10 Random Questions
Diffuse microvascular bleeding is noted in a patient who has received 25 units of whole blood for a liver resection. Platelet count is 40,000/mm3, prothrombin time is 18 sec, activated partial thromboplastin time is 54 sec, and serum fibrinogen concentration is 60 mg/dl. The most likely cause of the bleeding is
- (A) abnormal platelet function
- (B) citrate toxicity
- (C) depressed levels of factors V and VIII
- (D) dilutional thrombocytopenia
- (E) disseminated intravascular coagulation
Each of the following drugs is a cause of central anticholinergic syndrome EXCEPT
- (A) amitriptyline
- (B) atropine
- (C) diphenhydramine
- (D) promethazine
- (E) ranitidine
Which of the following statements concerning myasthenia gravis is true?
- (A) Neostigmine is inappropriate for antagonism of neuromuscular blockade
- (B) The number of acetylcholine receptors is decreased
- (C) Plasma cholinesterase concentration is decreased
- (D) The risk for malignant hyperthermia is increased
- (E) Succinylcholine is contraindicated
A 6-year-old child with severe cerebral palsy is scheduled for general anesthesia. He is at increased risk for each of the following EXCEPT
- (A) gastroesophageal reflux
- (B) hypersensitivity to central nervous system depressants
- (C) poor function of laryngeal reflexes
- (D) postoperative pulmonary complications
- (E) succinylcholine-induced hyperkalemia
Pulsus paradoxus is commonly seen during anesthesia in patients with each of the following conditions EXCEPT
- (A) severe asthma
- (B) right-sided heart failure
- (C) hypovolemia
- (D) atrial septal defect
- (E) obesity
Which of the following can be used as a sole criterion for brain death?
- (A) Absence of cerebral blood flow
- (B) Absence of doll's eye movements
- (C) Fixed, dilated pupils
- (D) Isoelectric EEG
- (E) Unresponsiveness to all externally applied stimuli
You are called to a witnessed cardiac arrest where cardiopulmonary resuscitation is being performed. After successful intubation, arterial blood gas values are PaO2 86 mmHg, PaCO2 63 mmHg, and pH 7.25 at an FiO2 of 1.0. The most appropriate management at this time is to
- (A) repeat arterial blood gas analysis using a new specimen
- (B) administer sodium bicarbonate
- (C) administer fluid challenge with 500 ml of normal saline solution
- (D) hyperventilate the patient
- (E) add positive end-expiratory pressure
A healthy, spontaneously breathing, supine, anesthetized patient has an arterial to end-tidal carbon dioxide tension difference of 3 mmHg. Following institution of mechanical ventilation the value increases to 12 mmHg. The most likely cause of this change is
- (A) cephalad displacement of the diaphragm
- (B) decreased production of carbon dioxide
- (C) increased cardiac output
- (D) increased shunting of blood through dependent lung zones
- (E) increased ventilation of nondependent lung zones
A child has tachypnea immediately after reintubation for intractable laryngospasm. Oxygen saturation is 78% at an FiO2 of 1.0. A radiograph of the chest taken 15 minutes later is most likely to show
- (A) bilateral pleural effusions
- (B) diffuse homogenous pulmonary infiltrates
- (C) patchy central infiltrates of the right upper lobe
- (D) pneumothorax
- (E) segmental atelectasis at both lung bases
The Mapleson A system (Magill circuit) illustrated
- (A) is functionally equivalent to the Bain circuit
- (B) prevents rebreathing more effectively during controlled ventilation than during spontaneous ventilation
- (C) provides better humidification than the Mapleson D system
- (D) requires a fresh gas flow equal to minute ventilation to prevent rebreathing during spontaneous ventilation
- (E) results in less rebreathing during controlled ventilation than the Mapleson C system