10 Random Questions
An endobronchial Robertshaw tube is inserted for resection of a midesophageal tumor under isoflurane, oxygen, pancuronium anesthesia. Forty minutes into a planned two-hour resection, arterial blood gas values are reported as PO2 45 mmHg, PCO2 45 mmHg, and pH 7.33. Ten minutes earlier, the values were PO2 210 mmHg, PCO2, 41 mmHg, and pH 7.39. The first action should be to
- (A) reposition the Robertshaw tube
- (B) apply positive end-expiratory pressure to the ventilated lung
- (C) reinflate and ventilate the non ventilated lung
- (D) increase minute ventilation
- (E) repeat the arterial blood gas analysis
Which of the following drugs has the shortest elimination half-life?
- (A) Diazepam
- (B) Flumazenil
- (C) Flumazepam
- (D) Lorazepam
- (E) Midazolam
Compared with similar use in adults, routine use of succinylcholine in children is hazardous because of the increased risk for which of the following?
- (A) Anaphylactoid reaction
- (B) Phase II blockade
- (C) Pseudocholinesterase deficiency
- (D) Pulmonary aspiration
- (E) Undiagnosed myopathy
During craniotomy in the sitting position, end-tidal carbon dioxide tension suddenly decreases. Ventilatory excursion of the chest is normal. Further evaluation is most likely to show a decrease in
- (A) alveolar-to-arterial oxygen tension difference
- (B) alveolar-to-arterial carbon dioxide tension difference
- (C) dead space ventilation
- (D) pulmonary artery pressure
- (E) pulmonary artery occlusion pressure
Postoperatively a 70-kg patient has a serum sodium value of 130 mEq/L. To increase this value to 140 mEq/L would require the administration of how much sodium in mEq?
- (A) 140
- (B) 250
- (C) 420
- (D) 600
- (E) 740
A woman is in labor at 40 weeks' gestation and the fetus is in breech presentation. Which of the following will provide adequate uterine relaxation for vaginal delivery?
- (A) Spinal anesthesia
- (B) Epidural anesthesia
- (C) Halothane anesthesia
- (D) Pudendal nerve block
- (E) Magnesium sulfate
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
Which of the following is indicated by an alarm condition in the line-isolation monitor?
- (A) An electrical shock to the patient
- (B) A power surge in the main hospital power supply
- (C) Disconnection of the patient from an electrocautery grounding pad
- (D) Overload of the operating room circuits
- (E) The presence of a current leak between an operating room electrical device and ground
A patient who is scheduled for a gastrectomy had abnormal liver function tests for four days following a prior cholecystectomy. In your consultation note, you should
- (A) recommend sevoflurane anesthesia since abnormal postoperative liver function tests are unlikely with this drug
- (B) recommend subarachnoid anesthesia since changes in hepatic blood flow would be less than with general anesthesia
- (C) indicate that abnormal liver function tests are likely to follow this operation regardless of the anesthetic drugs used
- (D) require preoperative screening for hepatitis B antigen and antibodies
- (E) recommend avoiding halothane since it is more likely to produce hepatitis in patients who had previous upper abdominal surgery
The preanesthetic ECG trace (lead II) shown from a 32-year-old woman suggests
- (A) potential for tachyarrhythmia
- (B) need for preanesthetic atropine
- (C) myocardial ischemia
- (D) left bundle branch block
- (E) right ventricular hypertrophy