10 Random Questions
During active labor, 10 ml of bupivacaine 0.5% with epinephrine 1:200,000 is administered epidurally. Fifteen minutes later, maternal blood pressure is 70/50 mmHg and heart rate is 70 bpm; fetal heart rate is 90 bpm for 45 seconds, with loss of beat-to-beat variability. The most likely explanation for the fetal vital signs is
- (A) fetal bupivacaine cardiotoxicity
- (B) maternal bupivacaine cardiotoxicity
- (C) maternal hypotension
- (D) uterine artery vasoconstriction
- (E) umbilical cord compression
Following induction of anesthesia with sufentanil and pancuronium, a patient with left main coronary artery disease has a decrease in blood pressure from 110/70 to 60/40 mmHg. There is no change in heart rate or ECG. The most appropriate management of the hypotension is administration of
- (A) calcium chloride
- (B) ephedrine
- (C) epinephrine
- (D) isoproterenol
- (E) phenylephrine
A moderately obese 38-year-old woman is using patient-controlled morphine analgesia one day after open cholecystectomy. While breathing room air, oxygen saturation is 85%, Pa02 is 48 mmHg, PaC02 is 42 mmHg, and pH is 7.36. In addition to administration of oxygen, the most effective management is to
- (A) decrease the dosage of opioids
- (B) change to epidural morphine
- (C) administer an inhaled bronchodilator
- (D) initiate 4 cm of nasal continuous positive airway pressure
- (E) initiate incentive spirometry therapy
Which of the following is greater in an obese patient than in a nonobese patient of equal height?
- (A) Milliliters of local anesthetic required for epidural block
- (B) Milligrams of succinylcholine required for intubation
- (C) Clearance of diazepam
- (D) Clearance of fentanyl
- (E) Oxygen consumption per body surface area
Compared with the adult airway, the airway of an infant is characterized by
- (A) greater narrowing at the cricoid ring
- (B) a less rigid epiglottis
- (C) a more caudad laryngeal opening
- (D) a relatively smaller tongue
- (E) relatively larger tonsils
A 60-kg 25-year-old woman is undergoing laparoscopy in the Trendelenburg position during general anesthesia. Five minutes after peritoneal inflation, the peak airway pressure required to deliver a tidal volume of 800 ml increases from 25 cmH2O to 60 cmH2O. SpO2 decreases from 100% to 80% and systolic blood pressure increases from 110 mmHg to 140 mmHg. Which of the following is the most likely cause?
- (A) Acute tension pneumothorax
- (B) Excessively steep Trendelenburg position
- (C) Excessive ventilator tidal volume setting
- (D) Kink in the endotracheal tube
- (E) Massive carbon dioxide embolism
Which of the following statements regarding latex allergy is true?
- (A) Diphenhydramine is the treatment of choice for latex-induced anaphylactic reaction
- (B) Hospital workers are at equal risk as the general population
- (C) It is more common in patients with frequent urethral catheterizations
- (D) Latex gloves can be rinsed free of antigens
- (E) Skin testing should be performed immediately after an acute reaction in the operating room
The arterial waveform and EKG shown are from a 60-year-old man with uremia who is the PACU after hip surgery under general anesthesia. The patient is drowsy, extubated, and breathing easily. The most likely diagnosis is
- (A) hypovolemia
- (B) myocardial ischemia
- (C) nontension pneumothorax
- (D) pericardial tamponade
- (E) pulmonary embolus
Which of the following is most likely to occur during deliberate hypotension with trimethaphan?
- (A) Bronchoconstriction
- (B) Cerebral vasodilation
- (C) Increased heart rate
- (D) Potentiation of pancuronium
- (E) Pupillary constriction
Which of the following statements regarding innervation of the upper extremity is true?
- (A) Blockade of the radial nerve decreases the patient's ability to spread the fingers apart
- (B) The brachial plexus receives preganglionic sympathetic fibers arising from C5 through T2
- (C) Interscalene injection of the brachial plexus at C6 is likely to spare the axillary nerve.
- (D) The musculocutaneous nerves receive contributions from C5 and C6
- (E) The vertebral artery lies posterior to the nerve roots of the brachial plexus