10 Random Questions
A 27-month-old, 14-kg infant with intestinal obstruction is anesthetized with nitrous oxide at 1 L/min, oxygen at 0.4 L/min, and halothane at 0.8% using a Bain circuit. Ventilation is controlled at a rate of 30/min. The child's temperature is 39°C, and the PaCO2 is 65 mmHg. Which of the following is most likely?
- (A) Malignant hyperthermia
- (B) Low gas inflow rate
- (C) Low respiratory rate
- (D) Pulmonary aspiration of gastric contents
- (E) Inaccurate flowmeters
Intrabiliary pressure will be increased to the greatest extent by intravenous administration of
- (A) atropine
- (B) glucagon
- (C) naloxone
- (D) fentanyl
- (E) butorphanol
This flow-volume loop from a 57-year-old man is most consistent with which of the following conditions?
- (A) Bronchospasm
- (B) Decreased vital capacity
- (C) Myasthenia gravis
- (D) Narrowing of the upper airway
- (E) Pneumothorax
After an axillary brachial plexus block, the patient feels pain when the surgeon clips the skin over the thenar eminence. The most likely cause is inadequate anesthesia in the distribution of the
- (A) intercostobrachial nerve
- (B) median nerve
- (C) musculocutaneous nerve
- (D) radial nerve
- (E) ulnar nerve
A 70-kg 24-year-old man with bilateral pneumonia whose lungs are being mechanically ventilated has the following measured parameters: tidal volume 750 ml; FiO2 0.7; rate 12/min; positive end-expiratory pressure 10 cmH2O; PaO2 75 mmHg; PaCO2 55 mmHg; pH 7.30. Which of the following alterations should be made in the ventilatory settings?
- (A) Decreasing positive end-expiratory pressure
- (B) Decreasing respiratory rate
- (C) Increasing fresh gas flow rate
- (D) Increasing FiO2
- (E) Increasing tidal volume
In a patient who is breathing spontaneously, the work of breathing increases with each of the following EXCEPT
- (A) decreased compliance
- (B) decreased vital capacity
- (C) increased carbon dioxide production
- (D) increased respiratory rate
- (E) increased dead space
Static lung compliance is decreased by each of the following EXCEPT
- (A) pulmonary emphysema
- (B) congestive heart failure
- (C) adult respiratory distress syndrome
- (D) pulmonary fibrosis
- (E) inhalational anesthesia
A 1150-g, 10-day-old infant is undergoing a bowel resection for necrotizing enterocolitis. Heart rate is 200 bpm and blood pressure measured through a femoral artery catheter is 45/24 mmHg. The most appropriate next step is administration of
- (A) calcium gluconate
- (B) epinephrine
- (C) esmolol
- (D) fentanyl
- (E) normal saline solution
Compared with a person of normal weight, which of the following findings are most likely on pulmonary function testing of a patient with morbid obesity? (FVC, FEV/FVC, FRC, A-a DO2)?
- (A) Decreased, Normal, Decreased, Normal
- (B) Decreased, Normal, Decreased , Increased
- (C) Decreased, Normal, Normal, Increased,
- (D) Increased, Decreased, Normal, Increased
- (E) Increased, Decreased, Decreased, Increased
A 50-year-old man with alcoholism and jaundice is scheduled to undergo umbilical herniorrhaphy. An increase in which of the following best indicates impaired synthetic hepatic function?
- (A) Prothrombin time
- (B) Serum alanine aminotransferase concentration
- (C) Serum albumin/globulin ratio
- (D) Serum alkaline phosphatase concentration
- (E) Serum bilirubin concentration