10 Random Questions
Which of the following statements concerning nalbuphine is true?
- (A) It causes partial reversal of morphine-induced ventilatory depression
- (B) Analgesia is partially mediated by delta receptor agonism
- (C) Its antagonist effects are mediated at kappa receptors
- (D) Duration of action is significantly shorter than that of morphine
- (E) Ventilatory drive is not depressed
Which of the following statements concerning the cardiovascular effects of intravenous bupivacaine is true?
- (A) Intralipid is effective in treating bupivacaine-induced ventricular arrhythmias
- (B) Cardiovascular toxicity is decreased during pregnancy
- (C) Cardiovascular toxicity occurs at lower blood levels than central nervous system toxicity
- (D) Systemic vascular resistance is unchanged
- (E) The rate of impulse conduction through the heart is increased
A healthy 57-year-old man with a ureteral calculus is scheduled for immersion extracorporeal shock wave lithotripsy. Which of the following statements is true?
- (A) Delivery of the shock wave is timed by the R wave of the ECG
- (B) Continuous epidural anesthesia is contraindicated because of the risk for infection
- (C) If a regional technique is used, a T10 sensory level is required for adequate anesthesia
- (D) If general anesthesia is used, high tidal volumes and low respiratory rate are preferred
- (E) Removal of the patient from the bath is accompanied by an increase in blood pressure
The arterial waveform and EKG shown are from a 60-year-old man with uremia who is the PACU after hip surgery under general anesthesia. The patient is drowsy, extubated, and breathing easily. The most likely diagnosis is
- (A) hypovolemia
- (B) myocardial ischemia
- (C) nontension pneumothorax
- (D) pericardial tamponade
- (E) pulmonary embolus
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
The best indication that a patient is ready for discharge from an outpatient facility after spinal anesthesia is return of
- (A) pinprick sensation to the S4-5 dermatome
- (B) micturition
- (C) plantar flexion
- (D) proprioception of the big toe
- (E) knee extension
A 24-year-old woman with abruptio placentae at 38 weeks' gestation has bleeding at the site of the intravenous catheter. Which of the following is the most likely cause?
- (A) Diffuse vasculitis
- (B) Disseminated intravascular coagulation
- (C) Isolated factor VIII deficiency
- (D) Primary fibrinolysis
- (E) Vitamin K deficiency
When using apneic oxygenation during endoscopy in a normothermic patient, PaC02
- (A) increases at a rate inversely proportional to oxygen flow rate
- (B) increases at a rate of 8 + 0.5 mmHg per minute
- (C) increases at the same rate that Pa02 decreases
- (D) equals mixed venous PC02 after one minute
- (E) is increased by airway obstruction
The physiologic function most likely to be spared when a local anesthetic differential nerve block is administered is
- (A) sweating
- (B) temperature sensation
- (C) proprioception
- (D) touch sensation
- (E) pain sensation
A 50-year-old woman notes loss of sensation in the medial lower leg 24 hours after vaginal hysterectomy in the lithotomy position. Which of the following nerves is most likely to be injured?
- (A) Lateral femoral cutaneous
- (B) Obturator
- (C) Peroneal
- (D) Saphenous
- (E) Tibial