10 Random Questions
A patient is scheduled for amputation of the third metatarsal. A tourniquet will not be used during the procedure. The most effective anesthesia will be provided by block of which of the following nerves?
- (A) Femoral
- (B) Common peroneal and tibial
- (C) Sural and deep peroneal
- (D) Sural and tibial
- (E) Tibial, saphenous, and deep peroneal
The ECG strip shown is recorded as a patient with a permanent transvenous DDD pacemaker enters the operating room. These changes indicate that the pacemaker is
- (A) sensing the T waves
- (B) sensing the retrograde P waves
- (C) triggering off the intrinsic atrial activity
- (D) malfunctioning in the atrial pacing mechanism
- (E) prematurely stimulating the ventricle
A 35-year-old patient with asymmetric septal hypertrophy (IHSS) is undergoing bladder suspension with sevoflurane 1%, nitrous oxide 50%, and oxygen 50%. Immediately after skin incision, blood pressure decreases to 90/60 mmHg and junctional tachycardia of 150 bpm is noted on the ECG. Which of the following is the most appropriate management?
- (A) Decreasing sevoflurane concentration
- (B) Infusion of nitroglycerin
- (C) Intravenous administration of a fluid bolus
- (D) Intravenous administration of esmolol
- (E) Intravenous administration of phenylephrine
Which of the following is LEAST likely to decrease myocardial oxygen supply?
- (A) Administration of enflurane
- (B) Epidural anesthesia to a sensory level of T6
- (C) Increased pulmonary artery occlusion pressure
- (D) Hypocarbia (PaCO, 25 mmHg)
- (E) Metabolic acidosis (pH 7.20)
For 30 minutes, a patient has been receiving oxygen 2 L, nitrous oxide 2 L, and halothane from an agent-specific vaporizer set at 1%. A mass spectrometer sampling gas from the patient's airway shows an end-tidal halothane concentration of 0.7%. The most likely explanation for this difference is
- (A) hyperventilation
- (B) low cardiac output
- (C) the second-gas effect
- (D) tissue solubility of halothane
- (E) vaporizer temperature less than 19°C
After brachial plexus block via an axillary approach, a patient has sensation on the dorsum of the second and third digits and is able to extend the distal phalanx of the thumb. To block the unaffected nerve, anesthetic should be injected at which of the following sites?
- (A) 2 Cm lateral to the biceps tendon at the level of the elbow
- (B) At the radial border of the palmaris longus tendon
- (C) Between the medial epicondyle and the olecranon
- (D) Between the radial artery and the styloid process
- (E) Just medial to the brachial artery at the elbow
A patient is undergoing thoracotomy in the lateral position. Five minutes after initiation of one-lung ventilation using a double-lumen tube and 100% oxygen, SpO2 decreases from 100% to 65%. Which of the following is the most appropriate initial step in management?
- (A) Adding continuous positive airway pressure to the nondependent lung
- (B) Adding positive end-expiratory pressure to the dependent lung
- (C) Increasing the tidal volume to the dependent lung
- (D) Resuming two-lung ventilation
- (E) Verifying the position of the double-lumen tube
A 40-year-old woman has continuous nondermatomal burning pain of the distal foot four weeks after sustaining a metatarsal fracture. On examination, the foot is mildly swollen, tender, and cool. Which of the following statements concerning this condition is true?
- (A) A radiograph of the distal bones of the painful foot will show severe osteoporosis
- (B) A technetium scan of the distal joints of the painful foot will show decreased uptake
- (C) Early use of opioid analgesia will prevent progression of the symptoms
- (D) Intravenous phentolamine will relieve the pain
- (E) The chance of spontaneous recovery within eight weeks is greater than 80%
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
Carbon dioxide retention first occurs when the ratio of forced expiratory volume in 1 second to vital capacity (FEV1/VC) decreases below
- (A) 15%
- (B) 35%
- (C) 50%
- (D) 65%
- (E) 75%