10 Random Questions
Each of the following is an adverse effect of intranasal administration of cocaine prior to nasotracheal intubation EXCEPT
- (A) complete heart block
- (B) hypertension
- (C) myocardial ischemia
- (D) seizures
- (E) ventricular tachycardia
A 62-year-old man, who had a myocardial infarction three years ago, complicated by congestive heart failure and renal failure, is undergoing a colectomy. A pulmonary artery catheter demonstrates a cardiac output higher than measurements recorded during a cardiac catheterization two months after the infarction. Which of the following most likely contributes to the increased cardiac output?
- (A) Creation of an arteriovenous fistula
- (B) Increased hemoglobin concentration from 10 to 12 g/dL
- (C) Stimulation of carotid body receptors
- (D) Transcutaneous nitroglycerin
- (E) Use of a beta-adrenergic blocker to prevent myocardial reinfarction
During use of the ventilator on an anesthesia machine, positive pressure is noted on the airway pressure gauge during exhalation. Positive end-expiratory pressure has not been purposefully added to the breathing circuit. Which of the following is the most likely cause?
- (A) Closure of the pop-off valve in the circle system
- (B) Excessive tidal volume settings on the ventilator
- (C) Obstruction of the pressure relief valve on the scavenging system
- (D) Overinflation of the endotracheal tube balloon
- (E) Tension pneumothorax
A 45-year-old man is scheduled for appendectomy under general anesthesia. He reports that for many years he has occasionally felt his heart "skip a beat." The ECG tracing shown was obtained one hour ago. Which of the following is the most appropriate next step?
- (A) Proceeding with induction of anesthesia
- (B) Administration of a loading dose of digoxin
- (C) Carotid sinus massage
- (D) Intravenous administration of atropine
- (E) Placement of a temporary pacemaker
A 50-year-old man with severe coronary artery disease undergoes coronary artery bypass grafting. Five minutes after successful termination of cardiopulmonary bypass, ST-segment elevation is noted in lead II of the ECG, and the following findings are noted: BP 70/40, Pulse 80, CVP 16 cmH2O, PAp 25/10. Appropriate management is to
- (A) administer propranolol
- (B) administer nitroglycerin
- (C) administer dopamine
- (D) administer crystalloid fluid
- (E) return the patient to cardiopulmonary bypass
A 72-year-old man has ST-segment depression of 2 mm in ECG lead II immediately after suprarenal aortic clamping. Which of the following is the most likely cause?
- (A) Decreased left ventricular stroke volume
- (B) Decreased venous return
- (C) Increased left ventricular wall tension
- (D) Reflex tachycardia
- (E) Release of epinephrine from hypoperfused adrenal medulla
The carbon dioxide/ventilation response curve
- (A) is primarily a measure of the integrity of the peripheral chemoreceptors
- (B) shows parallel displacement to the left in the presence of opioids
- (C) is linear between a PaCO2 of 20 and 120 mmHg
- (D) shows progressive changes in slope with increased doses of halogenated anesthetics
- (E) is unaffected by a decrease in PaO2 to 60 mmHg
A healthy, spontaneously breathing, supine, anesthetized patient has an arterial to end-tidal carbon dioxide tension difference of 3 mmHg. Following institution of mechanical ventilation the value increases to 12 mmHg. The most likely cause of this change is
- (A) cephalad displacement of the diaphragm
- (B) decreased production of carbon dioxide
- (C) increased cardiac output
- (D) increased shunting of blood through dependent lung zones
- (E) increased ventilation of nondependent lung zones
While delivering nitrous oxide 1.5 L/min, oxygen 1.5 L/min, and halothane 1%, a leak in the oxygen flowmeter will most likely be detected by the
- (A) low airway pressure alarm
- (B) "fail-safe" system
- (C) oxygen analyzer on the expiratory limb
- (D) oxygen flowmeter reading
- (E) mass spectrometric analysis of gases
Which of the following results in the greatest increase in right-to-left shunting in an infant with cyanotic heart disease?
- (A) Decreased pulmonary vascular resistance
- (B) Decreased systemic vascular resistance
- (C) Hemodilution
- (D) Increased heart rate
- (E) Myocardial depression