10 Random Questions
The arterial waveform and EKG shown are from a 60-year-old man with uremia who is the PACU after hip surgery under general anesthesia. The patient is drowsy, extubated, and breathing easily. The most likely diagnosis is
- (A) hypovolemia
- (B) myocardial ischemia
- (C) nontension pneumothorax
- (D) pericardial tamponade
- (E) pulmonary embolus
A 67-year-old man is undergoing total hip replacement under general anesthesia. He had a permanent endocardial VVI pacemaker placed two years ago for complete heart block, and since arrival in the operating room has been paced continuously. Use of the electrocautery causes the pacemaker to malfunction intermittently. The most appropriate management is to
- (A) tape a magnet over the pacemaker generator and convert to asynchronous mode
- (B) do nothing since the pacemaker is programmed to deal with this circumstance
- (C) stop the surgeon from using the electrocautery
- (D) limit the surgeon to 10 sec/min electrocautery bursts
- (E) place the electrocautery indifferent lead as close as possible to the pacemaker
Compared with fentanyl, alfentanil is characterized by
- (A) greater volume of distribution
- (B) greater lipid solubility
- (C) less protein binding
- (D) faster redistribution
- (E) longer terminal elimination phase
A 19-year-old woman receives a spinal anesthetic for a repeat cesarean delivery. Two days later she is afebrile but has severe occipital pain that is aggravated by sitting or standing and relieved by lying flat. Associated findings would likely include
- (A) bradycardia
- (B) difficulty swallowing
- (C) diplopia
- (D) facial pain
- (E) Horner's syndrome
Which of the following drugs best facilitates management of cerebral vasospasm after subarachnoid hemorrhage?
- (A) Nifedipine
- (B) Nimodipine
- (C) Nitroglycerin
- (D) Nitroprusside
- (E) Thiopental
A 76-year-old patient is restless and hallucinating in the preoperative holding area. He received morphine 5 mg and scopolamine 0.4 mg intramuscularly as premedication and is now breathing oxygen 2 L/min through nasal prongs. SpO2 is 98%. Which of the following is the most appropriate next step?
- (A) Administration of naloxone
- (B) Administration of physostigmine
- (C) Induction of general anesthesia
- (D) Determination of serum electrolyte concentrations
- (E) CT scan of the head
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
Each of the following statements concerning norepinephrine is true EXCEPT:
- (A) Extraneuronal uptake is important in the termination of its activity
- (B) It is formed from dopamine
- (C) Its release is facilitated by ephedrine
- (D) Its uptake is affected by cocaine
- (E) It has minimal beta2-adrenergic activity
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
In patients with blunt head trauma, cerebral perfusion pressure is determined by the gradient between
- (A) diastolic pressure and central venous pressure
- (B) intracranial pressure and central venous pressure
- (C) mean arterial pressure and central venous pressure
- (D) mean arterial pressure and intracranial pressure
- (E) systolic pressure and intracranial pressure