10 Random Questions
A patient with jaundice who has a minimally elevated SGOT (AST), markedly elevated alkaline phosphatase, and normal prothrombin time is to receive a muscle relaxant. Which of the following is most likely in this patient?
- (A) Decreased intubating dose of pancuronium
- (B) Increased intubating dose of atracurium
- (C) Prolonged duration of succinylcholine effect
- (D) Prolonged duration of vecuronium effect
- (E) Shortened duration of d-tubocurarine effect
During frontal craniotomy for removal of an astrocytoma, the surgeon notes that the brain is "tight." The patient is receiving nitrous oxide 50% in oxygen, isoflurane 0.5%, fentanyl, and pancuronium. Heart rate is 92 bpm, blood pressure is 110/60 mmHg, end-tidal carbon dioxide tension is 31 mmHg, and oxygen saturation is 98%. The most appropriate initial treatment is to
- (A) administer a beta-adrenergic blocker
- (B) administer thiopental
- (C) decrease isoflurane concentration
- (D) decrease mean arterial pressure to 60 mmHg
- (E) increase alveolar ventilation
Compared with epidural administration of hydrophilic opioids, epidural administration of lipophilic opioids is associated with
- (A) earlier onset of pruritus
- (B) greater motor block when combined with local anesthetics
- (C) higher incidence of delayed respiratory depression
- (D) lesser sensitivity to reversal of analgesia by naloxone
- (E) slower onset of analgesia
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
Which of the following is a characteristic of the Bain breathing circuit?
- (A) Condensation of moisture in inspired gases is facilitated by the circuit design
- (B) Fresh gas flows coaxially around the exhalation limb
- (C) Fresh gas flows need not exceed minute ventilation
- (D) The circuit eliminates the possibility of rebreathing
- (E) The circuit is functionally similar to the Jackson-Rees system
Which of the following malfunctions causes the line isolation monitor to alarm?
- (A) Discharge of static electricity
- (B) Flow of current to ground in the isolated circuit
- (C) Interruption of current to electrical outlets caused by a circuit breaker
- (D) Surge of current in the main power supply
- (E) Total electrical current exceeding circuit capacity
Compared with adults, neonates are more likely to become hypoxemic following anesthesia and extubation because of a relatively
- (A) higher rate of oxygen consumption
- (B) greater sensitivity to neuromuscular blockade
- (C) larger Vd/Vt ratio
- (D) lower blood pressure
- (E) smaller functional residual capacity
One hour after induction of anesthesia for a posterior fossa craniotomy using opioid, relaxant, and nitrous oxide, the brain begins to protrude through the dura. The most effective measure to decrease intracranial pressure is to
- (A) administer additional opioid
- (B) decrease PaCO2 from 25 to 15 mmHg
- (C) drain cerebrospinal fluid
- (D) discontinue nitrous oxide
- (E) induce hypotension
The trend plot shows end-tidal gases measured during a radical neck dissection. The event occurring at A is most likely
- (A) acute hypotension
- (B) endobronchial intubation
- (C) kinking of the endotracheal tube
- (D) rupture of the endotracheal cuff
- (E) venous air embolism
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