10 Random Questions
A 35-kg child requires mechanical ventilation with 100% oxygen at a tidal volume of 350 mL and a rate of 20/min during a severe asthma attack. The most likely cause of severe hypotension after initiating mechanical ventilation is
- (A) hypoxic circulatory depression
- (B) inadequate expiratory time
- (C) increased pulmonary vascular resistance
- (D) respiratory alkalosis
- (E) tension pneumothorax
During Harrington rod instrumentation for scoliosis, monitoring somatosensory evoked potentials
- (A) is unreliable if halothane is used
- (B) eliminates the need for a wake-up test
- (C) accurately assesses proprioceptive integrity
- (D) accurately assesses motor function integrity
- (E) is unreliable if nondepolarizing muscle relaxants are used
Four days after subarachnoid hemorrhage and surgical clipping of a cerebral aneurysm, a patient develops cerebral artery vasospasm. Appropriate treatment includes each of the following EXCEPT
- (A) administration of nimodipine
- (B) controlled hypertension
- (C) hemodilution to hematocrit of 33%
- (D) hyperventilation to PaC02 of 25 to 30 mmHg
- (E) increasing preload
Nitroprusside therapy for hypertension should be discontinued in the presence of
- (A) acute myocardial infarction
- (B) increasing metabolic acidosis
- (C) methemoglobinemia
- (D) mitral regurgitation
- (E) renal failure
An intubated patient is breathing spontaneously through the T-piece shown in Figure 1. Addition of tubing at A and B as shown in Figure 2 without an increase in minute ventilation will result in
- (A) unchanged FiO2 and increased PaCO2
- (B) unchanged FiO2 and unchanged PaCO2
- (C) increased FiO2 and increased PaCO2
- (D) increased FiO2 and unchanged PaCO2
- (E) decreased FiO2 and increased PaCO2
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
Arterial pressure in the radial artery is 155/70 mmHg measured by a correctly calibrated catheter-transducer system. At the same time, aortic pressure is 140/75 mmHg using a high-fidelity catheter tip transducer. The most likely cause of this discrepancy is
- (A) a large amount of air in the dome of the radial artery transducer
- (B) coarctation of the aorta
- (c) peripheral vascular constriction produced by sympathetic stimulation
- (D) physiologic amplification of the waveform from the aorta to the radial artery
- (E) too high a frequency response in the catheter-transducer system
Nausea and vomiting in pediatric outpatients are
- (A) directly related to postoperative pain
- (B) unrelated to the length of the procedure
- (C) eliminated by preoperative administration of droperidol
- (D) eliminated by intraoperative nasogastric drainage
- (E) more frequent than in adults
A 45-year-old woman with mitral stenosis is scheduled for elective mitral valve replacement. Two minutes after tracheal intubation, she develops atrial fibrillation with a ventricular response rate of 150 bpm and a decrease in blood pressure to 75/45 mmHg. Which of the following is the most appropriate first step in management?
- (A) Increasing the concentration of enflurane
- (B) Increasing the infusion rate of lactated Ringer's solution
- (C) Intravenous administration of digoxin
- (D) Intravenous administration of propranolol
- (E) Electrical cardioversion
Which of the following is characteristic of the airway in a 2-month-oId infant when compared with an adult airway?
- (A) Airway is narrowest at the cricoid cartilage
- (B) Epiglottis is broader
- (C) Laryngeal mucosa is more tightly adherent
- (D) Larynx is positioned lower in the neck
- (E) Vocal cords have a more cephalad anterior attachment