10 Random Questions
Which of the following is the most important factor affecting the incidence of postoperative pulmonary complications?
- (A) Age of the patient
- (B) Anesthetic technique
- (C) Duration of surgery
- (D) Obesity
- (E) Site of the operation
A patient sustains cardiac arrest while being mechanically ventilated. Which of the following is the most likely effect on PetCO2?
- (A) Gradual increase with the duration of asystole
- (B) Maintenance of the prearrest value
- (C) Abrupt decrease below the prearrest value
- (D) Decrease when thoracic compression is started
- (E) Gradual decrease independent of the ventilator cycle
A 70-year-old patient has absence of the left radial pulse one month after repair of an aortic aneurysm. Arterial pressure was monitored perioperatively with a 20-gauge left radial artery catheter. Which of the following statements concerning this complication is true?
- (A) A preoperative Allen's test would have predicted this complication
- (B) Stellate ganglion block should be performed
- (C) This complication would have been less likely with an 18-gauge catheter
- (D) This patient has poor collateral circulation in the hand
- (E) The pulse will likely return
A 68-year-old man who is scheduled for outpatient cystoscopy has non-insulin-dependent diabetes mellitus controlled with glipizide (Glucatrol) 5 mg twice daily. He has had nothing to eat since awakening this morning and has not taken glipizide today. His blood glucose level is 185 mg/dl. Before proceeding, the most appropriate management is to administer
- (A) glipizide 5 mg orally
- (B) NPH insulin 10 units subcutaneously
- (C) regular insulin 10 units intravenously
- (D) dextrose and regular insulin by infusion
- (E) no additional diabetic medication
A 6-year-old boy with spina bifida and a chronic indwelling urinary catheter has severe hypotension and hypoxemia during augmentation cystoplasty. Which of the following is the most likely cause?
- (A) Autonomic neuropathy
- (B) Disseminated intravascular coagulation
- (C) Latex allergy
- (D) Urinary sepsis
- (E) Venous air embolism
The plasma concentration of an intravenously administered drug follows the two-compartment kinetic model shown in the graph. Which of the following events is illustrated by the decline in plasma concentration shown at Time #2?
- (A) Decreasing activity of the drug at its receptor site
- (B) Distribution from plasma to tissue
- (C) Elimination of the drug from plasma
- (D) Increasing volume of distribution
- (E) Redistribution from vessel-rich groups to vessel-poor groups
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
- (A) administer thiopental
- (B) decrease left ventricular afterload
- (C) increase arterial blood pressure
- (D) replace the left ventricular vent
- (E) resume cardiopulmonary bypass
Which of the following is the most likely effect of intramuscular ketamine used for induction of anesthesia in a 2-year-old child undergoing elective surgery?
- (A) Bronchoconstriction
- (B) Decreased heart rate
- (C) Decreased intracranial pressure
- (D) Increased salivation
- (E) Respiratory depression
The concentration effect is greater with nitrous oxide than with the volatile anesthetics because nitrous oxide
- (A) has a lower blood-gas partition coefficient
- (B) has less effect on cardiac output (0 has lower lipid solubility
- (D) is affected less by ventilation-perfusion mismatch
- (E) is used in much higher concentrations
A 54-year-old man receives 25 ml of a 50% alcohol and 0.25% bupivacaine solution for celiac plexus block. During the next 20 minutes, blood pressure decreases from 130/75 mmHg to 85/55 mmHg. Which of the following is the most likely cause?
- (A) Intravascular injection
- (B) Retroperitoneal hemorrhage
- (C) Splanchnic vasodilation
- (D) Subarachnoid blockade
- (E) Tension pneumothorax