10 Random Questions
Each of the following indicates a hemolytic transfusion reaction in an anesthetized patient EXCEPT
- (A) bleeding diathesis
- (B) wheezing
- (C) hypotension
- (D) hemoglobinuria
- (E) decreased serum haptoglobin concentration
A multi-orifices right heart catheter is being positioned by EKG control prior to sitting craniotomy. The EKG tracing is obtained between the distal tip of the catheter and the right arm lead. The most appropriate next step is to
- (A) leave the catheter in place
- (B) advance the catheter 2 to 3 cm
- (C) withdraw the catheter 2 to 3 cm
- (D) remove the catheter completely
- (E) change polarity of the EKG
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
The most likely effect of a celiac plexus block for an abdominal operation is
- (A) bowel distention
- (B) hypotension
- (C) incisional analgesia
- (D) muscle relaxation
- (E) urinary retention
Cholinergic receptor blockade
- (A) decreases intraocular pressure
- (B) decreases lower esophageal sphincter tone
- (C) increases gastrointestinal motility
- (D) induces diaphoresis
- (E) produces copious secretions
A 64-year-old, 70-kg woman treated with lithium for manic-depressive psychosis is given methohexital 90 mg and succinylcholine 35 mg intravenously for electroconvulsive therapy. Ten minutes later she remains sedated and the peripheral nerve stimulator shows a decreased twitch response. The most likely explanation is
- (A) cerebral hypoxia
- (B) postictal depression
- (C) relative overdose of methohexital
- (D) unrecognized atypical pseudocholinesterase
- (E) residual lithium effects
Administration of magnesium sulfate for treatment of preeclampsia results in a decreased dose requirement for each of the following drugs EXCEPT
- (A) bupivacaine
- (B) halothane
- (C) midazolam
- (D) succinylcholine
- (E) vecuronium
A 20-year-old woman with poorly controlled diabetes mellitus is scheduled for urgent drainage of an abdominal abscess. She received an initial dose of regular insulin 10 units followed by regular insulin 5 units/hr for the past five hours. Laboratory studies show serum sodium concentration 128 mEq/L, potassium 5.4 mEq/L, chloride 80 mEq/L, and glucose 750 mg/dl. The most appropriate perioperative management is
- (A) addition of subcutaneous NPH insulin
- (B) administration of sodium bicarbonate to correct metabolic acidosis
- (C) administration of normal saline solution to correct the presumed hypovolemia
- (D) administration of furosemide to correct hyponatremia
- (E) infusion of 5% dextrose in 0.2% saline solution to prevent hypoglycemia
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
- (A) Maximum effect occurs one hour after injection
- (B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
- (C) Maximum effect occurs during the acute phase of the disease
- (D) The beneficial effect results primarily from sympathetic neurolysis
- (E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
The portion of the infant airway with the smallest cross-sectional area occurs at the level of the
- (A) cricoid cartilage
- (B) false vocal cords
- (C) thoracic inlet
- (D) tonsillar pillars
- (E) true vocal cords