10 Random Questions
A 32-year-old man with acute aortic regurgitation is scheduled to undergo emergency aortic valve replacement. Heart rate is 110 bpm, blood pressure is 90/35 mmHg, and pulmonary artery occlusion pressure is 14 mmHg. Cardiac index is 2.2 L/min/m2. Which of the following is the most appropriate management?
- (A) Administration of esmolol
- (B) Administration of a fluid bolus before induction
- (C) Infusion of dobutamine
- (D) Infusion of phenylephrine
- (E) Induction of anesthesia
In a patient with peripheral vascular disease, the most likely result of lumbar sympathetic block is
- (A) increased blood flow to skin and decreased blood flow to muscle
- (B) increased blood flow to skin and unchanged blood flow to muscle
- (C) increased blood flow to skin and muscle
- (D) decreased blood flow to skin and muscle
- (E) decreased blood flow to skin and unchanged blood flow to muscle
In the absence of coronary artery disease, isoflurane-induced vasodilation and tachycardia are beneficial hemodynamic goals for which of the following cardiac diseases?
- (A) Aortic regurgitation
- (B) Aortic stenosis
- (C) Asymmetric septal hypertrophy (IHSS)
- (D) Mitral stenosis
- (E) Pulmonary regurgitation
Bronchospasm occurring during anesthesia in a patient with an ileal carcinoid is best treated by administration of
- (A) aminophylline
- (B) dexamethasone
- (C) halothane
- (D) ketamine
- (E) somatostatin
During induction of anesthesia in a 70-year-old man with aortic stenosis, the blood pressure decreases from 140/ 80 to 70/45 mmHg as the cardiac rhythm changes from normal sinus at 70 bpm to junctional at 120 bpm. The most appropriate initial therapy would be
- (A) cardioversion
- (B) esmolol
- (C) fluid bolus
- (D) phenylephrine
- (E) verapamil
Each of the following increases arterial to end-tidal carbon dioxide tension difference EXCEPT
- (A) addition of positive-end expiratory pressure
- (B) deliberate hypotension
- (C) endobronchial intubation
- (D) hypovolemia
- (E) pulmonary embolism
Which of the following will most closely mimic the effects of stellate ganglion block?
- (A) Axillary perivascular block with 25 mL of 1.5% lidocaine
- (B) Cervical nerve block at C2-5 with 2 mL of 1.5% lidocaine
- (C) Supraclavicular block at the level of the first rib with 25 mL of 1.5% lidocaine
- (D) Block of the median, radial, ulnar, musculocutaneous, and intercostobrachial nerves
- (E) Excision of thoracic sympathetic ganglia Tl-4
A mechanically ventilated newborn infant is undergoing gastroschisis repair during halothane anesthesia. Based on the right radial artery catheter tracing shown, which of the following is the most appropriate conclusion?
- (A) The abdomen has not yet been incised
- (B) The anesthetic should be changed from halothane to isoflurane
- (C) The ductus arteriosus is still open
- (D) The infant is hypovolemic
- (E) The tidal volume is inadequate
A 40-year-old man who is scheduled to undergo repair of a tendon laceration of the left hand has complete anesthesia in the median, radial, and ulnar nerve distributions after supraclavicular block. Two hours of tourniquet inflation are required for completion of the procedure. The most appropriate next step is an additional block of which of the following?
- (A) Axillary nerve
- (B) Intercostobrachial nerve
- (C) Lateral antebrachial cutaneous nerve
- (D) Musculocutaneous nerve
- (E) Stellate ganglion
Desflurane is delivered using a vaporizer that contains internal heaters because
- (A) heat decreases the drug's viscosity
- (B) heat reduces thermal loss in the patient
- (C) heat increases the drug's oil-gas partition coefficient
- (D) heat prevents fluctuations of vapor pressure
- (E) it does not vaporize adequately at room temperature