10 Random Questions
A 65-year-old patient receiving long-term clonidine therapy fails to take it one day before surgery. This would most likely
- (A) be beneficial, since clonidine decreases cardiac output
- (B) be of no consequence due to the long half-life of clonidine
- (C) produce a lower anesthetic requirement than if the drug had been continued
- (D) produce rebound hypertension
- (E) result in seizure activity
The most likely explanation for the intraoperative capnographic tracing shown is
- (A) cardiac oscillation
- (B) exhaustion of soda lime
- (C) kinking of the endotracheal tube
- (D) partial recovery from vecuronium
- (E) presence of water droplets in the analyzer
In the diagram, point "X" represents a patient with severe left ventricular dysfunction. The points labeled 1, 2, and 3 each represent the results of a different therapeutic intervention. Which of the following represents the most likely intervention at each point?
- (A) 1-Dopamine, 2-Furosemide, 3-Nitroprusside
- (B) 1-Dopamine, 2-Nitroprusside, 3-Furosemide
- (C) 1-Furosemide, 2-Dopamine, 3-Nitroprusside
- (D) 1-Nitroprusside, 2-Dopamine, 3-Furosemide
- (E) 1-Nitroprusside, 2-Furosemide, 3-Dopamine
A previously healthy 28-year-old woman scheduled for laparoscopic tubal ligation becomes, agitated and refuses to undergo the procedure after being brought to the operating room. This behavior most likely resulted from preoperative administration of
- (A) droperidol
- (B) cimetidine
- (C) atropine
- (D) meperidine
- (E) midazolam
Spinal anesthesia at a T6 sensory level is most likely to improve cardiac output in patients with
- (A) aortic stenosis
- (B) asymmetric septal hypertrophy (IHSS)
- (C) chronic constrictive pericarditis
- (D) cor pulmonale
- (E) mitral regurgitation
A patient receiving monoamine oxidase inhibitor therapy for depression undergoes an emergency cholecystectomy. Which of the following is the best means of providing postoperative analgesia in this patient?
- (A) Epidural analgesia using 0.25% bupivacaine
- (B) Intravenous meperidine
- (C) Epidural analgesia using meperidine
- (D) Epidural analgesia using 1% lidocaine with epinephrine
- (E) Intercostal analgesia using 1% lidocaine with epinephrine
A 40-year-old woman is undergoing a posterior fossa craniotomy in the sitting position for clipping of a basilar artery aneurysm. Nitroprusside is being used to maintain mean arterial pressure at 50 mmHg, measured at head level. During dissection, over the course of one minute, the mean blood pressure decreases to 30 mmHg. Simultaneously, end-tidal carbon dioxide and pulmonary artery pressures decrease and heart rate increases. The most likely cause of these changes is
- (A) progressive hypoxemia
- (B) nitroprusside bolus
- (C) junctional rhythm
- (D) brain stem manipulation
- (E) venous air embolism
Which property of oxygen is detected by the fail-safe device on the anesthesia machine?
- (A) Concentration
- (B) Flow
- (C) Pressure
- (D) Partial pressure
- (E) Reserve volume
Pulmonary artery occlusion pressure is NOT a reliable estimate of left ventricular end-diastolic pressure when
- (A) junctional cardiac rhythm is present
- (B) mitral insufficiency is present
- (C) pulmonary compliance is decreased
- (D) pulmonary hypertension is present
- (E) the catheter tip is in zone 1 of the lung
Two days after myocardial infarction involving the left anterior descending coronary artery, a patient's blood pressure decreases acutely from 125/80 to 70/40 mmHg, heart rate increases from 75 to 90 bpm, pulmonary artery pressure increases to 50/30 mmHg, and urine output decreases from 60 to 10 ml/hr. Thermodilution cardiac output has increased from 4 to 7 L/min. The most appropriate action is to
- (A) compare mixed venous oxygen saturation in the right atrium and pulmonary artery
- (B) draw blood for culture and start antibiotic therapy
- (C) start dopamine infusion in low dose
- (D) administer a fluid challenge
- (E) monitor peripheral capillary oxygenation by transcutaneous oximetry