10 Random Questions
A 22-year-old woman with severe preeclampsia vaginally delivers a 3-kg infant after 12 hours of treatment with magnesium sulfate and continuous epidural infusion of bupivacaine 0.0625% and fentanyl 1 mcg/ml at 10 ml/hr. The infant is pink and hypotonic; heart rate is 110 bpm and blood pressure is 35/25 mmHg. Which of the following is the most appropriate initial management of the infant?
- (A) 10% Dextrose in water
- (B) Calcium gluconate
- (C) Epinephrine
- (D) Naloxone
- (E) Intubation and ventilation
Which of the following findings would be considered normal in the EEG of an adult?
- (A) Decreased frequency during induction with halogenated anesthetics
- (B) Decreased frequency in frontal areas with administration of nitrous oxide 50%
- (C) Dominance of beta rhythm at 20 to 30 Hz during the awake relaxed state
- (D) Electrical silence with administration of isoflurane 2.5 MAC
- (E) The presence of burst-suppression during natural sleep
Which of the following is a cardiorespiratory effect of epidural block to a T4 sensory level?
- (A) Decreased expiratory reserve volume
- (B) Decreased tidal volume
- (C) Increased circulating catecholamine concentrations
- (D) Increased heart rate
- (E) Unchanged vital capacity
During anesthesia with nitrous oxide and isoflurane in a 70-kg, 25-year-old patient, airway resistance would be decreased by
- (A) a decrease in lung volume
- (B) insertion of a 9-mm endotracheal tube
- (C) administration of atropine
- (D) neuromuscular block with d-tubocurarine
- (E) movement of the patient from the supine to the sitting position
The following changes occur during posterior cervical fusion in the prone position under halothane and nitrous oxide anesthesia with mechanical ventilation: HR 78 --> 84 with frequent PVCs; BP 110/70 --> 90/50; EtCO2 4.5% --> 2.0%; EtN2 0.12% --> 4% The most appropriate next step is to
- (A) administer lidocaine intravenously
- (B) decrease ventilatory rate
- (C) discontinue halothane
- (D) lower the patient's head
- (E) inspect the ventilator bellows
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
Fetal distress is noted after administration of an epidural local anesthetic during labor. Fetal scalp pH is 7.0. Compared with a fetus with a scalp pH of 7.3, in this fetus the local anesthetic is present in
- (A) a higher concentration, with a larger fraction in the ionized form
- (B) a higher concentration, with a larger fraction in the unionized form
- (C) the same concentration, with a larger fraction in the ionized form
- (D) the same concentration, with a larger fraction in the unionized form
- (E) a lower concentration, with a larger fraction in the ionized form
Which of the following can be used as a sole criterion for brain death?
- (A) Absence of cerebral blood flow
- (B) Absence of doll's eye movements
- (C) Fixed, dilated pupils
- (D) Isoelectric EEG
- (E) Unresponsiveness to all externally applied stimuli
A patient receives 1.5% bupivacaine 40 ml and epinephrine 1:200,000 for axillary brachial plexus block for reduction of a forearm fracture. The tourniquet is inflated to 300 mmHg; 45 minutes later, the patient has pain that radiates to the posteromedial elbow. Which of the following nerves is NOT adequately blocked?
- (A) Intercostobrachial
- (B) Median
- (C) Musculocutaneous
- (D) Ulnar
- (E) Radial
Each of the following is a complication of celiac plexus block with 0.5% lidocaine 40 ml EXCEPT
- (A) hematuria
- (B) ileus
- (C) postural hypotension
- (D) retroperitoneal hematoma
- (E) weakness of hip flexors