Pregunta 1
Pregunta
Which causes of hypoxemia will NOT improve with increasing FiO2?
Pregunta 2
Pregunta
Carotid bodies located at the bifurcation of the common carotid artery respond primarily to which parameter as a mechanism for chemical control of ventilation?
Pregunta 3
Pregunta
A 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?
Respuesta
-
Radiation heat loss to the operating room
-
Conductive heat loss to the operating table
-
Evaporative heat loss from surgical site
-
Redistribution of heat from the core to the periphery
Pregunta 4
Pregunta
A 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?
Respuesta
-
8 days
-
15 days
-
22 days
-
Indeterminate
Pregunta 5
Pregunta
The sensory nerves that innervate the anterior abdominal wall are located in a fascial plane between which muscle layers?
Respuesta
-
External oblique and internal oblique
-
External oblique and transversus abdominis
-
Internal oblique and transversus abdominis
-
Rectus abdominis and transversus abdominis
Pregunta 6
Pregunta
A femoral nerve block is MOST appropriate for which of the following surgical procedures:
Respuesta
-
Analgesia for a traumatic pelvic fracture
-
Surgical anesthesia for total hip arthroplasty
-
Analgesia for medial leg laceration repair
-
Sural nerve biopsy
Pregunta 7
Pregunta
You 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?
Pregunta 8
Pregunta
You 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?
Pregunta 9
Pregunta
The definition of functional residual capacity (FRC) is:
Respuesta
-
Gas remaining in the lungs at passive end-expiration
-
Gas remaining in lungs at end of forced maximal expiration
-
Gas that moves in and out of lungs during quiet breathing
-
Gas that can be expired from the lungs with effort after passive expiration
Pregunta 10
Pregunta
General anesthesia decreases functional residual capacity by what percentage?
Respuesta
-
1 - 2%
-
5 - 10%
-
20 - 25%
-
25 - 30%
Pregunta 11
Pregunta
The effect of hypercarbia on oxygenation is BEST explained by which of the following:
Respuesta
-
Hypercarbia decreases the partial pressure of oxygen in the alveolus
-
Hypercarbia has no effect on the partial pressure of oxygen
-
Hypercarbia increases oxygen saturation
-
Hypercarbia increases the partial pressure of oxygen in the alveolus
Pregunta 12
Pregunta
Physiologic effects of electroconvulsive therapy (ECT) include an:
Respuesta
-
initial sympathetic response with sustained tachycardia
-
initial sympathetic discharge followed by a sustained parasympathetic response
-
initial parasympathetic discharge followed by a sustained sympathetic response
-
initial parasympathetic response with sustained bradycardia
Pregunta 13
Pregunta
Which of the following BEST explains the shorter duration of action of single bolus of alfentanil relative to an equipotent bolus of fentanyl?
Pregunta 14
Pregunta
The postretrobulbar block apnea syndrome:
Respuesta
-
Is likely secondary to intravascular injection
-
most commonly occurs during or immediately after injection
-
is associated with unconsciousness
-
carries a high morbidity and mortality
Pregunta 15
Pregunta
Which of the following is LEAST likely to exacerbate pulmonary hypertension?
Pregunta 16
Pregunta
The arteria radicularis magna, or artery of Adamkiewicz, most commonly arises from:
Respuesta
-
T4 - T8
-
T8 - L2
-
L2 - L4
-
L4 - S1
Pregunta 17
Pregunta
A 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:
Respuesta
-
placing the grounding pad near the pacemaker
-
using infrequent bursts of longer duration
-
the use of a bipolar cautery
-
reducing the surface area of the return electrode
Pregunta 18
Pregunta
Which of the following is the MOST likely result of a new ulnar neuropathy in a patient?
Respuesta
-
Inability to extend the wrist
-
Inability to flex the fifth finger
-
Loss of sensation in posterior forearm
-
Loss of sensation over the palmar side of the thumb
Pregunta 19
Pregunta
The most severe transfusion reactions are due to:
Pregunta 20
Pregunta
You observe a regional wall motion abnormality in area indicated by the arrow. What coronary artery MOST likely supplies this part of the heart?
Respuesta
-
1st diagonal
-
Left circumflex
-
Left anterior descending
-
Right coronary artery
Pregunta 21
Pregunta
At what point in the cardiac cycle is left ventricular volume at its lowest?
Respuesta
-
When the aortic valve closes
-
Following the “T” wave on ECG
-
At the peak of the “v” wave on a CVP tracing
-
All of the above
Pregunta 22
Pregunta
At what point in the cardiac cycle is left ventricular volume at its lowest?
Respuesta
-
When the aortic valve closes
-
Following the “T” wave on ECG
-
At the peak of the “v” wave on a CVP tracing
-
All of the above
Pregunta 23
Pregunta
Intracranial hypertension is defined as a sustained increase in intracranial pressure (ICP) above:
Respuesta
-
5 mm Hg
-
15 mm Hg
-
25 mm Hg
-
30 mm Hg
Pregunta 24
Pregunta
What are the three terminal branches of the posterior tibial nerve?
Respuesta
-
Plantar nerve, lateral calcaneal nerve, medial calcaneal nerve
-
Medial plantar nerve, lateral plantar nerve, medial calcaneal nerve
-
Lateral calcaneal nerve, medial calcaneal nerve, medial plantar nerve
-
Lateral calcaneal nerve, medial calcaneal nerve, plantar nerve
Pregunta 25
Pregunta
Cholinesterase inhibitors that freely cross the blood-brain barrier include:
Respuesta
-
neostigmine
-
pyridostigmine
-
physostigmine
-
edrophonium
Pregunta 26
Pregunta
The perception of an ordinarily non-noxious stimulus as pain is referred to as:
Respuesta
-
allodynia
-
anesthesia dolorosa
-
dysesthesia
-
hyperalgesia
Pregunta 27
Pregunta
A 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?
Respuesta
-
Expiratory valve malfunction
-
Inspiratory valve malfunction
-
Right mainstem intubation
-
Venous air embolism
Pregunta 28
Pregunta
A 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?
Respuesta
-
10 mcg of epinephrine
-
50 mcg of nitroglycerine
-
100 mcg of phenylephrine
-
1 unit of vasopressin
Pregunta 29
Pregunta
Ninety percent of congenital diaphragmatic hernias occur:
Respuesta
-
through the left posterolateral foramen
-
through the right posterolateral foramen
-
through the anterior foramen
-
along the inferior vena cava
Pregunta 30
Pregunta
You are performing a transversus abdominis plane block. What is the inferior border of the Triangle of Petit?
Pregunta 31
Pregunta
When 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?
Pregunta 32
Pregunta
Pathophysiologic factors affecting the anesthetic management of patients with hypothyroidism include:
Pregunta 33
Pregunta
Airway obstruction caused by the tongue falling posteriorly against the wall of the pharynx is secondary to relaxation of the:
Pregunta 34
Pregunta
What bony surface landmarks are used for classical posterior approach to sciatic nerve blockade?
Respuesta
-
Anterior superior iliac spine, sacral hiatus, greater trochanter
-
Anterior superior iliac spine, pubic tubercle, greater trochanter
-
Posterior superior iliac spine, sacral hiatus, greater trochanter
-
Posterior superior iliac spine, sacral hiatus, iliac crest
Pregunta 35
Pregunta
A 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?
Pregunta 36
Pregunta
The most frequent manifestation of sickle cell disease is:
Pregunta 37
Pregunta
The effects of barbiturates on ischemic areas of the brain include:
Pregunta 38
Pregunta
A left ventricular pressure-volume loop is displayed below. Which cardiac valvular disease is MOST likely characterized by the red pressure-volume loop?
Respuesta
-
Aortic regurgitation
-
Aortic stenosis
-
Mitral regurgitation
-
Mitral stenosis
Pregunta 39
Pregunta
What is MOST sensitive marker or symptom for detecting a pheochromocytoma?
Pregunta 40
Pregunta
Which of the following syndromes is NOT associated with a pheochromocytoma?
Respuesta
-
Multiple endocrine neoplasia IIa
-
Neurofibromatosis
-
Treacher Collins Syndrome
-
von Hippel-Lindau disease
Pregunta 41
Pregunta
Which of the following syndromes is NOT associated with a pheochromocytoma?
Respuesta
-
Multiple endocrine neoplasia IIa
-
Neurofibromatosis
-
Treacher Collins Syndrome
-
von Hippel-Lindau disease
Pregunta 42
Pregunta
Venous irritation associated with the injection of diazepam and lorazepam is secondary to:
Respuesta
-
the high degree of water solubility of these agents
-
the presence of propylene glycol as a solvent
-
the presence of metabisulfite as a preservative
-
the low pH of these agents
Pregunta 43
Pregunta
A left ventricular pressure-volume loop is displayed below. Which cardiac valvular disease is MOST likely characterized by the red pressure-volume loop?
Respuesta
-
Aortic regurgitation
-
Aortic stenosis
-
Mitral regurgitation
-
Mitral stenosis
Pregunta 44
Pregunta
Which of the following is MOST likely a complication of using EMLA cream for topical analgesia?
Respuesta
-
Methemoglobinemia
-
Muscle spasm
-
Vasodilatation
-
Severe vomiting
Pregunta 45
Pregunta
Correct statements regarding cerebral metabolism include:
Respuesta
-
the brain can only utilize glucose as an energy source
-
forty percent of brain glucose consumption is anaerobically metabolized
-
hyperglycemia can reduce the damage from focal hypoxic injury
-
the adult brain consumes approximately 50 ml/min of oxygen
Pregunta 46
Pregunta
Portal hypertension is defined as sustained portal vein pressure greater than:
Respuesta
-
5 mmHg
-
10 mmHg
-
20 mmHg
-
25 mmHg
Pregunta 47
Pregunta
What is the maximum cuff pressure in a tracheostomy cuff?
Respuesta
-
10 mmHg
-
15 mmHg
-
20 mmHg
-
25 mmHg
Pregunta 48
Pregunta
What is the phenomenon that MOST likely causes the sciatic nerve to appear severed in this image?
Pregunta 49
Pregunta
In the graph of cerebral blood flow below, PaO2 would best be represented by curve:
Pregunta 50
Pregunta
A 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)?
Respuesta
-
It blocks the conversion of norepinephrine to epinephrine
-
It prevents release of catecholamines from nerve endings
-
It gives patients a euphoria and thus has high abuse potential
-
It decreases stores of catecholamines in peripheral neurons
Pregunta 51
Pregunta
In patients with a history of hypertrophic cardiomyopathy, intraoperative management should include:
Pregunta 52
Pregunta
A 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?
Respuesta
-
10 mcg of epinephrine
-
50 mcg of nitroglycerine
-
100 mcg of phenylephrine
-
1 unit of vasopressin
Pregunta 53
Pregunta
What 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?
Respuesta
-
Adaptive pressure control (APC)
-
Airway pressure release ventilation (APRV)
-
Bi-level
-
Synchronized intermittent mandatory ventilation (SIMV)
Pregunta 54
Pregunta
In patients receiving vecuronium, the greatest augmentation of neuromuscular blockade is seen with the use of:
Respuesta
-
isoflurane
-
sevoflurane
-
desflurane
-
nitrous oxide
Pregunta 55
Pregunta
What 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.
Respuesta
-
Adaptive pressure control (APC)
-
Airway pressure release ventilation (APRV)
-
Adaptive support ventilation (ASV)
-
Synchronized intermittent mandatory ventilation (SIMV)
Pregunta 56
Pregunta
Maternal mortality associated with amniotic fluid embolization is:
Respuesta
-
10 - 15%
-
20 - 25%
-
40 - 45%
-
greater than 50%
Pregunta 57
Pregunta
A 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?
Pregunta 58
Pregunta
Dextran 40 has been shown to improve microcirculation by:
Pregunta 59
Pregunta
The highest level of protein binding is seen with:
Respuesta
-
procaine
-
lidocaine
-
mepivacaine
-
bupivacaine
Pregunta 60
Pregunta
A 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?
Respuesta
-
Placing a head ring under the head so that the neck is flexed
-
Placing a shoulder roll under the patient so that the neck is extended
-
Placing the bed in Trendelenberg positioning
-
Placing the bed in reverse Trendelenberg positioning
Pregunta 61
Pregunta
What does 4-factor prothrombin complex concentrate (PCC) contain?
Respuesta
-
Thrombin
-
Factors I, II, IV, V
-
Factors II, VII, IX, X
-
Factors IV, VIII, IX, X
Pregunta 62
Pregunta
The highest rate of systemic absorption of local anesthetic is seen with
Pregunta 63
Pregunta
Absolute contraindications to electroconvulsive therapy (ECT) include:
Pregunta 64
Pregunta
Which of the following electrolyte abnormalities occurs MOST commonly with hydrochlorothiazide and is paired with the BEST choice for treatment?
Respuesta
-
Hypokalemia-spironolactone
-
Hypokalemia-magnesium sulfate
-
Hyperglycemia-regular insulin
-
Hyperglycemia-calcium chloride
Pregunta 65
Pregunta
In the neuromuscular junction, acetylcholine receptor binding sites are found on the:
Respuesta
-
α-subunits
-
β-subunits
-
δ-subunits
-
ε -subunits
Pregunta 66
Pregunta
A 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?
Respuesta
-
Vasopressin
-
Norepinephrine
-
Dobutamine
-
Phenylephrine
Pregunta 67
Pregunta
Oxygen 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:
Pregunta 68
Pregunta
In the fetus, the percentage of cardiac output directed to the placenta is approximately:
Pregunta 69
Pregunta
Which of the following drugs is associated with postoperative atrial fibrillation after CABG surgery?
Respuesta
-
Epinephrine
-
Dobutamine
-
Milrinone
-
A and B only
-
All of the above
Pregunta 70
Pregunta
You 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?
Respuesta
-
Norepinephrine
-
Epinephrine
-
Dobutamine
-
Dopamine
Pregunta 71
Pregunta
A fresh E-cylinder of oxygen:
Respuesta
-
contains more liters of gas than an E-cylinder of nitrous oxide
-
contains about 90% liquid oxygen and 10% oxygen as a gas
-
contains about 660 liters of oxygen
-
has a lower pressure than the pipeline oxygen supply
Pregunta 72
Pregunta
Which of the following is the MOST common cause of a new neurologic deficit following a carotid endarterectomy?
Pregunta 73
Pregunta
The elimination half-life of intravenously administered oxytocin in the parturient is approximately:
Respuesta
-
30 to 120 seconds
-
3 to 5 minutes
-
10 to 15 minutes
-
20 to 30 minutes
Pregunta 74
Pregunta
A 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?
Respuesta
-
Binds to V1a receptors: vascular smooth muscle
-
Binds to V1b receptors: pituitary gland
-
Binds to V2a receptors: renal collecting duct permeability
-
Binds to V2b receptors: vascular endothelium
Pregunta 75
Pregunta
Pathophysiologic factors affecting the anesthetic management of patients with hypothyroidism include:
Pregunta 76
Pregunta
When 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?
Pregunta 77
Pregunta
During hip replacement surgery, cardiopulmonary changes associated with the application of acrylic bone cement include: (Select 3)
Respuesta
-
hypotension secondary to cement monomer absorption
-
hypoxemia secondary to air embolization
-
hypoxemia secondary to fat embolization
-
hypocarbia
-
decreased pulmonary artery pressure
-
increased end-tidal carbon dioxide
Pregunta 78
Pregunta
All of the following changes in pulmonary physiology occur with aging EXCEPT:
Respuesta
-
Decreased sensitivity to hypoxemia
-
Dilation of alveoli and airspace enlargement
-
Increased elastic recoil of the lung
-
Increased small airway resistance
Pregunta 79
Pregunta
A 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?
Pregunta 80
Pregunta
The formation of active metabolites has NOT been associated with the use of:
Respuesta
-
vecuronium
-
rocuronium
-
pancuronium
-
succinylcholine
Pregunta 81
Pregunta
Which of the following comorbidities MOST increase the risk of central postoperative apnea in a preterm infant?
Respuesta
-
Anemia
-
Gastroschisis
-
Myelomeningocele
-
Omphalocele
Pregunta 82
Pregunta
A 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?
Respuesta
-
Decreases breakdown of cyclic AMP
-
Decreases breakdown of cyclic GMP
-
Increases breakdown of cyclic AMP
-
Increases breakdown of cyclic GMP
Pregunta 83
Pregunta
The rate of seroconversion after exposure of mucous membranes to HIV-infected blood is approximately:
Pregunta 84
Pregunta
A 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?
Respuesta
-
Low T3 syndrome
-
Low T4 syndrome
-
Low TSH syndrome
-
Low TRH syndrome
Pregunta 85
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 86
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 87
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 88
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 89
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 90
Pregunta
A decrease in cholinesterase activity has been associated with:
Respuesta
-
obesity
-
thyrotoxicosis
-
alcoholism
-
burns
Pregunta 91
Pregunta
Nicardipine belongs to what drug class?
Pregunta 92
Pregunta
Nicardipine belongs to what drug class?