10 Random Questions
Which of the following neurophysiologic monitoring modalities is LEAST affected by administration of volatile anesthetic agents?
- (A) Brain stem auditory evoked potentials
- (B) Electroencephalogram
- (C) Motor evoked potentials
- (D) Somatosensory evoked potentials
- (E) Visual evoked potentials
In a patient with aortic stenosis, myocardial ischemia following endotracheal intubation is most likely to result if there is an Increase in
- (A) heart rate
- (B) left ventricular end-diastolic pressure
- (C) myocardial contractility
- (D) pulmonary vascular resistance
- (E) systemic vascular resistance
A 62-year-old man, who had a myocardial infarction three years ago, complicated by congestive heart failure and renal failure, is undergoing a colectomy. A pulmonary artery catheter demonstrates a cardiac output higher than measurements recorded during a cardiac catheterization two months after the infarction. Which of the following most likely contributes to the increased cardiac output?
- (A) Creation of an arteriovenous fistula
- (B) Increased hemoglobin concentration from 10 to 12 g/dL
- (C) Stimulation of carotid body receptors
- (D) Transcutaneous nitroglycerin
- (E) Use of a beta-adrenergic blocker to prevent myocardial reinfarction
A 2-year-old child has cardiac arrest during an inguinal herniorrhaphy under general anesthesia administered during a Jackson-Rees system. The graph shows end-tidal PCO2 monitored from the tip of the endotracheal tube during cardiopulmonary resuscitation; minute ventilation is unchanged. Which of the following is the most likely cause of the change beginning at the arrow?
- (A) Decreased fresh gas flow
- (B) Inadequate chest compression
- (C) Increased dead space
- (D) Restoration of cardiac output
- (E) Sampling artifact
A healthy, spontaneously breathing, supine, anesthetized patient has a PaCO2 to PetCO2 difference of 3 mmHg. Following institution of mechanical ventilation the value increases to 12 mmHg. The most likely cause of this change is
- (A) cephalad displacement of the diaphragm
- (B) decreased production of carbon dioxide
- (C) increased cardiac output
- (D) increased shunting of blood through dependent lung zones
- (E) increased ventilation of nondependent lung zones
Which of the following statements concerning the innervation of the larynx is true?
- (A) The glossopharyngeal nerve provides motor innervation to the vocal cords
- (B) The recurrent laryngeal nerve provides sensory innervation to the mucosa of the larynx above the vocal cords
- (C) The hypoglossal nerve provides sensory innervation to the aryepiglottic folds
- (D) Unilateral recurrent laryngeal nerve injury results in an abducted vocal cord on the injured side
- (E) The vagus nerve provides innervation to all structures below the vocal cords
A 70-kg patient experiences pain on incision of a thigh abscess. The area around the abscess had been infiltrated with 30 ml of 1% lidocaine in 1:200,000 epinephrine. The local anesthetic was most likely ineffective because of
- (A) acidosis at the site of the injection
- (B) epinephrine-induced limitation of drug diffusion
- (C) insufficient dose
- (D) low ionization of lidocaine
- (E) protein binding of lidocaine
During cardiopulmonary bypass at a nasopharyngeal temperature of 28°C and a hematocrit of 20%, temperature-corrected PaCO2 is 50 mmHg and uncorrected PaCO2 is 60 mmHg. The most appropriate management is to
- (A) administer additional opioid
- (B) administer packed red blood cells to increase hematocrit to 25%
- (C) further decrease the patient's temperature
- (D) increase fresh gas flow to the oxygenator
- (E) institute mechanical ventilation
A direct 5-joule shock is unsuccessful in converting ventricular fibrillation occurring after discontinuation of cardiopulmonary bypass. The most appropriate next step is to
- (A) administer calcium chloride
- (B) administer bretylium
- (C) administer regular insulin
- (D) administer sodium bicarbonate
- (E) increase shock energy
If both recurrent laryngeal nerves were severed during a difficult thyroidectomy for cancer, the most likely finding would be
- {A) paralysis of the cricothyroid muscles
- (B) cadaveric positioning of the true vocal cords
- (C) anesthesia of both sides of the epiglottis
- (D) bilateral pure adductor vocal cord paralysis
- (E) stridor