Anesthesia Hub -

10 Random Questions

Bupivacaine is more likely than lidocaine to cause refractory cardiac arrest because bupivacaine

(A) has a lower rate of plasma clearance
(B) has a secondary blocking effect on cardiac beta,-adrenergic receptors
(C) dissociates more slowly from sodium channels in cardiac muscle
(D) inhibits spontaneous phase 4 depolarization in pacemaker cells
(E) preferentially blocks calcium channels in Purkinje fibers

Two days after coronary artery bypass grafting, a 62-year-old man remains sedated, tracheally intubated, and mechanically ventilated with full neuromuscular block. Over the next three hours, Pa02 decreases from 90 to 70 mmHg at an Fl02 of 0.7, peak inspiratory pressure measured proximally in the ventilatory circuit increases from 40 to 66 cmH20, and plateau pressure remains unchanged at 30 cmH20. Which of the following is the most likely cause of these changes?

(A) Adult respiratory distress syndrome
(B) Bronchial mucus plugging
(C) Left ventricular failure
(D) Lobar pneumonia
(E) Tension pneumothorax

A 30-year-old man has had burning pain, allodynia, and edema of the hand for six weeks after sustaining a forearm fracture. Appropriate treatment includes each of the following EXCEPT

(A) physical therapy, employing stress loading
(B) oral prazosin
(C) intravenous regional sympathetic block with guanethidine
(D) stellate ganglion block with 6% phenol
(E) transcutaneous electrical nerve stimulation

ADVANCED Regional & Pain

A patient has severe pain after total knee arthroplasty. Systemic opioids are most likely to modify the pain through action at which of the following sites?

(A) Corpus callosum
(B) Hippocampus
(C) Substantia gelatinosa
(D) Substantia nigra
(E) Ventral horn of the spinal cord

BASIC Pharmacology & Pharmacokinetics

A patient sustains cardiac arrest while being mechanically ventilated. Which of the following is the most likely effect on PetCO2?

(A) Gradual increase with the duration of asystole
(B) Maintenance of the prearrest value
(C) Abrupt decrease below the prearrest value
(D) Decrease when thoracic compression is started
(E) Gradual decrease independent of the ventilator cycle

BASIC Respiratory & Critical Care

Which of the following statements about pulmonary function testing is true?

(A) Forced expiratory volume in one second (FEV1) is directly related to maximum voluntary ventilation
(B) FEV, is the most reliable indicator of small airways resistance
(C) Forced vital capacity is markedly decreased in obstructive lung disease with air-trapping
(D) Maximum mid-expiratory flow is less effort dependent than FEV1
(E) Three-second forced expiratory volume is the amount of air exhaled during the third second of exhalation

ADVANCED Respiratory & Critical Care

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

Compared with the demand-flow intermittent mandatory ventilation (IMV) system, the continuous-flow IMV system has which of the following characteristics?

(A) It cannot be used with positive end-expiratory pressure
(B) It permits monitoring of exhaled tidal volume
(C) It decreases waste of medical gases
(D) It decreases the work of breathing
(E) It synchronizes mechanical and spontaneous breaths

Which of the following findings is most likely in patients with acute transection of the spinal cord at the level of C6?

(A) Autonomic hyperreflexia
(B) Hyperkalemia with administration of succinylcholine
(C) Hypotension
(D) Increased pulmonary blood flow
(E) Tachycardia

ADVANCED General Neuro

Five minutes after initiating one-lung ventilation using a double-lumen endobronchial tube, a 70-year-old patient has a decrease in Sp02 from 99% to 90%. Tidal volume and respiratory rate are unchanged. Fiberoptic bronchoscopy verifies appropriate positioning of the tube. Which of the following is the most likely cause of the desaturation?

(A) Blood flow to the nondependent lung
(B) Failure of hypoxic pulmonary vasoconstriction in the dependent lung
(C) Inadequate filling of the bronchial cuff
(D) Inadequate minute ventilation
(E) Surgical manipulation of the nondependent lung

ADVANCED General Respiratory & Critical Care