10 Random Questions
A patient with end-stage renal disease has prolonged ventilatory depression after administration of morphine. The most likely cause is increased
- (A) serum concentration of morphine-6-glucuronide
- (B) elimination half-life of morphine
- (C) opioid receptors
- (D) receptor affinity
- (E) volume of distribution
Which of the following statements concerning opioid dependence in anesthesiologists is true?
- (A) Mortality rate is high
- (B) Deterioration of professional performance is an early sign
- (C) Nalbuphine suppresses signs of withdrawal
- (D) Naltrexone prevents relapse
- (E) Sufentanil is detected by urine screening
An arterial blood sample is obtained from a patient undergoing hypothermic cardiopulmonary bypass at 28 C. Analysis at 37 C shows a pH of 7.40 and PaCO2 of 40 mmHg. Which of the following values are most likely if the analysis is corrected to 28 C?
- (A) pH = 7.40; PaCO2 = 40
- (B) pH > 7.40; PaCO2 < 40
- (C) pH > 7.40; PaCO2 > 40
- (D) pH < 7.40; PaCO2 < 40
- (E) pH < 7.40; PaCO2 > 40
The primary mechanism for pharmacologic reduction of intraoperative blood loss is
- (A) decreased blood viscosity
- (B) decreased cardiac output
- (C) decreased venous return
- (D) direct myocardial depression
- (E) hypotension
A 68-year-old man has signs of a coagulopathy after receiving 10 units of packed erythrocytes during emergency repair of a leaking abdominal aortic aneurysm. The most likely cause is
- (A) depletion of factor V
- (B) disseminated intravascular coagulation
- (C) hypothermia
- (D) platelet dysfunction
- (E) thrombocytopenia
A 64-year-old man is scheduled to have an elective right colon resection under nitrous oxide, oxygen, enflurane anesthesia. Following a myocardial infarction two years ago, a programmable VVI pacemaker was inserted for complete heart block. A pre induction rhythm strip is shown. Based on this EKG finding, the most appropriate action is to
- (A) proceed with induction of anesthesia
- (B) convert the pacemaker to the fixed rate mode
- (C) reprogram the pacemaker to increase R-wave sensitivity
- (D) increase the pacemaker current outpu
- (E) insert a temporary atrioventricular sequential pacemaker
A patient with chronic paraplegia (T4 level) is undergoing cystoscopy and removal of bladder calculi without anesthesia. After 10 minutes, blood pressure is 240/100 mmHg and pulse is 50 bpm. The most appropriate management is administration of
- (A) spinal anesthesia
- (B) inhalational anesthesia
- (C) thiopental intravenously
- (D) methyldopa intravenously
- (E) nitroprusside intravenously
In clinical anesthesia practice, the term "informed consent" is best described as a legal concept in which patients
- (A) agree to anesthesia care based on full disclosure of facts needed to make the decision intelligently
- (B) are told of all possible risks of anesthesia and anesthetic procedures
- (C) delegate all decisions regarding anesthesia care to the anesthesiologist
- (D) release the physicians from liability
- (E) sign global consent forms for surgical procedures that cover the administration of anesthesia care
Compared with an induction dose of thiopental (4 mg/kg), an induction dose of propofol (2.5 mg/kg) produces
- (A) better maintenance of cerebral perfusion pressure
- (B) greater inhibition of glucocorticoid production
- (C) higher incidence of myoclonus
- (D) less severe hypotension
- (E) less severe respiratory depression
A successful ankle block for transmetatarsal amputation of the first and second toes should include each of the following nerves EXCEPT the
- (A) saphenous
- (B) deep peroneal
- (C) superficial peroneal
- (D) sural
- (E) tibial