10 Random Questions
In the diagram, point "X" represents a patient with severe left ventricular dysfunction. The points labeled 1, 2, and 3 each represent the results of a different therapeutic intervention. Which of the following represents the most likely intervention at each point?
- (A) 1-Dopamine, 2-Furosemide, 3-Nitroprusside
- (B) 1-Dopamine, 2-Nitroprusside, 3-Furosemide
- (C) 1-Furosemide, 2-Dopamine, 3-Nitroprusside
- (D) 1-Nitroprusside, 2-Dopamine, 3-Furosemide
- (E) 1-Nitroprusside, 2-Furosemide, 3-Dopamine
Which of the following laboratory studies is the best indicator of reversal of the effects of warfarin?
- (A) Activated clotting time
- (B) Activated partial thromboplastin time
- (C) Bleeding time
- (D) Plasma fibrinogen concentration
- (E) Prothrombin time
Which of the following findings is characteristic of whole blood preserved in CPD and stored at 4°C for one week?
- (A) Increased potassium concentration
- (B) Normal concentrations of factors V and VIII
- (C) PaCO2 of 40 mmHg
- (D) pH of 7.3
- (E) 50% Viable platelets
Peak airway pressure increases from 25 to 50 cmH2O when beginning right endobronchial ventilation with a right double-lumen tube. The most likely explanation for this increase is
- (A) failure to decrease tidal volume
- (B) inadvertent intubation of the left mainstem bronchus
- (C) intrinsic resistance of small endobronchial lumina
- (D) obstruction of the orifice of the right upper lobe
- (E) overinflation of the bronchial tube cuff
Which of the following statements concerning cerebral vasospasm following intracranial hemorrhage is true?
- (A) It is accompanied by paradoxical intracranial hypotension
- (B) It responds to nitroprusside therapy
- (C) It persists more than 48 hours after hemorrhage
- (D) It is exacerbated by intravascular volume expansion
- (E) It is confirmed by ST-T wave changes in the absence of myocardial ischemia
A 58-year-old man undergoes repeat coronary artery bypass grafting. Which of the following is LEAST likely to decrease the need for exogenous blood transfusion?
- (A) Cell saver blood collection before and after cardiopulmonary bypass
- (B) Epsilon-aminocaproic acid administered during cardiopulmonary bypass
- (C) High-dose aprotinin administered during cardiopulmonary bypass
- (D) Tranexamic acid infusion during cardiopulmonary bypass
- (E) Desmospressin administered after cardiopulmonary bypass
A 69-year-old woman with mitral stenosis and atrial fibrillation is scheduled for mitral valve replacement and removal of a left atrial thrombus. After administration of pancuronium, heart rate increases to 140 bpm and blood pressure decreases to 70/40 mmHg. Which of the following is the LEAST appropriate treatment?
- (A) Cardioversion
- (B) Edrophonium
- (C) Esmolol
- (D) Phenylephrine
- (E) Verapamil
A 16-year-old patient who sustained trauma is being resuscitated. In deciding whether to infuse lactated Ringer's solution or albumin, which of the following is true?
- (A) At one hour, both will remain in the intravascular compartment to an equal extent
- (B) Both have zero risk for hepatitis transmission
- (C) Both will decrease ionized calcium levels
- (D) The glomerular filtration rate will be higher with infusion of albumin
- (E) Lactated Ringer's solution causes a greater increase in intracranial pressure
Diffuse microvascular bleeding is noted in a patient who has received 25 units of whole blood for a liver resection. Platelet count is 40,000/mm3, prothrombin time is 18 sec, activated partial thromboplastin time is 54 sec, and serum fibrinogen concentration is 60 mg/dl. The most likely cause of the bleeding is
- (A) abnormal platelet function
- (B) citrate toxicity
- (C) depressed levels of factors V and VIII
- (D) dilutional thrombocytopenia
- (E) disseminated intravascular coagulation
One hour after an open cholecystectomy, a 42-year-old patient is hemodynamically stable and breathing spontaneously (rate 10/min and regular) at an FiO2 of 0.4. Fentanyl, isoflurane, nitrous oxide, and pancuronium were used during the procedure. Analysis of arterial blood gases (pH, pCO2, pO2) is most likely to show:
- (A) 7.18 40 100
- (B) 7.18 60 140
- (C) 7.28 50 85
- (D) 7.40 26 220
- (E) 7.40 40 40