10 Random Questions
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
- (A) Maximum effect occurs one hour after injection
- (B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
- (C) Maximum effect occurs during the acute phase of the disease
- (D) The beneficial effect results primarily from sympathetic neurolysis
- (E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
Each of the following increases cardiac output EXCEPT
- (A) an arteriovenous fistula
- (B) fever
- (C) normovolemic anemia
- (D) shivering
- (E) carotid sinus stimulation
Which of the following statements concerning the choice of nitroprusside or nitroglycerin to induce deliberate hypotension is true?
- (A) Nitroglycerin is more potent
- (B) Nitroglycerin produces hypotension by acting on both arterial and venous capacitance vessels
- (C) Nitroprusside produces less rebound hypertension on discontinuation
- (D) The toxic effects of nitroprusside are independent of dose
- (E) The therapeutic effects of nitroprusside may persist on discontinuation
Which of the following is decreased by alkalinization of a 1.5% lidocaine solution?
- (A) Concentration of free base
- (B) Dose required for anesthesia
- (C) Duration of anesthesia
- (D) Intracellular concentration of ionized lidocaine
- (E) Time to onset of anesthesia
During laser excision of vocal cord polyps in a 5-year-old boy, dark smoke suddenly appears in the surgical field. The trachea is intubated and anesthesia is being maintained with halothane, nitrous oxide, and oxygen. The most appropriate initial step is to
- (A) change from oxygen and nitrous oxide to air
- (B) fill the oropharynx with water
- (C) instill water into the endotracheal tube
- (D) remove the endotracheal tube
- (E) ventilate with carbon dioxide
The most effective treatment of severe carbon monoxide poisoning in a 2-year-old child is
- (A) intravenous administration of methylene blue
- (B) intravenous administration of thiocyanate
- (C) intravenous administration of thiosulfate
- (D) exchange transfusion
- (E) hyperbaric oxygenation
The left ventricular function curve is from a young, healthy patient. If X represents the patient's myocardial function prior to anesthesia, the effect of 1 MAC of isoflurane at normocarbia is best represented by which of the following positions?
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
One hour after induction of anesthesia for a posterior fossa craniotomy using opioid, relaxant, and nitrous oxide, the brain begins to protrude through the dura. The most effective measure to decrease intracranial pressure is to
- (A) administer additional opioid
- (B) decrease PaCO2 from 25 to 15 mmHg
- (C) drain cerebrospinal fluid
- (D) discontinue nitrous oxide
- (E) induce hypotension
When using apneic oxygenation during endoscopy in a normothermic patient, PaC02
- (A) increases at a rate inversely proportional to oxygen flow rate
- (B) increases at a rate of 8 + 0.5 mmHg per minute
- (C) increases at the same rate that Pa02 decreases
- (D) equals mixed venous PC02 after one minute
- (E) is increased by airway obstruction
Each of the following statements concerning the activated clotting time (ACT) is true EXCEPT:
- (A) The ACT is more sensitive than the activated partial thromboplastin time (APTT) to blood heparin concentration
- (B) The ACT is prolonged if the specimen is not warmed during the assay
- (C) The ACT should be greater than 300 sec before initiating cardiopulmonary bypass
- (D) Hypofibrinogenemia may prolong the ACT after cardiopulmonary bypass
- (E) Whole blood is used for measurement of the ACT