10 Random Questions
Initiation of positive pressure mechanical ventilation is LEAST likely to decrease cardiac output in patients with which of the following conditions?
- (A) Abdominal distention with decreased lung volume
- (B) Acute cardiogenic pulmonary edema
- (C) Chronic obstructive pulmonary disease
- (D) Flail chest following an automobile accident
- (E) 20% Right pneumothorax
In the event of a leak in the air flowmeter, which flowmeter arrangement produces the lowest risk of delivering hypoxic gas mixtures?
- (A) Air, O2, N2O
- (B) N2O, O2, Air
- (C) N2O, Air, O2
- (D) O2, Air, N2O
- (E) O2, N2O, Air
Which of the following statements best describes the decrease in cerebral metabolic rate that occurs with administration of volatile anesthetics?
- (A) It is independent of anesthetic dose
- (B) It is maximal when the EEG is isoelectric
- (C) It is more profound with halothane than isoflurane at equipotent doses
- (D) It is not affected by enflurane-induced EEG hyperactivity
- (E) It parallels changes in cerebral blood flow at mean arterial pressures of 50 to 150 mmHg
Which of the following statements concerning the cardiovascular effects of intravenous bupivacaine is true?
- (A) Intralipid is effective in treating bupivacaine-induced ventricular arrhythmias
- (B) Cardiovascular toxicity is decreased during pregnancy
- (C) Cardiovascular toxicity occurs at lower blood levels than central nervous system toxicity
- (D) Systemic vascular resistance is unchanged
- (E) The rate of impulse conduction through the heart is increased
A patient with alcoholic cirrhosis, ascites, and gastrointestinal bleeding receives 4 units of red blood cells prior to anesthesia with isoflurane in oxygen for emergency exploratory laparotomy. After the peritoneum is opened and the fluid is drained, blood pressure decreases to 60/40 mmHg and SpO2 decreases to 90%. The most likely cause of the hypoxemia is
- (A) acute myocardial ischemia
- (B) decreased 2,3-diphosphoglycerate in transfused blood
- (C) increased intrapulmonary shunting
- (D) relative hypovolemia
- (E) venous air embolism
A 33-year-old woman is scheduled for emergency appendectomy under general anesthesia. She has hypertrophic cardiomyopathy and has had two episodes of syncope in the past year. Which of the following statements concerning anesthetic management is true?
- (A) Spinal anesthesia is preferred to general anesthesia
- (B) Deep levels of isoflurane anesthesia are appropriate
- (C) Fluid administration should be restricted
- (D) Phenylephrine is preferred to ephedrine to treat hypotension
- (E) Positive end-expiratory pressure will decrease left ventricular outflow obstruction
Bronchospasm occurring during anesthesia in a patient with an ileal carcinoid is best treated by administration of
- (A) aminophylline
- (B) dexamethasone
- (C) halothane
- (D) ketamine
- (E) somatostatin
In a patient with surgically significant aortic insufficiency, cardiac output measured by thermodilution will
- (A) be greater than right ventricular output
- (B) be less than left ventricular output
- (C) be less than cardiac output measured by the Fick method
- (D) be inaccurate because of decreased signal-to-noise ratio
- (E) underestimate net systemic arterial blood flow
A healthy 57-year-old man with a ureteral calculus is scheduled for immersion extracorporeal shock wave lithotripsy. Which of the following statements is true?
- (A) Delivery of the shock wave is timed by the R wave of the ECG
- (B) Continuous epidural anesthesia is contraindicated because of the risk for infection
- (C) If a regional technique is used, a T10 sensory level is required for adequate anesthesia
- (D) If general anesthesia is used, high tidal volumes and low respiratory rate are preferred
- (E) Removal of the patient from the bath is accompanied by an increase in blood pressure
Which of the following is the most common infection transmitted through transfusion of blood products?
- (A) Epstein-Barr virus
- (B) Hepatitis B
- (C) Hepatitis C
- (D) Human immunodeficiency virus
- (E) Toxoplasmosis