 mEq of sodium bicarbonate is administered. Which of the following is the most likely result?
- (A) Decreased mixed venous pH
- (B) Decreased SpO2
- (C) Increased PetCO2
- (D) Increased plasma lactate concentration
- (E) Increased serum potassium concentration