10 Random Questions
The flow-volume loop shown is most likely from a patient with which of the following?
- (A) Bilateral vocal cord paralysis
- (B) Chronic bronchitis
- (C) Tracheal stenosis six months after a previous tracheostomy
- (D) Tumor of the lower trachea
- (E) Normal respiratory status
Patients with acute alcohol intoxication are at increased risk for each of the following complications of general anesthesia EXCEPT
- (A) aspiration of gastric contents
- (B) hyperglycemia
- (C) hypothermia
- (D) ketoacidosis
- (E) respiratory depression
Anesthesia is induced with halothane in a 3-year-old girl. Sixty seconds after administration of succinylcholine 1 mg/kg intravenously, heart rate decreases rapidly from 120 to 60 bpm. The most likely cause is
- (A) acute hyperkalemia
- (B) failure to pretreat with a nondepolarizing relaxant
- (C) halothane overdose
- (D) muscarinic activity
- (E) sympathetic ganglionic blockade
A 20-kg, 5-year-old boy under treatment for five days for a cerebral contusion not requiring an operation is still unconscious. After three days of mechanical ventilation, humidified oxygen 40% via T-tube is started. Arterial blood gas analysis shows PaO2 120 mmHg, PaCO2 44 mmHg, pH 7.48, and base excess +6. A nasogastric tube is in place and draining to gravity. Daily fluid therapy has been 5% dextrose in 0.5 normal saline solution 500 ml and 5% dextrose in lactated Ringer's solution 500 ml. Serum electrolyte concentrations are sodium 140, potassium 3.2, and chloride 91 mEq/L. Serum osmolality is 300 mOsm/L. Urine output averages 15 ml/hour. Dexamethasone 8 mg/day has been the only drug therapy. This patient most likely requires
- (A) additional intravenous fluids
- (B) furosemide diuresis
- (C) administration of ammonium chloride
- (D) reinstitution of mechanical ventilation
- (E) administration of potassium chloride
Six months after repair of a lacerated peroneal nerve, a patient has electric-shock-like pain when pressure is applied to the middle of the gastrocnemius muscle. The most appropriate initial management is
- (A) administration of carbamazepine
- (B) epidural injection of morphine
- (C) local infiltration with bupivacaine
- (D) lumbar sympathetic blockade
- (E) peroneal nerve blockade
The most common clinical viral infection following homologous blood transfusion is caused by
- (A) cytomegalovirus
- (B) Epstein-Barr virus
- (C) hepatitis B virus
- (D) human immunodeficiency virus
- (E) non-A, non-B hepatitis virus
Which of the following statements concerning carbon monoxide poisoning is true? A 38-year-old woman with a large goiter has undergone subtotal thyroidectomy. Airway obstruction is noted immediately after extubation despite normal vocal cord function on laryngoscopy. Which of the following is the most likely explanation?
- (A) Arytenoid dislocation
- (B) Hematoma
- (C) Hypocalcemia
- (D) Recurrent laryngeal nerve injury
- (E) Tracheomalacia
During a reoperative total hip arthroplasty requiring transfusion of 8 units of packed red blood cells, blood begins to ooze from the operative field and intravenous catheter sites. Urine is pink. The most likely cause is
- (A) citrate intoxication
- (B) factor V and VIII deficiencies
- (C) rhabdomyolysis
- (D) thrombocytopenia
- (E) transfusion reaction
Which of the following increases during infusion of epinephrine?
- (A) Glycogen synthesis
- (B) Intracellular glucose concentration
- (C) Intracellular potassium concentration
- (D) Lipogenesis
- (E) Protein synthesis
A patient receiving monoamine oxidase inhibitor therapy for depression undergoes an emergency cholecystectomy. Which of the following is the best means of providing postoperative analgesia in this patient?
- (A) Epidural analgesia using 0.25% bupivacaine
- (B) Intravenous meperidine
- (C) Epidural analgesia using meperidine
- (D) Epidural analgesia using 1% lidocaine with epinephrine
- (E) Intercostal analgesia using 1% lidocaine with epinephrine