10 Random Questions
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 meconium-stained, full-term infant has an initial Apgar score of 2. The oropharynx is suctioned and the infant is placed on a heated table. Which of the following is the most appropriate next step in management of the airway?
- (A) If the oropharynx is clear, observation for respiratory effort
- (B) Placement of an oxygen mask and application of positive pressure to clear the airway
- (C) Nasotracheal suctioning
- (D) Tracheal suctioning using the endotracheal tube
- (E) Intubation and ventilation with 100% oxygen
In a patient with adult respiratory distress syndrome who is being mechanically ventilated, which of the following findings indicates the most severe disease?
- (A) Decreased functional residual capacity
- (B) Decreased lung compliance
- (C) Hypercarbia
- (D) Hypoxemia
- (E) Increased dead space
During induction of anesthesia in a 70-year-old man with aortic stenosis, the blood pressure decreases from 140/ 80 to 70/45 mmHg as the cardiac rhythm changes from normal sinus at 70 bpm to junctional at 120 bpm. The most appropriate initial therapy would be
- (A) cardioversion
- (B) esmolol
- (C) fluid bolus
- (D) phenylephrine
- (E) verapamil
Proper zeroing of an arterial pressure transducer attached to a supine anesthetized patient is best accomplished by
- (A) continuous flow of fluid through the intravascular catheter
- (B) opening the system to air at heart level
- (C) placement of the transducer diaphragm at heart level
- (D) proper damping of the transducer system
- (E) zeroing the transducer during the expiration phase of mechanical ventilation
Administration of succinylcholine 1 mg/kg to a pregnant woman rarely causes fetal neuromuscular blockade. Which characteristic of succinylcholine best explains this phenomenon?
- (A) High protein binding
- (B) Ionization
- (C) Lack of passive placental diffusion
- (D) Lipid solubility
- (E) Metabolism in the fetal liver
A patient undergoes axillary block for placement of an arteriovenous shunt in the forearm. Blockade of the musculocutaneous nerve is not achieved. Injection of a local anesthetic at which of the following sites will provide the required sensory block?
- (A) Between the tendon of the palmaris longus and flexor carpi radialis
- (B) Body of coracpbrachialis muscle
- (C) Medial to the brachial artery at the elbow
- (D) Proximal to the medial epicondyle against the medial surface of the humerus
- (E) Superficial to the pulse of the axillary artery
Which property of oxygen is detected by the fail-safe device on the anesthesia machine?
- (A) Concentration
- (B) Flow
- (C) Pressure
- (D) Partial pressure
- (E) Reserve volume
Which of the following statements concerning cerebral blood flow (CBF) during anesthesia is true?
- (A) CBF changes minimally when PaC02 increases from 30 to 40 mmHg
- (B) CBF changes minimally when P02 decreases from 160 to 100 mmHg
- (C) CBF is autoregulated when mean arterial pressure is 40 mmHg
- (D) CBF is coupled to cerebral metabolism during isoflurane anesthesia
- (E) CBF is unaffected by 1.2% isoflurane at a PaC02 of 40 mmHg
In a patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Each of the following findings correctly identifies the associated fluid EXCEPT
- (A) precipitation when mixed with an equal volume of thiopental — local anesthetic
- (B) pH 7.1— saline solution
- (C) glucose 55 mg/dl - CSF
- (D) sodium 150 mEq/L - CSF
- (E) PCO2 51 mmHg - CSF