10 Random Questions
A 2600-g neonate is to undergo surgical repair of a small gastroschisis. The infant is preoxygenated with 100% oxygen. Arterial hemoglobin desaturation is noted during laryngoscopy after a rapid-sequence induction. Which of the following is the most likely cause?
- (A) High fetal hemoglobin concentration
- (B) High ratio of oxygen consumption to functional residual capacity
- (C) Low functional residual capacity in milliliters per kilogram
- (D) Poor thoracic compliance
- (E) Patent ductus arteriosus
A bilateral superior laryngeal nerve block performed to facilitate fiberoptic intubation will provide anesthesia of the
- (A) base of the tongue
- (B) larynx above the vocal cords
- (C) superior surface of the epiglottis
- (D) tonsillar pillars
- (E) upper trachea
A newborn infant is undergoing repair of gastroschisis. During closure of the abdominal wall, ventilatory pressures and central venous pressure increase markedly. The most appropriate management is to
- (A) administer a bronchodilator
- (B) decrease tidal volume and increase ventilatory rate
- (C) increase the neuromuscular block
- (D) increase the depth of anesthesia
- (E) ask the surgeon to reopen the abdomen
The tracing indicates that the pacemaker generator is
- (A) malfunctioning
- (B) VVT sensing and capturing normally
- (C) VOO sensing and capturing normally
- (D) DVI sensing and capturing normally
- (E) VVI sensing and capturing normally
Which of the following findings necessitates the preoperative insertion of a ventricular pacemaker in a 48-year-old man scheduled to undergo cholecystectomy?
- (A) Atrial flutter with 3:1 atrioventricular block
- (B) Bifascicular (right bundle branch block and left anterior hemiblock) block
- (C) Left bundle branch block with first-degree atrioventricular block
- (D) Second-degree (Mobitz I) atrioventricular block
- (E) Second-degree (Mobitz II) atrioventricular block
Which of the following statements concerning carbon monoxide poisoning is true?
- (A) Diagnosis is excluded if the PaO2 is greater than 300 mmHg while breathing 100% oxygen
- (B) Increased inspired oxygen concentration accelerates displacement of carbon monoxide from hemoglobin
- (C) Methylene blue decreases binding of carbon monoxide to hemoglobin
- (D) Pulse oximetry accurately reflects hemoglobin oxygen saturation
- (E) Tissue oxygen delivery is normal
Which of the following will result in the largest change in oxygen content?
- (A) Increased hemoglobin (Hgb) concentration from 10 to 15 g/dl
- (B) Increased PaO2 from 40 to 50 mmHg (Hgb 15 g/dl)
- (C) Increased PaO2 from 60 to 70 mmHg (Hgb 15 g/dl)
- (D) Increased P50 of Hgb from 27 to 37 mmHg (Hgb 15 g/dl)
- (E) Increased pH from 7.20 to 7.40
A 2.2-kg, 6-hour-old neonate is to undergo gastrostomy followed by repair of a tracheoesophageal fistula. During induction with halothane, air, and oxygen, the abdomen becomes distended. Appropriate management is to
- (A) intubate and assist spontaneous ventilation
- (B) intubate and control ventilation
- (C) insert an orogastric tube
- (D) allow the patient to breathe spontaneously by mask until gastrostomy
- (E) control ventilation by mask until gastrostomy
A 90-kg, 59-year-old man with chronic obstructive pulmonary disease is undergoing laparotomy. Mechanical ventilation is being carried out with a fresh gas flow of 2 L/min at a rate of 16/min and tidal volume of 900 ml; I:E ratio is 1:2.5. PaCO2 remains greater than 50 mmHg. Preoperative PaCO2, was normal. Which of the following is the most appropriate next step?
- (A) Adding 10 cmH20 of positive end-expiratory pressure
- (B) Converting to spontaneous ventilation
- (C) Decreasing inspiratory flow rate
- (D) Increasing exhalation time
- (E) Increasing fresh gas flow
Which of the following is suggestive of epiglottitis rather than croup?
- (A) A 2-year-old child with a harsh, barking cough
- (B) A 4-year-old child who insists on sitting up and leaning forward
- (C) Leukocyte count of 10,000/mm3 with marked lymphocytosis
- (D) Rectal temperature of 38.5°C
- (E) Subglottic narrowing (steeple sign) on lateral neck radiograph