10 Random Questions
A delay in surgery for 24 to 48 hours for preoperative stabilization and preparation is acceptable in each of the following neonatal conditions EXCEPT
- (A) biliary atresia
- (B) diaphragmatic hernia
- (C) meningomyelocele
- (D) pyloric stenosis
- (E) tracheoesophageal fistula
A 72-year-old man has massive venous hemorrhage during a radical prostatectomy. Blood pressure decreases from 110/60 to 75/30 mmHg and central venous pressure decreases from 12 to 4 mmHg. PetC02 decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to
- (A) apply positive end-expiratory pressure to the breathing circuit
- (B) attempt to aspirate air from the central venous catheter
- (C) expand intravascular volume
- (D) place the patient in the Trendelenburg position
- (E) turn the patient to the left lateral decubitus position
You see a flash of fire from the endotracheal tube of a patient undergoing carbon dioxide laser excision of laryngeal polyps. The immediate response should be to
- (A) discontinue the fresh gas flow
- (B) increase the nitrous oxide concentration
- (C) spray water down the endoscope
- (D) insert wet pads into the pharynx
- (E) remove the endotracheal tube
During general anesthesia with spontaneous ventilation, a patient has a VD/VT of 0.5. Which of the following is most likely to decrease the ratio?
- (A) Acute bronchospasm
- (B) Continuous positive airway pressure
- (C) Decreased tidal volume
- (D) Increased cardiac output
- (E) Pulmonary embolism
A 40-year-old woman receives alfentanil 75 mcg/kg followed by an infusion of 1.5 mcg/kg/min for a one-hour cholecystectomy and cholangiogram. This regimen could be associated with each of the following EXCEPT
- (A) muscle rigidity
- (B) increased biliary tract pressure
- (C) inadequate anesthesia
- (D) postoperative respiratory depression
- (E) two to four hours of postoperative analgesia
Which of the following is characteristic of soda lime and Baralyme carbon dioxide absorption canisters used in circle systems?
- (A) Calcium carbonate is a major end product
- (B) Carbon dioxide absorption cools the anesthetic gases
- (C) Flushing the canister with oxygen for six hours will regenerate 50% of the spent Baralyme
- (D) Gases lose water vapor as they pass through the canisters
- (E) Soda lime and Baralyme depend on silica as a binding agent
A 24-year-old man is undergoing induction of general anesthesia prior to appendectomy. During laryngoscopy, he regurgitates a large amount of bilious material. An endotracheal tube is inserted; aspiration shows bile-stained fluid. Which of the following is the most appropriate next step in management?
- (A) Infusion of a loading dose of aminophylline
- (B) Intravenous administration of broad-spectrum antibiotics
- (C) Lavage of the tracheobronchial tree with saline solution
- (D) Radiograph of the chest
- (E) Proceeding with the operation
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
A patient who is paraplegic secondary to spinal cord transection at T3 develops bradycardia and facial flushing during a nephrectomy under general anesthesia with nitrous oxide, fentanyl, and atracurium. The most likely cause of this response is
- (A) release of histamine
- (B) stimulation of the carotid sinus
- (C) release of prostaglandins
- (D) vagal response to peritoneal traction
- (E) release of epinephrine
A patient who had liver transplantation two years ago now requires general anesthesia for ENT surgery. Minimal rejection has occurred on a regimen of cyclosporine and prednisone. Which of the following is most likely?
- (A) Hypoalbuminemia
- (B) Hypocalcemia
- (C) Episodic hypoglycemia
- (D) Increased serum creatinine concentration
- (E) Prolonged prothrombin time