10 Random Questions
Appropriate anesthetic management of a patient with hypertrophic cardiomyopathy includes each of the following EXCEPT
- (A) maintaining normal or slightly greater than normal preload
- (B) adjusting positive airway pressure to maintain near normal venous return
- (C) preference for volatile agents rather than opiates for anesthesia
- (D) use of beta-adrenergic blocking agents to increase ventricular wall compliance
- (E) decreasing afterload with peripheral vasodilators
A 25-year-old woman is receiving magnesium sulfate for eclampsia at 36 weeks' gestation. Each of the following is a maternal effect of this treatment EXCEPT
- (A) sedation
- (B) sensitization to depolarizing muscle relaxants
- (C) sensitization to nondepolarizing muscle relaxants
- (D) decreased uterine blood flow
- (E) loss of deep tendon reflexes prior to significant cardiac dysfunction
A 68-year-old patient is undergoing total hip replacement during general anesthesia using positive pressure ventilation and neuromuscular blockade. Intraoperative monitoring shows a gradual decrease in end-tidal CO2, an increase in exhaled tidal volume, and an increase in measured FiO2. Which of the following is the most likely cause of these changes?
- (A) Air entrainment around a deflated endotracheal tube cuff
- (B) Channeling of the exhaled air through the carbon dioxide canister
- (C) Fat embolism
- (D) Inadequate muscle relaxation with spontaneous patient ventilation
- (E) A small hole in the ventilator bellows
During liver transplantation, venovenous bypass from the femoral and portal veins to the axillary vein during cross-clamping of the inferior vena cava
- (A) decreases urine output
- (B) prevents hypothermia
- (C) prevents metabolic acidosis
- (D) requires heparinization
- (E) supports cardiac output
A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?
- (A) Fluid overload with 5% dextrose in water
- (B) Inappropriate secretion of antidiuretic hormone
- (C) Increased free water clearance
- (D) Nephrogenic diabetes insipidus
- (E) Neurogenic diabetes insipidus
If minute ventilation remains constant, a decrease in end-expiratory carbon dioxide concentration will occur with
- (A) a decrease in physiologic dead space
- (B) a decrease in cardiac output
- (C) a decrease in physiologic shunt fraction
- (D) the development of metabolic alkalosis
- (E) an increase in body temperature
Following pneumonectomy, a paralyzed patient being mechanically ventilated has the following arterial blood gas values: PaO2 71 mmHg, PaCO2 55 mmHg, pH 7.29. SvO2 is 45%. The most likely explanation for this SvO2 is
- (A) decreased red cell mass
- (B) high cardiac output
- (C) hypothermia
- (D) peripheral left-to-right arteriovenous shunt
- (E) ventilation / perfusion mismatch
Which of the following is a cardiorespiratory effect of epidural block to a T4 sensory level?
- (A) Decreased expiratory reserve volume
- (B) Decreased tidal volume
- (C) Increased circulating catecholamine concentrations
- (D) Increased heart rate
- (E) Unchanged vital capacity
A 60-kg, 17-year-old girl with severe idiopathic scoliosis is scheduled for Harrington rod fixation. Which of the following respiratory parameters is compatible with this disorder?
- (A) Alveolar-to-arterial oxygen tension difference (A-aDO2) less than 100 mmHg while breathing pure oxygen
- (B) FEV1/FVC ratio less than 50%
- (C) Forced vital capacity less than 2000 ml
- (D) Intrapulmonary shunt less than 10%
- (E) Normal pulmonary vascular resistance
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