65 questions match your search.


A 48-year-old woman underwent a posterior fossa craniotomy in the sitting position. Monitoring included precordial Doppler, arterial blood pressure, central venous pressure (CVP), and urine output. Furosemide was used intraopera-tively for cerebral decompression, and the operation was uneventful. In the recovery room, she was awake with stable vital signs when the CVP suddenly increased from 6 to 25 mmHg without any change in blood pressure. Shortly thereafter, premature ventricular contractions are noted. After administering lidocaine 1 mg/kg intravenously, the most appropriate action is to

ADVANCED Neuro

Each of the following statements about the blood supply of the spinal cord is true EXCEPT:

BASIC Neuro

In a patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Each of the following findings correctly identifies the associated fluid EXCEPT

ADVANCED Neuro Regional & Pain

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?

ADVANCED General Neuro

Deliberate hypothermia and circulatory arrest is planned for clipping of a giant basilar artery aneurysm. Which of the following statements is true?

ADVANCED Neuro

A 55-year-old man has quadriplegia after undergoing suboccipital craniotomy in the sitting position for treatment of acoustic neuroma. Which of the following is the most likely cause?

ADVANCED Neuro

A 45-year-old woman who sustained a subarachnoid hemorrhage 18 hours ago develops a severe headache and becomes unresponsive. Which of the following is the most likely cause of this patient's change in mental status?

ADVANCED Neuro

In treating arterial hypertension in a patient with a head injury, the agent LEAST likely to increase intracranial pressure is

ADVANCED Pharmacology & Pharmacokinetics Neuro

The following changes occur during posterior cervical fusion in the prone position under halothane and nitrous oxide anesthesia with mechanical ventilation: HR 78 --> 84 with frequent PVCs; BP 110/70 --> 90/50; EtCO2 4.5% --> 2.0%; EtN2 0.12% --> 4% The most appropriate next step is to

ADVANCED Neuro

Which of the following drugs increases cerebral blood flow while decreasing cerebral metabolic rate?

BASIC Pharmacology & Pharmacokinetics Neuro

Which of the following statements concerning brain stem auditory evoked responses is true?

ADVANCED Neuro

Massive venous air embolism occurs in a patient who is undergoing craniotomy in the sitting position with nitrous oxide, oxygen, fentanyl anesthesia. Which of the following changes in end-tidal (ET) concentrations of carbon dioxide, nitrogen, and nitrous oxide are most likely in this patient? (ETCO2, ETN2, ETN2O)

ADVANCED Neuro

A 70-kg, 46-year-old man is undergoing clipping of a cerebral aneurysm with nitrous oxide, opioid, relaxant anesthesia. He is otherwise healthy. As the surgeons are about to enter the dura, the brain is noted to be tense and bulging. Heart rate is 100 bpm and mean arterial pressure is 90 mmHg. PaO2 is 120 mmHg, PaCO2 is 23 mmHg, and pH is 7.50. Which of the following should be done immediately?

ADVANCED Neuro

A comatose 40-year-old man is to undergo evacuation of an acute subdural hematoma. His left pupil is dilated and blood is present behind the left tympanic membrane. Each of the following is an acceptable intervention EXCEPT


The most likely cause of bilateral fixed and dilated pupils after clipping of a basilar artery aneurysm is

ADVANCED Neuro

Which of the following would be most likely to increase the duration of seizures during electroconvulsive therapy using a barbiturate and succinyleholine for general anesthesia?

ADVANCED Pharmacology & Pharmacokinetics Neuro

Which of the following statements concerning air embolism during intracranial operations is true?

ADVANCED Neuro

Which of the following can be used as a sole criterion for brain death?

ADVANCED Neuro

A 6-year-old boy undergoes craniotomy in the supine position for brain tumor during anesthesia with 1.5% isoflurane in oxygen. PetCO2 is 38 mmHg, heart rate is 78 bpm, and blood pressure is 130/80 mmHg. After opening the dura, the surgeon notes that the brain is bulging. Which of the following management options is LEAST likely to significantly decrease brain size?

ADVANCED Pediatric Neuro

In a healthy patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Which of the following findings correctly identifies the associated fluid?

BASIC Neuro

Which of the following best explains the decreased effect of hyperventilation on cerebral blood flow when PaCO2 decreases below 20 mmHg?

BASIC Neuro

Which of the following statements concerning postspinal headache is true?

ADVANCED Neuro Regional & Pain

Which of the following best describes the relationship between cerebral perfusion pressure and cerebral blood flow in a patient with untreated chronic hypertension?

BASIC Neuro

Cerebral blood flow is decreased by each of the following EXCEPT

BASIC Neuro

Cerebral blood flow is decreased by

BASIC Neuro

In patients with blunt head trauma, cerebral perfusion pressure is determined by the gradient between

BASIC Neuro

Which of the following best reflects findings of inadequate cerebral perfusion during carotid cross clamping?

ADVANCED Neuro

A 50-year-old patient is undergoing craniotomy for clipping of a cerebral aneurysm with isoflurane, nitrous oxide, and fentanyl anesthesia. At the time of aneurysm exposure, the EEG shows burst suppression. Which of the following is the most likely cause?

ADVANCED Neuro

Monitoring sensory evoked potentials may be useful in detecting functional derangement of each of the following EXCEPT

ADVANCED Neuro

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

ADVANCED Neuro

A middle-aged, 70-kg man with a brain tumor is scheduled for an elective craniotomy. Preoperatively, he is alert but papilledema is present. Anesthesia is induced with thiopental 300 mg and succinylcholine 100 mg, followed by tracheal intubation. Immediately following intubation vigorous bucking occurs. The best immediate management would be to

BASIC General Neuro

Which of the following statements concerning brain stem auditory evoked responses is true?

ADVANCED Neuro

During a craniotomy for a supratentorial tumor, a 28-year-old man receives isoflurane 0.75% in nitrous oxide 70% and oxygen. Ventilation is controlled to maintain PaCO2 at 25 mmHg. Nasopharyngeal temperature is 35.8°C. While the dura mater is open, the surgeon complains that the brain is bulging. The most appropriate management at this time is to

ADVANCED Neuro

Which of the following is most likely to be effective in the treatment of clinically evident cerebral vasospasm occurring after subarachnoid hemorrhage?

ADVANCED Neuro

An otherwise healthy 16-year-old girl is undergoing posterior spinal fusion for thoracolumbar scoliosis. During the procedure, the most likely cause of a marked decrease in the amplitude of the somatosensory evoked potentials after stimulation of the posterior tibial nerve is

ADVANCED Equipment & Physics Pediatric Neuro

A patient suddenly makes a respiratory effort during craniotomy for clipping of a cerebral aneurysm in a 15-degree head-up position with controlled ventilation. The most likely cause is

ADVANCED Neuro

Each of the following is an effect of rapid infusion of mannitol EXCEPT

ADVANCED Pharmacology & Pharmacokinetics Neuro

The EEG begins to flatten during carotid endarterectomy when regional cerebral blood flow (in ml/min/100 g brain) decreases to

ADVANCED Neuro

A multi-orifices right heart catheter is being positioned by EKG control prior to sitting craniotomy. The EKG tracing is obtained between the distal tip of the catheter and the right arm lead. The most appropriate next step is to

ADVANCED Equipment & Physics Neuro

A 35-year-old woman with a grade III subarachnoid hemorrhage is undergoing clipping of a middle cerebral artery aneurysm 48 hours after initial hemorrhage. Which of the following drugs used to induce hypotension is LEAST likely to affect intracranial pressure?

ADVANCED Pharmacology & Pharmacokinetics Neuro

Which of the following drugs best facilitates management of cerebral vasospasm after subarachnoid hemorrhage?

ADVANCED Neuro

Which of the following statements concerning barbiturate protection from cerebral ischemia is true?

ADVANCED Neuro

During Harrington rod instrumentation for scoliosis, monitoring somatosensory evoked potentials

ADVANCED Pediatric Neuro

During craniotomy in the sitting position, end-tidal carbon dioxide tension suddenly decreases. Ventilatory excursion of the chest is normal. Further evaluation is most likely to show a decrease in

ADVANCED Respiratory & Critical Care Neuro

Immediately after sustaining severe head injury, a 20-year-old man has a blood pressure of 150/90 mmHg and an intracranial pressure of 35 mmHg. After one hour of thiopental infusion, blood pressure is 105/60 mmHg, intracranial pres sure is 20 mmHg, central venous pressure is 5 mmHg, and temperature is 36°C. The EEG shows slow-wave activity. The most appropriate next step is administration of

ADVANCED Neuro

The most sensitive means of detecting venous air embolism is

ADVANCED Equipment & Physics Neuro

A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?

ADVANCED Neuro

The most important factor regulating blood flow to ischemic cerebral tissue is

BASIC Neuro

Which of the following interventions is most effective in preventing neurologic injury resulting from global cerebral ischemia?

ADVANCED Neuro

A patient who is receiving ventilatory support after coronary artery bypass grafting has a PaO2 of 132 mmHg, a PaCO2 of 19 mmHg, and a pH of 7.57. Which of the following is most likely to result from this level of hypocarbia?

ADVANCED Neuro Cardiac

Prompt control of seizures induced by bupivacaine is necessary because

ADVANCED Neuro Regional & Pain

Which of the following provides the most definitive diagnosis in a patient with suspected brain death?

ADVANCED Respiratory & Critical Care Neuro

A 32-year-old woman is anesthetized for suboccipital craniotomy. During positioning, the capnograph shows an abrupt decrease in the slope of the expiratory upstroke. Which of the following is the most likely cause?

ADVANCED Equipment & Physics Neuro

Which of the following findings is most likely in patients with acute transection of the spinal cord at the level of C6?

ADVANCED General Neuro

Which of the following detects the smallest volume of venous air embolization?

ADVANCED Equipment & Physics Neuro

In a patient who is to undergo clipping of a cerebral aneurysm, an advantage of isoflurane over nitroprusside for induction of hypotension is

ADVANCED Pharmacology & Pharmacokinetics Neuro

A 50-year-old man is scheduled to undergo emergency craniotomy for evacuation of an epidural hematoma. His Glasgow Coma Scale score is 6; heart rate is 54 bpm, and blood pressure is 190/110 mmHg. The most appropriate initial management is administration of which of the following agents?

ADVANCED Neuro

Intravenous administration of mannitol during a craniotomy

ADVANCED Pharmacology & Pharmacokinetics Neuro

Depression of cerebral oxygen requirements below the level required to create an isoelectric EEG can be achieved by

BASIC Neuro

Brain stem auditory evoked potentials are most likely to be absent during which of the following?

ADVANCED Neuro

A 4-month-old child undergoing a craniectomy for craniosynostosis is anesthetized with nitrous oxide and halothane. Suddenly the systolic blood pressure decreases from 75 to 30 mmHg, and the PetCO2 decreases from 35 to 6 mmHg. Which of the following maneuvers is LEAST likely to have a beneficial effect?

ADVANCED Pediatric Neuro

A radial artery catheter is to be used for blood pressure measurement during a sitting craniotomy. When zeroing the transducer, which of the following describes the best levels for placement of the transducer and opening of the system to air? (Transducer, Opening to Air)

BASIC Equipment & Physics Neuro

A neurologically intact 48-year-old woman is scheduled for removal of a parietal lobe arteriovenous malformation. The relative risk for complete resection is to be determined by a test occlusion of the feeding artery. Which of the following intraoperative monitoring techniques is most appropriate for this test?

ADVANCED Equipment & Physics Neuro

Each of the following parameters of cerebral perfusion and metabolism is approximately equal to 50 EXCEPT

BASIC Neuro

A 30-year-old man who is breathing spontaneously has a ventilatory pattern of sustained deep inspiration and occasional expiratory gasps during emergence from general anesthesia after posterior fossa craniotomy. Which of the following is the most likely cause?

ADVANCED Neuro