10 Random Questions
Preoperative administration of alpha-adrenergic inhibitors will usually reverse ECG changes due to
- (A) catecholamine myocarditis
- (B) Preoperative administration of alpha-adrenergic inhibitors decreases operative mortality
- (C) Beta-adrenergic inhibitors should be administered preoperatively only in conjunction with alpha-adrenergic
- inhibitors
- (D) Vasopressor therapy may be necessary postoperatively for treatment of hypotension
An otherwise healthy 16-year-old girl is undergoing posterior spinal fusion for thoracolumbar scoliosis. During the procedure, the most likely cause of a marked decrease in the amplitude of the somatosensory evoked potentials after stimulation of the posterior tibial nerve is
- (A) administration of fentanyl 30 jag /kg for induction
- (B) administration of isoflurane 1.3 MAC for maintenance
- (C) administration of vecuronium 0.15 mg/kg
- (D) a decrease in body temperature from 37 to 35°C
- (E) a decrease in cerebrospinal fluid pressure
Following maternal epidural injection, fetal exposure to chloroprocaine is lower than fetal exposure to bupivacaine for which of the following reasons?
- (A) Chloroprocaine is metabolized by plasma cholinesterase
- (B) Chloroprocaine is more protein bound
- (C) Chloroprocaine is not readily absorbed from the epidural space
- (D) The ionized fraction of chloroprocaine in the fetal circulation is smaller
- (E) The pKa of chloroprocaine is less than that of bupivacaine
In an Infant, spinal anesthesia to a sensory level of T8 is achieved with tetracaine administered at the L2-3 interspace. Compared with spinal anesthesia to the same sensory level in an adult, this anesthetic is associated with a
- (A) higher risk for neurotoxicity
- (B) higher risk for systemic toxicity
- (C) lower risk for spinal cord injury
- (D) more significant decrease in blood pressure
- (E) shorter duration of action
Miosis, incontinence, excess salivation, and convulsions are toxic effects of
- (A) amphetamines
- (B) phenothiazines
- (C) cocaine
- (D) tricyclic antidepressants
- (E) organophosphate insecticides
A patient with chronic obstructive pulmonary disease is undergoing spinal anesthesia to a T6 sensory level. The most pronounced effect on pulmonary function will be a decrease in
- (A) minute ventilation
- (B) peak expiratory flow
- (c) physiologic dead space
- (D) tidal volume
- (E) vital capacity
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
When performed with identical doses, which of the following types of regional block is associated with the highest plasma concentration of the drug?
- (A) Brachial plexus
- (B) Caudal
- (C) Intercostal
- (D) Subcutaneous infiltration
- (E) Thoracic epidural
The arterial waveform and EKG shown are from a 60-year-old man with uremia who is the PACU after hip surgery under general anesthesia. The patient is drowsy, extubated, and breathing easily. The most likely diagnosis is
- (A) hypovolemia
- (B) myocardial ischemia
- (C) nontension pneumothorax
- (D) pericardial tamponade
- (E) pulmonary embolus
A 55-year-old man who is scheduled to undergo carotid endarterectomy (CEA) has a persistent myocardial filling defect at three hours on a dipyridamole-thallium scan. Which of the following statements is correct?
- (A) Coronary autoregulation is effective in this segment
- (B) Coronary revascularization should precede CEA
- (C) Isoflurane is contraindicated
- (D) Myocardial infarction is impending
- (E) There is a segment of nonviable myocardium