10 Random Questions
Left ventricular subendocardial perfusion pressure is best estimated by the difference between
- (A) mean arterial and central venous pressures
- (B) diastolic arterial and pulmonary artery occlusion pressures
- (C) mean arterial and pulmonary artery occlusion pressures
- (D) systolic arterial and pulmonary artery occlusion pressures
- (E) diastolic arterial and central venous pressures
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
Which of the following statements concerning myasthenia gravis is true?
- (A) Neostigmine is inappropriate for antagonism of neuromuscular blockade
- (B) The number of acetylcholine receptors is decreased
- (C) Plasma cholinesterase concentration is decreased
- (D) The risk for malignant hyperthermia is increased
- (E) Succinylcholine is contraindicated
A 45-year-old man with chronic liver failure is scheduled for liver transplantation. Which of the following preoperative findings is most likely?
- (A) Hypoxemia
- (B) Increased platelet count
- (C) Increased systemic vascular resistance
- (D) Increased serum factor VIII concentration
- (E) Metabolic alkalosis
During rapid-sequence induction prior to an emergency surgical procedure, a 20-year-old patient vomits gastric contents containing particulate matter. An endotracheal tube is easily inserted and ventilation with pure oxygen is initiated. Despite the presence of bilateral breath sounds, SpO2 is 90%. Which of the following is the most appropriate next step?
- (A) Administration of broad-spectrum antibiotics
- (B) Intravenous administration of high-dose methylprednisolone
- (C) Bronchial lavage with normal saline solution
- (D) Bronchoscopy to remove particulate matter
- (E) Cancellation of the surgical procedure
In a patient who is to undergo clipping of a cerebral aneurysm, an advantage of isoflurane over nitroprusside for induction of hypotension is
- (A) better maintenance of cardiac output
- (B) better maintenance of cerebral blood flow
- (C) greater decrease in cerebral oxygen consumption
- (D) greater decrease in afterload
- (E) more rapid titration of systemic blood pressure
Compared with blood anticoagulated with CPD, blood stored in CPDA-1 has
- (A) better preservation of 2,3-DPG concentration
- (B) better preservation of ATP concentration in erythrocytes
- (C) shorter erythrocyte survival
- (D) shorter shelf life
- (E) decreased platelet aggregation
A 66-year-old man with chronic obstructive pulmonary disease who underwent colectomy 12 hours ago has been receiving an epidural infusion of fentanyl at a rate of 100 mcg/hr. Which of the following is LEAST likely to develop?
- (A) Hypotension
- (B) Nausea
- (C) Pruritus
- (D) Respiratory depression
- (E) Urinary retention
After termination of cardiopulmonary bypass, a patient who is chronically digitalized receives digoxin 0.5 mg in error. An ECG shows sinus bradycardia with intermittent sinus arrest; blood pressure is 90/60 mmHg. Which of the following drugs is contraiindicated in this patient?
- (A) Atropine
- (B) Calcium chloride
- (C) Ephedrine
- (D) Magnesium sulfate
- (E) Phenylephrine
A 45-year-old man is scheduled for appendectomy under general anesthesia. He reports that for many years he has occasionally felt his heart "skip a beat." The ECG tracing shown was obtained one hour ago. Which of the following is the most appropriate next step?
- (A) Proceeding with induction of anesthesia
- (B) Administration of a loading dose of digoxin
- (C) Carotid sinus massage
- (D) Intravenous administration of atropine
- (E) Placement of a temporary pacemaker