10 Random Questions
To detect the delivery of a hypoxic gas mixture, the optimal location for an oxygen analyzer in this circle is
- (A) 1
- (B) 2
- (C) 3
- (D) 4
- (E) 5
Fetal distress is noted after administration of an epidural local anesthetic during labor. Fetal scalp pH is 7.0. Compared with a fetus with a scalp pH of 7.3, in this fetus the local anesthetic is present in
- (A) a higher concentration, with a larger fraction in the ionized form
- (B) a higher concentration, with a larger fraction in the unionized form
- (C) the same concentration, with a larger fraction in the ionized form
- (D) the same concentration, with a larger fraction in the unionized form
- (E) a lower concentration, with a larger fraction in the ionized form
A healthy 57-year-old man with a ureteral calculus is scheduled for immersion extracorporeal shock wave lithotripsy. Which of the following statements is true?
- (A) Delivery of the shock wave is timed by the R wave of the ECG
- (B) Continuous epidural anesthesia is contraindicated because of the risk for infection
- (C) If a regional technique is used, a T10 sensory level is required for adequate anesthesia
- (D) If general anesthesia is used, high tidal volumes and low respiratory rate are preferred
- (E) Removal of the patient from the bath is accompanied by an increase in blood pressure
Which of the following pre-existing conditions predisposes to new-onset third-degree heart block during pulmonary artery catheterization?
- (A) First-degree heart block
- (B) Left bundle branch block
- (C) Sick sinus syndrome
- (D) Sinus bradycardia
- (E) Wenckebach second-degree heart block
A 67-year-old man is undergoing total hip replacement under general anesthesia. He had a permanent endocardial VVI pacemaker placed two years ago for complete heart block, and since arrival in the operating room has been paced continuously. Use of the electrocautery causes the pacemaker to malfunction intermittently. The most appropriate management is to
- (A) tape a magnet over the pacemaker generator and convert to asynchronous mode
- (B) do nothing since the pacemaker is programmed to deal with this circumstance
- (C) stop the surgeon from using the electrocautery
- (D) limit the surgeon to 10 sec/min electrocautery bursts
- (E) place the electrocautery indifferent lead as close as possible to the pacemaker
Metoclopramide acts to
- (A) block dopamine receptors
- (B) decrease gastric acid production
- (C) decrease lower esophageal sphincter tone
- (D) delay gastric emptying
- (E) facilitate central cholinergic stimulation
Which of the following interventions is most effective in preventing neurologic injury resulting from global cerebral ischemia?
- (A) Induction of barbiturate coma prior to ischemia
- (B) Maintenance of serum glucose concentration greater than 200 mg/dl prior to ischemia
- (C) Induction of hypothermia to a core temperature of 15 degrees C prior to ischemia
- (D) Maintenance of PaCO2 less than 25 mmHg following ischemia
- (E) Prevention of systemic hypertension following ischemia
A patient receives an emergency transfusion of three units of O, Rh-negative blood for profuse hemorrhaging. If his blood type is AB, Rh-negative, which of the following is most appropriate for continuing transfusion?
- (A) AB, Rh-negative whole blood
- (B) B, Rh-negative whole blood
- (C) O, Rh-negative whole blood
- (D) A, Rh-negative erythrocytes
- (E) O, Rh-negative erythrocytes
Following a thyroidectomy, a patient develops severe dyspnea, inspiratory stridor, and cyanosis in the recovery room. On physical examination, the neck appears full. Attempts at bag-mask ventilation are unsuccessful. Immediate therapy is to
- (A) administer calcium chloride
- (B) perform an emergency tracheostomy
- (C) open the wound and institute bag-mask ventilation
- (D) return the patient to the operating room
- (E) perform endotracheal intubation
A 30-year-old woman has difficulty talking 15 minutes after initiation of interscalene block for closed reduction of a dislocated shoulder. The most likely cause is
- (A) cervical sympathetic block
- (B) delayed systemic toxic reaction
- (C) phrenic nerve paralysis
- (D) pneumothorax
- (E) recurrent laryngeal nerve block