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73c1a04b-8b0a-5467-a7c7-fee46402fc91 | A 17-year-old type 1 diabetic with history of renal failure is in the preoperative holding area awaiting an operation for acute appendicitis. | Renal tubular acidosis | Lactic acidosis | Diabetic ketoacidosis | Aspirin overdose | 4 | A | 2 | null | null | null | null | null |
087b9e50-1b86-5144-96b5-165b3552fac4 | Methods to decrease the incidence of central venous catheter infections include all of the following EXCEPT | Changing the central catheter every 3 to 4 days over a guidewire | Using minocycline/rifampin impregnated catheters over chlorhexidine/silver sulfadiazine impregnated catheters for suspected long-term use | Using the subclavian over the internal jugular route for access | Using a single lumen over a multilumen catheter | 4 | A | 1 | null | null | null | null | null |
7f582ea5-1c74-5ece-9e30-ee9bda21dad2 | Signs of Sarin nerve gas poisoning include all of the following EXCEPT | Diarrhea | Urination | Mydriasis | Lacrimation | 4 | C | 1 | null | null | null | null | null |
cf20ecb9-622c-5916-97aa-15c18aba13c1 | Which of the following conditions would be associated with the LEAST risk of venous air embolism during removal of a central line? | Spontaneous breathing, head up | Spontaneous breathing, flat | Spontaneous breathing, Trendelenburg | Mechanical ventilation, Trendelenburg | 4 | D | 3 | null | null | null | null | null |
e6752ed6-4511-5d32-a8f5-4e6a9191ed7f | Which of the following adverse effects is NOT attributable to | Increased intracranial pressure | Peripheral vasoconstriction | Increased pulmonary vascular resistance | Increased serum potassium concentration | 4 | B | 1 | null | null | null | null | null |
77404f82-a065-5b63-ba7c-63d51e173c8f | Which of the following maneuvers is LEAST likely to raise arterial | Inflating the pulmonary artery catheter balloon (in the left pulmonary artery) | Raising hemoglobin from 8 to 12 mg/dL | Raising Fio2 from 0.8 to 1.0 | Increasing cardiac output from 2 to 5 L/min | 4 | C | 2 | null | null | null | null | null |
ca9de464-9ab3-5915-8d55-8cf3ab823b32 | A 100-kg man is 24 hours status post four-vessel coronary artery bypass graft. Which of the following pulmonary parameters would be compatible with successful extubation in this patient? | Vital capacity 2.5 L | Paco2 44 mm Hg | Maximum inspiratory pressure −38 cm H2O | All of the above | 4 | D | 2 | null | null | null | null | null |
d393608a-a667-5bd0-b2e0-ae915bf34091 | Which of the following can cause a rightward shift of the oxyhemoglobin dissociation curve? | Methemoglobinemia | Carboxyhemoglobinemia | Hypothermia | Pregnancy | 4 | D | 1 | null | null | null | null | null |
8b6346a8-c6b1-56a1-8ebd-675e4c97bad3 | A 24-year-old man is brought to the operating room 1 hour after a motor vehicle accident. He has C7 spinal cord transection and ruptured spleen. Regarding his neurologic injury, anesthetic concerns include | Risk of hyperkalemia with succinylcholine administration | Risk of autonomic hyper-reflexia with urinary catheter insertion | Increased risk of hypothermia | All of the above | 4 | C | 2 | null | null | null | null | null |
550f13a0-1b53-5b70-a5d5-b5b648a8a985 | After sustaining traumatic brain injury, a 37-year-old patient in the ICU develops polyuria and a plasma sodium concentration of 159 mEq/L. What pathologic condition is associated with these clinical findings? | Syndrome of inappropriate antidiuretic hormone (SIADH) | Diabetes mellitus | Diabetes insipidus | Cerebral salt wasting syndrome | 4 | C | 1 | null | null | null | null | null |
d391c658-2f6e-568e-9ac5-4a3ca8fa3bfe | Which of the following drugs is the best choice for treating hypotension in the setting of severe acidemia? | Norepinephrine | Epinephrine | Phenylephrine | Vasopressin | 4 | D | 3 | null | null | null | null | null |
2021ac00-6e64-50ed-bbb9-d81626a4c24b | The end-tidal CO2 measured by an infrared spectrometer is 35 mm Hg. | Morbid obesity | Pulmonary embolism | Intrapulmonary shunt | Chronic obstructive pulmonary disease (COPD) | 4 | C | 2 | null | null | null | null | null |
20fb5600-daf4-5ef6-a23e-69dc7ee1781f | A transfusion-related, acute lung injury (TRALI) reaction is suspected in a 48-year-old man in the ICU after a 10-hour operation for scoliosis during which multiple units of blood and factors were administered. Which of the following items is inconsistent with the diagnosis of a TRALI reaction? | Fever | Alveolar-to-arterial (A–a) oxygen gradient of 25 mm Hg | Acute rise in neutrophil count after onset of symptoms | Bilateral pulmonary infiltrates | 4 | C | 1 | null | null | null | null | null |
501f9e11-a187-5dd4-bf96-8c8bf332a60e | If a central line located in the superior vena cava (SVC) is withdrawn such that the tip of the catheter is just proximal to the SVC, it would be located in which vessel? | Subclavian vein | Brachiocephalic vein | Cephalic vein | Internal jugular vein | 4 | B | 1 | null | null | null | null | null |
e7aeff23-c401-524f-8059-000e8d985efe | The time course of anticoagulation therapy is variable after different percutaneous coronary interventions (PCIs). Arrange the interventions in order, starting with the one requiring the shortest course of aspirin and clopidogrel (Plavix) therapy to the one requiring the longest course. | Bare-metal stent, percutaneous transluminal coronaryangioplasty (PTCA), drug-eluting stent | Drug-eluting stent, bare-metal stent, PTCA | PTCA, drug-eluting stent, bare-metal stent | PTCA, bare-metal stent, drug-eluting stent | 4 | D | 1 | null | null | null | null | null |
9d79f4d1-5769-54e8-87b8-3d42615c34fa | A 75-year-old patient in the ICU is intubated and ventilated on AC 12, Vt 500, and "some" PEEP. In a 60-second period, he initiates two spontaneous breaths. The peak airway pressure alarm has not sounded. His minute ventilation would be | Incalculable without knowledge of PEEP value | Incalculable without knowing dead space | Incalculable without knowing magnitude of the two spontaneous breaths | Seven liters | 4 | D | 2 | null | null | null | null | null |
62284627-0f88-570e-8961-1a7bc51b3003 | Which of the features below is suggestive of weaponized anthrax exposure as opposed to a common flu-like viral illness? | Widened mediastinum | Fever, chills, myalgia | Severe cough | Pharyngitis | 4 | A | 1 | null | null | null | null | null |
a9509a79-a0fd-541f-8fdc-31771f4fac22 | Which of the following factors could not explain a Pao2 of 48 mm Hg in a patient breathing a mixture of nitrous oxide and oxygen? | Hypoxic gas mixture | Eisenmenger syndrome | Profound anemia | Hypercarbia | 4 | C | 2 | null | null | null | null | null |
ba9aa064-d0e4-54e4-a3e9-414300df8fba | During a left hepatectomy under general isoflurane anesthesia, arterial blood gases are: O2 138, CO2 39, pH 7.38, saturation 99%. At the same time, CO2 on infrared spectrometer is 26 mm Hg. The most plausible explanation for the difference between CO2 measured with infrared spectrometer versus arterial blood gas gradie... | Mainstem intubation | Atelectasis | Shunting through thebesian veins | Hypovolemia | 4 | D | 3 | null | null | null | null | null |
89d1ed5e-e976-5688-87c3-75606aaa37e1 | Under which set of circumstances would energy expenditure per day be the greatest? | Sepsis with fever | 60% burn | Multiple fractures | 1 hour status post liver transplantation | 4 | B | 1 | null | null | null | null | null |
e79bf1e3-3bfa-59f4-a4ff-5ac07e7ebf76 | Select the FALSE statement regarding amiodarone (Cordarone). | It is shown to decrease mortality after myocardial infarction | It is indicated for ventricular tachycardia and fibrillation refractory to electrical defibrillation | Adverse effects include pulmonary fibrosis and thyroid dysfunction | It is useful in treatment of torsades de pointes | 4 | D | 1 | null | null | null | null | null |
692ba259-61a8-51ac-adb2-d2177b502d46 | A 58-year-old woman is awaiting orthotopic liver transplantation for primary biliary cirrhosis in the ICU. An oximetric pulmonary artery catheter is placed, and an Svo2 of 90% is measured. Which of the following blood pressure interventions is the LEAST appropriate for treatment of hypotension in this patient? | Milrinone | Norepinephrine | Vasopressin | Phenylephrine | 4 | A | 3 | null | null | null | null | null |
ce5d4ef9-0c46-58a4-ac27-a72eafc08af7 | A 73-year-old patient is on a ventilator after an MVA. Rate is set at AC 16, Vt 450 with 5 cm H2O PEEP. The respiratory therapist notes that the measured PEEP is greater than 15 cm H2O and that the patient is not breathing above the set rate. Which option below is most reasonable for reducing the measured PEEP? | Increase the respiratory rate | Increase inspiratory flow rate | Reverse the I to E ratio | Paralyze the patient | 4 | B | 2 | null | null | null | null | null |
3f0c9a86-c6ae-50e4-895b-4deff1fcc7d0 | A 68-year-old asthmatic drunk driver comes into the ER after being in a motor vehicle accident. After a difficult intubation, you fail to observe end-tidal CO2 on the monitor. Reasons for this include all of the following EXCEPT | You intubated the esophagus by mistake | You forgot to ventilate the patient | The connection between the circuit and monitor has become disconnected | The patient also has a pneumothorax, and high airway pressures are needed to adequately ventilate the patient | 4 | D | 2 | null | null | null | null | null |
04b35252-b08d-5b8a-a43e-046379ff94b9 | A 30-year-old woman has undergone a 2-hour abdominal surgical procedure and is sent to the ICU intubated for postoperative monitoring, due to suspected sepsis. Three hours later, the ventilator malfunctions and the resident disconnects the patient from the ventilator and hand ventilates the patient with 100% oxygen. Th... | Administer atropine | Start epinephrine | Confirm ETT position | Apply external pacemaker# Respiratory Physiology and Critical Care Medicine### | 4 | C | 3 | null | null | null | null | null |
6c4e621f-82dc-593c-8c6c-c99b355622bf | Which of the following muscle relaxants is eliminated the most by renal excretion? | Pancuronium | Vecuronium | Atracurium | Rocuronium | 4 | A | 1 | null | null | null | null | null |
d4ae8963-a913-5603-977f-b4f05ddc2b58 | All of the following conditions may develop when using propofol for prolonged sedation in the intensive care unit (ICU) EXCEPT | Pancreatitis | Hyperlipidemia | Metabolic acidosis | Adrenal suppression | 4 | D | 1 | null | null | null | null | null |
74e3e7cb-465b-5488-b8f0-6b0c743e38e6 | Under which scenario should dantrolene be withheld in a patient in whom malignant hyperthermia (MH) is suspected? | Concomitant treatment with a calcium channel blocker | History of previous uneventful anesthetic with volatileanesthetic | History of negative genetic test for ryanodine mutation | Never | 4 | D | 1 | null | null | null | null | null |
95b71f1f-7e7d-564c-8856-9eb248e42002 | A 78-year-old patient with Parkinson disease undergoes a cataract operation under general anesthesia. In the recovery room, the patient has two episodes of emesis and complains of severe nausea. Which of the following antiemetics would be the best choice for treatment of nausea in this patient? | Droperidol | Promethazine | Ondansetron | Metoclopramide | 4 | C | 2 | null | null | null | null | null |
50de533f-3f14-5ad5-9d33-134e822cc026 | Which of the following diseases is associated with increased resistance to neuromuscular blockade with succinylcholine? | Myasthenia gravis | Myasthenic syndrome | Huntington chorea | Polymyositis | 4 | A | 1 | null | null | null | null | null |
ec7fa703-42e1-5de4-aae8-7efdd09de397 | Sedation with which of the following drugs is most likely to resemble normal sleep? | Propofol | Midazolam | Dexmedetomidine | Ketamine | 4 | C | 1 | null | null | null | null | null |
615ba2d4-d0d4-50fc-bacd-b59c385265d3 | Which of the following intravenous anesthetics is converted from a water-soluble to a lipid-soluble drug after exposure to the bloodstream? | Propofol | Midazolam | Ketamine | None of the above | 4 | B | 1 | null | null | null | null | null |
7b833594-7b9e-554b-bdb9-ec96ed91e78a | A 33-year-old, 70-kg patient is brought to the operating room for resection of an anterior pituitary prolactin-secreting tumor. Anesthesia is induced with sevoflurane, nitrous oxide, and oxygen. The patient is intubated, and nitrous oxide is discontinued. Anesthesia is maintained with 1.2 minimum alveolar concentration... | 55 mL | 45 mL | 35 mL | 25 mL | 4 | C | 2 | null | null | null | null | null |
b22e75d9-98d5-59d4-a9e1-d405cfe79171 | Patients receiving antihypertensive therapy with propranolol are at increased risk for each of the following EXCEPT | Blunted response to hypoglycemia | Bronchoconstriction | Rebound tachycardia after discontinuation | Orthostatic hypotension | 4 | D | 1 | null | null | null | null | null |
bb150dbf-29ec-59b8-ae4f-38a486bd7578 | Atropine causes each of the following EXCEPT | Decreased gastric acid secretion | Inhibition of salivary secretion | Increased lower esophageal sphincter tone | Mydriasis | 4 | C | 1 | null | null | null | null | null |
10019042-8561-5c8a-b190-84e981e29c53 | Which of the following drugs is capable of crossing the blood-brain barrier? | Neostigmine | Pyridostigmine | Edrophonium | Physostigmine | 4 | D | 1 | null | null | null | null | null |
9fae8d6c-f8dc-5287-9b0a-42d29763c776 | Which drug exerts its main central nervous system (CNS) action by inhibiting the *N*-methyl-D-aspartate (NMDA) receptors? | Propofol | Midazolam | Etomidate | Ketamine | 4 | D | 1 | null | null | null | null | null |
497e4587-715d-5418-bc22-5b1218ca95d8 | Which of the following opioid-receptor agonists has anticholinergic properties? | Morphine | Hydromorphone | Sufentanil | Meperidine | 4 | D | 1 | null | null | null | null | null |
2c0c2f5e-a98c-5ab6-acc6-3626519ed8b5 | Which of the following statements about ketamine is FALSE? | In the United States it is a racemic mixture of two isomers | It is a potent cerebral vasodilator and can increase intracranial pressure (ICP) | Respiratory depression rarely occurs with induction doses | Its metabolite norketamine is more potent than the parent compound | 4 | D | 1 | null | null | null | null | null |
9fdb04fa-04b2-574e-9a37-94decd901864 | Which of the following vasopressor agents increases systemic blood pressure (BP) indirectly by stimulating the release of norepinephrine from sympathetic nerve fibers and directly by binding to adrenergic receptors? | Vasopressin | Ephedrine | Epinephrine | Phenylephrine | 4 | D | 1 | null | null | null | null | null |
05f06f3d-45bf-5288-aba5-82521d2e929f | Methadone-induced constipation could be reversed without loss of analgesic effect with which of the following opioid antagonists? | Naloxone | Nalmefene | Naltrexone | Methylnaltrexone | 4 | D | 1 | null | null | null | null | null |
112a57cf-a362-5be1-bb58-286cb688f15e | The treatment of patients with human immunodeficiency virus (HIV) may include indinavir, nelfinavir, or ritonavir. What anesthetic consideration is significant with these drugs? | Decreased platelet function | Increased sensitivity to midazolam | Hypoglycemia | Hyperkalemia | 4 | B | 1 | null | null | null | null | null |
66c00097-a0a8-5d74-b140-e264e33eb7d2 | Neurokinin-1 (NK1) antagonists such as aprepitant have all the following properties EXCEPT | Anxiolytic | Antidepressant | Analgesic | Antiemetic | 4 | C | 1 | null | null | null | null | null |
e6ffbad5-149d-539b-a07e-87b063af615a | Which of the following drugs should be administered with caution to patients receiving echothiophate for the treatment of glaucoma? | Atropine | Succinylcholine | Ketamine | Remifentanil | 4 | B | 1 | null | null | null | null | null |
a35b6496-30a3-5e00-9aef-4e803e267fa1 | When one of four thumb twitches in the train-of-four (TOF) stimulation of the ulnar nerve can be elicited, how much suppression would there be if you were measuring a single twitch? | 20 to 25 | 45 to 55 | 75 to 80 | 90 to 95 | 4 | D | 1 | null | null | null | null | null |
859eabbc-9cc4-52e5-b690-2b8815bf2a1f | Which of the following muscle relaxants causes slight histamine release at two to three times the ED95 (effective dose in 95% of subjects) dose? | Rocuronium | Pancuronium | Atracurium | Cisatracurium | 4 | C | 1 | null | null | null | null | null |
76c904ff-8732-55d3-9bb4-978e5b778147 | Termination of action of the neurotransmitter norepinephrine is achieved predominately by which mechanism? | Reuptake into postganglionic sympathetic nerve endings (uptake 1) | Dilution by diffusion away from receptors | Metabolism by catechol-*O*-methyltransferase (COMT) | Metabolism by monoamine oxidase (MAO) | 4 | A | 1 | null | null | null | null | null |
73fa0cb5-b65c-5787-8e69-958d26fd65f1 | The incidence of unpleasant dreams associated with emergence from ketamine anesthesia can be reduced by the administration of | Caffeine | Droperidol | Physostigmine | Midazolam | 4 | D | 1 | null | null | null | null | null |
9d2cdd27-6ce9-57fc-9198-f470ecbe4693 | The principal advantage of Ryanodex over conventional formulations of dantrolene is | Cost | Speed of reconstitution and administration | Absence of large amounts of mannitol | Need for lower dose | 4 | B | 1 | null | null | null | null | null |
c178cf61-3d2b-5ab4-8035-ac409042b23a | Eplerenone (Inspra) inhibits the renin-angiotensin-aldosterone system by which mechanism? | Blocks aldosterone receptor | Blocks conversion angiotensinogen to angiotensin I | Blocks angiotensin receptor | Prevents formation of renin | 4 | A | 1 | null | null | null | null | null |
8e6516f7-0882-528f-9468-2ef5b863e27a | Each of the following drugs can enhance the neuromuscular blockade produced by nondepolarizing muscle relaxants EXCEPT | Calcium | Aminoglycoside antibiotics | Magnesium | Intravenous lidocaine | 4 | A | 1 | null | null | null | null | null |
33e7181e-c1a6-54e5-a290-35ba510dfd83 | The primary site of action of lisinopril is | Heart | Lungs | Kidney | Metarterioles | 4 | B | 1 | null | null | null | null | null |
0f9c3b89-63da-5eaa-9733-137a4b245d1b | Circulating BNP (B-type natriuretic peptide) is a powerful biomarker predicting outcomes of which of the following? | Heart | CNS | Kidneys | Organ rejection | 4 | A | 1 | null | null | null | null | null |
e80a19b6-4103-57ae-a455-17103da77f92 | Hyperkalemia is NOT a risk for patients receiving succinylcholine with which of the following? | Multiple sclerosis (MS) | Myasthenia gravis | Guillain-Barré syndrome | Becker muscular dystrophy | 4 | B | 1 | null | null | null | null | null |
69b9b3ae-0113-5e16-8112-f83731559203 | Which of the antibiotics below does NOT augment neuromuscular blockade? | Clindamycin | Neomycin | Streptomycin | Erythromycin | 4 | D | 1 | null | null | null | null | null |
0879d068-d07c-57c9-bf79-450fe869013d | A 43-year-old woman with ascites, hepatopulmonary syndrome, and bleeding esophageal varices is admitted to the ICU. Which of the therapies below is LEAST likely to improve symptoms associated with hepatic encephalopathy (HE)? | Amino acid–rich total parenteral nutrition (TPN) | Neomycin | Lactulose | Flumazenil | 4 | D | 2 | null | null | null | null | null |
971362e3-a68a-510c-85db-8671b9fb3f93 | 100 mg succinylcholine is administered to a 70-kg anesthetized man before intubation. The patient remains paralyzed for 20 minutes. Which of the parameters below is NOT consistent with this finding? | Dibucaine number 70 | Heterozygous for atypical cholinesterase | Incidence of 1/480 | Presence of fasciculations with this dose | 4 | A | 2 | null | null | null | null | null |
94436d1f-8b2d-51b2-ad2f-1ce4d0d88348 | In which of the following situations is succinylcholine most likely to cause severe hyperkalemia? | 24 hours after a right hemisphere stroke | 14 days after a severe burn injury | 24 hours after a midthoracic spinal cord transection | 2 days with a severe abdominal infection | 4 | B | 2 | null | null | null | null | null |
19aa9aa2-6af7-5bee-bf24-b76fa7c9810a | The most common minor side effect reported after flumazenil administration in anesthesia is | Nausea and/or vomiting | Dizziness | Tremors | Hypertension | 4 | A | 1 | null | null | null | null | null |
6efbd3bc-516e-5fb6-839f-8655b304a202 | Ketorolac | Is a selective cyclooxygenase-2 (COX-2) inhibitor | Does not inhibit thromboxane A2 (TXA2 ) | Does not inhibit prostaglandin I2 | Exhibits a dose ceiling effect with regard to analgesia | 4 | D | 1 | null | null | null | null | null |
fbb91c41-cbbe-5e77-9dff-a69197f9ae03 | A 37-year-old patient with a history of acute intermittent porphyria is scheduled for knee arthroscopy under general anesthesia. Which of the following drugs is contraindicated in this patient? | Fentanyl | Isoflurane | Propofol | Etomidate | 4 | D | 1 | null | null | null | null | null |
0115eb0e-592f-5337-b3f4-04a0836cb003 | A 57-year-old male is discharged after tooth extraction of two molars. His only medication is paroxetine (Paxil), which he takes for depression. Codeine is a poor analgesic choice for this patient because | It is likely to be ineffective | It is likely to cause extreme sedation | He is at increased risk for nausea | He is at increased risk for serotonin syndrome | 4 | A | 2 | null | null | null | null | null |
217201f7-64a7-5aaa-8a6f-946f9aa446b5 | If etomidate were accidentally injected into a left-sided radial arterial line, the most appropriate step to take would be | Left stellate ganglion block | Administer intra-arterial clonidine | Slowly inject dilute (0.1 mEq/L) [HCO3 - ] | Observe | 4 | D | 1 | null | null | null | null | null |
a218bac5-0c9d-5332-80a6-35ee35b27324 | The most important reason for the more rapid onset and shorter duration of action of fentanyl with single dose compared with morphine is the difference in | Volume of distribution | Hepatic clearance | Protein binding | Lipid solubility | 4 | D | 1 | null | null | null | null | null |
64a6182c-aa00-59a5-b7e5-089e82dda9a5 | A narcotic infusion is initiated in a patient without a bolus (loading dose). Of the following drugs, which would reach steady state after 2 hours or less of continuous infusion (fentanyl, remifentanil, alfentanil, and morphine)? | All of these | Remifentanil and alfentanil | Alfentanil only | Remifentanil only | 4 | D | 1 | null | null | null | null | null |
ce5ffd84-46f6-52d6-85b2-633eced6c614 | The period of vulnerability after three courses of bleomycin for testicular cancer is | 1 month | 1 year | Lifelong | No vulnerability with just three courses | 4 | C | 1 | null | null | null | null | null |
b661d165-28dc-52e9-9e3e-aa2c0725647d | The unique advantage of rocuronium over other muscle relaxants is its | Short duration of action | Metabolism by pseudocholinesterase | Onset of action | Lack of need for reversal | 4 | C | 1 | null | null | null | null | null |
becd7d2b-3c36-56ac-b8b4-3b86691d7bf2 | Which of the following statements regarding the efficacy of neuromuscular blockade in the setting of acute hypokalemia is correct? | There is no effect with depolarizing or nondepolarizing muscle relaxants | There is resistance to effects of both depolarizing and nondepolarizing muscle relaxants | There is increased sensitivity to effects of both depolarizing and nondepolarizing muscle relaxants | There is resistance to depolarizing muscle relaxants and increased sensitivity to nondepolarizing muscle relaxants | 4 | D | 1 | null | null | null | null | null |
caecd4ea-ec00-5375-a734-41c5bc268d45 | A patient undergoing which of the following operations would be at highest risk for operative recall? | Laparoscopic cholecystectomy with total intravenous anesthesia (TIVA) (no volatile) | Cervical spine fusion with MEP (motor evoked potentials) monitoring | Pneumonectomy with one-lung ventilation | Emergency splenectomy after falling from a ladder | 4 | D | 2 | null | null | null | null | null |
5fe175ed-ab96-5ecf-838c-28951575d779 | A 58-year-old patient is brought to the emergency room with the following symptoms: miosis, abdominal cramping, salivation, loss of bowel and bladder control, bradycardia, ataxia, and skeletal muscle weakness. The most likely diagnosis is | Central anticholinergic syndrome | Malignant neuroleptic syndrome | Anticholinesterase poisoning | Serotonin syndrome | 4 | C | 1 | null | null | null | null | null |
6a83906d-dbc4-52d4-b36d-a705e6ea1941 | Flumazenil | Is contraindicated in narcotic addicts | Can be given orally as well as intravenously | Can produce seizures in chronic benzodiazepine users | Has a longer elimination half-life compared with midazolam | 4 | C | 1 | null | null | null | null | null |
46c08be3-a92b-5145-97e8-cef5c1c6de59 | What percentage of neuromuscular receptors could be blocked and still allow patients to carry out a 5-second head lift? | 5% | 15% | 25% | 50% | 4 | D | 1 | null | null | null | null | null |
eb0bd4e6-e6c4-515f-a955-8ebbbeb30f36 | Which of the following drugs can prevent tachyarrhythmias in patients with Wolff-Parkinson-White (WPW) syndrome? | Droperidol | Pancuronium | Ketamine | Verapamil | 4 | A | 1 | null | null | null | null | null |
12a413a9-3fdb-55ae-86a8-d62f2c5e64b2 | The half-life of pseudocholinesterase is | 1 hour | 12 hours | 1 week | 2 weeks | 4 | B | 1 | null | null | null | null | null |
da36f61e-d120-5c31-9515-1a682da1aa0a | A patient with CYP2D6 polymorphism is tested and shown to be an ultrarapid metabolizer. Which of the following statements regarding PONV prophylaxis with serotonin receptor antagonists is true? | Neither granisetron nor ondansetron would likely be efficacious | Granisetron would likely be more efficacious than ondansetron | Ondansetron would likely be more efficacious than granisetron | Both would likely be efficacious | 4 | B | 2 | null | null | null | null | null |
5b4f646f-c7ae-5652-9cc4-547e9d23349d | Which of the following equals the anti-inflammatory activity of 50 mg of prednisone (Deltasone)? | 100 mg cortisol (Solu-Cortef) | 80 mg methylprednisolone (Solu-Medrol) | 7.5 mg dexamethasone (Decadron) | 4 mg betamethasone (Celestone) | 4 | C | 1 | null | null | null | null | null |
df7fbfd0-516b-5731-9eb7-47c90ee7a558 | The recovery index (RI) of which of the following nondepolarizing muscle relaxants is NOT altered by aging? | Atracurium | Vecuronium | Rocuronium | Pancuronium | 4 | A | 1 | null | null | null | null | null |
c8aa8a13-3e8f-59bc-948e-fbe93f320059 | Side effects associated with cyclosporine therapy include each of the following EXCEPT | Nephrotoxicity | Pulmonary toxicity | Seizures | Limb paresthesias | 4 | B | 1 | null | null | null | null | null |
2c8970a5-cfd9-5002-a0f7-be8225644bf1 | What is the predominant mechanism for succinylcholine-induced tachycardia in adults? | Direct sympathomimetic effect at postjunctional muscarinic receptors | Stimulation of nicotinic receptors at autonomic ganglia | Blockade of nicotinic receptors at autonomic ganglia | Direct vagolytic effect at postjunctional muscarinic receptors | 4 | B | 1 | null | null | null | null | null |
beb7c198-cc50-5a7a-afb5-6129c259644d | A 72-year-old patient with a history of type 2 diabetes and hypertension is brought to the ICU after aortobifemoral bypass grafting. The patient is up 3 kilograms since surgery, and diuretic therapy is initiated to enhance urine output. Which of the choices below is LEAST likely to cause hypokalemic, hypochloremic meta... | Triamterene | Furosemide | Bumetanide | Oral thiazide | 4 | A | 2 | null | null | null | null | null |
19b2095d-ade9-541e-a2ff-58a04a50156f | Which of the commonly used drugs below is NOT metabolized by nonspecific esterases? | Propofol | Esmolol | Atracurium | Remifentanil | 4 | A | 1 | null | null | null | null | null |
4cfd675e-3bf2-5407-962d-3fbd71a32d97 | Succinylcholine is contraindicated for routine tracheal intubation in children because of an increased incidence of which of the following side effects? | Hyperkalemia | Malignant hyperthermia | Masseter spasm | Sinus bradycardia | 4 | A | 1 | null | null | null | null | null |
7404ccdc-ed86-5bb3-9c62-1f7df96bba98 | From MOST to LEAST rapid, select the correct temporal sequence of neuromuscular blockade in the adductor of the thumb, the orbicularis oculi, and the diaphragm after administration of an intubating dose of vecuronium to an otherwise healthy patient. | Diaphragm, orbicularis oculi, thumb | Orbicularis oculi, diaphragm, thumb | Orbicularis oculi, thumb, diaphragm | Orbicularis oculi same as diaphragm, thumb | 4 | D | 1 | null | null | null | null | null |
299c3162-be5a-51fd-94a2-375818d63da6 | Select the TRUE statement regarding interaction of nondepolarizing neuromuscular blocking drugs when durations of action are dissimilar. | If a long-acting drug is administered after an intermediateacting drug, the duration of the long-acting drug will be longer than normal | If a long-acting drug is administered after an intermediateacting drug, the duration of the long-acting drug will be about the same as expected | If an intermediate-acting drug is administered after a longacting drug, the duration of the intermediate-acting drug will be about the same as expected | If an intermediate-acting drug is administered after a longacting drug, the duration of action of the intermediate-acting drug will be longer than expected | 4 | D | 2 | null | null | null | null | null |
fc834ce0-8bd7-5f81-a7fb-295e986bedf5 | Select the correct statement regarding the effects of volatile anesthetics on nondepolarizing neuromuscular blocking drugs and the reversal agents. | Volatile anesthetics potentiate neuromuscular blockade but retard reversal agents | Volatile anesthetics potentiate both neuromuscular blocking drugs and reversal agents | Volatile anesthetics retard both neuromuscular blocking drugs and reversal agents | Volatile anesthetics retard neuromuscular blocking drugs but potentiate reversal agents | 4 | A | 1 | null | null | null | null | null |
08ac173d-edfb-5be6-8653-0d797b485fa1 | Meperidine is contraindicated in patients taking which of the following | Bromocriptine | Trihexyphenidyl (Artane) | Selegiline (Eldepryl) | Amantadine (Symmetrel) | 4 | C | 1 | null | null | null | null | null |
df8a5bdf-ed37-5955-a7f5-23c27d51e20b | Emergence delirium (ED) occurs most often with | Sevoflurane | Desflurane | Ketamine | Propofol | 4 | A | 1 | null | null | null | null | null |
115a3920-a623-5c7e-a4c2-628fb234db4b | The most common reason for patients to rate anesthesia with etomidate as unsatisfactory is | PONV | Pain on injection | Recall of intubation | Postoperative hiccups | 4 | A | 1 | null | null | null | null | null |
66c7489f-ffd7-544f-b207-6a593f36948c | Which of the following muscle relaxants inhibits the reuptake of norepinephrine by the adrenergic nerves? | Pancuronium | Vecuronium | Rocuronium | Atracurium | 4 | A | 1 | null | null | null | null | null |
5aacfb19-00cd-5619-82d0-78013109c6b8 | The most common side effect of oral dantrolene used to prevent MH is | Nausea and vomiting | Muscle weakness | Blurred vision | Tachycardia | 4 | B | 1 | null | null | null | null | null |
decd7aba-a383-5f43-8d86-c82f16473fc7 | A 65-year-old patient is admitted for right upper quadrant pain. Acute cholecystitis is diagnosed, and laparoscopic cholecystectomy planned. The patient has no major medical problems other than type 2 diabetes, for which she takes metformin, and depression, for which she takes paroxetine (selective serotonin reuptake i... | Risk of metabolic acidosis | Risk of hypoglycemia | Risk of serotonin syndrome | None of the above | 4 | D | 2 | null | null | null | null | null |
422a6fd0-7ff0-5d88-ad8a-798b7c6bedb0 | A 37-year-old man is brought to the operating room for repair of a broken mandible sustained in a motor vehicle accident. No other injuries are significant. The patient has been in treatment for alcohol abuse and takes disulfiram and naltrexone. Which of the following would be the best technique for management of this ... | Continue naltrexone with round-the-clock low-dose methadone | Continue naltrexone with small doses of morphine every 4 hours as needed | Continue naltrexone with small doses of nalbuphine every 4 hours as needed | Discontinue naltrexone and treat pain with morphine as needed | 4 | D | 3 | null | null | null | null | null |
3d7627cc-edab-54be-8ee4-86e11b6e4cd4 | Context sensitive half-time for a pharmacologic agent is most closely related its | Lipid solubility | Duration of administration | Concentration | Route of administration | 4 | A | 1 | null | null | null | null | null |
3d51b85b-2759-54fe-8449-e8dfe048447e | The neuromuscular effects of an intubation dose of vecuronium are terminated by | Diffusion from the neuromuscular junction back into the plasma | Nonspecific plasma cholinesterases | The kidneys | The liver | 4 | A | 1 | null | null | null | null | null |
e351ad31-8204-58fd-aa93-da6874fcce8d | Respiratory depression produced by which of the following analgesics is not readily reversed by administration of naloxone? | Meperidine | Methadone | Hydromorphone | Buprenorphine | 4 | D | 1 | null | null | null | null | null |
91e7ccb2-efc1-50d1-9705-140c258e3dc1 | Which of the following intravenous anesthetic agents is associated with the highest incidence of nausea and vomiting? | Midazolam | Etomidate | Ketamine | Propofol | 4 | B | 1 | null | null | null | null | null |
ec1c6c8e-fde9-5509-99b4-7484ba989e37 | If naloxone were administered to a patient who is receiving ketorolac for postoperative pain, the most likely result would be | Bradycardia | Hypotension | Pain | None of the above | 4 | D | 2 | null | null | null | null | null |
df2d4e7a-fe8b-527c-a69d-7a9fdd10772f | Which drug produces strong pulmonary arterial dilation with the least amount of systemic artery dilation? | Nitroprusside | Prostaglandin E1 | Phentolamine | Nitric oxide | 4 | D | 1 | null | null | null | null | null |
88184fc0-b7a4-5779-a813-ba93247be320 | The action of succinylcholine at the neuromuscular junction is terminated by which mechanism? | Hydrolysis by pseudocholinesterase | Diffusion into extracellular fluid | Reuptake into nerve tissue | Reuptake into muscle tissue | 4 | B | 1 | null | null | null | null | null |
a42d7642-c060-5c96-bd35-f55fdf4d808d | The LEAST likely side effect of dexmedetomidine in a healthy patient | Respiratory arrest | Bradycardia | Sinus arrest | Hypotension | 4 | A | 1 | null | null | null | null | null |
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