10 Random Questions
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
Which of the following changes is most likely in the patient whose pulmonary pathology is schematically illustrated?
- (A) Decreased diffusing capacity
- (B) Decreased PaO2
- (C) Decreased pH
- (D) Increased PaCO2
- (E) Increased Vd/Vt
A 76-year-old patient is restless and hallucinating in the preoperative holding area. He received morphine 5 mg and scopolamine 0.4 mg intramuscularly as premedication and is now breathing oxygen 2 L/min through nasal prongs. SpO2 is 98%. Which of the following is the most appropriate next step?
- (A) Administration of naloxone
- (B) Administration of physostigmine
- (C) Induction of general anesthesia
- (D) Determination of serum electrolyte concentrations
- (E) CT scan of the head
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
- (A) Maximum effect occurs one hour after injection
- (B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
- (C) Maximum effect occurs during the acute phase of the disease
- (D) The beneficial effect results primarily from sympathetic neurolysis
- (E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
Bupivacaine is more likely than lidocaine to cause refractory cardiac arrest because bupivacaine
- (A) has a lower rate of plasma clearance
- (B) has a secondary blocking effect on cardiac beta,-adrenergic receptors
- (C) dissociates more slowly from sodium channels in cardiac muscle
- (D) inhibits spontaneous phase 4 depolarization in pacemaker cells
- (E) preferentially blocks calcium channels in Purkinje fibers
Which of the following drugs administered to a parturient eliminates fetal heart rate variability?
- (A) Atropine
- (B) Ephedrine
- (C) Hydralazine
- (D) Magnesium sulfate
- (E) Terbutaline
A 72-year-old woman with stable angina is undergoing bowel resection. Anesthesia is induced with etomidate. Five minutes after starting isoflurane 1% in nitrous oxide 50%, her blood pressure decreases from 110/84 to 70/40 mmHg. The most likely cause is
- (A) coronary steal produced by isoflurane
- (B) direct myocardial depression produced by isoflurane
- (C) vasodilation produced by isoflurane
- (D) adrenocortical suppression produced by etomidate
- (E) myocardial depression produced by etomidate
When treating reflex sympathetic dystrophy of an arm, which of the following is the best indicator of a successful sympathetic blockade?
- (A) A pinprick sensory deficit in the distribution of C6
- (B) A 5°C increase in the temperature of the skin of the hand
- (C) An accentuated psychogalvanometric response in the forearm
- (D) An ipsilateral positive Horner's syndrome
- (E) Decreased temperature sensation in the hand
Increasing preload, systemic vascular resistance and heart rate will best maintain hemodynamic stability in patients with
- (A) aortic stenosis
- (B) asymmetric septal hypertrophy (IHSS)
- (C) cardiac tamponade
- (D) mitral regurgitation
- (E) mitral stenosis
Which of the following statements concerning brain stem auditory evoked responses is true?
- (A) They monitor cortical function
- (B) They are not affected by changes in PaCO2
- (C) They are not affected by mild hypothermia (34°C)
- (D) They are more resistant to anesthetic effects than somatosensory evoked responses
- (E) They are abolished coincident with flattening of the EEG