10 Random Questions
A 54-year-old woman who is scheduled to undergo emergency exploratory laparotomy takes warfarin sodium for anticoagulation. Prothrombin time is 19 sec (control 12 sec). Which of the following agents is most appropriate to reverse the effects of warfarin?
- (A) Cryoprecipitate
- (B) Desmopressin (DDAVP)
- (C) Factor IX concentrate
- (D) Fresh frozen plasma
- (E) Pooled factor VIII
Ninety minutes after administration of succinylcholine 1 mg/kg to a 28-year-old woman, the train-of-four shows a T4:T1 ratio of 25%. This is most consistent with
- (A) dibucaine number of 30
- (B) hypersensitivity to succinylmonocholine
- (C) pregnancy
- (D) pretreatment with pancuronium 2 mg
- (E) severe cirrhosis
Upon removal of the epidural catheter after uneventful labor and delivery in a 25-year-old primiparous woman, approximately 1.2 cm of the Teflon catheter is left behind in the epidural space. The patient is informed of the complication. The most appropriate management is
- (A) immediate surgical removal
- (B) prophylactic antibiotics
- (C) lumbar myelogram
- (D) monthly neurologic examinations
- (E) no intervention
At a body temperature of 30°C, resistance to blood flow increases because of
- (A) increased hematocrit
- (B) increased plasma fibrinogen concentration
- (C) increased viscosity of blood
- (D) rouleaux formation of red blood cells
- (E) sequestration of platelets in portal circulation
The central anticholinergic syndrome is LEAST likely to occur after administration of
- (A) atropine
- (B) chlorpromazine
- (C) diphenhydramine
- (D) glycopyrrolate
- (E) scopolamine
The concentration of bupivacaine is higher in maternal blood than in fetal blood because
- (A) bupivacaine is metabolized in the placenta
- (B) maternal blood has a higher pH
- (C) maternal blood has greater plasma protein binding
- (D) maternal hemoglobin has a higher affinity for bupivacaine
- (E) placental transfer of bupivacaine is limited
A 62-year-old man is scheduled for coronary artery bypass grafting. During induction of anesthesia with fentanyl, high peak inspiratory pressures occur with manual ventilation, and peripheral oxygen saturation decreases from 100% to 94%. The most appropriate management is administration of
- (A) albuterol
- (B) isoflurane
- (C) midazolam
- (D) nitroglycerin
- (E) succinylcholine
Which of the following limits the use of nalbuphine for relief of postoperative pain?
- (A) High incidence of nausea and vomiting
- (B) High incidence of delayed respiratory depression
- (C) Potential for inducing seizures with repeated doses
- (D) Relatively low maximal analgesic effect
- (E) Short duration of action
Which of the following findings is most likely in a 3-year-old child who has a secundum-type atrial septal defect with a 2:1 left-to-right shunt?
- (A) Pulmonary blood flow twice that of systemic blood flow
- (B) Pulmonary vascular resistance twice normal
- (C) Mean pulmonary artery pressure twice normal
- (D) Right atrial pressure twice normal
- (E) Hypoxemia while breathing room air
The following breath sounds are heard after placement of a left-sided double-lumen endobronchial tube. The most likely cause of these findings is
- (A) presence of both lumens in the right mainstem bronchus
- (B) presence of both lumens in the left mainstem bronchus
- (C) presence of both lumens in the trachea
- (D) herniation of the bronchial cuff at the bifurcation of the trachea
- (E) presence of the bronchial lumen in the right mainstem bronchus