10 Random Questions
A 73-year-old woman with a preoperative serum creatinine concentration of 2.1 mg/dl develops oliguria during enflurane anesthesia. Urine sodium concentration is 10 mEq/L and urine osmolality is 450 mOsm/L. The most likely cause of these findings is
- (A) acute renal failure
- (B) chronic renal insufficiency
- (C) decreased renal perfusion
- (D) fluoride nephrotoxicity
- (E) intraoperative administration of furosemide
During induction of general anesthesia in a patient with a supraglottic tumor, both intubation and subsequent ventilation via a face mask are impossible. A cricothyroidotomy is performed with a 16-gauge intravenous catheter. Which of the following statements is true?
- (A) Application of pressures greater than 35 cmH2O to the catheter will increase the risk for pulmonary barotrauma
- (B) PaC02 can be maintained at a normal level using a standard circle system attached to the catheter
- (C) PaO2 greater than 100 mmHg can be maintained indefinitely using transtracheal jet ventilation with pure oxygen through the catheter
- (D) Emergency surgical tracheostomy would have improved the likelihood of survival
- (E) The presence of this tumor contraindicates jet ventilation via cricothyroidotomy
Compared with a normal child, which of the following is expected during inhalation induction in a child with a 2:1 left-to-right intracardiac shunt?
- (A) Decreased rate of rise of alveolar anesthetic tension
- (B) Decreased anesthetic concentration in pulmonary artery blood
- (C) Decreased cerebral blood flow
- (D) Increased anesthetic concentration in vena cava blood
- (E) No difference in time for anesthetic induction
During apneic oxygenation (FiO2 1.0) through a rigid bronchoscope
- (A) duration of the procedure is limited by the increase in PaCO2
- (B) functional residual capacity decreases 5%/min
- (C) PaO2 remains unchanged for the first 5 minutes
- (D) PaCO2 increases 2 to 6 mmHg/min for 15 minutes and then reaches a plateau
- (E) PaO2 and PaCO2 equilibrate with mixed venous gases at the same rate
Each of the following structures may participate in causing acute bradycardia during strabismus surgery EXCEPT the
- (A) globe
- (B) rectus muscles
- (C) optic nerve
- (D) trigeminal nerve
- (E) vagus nerve
After administration of a single dose of vecuronium, function returns last to which of the following muscles?
- (A) Adductor pollicis
- (B) Diaphragm
- (C) Laryngeal muscles
- (D) Orbicularis oculi
- (E) Rectus abdominis
In this diagram of a circle system, an increase in dead space is most likely to result from placement of the pressure relief valve at location
- (A) 1
- (B) 2
- (C) 3
- (D) 4
- (E) 5
A parturient received 1000 ml of dextrose 5% in lactated Ringer's solution 20 minutes prior to delivery. Ten minutes later her blood glucose concentration is 580 mg/dl. In this situation
- (A) the risk for fetal intraventricular hemorrhage is increased
- (B) the risk for neonatal hypoglycemia is increased
- (C) placental glucose transport is insulin dependent
- (D) the neonate should be given dextrose 50% in water if depressed at delivery
- (E) the mother should be given insulin prior to delivery
One week after sustaining third-degree burns over 40% of his body surface area, a patient requires general anesthesia for debridement and skin grafting. Which of the following responses to neuromuscular blockers is most likely?
- (A) Clinically insignificant increases in serum potassium concentration after administration of succinylcholine 1 mg/kg
- (B) Increased risk of hyperkalemia after administration of succinylcholine 1 mg/kg
- (C) Increased sensitivity to vecuronium
- (D) Laudanosine toxicity after administration of atracurium 0.4 mg/kg
- (E) Normal serum potassium concentration if administration of succinylcholine is preceded by d-tubocurarine 3 mg
A 30-year-old woman is undergoing laparoscopic tubal ligation. Thirty minutes after induction of general anesthesia, arterial oxygen saturation has decreased to 89%. Arterial blood gases at an FiO2 of 1.0 are PaO2 63 mmHg and PaCO2 40 mmHg; PetCO2 is 32 mmHg. Which of the following is the most likely cause?
- (A) Carbon dioxide embolus
- (B) Endobronchial intubation
- (C) Hypoventilation
- (D) Inadvertent application of high levels of positive end-expiratory pressure
- (E) Leak in the capnography sampling catheter