10 Random Questions
If the oxygen supply pressure of an anesthesia machine exceeds a set value, which of the following safety devices maintains a constant oxygen flowmeter output?
- (A) Cylinder pressure regulator
- (B) Fail-safe valve
- (C) Flow-control valve
- (D) Pipeline inlet check valve
- (E) Second-stage regulator
Which of the following is the best initial treatment of anaphylaxis that occurs during general anesthesia?
- (A) Diphenhydramine
- (B) Dopamine
- (C) Epinephrine
- (D) Hydrocortisone
- (E) Ranitidine
The test dose of local anesthetic administered through an epidural needle or catheter should be sufficient to produce
- (A) bradycardia
- (B) seizure activity
- (C) hypotension
- (D) segmental analgesia
- (E) spinal anesthesia
The hemodynamic changes shown would most likely result from infusion of
- (A) dopamine
- (B) epinepherine
- (C) dobutamine
- (D) norepinepherine
- (E) isoproterenol
An endobronchial Robertshaw tube is inserted for resection of a midesophageal tumor under isoflurane, oxygen, pancuronium anesthesia. Forty minutes into a planned two-hour resection, arterial blood gas values are reported as PO2 45 mmHg, PCO2 45 mmHg, and pH 7.33. Ten minutes earlier, the values were PO2 210 mmHg, PCO2, 41 mmHg, and pH 7.39. The first action should be to
- (A) reposition the Robertshaw tube
- (B) apply positive end-expiratory pressure to the ventilated lung
- (C) reinflate and ventilate the non ventilated lung
- (D) increase minute ventilation
- (E) repeat the arterial blood gas analysis
A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?
- (A) Fluid overload with 5% dextrose in water
- (B) Inappropriate secretion of antidiuretic hormone
- (C) Increased free water clearance
- (D) Nephrogenic diabetes insipidus
- (E) Neurogenic diabetes insipidus
Alveolar and inspired anesthetic concentrations equilibrate more rapidly with nitrous oxide than with desflurane because nitrous oxide
- (A) has a higher vapor pressure
- (B) has a lower blood gas solubility
- (C) has a lower MAC
- (D) is delivered at a higher inspired concentration
- (E) produces a second gas effect
A 68-year-old man with stable angina treated with propranolol and nifedipine is scheduled for coronary artery bypass grafting. After induction with fentanyl and tracheal intubation, heart rate decreases to 40 bpm and blood pressure decreases to 70/40 mmHg. The ECG is shown. Which of the following is the most appropriate first step in management?
- (A) Infusion of isoproterenol
- (B) Administration of phenylephrine
- (C) Closed chest cardiopulmonary resuscitation
- (D) Defibrillation
- (E) Synchronized cardioversion
Three hours after undergoing coronary artery bypass grafting, an elderly man develops severe hypotension after intravenous administration of morphine 4 mg. Pulmonary artery occlusion pressure is 27 mmHg and central venous pressure is 30 mmHg. Transesophageal echocardiography shows decreased end-diastolic ventricular volumes. Which of the following is the most likely diagnosis?
- (A) Anaphylactoid reaction
- (B) Cardiac tamponade
- (C) Coronary graft occlusion
- (D) Excessive fluid administration
- (E) Pulmonary thromboembolus
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