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c899f28d-52ed-5906-bad3-9f38ce1f6fcf
Which of the following signs is NOT seen in patients suffering from thyrotoxicosis in whom thyroid storm is suspected
Tachycardia
Altered consciousness
Hypothermia
Weakness
4
C
1
null
null
null
null
null
161e3c7d-43f1-5a26-bb64-4a0178e0ffa5
Which of the following features of chronic morphine therapy is NOT subject to tolerance?
Analgesia
Respiratory depression
Constipation
All are subject to tolerance
4
C
1
null
null
null
null
null
7fe35591-b10c-5a37-b96b-fe0dbc1f1341
A 78-year-old woman with a history of reactive airway disease takes cimetidine (Tagamet) 400 mg at night. An additional dose is given IV 30 minutes before induction of anesthesia for an exploratory laparotomy. Possible side effects associated with this drug include all of the following EXCEPT
Bradycardia
Delayed awakening
Confusion
Increased metabolism of diazepam
4
D
1
null
null
null
null
null
0229d493-9767-5823-aeb8-f717c0a7837f
Intraoperative allergic reactions are LEAST common after patient exposure to
Ketamine
Latex
Muscle relaxants
Hydroxyethyl starch
4
A
1
null
null
null
null
null
f6e847da-a045-54a1-a242-9e6e572ff9e9
Which of the following medications would be useful in the definitive treatment of sarin nerve gas poisoning?
Sodium nitroprusside
Methylene blue
Atropine
All the above are useful
4
C
1
null
null
null
null
null
266f183c-34ea-5596-9918-ff645f47a386
Alfentanil
Has a more rapid onset of action compared with fentanyl
Has a longer duration of action compared with fentanyl
Is 250 times more potent than fentanyl
Is excreted unchanged in the urine
4
A
1
null
null
null
null
null
3a26e7c7-09e0-5d75-bd9f-1712d0ca6799
Which of the following medications is NOT useful in the immediate management of status asthmaticus?
Terbutaline
Subcutaneous (SQ) epinephrine
Magnesium sulfate
Cromolyn
4
D
1
null
null
null
null
null
2c36df4f-e115-5f8f-836b-9021b9404073
Clonidine
Is an α2 blocker
Increases CNS sympathetic response to painful stimuli
Can be given orally as well as intravenously, but notepidurally or intrathecally
Decreases postanesthetic shivering
4
D
1
null
null
null
null
null
d6001d54-702d-5223-b53d-9f2911b5b323
The plasma half-time of which of the following drugs is prolonged in patients with end-stage cirrhotic liver disease?
Diazepam
Pancuronium
Alfentanil
All are prolonged
4
D
1
null
null
null
null
null
314cafa0-c2e5-52ac-a6cd-e6afe7b9da14
A 24-year-old, 100-kg patient is brought to the emergency room by the fire department after suffering smoke inhalation and third-degree burns on the abdomen, chest, and thighs 30 minutes earlier. The best muscle relaxant choice for the most rapid intubation would be
2 mg vecuronium followed by succinylcholine
1 mg of vecuronium, then 2 to 4 minutes later, 9 mg vecuronium
Rocuronium
Succinylcholine
4
D
2
null
null
null
null
null
372190c4-1a90-53b3-a91b-0f4d43881a45
Clonidine is useful in each of the following applications EXCEPT
Reducing BP with pheochromocytoma
Treatment of postoperative shivering
Protection against perioperative myocardial ischemia
As an agent for prolonging a bupivacaine spinal
4
A
1
null
null
null
null
null
09c08768-f279-55d4-a779-113c28ec532d
A 79-year-old man is brought to the operating room for elective repair of bilateral inguinal hernias. The patient has a history of awareness during general anesthesia and refuses regional anesthesia. The patient is preoxygenated before induction of general anesthesia; 5 mg of midazolam and 250 mg of fentanyl are admini...
Flumazenil
Naloxone
Succinylcholine
Albuterol
4
C
2
null
null
null
null
null
a5d42527-aa97-5609-932d-5813f485957b
Respiratory depression is LEAST after the induction dose of which of the following drugs?
Etomidate
Ketamine
Fentanyl
Propofol
4
B
1
null
null
null
null
null
863eeecd-61ad-5b94-8e0e-b7ec38b24fc3
A 64-year-old man with colon cancer is anesthetized for hepatic resection of liver metastases. Medical history is significant for ileal conduit surgery for bladder cancer, diabetes treated with glyburide, 50 pack-per-year smoking history, and family history of Malignant hyperthermia. Anesthesia is provided with morphin...
Excessive infusion of normal saline
Renal tubular acidosis
Propofol infusion syndrome
Diabetic ketoacidosis (DKA)
4
C
3
null
null
null
null
null
997c4b45-e59d-568a-a615-37da0fe3d18e
Treatment of neuroleptic malignant syndrome (NMS) may be carried out with administration of the following drugs EXCEPT
Amantadine
Dantrolene
Bromocriptine
Physostigmine
4
D
1
null
null
null
null
null
21ef59ab-9b7e-5517-8d5a-66c363ffc7c7
A patient with a normal quantity of pseudocholinesterase (plasma cholinesterase) has a dibucaine number of 57. A 1 mg/kg dose of intravenous succinylcholine would likely result in
Hyperkalemic cardiac arrest
Paralysis lasting 5 to 10 minutes
Paralysis lasting 20 to 30 minutes
Paralysis lasting more than 1 to 3 hours
4
C
2
null
null
null
null
null
cb600a06-cac4-5da9-a8fe-4793198b09b7
Aprepitant exerts its pharmacologic effect by interaction with which receptor?
Neurokinin-1 (NK1 )
5-HT3
Histamine (H1 )
Dopamine (D2 )
4
A
1
null
null
null
null
null
6e7c0435-76ba-537e-972f-44583b7bc08c
A prolonged neuromuscular block with succinylcholine can be seen in all of the following patients EXCEPT those
Chronically exposed to malathion
Treated with echothiophate for glaucoma
Treated with cyclophosphamide for metastatic cancer
Having a C5 isoenzyme variant
4
D
1
null
null
null
null
null
c557efe4-8c04-5872-9a76-c49e63a305dd
Which of the following statements concerning midazolam is FALSE?
Midazolam has greater amnestic than sedative properties
Its breakdown is inhibited by cimetidine
It produces retrograde amnesia
It facilitates the actions of the inhibitory neurotransmitter γaminobutyric acid (GABA) in the CNS
4
C
1
null
null
null
null
null
d8563270-6af2-5574-a59d-96e80bd2d0ca
After a 2-hour vertical gastric banding procedure under desflurane, oxygen, and remifentanil anesthesia, the trocar is removed and the wound is closed. Upon emergence, the most likely scenario is
Adequate analgesia for 2 hours
Delayed emergence from narcotic
Pain
Respiratory depression in postanesthesia care unit (PACU)
4
C
2
null
null
null
null
null
1d8d3d58-2ec6-5c84-8fe2-0e3eab1089e9
An oral surgeon is about to perform a full mouth extraction on a 70-kg, 63-year-old man under conscious sedation. What is the maximum dose of lidocaine with epinephrine that he can safely infiltrate?
200 mg
300 mg
400 mg
500 mg
4
D
2
null
null
null
null
null
20fcb5e4-48c8-5f77-9a9f-f27d5d15d2c1
Postanesthetic shivering can be treated with all of the following EXCEPT
Naloxone
Physostigmine
Magnesium sulfate
Dexmedetomidine
4
A
1
null
null
null
null
null
25d5b321-0618-51ba-8962-40eb4469ab03
The main disadvantage of Sugammadex compared with neostigmine is
Recurarization
Contraindicated with renal failure
Not effective with benzylisoquinolinium relaxants
High incidence of allergic reactions
4
C
1
null
null
null
null
null
cf95aba4-7432-5290-879a-38b5c0863af9
Which of the biologic substances listed below is by itself the greatest determinant of serum osmolality?
AVP (arginine vasopressin)
Angiotensin I
Aldosterone
Renal prostaglandins (PGE2 )
4
A
1
null
null
null
null
null
59c6e720-3bc7-50b9-9c71-73546bd4a3cf
Remimazolam
Is less potent than its main metabolite
Is suitable for patients with liver disease
Is metabolized rapidly by amine precursor uptake and decarboxylation (APUD) cells in the gastrointestinal (GI) tract
Is a commercially available mixture of remifentanil plus midazolam
4
B
1
null
null
null
null
null
aa84ae40-9a68-5a9e-95e3-4bdb28488b5d
Amrinone
Is a positive inotropic drug
Is antagonized by esmolol
Is a vasoconstrictor
All the above
4
A
1
null
null
null
null
null
39a9a323-83de-548c-916c-aa110e2ea99c
Which statement concerning tricyclic antidepressants in patients receiving general anesthesia is TRUE?
They should be discontinued 2 weeks before elective operations
They may decrease the requirement for volatile anesthetics (decrease MAC)
Meperidine may produce hyperpyrexia in patients taking tricyclic antidepressants
They may exaggerate the response to ephedrine
4
D
1
null
null
null
null
null
d9282a8c-09ee-57e3-95ff-4461b9070272
Which of the following types of insulin preparations has the fastest onset of action if administered subcutaneously?
Glargine (Lantus)
Lispro (Humalog)
Regular (Humulin-R)
NPH (Humulin-N)
4
B
1
null
null
null
null
null
c0c616b7-28db-5efe-a7de-429faefce398
Which of the following mechanisms best explains the anticoagulative properties of tirofiban?
Cyclooxygenase (COX) inhibition
Interaction with von Willebrand factor (vWF)
Interaction with antithrombin III
Enhanced anti-Xa activity
4
B
1
null
null
null
null
null
b8adc1fd-8918-5568-bd91-79a7910cc261
The duration of action of remifentanil is attributable to which mode of metabolism?
Spontaneous degradation in blood (Hofmann elimination)
Hydrolysis by nonspecific plasma esterases
Hydrolysis by pseudocholinesterase
Rapid metabolism in the large intestine
4
B
1
null
null
null
null
null
e8c06a11-417b-591e-a557-ebd39bdad474
Pain at the intravenous site is LEAST with which IV drug?
Diazepam
Etomidate
Ketamine
Propofol
4
C
1
null
null
null
null
null
c4e89e85-6cfa-5f5b-9ce8-76a0f8aff96b
A 35-year-old patient with a history of grand mal seizures is anesthetized for thyroid biopsy under general anesthesia consisting of 4 mg midazolam with infusion of propofol (150 μg/kg/min) and remifentanil (1 μg/kg/min). The patient takes phenytoin for control of seizures. After 30 minutes, the infusion is stopped and...
Administer naloxone
Administer flumazenil
Administer naloxone and flumazenil
Ventilate by hand
4
D
3
null
null
null
null
null
9421461c-9c7a-5fa1-8650-77672a6763cb
Which of the following α-antagonists produces an irreversible blockade?
Phentolamine
Prazosin
Phenoxybenzamine
Labetalol
4
C
1
null
null
null
null
null
1bfd296f-a27b-5bfa-a7b0-c64b3ff11312
Which of the following drugs should NOT be used in the treatment of severe bradycardia induced by an excess of the beta-adrenergic receptor blockade as a result from a propranolol overdose?
Atropine
Isoproterenol
Dopamine
Glucagon
4
C
2
null
null
null
null
null
29f04fcd-303e-5a38-919a-7a3192aa875e
A dose of 150 mg of IV dantrolene is administered to a 24-year-old, 75 kg man in whom incipient MH is suspected. An expected consequence of this therapy would be
Muscle spasticity in the postoperative period
Hypothermia
Cardiac dysrhythmias
Diuresis
4
D
1
null
null
null
null
null
fa401710-3e9e-5771-9171-bcc9e459962d
Atracurium differs from cisatracurium in which way?
Molecular weight
Formation of laudanosine
Histamine release
No renal metabolism
4
C
1
null
null
null
null
null
4fb34f12-ce67-5344-88de-86f45ea108a2
Signs and symptoms of opioid withdrawal include all of the following
Increased BP and heart rate
Seizures
Abdominal cramps
Jerking of the legs# Pharmacology and Pharmacokinetics of Intravenous Drugs
4
B
1
null
null
null
null
null
e114f219-e519-53a4-8b4e-be506fc87f8d
The minimum alveolar concentration (MAC) is highest in neonates (0- 30 days old) versus other age groups with which of the following?
Isoflurane
Sevoflurane
Desflurane
N2O
4
B
1
null
null
null
null
null
84b37e0b-f283-535e-b96c-0a0880d29842
The rate of increase in the alveolar concentration of a volatile anesthetic relative to the inspired concentration (FA/FI) plotted against time is steep during the first moments of inhalation, with all volatile anesthetics. The reason for this observation is that
Volatile anesthetics reduce alveolar ventilation (Va)
There is minimal anesthetic uptake from the alveoli into pulmonary venous blood
Volatile anesthetics increase cardiac output initially
The volume of the anesthetic breathing circuit is small
4
B
1
null
null
null
null
null
6f226fcd-ac13-5090-a85b-183e08868b8e
During spontaneous breathing, volatile anesthetics
Increase tidal volume (Vt) and decrease respiratory rate
Increase Vt and increase respiratory rate
Decrease Vt and decrease respiratory rate
Decrease Vt and increase respiratory rate
4
D
1
null
null
null
null
null
2281c08e-dd1b-5221-ad57-c9aa59b5a1f1
Which of the following can NOT be considered an advantage of lowflow anesthesia?
Conservation of fossil fuel
Less ozone depletion
Reduced room pollution
Conservation of absorbent
4
D
1
null
null
null
null
null
99d0dc09-de47-5e14-9170-5a4ff529b902
The main reason desflurane is not used for inhalation induction in clinical practice is because of
Its low blood/gas partition coefficient
Its propensity to produce hypertension in high concentrations
Its propensity to produce airway irritability
Its propensity to produce tachyarrhythmias
4
C
1
null
null
null
null
null
c6fcd356-1155-558a-b126-26e9732cf9fd
A 24-year-old is undergoing open reduction of an ankle fracture under general anesthesia with sevoflurane, N2O, and O2 through a laryngeal mask airway (LMA). Just after the vaporizer dial is turned up to 2%, the patient begins spontaneously breathing, but the inspiratory valve is not fully closing. The likely result of...
N2O
CO2
O2
All of the above
4
B
2
null
null
null
null
null
16dc4d35-f1c0-566e-b2ac-8310f4623b8c
Select the TRUE statement regarding blood pressure when 1.5 MAC N2O-isoflurane is substituted for 1.5 MAC isoflurane-oxygen.
Blood pressure is less than awake value but greater than that seen with isoflurane-O2
Blood pressure is equal to awake value
Blood pressure is greater than awake value
Blood pressure is less than isoflurane-O2 pressure
4
A
2
null
null
null
null
null
fc8e1026-5da9-5be1-bc7a-5d601acd20d6
Which of the following volatile anesthetics decreases systemic vascular resistance?
Sevoflurane
Isoflurane
Desflurane
All of the above
4
D
1
null
null
null
null
null
b959174d-1569-55df-9cc3-59d795833c86
With which of the following inhalational agents is cardiac output moderately increased?
N2O
Sevoflurane
Desflurane
Isoflurane
4
A
1
null
null
null
null
null
0f52df3c-7cc4-5ea9-8507-2ece3262269e
Select the FALSE statement about isoflurane (≤ 1 MAC).
May attenuate bronchospasm
Increases right atrial pressure
Decreases mean arterial pressure
Decreases cardiac output
4
D
1
null
null
null
null
null
f5c8b44f-9c71-5733-9b88-702e9c603cb4
Abrupt and large increases in the delivered concentration of which of the following inhalational anesthetics may produce transient increases in systemic blood pressure and heart rate?
Desflurane
Isoflurane
Sevoflurane
N2O
4
A
1
null
null
null
null
null
f7cd9e0f-2e00-53bb-adaa-bea772b8dbb2
Discontinuation of 1 MAC of which volatile anesthetic followed by immediate introduction of 1 MAC of which second volatile anesthetic would temporarily result in the greatest combined anesthetic potency?
Isoflurane followed by desflurane
Sevoflurane followed by desflurane
Desflurane followed by isoflurane
Desflurane followed by sevoflurane
4
A
2
null
null
null
null
null
2013028b-8fcf-5830-9f64-25ff853e9e64
Cardiogenic shock has the greatest impact on the rate of increase in Fa/Fi for which of the following volatile anesthetics?
Isoflurane
Desflurane
Sevoflurane
N2O
4
A
2
null
null
null
null
null
4d262d28-1c2a-5a4c-9857-c7e33b2d5547
The vessel-rich group receives what percent of the cardiac output?
45%
60%
75%
90%
4
C
1
null
null
null
null
null
c5645fcb-714e-55f5-a06e-520a24d71eb7
What percent desflurane is present in the vaporizing chamber of a desflurane vaporizer (pressurized to 1500 mm Hg and heated to 23° C)?
Nearly 100%
85%
65%
45%
4
D
2
null
null
null
null
null
f6fa22dd-1c4b-519c-b3e7-958e970a0199
A 25-year-old man is undergoing lymph node dissection for testicular cancer under general anesthesia. He has received four courses of bleomycin. The sevoflurane vaporizer is set at 1.8%, the oxygen at 100 mL/min, and air at 900/mL/min. The Fio2 of the fresh gas flow is
26%
29%
34%
41%
4
B
2
null
null
null
null
null
f33e2c2c-16c8-50d1-9f74-23680ab224aa
How would a right mainstem intubation affect the rate of increase in arterial partial pressure of volatile anesthetics?
It would be reduced to the same degree for all volatile anesthetics
It would be accelerated to the same degree for all volatile anesthetics
It would be reduced the most for highly soluble agents
It would be reduced the most for poorly soluble agents
4
D
3
null
null
null
null
null
15b80bbc-fbd2-5891-83bd-0e0a58b58d51
During a breast biopsy with the patient under general anesthesia, the end-tidal carbon dioxide (ETCO2 ) is 25 mm Hg on infrared
Mainstem intubation
Enormous dead space
Incipient cardiac arrest
Overventilation
4
A
2
null
null
null
null
null
52ee1336-834c-5df7-a172-384639b98afb
Isoflurane, when administered to healthy patients in concentrations less than 1.0 MAC, will decrease all of the following EXCEPT
Cardiac output
Myocardial contractility
Stroke volume
Systemic vascular resistance
4
A
1
null
null
null
null
null
b62d5115-92f9-5e88-9817-f19be7eace2d
Increased Va will accelerate the rate of rise of the Fa/Fi ratio the MOST for
Desflurane
Sevoflurane
Isoflurane
N2O
4
C
2
null
null
null
null
null
4786b08e-ca39-5382-a812-016ba19dd5ff
Select the correct order from greatest to least for anesthetic requirement.
Adults > infants > neonates
Adults > neonates > infants
Infants > neonates > adults
Neonates > adults > infants
4
C
1
null
null
null
null
null
64c66ed3-a85b-57ce-a3cf-50bbe22f5063
Which of the following MOST closely determines anesthetic effect?
Volume percent administered to patient
Partial pressure at the level of the central nervous system (CNS)
Solubility in blood
End-tidal concentration
4
B
1
null
null
null
null
null
63e61cb0-7419-527f-a607-f815b7a6905d
A 31-year-old moderately obese woman is receiving a general anesthetic for cervical spinal fusion. After induction and intubation, the patient is mechanically ventilated with isoflurane at a vaporizer setting of 2.4%. The N2O flow is set at 500 mL/min, and the oxygen flowmeter is set at 250 mL/min. The infrared spectro...
0.85 MAC
1.1 MAC
1.8 MAC
2.1 MAC
4
B
2
null
null
null
null
null
9c20b4b8-ef1a-5183-a9f5-0acc90c58723
The rate of induction of anesthesia with isoflurane would be slower than expected in patients
With anemia
With chronic renal failure
In shock
With a right-to-left intracardiac shunt
4
D
2
null
null
null
null
null
b57f6b35-3af7-59c7-91ef-06f44625c3dd
Which of the antihypertensives below reduces MAC?
Lisinopril (Zestril)
Losartan (Cozaar)
Triamterene (Dyrenium)
Verapamil (Calan SR)
4
D
1
null
null
null
null
null
ae1e7fc1-b048-5a70-96c8-a984c5d7838f
A left-to-right tissue shunt, such as arteriovenous fistula, physiologically most resembles which of the following?
A left-to-right intracardiac shunt
A right-to-left intracardiac shunt
Ventilation of unperfused alveoli
A pulmonary embolism
4
A
1
null
null
null
null
null
fb892898-944d-501c-8ae3-46de27d15122
A fresh gas flow rate of 2 L/min or greater is recommended for administration of sevoflurane because
The vaporizer cannot accurately deliver the volatile at lesser flow rates
It prevents the formation of fluoride ions
It prevents the formation of compound A
It diminishes rebreathing
4
D
1
null
null
null
null
null
0428f289-3224-53ac-8f13-2773b756791c
Select the true statement regarding the arrangement of the reservoir (sump) and bypass chamber in the Datex-Ohmeda Anesthesia Delivery Unit.
All volatiles share a common sump and separate bypass chambers
Sevoflurane and isoflurane share a common sump and bypass chamber, and desflurane has its own
Sevoflurane and desflurane share a common sump and bypass chamber, and isoflurane has its own
All volatiles have independent sumps but share a common bypass chamber
4
D
1
null
null
null
null
null
ab77497f-a6b5-5bff-9f69-a952c3804a8d
Smokers are MOST likely to show a mild but transient increase in airway resistance after intubation and general anesthesia with which of the following?
Isoflurane
Sevoflurane
Halothane
Desflurane
4
D
1
null
null
null
null
null
cb55d95c-f768-5068-ab2c-49702c06a3bb
If a patient is anesthetized with 6% desflurane in a hyperbaric chamber at 1 atm and the pressure is increased to 2 atm, the desflurane dial should be set to which setting if the anesthesia provider wishes to maintain the anesthetic at the same level?
3%
6%
12%
Cannot be determined without knowledge of Fio2
4
A
2
null
null
null
null
null
d7a1a332-0c1b-53dc-9b7f-080b8a18cf5c
Which of the following organs is NOT considered a member of the vessel-rich group?
Lungs
Brain
Heart
Kidney
4
A
1
null
null
null
null
null
ea43b5b3-7962-5256-a1ac-b8b20421fc18
In isovolumic normal human subjects, 1 MAC of isoflurane anesthesia depresses mean arterial pressure by approximately 25%. The single BEST explanation for this is
Reduction in heart rate
Venous pooling
Myocardial depression
Decreased systemic vascular resistance
4
D
1
null
null
null
null
null
6da67c87-03b5-5823-8803-35de7ca57284
If cardiac output and Va are doubled, the effect on the rate of rise of Fa/Fi for isoflurane compared with that which existed immediately before these interventions will be
Doubled
Somewhat increased
Unchanged
Somewhat decreased
4
B
2
null
null
null
null
null
e7b11f9f-a017-592a-8663-1e4e1f563e70
Which of the following characteristics of inhaled anesthetics most closely correlates with recovery from inhaled anesthesia?
Blood/gas partition coefficient
Brain/blood partition coefficient
Fat/blood partition coefficient
MAC
4
A
1
null
null
null
null
null
5d1f5a75-38a8-5539-89f7-251f02ee50de
After a 12-hour 60% N2O-desflurane anesthetic, evidence of N2O can be best detected by histologic examination of
Bone marrow
Renal tubules
Hepatocytes
None of the above
4
A
1
null
null
null
null
null
478be4c6-0e05-5c2f-a8cd-28197cca55ec
An unconscious, spontaneously breathing patient is brought to the operating room (OR) from the intensive care unit for wound débridement. Which of the following maneuvers would serve to slow induction of inhalational anesthesia through the tracheostomy?
Using isoflurane instead of sevoflurane (using MACequivalent inspired concentrations)
Increasing fresh gas flow from 2 to 6 L/min
Esmolol 30 mg intravenously
None of the above
4
A
2
null
null
null
null
null
aaddbb38-c8c0-596b-9262-90cb2ec33450
Which of the settings below would give the highest arterial oxygen concentration during inhalation induction of general anesthesia with sevoflurane?
| Oxygen 0L/min | Air 2L/min | N2O 0L/min |
| Oxygen 2L/min | Air 0L/min | N2O 2L/min |
| Oxygen 2L/min | Air 2L/min | N2O 9L/min |
| Oxygen 2L/min | Air 3.5L/min | N2O 0L/min |
4
B
2
null
null
null
null
null
d2f9d1e5-71fd-57e7-bb2b-b590c45ddbd3
If a patient were anesthetized 90 minutes with 1.25 MAC isoflurane followed by 30 minutes of 1.25 MAC sevoflurane anesthesia, wake-up would be
The same as 2 hours of isoflurane anesthesia
The same as 2 hours of sevoflurane anesthesia
Less than 2 hours of isoflurane anesthesia, but greater than 2 hours of sevoflurane
Greater than 2 hours of isoflurane anesthesia
4
A
2
null
null
null
null
null
d51449f4-1a9c-51e1-9686-4c10915fd029
An anesthesia circuit is primed in preparation for an inhalation induction (with open adjustable pressure-limiting valve). The anesthesia hose is occluded with a flow of 6 L/min. The anesthesia circuit (canisters, hoses, mask, anesthesia bag) contains 6 L. A machine malfunction allows administration of 100% N2O. Approx...
32%
48%
63%
86%
4
C
2
null
null
null
null
null
b893871a-0736-55fc-958e-6ffb69e66887
Which of the following factors lowers MAC for volatile anesthetics?
Serum sodium 151 mEq/L
Red hair
Body temperature 38° C
Acute ethanol ingestion
4
D
1
null
null
null
null
null
7be65dd3-4ebc-5352-b2f2-9d99fd5e7790
Each of the following factors can influence the partial pressure gradient necessary for the achievement of anesthesia EXCEPT
Inspired anesthetic concentration
Cardiac output
Va
Ventilation of nonperfused alveoli (dead space)
4
D
3
null
null
null
null
null
72f4877a-0170-5ec3-b4a4-e264340ffa3f
Which of the following volatile anesthetics is unique in containing preservative?
Sevoflurane
Desflurane
Isoflurane
None of the above
4
D
1
null
null
null
null
null
236e3024-5d25-55e1-a16e-f928334029f1
If the alveolar-to-venous partial pressure difference of a volatile anesthetic (PA − Pv) is positive (i.e., PA > Pv) and the arterial-to-venous partial pressure difference (Pa − Pv) is negative (i.e., Pv > Pa), which of the following scenarios is MOST likely to be true?
The vaporizer has been shut off at the end of the case
Induction has just started
Steady state has been achieved
The vaporizer was shut off during emergence, then turned back on
4
D
3
null
null
null
null
null
ef05abef-c604-548c-b041-555668866fa9
Anesthetic loss to the plastic and rubber components of the anesthetic circuit, hindering achievement of an adequate inspired concentration, is a factor with which of the following anesthetics?
Desflurane
Isoflurane
Sevoflurane
N2O
4
B
1
null
null
null
null
null
388991b7-92a9-5673-aa12-7aa16f704e1b
Factors predisposing to formation and/or rebreathing of compound A include each of the following EXCEPT
Low fresh gas flow
Use of calcium hydroxide lime versus soda lime
High absorbent temperatures
Fresh absorbent
4
B
1
null
null
null
null
null
e4b80b1f-1e9e-5a43-b797-1bef7efc6158
The following volatile agents are correctly matched with their degree of metabolism (determined by metabolite recovery):
Sevoflurane 2%
Isoflurane 0.2%
Desflurane 0.02%
All are correctly matched
4
D
1
null
null
null
null
null
fa4ada1f-698c-5e24-9cd2-59498bfcbd87
Which of the components below is NOT considered in the process of "washin" of the anesthesia circuit at the onset of administration?
Infrared spectrometer tubing and reservoir
Expiratory limb
Anesthesia bag
CO2 absorber
4
A
1
null
null
null
null
null
1680c731-fd07-5d38-9a0c-dd4c992ad34c
Which of the following maneuvers would NOT increase the rate of an inhalation induction?
Giving the patient an inotropic infusion
Substituting sevoflurane for isoflurane
Overpressurizing
Carrying out the induction in San Diego instead of Denver
4
A
2
null
null
null
null
null
87a5e5a4-e6b2-57ef-86ad-6dc438373ff8
Which of the following anesthetics would undergo 90% elimination the most rapidly after a 6-hour Whipple procedure under 1 MAC for the
Isoflurane
Sevoflurane
Desflurane
Sevoflurane and desflurane are tied
4
C
1
null
null
null
null
null
f8929926-01df-509e-bc06-604d2e3f8270
After induction and intubation of a healthy patient and institution of a ventilator, the sevoflurane vaporizer is set at 2%, and fresh gas flow is 1 L/min (50% N2O and 50% O2 ). The inspired concentration on the infrared spectrometer 1 minute later is 1.4%. The MAIN reason for the difference between the dial setting an...
Rapid uptake of sevoflurane
Insufficient fresh gas flow for correct vaporizer function
Second gas effect
Dilution
4
D
2
null
null
null
null
null
688399c0-3f15-5f5e-af9e-f12919d18a50
After cessation of general anesthesia that consisted of air, oxygen, and a volatile agent only, the patient is given 100% oxygen. Each of the following serves as a reservoir for volatile anesthesia and may delay emergence EXCEPT
Rebreathed exhaled gases
The absorbent
The patient
Gases emerging from the common gas outlet
4
D
1
null
null
null
null
null
d118e692-e187-5445-a9e5-bb8c2e3dfcd3
Which of the following characteristics of volatile anesthetics is necessary for calculation of the time constant?
Blood/gas partition coefficient
Brain/blood partition coefficient
Oil/gas partition coefficient
All of the above
4
B
1
null
null
null
null
null
59c02103-3431-53c9-8881-ec30c50365da
The concept of "context sensitive half-time" emphasizes the importance of the relationship between half-time and
Va
Blood solubility
Concentration
Duration
4
D
1
null
null
null
null
null
5f90c270-1ac0-52fc-a138-d3a517d71b94
Select the FALSE statement regarding pharmacokinetics for volatile anesthetics. After three time constants
6 to 12 minutes have elapsed for "modern anesthetics"
The arterial-to-venous partial pressure difference (for the volatile) for the brain is very small
The expired volatile concentration will rise much less slowly than in the preceding 12 minutes
The venous blood will contain 95% of volatile content of arterial blood#### Directions(Questions 378 through 381): Match the inhalational agents with the characteristics to which they most closely correspond. Each lettered heading (A through D) may be selected once, more than once, or not at all.
4
D
3
null
null
null
null
null
a985d88a-f509-5a2b-8ac6-9330e1ae42d5
Each of the following treatments might be useful in decreasing a prolonged prothrombin time (PT) EXCEPT
Recombinant factor VIII
Vitamin K
Fresh frozen plasma (FFP)
Cryoprecipitate
4
A
1
null
null
null
null
null
b1c5c9eb-cf48-5175-98a0-598c4c762873
Which of the following practices for releasing platelets is most beneficial in avoiding future hemolytic reactions (from alloantibodies) in the recipient?
Serologic crossmatch
Extended phenotype matching
RhD matching
ABO matching
4
C
2
null
null
null
null
null
a1dc0cd9-f00d-5c2e-a83e-e108fea85b43
Which of the fluids below has the greatest osmolality?
Normal saline
Lactated Ringer solution
D5 ½NS normal saline
5% Albumin
4
C
2
null
null
null
null
null
2dc927a6-0c7d-558c-983f-4b9547648e27
In a 70-kg patient, 1 dose of platelets (1 apheresis platelet or six pooled units of whole blood–derived platelets) should increase the platelet count by
12,000 to 30,000/mm3
30,000 to 60,000/mm3
90,000 to 120,000/mm3
120,000 to 150,000/mm3
4
B
1
null
null
null
null
null
e207ce8b-37cc-54b3-b6fd-d0365c2a9936
A 68-year-old patient receives a 1-unit transfusion of packed red blood cells (RBCs) in the recovery room after a laparoscopic prostatectomy. As the blood is slowly dripping into his peripheral intravenous line, the patient complains of itching on his chest and arms, but his vital signs remain stable. The antibody most...
Rh
ABO
MN, P, and Lewis
None of the above
4
D
2
null
null
null
null
null
fe3aa550-acd0-5e38-aeef-5ffad84121ba
The likelihood of a clinically significant hemolytic transfusion reaction resulting from administration of type-specific blood is less than
1 in 250
1 in 500
1 in 1000
1 in 10,000
4
C
1
null
null
null
null
null
821a316f-2b25-533a-837b-64e3c1aec7c3
Which of the following is NOT tested in the first or immediate phase of blood crossmatching?
ABO
Rh
MN
Lewis
4
B
1
null
null
null
null
null
8a3a99a9-7f63-5d12-b6e3-eee179d23d3d
Which of the following clotting factors has the shortest half-life?
Factor II
Factor V
Factor VII
Factor IX
4
C
1
null
null
null
null
null
8500754e-5a15-5daa-82da-646c9f7c7db6
Which of the measures below does NOT reduce the incidence of transfusion-related acute lung injury (TRALI)?
Exclusion of female donors
Use of autologous blood
Leukocyte reduction
Use of blood less than 14 days old
4
C
1
null
null
null
null
null