10 Random Questions
A 35-year-old woman receiving isoflurane anesthesia suddenly develops tachycardia, hypertension, and multifocal ventricular ectopy during dissection of a pheochromocytoma. Each of the following would be appropriate treatment EXCEPT
- (A) administration of an alpha-adrenergic blocker
- (B) administration of a beta-adrenergic blocker
- (C) administration of lidocaine
- (D) administration of nitroprusside
- (E) switching from isoflurane to enflurane
An obese, 75-year-old woman is scheduled for open reduction of a left forearm fracture. Thirty minutes after successful interscalene block using 20 ml of 2% lidocaine, she becomes dyspneic. The dyspnea is most likely related to
- (A) cervical epidural block
- (B) cervical sympathetic block with bronchospasm
- (C) chylothorax
- (D) elevation of the left hemidiaphragm
- (E) recurrent laryngeal nerve block
Which of the following is the most likely beneficial effect of hyperbaric oxygen therapy in a 24-year-old scuba diver with decompression sickness?
- (A) Decreased production of carbon dioxide
- (B) Decreased size of gas bubbles
- (C) Increased functional residual capacity
- (D) Reversal of membrane pressure effects
- (E) Shift of the oxyhemoglobin dissociation curve to the left
A 6-year-old boy undergoes craniotomy in the supine position for brain tumor during anesthesia with 1.5% isoflurane in oxygen. PetCO2 is 38 mmHg, heart rate is 78 bpm, and blood pressure is 130/80 mmHg. After opening the dura, the surgeon notes that the brain is bulging. Which of the following management options is LEAST likely to significantly decrease brain size?
- (A) Decreased isoflurane concentration
- (B) Furosemide
- (C) Hyperventilation to a PaCO: of 25 mmHg
- (D) Mannitol
- (E) Nitroprusside
Maternal hyperventilation to a PaCO2 of 20 mmHg during labor can result in
- (A) decreased fetal trapping of local anesthetics
- (B) fetal metabolic acidosis
- (C) fetal respiratory acidosis
- (D) increased oxygen release at the placenta
- (E) uterine vasodilation
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
The acute onset of hypotension without a decrease in mixed venous oxygen saturation is most likely associated with the onset of
- (A) hemorrhage
- (B) myocardial infarction
- (C) pulmonary edema
- (D) pulmonary embolus
- (E) sepsis
Each of the following conditions can be accurately evaluated with transesophageal echocardiography EXCEPT
- (A) intimal tear at the aortic arch
- (B) intracardiac air
- (C) left atrial thrombus
- (D) patent foramen ovale
- (E) right atrial myxoma
Which of the following statements concerning cardiovascular physiology in a healthy term neonate is true?
- (A) Heart rate is increased in response to hypoxemia
- (B) Heart rate increases reflexly in response to hypotension
- (C) Stroke volume increases in response to decreased systemic vascular resistance
- (D) Stroke volume increases in response to bradycardia
- (E) Stroke volume is near-maximal under resting conditions
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