10 Random Questions
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
Each of the following is associated with an increased alveolar-arterial oxygen tension difference EXCEPT
- (A) advanced age
- (B) atelectasis
- (C) decreased cardiac output
- (D) decreased Fl02
- (E) right-to-left intracardiac shunt
A 37-year-old woman with pregnancy-induced hypertension develops oliguria two hours after cesarean delivery during epidural .anesthesia. Despite infusion of 2000 mL of crystalloid solution, urine output remains 10 mL/hr. Which of the following laboratory findings is most suggestive of acute tubular necrosis?
- (A) Blood urea nitrogen level of 30 mg/dL
- (B) Serum creatinine level of 1.2 mg/dL
- (C) Urinary/plasma osmolality of 1:1
- (D) Urinary sodium level of 10 mEq/L
- (E) Urinary specific gravity of 1.024
Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with
- (A) longer duration
- (B) more rapid onset
- (C) more intense block
- (D) more difficult reversibility
- (E) similar pharmacokinetics
A 65-year-old woman has respiratory distress and loss of consciousness immediately following superficial and deep cervical plexus block for right carotid endarterectomy. Which of the following is the most likely cause?
- (A) Phrenic nerve paralysis
- (B) Pneumothorax
- (C) Recurrent laryngeal nerve block
- (D) Subarachnoid injection
- (E) Vertebral artery injection
The most effective treatment of severe carbon monoxide poisoning in a 2-year-old child is
- (A) intravenous administration of methylene blue
- (B) intravenous administration of thiocyanate
- (C) intravenous administration of thiosulfate
- (D) exchange transfusion
- (E) hyperbaric oxygenation
A 46-year-old patient is undergoing resection of a posterior fossa tumor with the head elevated 10 cm above the level of the heart. During the procedure, the following changes in vital signs are observed. Which of the following is the most likely cause of the change in heart rate?
- (A) Brain stem compression
- (B) Increased intracranial pressure
- (C) Myocardial ischemia
- (D) Trigeminal nerve retraction
- (E) Venous air embolism
The following hemodynamic values are obtained two hours after coronary artery bypass surgery: Cardiac index 1.7 L/min/m2; Pulm Art. Occ. Pressure 22 mmHg; MAP 60 mmHg; Urine volume 0.2 ml/kg/hr. The most appropriate management is
- (A) dopamine infusion
- (B) nitroprusside infusion
- (C) norepinephrine infusion
- (D) volume expansion
- (E) observation without intervention
Which of the following combinations of anesthetic and incorrect vaporizer results in the smallest error in delivered concentration?
- (A) Sevoflurane in a halothane vaporizer
- (B) Sevoflurane in an isoflurane vaporizer
- (C) Halothane in a desflurane vaporizer
- (D) Isoflurane in a halothane vaporizer
- (E) Sevoflurane in a desflurane vaporizer
Which of the following is the most likely cause of the coronary steal phenomenon?
- (A) Idiopathic hypertrophic subaortic stenosis (IHSS)
- (B) Decreased cardiac contractility
- (C) Dilation of coronary arterioles
- (D) Dilation of epicardial coronary arteries
- (E) Increased systemic vascular resistance