Question 1
Question
A 50-year-old woman is undergoing a mitral valve repair. She has been taking garlic prior to surgery as an herbal supplement to reduce blood pressure and improve her overall health. She has significant mediastinal blood loss after separation from bypass. Which of the following effects can MOST be attributed to garlic?
Answer
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Increased fibrinolysis
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Increased consumption of coagulation factors
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Inhibition of the prothrombinase complex
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Inhibition of platelet aggregation
Question 2
Question
An 80-year-old man has been in the ICU for 12 hours following an aortic valve replacement and has been on nitroprusside for control of hypertension. Which of the following is MOST responsible for the toxicity caused by nitroprusside?
Answer
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Accumulation of thiosulfate and cyanide
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Formation of cyanmethemoglobin
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Inactivation of cytochrome oxidase
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Production of thiocyanate
Question 3
Question
A 79-year-old patient suffers an ascending aortic dissection and presents with acute pericardial tamponade physiology. The patient demonstrates pulsus paradoxus on his arterial waveform tracing. What physiologic event MOST accounts for this pulsus paradoxus?
Answer
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Increased systemic vascular resistance
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Reduced diastolic filling
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Shift of interventricular septum
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Tachycardia
Question 4
Question
A patient with preeclampsia is receiving magnesium and has a magnesium level of 10 mEq/L. A magnesium level of 10 mEq/L is MOST associated with which of the following?
Question 5
Question
Which nerve provides motor innervation to the cricothyroid muscle?
Answer
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External branch of superior laryngeal nerve
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Internal branch of superior laryngeal nerve
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Glossopharyngeal nerve
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Recurrent laryngeal nerve
Question 6
Question
An 8-year-old, obese girl with severe obstructive sleep apnea is taken to the PACU after a tonsillectomy and adenoidectomy. On arrival, she is tachycardic, dyspneic, tachypneic, and anxious. Her SpO2 is 89% despite 4L nasal cannula. Auscultation reveals occasional wheezes bilaterally. A chest radiograph reveals diffuse interstitial and alveolar infiltrates. Given these findings, which of the following is the MOST likely diagnosis?
Question 7
Question
While performing an interscalene block with a nerve stimulator, the patient’s diaphragm begins to twitch. In order to successfully perform the block, the needle should be redirected in which of the following directions?
Answer
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Advanced because the needle tip is too shallow
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Withdrawn because the needle tip is too deep
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Redirected anteriorly because the needle tip is too posterior
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Redirected posteriorly because the needle tip is too anterior
Question 8
Question
A 62-year-old woman with hyperparathyroidism underwent a parathyroidectomy 24 hours ago. She complains of numbness and tingling in her hands and feet and mild shortness of breath. Which of the following laboratory abnormalities is MOST consistent with her symptoms?
Answer
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Hypocalcemia
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Hypokalemia
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Hypermagnesemia
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Hyperphosphatemia
Question 9
Question
A previously healthy 78-year-old woman sustains a left femur fracture and is in the operating room undergoing a left femur intramedullary rod placement. During bone reaming her blood pressure acutely drops from 130/70 mmHg to 90/45 mmHg, her heart rate increases from 80 to 115 bpm, and her SpO2 falls to 88%. Which of the following signs is MOST specific for fat embolism ?
Answer
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Decreased hemoglobin
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PaO2 75 mmHg on 100% oxygen
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Petechial rash on upper body
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Left ventricular dilation
Question 10
Question
Which of the following is MOST correct regarding the MOST common cause of transfusion related mortality?
Answer
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It is due to clerical error
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It is due to gram-negative bacteria
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It is due to neutrophilic immune response
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It is due to platelet-mediated response