10 Random Questions
A patient who is scheduled for a parathyroidectomy for a parathyroid adenoma has a preoperative serum calcium concentration of 13.5 mg/dl. The ECG shows no acute changes. The most appropriate preoperative management is administration of
- (A) calcitonin
- (B) hydrocortisone
- (C) intravenous saline solution
- (D) mannitol
- (E) potassium phosphate
A 25-year-old woman is undergoing emergency appendectomy at 36 weeks' gestation. Following subarachnoid injection of hyperbaric bupivacaine and placement in the supine position, the patient has nausea; heart rate is 105 bpm and blood pressure is 90/60 mmHg. Which of the following is the most appropriate management?
- (A) Displacement of the uterus to the left
- (B) Immediate tracheal intubation
- (C) Intramuscular administration of ephedrine
- (D) Placement of the operating table in the reverse Trendelenburg position
- (E) Ventilation by mask with 100% oxygen
Evaluation of a postoperative neurologic deficit discloses inability to oppose the thumb and little finger, weakness of abduction of the thumb, and loss of flexion of the distal phalanx of the index finger. This problem is most likely related to
- (A) paresthesia occurring during an interscalene brachial plexus block
- (B) attempted radial artery cannulation at the wrist
- (C) inadequate padding under the elbow
- (D) attempted venipuncture in the antecubital fossa
- (E) abduction of the upper humerus against an "ether screen"
Which of the following decreases the clearance of atracurium?
- (A) Administration of cimetidine
- (B) Cholinesterase deficiency
- (C) Hepatic insufficiency
- (D) Hypothermia
- (E) Renal insufficiency
A 75-year-old man with aortic stenosis and coronary artery disease has a preinduction heart rate of 68 bpm and blood pressure of 125/70 mmHg. After induction of anesthesia with fentanyl, midazolam, and pancuronium, heart rate is 90 bpm and blood pressure is 85/45 mmHg. ECG shows a new ST-segment elevation in lead II. Which of the following is the most appropriate initial management?
- (A) Ephedrine
- (B) Epinephrine
- (C) Esmolol
- (D) Nitroglycerin
- (E) Phenylephrine
Which of the following is described by the standard deviation during analysis of the results of a clinical study?
- (A) Central tendency of the study results
- (B) Distribution of the results of the study group
- (C) Range of the results of the study group
- (D) Regression analysis of the study group
- (E) Statistical significance of the difference between the study groups
A 57-year-old man who weighs 150 kg and is 170 cm (67 in) tall is scheduled for cholecystectomy. He has a 100 pack-year smoking history. Which of the following findings on pulmonary function testing are most likely?
Which of the following changes is most likely in the patient whose pulmonary pathology is schematically illustrated?
- (A) Decreased diffusing capacity
- (B) Decreased PaO2
- (C) Decreased pH
- (D) Increased PaCO2
- (E) Increased Vd/Vt
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
Recommendations for maximal allowable trace anesthesia gases are based on
- (A) achievable levels with modern scavenging systems
- (B) data from animal studies
- (C) data on methionine synthetase levels in anesthesiologists
- (D) evidence for an association with malignancy in anesthesiologists
- (E) evidence for an association with spontaneous abortion In operating room personnel