10 Random Questions
A 58-year-old man with a history of angina is undergoing resection of an abdominal aortic aneurysm under morphine, nitrous oxide, d-tubocurarine anesthesia. Just before removal of the aortic cross-clamp, heart rate is 74 bpm, blood pressure is 115/70 mmHg, and pulmonary artery occlusion pressure is 7 mmHg. Immediately after removal of the cross-clamp, heart rate increases to 120 bpm, blood pressure decreases to 80/55 mmHg, and pulmonary artery occlusion pressure decreases to 3 mmHg. The V5 lead on the EKG demonstrates sudden ST-segment depression and T-wave inversion. Initial therapy should be
- (A) reapplication of the aortic cross-clamp
- (B) intravenous administration of sodium bicarbonate
- (C) initiation of a phenylephrine infusion
- (D) rapid expansion of blood volume by transfusion
- (E) initiation of a nitroglycerin infusion
A patient who has severe pain from unresectable cancer of the base of the tongue is referred for a neurolytic block. A block of which of the following will be effective?
- (A) Gasserian ganglion
- (B) Glossopharyngeal nerve
- (C) Hypoglossal nerve
- (D) Mandibular nerve
- (E) Vagus nerve
Each of the following increases arterial to end-tidal carbon dioxide tension difference EXCEPT
- (A) addition of positive-end expiratory pressure
- (B) deliberate hypotension
- (C) endobronchial intubation
- (D) hypovolemia
- (E) pulmonary embolism
A mechanically ventilated newborn infant is undergoing gastroschisis repair during halothane anesthesia. Based on the right radial artery catheter tracing shown, which of the following is the most appropriate conclusion?
- (A) The abdomen has not yet been incised
- (B) The anesthetic should be changed from halothane to isoflurane
- (C) The ductus arteriosus is still open
- (D) The infant is hypovolemic
- (E) The tidal volume is inadequate
Which of the following is the most likely cause of the rapid onset of local anesthesia when sodium bicarbonate is added to lidocaine?
- (A) Decreased extracellular calcium ion concentration
- (B) Increased extracellular pH
- (C) Increased intracellular pH
- (D) Increased ionized lidocaine diffusion
- (E) Increased nonionized lidocaine concentration
During axillary block of the brachial plexus, which nerve is most likely to be encountered if the needle is inserted through the posterior wall of the artery?
- (A) Intercostobrachial
- (B) Median
- (C) Musculocutaneous
- (D) Radial
- (E) Ulnar
Which of the following statements concerning the management of diabetes mellitus during pregnancy is true?
- (A) Insulin requirements remain essentially unchanged during pregnancy
- (B) Maternal blood glucose concentration of 200 mg/dL is optimal
- (C) Maternal hyperglycemia may cause neonatal acidosis
- (D) Neonatal hyperglycemia is common
- (E) Infants delivered under general anesthesia have lower Apgar scores than those delivered under spinal anesthesia
A multiparous 24-year-old woman sustains an amniotic fluid embolism during general anesthesia. The LEAST likely clinical finding is
- (A) increased end-tidal carbon dioxide tension
- (B) increased uterine bleeding
- (C) jugular venous distention
- (D) ST and T wave abnormalities on ECG
- (E) wheezing
Which of the following is suggestive of epiglottitis rather than croup?
- (A) A 2-year-old child with a harsh, barking cough
- (B) A 4-year-old child who insists on sitting up and leaning forward
- (C) Leukocyte count of 10,000/mm3 with marked lymphocytosis
- (D) Rectal temperature of 38.5°C
- (E) Subglottic narrowing (steeple sign) on lateral neck radiograph
Which of the following is the most appropriate action after an anesthetic vaporizer is tipped?
- (A) Return to the manufacturer for recalibration
- (B) Flush the vaporizer with oxygen at 5 L/min for 24 hours
- (C) Store the vaporizer for 24 hours at room temperature
- (D) Set the vaporizer at low concentration and flush with oxygen at 10 L/min for 30 minutes
- (E) Verify the vaporizer output with mass spectrography