10 Random Questions
A 50-year-old patient is undergoing craniotomy for clipping of a cerebral aneurysm with isoflurane, nitrous oxide, and fentanyl anesthesia. At the time of aneurysm exposure, the EEG shows burst suppression. Which of the following is the most likely cause?
- (A) Cerebral ischemia
- (B) Cerebral vasospasm
- (C) Fentanyl effect
- (D) Isoflurane effect
- (E) Petit mal seizure activity
During craniotomy in the sitting position, end-tidal carbon dioxide tension suddenly decreases. Ventilatory excursion of the chest is normal. Further evaluation is most likely to show a decrease in
- (A) alveolar-to-arterial oxygen tension difference
- (B) alveolar-to-arterial carbon dioxide tension difference
- (C) dead space ventilation
- (D) pulmonary artery pressure
- (E) pulmonary artery occlusion pressure
A patient who is scheduled for a gastrectomy had abnormal liver function tests for four days following a prior cholecystectomy. In your consultation note, you should
- (A) recommend sevoflurane anesthesia since abnormal postoperative liver function tests are unlikely with this drug
- (B) recommend subarachnoid anesthesia since changes in hepatic blood flow would be less than with general anesthesia
- (C) indicate that abnormal liver function tests are likely to follow this operation regardless of the anesthetic drugs used
- (D) require preoperative screening for hepatitis B antigen and antibodies
- (E) recommend avoiding halothane since it is more likely to produce hepatitis in patients who had previous upper abdominal surgery
Each of the following would slow induction with a volatile anesthetic agent EXCEPT
- (A) hypoalbuminemia
- (B) hyperlipemia
- (C) clean rubber tubing in the circle system
- (D) fresh soda lime
- (E) obesity
During anesthesia with nitrous oxide, oxygen, and a relaxant, the patient's lungs are being mechanically ventilated and there is a heated humidifier in the circuit. The most likely cause of an apparent increase in inspired oxygen concentration is
- (A) a hole in the ventilator bellows
- (B) backflow of fresh gas because of resistance in the humidifier
- (C) decreased oxygen utilization by the patient
- (D) heat damage to the oxygen sensor
- (E) water condensation on the oxygen sensor
The ECG strip shown is recorded as a patient with a permanent transvenous DDD pacemaker enters the operating room. These changes indicate that the pacemaker is
- (A) sensing the T waves
- (B) sensing the retrograde P waves
- (C) triggering off the intrinsic atrial activity
- (D) malfunctioning in the atrial pacing mechanism
- (E) prematurely stimulating the ventricle
A 68-year-old patient is undergoing total hip replacement during general anesthesia using positive pressure ventilation and neuromuscular blockade. Intraoperative monitoring shows a gradual decrease in end-tidal CO2, an increase in exhaled tidal volume, and an increase in measured FiO2. Which of the following is the most likely cause of these changes?
- (A) Air entrainment around a deflated endotracheal tube cuff
- (B) Channeling of the exhaled air through the carbon dioxide canister
- (C) Fat embolism
- (D) Inadequate muscle relaxation with spontaneous patient ventilation
- (E) A small hole in the ventilator bellows
Which of the following best reflects findings of inadequate cerebral perfusion during carotid cross clamping?
- (A) Decreased frequency on EEG
- (B) Increased latency of brain stem auditory evoked potentials
- (C) Increased spectral edge frequency
- (D) Jugular bulb oxygen tension of 27 mmHg
- (E) Stump pressure of 50 mmHg
Which of the following is the strongest indication for one-lung ventilation?
- (A) Descending thoracic aortic aneurysm
- (B) Esophageal resection
- (C) Lobectomy for lung abscess
- (D) Lobectomy for tumor
- (E) Pneumonectomy for tumor
You see a flash of fire from the endotracheal tube of a patient undergoing carbon dioxide laser excision of laryngeal polyps. The immediate response should be to
- (A) discontinue the fresh gas flow
- (B) increase the nitrous oxide concentration
- (C) spray water down the endoscope
- (D) insert wet pads into the pharynx
- (E) remove the endotracheal tube