Quiz
Anesthesia Questions of the Day
Questions in this quiz (92)
1Which causes of hypoxemia will NOT improve with increasing FiO2?
- Ahypoventilation
- Bimpaired diffusion
- Cshunt
- Dventilation-perfusion mismatch
2Carotid bodies located at the bifurcation of the common carotid artery respond primarily to which parameter as a mechanism for chemical control of ventilation?
- ApH
- BPaO2
- CPaCO2
- DSaO2
3A 55-year-old man with colon cancer undergoes an open colectomy under general anesthesia. Which of the following is the MOST likely cause of a 1oC decrease in core temperature during the first hour of anesthesia?
- ARadiation heat loss to the operating room
- BConductive heat loss to the operating table
- CEvaporative heat loss from surgical site
- DRedistribution of heat from the core to the periphery
4A 33-year-old critically ill woman develops ventilator-associated pneumonia (VAP) caused by a non-fermenting gram-negative rod. For how long should she be maintained on appropriate antibiotics?
- A8 days
- B15 days
- C22 days
- DIndeterminate
5The sensory nerves that innervate the anterior abdominal wall are located in a fascial plane between which muscle layers?
- AExternal oblique and internal oblique
- BExternal oblique and transversus abdominis
- CInternal oblique and transversus abdominis
- DRectus abdominis and transversus abdominis
6A femoral nerve block is MOST appropriate for which of the following surgical procedures:
- AAnalgesia for a traumatic pelvic fracture
- BSurgical anesthesia for total hip arthroplasty
- CAnalgesia for medial leg laceration repair
- DSural nerve biopsy
7You are providing the anesthetic for a 55-year-old man with end stage renal disease undergoing a parathyroidectomy. After surgery is completed, he is extubated but quickly develops acute airway obstruction necessitating reintubation. Which of the following is MOST likely responsible for his airway compromise?
- ABilateral recurrent laryngeal nerve injury
- BUnilateral recurrent laryngeal nerve injury
- CHematoma
- DHypocalcemia
8You are caring for a 40-year-old woman undergoing a thyroidectomy for Graves’ thyroid disease. In the recovery room, she develops sinus tachycardia to 135 beats per minute, a temperature increase from 36.6°C preoperatively to 38.9°C, and you note that she is difficult to arouse and has twitching movements. Which of the following is the BEST initial intervention?
- AAdminister hydrocortisone
- BAdminister IV propranolol
- CAdminister dantrolene
- DProvide topical cooling
9The definition of functional residual capacity (FRC) is:
- AGas remaining in the lungs at passive end-expiration
- BGas remaining in lungs at end of forced maximal expiration
- CGas that moves in and out of lungs during quiet breathing
- DGas that can be expired from the lungs with effort after passive expiration
10General anesthesia decreases functional residual capacity by what percentage?
- A1 - 2%
- B5 - 10%
- C20 - 25%
- D25 - 30%
11The effect of hypercarbia on oxygenation is BEST explained by which of the following:
- AHypercarbia decreases the partial pressure of oxygen in the alveolus
- BHypercarbia has no effect on the partial pressure of oxygen
- CHypercarbia increases oxygen saturation
- DHypercarbia increases the partial pressure of oxygen in the alveolus
- AHypercarbia decreases the partial pressure of oxygen in the alveolus
12Physiologic effects of electroconvulsive therapy (ECT) include an:
- Ainitial sympathetic response with sustained tachycardia
- Binitial sympathetic discharge followed by a sustained parasympathetic response
- C initial parasympathetic discharge followed by a sustained sympathetic response
- Dinitial parasympathetic response with sustained bradycardia
13Which of the following BEST explains the shorter duration of action of single bolus of alfentanil relative to an equipotent bolus of fentanyl?
- AIncreased clearance
- BGreater protein binding
- CLack of active metabolites
- DSmaller volume of distribution
- AIncreased clearance
14The postretrobulbar block apnea syndrome:
- AIs likely secondary to intravascular injection
- Bmost commonly occurs during or immediately after injection
- Cis associated with unconsciousness
- Dcarries a high morbidity and mortality
15Which of the following is LEAST likely to exacerbate pulmonary hypertension?
- A0.1 mcg/kg/min norepinephrine IV
- B1 unit of vasopressin IV
- C100 mcg of phenylephrine IV
- DApneic oxygenation
16The arteria radicularis magna, or artery of Adamkiewicz, most commonly arises from:
- AT4 - T8
- BT8 - L2
- CL2 - L4
- DL4 - S1
17A 76-year-old man is scheduled for a hemicolectomy. His past medical history is significant for third degree heart block treated with a permanent pacemaker. Problems with electrocautery use in this patient can be minimized by:
- Aplacing the grounding pad near the pacemaker
- Busing infrequent bursts of longer duration
- Cthe use of a bipolar cautery
- Dreducing the surface area of the return electrode
18Which of the following is the MOST likely result of a new ulnar neuropathy in a patient?
- AInability to extend the wrist
- BInability to flex the fifth finger
- CLoss of sensation in posterior forearm
- DLoss of sensation over the palmar side of the thumb
19The most severe transfusion reactions are due to:
- AABO incompatibility
- BRh incompatibility
- Cfebrile reactions
- Dnon-ABO hemolytic reactions
20You observe a regional wall motion abnormality in area indicated by the arrow. What coronary artery MOST likely supplies this part of the heart?
- A1st diagonal
- BLeft circumflex
- CLeft anterior descending
- DRight coronary artery
21At what point in the cardiac cycle is left ventricular volume at its lowest?
- AWhen the aortic valve closes
- BFollowing the “T” wave on ECG
- CAt the peak of the “v” wave on a CVP tracing
- DAll of the above
22At what point in the cardiac cycle is left ventricular volume at its lowest?
- AWhen the aortic valve closes
- BFollowing the “T” wave on ECG
- CAt the peak of the “v” wave on a CVP tracing
- DAll of the above
23Intracranial hypertension is defined as a sustained increase in intracranial pressure (ICP) above:
- A5 mm Hg
- B15 mm Hg
- C25 mm Hg
- D30 mm Hg
24What are the three terminal branches of the posterior tibial nerve?
- APlantar nerve, lateral calcaneal nerve, medial calcaneal nerve
- BMedial plantar nerve, lateral plantar nerve, medial calcaneal nerve
- CLateral calcaneal nerve, medial calcaneal nerve, medial plantar nerve
- DLateral calcaneal nerve, medial calcaneal nerve, plantar nerve
25Cholinesterase inhibitors that freely cross the blood-brain barrier include:
- Aneostigmine
- Bpyridostigmine
- Cphysostigmine
- Dedrophonium
26The perception of an ordinarily non-noxious stimulus as pain is referred to as:
- Aallodynia
- Banesthesia dolorosa
- Cdysesthesia
- Dhyperalgesia
27A 72-year-old man with an acoustic neuroma is undergoing a craniotomy in the sitting position. The patient acutely develops hypotension and tachycardia. The ETCO2 is 12 mmHg and an ABG reveals a PaCO2 of 43 mmHg. Which of the following represent the most likely cause of the PaCO2 to ETCO2 gradient?
- AExpiratory valve malfunction
- BInspiratory valve malfunction
- CRight mainstem intubation
- DVenous air embolism
28A 74-year-old woman undergoing an exploratory laparotomy and has blood pressure 60/40 mmHg and heart rate of 50 beats per minute. Based on the intraoperative TEE below (which shows severe aortic insufficiency), what would be the MOST appropriate drug to treat her hypotension?
- A10 mcg of epinephrine
- B50 mcg of nitroglycerine
- C100 mcg of phenylephrine
- D1 unit of vasopressin
29Ninety percent of congenital diaphragmatic hernias occur:
- Athrough the left posterolateral foramen
- Bthrough the right posterolateral foramen
- Cthrough the anterior foramen
- Dalong the inferior vena cava
30You are performing a transversus abdominis plane block. What is the inferior border of the Triangle of Petit?
- AIliac crest
- BExternal oblique muscle
- CTransversus abdominis muscle
- DInferior costal margin
31When performing a landmark-based thoracic paravertebral block, which transverse process is contacted when the needle is inserted at the level of the T5 spinous process?
- AT4
- BT5
- CT6
- DT7
32Pathophysiologic factors affecting the anesthetic management of patients with hypothyroidism include:
- Ahypernatremia
- Bhyperglycemia
- Cdifficulty with intubation and airway management
- Dincreased blood viscosity due to elevated hematocrit
33Airway obstruction caused by the tongue falling posteriorly against the wall of the pharynx is secondary to relaxation of the:
- Agenioglossus muscle
- Blongitudinal muscle of the tongue
- Cpalatoglossus muscle
- Dstyloglossus muscle
34What bony surface landmarks are used for classical posterior approach to sciatic nerve blockade?
- AAnterior superior iliac spine, sacral hiatus, greater trochanter
- BAnterior superior iliac spine, pubic tubercle, greater trochanter
- CPosterior superior iliac spine, sacral hiatus, greater trochanter
- DPosterior superior iliac spine, sacral hiatus, iliac crest
35A 70-year-old woman develops paraplegia after the repair of an open descending thoracoabdominal aortic aneurysm. Which of the following is the MOST likely cause?
- AEpidural hematoma
- BHypotension distal to the aortic cross-clamp
- CDecrease in CSF pressure
- DImproper patient positioning
36The most frequent manifestation of sickle cell disease is:
- Apain
- Bsplenic sequestration
- Caplastic crisis
- Dright upper quadrant syndrome
37The effects of barbiturates on ischemic areas of the brain include:
- Avasoconstriction
- Bvasodilation
- Credirection of blood flow to the ischemic areas
- Dredirection of blood flow away from ischemic areas
38A left ventricular pressure-volume loop is displayed below. Which cardiac valvular disease is MOST likely characterized by the red pressure-volume loop?
- AAortic regurgitation
- BAortic stenosis
- CMitral regurgitation
- DMitral stenosis
39What is MOST sensitive marker or symptom for detecting a pheochromocytoma?
- APlasma-free metanephrines
- BParoxysmal hypertension
- CUrinary norepinephrine
- DUrinary vanillylmandelic acid
40Which of the following syndromes is NOT associated with a pheochromocytoma?
- AMultiple endocrine neoplasia IIa
- BNeurofibromatosis
- CTreacher Collins Syndrome
- Dvon Hippel-Lindau disease
41Which of the following syndromes is NOT associated with a pheochromocytoma?
- AMultiple endocrine neoplasia IIa
- BNeurofibromatosis
- CTreacher Collins Syndrome
- Dvon Hippel-Lindau disease
42Venous irritation associated with the injection of diazepam and lorazepam is secondary to:
- Athe high degree of water solubility of these agents
- Bthe presence of propylene glycol as a solvent
- Cthe presence of metabisulfite as a preservative
- Dthe low pH of these agents
43A left ventricular pressure-volume loop is displayed below. Which cardiac valvular disease is MOST likely characterized by the red pressure-volume loop?
- AAortic regurgitation
- BAortic stenosis
- CMitral regurgitation
- DMitral stenosis
44Which of the following is MOST likely a complication of using EMLA cream for topical analgesia?
- AMethemoglobinemia
- BMuscle spasm
- CVasodilatation
- DSevere vomiting
45Correct statements regarding cerebral metabolism include:
- Athe brain can only utilize glucose as an energy source
- Bforty percent of brain glucose consumption is anaerobically metabolized
- Chyperglycemia can reduce the damage from focal hypoxic injury
- Dthe adult brain consumes approximately 50 ml/min of oxygen
46Portal hypertension is defined as sustained portal vein pressure greater than:
- A5 mmHg
- B10 mmHg
- C20 mmHg
- D25 mmHg
47What is the maximum cuff pressure in a tracheostomy cuff?
- A10 mmHg
- B15 mmHg
- C20 mmHg
- D25 mmHg
48What is the phenomenon that MOST likely causes the sciatic nerve to appear severed in this image?
- AAcoustic shadowing
- BAcoustic enhancement
- CBayonet artifact
- DIncorrect time gain compensation settings
49In the graph of cerebral blood flow below, PaO2 would best be represented by curve:
- AA
- BB
- CC
- DD
50A 33-year-old man with a pheochromocytoma presents for operative resection. Which of the following BEST describes the mechanism of pretreatment with alpha-methyl-para-tyrosine (metyrosine)?
- AIt blocks the conversion of norepinephrine to epinephrine
- BIt prevents release of catecholamines from nerve endings
- CIt gives patients a euphoria and thus has high abuse potential
- DIt decreases stores of catecholamines in peripheral neurons
51In patients with a history of hypertrophic cardiomyopathy, intraoperative management should include:
- Aa nitroglycerine infusion
- Binotropic support
- Cafterload reduction
- Dmaintenance of adequate preload
52A 74-year-old woman undergoing an exploratory laparotomy and has blood pressure 60/40 mmHg and heart rate of 50 beats per minute. Based on the intraoperative TEE that shows severe aortic insufficiency, what would be the MOST appropriate drug to treat her hypotension?
- A10 mcg of epinephrine
- B50 mcg of nitroglycerine
- C100 mcg of phenylephrine
- D1 unit of vasopressin
53What mode of mechanical ventilation is MOST characterized by constant pressure throughout inspiration, allowing both controlled breaths and assisted breaths (with pressure support), as well as a set tidal volume?
- AAdaptive pressure control (APC)
- BAirway pressure release ventilation (APRV)
- CBi-level
- DSynchronized intermittent mandatory ventilation (SIMV)
54In patients receiving vecuronium, the greatest augmentation of neuromuscular blockade is seen with the use of:
- Aisoflurane
- Bsevoflurane
- Cdesflurane
- Dnitrous oxide
55What mode of mechanical ventilation is MOST characterized by a requirement for the operator to set the percentage of required minute ventilation to be supported? The ventilator then automatically determines the respiratory rate and tidal volume required to provide the minimum minute ventilation should the patient not achieve that on his or her own.
- AAdaptive pressure control (APC)
- BAirway pressure release ventilation (APRV)
- CAdaptive support ventilation (ASV)
- DSynchronized intermittent mandatory ventilation (SIMV)
56Maternal mortality associated with amniotic fluid embolization is:
- A10 - 15%
- B20 - 25%
- C40 - 45%
- Dgreater than 50%
57A 10-year-old obese boy is in the recovery room after undergoing a tonsillectomy and adenoidectomy for obstructive sleep apnea. The majority of post-tonsillectomy hemorrhages are MOST likely to occur within what time period following surgery?
- Awithin the first 30 min
- Bwithin the first hour
- Cwithin the first 6 hours
- Dwithin the first 24 hours
58Dextran 40 has been shown to improve microcirculation by:
- Areducing blood density
- Bincreasing blood density
- Cdecreasing blood viscosity
- Dincreasing blood viscosity
59The highest level of protein binding is seen with:
- Aprocaine
- Blidocaine
- Cmepivacaine
- Dbupivacaine
60A 2-year-old, 11 kg boy is scheduled for cleft lip repair. You successfully intubate the patient with a 4.5 endotracheal tube and confirm bilateral breath sounds. Which change in patient positioning from the supine position would be MOST likely to increase the likelihood of endobronchial intubation?
- APlacing a head ring under the head so that the neck is flexed
- BPlacing a shoulder roll under the patient so that the neck is extended
- CPlacing the bed in Trendelenberg positioning
- DPlacing the bed in reverse Trendelenberg positioning
61What does 4-factor prothrombin complex concentrate (PCC) contain?
- AThrombin
- BFactors I, II, IV, V
- CFactors II, VII, IX, X
- DFactors IV, VIII, IX, X
62The highest rate of systemic absorption of local anesthetic is seen with
- Aepidural injection
- Bintercostal injection
- Ccaudal injection
- Dbrachial plexus injection
63Absolute contraindications to electroconvulsive therapy (ECT) include:
- Acongestive heart failure
- Bpregnancy
- Cmyocardial infarction 5 months prior to therapy
- Dincreased intracranial pressure
64Which of the following electrolyte abnormalities occurs MOST commonly with hydrochlorothiazide and is paired with the BEST choice for treatment?
- AHypokalemia-spironolactone
- BHypokalemia-magnesium sulfate
- CHyperglycemia-regular insulin
- DHyperglycemia-calcium chloride
65In the neuromuscular junction, acetylcholine receptor binding sites are found on the:
- Aα-subunits
- Bβ-subunits
- Cδ-subunits
- Dε -subunits
66A 65-year-old woman with rheumatic mitral stenosis, tricuspid regurgitation, and pulmonary hypertension has undergone combined mitral valve replacement and tricuspid valve repair surgery. She has low systemic vascular resistance with arterial blood pressure 80/40 mmHg after separation from bypass but her pulmonary arterial blood pressure continues to be elevated at 60/30 mmHg. She is receiving milrinone and epinephrine by infusion. Which of the following medications would provide the MOST favorable conditions to increase systemic blood pressure but not worsen pulmonary hypertension?
- AVasopressin
- BNorepinephrine
- CDobutamine
- DPhenylephrine
67Oxygen 100 mL/min is bubbled through a vaporizer containing an anesthetic with a vapor pressure of 253 mmHg. This mixture is added to a fresh gas flow of 5 L/min. The delivered anesthetic concentration is:
- A0.25%
- B0.5%
- C1%
- D2%
68In the fetus, the percentage of cardiac output directed to the placenta is approximately:
- A10%
- B25%
- C50%
- D100%
69Which of the following drugs is associated with postoperative atrial fibrillation after CABG surgery?
- AEpinephrine
- BDobutamine
- CMilrinone
- DA and B only
- EAll of the above
70You are anesthetizing a 60-year-old woman for coronary artery bypass surgery. After completion of the surgery, her left ventricular function is hyperdynamic on TEE, her cardiac output is increased to 6 liters/minute but her blood pressure is 85/50 mmHg. Due to her left ventricular hypertrophy you want to increase her blood pressure to maintain end organ perfusion. Which of the following agents would be the BEST choice at this time to achieve these goals?
- ANorepinephrine
- BEpinephrine
- CDobutamine
- DDopamine
71A fresh E-cylinder of oxygen:
- Acontains more liters of gas than an E-cylinder of nitrous oxide
- Bcontains about 90% liquid oxygen and 10% oxygen as a gas
- Ccontains about 660 liters of oxygen
- Dhas a lower pressure than the pipeline oxygen supply
72Which of the following is the MOST common cause of a new neurologic deficit following a carotid endarterectomy?
- AIntracranial hemorrhage
- BIpsilateral hypoperfusion
- CReperfusion injury
- DThromboembolism
73The elimination half-life of intravenously administered oxytocin in the parturient is approximately:
- A30 to 120 seconds
- B3 to 5 minutes
- C10 to 15 minutes
- D20 to 30 minutes
74A 40-year-old woman has undergone mitral valve surgery for mitral regurgitation. She has been given vasopressin by infusion for systemic hypotension. Which of the following is the CORRECT mechanism of action by which vasopressin improves systemic blood pressure?
- ABinds to V1a receptors: vascular smooth muscle
- BBinds to V1b receptors: pituitary gland
- CBinds to V2a receptors: renal collecting duct permeability
- DBinds to V2b receptors: vascular endothelium
75Pathophysiologic factors affecting the anesthetic management of patients with hypothyroidism include:
- Ahypernatremia
- Bhyperglycemia
- Cdifficulty with intubation and airway management
- Dincreased blood viscosity due to elevated hematocrit
76When performing a landmark-based thoracic paravertebral block, which transverse process is contacted when the needle is inserted at the level of the T5 spinous process?
- AT4
- BT5
- CT6
- DT7
77During hip replacement surgery, cardiopulmonary changes associated with the application of acrylic bone cement include: (Select 3)
- Ahypotension secondary to cement monomer absorption
- Bhypoxemia secondary to air embolization
- Chypoxemia secondary to fat embolization
- Dhypocarbia
- Edecreased pulmonary artery pressure
- Fincreased end-tidal carbon dioxide
78All of the following changes in pulmonary physiology occur with aging EXCEPT:
- ADecreased sensitivity to hypoxemia
- BDilation of alveoli and airspace enlargement
- CIncreased elastic recoil of the lung
- DIncreased small airway resistance
79A healthy 28-year-old male fell 8 feet from a ladder and suffered a small calcaneal fracture. An incision from the heel to the midfoot is planned. The anesthetic plan calls for an ankle block. Blocking which nerve is MOST important for this surgery?
- ASaphenous nerve
- BDeep peroneal nerve
- CSuperficial peroneal nerve
- DPosterior tibial nerve
80The formation of active metabolites has NOT been associated with the use of:
- Avecuronium
- Brocuronium
- Cpancuronium
- Dsuccinylcholine
81Which of the following comorbidities MOST increase the risk of central postoperative apnea in a preterm infant?
- AAnemia
- BGastroschisis
- CMyelomeningocele
- DOmphalocele
82A 75-year-old man with coronary artery disease and ejection fraction of 25% has just undergone CABG surgery and is receiving milrinone and epinephrine to improve left ventricular function. Milrinone acts by which of the following mechanisms?
- ADecreases breakdown of cyclic AMP
- BDecreases breakdown of cyclic GMP
- CIncreases breakdown of cyclic AMP
- DIncreases breakdown of cyclic GMP
83The rate of seroconversion after exposure of mucous membranes to HIV-infected blood is approximately:
- A0.03%
- B0.09%
- C0.3%
- D0.9%
84A 70-year-old woman is started on maintenance therapy with amiodarone for atrial fibrillation. She develops cold intolerance, weight gain, constipation and fatigue. Which of the following is MOST likely responsible for her symptoms?
- ALow T3 syndrome
- BLow T4 syndrome
- CLow TSH syndrome
- DLow TRH syndrome
- ALow T3 syndrome
85A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
86A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
87A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
88A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
89A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
90A decrease in cholinesterase activity has been associated with:
- Aobesity
- Bthyrotoxicosis
- Calcoholism
- Dburns
91Nicardipine belongs to what drug class?
- AAlpha-blocker
- BBeta-blocker
- CDihydropyridine calcium channel blocker
- DDiuretic
92Nicardipine belongs to what drug class?
- AAlpha-blocker
- BBeta-blocker
- CDihydropyridine calcium channel blocker
- DDiuretic
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