10 Random Questions
A 25-year-old man with known rheumatic heart disease is being evaluated in the critical care unit. Despite decreasing cardiac output, mixed venous blood from a pulmonary artery catheter shows an increase in Sv02. Which of the following is the most likely cause?
- (A) Decreasing hematocrit
- (B) Hypothermia to 35°C
- (C) Metabolic alkalosis
- (D) Mitral regurgitation
- (E) Wedging of the catheter
A 75-year-old, 60-kg man with moderately disabling heart failure secondary to ischemic heart disease is undergoing a transurethral prostatic resection under halothane-nitrous oxide anesthesia. Resection time is 30 minutes, and fluid replacement has been lactated Ringer's solution 500 mL. Although heart rate is unchanged, the arterial pressure monitor used because of his cardiac condition has changed from A to B over the last 15 minutes. The most appropriate management is to
- (A) discontinue halothane
- (B) adminster ephedrine 10 mg intravenously
- (C) administer digoxin one half of his daily dose intravenously
- (D) administer sodium chloride 100 mL of 3%
- (E) do none of the above
Immediately after a retrobulbar block for cataract surgery, the eye grossly protrudes and the patient has the sensation of pressure in the eye. The most appropriate initial intervention is
- (A) hyperventilation
- (B) surgical drainage of a hematoma
- (C) manual compression of the globe
- (D) administration of atropine intravenously
- (E) administration of mannitol intravenously
The five curves shown represent the uptake of enflurane, desflurane, halothane, isoflurane, and nitrous oxide. Which uptake curve best depicts desflurane?
- (A) Curve A
- (B) Curve B
- (C) Curve C
- (D) Curve D
- (E) Curve E
Which of the following findings is most likely in a 3-year-old child who has a secundum-type atrial septal defect with a 2:1 left-to-right shunt?
- (A) Pulmonary blood flow twice that of systemic blood flow
- (B) Pulmonary vascular resistance twice normal
- (C) Mean pulmonary artery pressure twice normal
- (D) Right atrial pressure twice normal
- (E) Hypoxemia while breathing room air
Alveolar stability at varying lung volumes is maintained by
- (A) constant surface tension
- (B) increased surface tension at low lung volume
- (C) decreased surface tension at high lung volume
- (D) decreased surface tension at low lung volume
- (E) none of the above
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
Which of the following is a sign of cyclosporine toxicity?
- (A) Abnormal hepatic enzyme activity
- (B) Decreased hemoglobin concentration
- (C) Increased serum creatinine concentration
- (D) Nodular density on radiograph of the chest
- (E) ST-T wave changes on ECG
Compared with a patient who is breathing spontaneously, a patient in the supine position receiving controlled positive-pressure ventilation will most likely have which of the following findings?
- (A) Decreased pulmonary vascular resistance
- (B) Decreased ratio of dead space to tidal volume
- (C) Increased ventilation of nondependent alveoli
- (D) Increased perfusion of nondependent alveoli
- (E) Improved matching of ventilation to perfusion
The condition LEAST likely to be associated with sustained pain relief following a nerve block is
- (A) causalgia
- (B) myofascial pain
- (C) diabetic neuropathy
- (D) acute herpes zoster
- (E) reflex sympathetic dystrophy