10 Random Questions
A comatose 40-year-old man is to undergo evacuation of an acute subdural hematoma. His left pupil is dilated and blood is present behind the left tympanic membrane. Each of the following is an acceptable intervention EXCEPT
- (A) application of 5 cm H20 positive end-expiratory pressure
- (B) blind nasotracheal intubation
- (C) use of isoflurane
- (D) use of nitrous oxide
- (E) use of succinylcholine
To detect the delivery of a hypoxic gas mixture, the optimal location for an oxygen analyzer in this circle is
- (A) 1
- (B) 2
- (C) 3
- (D) 4
- (E) 5
Which of the following drugs best facilitates management of cerebral vasospasm after subarachnoid hemorrhage?
- (A) Nifedipine
- (B) Nimodipine
- (C) Nitroglycerin
- (D) Nitroprusside
- (E) Thiopental
Electrocautery units operate at frequencies between 300 kHz and 2 mHz to
- (A) avoid pacemaker interference
- (B) minimize ECG tracing interference
- (C) minimize the likelihood of ventricular fibrillation
- (D) optimize hemostasis
- (E) provide the best "cutting" current
Which of the following statements concerning carbon monoxide poisoning is true?
- (A) Diagnosis is excluded if the PaO2 is greater than 300 mmHg while breathing 100% oxygen
- (B) Increased inspired oxygen concentration accelerates displacement of carbon monoxide from hemoglobin
- (C) Methylene blue decreases binding of carbon monoxide to hemoglobin
- (D) Pulse oximetry accurately reflects hemoglobin oxygen saturation
- (E) Tissue oxygen delivery is normal
A 46-year-old man is scheduled for repair of an inguinal hernia. Six years ago, he had an episode of malignant hyperthermia during cholecystectomy. Which of the following is the most appropriate perioperative management?
- (A) Administration of a regional anesthetic
- (B) Administration of dantrolene orally for two days prior to surgery
- (C) Avoidance of all inhalational anesthetics except isoflurane
- (D) Avoidance of ester local anesthetics
- (E) Flushing the anesthesia machine with oxygen 10 L/min for a minimum of 12 hours
During insufflation of the peritoneal cavity with carbon dioxide at the start of laparoscopy, heart rate increases to 140 bpm, blood pressure decreases to 70/40 mmHg, and a loud murmur is heard through the esophageal stethoscope. The most appropriate immediate step is to
- (A) administer a vasoconstrictor
- (B) infuse crystalloid solution rapidly
- (C) discontinue the inhaled anesthetic
- (D) insert a central venous catheter
- (E) deflate the abdomen
Compared with halothane, desflurane has which of the following characteristics?
- (A) Greater potency
- (B) A higher boiling point
- (C) Increased blood solubility
- (D) Less airway irritability
- (E) Less biodegradation
A 2.2-kg, 6-hour-old neonate is to undergo gastrostomy followed by repair of a tracheoesophageal fistula. During induction with halothane, air, and oxygen, the abdomen becomes distended. Appropriate management is to
- (A) intubate and assist spontaneous ventilation
- (B) intubate and control ventilation
- (C) insert an orogastric tube
- (D) allow the patient to breathe spontaneously by mask until gastrostomy
- (E) control ventilation by mask until gastrostomy
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