10 Random Questions
A 26-year-old man is in the ICU one hour after sustaining a displaced cervical fracture at the level of C7-8 in a diving accident. Each of the following findings is consistent with this patient's injury EXCEPT
- (A) bilateral paralysis of the vocal cord adductors
- (B) gastric dilatation
- (C) hypotension without tachycardia
- (D) inward movement of the chest with inspiration
- (E) normal tidal volume
Which of the following would be most likely to increase the duration of seizures during electroconvulsive therapy using a barbiturate and succinyleholine for general anesthesia?
- (A) Administration of atropine prior to therapy
- (B) Changing to a benzodiazepine for induction
- (C) Changing to etomidate for induction
- (D) Adding phenytoin to preoperative medications
- (E) Decreasing the dose of barbiturate used for induction
Which of the following statements concerning brain stem auditory evoked responses is true?
- (A) They monitor cortical function
- (B) They are not affected by changes in carbon dioxide tension
- (C) They are not affected by mild hypothermia (34°C)
- (D) They are more resistant to anesthetic effects than somatosensory evoked responses
- (E) They are abolished coincident with flattening of the EEG
A patient is undergoing a craniotomy in the sitting position. Mean arterial pressure measures 80 mmHg from a radial artery catheter located 27 cm below the right atrium and a transducer located, zeroed, and calibrated at the level of the right atrium. The circle of Willis is 27 cm above the right atrium. Intracranial pressure is 0 cmH20 and right atrial pressure is 5 cmH20. The cerebral perfusion pressure in mmHg is
- (A) 75
- (B) 60
- (C) 53
- (D) 48
- (E) 26
Which of the following factors will slow the induction of anesthesia in patients receiving volatile anesthetics?
- (A) Addition of 70% nitrous oxide
- (B) Increased cardiac output
- (C) Increased minute ventilation
- (D) Low blood/gas solubility coefficient
- (E) Previous pneumonectomy
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
Following induction of general anesthesia, mask ventilation and the initial attempt at intubation is unsuccessful. Which of the following procedures is most appropriate?
- (A) Administration of additional muscle relaxant
- (B) Repeat attempt at intubation
- (C) Fiberoptic intubation
- (D) Retrograde intubation
- (E) Cricothyroidotomy
A multi-orifices right heart catheter is being positioned by EKG control prior to sitting craniotomy. The EKG tracing is obtained between the distal tip of the catheter and the right arm lead. The most appropriate next step is to
- (A) leave the catheter in place
- (B) advance the catheter 2 to 3 cm
- (C) withdraw the catheter 2 to 3 cm
- (D) remove the catheter completely
- (E) change polarity of the EKG
In an unpremedicated, spontaneously breathing patient, an alveolar halothane concentration of 0.74% in oxygen is consistently associated with
- (A) absence of overt response to skin incision
- (B) constricted pupils
- (C) flaccidity of abdominal muscles
- (D) normal glomerular filtration rate
- (E) normal myocardial contractility
The most beneficial effect of continuous positive airway pressure in a newborn with respiratory distress syndrome is
- (A) increased functional residual capacity
- (B) decreased airway resistance
- (C) promotion of surfactant formation
- (D) increased alveolar PO2
- (E) maintenance of functional closure of the foramen ovale