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500db74c-4447-56d3-b56b-7864d821de6a | A V/Q ratio of 1:0 is known as which one of the following? | Normal | Dead space | Shunt | Silent unit | 4 | B | 1 | null | null | null | null | null |
7cd97bc9-a105-5b0d-93df-9cf68cd64bb1 | A V/Q ratio of 0:0 is known as which one of the following? | Normal | Dead space | Shunt | Silent unit | 4 | D | 1 | null | null | null | null | null |
6aa7cf81-3f82-5d80-9601-1f3f9001f888 | A V/Q ratio of 0:1 is known as which one of the following? | Normal | Dead space | Shunt | Silent unit | 4 | C | 1 | null | null | null | null | null |
dee78a7d-9068-5cca-838d-e32f851352f4 | 29. Which of the following statements regarding hypoxic pulmonary vasoconstriction (HPV) is false? | HPV leads to bronchiolar constriction. | HPV is stimulated by alveolar hypoxia. | HPV decreases blood flow. | HPV causes areas that were previously shunted to effectively become silent units. | 4 | A | 1 | null | null | null | null | null |
5ea2755f-c289-5768-b72c-743de2849f50 | Which of the following is/are direct inhibitor(s) of HPV? | Infection | Vasodilator drugs | Hypocarbia | A and C | 5 | E | 1 | All of the above | null | null | null | null |
245e9c49-eb8e-5e6c-a364-e802a1ae3b83 | Which of the following medical conditions shift(s) the oxyhemoglobin dissociation curve to the right? | Hypocapnia | Acidosis | Hyperthermia | B and C | 5 | D | 1 | A and B | null | null | null | null |
a73f5302-16b8-5477-9de8-8891e00b6c18 | In a normal patient, the Po2 drops from 100 to 40 mm Hg. What do you expect the pulse oximeter to read? | 99% | 95% | 85% | <75% | 4 | D | 1 | null | null | null | null | null |
c6a84037-19bf-583d-8570-e53a101dde94 | Which of the following medical conditions cause(s) a leftward shift to the oxyhemoglobin dissociation curve? | Hypothermia | Alkalosis | Fetal hemoglobin | All of the above | 4 | D | 1 | null | null | null | null | null |
3e4772c4-e063-56e0-9773-169ec8e284ce | Which of the following statements regarding respiratory acidosis is false? | It is improved with laparoscopic procedures. | It is always characterized by hypercarbia (PaCO2 > 45 mm Hg). | It occurs because of a decrease in minute alveolar ventilation. | It is usually characterized by a low pH (<7.35). | 4 | A | 1 | null | null | null | null | null |
648a40ca-13c8-50e8-a1ec-5efd4aa0fc12 | Which of the following statements is/are true regarding systemic effects of hypercapnia? | Arteriolar dilation | Increased sympathetic output | Pulmonary vasoconstriction | All of the above | 4 | D | 1 | null | null | null | null | null |
53765e0a-d886-5522-8603-7d2f3f5196ce | Which of the following statements is false regarding hyperoxia? | It contributes to atelectasis. | Prolonged exposure may increase the risk of secondary infections. | It increases intracranial pressure. | It increases systemic vascular resistance. | 4 | C | 1 | null | null | null | null | null |
f545b1ce-5532-5c13-af94-84c1b31a4036 | 37. Which of the following is/are the systemic effect(s) of hypoxia? | Peripheral vessels dilate | Increased ventilation | Increased cardiac output | All of the above | 4 | D | 1 | null | null | null | null | null |
0c325aa4-5589-51be-a451-5772e543582f | Interpret this arterial blood gas (ABG): pH = 7.27, CO2 = 53, HCO2 = 24. | Metabolic acidosis | Metabolic alkalosis | Respiratory acidosis | Respiratory alkalosis | 4 | C | 2 | null | null | null | null | null |
daa73226-a6e0-5a2a-8840-e2b543f5f456 | Interpret this ABG: pH = 7.18, CO2 = 38, HCO3 = 16 | Metabolic acidosis | Metabolic alkalosis | Respiratory acidosis | Respiratory alkalosis | 4 | A | 2 | null | null | null | null | null |
33df2df2-e193-53a3-bc1d-a39a59c295f6 | Interpret this ABG: pH = 7.60, CO2 = 37, HCO3 = 35 | Metabolic acidosis | Metabolic alkalosis | Respiratory acidosis | Respiratory alkalosis | 4 | B | 2 | null | null | null | null | null |
c9d529b4-7d4f-5cd7-960d-f159c92a7f40 | The respiratory centers in the brain are located in which one of the following? | Cerebrum | Cerebellum | Brainstem | Spinal cord | 4 | C | 1 | null | null | null | null | null |
2273a1a7-2dc9-5014-8071-86c87501b39d | Which of the following structures comprise(s) the peripheral chemoreceptors? | Carotid bodies | Carotid sinus | Aortic bodies | A and C | 5 | D | 1 | All of the above | null | null | null | null |
02fec6f5-e07d-5db6-aca2-9a1cda5e7886 | Central chemoreceptors are primarily sensitive to changes in which one of the following? | Carbon dioxide | Hydrogen ion concentration | Oxygen | Bicarbonate | 4 | B | 1 | null | null | null | null | null |
45696ae6-6a1d-5d36-9f7a-6676f8884e85 | The sources of ventilatory rhythmicity are located in which one of the following? | Dorsal respiratory group | Ventral respiratory group | Apneustic center | Pneumotaxic respiratory center | 4 | A | 1 | null | null | null | null | null |
153a64aa-21e5-53fa-b68a-850407518850 | 45. Which of the following is/are known as cause(s) of true hyperventilation? | Arterial hypoxemia | Metabolic acidemia | A and B | None of the above | 5 | E | 1 | All of the above | null | null | null | null |
446e1b82-6738-5687-ba3f-07d07471b3a9 | At what level does PaO2 lack any influence on the carbon dioxide response curve? | <65 mm Hg | 65 mm Hg | 85 mm Hg | 100 mm Hg | 4 | D | 1 | null | null | null | null | null |
b291a79f-1aa7-5605-b080-9aea3599a1bf | Changes in physiology that can displace the carbon dioxide response curve to the right include which of the following? | Normal sleep | Opioids | Inhaled anesthetics | All of the above | 4 | D | 1 | null | null | null | null | null |
5de0c7a5-077c-5075-acb8-242bf65c3c54 | Which of the following statements is true regarding the oxyhemoglobin | Left shift leads to lower O2 affinity. | Left shift leads to higher O2 affinity. | Right shift leads to higher O2 affinity. | None of the above. | 4 | B | 1 | null | null | null | null | null |
859b4e21-891a-57f0-8163-c75799c15cbd | 50. How does fetal hemoglobin impact the hemoglobin dissociation curve? | Shifts it to the left. | Shifts it to the right. | Shifts it up. | Shifts it down. | 4 | A | 1 | null | null | null | null | null |
e3256784-65f3-554e-8b3f-16ea7603baf6 | With regards to smoking, which of the following statements is/are true? | Smoking leads to V/Q mismatch, bronchitis, and airway hyperreactivity. | Smoking leads to increased carboxyhemoglobin concentration. | Smoking is one of the main risk factors associated with postoperative morbidity. | All of the above. | 4 | D | 1 | null | null | null | null | null |
9377e3b9-e1c5-5307-b0e9-8c801d22932a | Which of the following statements about smoking cessation is true? | Patients who quit smoking less than 8 weeks preoperatively have a significantly higher complication rate compared with those who quit more than 8 weeks preoperatively. | Smokers who decrease cigarette consumption in an attempt to quit without nicotine replacement therapy decrease their nicotine intake. | Smokers should be advised to stop smoking 3 months before elective operations to maximize the effect of smoking cessation. | If smokers stop for at least 2 weeks preoperatively, they benefit from improved mucociliary function. | 4 | A | 1 | null | null | null | null | null |
1fa884b1-9eee-572a-88d7-99bf05267d17 | Bronchodilators, such as albuterol, act on which type of receptor? | α1-Adrenergic | α2-Adrenergic | β1-Adrenergic | β2-Adrenergic | 4 | D | 1 | null | null | null | null | null |
a88329ab-fe85-51f1-9c0c-b8c09551feb1 | With regard to the action of anticholinergic bronchodilators, which of the following statements is/are true? | They act to block nicotinic receptors. | They block the formation of cyclic guanosine monophosphate. | They are muscarinic agonists. | B and C. | 4 | B | 1 | null | null | null | null | null |
1ce44eb6-14db-52ec-9807-24cd1291b059 | Which of the following statements describes the correct mechanism of action of β2-agonist bronchodilators? | Receptor activation leads to increased production of cyclic guanosine monophosphate. | Receptor activation leads to decreased production of cyclic guanosine monophosphate. | Receptor activation leads to increased production of cyclic adenosine monophosphate (cAMP). | Receptor activation leads to decreased production of cAMP. | 4 | C | 1 | null | null | null | null | null |
a233f290-b124-5f11-b0b5-c550e9333744 | Which of the following is the mechanism of action of leukotriene modifiers? | Decreasing the production of leukotrienes | Increasing the production of leukotrienes | Agonizing the leukotriene receptor agonist | Antagonizing the leukotriene receptor antagonist | 4 | D | 1 | null | null | null | null | null |
5c92c38e-7c1e-5d9a-b9cc-0473f39f02cd | Which of the following statements is/are true regarding immunoglobulin E (IgE) blockers? | They inhibit binding of IgE to the receptor on the surface of mast cells and basophils. | One agent is a monoclonal antibody. | They can be used for the treatment of asthma. | All of the above. | 4 | D | 1 | null | null | null | null | null |
ffd67eb3-656e-54d0-8fcb-056e8cddb44e | 58. Which of the following is the mechanism of action of first-generation medications that target mast cells? | Enhancement of mast cell chemical mediator release | Stabilization of mast cells to inhibit release of chemical mediators | Antagonizing the H1 receptor | Agonizing the H1 receptor | 4 | B | 1 | null | null | null | null | null |
92b1d6fe-cea4-509e-8613-6fee0e4fcddd | Which of the following statements is/are true about the mechanism of action of exogenous glucocorticoids? | They directly bind to glucocorticoid receptors to exert their action. | They inhibit molecules such as cytokines, chemokines, and arachidonic acid metabolites. | They upregulate anti-inflammatory mediators. | All of the above. | 4 | D | 1 | null | null | null | null | null |
7b84091c-17cd-5f26-a0f0-4c31e8d3fef9 | Select the correct order of greatest to least anti-inflammatory properties of the following glucocorticoids: | Hydrocortisone > prednisone > methylprednisolone > dexamethasone | Dexamethasone > methylprednisolone > prednisone > hydrocortisone | Dexamethasone > hydrocortisone > methylprednisolone > prednisone | Hydrocortisone > dexamethasone > prednisone > methylprednisolone | 4 | B | 1 | null | null | null | null | null |
bbe09804-2f99-5a0f-a174-c30959336bb8 | Which portion of the cardiac cycle has the highest myocardial oxygen consumption? | Isovolumic relaxation period | Ejection | Diastasis | Isovolumic contraction period | 4 | D | 1 | null | null | null | null | null |
446af164-074a-5304-8e9d-e9f130cae665 | Which of the following defines the Frank-Starling relationship? | The relationship between preload (resting myocardial length) and contractile performance | The relationship between the left ventricle (LV) pressure and wall stress | The relationship between pressure, flow, and resistance | The balance between hydrostatic pressure and oncotic pressure gradients across a membrane | 4 | A | 1 | null | null | null | null | null |
fa1bf99a-6af4-59f4-85ef-76407f733016 | Which of the following is the earliest indicator of myocardial ischemia? | Increased left ventricle end-diastolic volume (LVEDV) and decreased compliance | ECG abnormalities | Wall motion abnormalities | Congestive heart failure | 4 | A | 1 | null | null | null | null | null |
e87858f7-7eb2-5d7c-8330-dfaa24380369 | Which of the following contribute(s) to cardiac output? | Heart rate | Stroke volume | Preload | Afterload | 5 | E | 1 | All of the above | null | null | null | null |
97e55170-49b9-5d00-b9dd-bb393dfe93cb | Which of the following factors will increase venous oxygen saturation measured in the pulmonary artery? | Decreases in cardiac output | Increases in oxygen consumption | Decreased temperature | Lower hemoglobin concentration | 4 | C | 2 | null | null | null | null | null |
b97511d5-bc4e-52b9-a670-d087e67fc0c2 | 6. Which of the following indicate(s) impaired diastolic function of the LV? | Prolonged isovolumic relaxation time | "E" wave to "A" wave ratio less than 1 (E/A <1) | Prolonged time constant for LV relaxation measured at cardiac catheterization | All of the above | 4 | D | 1 | null | null | null | null | null |
153b74c5-e0b5-5714-9d93-6152cdbad46c | Which of the following statements is false concerning baroreceptor function? | Pressure-sensitive stretch receptors are located in the carotid sinus and aortic arch. | The effects of such stretch are to reduce heart rate at the sinoatrial node, as well as the atrioventricular node. | The vagus nerve is the only nerve involved in the afferent limb of the baroreceptor response. | Massage of the carotid artery will increase parasympathetic stimuli and can slow narrow complex supraventricular tachycardia. | 4 | C | 1 | null | null | null | null | null |
8e206f78-f505-524b-87c4-17d79b9e160f | Which of the following statements is true regarding blood pressure in the arterial vascular tree? | Pulse pressure is the difference between the systolic blood pressure (SBP) in the ventricle and the diastolic blood pressure (DBP) measured within the ventricle. | Mean arterial blood pressure (MAP) = DBP + (0.33 * pulse pressure). | The SBP measured in the femoral artery is lower than that measured in the aorta. | The DBP is higher in the femoral artery than in the aorta. | 4 | B | 1 | null | null | null | null | null |
b7f73e08-2caa-53f1-9a7a-037bdfe47df6 | Spontaneous respiration facilitates venous return primarily due to which of the following conditions? | Thoracic expansion creates a slightly positive pressure in the chest. | Mean intrathoracic pressure during spontaneous ventilation is slightly negative, facilitating venous return. | Downward movement of the diaphragm reduces intra-abdominal pressure. | Muscle contraction moves blood from the vasculature into muscles. | 4 | B | 1 | null | null | null | null | null |
89aa5dc1-b5e8-5945-bfe0-e8c4f3fffae3 | Distribution of blood throughout the circulatory system is not uniform. Which of the following components of the tree has the largest blood volume? | Venous system | Arterial system | Pulmonary vasculature | Heart | 4 | A | 1 | null | null | null | null | null |
5d800ccd-f37e-5545-bfb2-e794d37fbb11 | Which of the following statements is true? | The arterial system has higher compliance than the venous system. | The compliance of the venous system is 10-20 times greater than the arterial system. | Small changes of blood within the venous system result in large changes in pressure. | The cross-sectional area of the small and large arteries is larger than that of the corresponding veins. | 4 | B | 1 | null | null | null | null | null |
5ae13f2d-2c5f-5762-aa77-c297b6d822e6 | Which of the following does NOT contribute to reduced cardiac output and blood pressure in the setting of acute massive pulmonary embolism? | Tricuspid regurgitation | Occlusion of the pulmonary arterial vasculature by thrombotic material | Shift of the interventricular septum toward the left | Hypokinesis of the LV | 4 | D | 3 | null | null | null | null | null |
18ce551c-277c-55db-b94b-078b09da9083 | Which of the following is/are the primate determinant(s) of capillary blood flow? | Transmural pressure | Oncotic pressure | Contraction and relaxation of the precapillary and postcapillary sphincters | A and C | 4 | D | 1 | null | null | null | null | null |
2544d08e-68cd-52fe-b846-2f7796feab47 | 14. Blood flow through a tube is determined by several factors and explained by | Blood flow is inversely proportional to the pressure gradient. | Blood flow is proportional to the radius of the tube to the second power. | Blood flow is proportional to the length of the tube. | Blood flow is inversely proportional to the viscosity of the fluid. | 4 | D | 1 | null | null | null | null | null |
998fc416-51f3-5780-9a6f-5cb8f811459f | Which of the following tissues has the greatest capillary density? | Fat | Cartilage | Bone | Skeletal muscle | 4 | D | 1 | null | null | null | null | null |
97e2be7f-20bf-54e9-a7a7-d799c0090ed5 | Myocardial tissue has the highest oxygen extraction of any tissue. Which of the following statements is false concerning myocardial metabolism? | Normal coronary blood flow is approximately 250 mL/min or 5% of cardiac output. | Myocardial oxygen consumption is affected by heart rate, contractility, and wall stress. | Coronary blood flow to both the right and left ventricles occurs exclusively during diastole. | Venous oxygen saturation is higher in the right atrium than in the pulmonary artery. | 4 | C | 1 | null | null | null | null | null |
048e1af8-5265-5278-acbc-30dfa98fb719 | All of the following concerning cerebral perfusion are true EXCEPT which one? | Cerebral perfusion pressure is the difference between the MAP and the intracranial pressure or central venous pressure (CVP), whichever is higher. | Cerebral blood flow (CBF) always varies consistently depending on the blood pressure. | Blood carbon dioxide tension (PaCO2 ) plays a more important role in determining CBF than oxygen tension (PaO2 ). | CBF remains constant if the MAP is between 60 and 160 mm Hg. | 4 | B | 1 | null | null | null | null | null |
f3dc9654-da12-5697-a994-088054719a5a | Which of the following statements is false? | There are 3 mechanisms whereby renal blood flow and glomerulofiltration rate are regulated: myogenic response, tubuloglomerular feedback, and sympathetic nervous system input. | The renal system does not exhibit autoregulation. | Sympathetic nervous system input results in constriction of all renal vessels. | The myogenic response is an intrinsic action of vascular smooth muscle inresponse to increased transmural pressure. | 4 | B | 1 | null | null | null | null | null |
b4c9c684-3125-574f-907d-98a7ba6197c4 | Approximately what percentage of cardiac output goes to the liver? | 5% | 10% | 15% | 25% | 4 | D | 1 | null | null | null | null | null |
d309139e-297c-55d1-84ae-39cdf6b8d559 | Which of the following statements describes coronary perfusion pressure? | The difference between the pressures in the aorta during systole and diastole | The difference between the pressure in the aorta and the mean arterial pressure | The difference between the aortic root pressure and the left or right ventricular pressure | The difference between the mean pulmonary pressure and the left atrial pressure (LAP) | 4 | C | 1 | null | null | null | null | null |
94cac3af-5192-5e3f-bb63-5a9f6a90e163 | 21. A 73-year-old man complains of weakness and then falls to the ground. Cardiopulmonary resuscitation (CPR) including chest compressions is initiated. A monitor reveals that the patient is in ventricular fibrillation (VF). Defibrillation is performed, and the monitor reveals a wide complex rhythm at 90 beats per minute. Which of the following is appropriate? | Continue CPR for 2 minutes. | Cease CPR immediately. | Administer sodium bicarbonate. | Administer vasopressin. | 4 | A | 2 | null | null | null | null | null |
8c01f535-537b-5d48-a8e4-6b1a00324ea1 | Which of the following indicates adequacy of CPR during resuscitation? | PETCO2 more than 10 mm Hg during CPR | DBP less than 20 mm Hg | PETCO2 less than 10 mm Hg | Peripheral cyanosis | 4 | A | 1 | null | null | null | null | null |
db7c5d8c-cb43-513a-b6a4-9aadd1db7b70 | A patient is found to be in cardiac arrest, and asystole is noted on the ECG. CPR is initiated, and venous access is established. Which of the following is the first medication indicated? | Vasopressin 40 units | Epinephrine 1 mg | Amiodarone 300 mg | Sodium bicarbonate 50 mEq | 4 | B | 2 | null | null | null | null | null |
a6c6bc28-9872-58bc-9039-6140ce3c0f6d | A young man is found lying down on the street unresponsive. He appears to be | Initiate CPR and continue for 2 minutes. | After 2 minutes of CPR if necessary, leave the patient and call 9-1-1. | Administer naloxone. | All of the above. | 4 | D | 2 | null | null | null | null | null |
95891ae5-2289-52e2-ace0-823b1dfb435f | A patient is noted to have altered mental status and hypotension and complains of chest pain. The heart monitor shows a hear rate of 27 beats per minute. Blood pressure is 60/30 mm Hg. After administration of oxygen and lying the patient flat, atropine 0.5 mg is administered every 5 minutes for a total of 3 mg. No response is noted. Which of the following actions is next indicated? | Amiodarone 300 mg IV (intravenous) over 10 minutes | Additional atropine | Vasopressin 40 units | Dopamine infusion at 2-20 μg/kg/min | 4 | D | 3 | null | null | null | null | null |
fc463bc8-f1a4-57b9-90b1-28d2a6cbef24 | A patient is found to be in cardiac arrest. CPR is initiated, and IV access is established. After 2 minutes of CPR, VF is noted on the heart monitor. Epinephrine is administered, and CPR is resumed. VF is still noted. Which of the following is the next medication to be administered? | Amiodarone 150 mg IV | Amiodarone 300 mg IV | Atropine 0.5 mg | Vasopressin 40 units | 4 | B | 1 | null | null | null | null | null |
1498476c-4b64-54e4-aef4-113844344be0 | Which of the following is true concerning alternative routes of drug administration? | Interosseous (IO) access should not be attempted in children. | The same drug dose should be administered via the endotracheal tube as via IV/IO. | CPR does not need to be stopped when a medication is administered via the endotracheal route. | When administering lidocaine, epinephrine, or vasopressin via the endotracheal tube, the dose should be diluted in 10 mL or normal saline or sterile water. | 4 | D | 1 | null | null | null | null | null |
ed45e887-c68e-5caa-ba2a-83672bee4c4f | 28. A patient presents with complaints of slight light-headedness as well as palpitations. ECG is obtained, and it is noted that he has a narrow complex (QRS <0.12 s), monomorphic, regular rhythm. Which of the following is/are indicated? | Vagal maneuver | β-Blocker or calcium channel blocker | Adenosine | All of the above | 4 | D | 2 | null | null | null | null | null |
59b5afe1-1627-50e8-833e-01d88eb45dbf | All of the following are considered goals for in the management of acute coronary syndrome in the setting of ST-segment elevation myocardial infarction (STEMI) EXCEPT? | Door-to-balloon time of 90 minutes for percutaneous coronary intervention (PCI) | Door-to-needle time of 30 minutes when fibrinolysis is utilized | Emergency room assessment of 10 minutes or less | Complete stabilization within the emergency department before catheterization | 4 | D | 1 | null | null | null | null | null |
267908ff-fd3f-5062-8054-292434a39112 | Which of the following statements is false regarding airway management during CPR? | Cricoid pressure should always be applied throughout chest compressions. | The oral pharyngeal size should be approximately the same as the distance from the tip of the patient's nose to the earlobe. | An excessively long oropharyngeal airway (OPA) may enter the esophagus and may result in gastric distention with air during bag-mask ventilation. | Ventilations during CPR should occur every 5-6 seconds. | 4 | A | 1 | null | null | null | null | null |
0f46c517-62f6-5b91-821c-5878734603a2 | Which of the following coronary arteries is located in the posterior interventricular groove? | Left anterior descending coronary artery | Right coronary artery | Posterior interventricular (descending) coronary artery (PDA) | Left circumflex coronary artery | 4 | C | 1 | null | null | null | null | null |
082a7c62-0413-5486-b7e7-4613c45f39da | The aortic valve is composed of which of the following 3 leaflets? | Right, left, and anterior | Right, left, and noncoronary | Anterior, posterior, and septal | Anterolateral, posteromedial, and septal | 4 | B | 1 | null | null | null | null | null |
5d294523-9bc4-5b07-b8da-067a911fffee | A patient presents with acute severe pulmonary edema and cardiogenic shock. Transesophageal echocardiography (TEE) demonstrates a ruptured papillary muscle. Which papillary muscle is most commonly affected? | Posteromedial | Septal | Noncoronary | Anterolateral | 4 | A | 1 | null | null | null | null | null |
0206fffe-46dc-5330-90fc-532590eb7e02 | A 55-year-old man is undergoing coronary artery bypass grafting. The TEE shows an enlarged coronary sinus. When saline is injected into an IV line in the left upper extremity, bubbles are noted, entering the left atrium (LA) near the inferior vena cava. Which of the following conditions most likely explains the findings? | An aberrant right coronary artery | Anomalous pulmonary venous return | A left-sided superior vena cava (SVC) | A patent foramen ovale | 4 | C | 3 | null | null | null | null | null |
8329f640-2168-5f66-bfcc-db46c9b209ae | 35. Which of the following structures is responsible for the conduction of impulses from the right atrium to the LA? | Purkinje fibers | Bundle of His | Left bundle branch | Bachmann bundle | 4 | D | 1 | null | null | null | null | null |
1e0fc152-7550-5215-b072-00d46909a7ab | A 79-year-old man is scheduled to undergo lumbar laminectomy for spinal stenosis. His medical history is significant for aortic stenosis, with a valve area of 0.9 cm2 and a mean gradient of 45 mm Hg. Which of the following vasoactive agents would be most beneficial to this patient? | Dopamine | Phenylephrine | Hydralazine | Nitroglycerin | 4 | B | 2 | null | null | null | null | null |
58f4a919-b2da-549f-80ab-5c2e5e8fe285 | 41. Which of the following is the MOST accurate description of perfusion of the left and right sides of the heart in a normal healthy adult? | Both the left and right sides of the heart are perfused during both systole and diastole. | Both the left and right sides of the heart are perfused during diastole only. | The left side of the heart is perfused during both systole and diastole; the right side of the heart is perfused during systole only. | The left side of the heart is perfused during diastole only; the right side of the heart is perfused during both systole and diastole. | 4 | D | 1 | null | null | null | null | null |
95722958-fb3d-5b11-b699-9b54b61d5e25 | In a patient with severe pulmonary hypertension (HTN), use of which of the following agents would best preserve perfusion to the right side of the heart | Milrinone | Vasopressin | Dobutamine | Phenylephrine | 4 | B | 2 | null | null | null | null | null |
acbc7677-9285-520c-adae-d9caf08b079f | On a preoperative evaluation, the American College of Cardiology/American Heart Association (ACC/AHA) guidelines do NOT help direct your decisionmaking process with regard to which of the following ECG abnormalities? | Left bundle branch block | Atrial fibrillation with rapid ventricular response | Mobitz type II block | ST-elevation myocardial infarction | 4 | A | 1 | null | null | null | null | null |
cbfa8a95-cf2a-5285-8eb4-92d5a4bde7f9 | Which of the following components of the cardiac conduction system has the FASTEST conduction velocity? | SA node | AV node | His-Purkinje system | Ventricular myocardium | 4 | C | 1 | null | null | null | null | null |
da551c17-2845-5cd6-8075-edb4aa0bc53f | A patient who received a heart transplant 2 years ago presents for laparoscopic appendectomy. Which of the following medications should be avoided during this planned general anesthetic? | Cisatracurium | Vecuronium | Neostigmine | Glycopyrrolate | 4 | C | 2 | null | null | null | null | null |
360b5ce7-467d-54aa-a2ac-81d7b1fe0905 | In a normal CVP tracing, where does the tricuspid valve close? | Between the a-wave and c-wave | At the peak of the c-wave | Between the c-wave and x-descent | Between the x-descent and v-wave | 4 | A | 1 | null | null | null | null | null |
30e0cf97-bd9e-5d9d-a5bf-ee9caf0fed0d | The V5 ECG lead is MOST SENSITIVE for detecting which of the following? | Atrial fibrillation | Anteroseptal ischemia | Lateral wall ischemia | Conduction abnormalities | 4 | C | 1 | null | null | null | null | null |
a25c919c-0522-5a8f-9173-fd86626dbaf9 | Which of the following cardiac abnormalities would be MOST LIKELY to benefit from relative tachycardia? | Aortic stenosis | Mitral regurgitation | Hypertrophic obstructive cardiomyopathy (HOCM) | Unstable angina | 4 | B | 2 | null | null | null | null | null |
934665f6-da70-53da-956a-12f0b0c526dd | Which of the following is the "agent of choice" for treatment of tachyarrhythmias associated with Wolff-Parkinson-White? | Metoprolol | Verapamil | Carvedilol | Procainamide | 4 | D | 1 | null | null | null | null | null |
ad85c279-eff1-59c5-a20d-be846fe2421f | Which of the following is NOT considered a "cyanotic" heart lesion? | Truncus arteriosus | Pulmonic stenosis | Tricuspid atresia | Total anomalous pulmonary venous return | 4 | B | 1 | null | null | null | null | null |
abb8d19a-e997-500a-9cc5-edc588d54d3d | 52. Which of the following is LEAST LIKELY to be a complication of a transcatheter aortic valve replacement? | Complete heart block | Pneumothorax | Cardiac tamponade | Embolic stroke | 4 | B | 1 | null | null | null | null | null |
f8c71180-5d94-51fc-97c7-fbfc021e4d0f | A patient with long-standing HTN and normally well-managed congestive heart failure is also found to have bilateral coarse rales on lung examination. He admits that he went to a wedding and had a dietary indiscretion, which is very rare for him. Which of the following is most likely true? | | Volume overload | Transient | Noncompliant ventricle | Permanent | | | Volume overload | Permanent | Noncompliant ventricle | Transient | | | Noncompliant ventricle | Transient | Volume overload | Transient | | | Noncompliant ventricle | Permanent | Volume overload | Permanent | | 4 | A | 2 | null | null | null | null | null |
af6faa5c-f2ae-5320-85bc-30101b140df8 | Which of the following is the MOST UNLIKELYcause of myocardial ischemia? | Severe tachycardia | Severe hypotension | Severe anemia | Severe hypokalemia | 4 | D | 1 | null | null | null | null | null |
9acac981-dc89-5da4-8383-e6ee53eba163 | Which of the following is false regarding heart failure with preserved ejection fraction (HFpEF)? | The most sensitive test of adequacy of tissue perfusion is mixed venous O2 saturation at rest. | The most common causes of HFpEF in the United Sates are chronic HTN and aortic stenosis. | Diagnosis of HFpEF requires echocardiography with Doppler. | Atrial systole contributes relatively more to the left ventricular end diastolic volume (LVEDV) in patients with HFpEF than it does to those with normal ventricular function. | 4 | A | 1 | null | null | null | null | null |
f7fdedcc-f38d-5074-9115-5d5650e399c1 | Which of the following is false regarding heart rate in normal healthy adults? | Cholinergic slowing of heart rate occurs via M2 muscarinic receptors. | Factors that decrease the rate of SA node depolarization increase the likelihood that the pacemaker of the heart will become located at the AV junction. | The normal intrinsic rate of the SA node increases over time. | β1-Adrenergic stimulation increases the rate of phase 4 depolarization. | 4 | C | 1 | null | null | null | null | null |
8b9c3fe4-42fe-5a37-903e-6f77a50dc1ef | When the surgeon requests for the patient be placed in the "reverse Trendelenburg" position, which of the following is the PRIMARY parameter initially affected? | Systemic afterload | Venous return | Myocardial inotropy | Cerebral perfusion | 4 | B | 1 | null | null | null | null | null |
4425c3c4-f0ee-51b5-87df-209e85684de7 | 58. You are about to induce anesthesia in a 38-year-old man with HOCM. Which of the following options should be your goals with regard to preload, afterload, rate, rhythm, and contractility? | | PRELOAD Increased | AFTERLOAD Increased | RATE Normal | RHYTHM Sinus | CONTRACTILITY Depressed | | | PRELOAD Increased | AFTERLOAD Decreased | RATE Decreased | RHYTHM Sinus | CONTRACTILITY Increased | | | PRELOAD Decreased | AFTERLOAD Increased | RATE Decreased | RHYTHM Sinus | CONTRACTILITY Depressed | | | PRELOAD Decreased | AFTERLOAD Decreased | RATE Increased | RHYTHM Sinus | CONTRACTILITY Increased | | 4 | A | 2 | null | null | null | null | null |
4ba8ba4d-c9c0-5299-9aea-05298f5e3f62 | Which of the following conditions is MOST sensitive to loss of the "atrial kick"? | Mitral regurgitation | Aortic insufficiency | Mitral stenosis | Diastolic dysfunction | 4 | D | 3 | null | null | null | null | null |
dd94d180-a557-58fd-b2cc-6ad87901c31a | Which of the following is false regarding mitral stenosis? | Hyperdynamic states, such as sepsis, can lead to pulmonary edema. | Pulmonary capillary wedge pressure approximates left ventricular end-diastolic pressure (LVEDP). | The progression of disease includes right ventricular hypertrophy and dysfunction. | Medical management of mitral stenosis includes use of β-blockers and calcium channel blockers. | 4 | B | 2 | null | null | null | null | null |
5802cac7-1dc7-5c41-aeb5-d876de59f9ab | What percentage of hepatic blood flow comes from the portal vein? | 25% | 50% | 75% | 90% | 4 | C | 1 | null | null | null | null | null |
c54e1f2b-bbce-57da-bbad-a608629561a4 | What percentage of oxygen delivery to the liver comes from the hepatic artery? | 25% | 50% | 75% | 90% | 4 | B | 1 | null | null | null | null | null |
a62536f1-8517-53c9-b5bc-ad57fd301975 | Hepatomegaly may be observed in all of the following conditions EXCEPT which one? | Congestive heart failure | Hypovolemic shock | Leukemia | Renal failure | 4 | B | 1 | null | null | null | null | null |
05ac8484-e000-5207-9231-5aee7b7a38bf | The round ligament separates which 2 hepatic segments? | 1 and 2 | 2 and 3 | 3 and 4 | 4 and 5 | 4 | C | 1 | null | null | null | null | null |
4a78dc65-d5d7-5755-b4a0-0fafb7020635 | Which of the following signaling factors is decreased in a cirrhotic liver? | Nitric oxide | Endothelin | Norepinephrine | Thromboxane A2 | 4 | A | 1 | null | null | null | null | null |
d725bd35-f37d-57c9-925b-94cecc9758ad | 6. Compared with the hepatic artery, which statement about portal vein is true? | Portal vein supplies 50% of the liver's overall blood flow. | Portal vein is a low-pressure/low-resistance system. | Portal vein blood is richly oxygenated. | Portal vein supplies 75% of the liver's overall oxygen delivery. | 4 | B | 1 | null | null | null | null | null |
03287ed4-346a-5630-a319-ce084d8c4f12 | Increase in the serum level of which of the following may be observed in liver failure? | IgG | Factor VII | Albumin | Ammonia | 4 | D | 1 | null | null | null | null | null |
e893eec1-777c-5c26-8d6c-d61c220f0254 | Glucose is synthesized in the liver as the result of all of the following processes EXCEPT which one? | Glycogenolysis | Gluconeogenesis | Tricarboxylic acid cycle | Oxidation of lactate | 4 | C | 1 | null | null | null | null | null |
15cf3859-1f54-57fd-a79c-b5e99c04d636 | In the assessment of patient with liver failure, which parameter is used in the MELD (model for end-stage liver disease) scoring system but NOT the Child-Pugh scoring system? | Creatinine | International normalized ratio (INR) | Bilirubin | Albumin | 4 | A | 1 | null | null | null | null | null |
66e8a183-22ae-57b6-a950-2b68f3b45ff4 | Elevation in the serum level of which factor is a specific marker of acute liver injury? | Aspartate aminotransferase (AST) | Alanine aminotransferase (ALT) | Alkaline phosphatase | Lactate dehydrogenase (LDH) | 4 | B | 1 | null | null | null | null | null |
d099fe56-4855-5fdc-95b8-0bb18b951461 | Which laboratory test is a sensitive indicator for decreased synthetic function of the liver? | Aspartate aminotransferase | Albumin | International normalized ratio | γ-Glutamyl transpeptidase (GGT) | 4 | C | 1 | null | null | null | null | null |
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