10 Random Questions
A 68-year-old man with stable angina treated with propranolol and nifedipine is scheduled for coronary artery bypass grafting. After induction with fentanyl and tracheal intubation, heart rate decreases to 40 bpm and blood pressure decreases to 70/40 mmHg. The ECG is shown. Which of the following is the most appropriate first step in management?
- (A) Infusion of isoproterenol
- (B) Administration of phenylephrine
- (C) Closed chest cardiopulmonary resuscitation
- (D) Defibrillation
- (E) Synchronized cardioversion
Arterial oxyhemoglobin desaturation develops more rapidly following apnea in a pregnant patient at term than in a nonpregnant patient with a large intra-abdominal tumor. Which of the following findings in pregnancy is the most likely cause?
- (A) Higher cardiac output
- (B) Higher oxygen consumption
- (C) Larger anatomic dead space
- (D) Smaller blood volume
- (E) Smaller functional residual capacity
A 68-year-old man has signs of a coagulopathy after receiving 10 units of packed erythrocytes during emergency repair of a leaking abdominal aortic aneurysm. The most likely cause is
- (A) depletion of factor V
- (B) disseminated intravascular coagulation
- (C) hypothermia
- (D) platelet dysfunction
- (E) thrombocytopenia
A 70-kg patient is anesthetized for a craniotomy in the sitting position. Minute ventilation through a circle system is 15 L/min; PetC02 is 65 mmHg. Which of the following is the most likely cause of the increased PetC02?
- (A) Inadequate flow of fresh gas
- (B) Incompetent expiratory valve
- (C) Intubation of the right mainstem bronchus
- (D) Light anesthesia
- (E) Venous air embolism
The illustration depicts flow-volume loops for the same person at two different times in his life. Which of the following is indicated by the dotted loop?
- (A) Bronchial tumor
- (B) Chronic asthmatic bronchitis
- (C) Morbid obesity
- (D) Paralysis of a vocal cord
- (E) Subglottic stenosis
A 2500-g, 12-hour-old infant is tracheally intubated and mechanically ventilated at a rate of 20/min with an FiO2 of 0.4 and peak inspiratory pressure of 25 cmH2O. At birth, amniotic fluid was meconium stained and Apgar scores were 2 and 7. The most recent arterial blood gas levels are PaO2, 50 mmHg, PaCO2, 55 mmHg, and pH 7.20. The most appropriate management is to
- (A) administer sodium bicarbonate
- (B) begin intravenous infusion of prostaglandin E,
- (C) increase FiO2
- (D) increase ventilation
- (E) perform bronchial lavage
Neostigmine administered intravenously without atropine can produce each of the following EXCEPT
- (A) arousal
- (B) bradycardia
- (C) bronchoconstriction
- (D) increased gastric motility
- (E) increased urinary bladder tone
The ECG rhythm shown developed during cholecystectomy in a 62-year-old man who had a myocardial infarction and is taking atenolol. The drug of choice for treating this dysrhythmia is
- (A) atropine
- (B) bretylium
- (C) isoproterenol
- (D) lidocaine
- (E) procainamide
Postdural puncture headache occurs most commonly in which of the following patients?
- (A) Children
- (B) Elderly persons
- (C) Misn
- (D) Parturients
- (E) Persons with obesity
Compared with a semiclosed circle system, a closed system
- (A) decreases the risk for anesthetic overdose
- (B) decreases the risk for rebreathing carbon dioxide
- (C) has lower resistance to gas flow
- (D) permits calculation of oxygen consumption
- (E) permits more rapid changes in anesthetic depth