Anesthesia Hub -

10 Random Questions

A patient is undergoing a craniotomy in the sitting position. Mean arterial pressure measures 80 mmHg from a radial artery catheter located 27 cm below the right atrium and a transducer located, zeroed, and calibrated at the level of the right atrium. The circle of Willis is 27 cm above the right atrium. Intracranial pressure is 0 cmH20 and right atrial pressure is 5 cmH20. The cerebral perfusion pressure in mmHg is

(A) 75
(B) 60
(C) 53
(D) 48
(E) 26

Which of the following is a potentially beneficial effect of ketamine used for induction of anesthesia?

(A) Analgesia
(B) Attenuation of respiratory response to carbon dioxide
(C) Decreased cerebral metabolic rate
(D) Increased stroke volume in patients with hemorrhagic shock
(E) Preservation of laryngeal reflexes

BASIC Pharmacology & Pharmacokinetics

A 25-year-old man with known rheumatic heart disease is being evaluated in the critical care unit. Despite decreasing cardiac output, mixed venous blood from a pulmonary artery catheter shows an increase in Sv02. Which of the following is the most likely cause?

(A) Decreasing hematocrit
(B) Hypothermia to 35°C
(C) Metabolic alkalosis
(D) Mitral regurgitation
(E) Wedging of the catheter

In patients with renal failure, which of the following muscle relaxants has the most prolonged elimination half-life?

(A) Atracurium
(B) Pancuronium
(C) Succinylcholine
(D) d-Tubocurarine
(E) Vecuronium

BASIC Pharmacology & Pharmacokinetics

Which of the following is the most likely adverse effect of prolonged intravenous administration of nitroglycerin?

(A) Cyanmethemoglobinemia
(B) Hemolysis
(C) Methemoglobinemia
(D) Neutropenia
(E) Thrombocytopenia

BASIC Pharmacology & Pharmacokinetics

The physiologic function most likely to be spared when a local anesthetic differential nerve block is administered is

(A) sweating
(B) temperature sensation
(C) proprioception
(D) touch sensation
(E) pain sensation

ADVANCED Pharmacology & Pharmacokinetics Regional & Pain

Nonsteroidal analgesics such as aspirin decrease pain by

(A) decreasing axonal transmission of pain stimuli through a local anesthetic mechanism
(B) directly competing with substance P for receptor occupancy
(C) inhibiting enzymatic breakdown of met-enkephalin
(D) inhibiting production of prostaglandin E2
(E) potentiating the action of endorphin in the substantia gelantinosa of the spinal cord

BASIC Pharmacology & Pharmacokinetics

A 2-year-old child is hospitalized for exposure. Rectal temperature is 30°C. The most appropriate method of warming is to

(A) apply radiant heat
(B) increase ambient temperature to 28°C
(C) use a heating blanket set at 39°C
(D) warm and humidify inspired gases
(E) warm intravenous fluids to 37°C

ADVANCED Pediatric

A healthy 18-year-old youth is scheduled for an emergency operation for removal of a steel splinter from his right iris. Anesthesia is induced with thiopental and pancuronium and, following tracheal intubation, is maintained with nitrous oxide 2 liters, oxygen 2 liters, and halothane 1.5%. Conjunctival instillation of phenylephrine solution 10% increases blood pressure from 110/70 to 230/110 mmHg and decreases pulse from 70 to 46 bpm. The ECG shows a bigeminal pattern. The most appropriate treatment is to

(A) administer lidocaine
(B) administer atropine
(C) administer propranolol
(D) decrease halothane
(E) administer nitroprusside

Which of the following statements concerning the pharmacokinetics of nondepolarizing muscle relaxants is true?

(A) Drugs with a longer duration of action depend on the liver for excretion
(B) Drugs with a shorter duration of action depend primarily on redistribution for recovery
(C) Onset of action is independent of dose
(D) Recovery rate parallels the decrease in plasma relaxant concentration
(E) The shorter the duration of action, the faster the onset