10 Random Questions
Which of the following is more likely to occur with use of trimethaphan to induce hypotension than with use of nitroprusside?
- (A) A predictable decrease in mean arterial pressure
- (B) Increased mixed venous P02
- (C) Increased serum lactate concentration
- (D) Mydriasis
- (E) Reflex tachycardia
A 66-year-old patient with aortic stenosis is scheduled for aortic valve replacement. Examination shows blood pressure of 110/60 mmHg and sinus rhythm at a rate of 75 bpm. Pulmonary artery occlusion pressure (PAOP) is 20 mmHg with a prominent a-wave on the tracing. Which of the following is the most appropriate management?
- (A) Increasing myocardial contractility
- (B) Maintaining PAOP below 20 mmHg
- (C) Maintaining sinus rhythm
- (D) Promoting mild tachycardia
- (E) Decreasing peripheral resistance
The metabolism of which of the following hypotensive agents is most likely to be affected in patients with severe renal disease?
- (A) Esmolol
- (B) Hydralazine
- (C) Nitroglycerin
- (D) Nitroprusside
- (E) Trimethaphan
Which of the following shaded areas most accurately represents the dead space of a properly functioning circle system?
A 72-year-old woman is somnolent one day after left carotid endarterectomy. She has smoked 2 packs of cigarettes daily for 50 years. Six weeks ago, she underwent right carotid endarterectomy. At this time, arterial blood gases while breathing room air are PO2, 45 mmHg, PCO2, 60 mmHg, and pH 7.30. Which of the following is the most likely cause of the increased PCO2?
- (A) Bilateral vocal cord paralysis
- (B) Cerebral infarction
- (C) Congestive heart failure
- (D) Denervation of the carotid bodies
- (E) Phrenic nerve injury
Prompt control of seizures induced by bupivacaine is necessary because
- (A) cerebral metabolic rate for oxygen increases more than cerebral blood flow
- (B) cerebral blood flow is increased
- (C) bupivacaine decreases aerobic cerebral metabolism
- (D) cardiac failure may occur
- (E) ventilation may be impaired
Pulmonary artery occlusion pressure
- (A) does not reliably reflect left ventricular end-diastolic volume when left ventricular compliance is reduced
- (B) inaccurately reflects left atrial pressure when left atrial pressure exceeds 15 mmHg
- (C) is measured at end-inspiration in mechanically ventilated patients
- (D) overestimates left atrial pressure in patients with poor lung compliance
- (E) reflects left atrial pressure only if the catheter tip is located in zone II of the lung
During induction of anesthesia in a 70-year-old man with aortic stenosis, the blood pressure decreases from 140/ 80 to 70/45 mmHg as the cardiac rhythm changes from normal sinus at 70 bpm to junctional at 120 bpm. The most appropriate initial therapy would be
- (A) cardioversion
- (B) esmolol
- (C) fluid bolus
- (D) phenylephrine
- (E) verapamil
A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of
- (A) droperidol
- (B) nifedipine
- (C) normal saline solution
- (D) propranolol
- (E) verapamil
Compared with blood anticoagulated with CPD, blood stored in CPDA-1 has
- (A) better preservation of 2,3-DPG concentration
- (B) better preservation of ATP concentration in erythrocytes
- (C) shorter erythrocyte survival
- (D) shorter shelf life
- (E) decreased platelet aggregation