10 Random Questions
A 39-year-old patient with insulin-dependent diabetes mellitus receives thiopental 250 mg and succinylcholine 80 mg and is ventilated with 0.75% isoflurane in oxygen. Arterial pressure decreases abruptly from 140/100 to 80/50 mmHg while heart rate remains unchanged at 70 bpm. Failure of heart rate to increase most likely results from
- (A) acute hypoglycemia
- (B) autonomic neuropathy
- (C) depression of sinus node function by thiopental
- (D) depression of the baroreflex response by isoflurane
- (E) ganglionic stimulation by succinylcholine
During transurethral resection of the prostate under spinal anesthesia with a sensory level to T10, a patient has sudden onset of sharp upper abdominal pain and nausea. Arterial blood pressure increases from 120/80 to 150/90 mmHg; the patient becomes diaphoretic. Which of the following is the most likely diagnosis?
- (A) Bladder perforation
- (B) Hemolysis
- (C) Hypervolemia
- (D) Hyponatremia
- (E) Myocardial ischemia
Which of the following is indicated by an alarm condition in the line-isolation monitor?
- (A) An electrical shock to the patient
- (B) A power surge in the main hospital power supply
- (C) Disconnection of the patient from an electrocautery grounding pad
- (D) Overload of the operating room circuits
- (E) The presence of a current leak between an operating room electrical device and ground
A 7-year-old, obese, 30-kg boy was anesthetized using an adult circle system containing a 3-liter bag and mask. Induction with nitrous oxide (2 liters), oxygen (1 liter), and enflurane 3% was characterized by three minutes of hyperventilation followed by apnea. Forty-five seconds later, the child moved and became difficult to control. The most likely cause of the movement is
- (A) decreased alveolar concentration of enflurane during the period of apnea
- (B) excessive uptake of enflurane by the child's fat
- (C) higher fresh gas flows required with use of an adult circle system in a child
- (D) convulsions induced by enflurane
- (E) hypoxia developing during the period of apnea
Normal pseudocholinesterase
- (A) is highly concentrated at the motor end-plate
- (B) hydrolyzes succinylcholine by Hofmann elimination
- (C) is produced primarily at nerve terminals
- (D) is antagonized by acetylcholinesterase inhibitors
- (E) resists dibucaine inhibition more than its atypical variant
During ligation of a patent ductus arteriosus, a newborn infant receives a total gas flow of 5 L/min through a nonheated Jackson-Rees system. Operating room temperature is maintained at 30°C. The primary cause of a rapid decrease in rectal temperature from 36.8°C to 35°C is
- (A) absence of the central temperature control mechanism
- (B) conductive heat loss
- (C) convective heat loss
- (D) evaporative heat loss
- (E) radiant heat loss
The flow-volume loop shown is most likely from a patient with which of the following?
- (A) Bilateral vocal cord paralysis
- (B) Chronic bronchitis
- (C) Tracheal stenosis six months after a previous tracheostomy
- (D) Tumor of the lower trachea
- (E) Normal respiratory status
During an inguinal hernia repair, a newborn infant will have a larger fluid requirement (in milliliters per kilogram) than an adult because of relatively greater
- (A) insensible water loss
- (B) lean body mass
- (C) metabolic rate
- (D) sodium loss
- (E) third space losses
Which of the following is an effect of nitrous oxide?
- (A) Decreased pulmonary vascular resistance
- (B) Depression of uterine contractility
- (C) Inhibition of methionine synthetase
- (D) Stimulation of lymphocyte chemotaxis
- (E) Stimulation of myocardial contractility
An anesthetized patient in the sitting position has a mean arterial pressure of 80 mmHg measured with a transducer placed at the level of the heart. Mean cerebral arterial pressure 20 cm above the transducer is
- (A) 100 mmHg
- (B) 80 mmHg
- (C) 65 mmHg
- (D) 60 mmHg
- (E) 50 mmHg