10 Random Questions
The most likely effect of a celiac plexus block for an abdominal operation is
- (A) bowel distention
- (B) hypotension
- (C) incisional analgesia
- (D) muscle relaxation
- (E) urinary retention
An 8-kg, 1-year-old child has a measured blood loss of 50 ml during the first two hours of a rectal pull-through operation. Preoperative hematocrit was 31%. Balanced saline solution 150 ml has been administered for replacement. Urine output has been 2 ml for the last hour, heart rate is 160 bpm, and blood pressure is 40/15 mmHg. The most appropriate fluid therapy is,
- (A) 25% albumin
- (B) balanced salt solution
- (C) balanced salt solution and mannitol
- (D) 5% dextrose in 0.45% saline solution
- (E) packed red blood cells
A 58-year-old man undergoes repeat coronary artery bypass grafting. Which of the following is LEAST likely to decrease the need for exogenous blood transfusion?
- (A) Cell saver blood collection before and after cardiopulmonary bypass
- (B) Epsilon-aminocaproic acid administered during cardiopulmonary bypass
- (C) High-dose aprotinin administered during cardiopulmonary bypass
- (D) Tranexamic acid infusion during cardiopulmonary bypass
- (E) Desmospressin administered after cardiopulmonary bypass
Three hours after undergoing coronary artery bypass grafting, an elderly man develops severe hypotension after intravenous administration of morphine 4 mg. Pulmonary artery occlusion pressure is 27 mmHg and central venous pressure is 30 mmHg. Transesophageal echocardiography shows decreased end-diastolic ventricular volumes. Which of the following is the most likely diagnosis?
- (A) Anaphylactoid reaction
- (B) Cardiac tamponade
- (C) Coronary graft occlusion
- (D) Excessive fluid administration
- (E) Pulmonary thromboembolus
Compared with similar use in adults, routine use of succinylcholine in children is hazardous because of the increased risk for which of the following?
- (A) Anaphylactoid reaction
- (B) Phase II blockade
- (C) Pseudocholinesterase deficiency
- (D) Pulmonary aspiration
- (E) Undiagnosed myopathy
The human immunodeficiency virus (HIV)
- (A) is inactivated by irradiation
- (B) is transmitted by cryoprecipitate
- (C) is transmitted by 5% albumin
- (D) passes through intact dermis
- (E) provokes an immediate antibody response
The cardiovascular effects of an inhalational anesthetic are evaluated in 10 normal volunteers in the awake resting state and after 15 minutes of constant inspired concentration. Results were analyzed by t-test for paired data and are presented below as mean +/- standard deviation. Based on these data, which of the following conclusions is most valid?
- (A) A decrease in cardiac output would have been evident if more subjects were included in the study
- (B) The anesthetic decreases mean arterial pressure
- (C) The anesthetic does not cause cardiac depression
- (D) The anesthetic is unsafe for patients with coronary after disease
- (E) There is a 95% to 100% chance that the anesthetic increases heart rate
A 62-year-old man is undergoing elective coronary artery bypass grafting and aortic valve replacement for three-vessel coronary artery disease and aortic stenosis. Shortly after intubation, heart rate increases from 75 to 100 bpm and blood pressure decreases from 130/70 to 70/40 mmHg with acute, severe ST-segment depression in lead V5. Which of the following is the most appropriate management?
- (A) Crystalloid
- (B) Ephedrine
- (C) Esmolol
- (D) Nitroglycerin
- (E) Phenylephrine
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
The graphs shown illustrate various respiratory patterns in a patient who is breathing spontaneously with continuous positive airway pressure. Which of the following patterns is associated with the LEAST work of breathing?
- (A) 1
- (B) 2
- (C) 3
- (D) All patterns are associated with equal work
- (E) There is not enough information to answer the question