10 Random Questions
A 35-year-old patient with asymmetric septal hypertrophy (IHSS) is undergoing bladder suspension with sevoflurane 1%, nitrous oxide 50%, and oxygen 50%. Immediately after skin incision, blood pressure decreases to 90/60 mmHg and junctional tachycardia of 150 bpm is noted on the ECG. Which of the following is the most appropriate management?
- (A) Decreasing sevoflurane concentration
- (B) Infusion of nitroglycerin
- (C) Intravenous administration of a fluid bolus
- (D) Intravenous administration of esmolol
- (E) Intravenous administration of phenylephrine
Immediately after sustaining severe head injury, a 20-year-old man has a blood pressure of 150/90 mmHg and an intracranial pressure of 35 mmHg. After one hour of thiopental infusion, blood pressure is 105/60 mmHg, intracranial pres sure is 20 mmHg, central venous pressure is 5 mmHg, and temperature is 36°C. The EEG shows slow-wave activity. The most appropriate next step is administration of
- (A) additional thiopental
- (B) a corticosteroid
- (C) furosemide
- (D) nimodipine
- (E) phenylephrine
Which of the following is the most reliable indicator of adequate reversal of neuromuscular block?
- (A) Inspiratory force equal to -30 cmH20
- (B) Sustained head lift for 5 seconds
- (C) Train-of-four ratio of 0.7
- (D) Twitch height at 100% of control
- (E) Vital capacity of 15 ml/kg
A patient has an anterior neck injury, hoarseness, labored respirations, subcutaneous emphysema, and laryngeal crepitus following a motor vehicle accident. Which of the following is the best method of securing the airway in this situation?
- (A) Blind nasotracheal intubation
- (B) Lightwand intubation
- (C) Retrograde wire-guided intubation
- (D) Tracheostomy
- (E) Transtracheal jet ventilation
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
Which of the following is a characteristic of phase II neuromuscular block?
- (A) It is diagnosed by the intravenous administration of calcium
- (B) It is potentiated by edrophonium
- (C) It produces nondepolarizing train-of-four characteristics
- (D) It requires evaluation for pseudocholinesterase deficiency
- (E) It requires less succinylcholine than a phase I block
Which of the following statements concerning barbiturate protection from cerebral ischemia is true?
- (A) It may be achieved with dosages low enough to avoid cardiovascular effects
- (B) It is linearly dose-related
- (C) It improves neurologic outcome following cardiac arrest
- (D) It is most useful in patients with focal ischemia
- (E) It is unrelated to EEG activity
Bupivacaine 30 ml injected into the inguinal perivascular space will usually block the
- (A) femoral, lateral femoral cutaneous, and obturator nerves
- (B) ilioinguinal, femoral, and sciatic nerves
- (C) femoral, sciatic, and obturator nerves
- (D) ilioinguinal, iliohypogastric, and pudendal nerves
- (E) sciatic, femoral, and posterior femoral cutaneous nerves
An isoflurane-specific vaporizer that is 25% full is mistakenly refilled with halothane, and the dial is set at 1.5%. Which of the following statements concerning this situation is true?
- (A) The gas mixture will contain equal partial pressures of halothane and isoflurane
- (B) The gas mixture will produce a greater depth of anesthesia than 1.5% isoflurane alone
- (C) The gas mixture will produce a greater depth of anesthesia than 1.5% halothane alone
- (D) The liquid mixture will have a higher vapor pressure than 1.5% halothane alone
- (E) The liquid mixture will have a higher vapor pressure if it is placed in a halothane-specific vaporizer
Compared with morphine 5 mg administered epidurally at T12, morphine 5 mg administered intravenously is associated with
- (A) greater incidence of urinary retention
- (B) less intense analgesia
- (C) less nausea and vomiting
- (D) longer duration of analgesia
- (E) longer time to maximum analgesia