10 Random Questions
A patient with cirrhosis presenting for liver transplantation is likely to exhibit each of the following EXCEPT
- (A) decreased cardiac output
- (B) decreased serum glucose concentration (0 decreased serum sodium concentration
- (D) decreased systemic vascular resistance
- (E) increased alveolar-arterial oxygen tension difference
In performing a diagnostic left lumbar sympathetic block for lower extremity claudication, the tip of the needle ideally should lie at point
- (A) A
- (B) B
- (C) C
- (D) D
- (E) E
In children with preoperative upper respiratory tract infection, which of the following is associated with the greatest risk for postoperative airway obstruction?
- (A) Age less than 1 year
- (B) Endotracheal intubation
- (C) Head and neck surgery
- (D) Inadequate airway humidification
- (E) Surgery for more than two hours
Each of the following conditions is associated with autonomic hyperreflexia in patients with spinal cord injury EXCEPT
- (A) bradycardia
- (B) flushing below the level of injury
- (C) headache
- (D) sweating above the level of injury
- (E) systolic hypertension
A 3.3-kg neonate is brought to the operating room for repair of a left diaphragmatic hernia. A 3-mm endotracheal tube is placed to a depth of 9 cm. Initial arterial blood gas values from a right radial catheter while spontaneously breathing oxygen 50% are PaO2 82 mmHg, PaCO2 41 mmHg, pH 7.33, and base excess -5. After reduction of the hernia (during closure of the abdomen), vigorous attempts to expand the atelectatic lung are unsuccessful. The infant rapidly becomes very dusky, heart rate is 60 bpm, breath sounds are distant and squeaky bilaterally, and pulmonary compliance is decreased. Which of the following should be done first?
- (A) Obtain a radiograph of the chest
- (B) Place a chest tube on the left side
- (C) Place a chest tube on the right side
- (D) Withdraw the endotracheal tube 1 cm and suction
- (E) Reopen the abdomen
High positive end-expiratory pressure can result in each of the following EXCEPT
- (A) decreased venous return
- (B) increased functional residual capacity
- (C) a left-to-right shift of the ventricular septum
- (D) decreased PaO2
- (E) pulmonary barotrauma
A 70-kg 24-year-old man with bilateral pneumonia whose lungs are being mechanically ventilated has the following measured parameters: tidal volume 750 ml; FiO2 0.7; rate 12/min; positive end-expiratory pressure 10 cmH2O; PaO2 75 mmHg; PaCO2 55 mmHg; pH 7.30. Which of the following alterations should be made in the ventilatory settings?
- (A) Decreasing positive end-expiratory pressure
- (B) Decreasing respiratory rate
- (C) Increasing fresh gas flow rate
- (D) Increasing FiO2
- (E) Increasing tidal volume
Following the administration of 4 MAC hours of enflurane, peak serum concentrations of inorganic fluoride are highest in patients who
- (A) are physically dependent on barbiturates
- (B) are taking isoniazid chronically to suppress tuberculosis
- (C) are epileptics taking phenytoin chronically
- (D) are obese
- (E) consume alcohol regularly
Following induction of general anesthesia, mask ventilation and the initial attempt at intubation is unsuccessful. Which of the following procedures is most appropriate?
- (A) Administration of additional muscle relaxant
- (B) Repeat attempt at intubation
- (C) Fiberoptic intubation
- (D) Retrograde intubation
- (E) Cricothyroidotomy
Metoclopramide acts to
- (A) block dopamine receptors
- (B) decrease gastric acid production
- (C) decrease lower esophageal sphincter tone
- (D) delay gastric emptying
- (E) facilitate central cholinergic stimulation