10 Random Questions
A 70-kg, 50-year-old man is scheduled for muscle flap closure of a decubitus ulcer over the sacrum. He has been quadriplegic at the level of C6-7 for six years. Which of the following is most likely to result from subarachnoid anesthesia with tetracaine 10 mg for this procedure?
(A) Atrioventricular block
(B) Decreased risk for autonomic dysreflexia
(C) Impaired expiratory muscle function
(D) Impaired inspiratory muscle function
(E) Inadequate block of spastic movements
Reveal Answer
ADVANCED
General
Regional & Pain
During induction of anesthesia for cesarean delivery, pancuronium is inadvertently substituted for succinylcholine. The neonate shows no clinical signs of muscle relaxation because pancuronium is
(A) highly ionized
(B) highly protein bound
(C) a large molecule
(D) lipid soluble
(E) unaffected by "ion trapping"
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Desflurane at a stable alveolar concentration of 7%
(A) causes bradycardia
(B) decreases cerebrovascular resistance
(C) degrades in soda lime
(D) increases systemic vascular resistance
(E) stimulates the respiratory centers
Reveal Answer
BASIC
Equipment & Physics
Pharmacology & Pharmacokinetics
Each of the following is a complication of celiac plexus block with 0.5% lidocaine 40 ml EXCEPT
(A) hematuria
(B) ileus
(C) postural hypotension
(D) retroperitoneal hematoma
(E) weakness of hip flexors
Reveal Answer
ADVANCED
Regional & Pain
With direct arterial blood pressure monitoring
(A) systolic pressure in the aortic root exceeds that in the radial artery
(B) mean and diastolic pressures are lower in the dorsalis pedis artery than in the aortic root
(C) the dicrotic notch is not clearly found on femoral arterial waveforms
(D) an underdamped waveform is characteristic of bubbles in the system
(E) longer tubing between artery and transducer artifactually augments systolic pressure
Reveal Answer
BASIC
Equipment & Physics
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
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Which of the following statements concerning use of amitriptyline to treat chronic pain is true?
(A) It acts primarily via opioid receptors
(B) It increases serotonin levels in the brain
(C) It is rarely effective for postherpetic neuralgia
(D) Onset of action occurs after four to six weeks of treatment
(E) Response depends on reversal of depression
Reveal Answer
ADVANCED
Regional & Pain
Maximum current is delivered to the myocardium by a countershock for defibrillation when
(A) paddle contact pressure is minimal
(B) petroleum jelly is used under the paddles
(C) previous countershocks of the same power have been attempted
(D) the patient is grounded securely
(E) the shock is applied at the end of inspiration
Reveal Answer
BASIC
Equipment & Physics
Delirium produced by high doses of atropine can be reversed by intravenous injection of
(A) diphenhydramine
(B) flumazenil
(C) naloxone
(D) neostigmine
(E) physostigmine
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with
(A) longer duration
(B) more rapid onset
(C) more intense block
(D) more difficult reversibility
(E) similar pharmacokinetics
Reveal Answer