10 Random Questions
The EKG rhythm shown developed during cholecystectomy in a 62-year-old man who had a myocardial infarction and is taking atenolol. The drug of choice for treating this arrhythmia is
- (A) atropine
- (B) bretylium
- (C) isoproterenol
- (D) lidocaine
- (E) procainamide
Which of the following is the primary factor regulating normal coronary blood flow?
- (A) Aortic diastolic pressure
- (B) Coronary perfusion pressure
- (C) Heart rate
- (D) Myocardial oxygen consumption
- (E) Systolic wall tension
Which of the following statements concerning successful blockade of the femoral nerve is true?
- (A) It requires that a paresthesia be elicited prior to injection
- (B) It provides motor blockade below the knee
- (C) It is accomplished with an injection medial to the femoral artery
- (D) It permits surgery for entrapment of the lateral femoral cutaneous nerve
- (E) It provides anesthesia to the anterior thigh
Surgery is cancelled 10 minutes after initiation of intravenous regional anesthesia with 50 ml of lidocaine 0.5%. To terminate anesthesia safely, what is the most appropriate timing for deflating the tourniquet?
- (A) Immediately if benzodiazepines have been administered
- (B) Immediately after intravenous administration of ephedrine 10 mg
- (C) Immediately, followed by repeated reinflation and deflation
- (D) In no less than 20 minutes after initial injection
- (E) In no less than 45 minutes after initial injection
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
A 3-day-old infant is comatose 18 hours after surgical correction of transposition of the great vessels. Tracheal suctioning produces only a tachycardic response. Anesthesia included midazolam 0.5 mg/kg, fentanyl 60 mcg/kg, and pancuronium 0.3 mg/kg. Which of the following is the most appropriate first step in evaluation of this infant?
- (A) Administration of flumazenil
- (B) Administration of naloxone
- (C) Train-of-four assessment
- (D) CT scan of the head
- (E) EEG
A normal adult is receiving general anesthesia via a standard circle system and controlled ventilation. Mass spectrometer data are shown. Which event is most compatible with these data?
- (A) Endobronchial intubation
- (B) Hemorrhagic shock
- (C) Incompetent expiratory valve
- (D) Substantial decrease in fresh gas flow
- (E) Venous air embolism
A 65-year-old man undergoes prostatectomy in the lithotomy position under spinal anesthesia using bupivacaine 12 mg. Ten hours later, he reports that his left foot is numb. Examination shows decreased pinprick sensation over the lateral dorsal aspect of the left foot; dorsiflexion is limited. Which of the following is the most likely cause?
- (A) Cauda equina syndrome
- (B) Compression of the common peroneal nerve
- (C) Compression of the posterior tibial nerve
- (D) L5 nerve root damage
- (E) Stretching of the sciatic nerve
An 8-kg, 1-year-old child has a measured blood loss of 50 ml during the first two hours of a rectal pull-through operation. Preoperative hematocrit was 31%. Balanced saline solution 150 ml has been administered for replacement. Urine output has been 2 ml for the last hour, heart rate is 160 bpm, and blood pressure is 40/15 mmHg. The most appropriate fluid therapy is,
- (A) 25% albumin
- (B) balanced salt solution
- (C) balanced salt solution and mannitol
- (D) 5% dextrose in 0.45% saline solution
- (E) packed red blood cells
A 39-year-old patient with insulin-dependent diabetes mellitus receives thiopental 250 mg and succinylcholine 80 mg and is ventilated with 0.75% isoflurane in oxygen. Arterial pressure decreases abruptly from 140/100 to 80/50 mmHg while heart rate remains unchanged at 70 bpm. Failure of heart rate to increase most likely results from
- (A) acute hypoglycemia
- (B) autonomic neuropathy
- (C) depression of sinus node function by thiopental
- (D) depression of the baroreflex response by isoflurane
- (E) ganglionic stimulation by succinylcholine