10 Random Questions
Twenty minutes after thiopental induction for femoral herniorrhaphy, a 34-year-old woman is breathing spontaneously and receiving nitrous oxide-oxygen (2 liters each) and enflurane 3% by face mask. Pulse is 90 bpm, blood pressure is 80/60 mmHg, end-tidal enflurane concentration is 2%, and end-tidal carbon dioxide tension is 48 mmHg. Which of the following is most likely to occur on skin incision?
- (A) Pupillary dilation
- (B) Laryngeal stridor
- (C) Gross muscular movement
- (D) Increased blood pressure
- (E) No response
Which of the following statements concerning autonomic hyperreflexia after spinal cord transection is true?
- (A) It occurs within 24 hours after the injury
- (B) It occurs with lesions below T10
- (C) It is caused by a reflex increase in parasympathetic outflow
- (D) It is characterized by paroxysmal hypotension and tachycardia
- (E) It is prevented by blocking afferent visceral pathways
The muscular action most likely to remain intact following an axillary brachial plexus block is
- (A) flexion at the elbow
- (B) extension at the wrist
- (C) flexion of digits 3, 4, and 5
- (D) extension of digits 1, 2, and 3
- (E) extension at the elbow
In patients with head trauma, which of the following factors results in a return of arterial pH toward normal levels after two days of mechanical hyperventilation?
- (A) Decreased renal absorption of hydrogen ions
- (B) Decreased renal blood flow
- (C) Increased PaCO2 with constant minute ventilation
- (D) Increased renal excretion of bicarbonate ions
- (E) Normalized cerebrospinal fluid pH
A patient undergoes thoracotomy in the lateral decubitus position. Which of the following maneuvers is most likely to increase PaO2 during one-lung ventilation?
- (A) Applying continuous positive airway pressure to the nondependent lung
- (B) Applying positive end-expiratory pressure to the dependent lung
- (C) Increasing inspiratory flow rate
- (D) Increasing the tidal volume
- (E) Increasing the ventilatory rate
A 78-year-old man who is scheduled for an inguinal hernia repair has a preoperative ECG showing left bundle branch block. He has had no symptoms of cardiovascular disease. This ECG finding most likely indicates
- (A) cardiac disease
- (B) the need for spinal anesthesia
- (C) an electrolyte disturbance
- (D) the need for insertion of a temporary pacemaker
- (E) a normal finding in a patient of this age
A woman is in labor at 40 weeks' gestation and the fetus is in breech presentation. Which of the following will provide adequate uterine relaxation for vaginal delivery?
- (A) Spinal anesthesia
- (B) Epidural anesthesia
- (C) Halothane anesthesia
- (D) Pudendal nerve block
- (E) Magnesium sulfate
The twitch responses shown are from a healthy 80-kg patient anesthetized with fentanyl and nitrous oxide. Relaxant drugs X and Y are most likely
- (A) X: atracurium 30 mg, Y: vecuronium 4 mg
- (B) X: atracurium 30 mg, Y: vecuronium 8 mg
- (C) X: pancuronium 4 mg, Y: pancuronium 8 mg
- (D) X: vecuronium 4 mg, Y: atracurium 30 mg
- (E) X: vecuronium 4 mg, Y: pancuronium 8 mg
Following a right lower lobectomy, a patient develops a bronchopleural fistula and becomes hypoxic. He is orally intubated and mechanically ventilated with pure oxygen. PaO2 is 65 mmHg, PaCO2 is 70 mmHg, and pH is 7.25. Which of the following will produce the most favorable change in the blood gases?
- (A) Increasing ventilatory frequency
- (B) Increasing suction on the chest tube
- (C) Applying 10 cmH2O positive end-expiratory pressure
- (D) Using a double-lumen tube for differential ventilation
- (E) Starting negative-pressure ventilation
In a patient undergoing liver transplantation, sodium bicarbonate and calcium chloride are administered immediately before reperfusion of the transplanted liver to counteract
- (A) coagulopathy
- (B) decreased cardiac output
- (C) hyperkalemia
- (D) hypermagnesemia
- (E) hypotension