10 Random Questions
Four days after mitral valve replacement, a 49-year-old, 70-kg woman who has had oliguric renal failure since the operation requires insertion of a Schribner shunt for hemodialysis. Her BUN concentration is 104 mg/dl, serum creatinine is 9.3 mg/dl, serum sodium is 130 mEq/L, and serum potassium is 6.7 mEq/L. During the operation under local anesthesia, diazepam 7.5 mg and morphine 10 mg are administered intravenously to control agitation. Five minutes later while she is sleeping quietly, unifocal premature ventricular contractions appear at a rate of 10 per minute on the ECG monitor. The most appropriate therapy is to
(A) administer calcium gluconate 250 mg intravenously
(B) augment ventilation with bag and mask
(C) administer lidocaine 100 mg intravenously
(D) administer NaHC03 50 mEq intravenously
(E) observe only
Reveal Answer
ADVANCED
General
Cardiac
Fresh frozen plasma is indicated in each of the following situations EXCEPT
(A) after rapid transfusion of 1.5 L CPD-stored red blood cells
(B) antithrombin III deficiency
(C) replacement of factor VIII
(D) reversal of warfarin effect
(E) thrombotic thrombocytopenic purpura
Reveal Answer
BASIC
Transfusions & Fluids
Each of the following is a complication or side effect of neurolytic celiac plexus blockade EXCEPT
(A) constipation
(B) hematuria
(C) orthostatic hypotension
(D) paraplegia
(E) pneumothorax
Reveal Answer
ADVANCED
Regional & Pain
Compared with morphine, a single epidural administration of fentanyl is associated with
(A) delayed onset of analgesia
(B) increased incidence of pruritus
(C) increased incidence of respiratory depression
(D) longer duration of action
(E) more restricted segmental spread
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Regional & Pain
During an otherwise uneventful nitrous oxide-sevoflurane anesthetic in a spontaneously breathing patient, 85% nitrous oxide is accidently administered, resulting in a PO2 of 48 mmHg. Which of the following would be expected?
(A) Tachycardia
(B) Sweating
(C) Tachypnea
(D) Hyperactive EEG
(E) None of the above
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Which of the following statements concerning absorption of irrigation fluid during transurethral resection of the prostate is true?
(A) Hydrostatic pressure has minimal effect on the amount of fluid absorbed
(B) Typically 10 to 30 ml of fluid per minute are absorbed
(C) Use of iso-osmotic solutions decreases the risk of hyponatremia
(D) CNS complications are independent of the type of fluid used
(E) Spinal anesthesia to T6 will mask the symptoms of overhydration
Reveal Answer
ADVANCED
General
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
Reveal Answer
Which of the following statements regarding fetal heart rate patterns is true?
(A) Early decelerations suggest umbilical cord compression
(B) Fetal heart rates between 160 and 180 bpm are normal
(C) Fetal heart rate unaffected by uterine contraction suggests fetal well-being
(D) Late decelerations indicate inadequate uteroplacental perfusion
(E) Variable decelerations indicate need for urgent delivery
Reveal Answer
ADVANCED
Pediatric
OB
Early deceleration of fetal heart rate
(A) correlates with high concentrations of local anesthetic in maternal blood
(B) frequently occurs with fetal scalp pH greater than 7.25
(C) indicates need for immediate cesarean delivery
(D) indicates subclinical uteroplacental insufficiency
(E) predicts low Apgar scores at delivery
Reveal Answer
The rate of induction with inhalational agents is more rapid in neonates than adults because of a relatively increased
(A) cardiac output
(B) cerebral blood flow
(C) functional residual capacity
(D) metabolic rate
(E) minute ventilation
Reveal Answer
ADVANCED
Pediatric