Question 1
Question
The administration of propofol (2 mg/kg) to an otherwise healthy adult for the induction of anesthesia is MOST commonly associated with which one of the following hemodynamic changes?
Answer
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Decreased afterload
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Decreased contractility
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Decreased heart rate
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Decreased preload
Question 2
Question
A 4-year-old boy presents with the acute onset of inspiratory stridor and a barking cough after waking in the middle of the night. The child is febrile, sounds noticeably hoarse, and cries loudly when handled by medical personnel. The patient's parents report that the child has had a "cold for a couple of days." What is the MOST likely infectious etiology of this child's disease?
Answer
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Haemophilus influenzae
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Influenza A
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Parainfluenza virus
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Streptococcus pyogenes
Question 3
Question
Which of the following is LEAST likely to be observed in an infant presenting with pyloric stenosis?
Answer
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Hypernatremia
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Hypochloremia
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Hypokalemia
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Metabolic alkalosis
Question 4
Question
Which of the following DECREASES MAC for volatile anesthetics?
Answer
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Clonidine
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Female sex
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Hyperthermia
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MAO inhibitors
Question 5
Question
Which of the following describes the type of ventilation that is characterized by the delivery of a set tidal volume whenever a breath is initiated, either by the patient or by the ventilator?
Answer
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Assist control
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Intermittent mandatory ventilation
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Pressure support ventilation
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Pressure controlled ventilation
Question 6
Question
In the midesophageal long axis view at approximately 110-130 degree multiplane angle, which of the left ventricular walls can be BEST assessed for function and regional wall motion abnormalities?
Question 7
Question
A 30-year-old woman undergoes a right frontal craniotomy for resection of a low grade glioma. She is given dexamethasone and levetiracetam. Mannitol (1 g/kg) and hyperventilation are used to provide brain bulk reduction. Her sodium drops acutely from 139 meq/L preoperatively to 125 meq/L intraoperatively. Serum osmolality is 310. What is the MOST appropriate management?
Question 8
Question
Terbutaline is often administered to treat preterm labor or to stop tetanic uterine contractions that interfere with fetal oxygenation. Which of the following is MOST likely a maternal side effect of terbutaline administered under these circumstances?
Answer
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Bradycardia
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Hypokalemia
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Hypoglycemia
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Hypertension
Question 9
Question
The timing of heparin induced thrombocytopenia is BEST described by which of the following?
Answer
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Immediate upon heparin administration
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Within 24 hours of heparin administration
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From 5 to 14 days after heparin administration
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Greater than 2 weeks after heparin administration
Question 10
Question
What features BEST distinguish heparin induced thrombocytopenia and thrombocytopenia induced by other drugs?
Answer
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Drug induced thrombocytopenia results in mild thrombocytopenia
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Heparin induced thrombocytopenia results in severe thrombocytopenia with mucocutaneous bleeding
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Drug induced thrombocytopenia results in significant arterial thrombosis
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Heparin induced thrombocytopenia results in moderate thrombocytopenia with venous thrombosis
Question 11
Question
A patient with aneurysmal subarachnoid hemorrhage is 5 days status-post clip ligation of a right middle cerebral artery aneurysm. A ventriculostomy is in place to manage hydrocephalus. She acutely develops lethargy and left sided weakness. Which of the following is the MOST appropriate evaluative strategy?
Answer
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Carotid ultrasound
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CT with CT angiography
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MRI with contrast
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PET Scan
Question 12
Question
Which of the following is NOT a side effect of mild hypothermia?
Answer
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Coagulopathy
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Diuresis
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Seizures
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Ventricular arrhythmias
Question 13
Question
Which of the following cardiac valvular abnormalities is MOST frequently observed during the acute embolization of fat, air or thrombus?
Answer
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Aortic regurgitation
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Mitral regurgitation
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Pulmonic regurgitation
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Tricuspid regurgitation
Question 14
Question
A 74-year-old man with a past medical history significant for hypertension and coronary artery disease is scheduled for a right thoracotomy for right upper lobectomy. His current medications include aspirin, clopidogrel, lisinopril, and atenolol. A T5-6 thoracic epidural is planned or preoperative analgesia. What is the MINIMUM amount of time the patient should be off his aspirin and clopidogrel prior to having an epidural placed?
Question 15
Question
Which of the following respiratory parameters remains UNCHANGED in pregnancy?
Answer
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Functional residual capacity (FRC)
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Inspiratory reserve volume (IRV)
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Total lung capacity (TLC)
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Expiratory reserve volume (ERV)
Question 16
Question
A 70-year-old man with a DDD-R pacemaker for a history of symptomatic bradycardiais undergoing an anterior cervical discectomy and fusion with somatosensory evoked potential (SSEP) and motor evoked potential (MEP) monitoring. The pacemaker should be reprogrammed to which of the following?
Question 17
Question
A 75-year-old man is undergoing a mitral valve replacement via cardiopulmonary bypass. The perfusionist is running bypass flows at > 2.5 liters/minute/m2. Which of the following is the MOST likely adverse consequence of undergoing cardiopulmonary bypass at increased flow rates?
Answer
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Increased trauma to blood elements
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Increased hypothermia
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Decreased blood flow to the brain
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Decreased myocardial blood flow
Question 18
Question
A 35-year-old woman who underwent orthotopic heart transplantation 2 years ago for nonischemic cardiomyopathy presents after a motor vehicle accident for exploratory laparotomy under general anesthesia. Intraoperatively, her blood pressure is 75/35 mmHg and heart rate is 90 bpm. After the administration of phenylephrine, which of the following hemodynamic responses do you MOST expect?
Answer
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HR decreased, BP increased
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HR decreased, BP no change
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HR no change, BP increased
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HR no change, BP no change
Question 19
Question
A 55-year-old woman with a history of congenital long QT syndrome is undergoing a hysteroscopy for abnormal uterine bleeding. She had uneventful induction of general anesthesia but after paracervical block with lidocaine develops ventricular tachycardia with morphological appearance of torsades de pointe. Which of the following medications should be AVOIDED in the treatment of her arrhythmia?
Answer
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Amiodarone
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Calcium chloride
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Esmolol
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Magnesium sulfate
Question 20
Question
A 59-year-old man presents with nausea, diaphoresis, and bradycardia. His blood pressure is 80/40 mmHg, HR 45 bpm. A transthoracic echocardiogram reveals global left ventricular hypokinesis with bulging of the interventricular septum into the left ventricle, mild mitral regurgitation, and moderate tricuspid regurgitation. Which coronary artery do you MOST expect to be occluded?
Question 21
Question
Which of the following is MOST often associated with carbon monoxide poisoning?
Answer
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Salicylate poisoning
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Cyanide toxicity
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Ethanol toxicity
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Acetaminophen toxicity
Question 22
Question
After an accidental needle stick with a contaminated needle, which of the following viruses carries the HIGHEST risk of transmission?
Answer
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HIV
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Hepatitis A
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Hepatitis B
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Hepatitis C
Question 23
Question
Which of the following statements regarding the addition of clonidine to an epidural infusion is MOST correct?
Answer
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Clonidine is an alpha-2-receptor antagonist
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Clonidine effect in peripheral nerve blocks is primarily centrally mediated
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Clonidine prolongs the sensory block when added to intermediate local anesthetics
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Commonly reported side effects include tachycardia and hypertension
Question 24
Question
Compared to "plain" local anesthetic without epinephrine, a pre-mixed local anesthetic with epinephrine solution is MOST associated with which of the following?
Question 25
Question
Which of the following BEST explains why higher settings of desflurane are needed at higher altitudes to produce the same anesthetic effect?
Answer
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Decreased concentration of desflurane at higher altitudes
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Decreased partial pressure of desflurane at higher altitudes
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Decreased oxygen concentration at higher altitudes
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This statement is incorrect; equivalent settings produce the same anesthetic effect