10 Random Questions
A 48-year-old woman with von Willebrand's disease is scheduled for a hysterectomy. The most appropriate initial preoperative therapy to decrease bleeding is administration of
(A) cryoprecipitate
(B) desmopressin (DDAVP)
(C) fresh frozen plasma
(D) platelets
(E) vitamin K
Reveal Answer
BASIC
Transfusions & Fluids
General
During laser excision of vocal cord polyps in a 5-year-old boy, dark smoke suddenly appears in the surgical field. The trachea is intubated and anesthesia is being maintained with halothane, nitrous oxide, and oxygen. The most appropriate initial step is to
(A) change from oxygen and nitrous oxide to air
(B) fill the oropharynx with water
(C) instill water into the endotracheal tube
(D) remove the endotracheal tube
(E) ventilate with carbon dioxide
Reveal Answer
ADVANCED
Equipment & Physics
General
Pediatric
A patient with chronic paraplegia (T4 level) is undergoing cystoscopy and removal of bladder calculi without anesthesia. After 10 minutes, blood pressure is 240/100 mmHg and pulse is 50 bpm. The most appropriate management is administration of
(A) spinal anesthesia
(B) inhalational anesthesia
(C) thiopental intravenously
(D) methyldopa intravenously
(E) nitroprusside intravenously
Reveal Answer
ADVANCED
General
Which of the following findings is most likely in a 3-year-old child who has a secundum-type atrial septal defect with a 2:1 left-to-right shunt?
(A) Pulmonary blood flow twice that of systemic blood flow
(B) Pulmonary vascular resistance twice normal
(C) Mean pulmonary artery pressure twice normal
(D) Right atrial pressure twice normal
(E) Hypoxemia while breathing room air
Reveal Answer
ADVANCED
Pediatric
Which of the following statements concerning diazepam is true?
(A) Absorption is more predictable after intramuscular administration than after oral administration
(B) It produces a shift to the left of the carbon dioxide ventilatory response curve
(C) Rebound drowsiness is caused by a metabolite
(D) The degree of CNS depression is independent of serum albumin concentration
(E) The extent of amnesia is proportional to the degree of sedation
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Which of the following statements concerning cerebral blood flow (CBF) during anesthesia is true?
(A) CBF changes minimally when PaC02 increases from 30 to 40 mmHg
(B) CBF changes minimally when P02 decreases from 160 to 100 mmHg
(C) CBF is autoregulated when mean arterial pressure is 40 mmHg
(D) CBF is coupled to cerebral metabolism during isoflurane anesthesia
(E) CBF is unaffected by 1.2% isoflurane at a PaC02 of 40 mmHg
Reveal Answer
When inspired anesthetic gases are humidified
(A) most particles 1 to 2 microns in size are deposited in the trachea
(B) respiratory epithelial cilia become less active
(C) alveolar water vapor pressure is unchanged
(D) respiratory heat loss is abolished
(E) sterilization of breathing apparatus is mandatory
Reveal Answer
BASIC
Equipment & Physics
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
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
An increased initial dose and a decreased maintenance dose of pancuronium are required in patients with
(A) advanced age
(B) burns
(C) cirrhosis
(D) chronic renal failure
(E) fever
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
A 75-year-old man received an uneventful epidural anesthetic for total knee arthroplasty. Twenty-four hours later he has a 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
Reveal Answer
ADVANCED
Regional & Pain