10 Random Questions
A 45-year-old man is scheduled for appendectomy under general anesthesia. He reports that for many years he has occasionally felt his heart "skip a beat." The ECG tracing shown was obtained one hour ago. Which of the following is the most appropriate next step?
- (A) Proceeding with induction of anesthesia
- (B) Administration of a loading dose of digoxin
- (C) Carotid sinus massage
- (D) Intravenous administration of atropine
- (E) Placement of a temporary pacemaker
While checking an anesthesia machine, opening the oxygen flow-control valve yields no oxygen flow, although the wall-mounted oxygen pipeline supply gauge reads 50 psig. Opening the backup oxygen cylinder results in normal oxygen flow. The most likely cause is
- (A) failure of the oxygen pipeline supply
- (B) failure of the second-stage oxygen pressure regulator
- (C) a malfunctioning check valve in the oxygen pipeline supply inlet
- (D) a malfunctioning fail-safe valve
- (E) a malfunctioning oxygen flow-control valve
After two hours of anesthesia with halothane 1.2% and oxygen, nitrous oxide 75% is added to the inspired gas mixture. This addition would
- (A) increase the alveolar halothane and oxygen concentrations above inspired
- (B) increase the alveolar halothane concentration only
- (C) cause no change in alveolar gas concentrations compared with inspired
- (D) decrease alveolar oxygen concentration compared with inspired
- (E) decrease alveolar oxygen and halothane concentrations below inspired
A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of
- (A) droperidol
- (B) nifedipine
- (C) normal saline solution
- (D) propranolol
- (E) verapamil
A healthy patient is receiving general endotracheal anesthesia with nitrous oxide 4 L/min, oxygen 2 L/min, and isoflurane 1% with spontaneous ventilation. The inspiratory breathing hose becomes disconnected from the inspiratory valve. The earliest alarm will be produced by
- (A) a pulse oximeter with finger probe set to alarm at 60% saturation
- (B) a mass spectrometer set to alarm when no breath is detected for 30 seconds
- (C) an oxygen analyzer mounted on the inspiratory valve outlet and set to alarm at 25% oxygen concentration
- (D) a capnograph sensor at the Y-piece that alarms when end-tidal carbon dioxide tension is greater than 60
- mmHg
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
Bronchospasm occurring during anesthesia in a patient with an ileal carcinoid is best treated by administration of
- (A) aminophylline
- (B) dexamethasone
- (C) halothane
- (D) ketamine
- (E) somatostatin
Which of the following is the most appropriate action after an anesthetic vaporizer is tipped?
- (A) Return to the manufacturer for recalibration
- (B) Flush the vaporizer with oxygen at 5 L/min for 24 hours
- (C) Store the vaporizer for 24 hours at room temperature
- (D) Set the vaporizer at low concentration and flush with oxygen at 10 L/min for 30 minutes
- (E) Verify the vaporizer output with mass spectrography
After receiving excessive intraoperative blood replacement, a patient anesthetized with fentanyl, diazepam, and nitrous oxide develops acute pulmonary edema. The drug most likely to help him acutely is
- (A) isoflurane
- (B) nitroprusside
- (C) digoxin
- (D) nitroglycerin
- (E) furosemide
Which of the following statements concerning the pharmacokinetics of local anesthetics is true?
- (A) Decreased molecular weight is associated with decreased incidence of allergic reactions
- (B) Decreased protein binding is associated with decreased systemic toxicity
- (C) Increased ionization is associated with increased placental transfer
- (D) Increased lipid solubility is associated with faster onset
- (E) Presence of an ester linkage is associated with increased duration of action