10 Random Questions
Which of the following perioperative interventions decreases the risk for renal insufficiency in patients undergoing aortic aneurysm repair?
(A) Administration of furosemide
(B) Administration of mannitol
(C) Administration of renal-dose dopamine
(D) Epidural anesthesia
(E) Preoperative volume expansion
Reveal Answer
ADVANCED
General
Hypomagnesemia is associated with
(A) decreased risk for digitalis toxicity
(B) dysrhythmias sensitive to bretylium
(C) hypercalcemia
(D) prolonged succinylcholine blockade
(E) surgery requiring cardiopulmonary bypass
Reveal Answer
ADVANCED
General
Cardiac
A 68-year-old man has signs of a coagulopathy after receiving 10 units of packed erythrocytes during emergency repair of a leaking abdominal aortic aneurysm. The most likely cause is
(A) depletion of factor V
(B) disseminated intravascular coagulation
(C) hypothermia
(D) platelet dysfunction
(E) thrombocytopenia
Reveal Answer
ADVANCED
Transfusions & Fluids
General
When treating reflex sympathetic dystrophy of an arm, which of the following is the best indicator of a successful sympathetic blockade?
(A) A pinprick sensory deficit in the distribution of C6
(B) A 5°C increase in the temperature of the skin of the hand
(C) An accentuated psychogalvanometric response in the forearm
(D) An ipsilateral positive Horner's syndrome
(E) Decreased temperature sensation in the hand
Reveal Answer
Which of the following best explains why neonates are at greater risk than adults for hypothermia during surgical procedures?
(A) Greater body surface area relative to body mass
(B) Greater cutaneous vasodilation at equal MAC concentrations of volatile anesthetics
(C) Greater dependence on shivering to produce heat
(D) Inability to increase metabolic rate
(E) Less insulation by adipose tissue
Reveal Answer
ADVANCED
Pediatric
A patient with end-stage renal disease has prolonged ventilatory depression after administration of morphine. The most likely cause is increased
(A) serum concentration of morphine-6-glucuronide
(B) elimination half-life of morphine
(C) opioid receptors
(D) receptor affinity
(E) volume of distribution
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
A patient is in sinus rhythm but has no pulse during cardiopulmonary resuscitation. There is marked resistance to positive pressure ventilation and breath sounds are difficult to hear bilaterally. The endotracheal tube is clearly in the trachea. The most appropriate next step in management is to
(A) administer isoetharine by inhalation
(B) apply electrical countershock
(C) insert needles in the left and right chest
(D) order a roentgenogram of the chest
(E) start an infusion of aminophylline
Reveal Answer
BASIC
General
A 65-kg, 57-year-old man has an initial activated clotting time (ACT) of 122 seconds prior to elective cardiopulmonary bypass. Five minutes after administration of heparin 200 mg, ACT increases to 154 seconds. After two additional doses of 200 mg each from different lots, ACT increases to 240 seconds. The most appropriate next step is to
(A) administer additional heparin 400 mg
(B) administer fresh frozen plasma 2 units
(C) initiate cardiopulmonary bypass
(D) measure the plasma heparin concentration
(E) start an infusion of desmopressin
Reveal Answer
ADVANCED
Transfusions & Fluids
Cardiac
Compared with thiopental, methohexital is characterized by
(A) better absorption after rectal administration
(B) greater protein binding
(C) greater hepatic clearance
(D) larger volume of distribution
(E) more complete biotransformation
Reveal Answer
BASIC
Pharmacology & Pharmacokinetics
Which of the following drugs increases gastric pH while decreasing gastric volume?
(A) Glycopyrrolate
(B) Magnesium trisilicate
(C) Metoclopramide
(D) Ranitidine
(E) Sodium citrate
Reveal Answer