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d49eb96e-2409-52e1-bf8a-31e054a7e0ab | Blood is routinely tested for | Hepatitis A | Severe acute respiratory syndrome (SARS) | West Nile virus | Bovine spongiform encephalitis (BSE, or mad cow disease) | 4 | C | 1 | null | null | null | null | null |
89c9cccf-5f69-5709-b15f-6491a17aca56 | The blood volume of a 10-kg, 1-year-old infant is | 600 mL | 800 mL | 1000 mL | 1300 mL | 4 | B | 1 | null | null | null | null | null |
2e9ea9cd-90f4-5a41-87f1-bab9b0d77386 | Which of the infections below has the highest risk of causing a transfusion-transmitted infection? | Human T-cell lymphotropic virus (HTLV)-II | Hepatitis B | Hepatitis C | Human immunodeficiency virus (HIV) | 4 | B | 1 | null | null | null | null | null |
06a3b7d9-47d9-518a-ab8b-34920acaef9d | A 40-year-old, 78-kg patient with hemophilia A is scheduled for a right total knee arthroplasty. His laboratory test results show a hematocrit of 40, a factor VIII level of 0%, and no inhibitors to factor VIII. How much factor VIII concentrate do you need to give him to bring his factor VIII level to 100%? | 3000 units | 2500 units | 2000 units | 1500 units | 4 | A | 2 | null | null | null | null | null |
a9b6ded0-6282-5dee-8e96-4710d5b4193d | A 38-year-old man is undergoing a total colectomy under general | Offset the effects of increased antidiuretic hormone (ADH) | Improve renal blood flow | Convert oliguric renal failure to nonoliguric renal failure | Offset the effects of increased renin | 4 | A | 1 | null | null | null | null | null |
9ef81354-9a47-5ee4-a07d-cbbe7f78df70 | A 65-year-old man involved in a motor vehicle accident (MVA) is brought to the emergency room with a blood pressure of 60 mm Hg systolic. He is transfused with 4 units of type O, Rh-negative whole blood and 4 L of normal saline solution. After the patient is brought to the operating room, his blood type is determined t... | Type A, Rh-positive whole blood | Type O, Rh-negative RBCs | Type A, Rh-positive RBCs | Type O, Rh-negative whole blood | 4 | B | 3 | null | null | null | null | null |
052a81e0-f89c-5514-96a7-ed190cd828c2 | The criterion used to determine how long blood can be stored before transfusion is | 90% of transfused erythrocytes must remain in circulation for 24 hours | 70% of transfused erythrocytes must remain in circulation for 24 hours | 70% of transfused erythrocytes must remain in circulation for 72 hours | 75% of transfused erythrocytes must remain in circulation for 7 days | 4 | B | 1 | null | null | null | null | null |
e8287f52-0ad6-5c83-8cd0-2ca01211eaba | The rationale for storage of platelets at room temperature (22° C) is | There is less splenic sequestration | It preserves platelet survival | It reduces the chance for infection | It decreases the incidence of allergic reactions | 4 | B | 1 | null | null | null | null | null |
a09e8194-55a2-50ef-a0ae-386822046104 | An 18-year-old woman involved in an MVA is brought to the emergency room in shock. She is transfused with 10 units of type O, Rh-negative whole blood over 30 minutes. After infusion of the first 5 units, bleeding is controlled, and her blood pressure rises to 85/51 mm Hg. During the | Citrate toxicity | Hyperkalemia | Hemolytic transfusion reaction | Tension pneumothorax | 4 | A | 1 | null | null | null | null | null |
5d9e560f-d227-510e-aca4-c7ad6557f0f5 | A 20-kg, 5-year-old child with a hematocrit of 40% could lose how much blood and still maintain a hematocrit of 30%? | 140 mL | 250 mL | 350 mL | 450 mL | 4 | C | 2 | null | null | null | null | null |
1c7adc77-5ae9-5bb6-89ef-b0adf57a8fac | A 68-year-old man with recent cardiac stent placement is taking 75 mg clopidogrel (Plavix) daily. He is scheduled for retinal surgery, and a thromboelastogram (TEG) is ordered before surgery. The likely result of the TEG will show | Increased R + K | Increased alpha | Increased MA 30 | Normal TEG | 4 | D | 1 | null | null | null | null | null |
f4a4131e-5448-54b0-b959-b7983f9cec12 | Paramedics respond to an MVA site and immediately stabilize the neck, secure the airway, and place an intravenous line into a 19-year-old, 70 kg man lying in a pool of blood. Before the infusion is started, 3 mL of blood are withdrawn for hemoglobin and drug screening. The first responders estimate that the patient has... | 9 g/dL | 11 g/dL | 14 g/dL | 17 g/dL | 4 | D | 2 | null | null | null | null | null |
6c268e92-2b40-525d-b375-a8c5c399453f | In an emergency when there is a limited supply of type O-negative RBCs, type O-positive RBCs are preferable for transfusion for each of the following patients EXCEPT | A 60-year-old woman with diabetes who was involved in an MVA | A 23-year-old man who sustained a gunshot wound to the upper abdomen | An 84-year-old man with a ruptured abdominal aortic aneurysm | A 21-year-old, gravida 2, para 1 woman with placenta previa who is bleeding profusely | 4 | D | 2 | null | null | null | null | null |
31895ad5-727c-5685-9650-af835efa7e3a | Hetastarch exerts an anticoagulative effect through interference with the function of | Antithrombin III | Factor VIII | Fibrinogen | Prostacyclin | 4 | B | 1 | null | null | null | null | null |
cf827e1b-98b8-5dba-8863-0ef0f8ce4fd4 | All of the following characterize packed RBCs that have been stored for 35 days at 4° C in citrate phosphate dextrose adenine-1 (CPDA-1) anticoagulant preservative EXCEPT | Serum potassium greater than 70 mEq/L | pH less than 7.0 | Blood glucose less than 100 mg/dL | P50 of 28 | 4 | D | 1 | null | null | null | null | null |
eaef7c12-76c3-52dd-8f24-83a8c4a07777 | Which of the following statements about coagulation factor Xa (FXa) | It is used only to reverse the FXa inhibitors (apixaban and rivaroxaban) | It is used only if the patient has life-threatening or uncontrolled bleeding | Urinary tract infections and pneumonia occur in > 5% of patients | Thromboembolic risks are rare (< 2%) and usually occur within 24 hours | 4 | D | 1 | null | null | null | null | null |
8f4445f9-a424-552e-a756-8215848bcae0 | In the adult, the liver is the primary organ for | Hemoglobin synthesis | Hemoglobin degradation | Factor VIII synthesis | Antithrombin III synthesis | 4 | D | 1 | null | null | null | null | null |
66c5128f-f0c9-5674-8bc6-28557b0f795c | Anticoagulation with low-molecular-weight heparin (LMWH) can be best monitored through which of the following laboratory tests? | Activated partial thromboplastin time (aPTT) | Anti-Xa assay | Thrombin time | Reptilase test | 4 | B | 1 | null | null | null | null | null |
6045395f-eb44-5a91-965e-25981522876a | Heparin resistance is likely in patients with which of the following heritable conditions? | Factor V Leiden mutation | Prothrombin *G20210A* gene mutation | Protein S deficiency | Antithrombin or antithrombin III (AT3) deficiency | 4 | D | 1 | null | null | null | null | null |
b92eaf29-0478-52f4-b3ad-d78ae1c5cb8b | Type 1 von Willebrand disease (vWD) could be treated by any of the following EXCEPT | Cryoprecipitate | Desmopressin (DDAVP) | FFP | Recombinant factor VIII | 4 | D | 1 | null | null | null | null | null |
a6dd5c71-567f-53de-959a-e946f8d24786 | The significance of immunoglobulin A (IgA) antibodies in transfusion medicine is related to | Allergic reaction | Febrile reaction | Delayed hemolytic reaction (immune extravascularreaction) | Diagnosis of TRALI reaction | 4 | A | 1 | null | null | null | null | null |
f6bea6e9-eb84-50fd-b506-45df4a90f868 | The most common cause of mortality associated with administration of blood is | TRALI | Non-ABO hemolytic transfusion reaction | Microbial infection | Anaphylactic reaction | 4 | A | 1 | null | null | null | null | null |
1cfbf198-823d-5618-81f6-257951f2fd9b | Fluid resuscitation during major abdominal surgery with which of the following agents is associated with the BEST survival data? | 5% Albumin | 6% Hydroxyethyl starch | Dextran 70 | None of the above# Blood Products, Transfusion, and Fluid Therapy# | 4 | D | 1 | null | null | null | null | null |
8a7fa05f-087d-536d-b9ff-95cc8c8acd5e | A 78-year-old patient with a history of hypertension and adult-onset diabetes for which she takes chlorpropamide (Diabinese) is admitted for elective cholecystectomy. On the day of admission, blood glucose is noted to be 270 mg/dL, and the patient is treated with 15 units of regular insulin subcutaneously (SQ) in addit... | Insulin | Chlorpropamide | Hypovolemia | Effect of general anesthesia | 4 | B | 3 | null | null | null | null | null |
a5f78a37-12b3-5eef-96cc-94d691401d2f | Select the TRUE statement. | Dibucaine is an ester-type local anesthetic | A dibucaine number of 20 is normal | The dibucaine number represents the quantity of normal pseudocholinesterase | None of the above | 4 | D | 1 | null | null | null | null | null |
fb2c8672-644d-5f89-99db-8af43677f6b8 | Normal tracheal capillary pressure is | 10 to 15 mm Hg | 15 to 20 mm Hg | 25 to 30 mm Hg | 35 to 40 mm Hg | 4 | C | 1 | null | null | null | null | null |
3ea9ec06-fa05-5194-96bc-7353fad9c91a | How many hours should elapse before performing a single-shot spinal anesthetic in a patient who is receiving 1 mg/kg enoxaparin (Lovenox) twice a day for the treatment of a deep vein thrombosis? | 6 hours | 12 hours | 24 hours | 48 hours | 4 | C | 1 | null | null | null | null | null |
da7717ae-64b3-58f3-895a-ee67e1f3c45e | A 46-year-old female with low back pain and left-sided L4 radiculopathy presents for an L4/L5 lumbar discectomy. Her past medical history includes hypothyroidism, insulin-dependent diabetes type 1, and chronic low back pain, for which she is maintained on sublingual buprenorphine/naloxone, with the last dose having bee... | DECREASED response due to upregulation of the cytochrome P450 system | DECREASED response secondary to opioid receptor antagonism by naloxone | DECREASED response due to high-affinity binding of buprenorphine to the opioid receptor | No DIFFERENCE in response IF an opioid agonist with a high binding affinity is administered | 4 | C | 3 | null | null | null | null | null |
546cf858-77bb-5652-82ee-1c459364571c | Which of the following is the most plausible explanation for the lack of analgesia with codeine administration? | Lack of CYP2D6 enzyme | VKORC1 polymorphism | CYP3A4 polymorphism | Lack of μ receptors | 4 | A | 1 | null | null | null | null | null |
03b34005-eea0-5125-9bc7-9346ce5a4373 | A 62-year-old patient with a bare-metal stent in the mid portion of the left anterior descending artery is scheduled for rotator cuff repair under general anesthesia. The stent was placed 6 weeks before surgery, and the patient is on dual therapy (aspirin and clopidogrel). Which of the paradigms below would be best for... | Continue both up to the day of surgery | Stop both 7 to 10 days before surgery | Stop aspirin and continue clopidogrel | Stop clopidogrel and continue aspirin | 4 | D | 2 | null | null | null | null | null |
98052853-5b6a-53e8-a0c4-ea2bca24853b | A patient with which of the following eye diseases would be at greatest risk for retinal damage from hypotension during surgery? | Strabismus | Open eye injury | Glaucoma | Severe myopia | 4 | C | 2 | null | null | null | null | null |
dc435ce7-d0b8-57c7-ab81-a307f2e206bb | Naltrexone is | A narcotic with local anesthetic properties | An opioid agonist-antagonist similar to nalbuphine | A pure opioid antagonist with a shorter duration of action than naloxone | An opioid antagonist used for treatment of previously detoxified heroin addicts | 4 | D | 1 | null | null | null | null | null |
0fc4ff53-d231-566b-a40c-e227d0c54b72 | Which of the following mechanisms is most frequently responsible for hypoxia in the recovery room? | Ventilation/perfusion mismatch | Hypoventilation | Hypoxic gas mixture | Intracardiac shunt | 4 | A | 1 | null | null | null | null | null |
b41a2c50-fa60-5275-92e4-24428d38651b | Hypoparathyroidism secondary to the inadvertent surgical resection of the parathyroid glands during total thyroidectomy typically results in | 1 to 2 hours | 3 to 12 hours | 12 to 24 hours | 24 to 72 hours | 4 | D | 1 | null | null | null | null | null |
c386c191-5503-5110-90e4-284446a23dc4 | Damage to which nerve may lead to wrist drop? | Radial | Axillary | Median | Ulnar | 4 | A | 1 | null | null | null | null | null |
d5a5aab5-1296-52e4-9254-d83e507e9b74 | A 25-year-old woman with a body mass index (BMI) 42 kg/m2 is to be anesthetized for laparoscopic bariatric surgery. She has a history of knee pain while walking. She has no medication allergies and takes multivitamins and an oral contraceptive. Her American Society of Anesthesiologists (ASA) designation should be | ASA I | ASA II | ASA III | ASA IV | 4 | C | 2 | null | null | null | null | null |
415b0d39-9787-51c5-8d93-a7770a015243 | A 6-year-old child is transported to the recovery room after a tonsillectomy. The patient was anesthetized with isoflurane, fentanyl, and N2O. Twenty minutes before emergence and tracheal extubation, droperidol was administered. The anesthesiologist is called to the recovery room because the patient is "making strange ... | Dantrolene | Diazepam | Glycopyrrolate | Diphenhydramine | 4 | D | 2 | null | null | null | null | null |
d379024c-2206-5056-baaf-6f6f6b1aa2ce | A 22-year-old with multiple medical problems lists 5-HT3 antagonists on her allergy band. With which of the medications listed below was this allergy most likely discovered? | Granisetron (Kytril) | Paroxetine (Paxil) | Milrinone | Cyproheptadine (Periactin) | 4 | A | 1 | null | null | null | null | null |
6b30a94e-c11f-5238-90d2-e286652cf9d9 | Pheochromocytoma would be MOST likely to coexist with which of the following? | Insulinoma | Pituitary adenoma | Primary hyperaldosteronism (Conn syndrome) | Medullary carcinoma of the thyroid | 4 | D | 1 | null | null | null | null | null |
4c2d6c5c-22b4-59f6-a9e3-f91418ac67a7 | Which of the following oral antidiabetic drugs is unique in that it does NOT produce hypoglycemia when administered to a fasting patient? | Glyburide (Micronase) | Glipizide (Glucotrol) | Tolbutamide (Orinase) | Metformin (Glucophage) | 4 | D | 1 | null | null | null | null | null |
72d82014-1e11-5665-a6ae-d5595bf4335d | The onset of delirium tremens (DTs) after abstinence from alcohol usually occurs in | 8 to 24 hours | 24 to 48 hours | 2 to 4 days | 4 to 7 days | 4 | C | 1 | null | null | null | null | null |
010bbc6b-5e57-55cd-81ce-d676d5945b6d | A 78-year-old retired coal miner with an intraluminal tracheal tumor is scheduled for tracheal resection. Which of the following is a relative contraindication for tracheal resection? | Need for postoperative mechanical ventilation for underlying lung disease | Tumor located at the carina | Documented liver metastases | Ischemic heart disease with a history of CHF | 4 | A | 1 | null | null | null | null | null |
be11c44c-09b3-552e-a816-7c7469a14665 | A 78-year-old patient with multiple myeloma is admitted to the intensive care unit (ICU) for treatment of hypercalcemia. The primary risk associated with anesthetizing patients with hypercalcemia (levels of 14-16 mg/dL) is | Coagulopathy | Cardiac dysrhythmias | Hypotension | Laryngospasm | 4 | B | 1 | null | null | null | null | null |
15f2f646-37f0-5765-a13d-e38b6ea79d2a | A normal, healthy 3-year-old child was involved in a motor vehicle accident (MVA). He is coming emergently to the OR. Drug doses need to be calculated, but his weight is not known. What value should be used to estimate the 3-year-old child's weight? | 8 kg | 10 kg | 12 kg | 14 kg | 4 | D | 2 | null | null | null | null | null |
1dc81dce-3455-5ea0-a5ea-d7b333f03c5e | A 16-year-old patient presents for extraction of multiple teeth. In her history, it is noted that she is on a ketogenic diet. The likely reason for this is history of | Phenylketonuria (PKU) | Mitochondrial myopathies | Intractable seizures | Glycogen storage disease | 4 | C | 1 | null | null | null | null | null |
8b6cb8b6-d176-5dd9-932c-85fbd8fb4f72 | A 28-year-old obese patient has diminished breath sounds bilaterally at the lung bases 18 hours after an emergency appendectomy under general anesthesia. Which of the following maneuvers would be LEAST effective in preventing postoperative pulmonary complications in this patient? | Coughing | Voluntary deep breathing | Performing a forced vital capacity (FVC) | Use of incentive spirometry | 4 | C | 2 | null | null | null | null | null |
0f6fe6ab-a9e6-55b5-99c2-c8f3af566017 | Easily discernable improvement in patient outcomes can be observed through which measure of quality improvement? | Process measure (e.g., timing of antibiotics with incision) | Structural measures (e.g., electronic medical record) | Outcome measures (e.g., incidence of wound infection) | None of the above | 4 | D | 1 | null | null | null | null | null |
9cd2ea07-7a22-5e21-8461-56a192e4a2c5 | The mechanism of action of clopidogrel is | Adenosine diphosphate (ADP) receptor blockade (P2Y12 ) | Platelet glycoprotein IIB/IIIa antagonism | Cyclooxygenase COX-1 and COX-2 inhibition | Direct thrombin inhibition | 4 | A | 1 | null | null | null | null | null |
0f0e43cc-1956-5010-8116-df83ae65e7dc | Which of the following is most closely associated with minimum alveolar concentration (MAC)? | Blood/gas partition coefficient | Oil/gas partition coefficient | Vapor pressure | Brain/blood partition coefficient | 4 | B | 1 | null | null | null | null | null |
dd1bf381-de88-581d-a86b-443fcacb4085 | By federal law, any breach in protected health information (PHI) must be disclosed to | Department of Health and Human Services (HHS) | Department of Justice (DOJ) | Joint Commission on Accreditation of Healthcare Organizations (JCAHO) | American Accreditation HealthCareCommission/Utilization Review Accreditation Commission (AAHC/URAC) | 4 | A | 1 | null | null | null | null | null |
f68b1281-6a50-5538-8c0f-7d19a9fa41ff | Scopolamine should not be given as a premedication in patients with which of the following neurologic diseases? | Parkinson disease | Alzheimer disease | Multiple sclerosis | Narcolepsy | 4 | B | 2 | null | null | null | null | null |
489291fb-881c-524f-a9bb-a36c987a9981 | A 53-year-old woman with endometrial cancer is undergoing an abdominal hysterectomy under general anesthesia with desflurane. During the first hour of anesthesia, urine output is 100 mL. Blood loss is minimal. When the patient is placed in the Trendelenburg position, the urine output declines to virtually zero. The mos... | Pooling of urine in the dome of the bladder | Increased central venous pressure | Increased antidiuretic hormone (ADH) production from surgical stimulation | Hypovolemia | 4 | A | 1 | null | null | null | null | null |
e7672693-a843-5f92-8177-2b43ccbe77a6 | Which of the following diseases is NOT associated with a decrease in DLCO? | Emphysema | Obesity | Pulmonary emboli | Anemia | 4 | B | 1 | null | null | null | null | null |
274047ee-7a2b-5d35-85d9-7cdc21ee48c5 | Each of the following postoperative complications of thyroid surgery can result in upper airway obstruction EXCEPT | Cervical hematoma | Tetany | Bilateral superior laryngeal nerve injury | Bilateral recurrent laryngeal nerve injury | 4 | C | 1 | null | null | null | null | null |
fe6d872e-0578-5352-a5af-7f733bacf22b | The MOST sensitive early sign of malignant hyperthermia (MH) during | Tachycardia | Hypertension | Fever | Increased end-expiratory CO2 tension (PECO2 ) | 4 | D | 1 | null | null | null | null | null |
b0e52779-b673-594d-af2c-7a5231193c5a | A 78-year-old woman is anesthetized for a right hemicolectomy for 3 hours. At the end of the operation the patient's blood pressure is 130/85 mm Hg, heart rate is 84 beats/min, core body temperature is 35.4° C, and PECO2 on infrared spectrometer is 38 mm Hg. Which of the following would be the LEAST plausible reason fo... | Residual neuromuscular blockade | Narcotic overdose | Unrecognized obstructive pulmonary disease and high baseline PaCO2 | Persistent intraoperative hyperventilation | 4 | D | 3 | null | null | null | null | null |
d8cfb00d-cb9b-5f68-8eef-96f3ca98500d | A 68-year-old woman with severe rheumatoid arthritis undergoes pulmonary function evaluation before an elective abdominal surgery. Forced expiratory volume in 1 second (FEV1 ) and FVC are within normal limits; however, the maximum voluntary ventilation (MVV) is only 40% of predicted. The next step in the pulmonary func... | Obtain ABGs on room air | Obtain a flow-volume loop | Obtain a measurement of peak flow | Obtain a ventilation/perfusion scan | 4 | B | 2 | null | null | null | null | null |
ddcff4e4-976d-5848-941f-7f4e2dd82279 | Which of the following is NOT a component of the postanesthetic discharge scoring system (PADSS) used to evaluate the suitability of a patient to be discharged from an ambulatory surgical facility? | Drinking | Ambulation | Absence of nausea and vomiting | Pain control | 4 | A | 1 | null | null | null | null | null |
10182cf3-a6a5-599c-bbd6-baf2621d8fc5 | During emergency repair of a mandibular jaw fracture in an otherwise healthy 19-year-old man, the patient's temperature is noted to rise from 37° C on induction to 38° C after 2 hours of surgery. Which of the | Normal heart rate and blood pressure | History of negative caffeine-halothane contracture test carried out 6 months earlier | History of an uncomplicated general anesthetic at age 16 years with halothane and succinylcholine | Normal ABGs drawn when the patient's temperature reached 38° C | 4 | C | 2 | null | null | null | null | null |
033568cb-b4c6-5eb3-8f00-635d5a311021 | Which of the following drugs is useful in the treatment of asthma by specifically interfering with the leukotriene pathway? | Fluticasone (Flovent) | Ipratropium bromide (Atrovent) | Triamcinolone (Azmacort) | Montelukast (Singulair) | 4 | D | 1 | null | null | null | null | null |
3cd9244b-875e-5376-abdb-85052ebef77c | A 68-year-old, 100-kg patient is undergoing a transurethral resection of the prostate gland under general anesthesia. Upon arrival in the recovery room, the patient appears restless and confused. Serum sodium is checked and found to be 110 mEq/L. How many mEq of sodium are needed to raise the serum [Na + ] to 120 mEq/L... | 300 mEq | 400 mEq | 500 mEq | 600 mEq | 4 | D | 2 | null | null | null | null | null |
6c2f6582-6086-5de4-bf95-2773167e176f | Which of the intravenous (IV) anesthetics below is LEAST useful in the treatment of status epilepticus? | Phenobarbital | Dexmedetomidine | Propofol | Midazolam | 4 | B | 1 | null | null | null | null | null |
e720670b-968c-5856-bffb-bdeb6973d050 | A 45-year-old man is brought to the OR emergently for repair of a ruptured abdominal aortic aneurysm. Anesthesia is induced with ketamine 2 mg/kg IV, and tracheal intubation is facilitated with succinylcholine 1.5 mg/kg IV. Immediately after tracheal intubation, the patient's blood pressure falls from 110/80 to 50/20 m... | Hypovolemia | Direct myocardial depression from ketamine | Vasovagal response to direct laryngoscopy | Arteriolar vasodilation from succinylcholine-mediated histamine release | 4 | B | 3 | null | null | null | null | null |
9b0a97e0-90bd-53b0-89e8-6f16e135b47f | MH is believed to involve a generalized disorder of membrane permeability to | Sodium | Potassium | Calcium | Magnesium | 4 | C | 1 | null | null | null | null | null |
397878e9-f783-51f3-87db-42fe3e75cbda | A 25-year-old man with a history of testicular cancer is scheduled to undergo an exploratory laparotomy under general anesthesia. He has received bleomycin for metastatic disease. Which of the following is an important consideration concerning the pulmonary toxicity of bleomycin? | N2O should not be used | Preoperative pulmonary function tests should be obtained | The patient should be ventilated at a slow rate and inspiratory-to-expiratory (I:E) ratio of 1:3 | FIO2 should be less than 0.3 | 4 | D | 2 | null | null | null | null | null |
59086aaa-d8ba-5a05-bb38-bb6042a9e505 | A 39-year-old obese woman undergoes an abdominal hysterectomy under general anesthesia. Induction of anesthesia is uneventful. SaO2 is 98% during the first 15 minutes of the operation, with 50% oxygen and 50% N2O. Then, at the request of the surgeon, N2O is discontinued (now 50% oxygen, 50% N2 ), the head is flexed, an... | Diffusion hypoxia | Decreased functional residual capacity (FRC) | Mainstem intubation | Decreased cardiac output | 4 | C | 3 | null | null | null | null | null |
64599e0f-f87a-5854-87d3-63b7fd42a4dc | How long after intravitreal injection of sulfur hexafluoride and air can N2O be used without risk of increasing intraocular pressure? | 1 hour | 24 hours | 10 days | 1 month | 4 | C | 1 | null | null | null | null | null |
4ec7da92-0f64-5ded-81ab-241ae9ec105d | A 54-year-old woman is undergoing a total thyroidectomy under general anesthesia. The patient is awakened in the OR, the mouth and pharynx are suctioned, and after intact laryngeal reflexes are demonstrated, the endotracheal tube is removed. Two days later, the anesthesiologist is consulted because the patient has seve... | Damage to the recurrent laryngeal nerve | Hematoma | Tracheomalacia | Hypocalcemia | 4 | D | 2 | null | null | null | null | null |
8f15bf5c-078c-5553-88a9-e1eb599f0923 | A 27-year-old obese woman is scheduled to undergo foot surgery under general anesthesia. She underwent a subtotal thyroidectomy 3 years ago and takes levothyroxine (Synthroid). Which of the following laboratory tests would be the MOST useful in evaluating whether this patient is euthyroid? | Total plasma thyroxine (T4 ) | Total plasma triiodothyronine (T3 ) | Thyroid-stimulating hormone (TSH) | Resin triiodothyronine uptake | 4 | C | 2 | null | null | null | null | null |
d468ab08-0470-5ad4-a2c9-2e52ae7d2de8 | An 85-year-old man with no previous medical history except for cataracts is undergoing a transurethral resection of the prostate gland under spinal anesthesia. Twenty minutes into the procedure the patient becomes restless. Over the next 20 minutes, his blood pressure increases from 110/70 to 140/90 mm Hg and his heart... | Volume overload | Hyponatremia | High spinal | Bladder perforation | 4 | A | 2 | null | null | null | null | null |
753360f8-7993-59e7-9efd-6b712764eb07 | A 17-year-old patient with third-degree burns over 30% of his body is scheduled for débridement and skin grafting 12 days after sustaining a thermal injury. Select the TRUE statement regarding the use of depolarizing and nondepolarizing muscle relaxants in this patient, compared with normal patients. | Sensitivity to both depolarizing and nondepolarizing muscle relaxants is increased | Sensitivity to both depolarizing and nondepolarizing muscle relaxants is decreased | Sensitivity to depolarizing muscle relaxants is increased while sensitivity to nondepolarizing muscle relaxants is decreased | Sensitivity to depolarizing muscle relaxants is decreased while sensitivity to nondepolarizing muscle relaxants is increased | 4 | C | 2 | null | null | null | null | null |
024ad1f1-1d24-5bfa-9db0-cf0018244ed8 | A patient undergoes parotid gland removal under general anesthesia. Each of the following assesses facial nerve function EXCEPT | Clenching teeth | Closing eyes | Pursing lips | Eyebrow lift | 4 | A | 1 | null | null | null | null | null |
640ff256-e11d-53f8-a69b-4f2818a89342 | A 65-year-old patient with a history of chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) undergoes a laparoscopic nephrectomy uneventfully under general desflurane anesthesia. In the recovery room, ABGs are as follows: PaO2 60 mm Hg, PaCO2 50 mm Hg, pH 7.35, and hemoglobin 8.1 g/dL. Which ... | Administration of 100% O2 with a close-fitting mask | Administration of 35% O2 with a Venturi mask | Administer 1 ampule of HCO3 | Transfuse with 2 units of packed red blood cells (RBCs) | 4 | D | 3 | null | null | null | null | null |
66084e01-d0c0-556d-a213-53071fb46c24 | Allergic reactions occurring during the immediate perioperative period are MOST commonly attributable to administration of | Muscle relaxants | Local anesthetics | Antibiotics | Opioids | 4 | A | 1 | null | null | null | null | null |
591e2cc0-473e-5aa8-8fb7-0ef659f15d62 | Caution is advised when using succinylcholine in patients with Huntington chorea because | They are at increased risk for MH | Potassium release may be excessive | They may have a decreased concentration of pseudocholinesterase | There may be adverse interactions between succinylcholine and phenothiazine | 4 | C | 1 | null | null | null | null | null |
bfcd5ee3-6e75-5d28-abb9-e391e6b1c403 | Which of the following would NOT result in an increase in intraocular pressure? | Increase in PaCO2 from 35 to 40 mm Hg | 100 mg intramuscular (IM) succinylcholine | Acute rise in venous pressure from coughing | 100 mg IV succinylcholine in a patient in whom eye muscles have been detached from the globe | 4 | A | 2 | null | null | null | null | null |
2ce4afbb-7cfd-5af9-8155-9f47b8a3f8ad | An apnea-hypopnea index (AHI) of 30 means | Episodes of hypopnea are 30 times more common than apnea | Apnea/hypopnea episodes occur at a rate of 30 per sleep cycle | Episodes of apnea and hypopnea occur at a rate of 30 per hour | Apnea/hypopnea episodes last 30 seconds | 4 | C | 1 | null | null | null | null | null |
1528f9a4-0547-5f1f-a052-c4913be97992 | A 26-year-old man is undergoing an emergency exploratory laparotomy under general anesthesia with isoflurane. SaO2 is 89% on the pulse oximeter. PaO2 on ABGs is 77 mm Hg. The patient's core body temperature is 35° C. What is the corrected PaO2? | 68 mm Hg | 72 mm Hg | 77 mm Hg | 86 mm Hg | 4 | A | 2 | null | null | null | null | null |
e51598a7-a498-5057-9eff-7c9c3837ee98 | Low-molecular-weight heparin (LMWH) | Is as likely to cause heparin-induced thrombocytopenia (HIT) as unfractionated heparin | Should be monitored with partial thromboplastin time (PTT) for clinical effect | Can be fully reversed with protamine | LMWH has a longer plasma half-life than unfractionated heparin | 4 | D | 1 | null | null | null | null | null |
fa4627c6-4d6c-51ff-9fd1-da4da364b0dc | In a given patient, if a creatinine of 1.0 corresponds to a glomerular filtration rate (GFR) of 120 mL/min, a creatinine of 4.0 would correspond to | 20 mL/min | 30 mL/min | 40 mL/min | 50 mL/min | 4 | B | 2 | null | null | null | null | null |
0b9524b1-7a1a-5bd9-84a1-bcaa8dd77bd8 | The incidence of each of the following is increased in patients with Down syndrome (trisomy 21) EXCEPT | MH | Congenital heart disease | Smaller trachea | Occipito-atlantoaxial instability | 4 | A | 1 | null | null | null | null | null |
81514478-8cab-5936-b4eb-3e73cdbe80a5 | A 55-year-old man is to undergo a laparoscopic cholecystectomy under general anesthesia. The patient has a 40-pack-per-year smoking history and a history of CHF. The patient receives metoclopramide and scopolamine preoperatively. General anesthesia is induced with | Emergence delirium from ketamine anesthesia | Effect of scopolamine | Effect of Trendelenburg position | Corneal abrasion | 4 | B | 2 | null | null | null | null | null |
b41d584d-93b6-5b55-8320-b8669a82046b | MH and neuroleptic malignant syndrome share each of the following characteristics EXCEPT | Generalized muscular rigidity | Hyperthermia | Effectively treated with dantrolene | Flaccid paralysis after administration of vecuronium | 4 | D | 1 | null | null | null | null | null |
dfd07f09-681a-5265-95a1-ed786aa6eb6b | What of the following statements about vasopressin is true? | It has a potent vasopressor effect at high doses in normal subjects | Plasma levels are inappropriately high in patients immediately after cardiopulmonary bypass | Plasma levels are inappropriately low in the setting of septic shock | It causes pulmonary vasoconstriction secondary to inhibition of endothelial nitric oxide release | 4 | C | 1 | null | null | null | null | null |
de747cef-8514-5a26-930d-eb4db464e398 | Remifentanil is metabolized primarily by | Kidneys | Liver | Nonspecific esterases | Pseudocholinesterase | 4 | C | 1 | null | null | null | null | null |
8a67ab16-d1b2-528d-80b6-1b050b66de14 | A term infant with good muscle tone and strong cry has an 83% saturation on room air 5 minutes after delivery. The MOST appropriate action at this point would be | Bag and mask ventilation with 100% oxygen | Intubate and ventilate with 100% oxygen | Spontaneous breathing with 100% oxygen | Observe | 4 | D | 2 | null | null | null | null | null |
825dbce1-705f-5f0a-ad72-58d66b66076a | Patients who undergo extracorporeal shock wave lithotripsy are at increased risk for | Venous air embolism | Pneumothorax | Hypotension with regional anesthesia at the end of the procedure | Postdural puncture headache with spinal anesthesia | 4 | C | 1 | null | null | null | null | null |
daf11f50-801d-57af-ab79-604f3ebea8d6 | The most common reason for admitting outpatients to the hospital following general anesthesia is | Nausea and vomiting | Inability to void | Inability to ambulate | Surgical pain | 4 | A | 1 | null | null | null | null | null |
97695799-6984-5d4e-9cbc-22e3f85df8c4 | A 37-year-old man with myasthenia gravis arrives in the emergency room confused and agitated after a 2-day history of weakness and increased difficulty breathing. ABGs on room air are PaO2 60 mm Hg, | Tracheal intubation and mechanical ventilation | Repeat the test dose of edrophonium | Administer neostigmine | Administer atropine for cholinergic crisis | 4 | A | 3 | null | null | null | null | null |
09f593cf-2fb1-527c-a618-7d41efba2dba | Select the FALSE statement regarding tramadol (Ultram). | Ondansetron may interfere with part of tramadol's analgesia | Tramadol is associated with seizures in patients taking selective serotonin reuptake inhibitors (SSRIs) | It is relatively safe in patients whose pain makes them suicidal | Its analgesic effects are partially antagonized by naloxone | 4 | C | 1 | null | null | null | null | null |
8cca68e1-d858-5b31-b606-9c31f0af4138 | In statistical hypothesis testing, if the *P* value is less than the | The observed result is unlikely under the null hypothesis | The observed result is unlikely under an alternative hypothesis | The sample size is too small | The predetermined power is too low | 4 | A | 1 | null | null | null | null | null |
c13e4393-e6bf-5640-a739-095844c67f00 | A 72-year-old man undergoes emergency repair of an abdominal aortic aneurysm. In the first hour after release of the suprarenal cross-clamp, urine output is only 10 mL. After administration of furosemide 20 mg IV, urine output increases to 100 mL/hr. Urine [Na + ] is 43 mEq/L, and urine osmolality is 210 mOsm/L. The MO... | Increased ADH | Renal hypoperfusion | Acute tubular necrosis | Impossible to differentiate | 4 | D | 3 | null | null | null | null | null |
2dc4d702-8cc7-505e-8076-c401e2e1fc18 | Brice Questionnaire is used to estimate | Risk of sleep apnea | Intraoperative awareness | Postoperative nausea and vomiting (PONV) | Suitability for postanesthesia care unit (PACU) discharge | 4 | B | 1 | null | null | null | null | null |
e6fe2e8e-fe0d-5380-9954-6c0bd3b38a4a | A 40-year-old man is undergoing a left inguinal hernia repair under general anesthesia in San Diego, California. N2O is administered at 3 L/min, O2 at 1 L/min, and isoflurane at 0.85%. What MAC is this patient receiving? | 0.8 | 1.25 | 1.50 | 1.75 | 4 | C | 2 | null | null | null | null | null |
8eeb584b-f6ae-50d3-ad72-a6d1589445d2 | An otherwise healthy 140-kg, 24-year-old man is scheduled for vocal cord surgery under general anesthesia. Which of the following statements concerning his cardiac output at 140 kg compared with his cardiac output at his ideal body weight (70 kg) is CORRECT? | Cardiac output is the same | Cardiac output is increased by 10% | Cardiac output is increased by 50% | Cardiac output is doubled | 4 | D | 2 | null | null | null | null | null |
85e394c1-e802-5d39-a612-075db7f33d92 | After a single 150-mg dose of propofol to a 75-kg healthy patient, which of the following statements is FALSE? | The peak plasma concentration is reached in < 1 minute | The peak plasma concentration of propofol is 7 to 8 μg/mL | The therapeutic plasma concentration range for propofol is 1.5-5 μg/mL | It takes about 15 to 20 minutes for the drug level to fall to a subtherapeutic level | 4 | D | 1 | null | null | null | null | null |
412fe940-5c4e-5c94-b239-86900fe4f053 | A 58-year-old hemophiliac is scheduled for total knee arthroplasty. His factor VIII levels are 35% of normal. Which of the following would be the most appropriate therapy before surgery? | Administer sufficient cryoprecipitate to raise factor VIII levels to 50% normal | Administer factor VIII concentrates to achieve levels of 100% normal | Transfuse fresh frozen plasma until factor VIII levels are 100% normal | None of the above | 4 | B | 2 | null | null | null | null | null |
50ed1df7-f2af-5ea1-9d6a-412fcc4bf201 | A 16-year-old boy whose maternal uncle has hemophilia A is scheduled for wisdom tooth extraction. Which test below would be the best screening test for hemophilia A? | PTT | Prothrombin time (PT) | Thrombin time | Bleeding time | 4 | A | 1 | null | null | null | null | null |
5f63f959-b2ba-5b4b-aee7-5c43ee427a88 | Five minutes after a single 150-mg dose of propofol to a 75-kg patient, which of the following is most likely regarding the cytosol | The concentration in the brain would be rising | The concentration in the spinal cord would be rising | The concentration in the leg muscles would be falling | The concentration in fat would be rising | 4 | D | 2 | null | null | null | null | null |
ebb5b8d0-edd3-54ae-99ad-e52c4ac0b042 | A 57-year-old man is undergoing a right eye enucleation under general anesthesia. The patient has no history of cardiac disease. During the operation, 5-mm ST-segment elevation is noted on lead II, and the patient develops complete heart block. The coronary artery most likely affected is | Circumflex coronary artery | Right coronary artery | Left main coronary artery | Left anterior descending coronary artery | 4 | B | 2 | null | null | null | null | null |
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