10 Random Questions
Which of the following results in decreased mixed venous oxygen saturation?
- (A) Cardiogenic shock
- (B) Decreased metabolic rate
- (C) Increased cardiac output
- (D) Left-to-right intracardiac shunt
- (E) Pulmonary vasodilation
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
A 50-year-old woman notes loss of sensation in the medial lower leg 24 hours after vaginal hysterectomy in the lithotomy position. Which of the following nerves is most likely to be injured?
- (A) Lateral femoral cutaneous
- (B) Obturator
- (C) Peroneal
- (D) Saphenous
- (E) Tibial
The ECG rhythm shown developed during cholecystectomy in a 62-year-old man who had a myocardial infarction and is taking atenolol. The drug of choice for treating this dysrhythmia is
- (A) atropine
- (B) bretylium
- (C) isoproterenol
- (D) lidocaine
- (E) procainamide
Ninety minutes after administration of succinylcholine 1 mg/kg to a 28-year-old woman, the train-of-four shows a T4:T1 ratio of 25%. This is most consistent with
- (A) dibucaine number of 30
- (B) hypersensitivity to succinylmonocholine
- (C) pregnancy
- (D) pretreatment with pancuronium 2 mg
- (E) severe cirrhosis
A 157 cm (5 ft 2 in), 180-kg, 40-year-old woman has a PaO2 of 65 mmHg, a PaCO2 of 38 mmHg, and a pH of 7.43 while breathing room air preoperatively. The most likely cause of these values is
- (A) decreased hypoxic ventilatory drive
- (B) higher than normal oxygen extraction from blood
- (C) lower than normal cardiac output
- (D) lower than normal functional residual capacity
- (E) polycythemia
A 120-kg 56-year-old man undergoing gastrectomy during anesthesia with fentanyl and isoflurane has a PetCO2 of 35 mmHg and a PaCO2 of 50 mmHg. His FEV,/FVC ratio is 80% of predicted. Heart rate is 120 bpm and arterial blood pressure is 80/40 mmHg. Which of the following is the most likely cause of the difference in PaCO2 and PetCO2?
- (A) Aspiration pneumonitis
- (B) Chronic obstructive pulmonary disease
- (C) Decreased cardiac output
- (D) Decreased VD/VT ratio
- (E) Increased QS/QT ratio
A 70-year-old man undergoes cross clamping of the aorta for repair of an abdominal aneurysm. Which of the following methods is most appropriate for decreasing hypotension associated with removal of the cross clamp?
- (A) Administration of a phenylephrine bolus when the cross clamp is removed
- (B) Correction of any base deficit with sodium bicarbonate during clamping
- (C) Decrease of anesthetic to allow blood pressure to increase to 20% above preclamp levels
- (D) Volume loading to increase pulmonary artery occlusion pressure prior to removal
- (E) Infusion of dopamine 10 minutes prior to removal
A 40-year-old woman is undergoing a posterior fossa craniotomy in the sitting position for clipping of a basilar artery aneurysm. Nitroprusside is being used to maintain mean arterial pressure at 50 mmHg, measured at head level. During dissection, over the course of one minute, the mean blood pressure decreases to 30 mmHg. Simultaneously, end-tidal carbon dioxide and pulmonary artery pressures decrease and heart rate increases. The most likely cause of these changes is
- (A) progressive hypoxemia
- (B) nitroprusside bolus
- (C) junctional rhythm
- (D) brain stem manipulation
- (E) venous air embolism
In which of the following clinical circumstances does down-regulation of beta-adrenergic receptors occur?
- (A) Chronic congestive heart failure
- (B) Hypothyroidism
- (C) Long-term clonidine administration
- (D) Long-term metoprolol administration
- (E) Stable angina