10 Random Questions
A 27-year-old man with chronic renal failure is to undergo revision of an arteriovenous graft. He insists on general anesthesia. Hemodialysis was completed two hours ago, and serum potassium concentration is now 5 mEq/L. Which of the following statements concerning anesthetic management of this patient is true?
- (A) Enflurane is contraindicated
- (B) Succinylcholine is contraindicated
- (C) Neostigmine will be required in larger than usual dosage
- (D) The duration of action of atracurium will be prolonged
- (E) The duration of action of propofol will be unchanged
After termination of an inhalation anesthetic, patient-controlled analgesia will
- (A) be effective without a loading dose of opioid if started in the immediate postanesthetic period
- (B) be associated with greater analgesic requirements than conventional intramuscular opioid techniques
- (C) cause addiction or dependence to opioids if continued for more than 72 hours
- (D) produce less patient satisfaction than intermittent intravenous administration of opioids
- (E) show a diurnal variation in analgesic requirement
The decreased duration of action of an intravenous dose of fentanyl compared with an intravenous dose of morphine is best explained by
- (A) greater lipid solubility
- (B) increased hepatic metabolism
- (C) less protein binding
- (D) shorter elimination half-life
- (E) smaller volume of distribution
In a spontaneously breathing patient, each of the following increases the work of breathing EXCEPT
- (A) an increase in respiratory rate by 10/min
- (B) a decrease in lung-thorax compliance by 10 cmH2O
- (C) an increase in carbon dioxide production by 1 ml/kg/min
- (D) a decrease in PaO2 from 80 to 65 mmHg
- (E) a 0.1 increase in the ratio of dead space to tidal volume
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
An otherwise healthy 16-year-old girl is undergoing posterior spinal fusion for thoracolumbar scoliosis. During the procedure, the most likely cause of a marked decrease in the amplitude of the somatosensory evoked potentials after stimulation of the posterior tibial nerve is
- (A) administration of fentanyl 30 jag /kg for induction
- (B) administration of isoflurane 1.3 MAC for maintenance
- (C) administration of vecuronium 0.15 mg/kg
- (D) a decrease in body temperature from 37 to 35°C
- (E) a decrease in cerebrospinal fluid pressure
Which of the following changes is most likely in the patient whose pulmonary pathology is schematically illustrated?
- (A) Decreased diffusing capacity
- (B) Decreased PaO2
- (C) Decreased pH
- (D) Increased PaCO2
- (E) Increased Vd/Vt
Which of the following is the most likely effect of intramuscular ketamine used for induction of anesthesia in a 2-year-old child undergoing elective surgery?
- (A) Bronchoconstriction
- (B) Decreased heart rate
- (C) Decreased intracranial pressure
- (D) Increased salivation
- (E) Respiratory depression
Which of the following drugs best facilitates management of cerebral vasospasm after subarachnoid hemorrhage?
- (A) Nifedipine
- (B) Nimodipine
- (C) Nitroglycerin
- (D) Nitroprusside
- (E) Thiopental
The acute onset of hypotension without a decrease in mixed venous oxygen saturation is most likely associated with the onset of
- (A) hemorrhage
- (B) myocardial infarction
- (C) pulmonary edema
- (D) pulmonary embolus
- (E) sepsis