10 Random Questions
Pulmonary artery occlusion pressure is NOT a reliable estimate of left ventricular end-diastolic pressure when
- (A) junctional cardiac rhythm is present
- (B) mitral insufficiency is present
- (C) pulmonary compliance is decreased
- (D) pulmonary hypertension is present
- (E) the catheter tip is in zone 1 of the lung
A 64-year-old man is scheduled to have an elective right colon resection under nitrous oxide, oxygen, enflurane anesthesia. Following a myocardial infarction two years ago, a programmable VVI pacemaker was inserted for complete heart block. A pre induction rhythm strip is shown. Based on this EKG finding, the most appropriate action is to
- (A) proceed with induction of anesthesia
- (B) convert the pacemaker to the fixed rate mode
- (C) reprogram the pacemaker to increase R-wave sensitivity
- (D) increase the pacemaker current outpu
- (E) insert a temporary atrioventricular sequential pacemaker
If administered prior to induction of anesthesia, which of the following drugs is most likely to cause tachycardia?
- (A) Fentanyl
- (B) Meperidine
- (C) Midazolam
- (D) Morphine
- (E) Sufentanil
The most important cause of hypotension that occurs normally at initiation of cardiopulmonary bypass is
- (A) hemodilution
- (B) acidosis
- (C) decreased flow rate
- (D) vasodilation
- (E) hypothermia
A 70-year-old man sustains injuries to both carotid bodies during bilateral carotid endarterectomies performed four days apart. Two hours after the second procedure, the patient is breathing room air in the PACU. Which of the following sets (pH, pCO2, pO2) of arterial blood gas values is LEAST likely?
- (A) 7.3 50 58
- (B) 7.3 50 86
- (C) 7.4 40 86
- (D) 7.4 42 58
- (E) 7.5 32 58
During nitrous oxide anesthesia, which of the following expands most rapidly?
- (A) Air bubble in the blood
- (B) Air in the intestine
- (C) Endotracheal tube cuff
- (D) Pneumothorax
- (E) Sulfahexafluoride bubble in the vitreal cavity
A 65-year-old patient with hypertrophic cardiomyopathy has chest pain prior to induction of anesthesia. Pulse is 80 bpm and blood pressure is 130/80 mmHg. The ECG (V5) shows sinus rhythm and new ST-segment depression. The most appropriate management is administration of
- (A) furosemide
- (B) metoprolol
- (C) morphine
- (D) nifedipine
- (E) nitroglycerin
A 75-year-old man received an uneventful epidural anesthetic for total knee arthroplasty. Twenty-four hours later he has a painless flaccid paralysis in both legs. This clinical presentation is most consistent with
- (A) adhesive arachnoiditis
- (B) anterior spinal artery thrombosis
- (C) epidural abscess
- (D) epidural hematoma
- (E) transverse myelitis
A 55-year-old man requires intravenous lidocaine for multifocal premature ventricular contractions occurring in the first hour after a below-knee amputation. He has alcoholic cirrhosis, portal hypertension, and ascites. Which of the following correctly describes the appropriate modification of the usual loading bolus and maintenance infusion of lidocaine?
- (A) Larger bolus, faster infusion
- (B) Larger bolus, slower infusion
- (C) Smaller bolus, faster infusion
- (D) Smaller bolus, slower infusion
- (E) No change necessary
An 8-kg, 1-year-old boy is scheduled for a bilateral inguinal hernia repair. If regional anesthesia is to be used for post-operative analgesia, which of the following statements is true?
- (A) Caudal administration of 0.25% bupivacaine will provide analgesia without evidence of motor block
- (B) Caudal administration of 0.125% bupivacaine is as effective as caudal administration of 0.25% bupivacaine
- (C) Caudal analgesia is more difficult to achieve in young children than in adults
- (D) The recommended volume of local anesthetic used for caudal analgesia in children is 3 ml per year of age
- (E) The volume of 0.25% bupivacaine required for bilateral ilioinguinal and iliohypogastric nerve blocks would be too large