Anesthesia Question of the Day 2

A 73-year-old woman taking warfarin for chronic atrial fibrillation is brought to the operating room for evacuation of a spontaneous left temporal intracerebral hematoma with uncal herniation syndrome. Her INR is 3.8. Her platelet count and hematocrit are normal. What is the recommended medical therapy for reversing her coagulopathy?

The incidence of headache with inadvertent dural puncture during epidural anesthesia is decreased:

All of the following statements are true about hypoxic pulmonary vasoconstriction (HPV) EXCEPT:

Factors decreasing physiologic dead space include:

A 64-year-old, 73 kilogram male with a 50 pack-year smoking history is scheduled to undergo a lobectomy for a right upper lobe mass. You have placed a left-sided double lumen endotracheal tube, and you would like to confirm proper placement. Which of the following findings would suggest that your double-lumen endotracheal tube has entered the right main bronchus by accident?

The development of transient neurologic symptoms (TNS) after spinal anesthesia is MOST associated with which of the following local anesthetics?

Selective adrenergic stimulation of the β2-receptor results in:

A patient with a severe traumatic brain injury is emergently brought to the operating room for evacuation of a parenchymal hematoma causing uncal herniation. The neurosurgeon requests that you limit systolic blood pressure to < 160 mmHg but keep cerebral perfusion pressure > 60mmHg. Currently, blood pressure is 190/100 mmHg and ICP is 25 mmHg. What antihypertensive agent will avoid a further increase in intracranial pressure?

Hormones released by the neurohypophysis include: (Select 2)

A 50-year-old woman presents for lumbar spine surgery. Vital signs include blood pressure 210/130 mmHg. She appears comfortable but somewhat anxious. The anesthesiologist is concerned that this is a hypertensive emergency. What is the MOST appropriate next step in her management?

At 10,000 feet elevation (atmospheric pressure is 520 mm Hg), oxygen 100 mL/min is bubbled through a vaporizer containing an anesthetic with a vapor pressure of 260 mmHg. This mixture is added to a fresh gas flow of 5 L/min. The delivered anesthetic concentration is:

Pancreatic somatostatin producing cells in the Islets of Langerhans are:

Pancreatic somatostatin producing cells in the Islets of Langerhans are:

The recommended maximum leakage current allowed in operating room equipment is:

In a coagulopathic patient, the risk of bleeding after a paravertebral blockade is MOST similar to which other form of regional anesthesia?

Which of the following changes would MOST likely result in increased coronary artery perfusion in a patient with aortic stenosis?

Causes of normal-anion-gap acidosis include:

A 62-year-old man has had CABG surgery and develops atrial fibrillation in the ICU afterward. He is administered an amiodarone loading dose with a planned maintenance dose to follow. Which of the following hemodynamic effects is MOST likely to occur during the acute bolus phase?

The area of myocardium most vulnerable to ischemia is the:

Hypoxemia during one-lung anesthesia is most effectively treated by:

Which of the following antibiotics is nephrotoxic?

Which of the following statements regarding open surgical versus percutaneous tracheostomies is MOST likely true?

Sympathetic blockade during acute herpes zoster has been shown to:

Sympathetic blockade during acute herpes zoster has been shown to:

Branches of the femoral nerve anesthetized during an ankle block include the:

A 35-year-old woman complains of chest pain on her seventh postpartum day. EKG reveals STEMI in anterior leads and a regional wall motion abnormality is appreciated on TTE. An angiogram reveals LCA dissection and the diagnosis of acute MI secondary to spontaneous coronary artery dissection (SCAD) is made. What is the incidence of SCAD in pregnant patients with MI?

Pulmonary complications from advanced hepatic disease with cirrhosis include:

A patient with a large mediastinal tumor presents for excision of the mass. CT scan shows a mass of 14 x 10 cm causing about 40% tracheal compression and moderate compression of the superior vena cava (SVC) and other mediastinal structures. The heart is displaced laterally and an apical impulse is felt just medial to the anterior axillary line. The patient is asymptomatic with no signs of SVC syndrome. Which of the following is the MOST common mechanism of hemodynamic collapse under general anesthesia in this patient?

An anxiolytic herbal medication associated with a decrease in the requirement of inhaled anesthetic agent (MAC) is:

A 23-year-old primiparous woman in spontaneous labor is monitored with continuous fetal heart monitors. The cardiotocograph shows a baseline fetal heart rate of 110/min with moderate variability. There are no accelerations over a period of 20 minutes and no early decelerations. This tracing falls under which of the following categories?

The formation of metanephrine is the result of:

A 35-year-old man who had right ankle ORIF under general anesthesia after sciatic-saphenous nerve blockade develops right foot drop postoperatively. Which nerve is most likely injured?

Which of the following is MOST true regarding a pediatric patient with a URI and the risk of anesthesia?

Characteristics of human immunodeficiency virus neuropathy include: (Select 2)

An action potential characterized by a spike followed by a plateau phase is seen in:

Patient risk factors associated with the development of perioperative peripheral nerve injuries include all of the following EXCEPT:

Autonomic hyperreflexia:

Mannitol may be administered during surgical clipping of an aneurysm to decrease brain water and thus brain bulk. The peak effect of mannitol occurs approximately:

Renal effects of nitrous oxide include:

What are the primary anatomic landmarks for a fascia iliaca block?

The dibucaine number:

A 45-year-old morbidly obese man with a medical history of hypertrophic cardiomyopathy presents for ear surgery. He has an ejection fraction of 65% on transthoracic echocardiography. After induction of general anesthesia, his blood pressure is 78/40 mmHg with a regular heart rate of 80 bpm. Which of the following is the MOST appropriate initial intervention?

Chronic aortic regurgitation results in all the following EXCEPT:

Release of aldosterone by the adrenal cortex is stimulated by: (select 3)

The most common complication of thoracic paravertebral nerve block is:

A 55-year-old woman with an infected automatic cardioverter-defibrillator (AICD) lead presents for removal. During the course of the procedure she develops acute profound, refractory hypotension that progresses to cardiovascular collapse and pulseless electrical activity. Which of the following is the MOST appropriate intervention at this time?

Which of the following drugs is NOT a cell cycle inhibitor?

According to the Modified Glasgow Coma Scale, a moderate head injury is associated with a score of: