Which of the following statements best describes the decrease in cerebral metabolic rate that occurs with administration of volatile anesthetics?
(A) It is independent of anesthetic dose
(B) It is maximal when the EEG is isoelectric
(C) It is more profound with halothane than isoflurane at equipotent doses
(D) It is not affected by enflurane-induced EEG hyperactivity
(E) It parallels changes in cerebral blood flow at mean arterial pressures of 50 to 150 mmHg
B
A patient with hypokalemic familial periodic paralysis develops weakness of skeletal muscles at the end of an emergency appendectomy under spinal anesthesia. If the weakness is a result of the familial periodic paralysis, which of the following statements is true?
(A) Bicarbonate therapy is indicated
(B) Cardiac dysrhythmias are unlikely
(C) Initial treatment is intravenous edrophonium
(D) Potassium infusion is contraindicated
(E) The paralysis spares the diaphragm
E
A 35-kg child requires mechanical ventilation with pure oxygen at a tidal volume of 350 ml and a rate of 20/min during a severe asthma attack. The most likely cause of severe hypotension after initiating mechanical ventilation is
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
(A) Maximum effect occurs one hour after injection
(B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
(C) Maximum effect occurs during the acute phase of the disease
(D) The beneficial effect results primarily from sympathetic neurolysis
(E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
C
A conscious patient has an acute subdural hematoma that will require surgical evacuation. Which of the following interventions to be carried out in the emergency department is most likely to decrease intracranial pressure?
(A) Having the patient hyperventilate
(B) Intravenous administration of an opioid
(C) Intravenous administration of a corticosteroid
(D) Intravenous administration of nitroprusside
(E) Intravenous administration of furosemide
E
Which of the following limits the use of nalbuphine for relief of postoperative pain?
(A) High incidence of nausea and vomiting
(B) High incidence of delayed respiratory depression
(C) Potential for inducing seizures with repeated doses
Failure to block the musculocutaneous nerve adequately during the axillary approach to brachial plexus block will result in inadequate anesthesia of the
(A) thumb and index finger
(B) dorsum of the wrist
(C) lateral aspect of the forearm
(D) lateral aspect of the elbow
(E) medial aspect of the upper arm
C
Each of the following conditions can be accurately evaluated with transesophageal echocardiography EXCEPT
To predict the requirement for isoflurane in milliliters of vapor per minute during closed circuit anesthesia, each of the following is necessary EXCEPT
An unconscious adult patient is being ventilated through an esophageal obturator airway (EOA) in the emergency department. In the absence of cervical spine injury, which of the following is appropriate?
(A) Use of the EOA for airway management until the patient regains consciousness
(B) Removal of the EOA before insertion of an endotracheal tube
(C) Placement of an endotracheal tube before removal of the EOA
(D) Removal of the EOA under fiberoptic endoscopic visualization