10 Random Questions
A 52-year-old man develops oliguria 24 hours after left hemicolectomy. Urinalysis shows a specific gravity of 1.028, an osmolality of 650 mOsm/L, and a sodium concentration of 10 mEq/L. Which of the following is the most likely diagnosis?
- (A) Acute tubular necrosis
- (B) Hypoaldosteronism
- (C) Hypovolemia
- (D) Interstitial renal disease
- (E) Obstructive uropathy
An 18-year-old patient with hemophilia A is scheduled for inguinal hernia repair. Preoperatively, factor VIII concentration is 60% of normal. The most appropriate management is administration of
- (A) fresh frozen plasma
- (B) cryoprecipitate
- (C) factor VIII concentrate
- (D) vitamin K
- (E) none of the above
To predict the requirement for isoflurane in milliliters of vapor per minute during closed circuit anesthesia, each of the following is necessary EXCEPT
- (A) cardiac output
- (B) oxygen consumption
- (C) MAC of isoflurane
- (D) duration of administration
- (E) blood-gas partition coefficient
Which of the following statements concerning carbon monoxide poisoning is true? A 38-year-old woman with a large goiter has undergone subtotal thyroidectomy. Airway obstruction is noted immediately after extubation despite normal vocal cord function on laryngoscopy. Which of the following is the most likely explanation?
- (A) Arytenoid dislocation
- (B) Hematoma
- (C) Hypocalcemia
- (D) Recurrent laryngeal nerve injury
- (E) Tracheomalacia
During cardiopulmonary bypass, the perfusionist notes that the mixed venous oxygen saturation has decreased from to 55%. Which of the following is the most likely cause?
- (A) Administration of a nitroprusside bolus
- (B) Administration of a thiopental bolus
- (C) Decrease in rectal temperature from 34°C to 28°C
- (D) Inadequate muscle relaxation
- (E) Increase in pump flow
The following breath sounds are heard after placement of a left-sided double-lumen endobronchial tube. The most likely cause of these findings is
- (A) presence of both lumens in the right mainstem bronchus
- (B) presence of both lumens in the left mainstem bronchus
- (C) presence of both lumens in the trachea
- (D) herniation of the bronchial cuff at the bifurcation of the trachea
- (E) presence of the bronchial lumen in the right mainstem bronchus
Which of the following differentiates midazolam from diazepam administered intravenously in equipotent doses?
- (A) Greater hemodynamic stability
- (B) Lack of active metabolites
- (C) Less respiratory depression
- (D) Longer duration of action
- (E) More rapid onset
Reduction of fire hazards during laser surgery of the airway is best accomplished by use of
- (A) continuous mode laser emissions
- (B) a nitrous oxide/opioid/relaxant anesthetic technique
- (C) a polyvinylchloride endotracheal tube and cuff
- (D) topical lidocaine
- (E) saline-filled sponges over exposed tissues
Which of the following findings on the left is most likely to be associated with an increased risk of complications with cannulation of the left internal jugular vein compared with cannulation of the right internal jugular vein?
- (A) Longer recurrent laryngeal nerve
- (B) Lower location of the cupola of the pleura
- (C) More acute angle between the internal jugular and innominate veins
- (D) More anterior location of the phrenic nerve
- (E) Presence of the thoracic duct
A patient with hypokalemic familial periodic paralysis develops weakness of skeletal muscles at the end of an emergency appendectomy under spinal anesthesia. If the weakness is a result of the familial periodic paralysis, which of the following statements is true?
- (A) Bicarbonate therapy is indicated
- (B) Cardiac dysrhythmias are unlikely
- (C) Initial treatment is intravenous edrophonium
- (D) Potassium infusion is contraindicated
- (E) The paralysis spares the diaphragm