Anesthesia Hub -

10 Random Questions

In normal tissue, which property of drugs has the greatest effect on the speed of onset of a local anesthetic?

(A) Amide structure
(B) Degree of protein binding
(C) Intrinsic vasoconstrictor activity
(D) pKa
(E) Potency

A 70-kg, 20-year-old athlete receives nitrous oxide and oxygen, thiopental, and fentanyl 1.25 mg (25 ml) during a knee reconstruction procedure lasting three hours. Postoperatively, he does not awaken or resume spontaneous breathing for three hours. The most likely explanation for the prolonged effect of fentanyl is

(A) dose-dependent elimination half-life
(B) genetically slow biotransformation
(C) large volume of distribution
(D) presence of an active metabolite in high concentration
(E) time required for hepatic elimination

BASIC Pharmacology & Pharmacokinetics

Which of the following statements concerning absorption of irrigation fluid during transurethral resection of the prostate is true?

(A) Hydrostatic pressure has minimal effect on the amount of fluid absorbed
(B) Typically 10 to 30 ml of fluid per minute are absorbed
(C) Use of iso-osmotic solutions decreases the risk of hyponatremia
(D) CNS complications are independent of the type of fluid used
(E) Spinal anesthesia to T6 will mask the symptoms of overhydration

ADVANCED General

A patient with end-stage renal disease has prolonged ventilatory depression after administration of morphine. The most likely cause is increased

(A) serum concentration of morphine-6-glucuronide
(B) elimination half-life of morphine
(C) opioid receptors
(D) receptor affinity
(E) volume of distribution

BASIC Pharmacology & Pharmacokinetics

Each of the following is a recognized complication during a transurethral resection for which glycine is used as an irrigant EXCEPT

(A) disseminated intravascular coagulopathy
(B) hemolysis
(C) hyperammonemia
(D) shoulder pain
(E) transient blindness

ADVANCED Pharmacology & Pharmacokinetics General

The most likely cause of a fetal heart rate pattern of variable decelerations to 90 bpm is

(A) aortocaval compression
(B) compression of the fetal head
(C) fetal acidosis
(D) maternal hypotension
(E) umbilical cord compression

ADVANCED OB

Preoperative administration of an alpha-adrenergic blocker for 10 days to patients with pheochromocytoma will decrease

(A) episodic tachycardia
(B) hyperglycemia
(C) hypovolemia
(D) nasal stuffiness
(E) postural hypotension

ADVANCED General

A patient being mechanically ventilated in the ICU requires wound debridement twice daily. Each of the following agents would be appropriate for induction of brief general anesthesia EXCEPT

(A) nitrous oxide
(B) etomidate
(C) ketamine
(D) methohexital
(E) midazolam

BASIC General

You are asked to evaluate a 2000-g male infant three hours after vaginal delivery because of a respiratory rate of 50/min, pulse rate of 115 bpm, and the following arterial blood gas values while breathing room air: PaO2 64 mmHg, PaCO2 43 mmHg, and pH 7.33. His mother received meperidine 75 mg two hours before delivery. Appropriate management includes

(A) administration of naloxone 50 mcg intramuscularly
(B) increasing the FiO2 to 0.4
(C) intubation and mechanical ventilation at an FiO2 of 0.5
(D) administration of oxygen 50% with 5 cm H2O continuous positive airway pressure
(E) observation, with no action at present

ADVANCED Pediatric

A 19-year-old woman has severe nausea and vomiting following laparoscopy. After intramuscular administration of prochlorperazine 10 mg, she has muscle spasms in the face, neck, and tongue. Which of the following is the most appropriate management?

(A) Baclofen
(B) Diphenhydramine
(C) Epinephrine
(D) Hydrocortisone
(E) Naloxone

BASIC Pharmacology & Pharmacokinetics