10 Random Questions
A 65-kg man is scheduled for wrist surgery with intravenous regional anesthesia with 0.5% lidocaine 50 ml. Which of the following statements is true?
- (A) This anesthetic is contraindicated if the patient has sickle cell disease
- (B) Mottling of the skin after injection dictates abandonment of the technique
- (C) Tourniquet discomfort is an indication to inject more local anesthetic
- (D) Bupivacaine 0.5% could be substituted to prolong anesthesia
- (E) Epinephrine (1:400,000) should be added to prolong anesthesia
The figure describes the uptake of nitrous oxide 75% by individual tissue groups (VRG = vessel-rich group, MG = muscle group, FG = fat group) and their sum (total uptake, TU). Which set of labels accurately describes the curves?
- (A) 1- MG, 2- FG, 3- VRG, 4- TU
- (B) 1- VRG, 2- MG, 3- FG, 4- TU
- (C) 1- FG, 2- MG, 3- TU, 4- VRG
- (D) 1- TU, 2- FG, 3- MG, 4- VRG
- (E) 1- TU, 2- VRG, 3- MG, 4- FG
A newly developed volatile anesthetic has a MAC of 10% in oxygen for adults. Which of the following statements concerning this anesthetic is true?
- (A) The expected MAC of this drug in combination with 60% nitrous oxide is 7.5%
- (B) The dose of this drug required to anesthetize a patient with acute amphetamine intoxication is less than the dose required for a normal patient
- (C) The potency of this drug is 25% of a drug with a MAC of 2.5%
- (D) The dose of this drug required to suppress the hormonal response to surgical incision is less than the MAC value
- (E) The MAC of this drug is decreased by metabolic alkalosis
A healthy 24-year-old woman is undergoing knee arthroscopy with spinal anesthesia to a level of T4. Which of the following findings is LEAST likely?
- (A) Decreased heart rate
- (B) Decreased hepatic blood flow
- (C) Decreased mean arterial pressure
- (D) Decreased tidal volume
- (E) Hyperperistalsis
Which of the following neural functions demonstrates the highest segmental block after spinal anesthesia?
- (A) Afferent sympathetic activity
- (B) Proprioception
- (C) Sharp pain perception
- (D) Temperature sensation
- (E) Touch sensation
Depression of cerebral oxygen requirements below the level required to create an isoelectric EEG can be achieved by
- (A) administration of isoflurane
- (B) administration of nimodipine
- (C) barbiturate coma
- (D) hyperventilation
- (E) hypothermia
An oxygen-driven anesthesia ventilator with a bellows that ascends during exhalation develops a small hole in the bellows. Which of the following is the most likely effect?
- (A) Alveolar hyperinflation
- (B) Decreased inspiratory flow rate
- (C) Decreased inspired oxygen concentration
- (D) Increased concentration of inhalational agent
- (E) Rebreathing of exhaled gases
An otherwise healthy 70-year-old man receives 12 units of packed red blood cells for persistent diffuse bleeding during suprapubic prostatectomy. Hemoglobin concentration is 11 g/dL, platelet count is 55,000/mm3, plasma fibrinogen concentration is 180 mg/dL, protime is 14 sec, and partial thromboplastin time is 35 sec. The most appropriate therapy is administration of
- (A) cryoprecipitate
- (B) desmopressin (DDAVP)
- (C) epsilon-aminocaproic acid
- (D) fresh frozen plasma
- (E) platelets
Which of the following statements concerning awareness (recall) during opioid anesthesia is true?
- (A) It is usually not associated with pain
- (B) It correlates well with intact auditory evoked responses
- (C) It is prevented if the dose of opioid blocks the hemodynamic response to stimuli
- (D) It is prevented if the dose of opioid is adequate to prevent movement without muscle relaxants
- (E) It is predicted by a specific EEG pattern
Each of the following conditions is associated with upregulation of the acetylcholine receptor at the neuromuscular junction EXCEPT
- (A) burn injuries
- (B) myasthenia gravis
- (C) prolonged bed rest
- (D) prolonged use of neuromuscular relaxants
- (E) upper motor neuron injury