10 Random Questions
A 62-year-old man is undergoing elective coronary artery bypass grafting and aortic valve replacement for three-vessel coronary artery disease and aortic stenosis. Shortly after intubation, heart rate increases from 75 to 100 bpm and blood pressure decreases from 130/70 to 70/40 mmHg with acute, severe ST-segment depression in lead V5. Which of the following is the most appropriate management?
- (A) Crystalloid
- (B) Ephedrine
- (C) Esmolol
- (D) Nitroglycerin
- (E) Phenylephrine
An 80-kg, 70-year-old woman is scheduled for a mastectomy. She has a history of congestive heart failure treated with digoxin 0.25 mg daily. Preoperative examination shows a sinus rhythm at 80 bpm and blood pressure of 110/70 mmHg. Laboratory studies show a serum potassium concentration of 4.2 mEq/L and a serum digoxin concentration of 1.5 mcg/ml. Five minutes after induction of general anesthesia, ventricular bigeminy is noted; blood pressure is 85/65 mmHg, SpO2 is 97%, and PetCO2, is 20 mmHg. Which of the following is the most appropriate management?
- (A) Administration of calcium chloride
- (B) Administration of ephedrine
- (C) Administration of lidocaine
- (D) Administration of potassium chloride
- (E) Decrease in ventilation
A 5-year-old child undergoes strabismus correction during spontaneous ventilation with halothane 1.5%, nitrous oxide and oxygen 50%. Intravenous atropine 0.2 mg is administered after inhalation induction. Ten minutes after incision, heart rate decreases from 110 bpm to 40 bpm. Which of the following is the most likely cause?
- (A) Administration of phenylephrine eyedrops
- (B) Inadvertent external pressure on the carotid sinus
- (C) Paradoxical response to a small dose of atropine
- (D) Sinoatrial nodal depression by halothane
- (E) Traction on an extraocular muscle
The figure describes the uptake of nitrous oxide 75% by individual tissue groups (VRG = vessel-rich group, MG = muscle group, FG = fat group) and their sum (total uptake, TU). Which set of labels accurately describes the curves?
- (A) 1- MG, 2- FG, 3- VRG, 4- TU
- (B) 1- VRG, 2- MG, 3- FG, 4- TU
- (C) 1- FG, 2- MG, 3- TU, 4- VRG
- (D) 1- TU, 2- FG, 3- MG, 4- VRG
- (E) 1- TU, 2- VRG, 3- MG, 4- FG
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
Which of the following statements concerning myasthenia gravis is true?
- (A) Neostigmine is inappropriate for antagonism of neuromuscular blockade
- (B) The number of acetylcholine receptors is decreased
- (C) Plasma cholinesterase concentration is decreased
- (D) The risk for malignant hyperthermia is increased
- (E) Succinylcholine is contraindicated
A single dose of etomidate for induction of anesthesia will cause
- (A) adrenal cortical suppression
- (B) decreased skeletal muscle tone
- (C) hypotension
- (D) increased airway reactivity
- (E) tachycardia
When performed with identical doses, which of the following types of regional block is associated with the highest plasma concentration of the drug?
- (A) Brachial plexus
- (B) Caudal
- (C) Intercostal
- (D) Subcutaneous infiltration
- (E) Thoracic epidural
A 70-year-old man who underwent bilateral carotid endarterectomies two years ago is to undergo anesthesia and surgery. The denervation of the carotid bodies is likely to result in
- (A) chronic respiratory alkalosis
- (B) decreased ventilatory response to hypoxemia
- (C) increased ventilatory response to hypercarbia
- (D) labile hypertension
- (E) resting bradycardia
If administered epidurally in equipotent doses, which of the following opioids will produce analgesia over the greatest number of dermatomes?
- (A) Fentanyl
- (B) Hydromorphone
- (C) Meperidine
- (D) Morphine
- (E) Sufentanil