10 Random Questions
Which of the following must be considered during perioperative management of a patient on long-term lithium therapy?
- (A) Intravenous fluids should include sodium
- (B) Therapy should be discontinued for 14 days prior to anesthesia
- (C) The requirement for succinylcholine is increased
- (D) The requirement for volatile anesthetics is increased
- (E) Urine output should be maintained with furosemide
In the supraclavicular region, the brachial plexus
- (A) is anterior to the apex of the pleura
- (B) is anterior to the subclavian artery
- (C) is posterior to the medial scalene muscle
- (D) is enclosed in a sheath with the subclavian vein
- (E) no longer contains fibers from the Tl nerve root
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
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
A celiac plexus block provides effective relief of pain associated with primary cancers at each of the following locations EXCEPT the
- (A) adrenal gland
- (B) liver
- (C) pancreas
- (D) sigmoid colon
- (E) stomach
During carotid endarterectomy, blood pressure suddenly decreases from 140/90 to 80/50 mmHg. The EKG shows a heart rate of 42 bpm, with normal sinus rhythm and occasional premature ventricular contractions. The most appropriate therapy is intravenous administration of
- (A) atropine
- (B) epinephrine
- (C) isoproterenol
- (D) lidocaine
- (E) phenylephrine
During spinal anesthesia in a healthy patient, the sensory level rises to C8. The patient will most likely have
- (A) hoarseness due to block of the recurrent laryngeal nerve
- (B) numbness over the clavicles
- (C) impaired resting ventilation
- (D) numbness of the little finger
- (E) inability to raise his arm
Three hours after total thyroidectomy, a 33-year-old man develops inspiratory stridor. The most likely cause is
- (A) hematoma formation
- (B) tracheomalacia
- (C) tetany
- (D) recurrent laryngeal nerve injury
- (E) superior laryngeal nerve injury
Compared with isoflurane, desflurane
- (A) causes higher plasma norepinephrine levels
- (B) has greater biodegradability
- (C) has a higher blood/gas partition coefficient
- (D) has a lower MAC value
- (E) has a lower vapor pressure
A 30-year-old woman develops urticaria immediately after administration of 2% 2-chloroprocaine for removal of a nevus on the chest wall. This reaction resolves with administration of diphenhydramine and the surgery is rescheduled. During the second procedure, a field block is performed using 10 ml of 1% lidocaine from a multidose vial. Within 10 minutes the patient develops urticaria and wheezing and has difficulty breathing. These symptoms resolve with administration of epinephrine. Which of the following substances is the most likely cause of these reactions?
- (A) A paraben derivative
- (B) Povidone-iodine
- (C) Ethylenediaminetetraacetic acid (EDTA)
- (D) Propylene glycol
- (E) Sodium bisulfite