10 Random Questions
A patient who is scheduled for a parathyroidectomy for a parathyroid adenoma has a preoperative serum calcium concentration of 13.5 mg/dl. The ECG shows no acute changes. The most appropriate preoperative management is administration of
- (A) calcitonin
- (B) hydrocortisone
- (C) intravenous saline solution
- (D) mannitol
- (E) potassium phosphate
An otherwise healthy 70-year-old man receives 12 units of packed red blood cells for persistent diffuse bleeding during suprapubic prostatectomy. Hemoglobin concentration is 11 g/dL, platelet count is 55,000/mm3, plasma fibrinogen concentration is 180 mg/dL, protime is 14 sec, and partial thromboplastin time is 35 sec. The most appropriate therapy is administration of
- (A) cryoprecipitate
- (B) desmopressin (DDAVP)
- (C) epsilon-aminocaproic acid
- (D) fresh frozen plasma
- (E) platelets
A 65-year-old man has a history of alcohol abuse. Which of the following preoperative serum concentrations would provide the best assessment of synthetic hepatic function?
- (A) Albumin
- (B) Alkaline phosphatase
- (C) Bilirubin
- (D) Globulin
- (E) Transaminases
A 72-year-old man has massive venous hemorrhage during a radical prostatectomy. Blood pressure decreases from 110/60 to 75/30 mmHg and central venous pressure decreases from 12 to 4 mmHg. PetC02 decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to
- (A) apply positive end-expiratory pressure to the breathing circuit
- (B) attempt to aspirate air from the central venous catheter
- (C) expand intravascular volume
- (D) place the patient in the Trendelenburg position
- (E) turn the patient to the left lateral decubitus position
Five minutes after initiating one-lung ventilation using a double-lumen endobronchial tube, a 70-year-old patient has a decrease in Sp02 from 99% to 90%. Tidal volume and respiratory rate are unchanged. Fiberoptic bronchoscopy verifies appropriate positioning of the tube. Which of the following is the most likely cause of the desaturation?
- (A) Blood flow to the nondependent lung
- (B) Failure of hypoxic pulmonary vasoconstriction in the dependent lung
- (C) Inadequate filling of the bronchial cuff
- (D) Inadequate minute ventilation
- (E) Surgical manipulation of the nondependent lung
The vapor pressure of a volatile anesthetic depends on
- (A) temperature only
- (B) ambient pressure only
- (C) temperature and ambient pressure
- (D) pressure and volume of the system
- (E) none of the above
Microatelectasis 48 hours after abdominal surgery is most consistently manifested by
- (A) decreased PaO2
- (B) ground glass infiltrate on a roentgenogram of the chest
- (C) scattered fine inspiratory rales
- (D) increased PaCO2
- (E) scattered areas of dullness to chest percussion
The ECG strip shown is recorded as a patient with a permanent transvenous DDD pacemaker enters the operating room. These changes indicate that the pacemaker is
- (A) sensing the T waves
- (B) sensing the retrograde P waves
- (C) triggering off the intrinsic atrial activity
- (D) malfunctioning in the atrial pacing mechanism
- (E) prematurely stimulating the ventricle
The potency of an inhalational anesthetic correlates best with its
- (A) vapor pressure
- (B) blood/gas partition coefficient
- (C) molar volume
- (D) brain/gas partition coefficient
- (E) oil/gas partition coefficient
A 40-year-old man who is scheduled to undergo repair of a tendon laceration of the left hand has complete anesthesia in the median, radial, and ulnar nerve distributions after supraclavicular block. Two hours of tourniquet inflation are required for completion of the procedure. The most appropriate next step is an additional block of which of the following?
- (A) Axillary nerve
- (B) Intercostobrachial nerve
- (C) Lateral antebrachial cutaneous nerve
- (D) Musculocutaneous nerve
- (E) Stellate ganglion