10 Random Questions
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
A 70-kg, 47-year-old man is undergoing a repeat coronary artery bypass graft. Following sternotomy, administration of heparin 300 units/kg for anticoagulation increases the activated coagulation time from a baseline of 135 sec to 210 sec. This finding is compatible with
- (A) antithrombin III deficiency
- (B) heparin-induced thrombocytopenia
- (C) normal response to this dose of heparin
- (D) increased sensitivity to heparin
- (E) von Willebrand's disease
During laparotomy for a ruptured spleen, unexplained oozing occurs after infusion of 2 liters of crystalloid and 3 units of blood. The most likely cause is
- (A) citrate toxicity
- (B) dilutional thrombocytopenia
- (C) hemolytic transfusion reaction
- (D) labile clotting factor deficiency
- (E) leukoagglutinin reaction
When used for irrigation during transurethral resection of the prostate, glycine 1.5% is associated with each of the following EXCEPT
- (A) hemolysis
- (B) hyperammonemia
- (C) cerebral edema
- (D) hypofibrinogencmia
- (E) visual disturbances
A 45-year-old man with chronic liver failure is scheduled for liver transplantation. Which of the following preoperative findings is most likely?
- (A) Hypoxemia
- (B) Increased platelet count
- (C) Increased systemic vascular resistance
- (D) Increased serum factor VIII concentration
- (E) Metabolic alkalosis
An increased initial dose and a decreased maintenance dose of pancuronium are required in patients with
- (A) advanced age
- (B) burns
- (C) cirrhosis
- (D) chronic renal failure
- (E) fever
A 68-year-old woman who is receiving urokinase for deep venous thrombosis and pulmonary emboli requires emergency laparotomy for a bleeding gastric ulcer. Which of the following agents is most appropriate to reverse the effects of urokinase?
- (A) Cryoprecipitate
- (B) Factor VIII concentrate
- (C) Fresh frozen plasma
- (D) Platelets
- (E) Vitamin K
A patient who is receiving ventilatory support after coronary artery bypass grafting has a PaO2 of 132 mmHg, a PaCO2 of 19 mmHg, and a pH of 7.57. Which of the following is most likely to result from this level of hypocarbia?
- (A) Decreased airway resistance
- (B) Increased myocardial contractility
- (C) Hyperkalemia
- (D) Shortened QT interval
- (E) Cerebral ischemia
Which of the following remains normal in an otherwise healthy patient with obesity?
- (A) Alveolar PO2
- (B) Expiratory reserve volume
- (C) Functional residual capacity
- (D) Lung compliance
- (E) Static lung volumes
A 30-year-old woman undergoes thyroidectomy under general endotracheal anesthesia. Immediately after extubation while breathing spontaneously, she has laryngospasm that resolves after 60 seconds of continuous positive airway pressure applied by face mask. In the PACU, she develops shortness of breath, tachypnea, hypoxemia, and rales. Which of the following is the most likely diagnosis?
- (A) Gastric acid aspiration
- (B) Myocardial infarction
- (C) Pulmonary edema
- (D) Pulmonary embolism
- (E) Vocal cord paralysis