10 Random Questions
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
Which of the following limits the use of nalbuphine for relief of postoperative pain?
- (A) High incidence of nausea and vomiting
- (B) High incidence of delayed respiratory depression
- (C) Potential for inducing seizures with repeated doses
- (D) Relatively low maximal analgesic effect
- (E) Short duration of action
Nitroprusside therapy for hypertension should be discontinued in the presence of
- (A) acute myocardial infarction
- (B) increasing metabolic acidosis
- (C) methemoglobinemia
- (D) mitral regurgitation
- (E) renal failure
Pseudocholinesterase
- (A) is increased in patients with myasthenia gravis
- (B) is inhibited by glycopyrrolate
- (C) is inhibited by pilocarpine
- (D) is synthesized by the liver
- (E) reverses atracurium blockade
A 76-year-old man has a leaking abdominal aortic aneurysm. His blood pressure and pulse have remained stable for 15 minutes at 90/60 mmHg and 130 bpm, respectively. His hemoglobin concentration is 11 g/dl, and the EKG shows a left bundle branch block. Induction of anesthesia should proceed
- (A) after a pulmonary artery catheter has been inserted and the pulmonary artery occlusion pressure is greater than 7 mmHg
- (B) when the pulse has decreased below 130 bpm from the rapid transfusion of blood
- (C) when systolic blood pressure has increased to more than 120 mmHg from the rapid infusion of lactated Ringer's solution
- (D) immediately on arrival in the operating room
- (E) when circulatory signs deteriorate or cease to improve with rapid volume expansion
A 46-year-old patient is undergoing resection of a posterior fossa tumor with the head elevated 10 cm above the level of the heart. During the procedure, the following changes in vital signs are observed. Which of the following is the most likely cause of the change in heart rate?
- (A) Brain stem compression
- (B) Increased intracranial pressure
- (C) Myocardial ischemia
- (D) Trigeminal nerve retraction
- (E) Venous air embolism
Which of the following statements best describes the decrease in functional residual capacity that accompanies the induction of general anesthesia?
- (A) It does not change compliance
- (B) It is greater with spontaneous ventilation than with controlled ventilation
- (C) It is independent of body position
- (D) It is not corrected by application of positive end-expiratory pressure
- (E) It occurs within the first 10 minutes of anesthesia
A 54-year-old man receives 25 ml of a 50% alcohol and 0.25% bupivacaine solution for celiac plexus block. During the next 20 minutes, blood pressure decreases from 130/75 mmHg to 85/55 mmHg. Which of the following is the most likely cause?
- (A) Intravascular injection
- (B) Retroperitoneal hemorrhage
- (C) Splanchnic vasodilation
- (D) Subarachnoid blockade
- (E) Tension pneumothorax
A 35-year-old woman with systemic lupus erythematosus is admitted to the critical care unit following sudden onset of severe chest pain. Examination shows tachycardia, hypotension, pulmonary edema, and a blowing systolic murmur in the left parasternal region. The most appropriate management is
- (A) aerosol administration of terbutaline
- (B) intravenous infusion of phenylephrine and nitroglycerin
- (C) intravenous infusion of esmolol
- (D) intravenous infusion of epinephrine and nitroprusside
- (E) volume loading with lactated Ringer's solution
Inhibition of labor by terbutaline causes each of the following maternal side effects EXCEPT
- (A) hyperkalemia
- (B) hypotension
- (C) ventricular dysrhythmias
- (D) hyperglycemia
- (E) pulmonary edema