10 Random Questions
A 75-year-old, 60-kg man with moderately disabling heart failure secondary to ischemic heart disease is undergoing a transurethral prostatic resection under halothane-nitrous oxide anesthesia. Resection time is 30 minutes, and fluid replacement has been lactated Ringer's solution 500 mL. Although heart rate is unchanged, the arterial pressure monitor used because of his cardiac condition has changed from A to B over the last 15 minutes. The most appropriate management is to
- (A) discontinue halothane
- (B) adminster ephedrine 10 mg intravenously
- (C) administer digoxin one half of his daily dose intravenously
- (D) administer sodium chloride 100 mL of 3%
- (E) do none of the above
A patient undergoes differential spinal block for evaluation of persistent foot pain. If the pain returns coincident with a decrease in skin temperature, which of the following is the most appropriate conclusion?
- (A) A somatic origin is ruled out
- (B) The patient has causalgia
- (C) The patient has peripheral vascular disease
- (D) The pain is caused by central neuropathy
- (E) Lumbar sympathetic blocks are indicated
In a healthy 70-kg adult, which of the following is the most likely effect of intravenous administration of morphine 10 mg on ventilatory responses?
- (A) Increased response to hypoxia and decreased response to hypercarbia
- (B) Decreased response to hypercarbia and no change in response to hypoxia
- (C) Decreased response to both hypoxia and hypercarbia
- (D) No change in response to hypercarbia and decreased response to hypoxia
- (E) No change in response to hypoxia or hypercarbia
A 35-kg child requires mechanical ventilation with pure oxygen at a tidal volume of 350 ml and a rate of 20/min during a severe asthma attack. The most likely cause of severe hypotension after initiating mechanical ventilation is
- (A) hypoxic circulatory depression
- (B) inadequate expiratory time
- (C) increased pulmonary vascular resistance
- (D) respiratory alkalosis
- (E) tension pneumothorax
Microatelectasis 48 hours after abdominal surgery is most consistently manifested by
- (A) decreased PaO2
- (B) ground glass infiltrate on a roentgenogram of the chest
- (C) scattered fine inspiratory rales
- (D) increased PaCO2
- (E) scattered areas of dullness to chest percussion
A 2.2-kg, 6-hour-old neonate is to undergo gastrostomy followed by repair of a tracheoesophageal fistula. During induction with halothane, air, and oxygen, the abdomen becomes distended. Appropriate management is to
- (A) intubate and assist spontaneous ventilation
- (B) intubate and control ventilation
- (C) insert an orogastric tube
- (D) allow the patient to breathe spontaneously by mask until gastrostomy
- (E) control ventilation by mask until gastrostomy
Positive end-expiratory pressure is effective for treatment of hypoxia resulting from each of the following EXCEPT
- (A) cardiogenic pulmonary edema
- (B) intraoperative Trendelenburg position
- (C) lateral position during total hip replacement
- (D) lung contusion
- (E) status asthmaticus
After brachial plexus block, a patient has sensation over the inner aspect of the upper arm. Block of which of the following nerves would obtund this sensation?
- (A) Intercostobrachial
- (B) Median
- (C) Musculocutaneous
- (D) Radial
- (E) Ulnar
Which of the following procedures is most specific for diagnosing reflex sympathetic dystrophy in a patient with pain of the lower extremity?
- (A) Caudal epidural local anesthetic block
- (B) Differential spinal anesthesia
- (C) Intravenous regional administration of bretylium
- (D) Lumbar epidural administration of a corticosteroid
- (E) Paramedian L1-L5 facet injections of lidocaine
The illustration depicts flow-volume loops for the same person at two different times in his life. Which of the following is indicated by the dotted loop?
- (A) Bronchial tumor
- (B) Chronic asthmatic bronchitis
- (C) Morbid obesity
- (D) Paralysis of a vocal cord
- (E) Subglottic stenosis