10 Random Questions
Which of the following characteristics of local anesthetics is associated with long duration of action?
- (A) High degree of lipid solubility
- (B) High degree of protein binding
- (C) High molecular weight
- (D) High pKa
- (E) Presence of ester linkage
A 48-year-old woman underwent a posterior fossa craniotomy in the sitting position. Monitoring included precordial Doppler, arterial blood pressure, central venous pressure (CVP), and urine output. Furosemide was used intraopera-tively for cerebral decompression, and the operation was uneventful. In the recovery room, she was awake with stable vital signs when the CVP suddenly increased from 6 to 25 mmHg without any change in blood pressure. Shortly thereafter, premature ventricular contractions are noted. After administering lidocaine 1 mg/kg intravenously, the most appropriate action is to
- (A) position the patient head down, right side up and aspirate the CVP catheter
- (B) withdraw the CVP catheter 5 cm
- (C) infuse potassium chloride rapidly
- (D) administer furosemide
- (E) ask the neurosurgeon to reevaluate the patient immediately
The laryngeal mask airway
- (A) causes more hemodynamic stimulation than an oropharyngeal airway
- (B) is contraindicated in patients with cervical spine instability
- (C) is more easily inserted when cricoid pressure is applied
- (D) may serve as a temporary airway in case of a failed rapid sequence intubation
- (E) requires administration of a muscle relaxant to avoid laryngospasm during insertion
Which of the following is the most reliable indicator of antagonism of nondepolarizing neuromuscular block sufficient for airway protection?
- (A) Clinically assessed ulnar nerve train-of-four ratio of 0.75
- (B) Peak negative pressure of 25 cmH2O
- (C) End-tidal PC02 of 40 mmHg during spontaneous ventilation
- (D) Sustained head lift for 5 seconds
- (E) Vital capacity of 15 ml/kg
Delirium produced by high doses of atropine can be reversed by intravenous injection of
- (A) diphenhydramine
- (B) flumazenil
- (C) naloxone
- (D) neostigmine
- (E) physostigmine
Which of the following is most indicative of reflex sympathetic dystrophy?
- (A) Dry skin
- (B) Dull pain that improves with movement
- (C) Fasciculations
- (D) Motor weakness
- (E) Pallor and cyanosis
Which of the following limits the use of nalbuphine for relief of postoperative pain?
- (A) High incidence of nausea and vomiting
- (B) High incidence of delayed respiratory depression
- (C) Potential for inducing seizures with repeated doses
- (D) Relatively low maximal analgesic effect
- (E) Short duration of action
A 31-year-old man received an uneventful epidural anesthetic for arthroscopy of the knee and meniscectomy. Twenty-four hours later he still has painless flaccid paralysis in both legs. This clinical presentation is most consistent with
- (A) adhesive arachnoiditis
- (B) anterior spinal artery thrombosis
- (C) epidural abscess
- (D) epidural hematoma
- (E) transverse myelitis
During liver transplantation, venovenous bypass from the femoral and portal veins to the axillary vein during cross-clamping of the inferior vena cava
- (A) decreases urine output
- (B) prevents hypothermia
- (C) prevents metabolic acidosis
- (D) requires heparinization
- (E) supports cardiac output
An intubated patient is breathing spontaneously through the T-piece shown in Figure 1. Addition of tubing at A and B as shown in Figure 2 without an increase in minute ventilation will result in
- (A) unchanged FiO2 and increased PaCO2
- (B) unchanged FiO2 and unchanged PaCO2
- (C) increased FiO2 and increased PaCO2
- (D) increased FiO2 and unchanged PaCO2
- (E) decreased FiO2 and increased PaCO2