Key words

A 67-yo with a Hodgkin's lymphoma on bleomycin to undergo a laparotomy. Which of the following increase risk of pulmonary toxicity?

5-year-old boy is admitted to the PACU after receiving GA for a MRI. The patient is screaming, kicking and not making eye contact. The PACU nurse cannot calm him down. Which of the following would prevented this presentation?

40-year-old man receives a 0.7 mcg/kg bolus of dexmedetomidine over ten minutes before an intubation. What will be the most likely effect from this dose of dexmedetomidine ?

60-year-old woman is oliguric after a bowel resection marked by intraoperative hypotension despite aggressive Ringer's lactate administration. Her plasma sodium is 126 mEq/L. Which one is the most probable cause for her oliguria?

Two days after returning from Colombia a 37-year-old man became ill with flu-like prodrome, mild fever and rash in the face and trunk, as well as ocular pain and arthralgia; The symptoms alleviated after a few days. Along with the serum sample, a urine sample was taken and identified as Zika virus. He had been evaluated now for paresthesia of the four limb extremities that evolved into ascendant muscular weakness. Which of the following has been associated with Zika virus infection?

A 75-yo man with CAD on aspirin and clopidogrel after a bare metal stent placement. He need ligation and stripping of painful varicose veins in his legs. Which is the earliest time after stent placement that appropriate to discontinue clopidogrel for elective surgery?

A 72-kg patient receives GA in a semi-closed circle system with fresh gas flows of O2 0.4 L/min, N2O 0.4 L/min and desflurane 4%. After 90 minutes, the inspired FiO2, as measured by the oxygen analyzer in the circuit, is 33%. Which of the following is likely explanation for the discrepancy between the delivered and inspired oxygen concentrations?

Which of the following changes in CV function is usually occur in a healthy extremely old patient compared to his status at young age?

A 33 yo woman is for a laparoscopic assisted hysterectomy under general anesthesia placed in the Trendelenburg position. Over the first 40 minutes, her SpO2 decreases to 86% with no change in vital signs, pulse oximeter waveform, or end tidal CO2. Which of the following interventions is needed to treat her hypoxemia?

After knee replacement, a woman reports no pain relief after taking relatively large doses of codeine fPO. Which of the following pharmacodynamics problems with codeine is causing the inadequate analgesia?

After complete reversal of rocuronium with neostigmine a full dose of succinylcholine was given for re-intubating . How this going to effect the duration of the succinylcholine-induced neuromuscular blockade?

Pulse pressure variation will be most accurate indicator of hypovolemia with which of the following methods of ventilation ?

A 61-year-old woman with a serum creatinine of 2.2 mg/dL requires intravenous contrast for an interventional radiology procedure. Which one of the following interventions is proven to reduce his risk of renal failure from contrast-induced nephrotoxicity?

After an block placement, a previously healthy woman suffers a cardiac arrest. Which one of the following medications is appropriate to be used during local anesthetic systemic toxicity resuscitation?

Which of the following anesthesia machine safety devices is only one that continuously monitors to detect a low-pressure leak when delivering an anesthetic?

A 63-year-old woman had a CABG five hours ago. She is intubated and mechanically ventilated. Her BP decreases to 65/45 mmHg with a HR of 120 bpm. His CVP is 19 mmHg, PAP is 25/20 mmHg, and PCWP is 20 mmHg. Which of the following TEE findings is more likely to be present in this patient?

Which of the following clinical scenarios does NOT constitute a sentinel event?

A 70-year-old woman with dementia received GA for a hysterectomy. After the operation her pain was treated with opioids and nonsteroidal anti-inflammatory drug (NSAID). Three days after surgery the patient develops delirium. Which of the following preoperative factors is the best predictor of her postoperative delirium?

A 72-year-old woman develops arterial hypotension, bradycardia, and respiratory arrest immediately after undergoing a retrobulbar block using 5 mL of lidocaine for a vitrectomy, . Injection into which one of the following structures is responsible for her condition?

A 55-year-old woman with CAD would like to have a breast augmentation. She has been on aspirin and clopidogrel since placement of a drug-eluting stent (DES) two months ago. At what point after stent placement would it be very appropriate to consider stopping clopidogrel for elective surgery?

A 43 yo man was admitted to the hospital six days earlier for an intracranial hemorrhage that required emergency evacuation. The patient was later extubated when his neurologic status improved. He has been receiving 0.9% normal saline since admission, and his sodium level has been gradually decreasing from 141mEq/L, the level at admission, to 121 mEq/L. The patient appears hypovolemic, with a blood pressure of 115/70 mm Hg and pulse of 90 beats per minute. His intake and outtake documentation reveals that his urine output has been 2 to 4 L/d despite a fluid restriction of <1.5 L/d that was initiated two days earlier. Workup reveals a low serum osmolarity of, a normal serum creatinine level, and high urine osmolarity. His brain natriuretic peptide (BNP) is elevated. Which of the following is NOT correct in differentiating syndrome of inappropriate antidiuretic hormone (SIADH) from cerebral salt wasting (CSW)?

A 55-y-o man with NIDDM, HTN and Afib is scheduled for elective surgery. Which one of the following oral medications is appropriate for the patient to continue on the morning of surgery?

A 65 yo male with a history of HTN and nicotine abuse complaint of severe chest pain, nausea, dyspnea and diaphoresis. On examination, the patient is in moderate distress. His skin is warm and dry. BP is 98/64 mm Hg and pulse is regular at 63/min. There is an S4 gallop at the apex together with a grade 2/6 systolic ejection murmur. Neck veins are 4 cm above the clavicle at 30 degrees. Lungs are clear and the peripheral pulses are normal. His ECG is shown, below. The patient received sublingual NTG, 3 mg of intravenous morphine sulfate, and ASA. Two minutes later, the patient's BP drops to 70/30 mm Hg. Pulse is 60/min. Which of the following represents the most likely cause for his hypotension:

Which safety event is NOT considered sentinel event by The Joint Commission?

A 64-yo woman is evaluated prior to THR. She takes losartan for HTN, simvastatin for hyperlipidemia, and metformin for T2D. She can climb a flight of stairs (4 METS). When she shovels snow in the winter she has to take breaks because she gets short of breath. Which one of the following actions is the more appropriate next step?

In which patients low flow anesthesia is NOT contraindicated?

A 55-yo woman with asthma for an endovascular aneurysm repair. She currently takes metoprolol and has an allergy to shellfish. Which one of the following is the predictor for an anaphylactic reaction to intravenous contrast media in this patient?

A 55-yo smoker undergoes laparotomy using GA with desflurane after awake intubation. Which one of the following factors would be responsible for a carboxyhemoglobin level of 22% in this patient after surgery?

A 19-yo patient with Down syndrome will receive a GA for an cholecystectomy. Which one of the following findings is more likely to impair visualization of the vocal cords during direct laryngoscopy in this patient?

A patient receives 20 mg of IV morphine over the first 24 hours after an exploratory laparotomy and develops postoperative nausea and vomiting (PONV). Which one of the following is the most important opioid-related factor contributing to the risk of postoperative nausea and vomiting?