10 Random Questions
A 65-year-old patient with hypertrophic cardiomyopathy has chest pain prior to induction of anesthesia. Pulse is 80 bpm and blood pressure is 130/80 mmHg. The ECG (V5) shows sinus rhythm and new ST-segment depression. The most appropriate management is administration of
- (A) furosemide
- (B) metoprolol
- (C) morphine
- (D) nifedipine
- (E) nitroglycerin
A 70-year-old patient has absence of the left radial pulse one month after repair of an aortic aneurysm. Arterial pressure was monitored perioperatively with a 20-gauge left radial artery catheter. Which of the following statements concerning this complication is true?
- (A) A preoperative Allen's test would have predicted this complication
- (B) Stellate ganglion block should be performed
- (C) This complication would have been less likely with an 18-gauge catheter
- (D) This patient has poor collateral circulation in the hand
- (E) The pulse will likely return
Each of the following statements about the anatomy of the autonomic nervous system is true EXCEPT:
- (A) Preganglionic cell bodies are located in the central nervous system
- (B) Postganglionic neurons are located in outlying ganglia
- (C) The parasympathetic ganglia are located near their target organs
- (D) The adrenal gland is innervated only by the sympathetic nervous system
- (E) The parasympathetic nervous system has thoracic and sacral segments
The illustration depicts flow-volume loops for the same person at two different times in his life. Which of the following is indicated by the dotted loop?
- (A) Bronchial tumor
- (B) Chronic asthmatic bronchitis
- (C) Morbid obesity
- (D) Paralysis of a vocal cord
- (E) Subglottic stenosis
A 26-year-old woman is hospitalized in early labor at 38 weeks' gestation. Vaginal bleeding occurred prior to admission. Systemic blood pressure remains 140/80 mmHg during intravenous infusion of fluids. Which of the following factors would contraindicate epidural anesthesia for labor at this time?
- (A) Early fetal heart rate decelerations
- (B) Hematocrit of 29%
- (C) Blood pressure of 110/75 mmHg when sitting
- (D) Platelet count of 100,000/mm3
- (E) Increased respiratory rate
The laryngeal mask airway
- (A) causes more hemodynamic stimulation than an oropharyngeal airway
- (B) is contraindicated in patients with cervical spine instability
- (C) is more easily inserted when cricoid pressure is applied
- (D) may serve as a temporary airway in case of a failed rapid sequence intubation
- (E) requires administration of a muscle relaxant to avoid laryngospasm during insertion
A 20-year-old woman with poorly controlled diabetes mellitus is scheduled for urgent drainage of an abdominal abscess. She received an initial dose of regular insulin 10 units followed by regular insulin 5 units/hr for the past five hours. Laboratory studies show serum sodium concentration 128 mEq/L, potassium 5.4 mEq/L, chloride 80 mEq/L, and glucose 750 mg/dl. The most appropriate perioperative management is
- (A) addition of subcutaneous NPH insulin
- (B) administration of sodium bicarbonate to correct metabolic acidosis
- (C) administration of normal saline solution to correct the presumed hypovolemia
- (D) administration of furosemide to correct hyponatremia
- (E) infusion of 5% dextrose in 0.2% saline solution to prevent hypoglycemia
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 best describes the relationship between cerebral perfusion pressure and cerebral blood flow in a patient with untreated chronic hypertension?
- (A) It is constant at mean blood pressures between 50 and 150 mmHg
- (B) It is linear for all blood pressures
- (C) Flow versus pressure curve is hyperbolic
- (D) Flow versus pressure curve is shifted to the right
- (E) Flow versus pressure curve is shifted to the left
Which of the following is an effect of clonidine?
- (A) Agitation
- (B) Salivation
- (C) Tachycardia
- (D) Tachypnea
- (E) Vasodilation