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4c5b320b-023d-54aa-9b23-14ce311e6a6d | Of the following syndromes, which one typically causes cognitive impairment, skeletal abnormalities, short stature, cardiac disease, and restrictive lung disease and is considered to present one of the greatest airway challenges in pediatric anesthesia because of the progressive craniofacial anomalies that can make both intubation and mask ventilation extremely challenging? | Beckwith-Wiedemann syndrome | Angelman syndrome | Treacher-Collins syndrome | Hurler syndrome | 5 | D | 1 | Trisomy 21 | null | null | null | null |
9b6fd654-97e2-52e3-92b5-e721cbdc63eb | Which of the following is the most common type of tracheoesophageal fistula (TEF) seen in neonates? | Esophageal atresia with a blind esophageal pouch and a distal TEF | TEF in the absence of esophageal atresia | Proximal TEF with proximal esophageal pouch ending distal to the fistula | Esophageal atresia with 2 TEFs, one each between the proximal and distal esophagus and the trachea | 4 | A | 1 | null | null | null | null | null |
4130d7ce-7d15-596d-91b1-8ae4303cbcf4 | Which of the following scenarios would be least appropriate for a parentpresent induction of anesthesia? | An anxious 4-year-old girl here for tonsillectomy with her mother, who is tearful but cooperative | A crying 7-year-old for unilateral orchiopexy here with his father, who states he prefers to be with his son when he goes to sleep | A 5-month-old girl for diagnostic MRI under general anesthesia here with her mother, who is an anesthesiologist | A 17-year-old boy with Down syndrome for general anesthesia in the cardiac catheterization suite here with his mother, who attends all of his medical appointments | 4 | C | 2 | null | null | null | null | null |
b7013e2b-f325-5bba-8afe-7bc4ff9767e7 | A woman who has received little prenatal care presents in labor with a frank breech fetus. Fetal age is estimated by ultrasonography to be 33 weeks. Her labor proves unstoppable and she undergoes an emergency cesarean delivery. A live-born, 2-kg female infant is delivered. Shortly after the birth, the infant is noted to have grunting, nasal flaring, and retractions. Cardiac examination is within normal limits. There are no structural abnormalities noted, and oral secretions are of the usual amount. Which of the following radiologic findings is/are most likely on chest X-ray of this infant? | Lung hyperinflation with diaphragmatic flattening and layering of fluid in horizontal lung fissures | Diffuse ground-glass opacities and reduced lung volumes | Loops of bowel in the left thorax with mediastinal shift to the right | Right-sided pneumothorax | 5 | B | 2 | Pulmonary edema | null | null | null | null |
144a7b6c-681b-53fc-9e0c-322a3a5ad396 | 43. An 8-year-old, 45-kg girl with severe obstructive sleep apnea (OSA) presents for tonsillectomy and adenoidectomy. She has an uneventful inhalational induction and is intubated after IV placement and administration of propofol, rocuronium, and 50 µg of fentanyl. Intraoperatively, she receives 500 mg of IV Tylenol and 2 mg of IV morphine. At the end of her procedure she is extubated uneventfully and brought to the recovery room. Approximately 2 hours later, she begins to complain of pain. Which of the following is the most appropriate analgesic choice for her? | 500 mg of PO Tylenol elixir | 30 mg of IV ketorolac | 25 µg of IV fentanyl | 5 mg of IV morphine | 5 | C | 3 | 1 mg of IV hydromorphone | null | null | null | null |
48a280c8-2eee-5fbc-8bd6-c89e1f015212 | The P50 of fetal hemoglobin is which of the following? | 15 | 20 | 27 | 32 | 4 | B | 1 | null | null | null | null | null |
b12a7975-b8f8-5652-92ba-c07fb0f3f37c | With regard to the fetal circulatory system, which of the following sites will possess the most oxygenated blood? | The inferior vena cava (IVC) | The superior vena cava (SVC) | The right atrium | The left atrium | 5 | A | 1 | The aorta | null | null | null | null |
71beac74-7b21-5388-a3e4-de91dc989cb5 | A 6-year-old girl who has been diagnosed with a Wilms tumor presents to the OR for resection. You obtain consent from the parents for epidural placement to aid with postoperative analgesia. The safest technique for placement of a thoracic epidural in this age group is which of the following? | Awake with minimal sedation, in the seated position, using the paramedian approach | Under general anesthesia, in the right lateral decubitus position, using the paramedian approach | Awake with moderate sedation, in the seated position, using the midline approach | Under general anesthesia, in the right lateral decubitus position, using the midline approach | 4 | D | 2 | null | null | null | null | null |
a8518751-83e6-551d-b350-f0ba02a28dea | A 10-year-old, 40-kg boy is involved in a motor vehicle accident along with his parents. He is transported by ambulance to the emergency department after intubation in the field for decreased level of consciousness and hypotension. He is found in the emergency department to have a rigid abdomen concerning for intra-abdominal hemorrhage and is brought emergently to the OR for exploratory laparotomy. His father, who was injured minorly in the crash, accompanies him to the preoperative area and says to you as you take the patient into the OR, "We are Jehovah's Witnesses. He is not to receive blood transfusions." During the case, the patient is hypotensive with BP 60/30, HR 130, and SpO2 94%. Upon entry to the abdomen, 500 mL of frank blood is appreciated. An arterial blood gas is obtained, which shows a hematocrit of 20% with ongoing blood loss. The most appropriate course of action in this case is which of the following? | Begin fluid resuscitation with nonblood products, including crystalloid and nonhuman colloid. | Call the hospital lawyer to obtain an emergency court order to transfuse blood. | Consult the hospital Ethics Committee. | Transfuse blood. | 5 | D | 3 | Ask a colleague to go discuss with the parents that without permitting blood transfusion, their child will die. | null | null | null | null |
662bb979-77eb-526d-bbfc-ddcd49ecf918 | 48. Differences in required dosing of propofol between children and adults can be attributed to which of the following? | Increased clearance of propofol in children | Larger volume of distribution in children | More rapid redistribution of propofol from vessel-rich organs in children | A and B | 5 | E | 1 | B and C | null | null | null | null |
73f23b78-cfb9-5324-941a-92f54cdeffcd | Dexmedetomidine can be safely used in children for all of the following situations EXCEPT which one? | Prevention of emergence delirium | Treatment of opioid withdrawal | As an analgesic adjunct | Induction of general anesthesia with a loading dose of 2-4 μg/kg over 10 minutes | 5 | D | 1 | Procedural sedation | null | null | null | null |
7bfb30ac-f0bf-5059-8c90-dc6bafd2cf29 | When administering sedation outside the OR, which of the following corresponds to a plane of moderate sedation? | Normal response to verbal stimuli; patent-unassisted airway | Responsive to touch or verbal stimuli; may require assistance to maintain patency of airway | Responsive to touch or verbal stimuli; patent-unassisted airway | Purposeful response to painful stimuli but not verbal stimuli; patent-unassisted airway | 5 | C | 1 | No response to painful stimuli; requires assistance to maintain patency of airway | null | null | null | null |
91c3ad56-2e52-5d63-bd22-550f81b7a339 | Which of the following cardiovascular parameters increases with pregnancy? | Left ventricular end-systolic volume | Left ventricular end-diastolic volume | Central venous pressure | Pulmonary artery diastolic pressure | 5 | B | 1 | Pulmonary vascular resistance | null | null | null | null |
143a02dc-cd1d-5715-a192-3b15e40e178b | Which of the following is NOT consistent with supine hypotensive syndrome of pregnancy? | Bradycardia | Decreased right atrial filling pressure | Normal blood flow in the upper extremities | Increased femoral vein velocity | 4 | D | 1 | null | null | null | null | null |
0290ee29-306e-5a3b-9173-3f1283858a16 | Which of the following characteristics of local anesthetic administration for spinal anesthesia is more common in a parturient than in a nonpregnant patient? | Increased dose requirement for the same level and duration of block | Slower onset of neuraxial blockade | Longer duration of neuraxial blockade | Decreased neural sensitivity to local anesthetics | 5 | C | 1 | Increased risk of local anesthetic systemic toxicity | null | null | null | null |
8c0dd17f-a6e3-51f2-86cd-70b33645dc3c | Which of the following pharmacokinetic physiologic changes in drug metabolism do you anticipate in a pregnant woman at term? | Decreased requirement of isoflurane for maintenance of general anesthesia | Slower increase in alveolar concentration of inhaled anesthetics due to increased cardiac output | Increased susceptibility to propofol induction | Prolonged paralysis after succinylcholine administration | 5 | A | 1 | Increased dose requirements for aminosteroidal neuromuscular blockers (such as vecuronium and rocuronium) | null | null | null | null |
d1f29e72-3289-5223-be22-2de8478b5d44 | 5. During which time period of a normal pregnancy does the PaCO2 decrease to reach a level of 30 mm Hg? | 8 weeks | 12 weeks | 20 weeks | 28 weeks | 4 | B | 1 | null | null | null | null | null |
7fce1074-8403-54d0-8f60-f7ff60fc47a8 | Which of the following changes in lung volume occurs in a pregnant patient at term compared with prepregnancy? | Increased functional residual capacity (FRC) | Increased vital capacity | Decreased inspiratory capacity | Decreased expiratory reserve volume | 5 | D | 1 | Decreased inspiratory reserve volume | null | null | null | null |
f39189cf-a820-55b8-a922-a13f4b69a915 | Which of the following renal physiologic adaptations is NOT commonly seen in pregnancy? | Increased creatinine clearance | Increased glomerular filtration rate | Increased protein excretion | Decreased serum bicarbonate | 5 | E | 1 | Decreased glucose excretion | null | null | null | null |
cb25967b-3c34-50d3-be34-8524b8e04dc0 | Which of the following statements is correct regarding biliary disease during pregnancy? | Hormonal changes in pregnancy account for altered bile acid content. | Alkaline phosphatase (AP) levels increase during pregnancy because of biliary stasis. | Intrahepatic cholestasis of pregnancy is a normal phenomenon that is not associated with increased risk to the fetus. | Computerized tomography is the gold standard for diagnosis of gallstones in pregnancy. | 5 | A | 1 | Laparoscopic surgery is significantly safer during pregnancy in reducing fetal loss as compared with open cholecystectomy. | null | null | null | null |
aaf2856d-cc60-519c-92f8-cc4de2aa2ebc | Which of the following statements regarding gastrointestinal (GI) changes during pregnancy is true? | Gastroesophageal reflux disease is common, and lower esophageal sphincter pressures are significantly reduced during the first trimester. | Gastric emptying becomes progressively more delayed during the later trimesters of pregnancy. | Preoperative fasting guidelines for scheduled cesarean section required increased fasting periods compared with other surgical procedures. | Intestinal transit and peristalsis are slowed during pregnancy, resulting in constipation. | 5 | D | 1 | The use of nonparticulate antacids to increase gastric pH has demonstrated a significant decrease in clinical aspiration events. | null | null | null | null |
ff3e02be-95fb-5aa6-81bf-538f17c8b71f | Which of the following statements regarding hematologic changes during pregnancy is false? | Plasma volume increases more in pregnancy than red blood cell (RBC) volume, resulting in a physiologic anemia of pregnancy. | There is increased fibrinolytic activity during pregnancy, resulting in elevated fibrin degradation products. | Procoagulant proteins including factors I, VII, VIII, IX, and X are increased during pregnancy, resulting in a prothrombotic state. | White blood cell function is impaired during pregnancy. | 5 | E | 1 | Platelet consumption during pregnancy is unchanged compared with that during prepregnancy. | null | null | null | null |
5bb35384-1164-5b16-9064-d8903b2b2828 | 11. Which of the following drugs when administered to the mother is least likely to have clinical effects on the neonate? | Vecuronium | Propofol | Morphine | Diazepam | 5 | A | 1 | Ketamine | null | null | null | null |
223e0e26-1ee2-5841-a3cd-7aee55f8ecc2 | Which of the following drugs administered for postpartum hemorrhage (PPH) is incorrectly paired with a commonly associated side effect? | Carbetocin—hypotension | Oxytocin—hypernatremia | Misoprostol—fever | Methylprostaglandin—bronchoconstriction | 5 | B | 1 | Methylergonovine—arteriolar constriction | null | null | null | null |
d720b6c5-5f5b-5b29-a753-9fd679f0476a | Which of the following drugs administered to reduce preterm labor is least likely to reduce preterm birth? | β-Adrenergic agonists | Magnesium sulfate | Progesterone | Calcium channel blockers | 5 | B | 1 | Indomethacin | null | null | null | null |
fc646010-a555-5ad5-bb2e-72e8d0f624eb | A 22-year-old G2P1 is seen preoperatively for an anesthesia consultation at 32 weeks. She has a history of complex partial seizures since the age of 8 years and has been maintained on carbamazepine for the last several years with good control, and her last seizure was 19 months ago. Which of the following is NOT a common perinatal consequence of maternal antiepileptic drug use? | Small for gestational age | Decreased Apgar scores | Thromboembolic events | Admission to NICU | 5 | C | 1 | Preterm delivery | null | null | null | null |
0a26c3e0-5d9e-5763-acf7-455d70fedd67 | You are called to assist with an emergent general anesthesia for a 34-year-old G1P0 for nonreassuring fetal heart tones and persistent fetal bradycardia. During induction, you give propofol, succinylcholine, and fentanyl intravenously. Which of the following pharmacologic drug characteristics is most likely to be associated with an increased transfer of drugs across the placental membrane? | Lipophilic substances | Charged molecules | Molecular weight >1000 Da | Low free drug fraction | 5 | A | 1 | α-1-Acid glycoprotein binding | null | null | null | null |
22a9228f-f15d-5ab1-8713-92c825edbbcb | Which of the following statements comparing chorionic villus sampling (CVS) with amniocentesis is most accurate? | Amniocentesis is associated with a risk of Rh isoimmunization; however, CVS is not. | CVS is safer than amniocentesis before 15 weeks of gestation. | Pregnancy loss following CVS and amniocentesis is directly related to provider experience. | Both techniques evaluate amniotic fluid and desquamated fetal cells (amniocytes) to perform genetic analysis. | 5 | B | 1 | Amniocentesis is contraindicated in patients with a history of pregnancy loss. | null | null | null | null |
dfe78e90-01ec-5b32-9b52-33f8868582bd | 17. Which of the following statements regarding oligohydramnios is most accurate? | The amniotic fluid volume can be influenced by acute fetal hypoxia or acute fetal CNS dysfunction. | Oligohydramnios secondary to amniocentesis carries a worse prognosis than other causes and rarely reverts to normal volumes of amniotic fluid. | The most common cause of oligohydramnios is fetal anomalies. | Uteroplacental insufficiency is not associated with oligohydramnios. | 5 | C | 1 | Hydrops fetalis is classically associated with oligohydramnios. | null | null | null | null |
88647bbc-c04d-5a6a-8a16-a841cf4b5d2b | Which of the following statements regarding the etiology of hydrops fetalis is most correct? | Since the introduction of Rho(D) immune globulin, the most common causes of hydrops fetalis are nonimmune. | Maternal viral infections are not associated with hydrops fetalis. | Although the etiology of this condition must be addressed after delivery, the overall perinatal mortality associated with hydrops fetalis is <10%. | Non-ABO RBC antigens such as Kell, Rh(E), Rh(c), and Duffy are not associated with severe immune hydrops. | 5 | A | 1 | Isolated blunt abdominal trauma to a pregnant woman is not an indication for Rho(D) immune globulin. | null | null | null | null |
5f357a70-2a73-531b-9de4-2938e2134f45 | Which of the following variables is NOT included in a biophysical profile (BPP)? | Fetal limb movements | Fetal breathing movements | Fetal response to stimulation | Qualitative amniotic fluid volume | 5 | C | 1 | Fetal body movements | null | null | null | null |
d3c8f1b5-316a-5e9e-8b87-f7740fa90aef | A 23-year-old G2P0 undergoes ultrasound at 38 weeks, which demonstrates an estimated fetal weight (EFW) of 4850 g. Which of the following statements is the correct statement regarding fetal macrosomia? | An EFW greater than 4500 g in a nondiabetic woman or greater than 5000 g in a diabetic woman may warrant an elective cesarean delivery. | Fetal macrosomia is associated with an increased risk of cesarean and instrumental vaginal delivery. | Fetal macrosomia is more accurately predicted by ultrasound than by Leopold maneuvers. | Induction of labor at 38 weeks for suspected fetal macrosomia is associated with improved maternal and fetal outcomes. | 5 | B | 1 | The risk of PPH is unchanged by the presence of fetal macrosomia. | null | null | null | null |
96afea9c-4b55-5fa5-940f-c8d194dd3c9c | For which of the following urgent obstetric conditions would it be considered most appropriate to perform neuraxial anesthesia? | Placenta previa | Preterm footling breech | Uterine rupture with hemodynamic compromise | Severe obstetric hemorrhage | 5 | A | 2 | Profound fetal bradycardia | null | null | null | null |
a88ab7c9-555c-51bd-b956-09c3c8a1c9ce | Which of the following symptoms is not consistent with a postdural puncture headache (PDPH)? | Improves with lying flat, worsened by sitting or standing | Neck stiffness | Tinnitus | Bifrontal distribution | 5 | E | 1 | Scalp tenderness | null | null | null | null |
2b6d7784-f7c1-5970-a682-8b34e7aa1b2b | 23. What is the anticipated change in oxygen consumption during a normal second stage of labor? | Unchanged | Increased by 20% | Increased by 50% | Increased by 70% | 5 | D | 1 | Increased by 100% | null | null | null | null |
4b9ad33c-25a9-5273-99fb-9daf6a4d7c14 | You are participating in the care of a complex obstetric patient who has a history of severe pulmonary arterial hypertension and is undergoing induction of labor. She is a G3P2 at 37 weeks with 2 prior vaginal deliveries and has had progressive dyspnea over the last month, and a multidisciplinary discussion with her cardiologist, maternal fetal medicine specialist, and anesthesia team took place before her admission. She has an epidural in place and is now fully dilated | At the beginning of the first stage of labor (onset of contractions, cervical dilation <5 cm) | At the end of the first stage of labor (full cervical dilation) | At the end of the second stage of labor (immediate postpartum period) | At the end of 24 hours after delivery | 5 | C | 3 | At the end of 72 hours after delivery | null | null | null | null |
2a7e4f74-197c-5770-9d86-580772e8e565 | A 23-year-old G1P0 woman with an uncomplicated pregnancy is now beginning the second stage of labor. Which of the following changes in respiratory physiology would be expected for this patient compared with prepregnancy? | Decreased tidal volume and increased respiratory rate | Increased tidal volume and increased minute ventilation | Decreased tidal volume and increased minute ventilation | Increased tidal volume and decreased respiratory rate | 5 | B | 1 | Increased tidal volume and decreased minute ventilation | null | null | null | null |
c272098e-4ce3-541a-a36b-31b38270a19a | Which of the following statements regarding the effect of combined spinal epidural (CSE) anesthesia on progress of labor is most correct? | CSE anesthesia techniques accelerate the progress of the second stage of labor. | CSE anesthesia techniques increase the rate of instrumental vaginal delivery. | Early placement CSE anesthesia increases the risk of cesarean delivery when compared with later placement. | CSE anesthesia has no greater effect on the progress of labor than epidural anesthesia. | 5 | D | 1 | CSE has been shown to increase the risk of requiring a cesarean delivery compared with epidural anesthesia alone. | null | null | null | null |
5ece50d2-33c4-5760-a459-bf67e0fe9637 | A 31-year-old G2P0 woman with an epidural in place for labor analgesia has been actively pushing for the last 2 hours and 15 minutes. Her partner inquires whether this is a concerning duration of time. What would be considered a prolonged second stage of labor in this patient? | Second stage lasting more than 1 hour with neuraxial anesthesia | Second stage lasting more than 1 hour without neuraxial anesthesia | Second stage lasting more than 2 hours with neuraxial anesthesia | Second stage lasting more than 3 hours with neuraxial anesthesia | 5 | D | 1 | Second stage lasting more than 4 hours with neuraxial anesthesia | null | null | null | null |
9249243e-eb12-5204-8432-eed4bad30447 | Which of the following is not a strong indication for cesarean delivery? | Previous Pfannenstiel incision cesarean delivery | Placenta previa | Breech presentation | Prolapsed umbilical cord | 5 | A | 1 | Prior myomectomy | null | null | null | null |
ef59cab2-de2b-53ec-aba3-85e63358029f | 29. For which of the following conditions would general anesthesia be considered the preferred technique for a cesarean delivery? | High body mass index (BMI)/obesity | History of malignant hyperthermia | Severe psychiatric disorder | History of pulmonary disease | 5 | C | 2 | History of difficult intubation | null | null | null | null |
2f2bf7db-fe39-5cda-a1eb-975e172b55d3 | Which of the following pregnancy-related changes is least likely to contribute to airway complications during intubation? | Presence of a Mallampati class III or IV airway | Friable oral mucosa | Increased metabolic need and oxygen consumption | Decreased lower esophageal sphincter tone | 5 | E | 2 | Decreased duration of paralysis following succinylcholine administration | null | null | null | null |
cf1b4f4e-dfa0-58f8-9ea8-2a3a4c024f91 | You are asked to provide an anesthesia consultation for a 33-year-old G1P0 with a medical history significant for relapsing and remitting multiple sclerosis that was diagnosed 4 years before this pregnancy. She is currently not taking any medications, and her last relapse was 15 months ago. Her physical examination is significant only for right foot drop. Which of the following is the most appropriate management for her obstetric anesthesia? | Spinal and epidural analgesia are contraindicated for labor. | Spinal techniques are significantly safer than epidural techniques and are preferred for analgesia or anesthesia. | Epidural techniques are significantly safer than spinal techniques and are preferred for analgesia or anesthesia. | Spinal and epidural techniques are both considered to be safe and can be pursued for analgesia or anesthesia. | 5 | D | 2 | General anesthesia has been implicated in relapses of multiple sclerosis and should be avoided. | null | null | null | null |
77119422-7141-5769-8cce-eca2c3026482 | A 24-year-old G2P0 woman, 7 weeks pregnant based on the last menstrual period, presents to the ED with right lower quadrant pain, tachycardia, and | If on physical examination she has cervical dilation without fetal or placental expulsion, this would be considered a threatened abortion. | Spontaneous abortions are most commonly related to maternal immunologic phenomena. | Methotrexate may be used to treat this patient with suspected ectopic pregnancy. | The rate of serum β-hCG concentration rise is not reliable for the diagnosis of ectopic pregnancies. | 5 | E | 1 | Transvaginal ultrasound is the best modality to image if an ectopic pregnancy is suspected. | null | null | null | null |
fae4f6a3-fc2b-53b1-96eb-25d45fd3e369 | Which of the following statements is not true regarding systemic lupus erythematosus (SLE) in pregnancy? | Patients with SLE have an increased risk of preterm delivery. | The presence of atypical blood antibodies may make it challenging to obtain a blood type and crossmatch. | The presence of lupus anticoagulant increases the patient's risk of bleeding complications from neuraxial anesthesia. | Patients with SLE are at risk of pericarditis and cardiac tamponade. | 5 | C | 1 | Infants born to mothers with SLE may be born with congenital heart block. | null | null | null | null |
93d0fc02-aef4-5cd7-af05-5f3cdeb70159 | 34. Which of the following hematologic disorders is not associated with an increased risk of thrombotic events in pregnancy? | Protein C deficiency | Antithrombin III deficiency | Disseminated intravascular coagulation | Von Willebrand disease | 5 | D | 1 | Antiphospholipid syndrome | null | null | null | null |
dbc39872-e445-557b-b0a5-afaae47438f2 | Which of the following statements regarding management of a parturient with mitral stenosis is most correct? | Percutaneous mitral balloon valvuloplasty may be considered during pregnancy in patients with severe disease who are refractory to medical management. | The physiologic changes of pregnancy are well tolerated with the peak period of symptoms in the first trimester that typically improves throughout gestation. | Peripartum β-blockers may be used but have been associated with worse maternal outcomes. | Percutaneous valvuloplasty should be performed postconception in patients withmoderate or severe mitral stenosis, as the clinical course during pregnancy is widely variable. | 5 | A | 1 | Epidural labor analgesia is not recommended given the risk of cardiovascular collapse. | null | null | null | null |
ec1570ce-e82a-51a6-95af-951fda634026 | Which of the following associations between findings from fetal heart rate (FHR) monitoring and their causes is most accurately paired? | Early decelerations—umbilical cord compression | Variable decelerations—fetal head compression | Late decelerations—umbilical cord compression | Sinusoidal pattern—fetal anemia | 5 | D | 1 | Accelerations—fetal distress | null | null | null | null |
91ac74d5-ef6b-5a26-8ad7-332e9b192593 | A 36-year-old G1P0 at 37 weeks' gestation presents to triage complaining of a severe headache and blurry vision. Her vital signs include T 37.8, HR 84, RR 28, and BP 190/114. Her laboratory evaluation is significant for proteinuria and shows a platelet count of 86 000/mm3 with normal coagulation studies. Which of the following steps of management is inappropriate? | Treatment of hypertension to a goal of 15%-25% reduction in mean arterial pressure with intravenous (IV) hydralazine | Initiating seizure prophylaxis with magnesium sulfate | Performing an epidural for labor analgesia | Placement of a radial arterial blood pressure catheter | 5 | E | 3 | Platelet transfusion to achieve a platelet count of >100 000 mm3 before performing neuraxial anesthesia | null | null | null | null |
34a55d3e-6c05-58f9-955f-3df9ada40412 | A 42-year-old G1P0 woman complains of shortness of breath 3 hours after undergoing cesarean delivery of a term infant. She was initially admitted for preeclampsia and had a prolonged induction during which time she received 5 L of crystalloid infusions. Which of the following is the most likely etiology of her hypoxemia? | Pulmonary embolism | Pulmonary edema | Spontaneous pneumothorax | Atelectasis | 5 | B | 3 | Pneumonia | null | null | null | null |
23b633ac-c8ee-59ff-8a45-a9fa225d630a | 39. Which of the following statements is most correct regarding umbilical cord prolapse during labor? | Vaginal delivery may be attempted if the diagnosis is made during the first stageof labor; however, if diagnosed in the second stage, then cesarean delivery should be performed. | Manual elevation of the presenting limb is contraindicated. | Neuraxial anesthesia should be attempted before the use of general anesthesia. | Macrosomia is associated with an increased risk of umbilical cord prolapse. | 5 | E | 1 | The risk of complications is decreased with a shorter interval from diagnosis to delivery. | null | null | null | null |
364c3087-0fa0-506f-84ee-c4d8a292296d | Which of the following interventions is not recommended for aspiration prophylaxis in pregnant patients? | Ondansetron | Metoclopramide | H2 -receptor antagonists | Nonparticulate antacids | 5 | A | 1 | Avoidance of solid foods during labor | null | null | null | null |
5c12121d-baba-57aa-8bf7-a35cb9ca3592 | A 23-year-old G1P0 woman who just had a successful vaginal delivery with epidural analgesia now has persistent bleeding suspected to be related to retained placenta. Which of the following actions is the least appropriate to pursue for this patient's anesthetic management? | Use of oxytocin for increased uterine tone after manual removal of the placenta | Neuraxial anesthesia to achieve a block height of T6 | Intermittent boluses of ketamine to facilitate extraction | Administering nitroglycerin spray to the mother | 5 | E | 3 | Transport to OR and induction of general anesthesia with 1.5-2 MAC (minimum alveolar concentration) of volatile anesthetic | null | null | null | null |
3e0cbedb-de04-5605-91e5-f719ba0406f0 | You are called to the bedside to evaluate a 31-year-old G2P1 at term who is attempting a trial of labor after cesarean (TOLAC) and is complaining of abrupt onset of abdominal pain despite previously adequate epidural analgesia. She has a history of a prior cesarean delivery for arrest of descent at 39 weeks. Which of the following statements regarding TOLAC and vaginal birth after cesarean (VBAC) is false? | Contraindications to VBAC include a previous classic incision uterine surgery. | Risk of uterine rupture is significantly increased in patients attempting a TOLAC. | The risk of maternal mortality is less in a TOLAC than that in an elective cesarean section. | Gestation beyond 40 weeks carries a higher risk of uterine rupture in an attempted TOLAC. | 5 | D | 1 | Increased BMI (>30) significantly decreases the likelihood of a successful VBAC. | null | null | null | null |
45939f65-726a-5bda-98ae-e2b4aeb0cdcf | A 24-year-old G1P0 patient at 33 weeks' gestation with twins presents to triage with uterine contractions and a concern for preterm premature rupture of membranes. Which of the following complications of pregnancy is not consistently associated with multiple gestations? | Preterm labor | Acute fatty liver of pregnancy | Placental abruption | Postpartum hemorrhage | 5 | E | 1 | Gestational diabetes | null | null | null | null |
2e447d47-78be-55ff-bc0e-abe3b752234a | Which of the statements below regarding preterm labor is most correct? | Preterm labor complicates roughly 5% of all pregnancies in the United States. | Birth weight of preterm neonates does not correlate with morbidity and mortality. | Urinary tract infections may predispose patients to preterm labor. | Neonatal benefits of maternal administration of corticosteroids in preterm labor are limited to pulmonary maturation. | 5 | C | 1 | Magnesium sulfate is preferred as a first-line agent for tocolysis in preterm labor. | null | null | null | null |
1b8f385c-f168-54e0-b75f-fcec9cd9f56b | 45. Which of the following statements is false regarding breech presentation and delivery? | External cephalic version is more likely to be successful if performed with general anesthesia. | Perinatal morbidity and mortality are greater in planned cesarean delivery than those in planned vaginal delivery. | Maternal morbidity is lower in planned cesarean delivery than that in planned vaginal delivery. | Institutional protocols for vaginal breech delivery to select appropriate candidates and labor management may be appropriate. | 5 | C | 1 | Fetal head entrapment during delivery may require administration of nitroglycerin to the mother. | null | null | null | null |
50d82b12-6876-5bf9-a843-da17ea50bf24 | A neonate, born with a heart rate of 109 beats per minute, is taking gasping irregular breaths, appears cyanotic, grimaces to stimulation, and flexes the extremities. Which of the following is the infant's Apgar score? | 2 | 4 | 5 | 7 | 5 | C | 2 | 8 | null | null | null | null |
c84fa092-43e4-5a8f-be14-a8dea81a9773 | A neonate is delivered at 38 weeks via cesarean section after a failed induction for intrauterine growth restriction. Which of the following is most likely to be associated with increased neonatal morbidity? | Two separate episodes of FHR late decelerations each lasting 90 seconds | An Apgar score of 6 at 1 minute after delivery | Umbilical artery pH of 7.18 and base deficit of 10 mmol/L | Umbilical artery pH less than 7.0 and base deficit of 14 mmol/L | 5 | D | 1 | Stage I hypoxic-ischemic encephalopathy | null | null | null | null |
fa0c4a80-a347-5122-8330-97cb2cf5b6d0 | A neonate is delivered at 35 weeks via an emergent cesarean section and is noted to have rapid shallow gasping, appears cyanotic, and has a heart rate of 110 beats per minute. Which of the following is the most appropriate next step in fetal resuscitation? | Continue to observe. | Provide positive pressure ventilation. | Provide blow-by supplementary oxygen. | Administer epinephrine. | 5 | B | 2 | Begin chest compressions. | null | null | null | null |
59a0bda3-f4ef-5334-b9d1-d370ab2d9dff | You are caring for a 29-year-old G2P1 at 28 weeks' gestation with the pregnancy complicated by a fetal sacrococcygeal teratoma, who is presenting for an intrauterine surgical intervention. Which of the following statements is NOT true regarding intrauterine surgery? | Volatile anesthetic agents are used at 2-3 MAC for maintenance of anesthesia. | Magnesium and nitroglycerin may be used to provide tocolysis. | Maternal administration of paralytic agents is needed to ensure maternal and fetal immobility. | Vasopressor use to maintain placental perfusion is frequently required. | 5 | C | 1 | Subsequent pregnancies should be delivered via cesarean section rather than allowing labor. | null | null | null | null |
ca75dbd4-a6be-586f-9bfc-0f921d5ee1a5 | A healthy 24-year-old G2P1 at term with an epidural in place for analgesia who is currently at 7 cm cervical dilatation develops a late deceleration in the FHR tracing. Her current heart rate is 108 beats per minute, blood pressure is 80/47 mm Hg, and oxygen saturation is 97%on room air. Which of the following interventions is least likely to be beneficial for correction of fetal distress? | IV fluid bolus | IV bolus of phenylephrine | Terbutaline | Maternal repositioning | 5 | E | 3 | Maternal oxygen supplementation | null | null | null | null |
d79cadc3-15b6-5f21-b399-e2e22114f5d9 | A 64-year-old man with a medical history significant for Mobitz type II seconddegree heart block after permanent pacemaker (PPM) placement presents for video-assisted right upper lobe wedge resection for a pulmonary nodule. Which of the following intraoperative issues is unlikely to occur from electromagnetic interference (EMI)? | Increase in ventricular thresholds | Inhibition of pacemaker by EMI | Pacemaker battery failure | Transient or permanent loss of capture | 4 | C | 1 | null | null | null | null | null |
78f47e09-9b94-5431-a66c-4bc8ad932266 | Which of the following codes correctly describes a pacemaker that utilizes synchronous, dual-chamber pacing and is rate-responsive? | DOOR | DDDO | VVIR | DDIR | 4 | D | 1 | null | null | null | null | null |
157201a3-b2cf-5534-b129-d25587b7e167 | 8. A 74-year-old man is 3 weeks after pulmonary vein isolation for atrial fibrillation and presents to the emergency department with fever, chills, and dysphagia. He is found to be hypotensive and anemic. Which of the following complications from pulmonary vein isolation commonly presents during this period? | Atrial-esophageal fistula (AEF) | Complete heart block | Cardiac tamponade | Phrenic nerve injury | 4 | A | 1 | null | null | null | null | null |
5f162bdd-6680-5783-8131-138d0ca0373e | An otherwise healthy 26-year-old woman undergoing laparoscopic myomectomy develops intraoperative narrow-complex tachycardia at a rate of 170 beats per minute, with loss of P wave. Her blood pressure quickly drops to 55/30. Which of the following is the correct next step in treatment? | Diltiazem | Adenosine | Metoprolol | Synchronized cardioversion | 4 | D | 2 | null | null | null | null | null |
78d1bb52-b5d9-5c3b-a160-00753dbf29a7 | A 58-year-old woman one day after catheter ablation for atrial fibrillation complains of shortness of breath. Vital signs are as follows: 36.8°C | 74 | 134/68 | 26 | 98% on room air. ECG shows restoration of normal sinus rhythm. Chest Xray demonstrates an elevated right hemidiaphragm. Which of the following procedural complications is the most likely source of her dyspnea? | Volume overload | Phrenic nerve injury | Atrial-esophageal fistula | Cardiac tamponade | 4 | B | 2 | null | null | null | null | null |
56ba7314-388f-5951-a4cd-08b39afb751d | Which of the following patients should undergo additional cardiac testing before proceeding for an intraoperative surgical procedure? | A 71-year-old man with known untreated 3-vessel coronary disease presenting for exploratory laparotomy for perforated bowel | An 81-year-old woman with chronic kidney disease (creatinine 2.3 mg/dL) and prior ischemic stroke presenting for lumpectomy for breast cancer | A 68-year-old man with type 2 diabetes mellitus and prior ischemic strokepresenting for revascularization procedure for peripheral arterial disease, which limits his exercise capacity | An otherwise healthy 48-year-old man presenting for median sternotomy for thymoma resection | 4 | C | 3 | null | null | null | null | null |
3b80ebd2-bab9-5660-9031-9a78418f5cd6 | A patient with type 1 diabetes mellitus and chronic kidney disease, stage III (Cr 2.5 mg/dL) presents for a video-assisted right upper lobe wedge resection for pulmonary nodule. Which of the following medications is appropriate to initiate preoperatively? | Metoprolol | Lisinopril | Amlodipine | Aspirin | 4 | A | 2 | null | null | null | null | null |
1d97bff8-af4f-522e-b418-e0b7010df2f2 | When used alone, which ECG lead will most likely detect intraoperative myocardial ischemia? | aVL | II | V4 | V5 | 4 | D | 1 | null | null | null | null | null |
d316e6c7-fd64-5487-8d7f-f365e7b77a3d | 14. A 59-year-old man with a suspected bowel perforation is scheduled to undergo exploratory laparotomy. His vitals are as follows: 38.2°C | 122 | 81/43 | 24 | 97% on 3 L nasal cannula. Laboratory analysis is notable for troponin of 0.12 ng/mL, and ECG shows ST depressions in leads V4 -V6 . Which of the following is the most appropriate diagnosis? | Unstable angina | Non-ST elevation myocardial infarction (MI), type I | Non-ST elevation MI, type II | ST elevation MI | 4 | C | 3 | null | null | null | null | null |
5f8d574f-60cb-5e25-9171-1909181ce8cc | A 49-year-old man is undergoing retroperitoneal sarcoma resection, which has been complicated by an injury to the inferior vena cava (IVC) and substantial blood loss. You note ST depressions in lead II and send an arterial blood gas revealing the following information: | Increasing FiO2 | Transfusion of 2 units of packed red blood cells | Administering rectal aspirin | Increasing phenylephrine infusion | 4 | B | 2 | null | null | null | null | null |
b4e84e23-7570-5708-a6a7-6012fe9af85f | Which of the following statements is true concerning patients with ventricular assist devices (VADs) presenting for noncardiac surgery? | Noninvasive blood pressure cuffs will not function correctly in a patient with a VAD. | Anticoagulation should be held for at least 48 hours before proceeding to the operating room (OR). | Implantation of a VAD may delay gastric emptying and necessitate a rapid sequence induction. | Regional anesthesia should be utilized whenever possible for VAD patients. | 4 | C | 2 | null | null | null | null | null |
f9f44cc8-2710-572b-b681-b5d11efc657c | Which of the following statements is true with respect to extracorporeal membrane oxygenation (ECMO) as compared with cardiopulmonary bypass (CPB)? | Arterial line tracing for both ECMO and CPB will lack pulsatility. | The membrane oxygenator in CPB is designed for longer-term use compared with ECMO. | The heart is stopped in both ECMO and CPB. | Lower flow rates are used in CPB, necessitating a greater degree of anticoagulation. | 4 | D | 1 | null | null | null | null | null |
560d3ed0-d42e-590d-a328-5fd67db5edd0 | Which of the following factors places a patient at increased risk of anaphylaxis to protamine during reversal of heparin following CPB? | Prior exposure to protamine | Diabetes treated with metformin | History of atopy (asthma, eczema) | Prolonged heparin time | 4 | A | 1 | null | null | null | null | null |
1e5c7646-839c-54af-92c6-292536382b76 | 19. Which of the following is an advantage of traditional, on-pump coronary artery bypass grafting (CABG) as compared with off-pump coronary artery bypass grafting (OPCABG)? | Lower intraoperative blood loss | Reduced risk of postoperative cognitive dysfunction | Higher rates of graft patency | Reduced risk of thrombotic events | 4 | C | 1 | null | null | null | null | null |
e6447c4b-c1c7-5a1d-82ca-97cd1282551f | Which of the following correctly describes the appropriate timing of inflation of an intra-aortic balloon pump? | Just after the dicrotic notch | At the onset of ventricular systole | When the P wave is seen on ECG | During isovolumetric contraction | 4 | A | 1 | null | null | null | null | null |
e3934282-4f43-5a00-b816-4b2a8cdc6236 | A patient with asymptomatic, moderate aortic stenosis (Vmax = 3.7 m/s) is presenting for elective laparoscopic colectomy for newly diagnosed colon cancer. Within what time frame should an echocardiogram have been performed before proceeding with elective surgery? | 3 months | 6-12 months | 1-2 years | 3-5 years | 4 | C | 2 | null | null | null | null | null |
eeb42aa7-9f0a-58cc-9ef1-909c3124bec9 | Which one of the following patients should receive infective endocarditis (IE) prophylaxis before undergoing his/her associated procedure? | A 61-year-old man with a mechanical mitral valve presenting for root canal | A 34-year-old woman with a history of repaired tetralogy of Fallot presenting for dental cleaning | A 54-year-old woman after aortic valve replacement for bicuspid aortic valvepresenting for elective cystoscopy | A 28-year-old man with history of IE because of IV drug use presenting for esophagogastroduodenoscopy | 4 | A | 2 | null | null | null | null | null |
a1d33b4e-25ab-5166-91ab-d698077064c8 | 24. A 71-year-old man is presenting for elective aortic valve replacement. His transthoracic echocardiogram (TTE) shows a hypertrophic left ventricle (LV) with preserved function and an aortic valve area = 1.4 cm2 , Vmax = 3.4 m/s, and mean gradient = 37 mm Hg. He is currently asymptomatic and denies angina, syncope, and dyspnea. Which of the following statements is correct regarding his anesthetic management? | Phenylephrine infusion will decrease stroke volume because of increased afterload. | Atrial fibrillation will be poorly tolerated. | Heart rate between 80 and 100 beats per minute is ideal. | Dopamine is the inotrope of choice. | 4 | B | 2 | null | null | null | null | null |
7ce216a5-450b-50fb-b1c2-4e6578445e60 | A 61-year-old man with moderate mitral regurgitation (MR) is presenting for emergent exploratory laparotomy secondary to perforated bowel. Which of the following goals is most critical in the anesthetic management of MR? | Target heart rates at the upper limit of normal (80-100 bpm). | Increase preload slightly. | Maintain sinus rhythm. | Reduce SVR. | 4 | D | 2 | null | null | null | null | null |
6b28279d-9d1d-5064-84ac-cebd41de5cd7 | A otherwise healthy 24-year-old man with hypertrophic cardiomyopathy (HCM) is undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. He becomes acutely hypotensive following insufflation of the abdomen and positioning in the reverse Trendelenburg position. His blood pressure is unchanged at 68/43 following a rapid bolus of IV fluids, lightening the anesthetic and leveling the bed. Administration of which of the following drugs is the most appropriate next step in management? | Epinephrine 10 µg IV | Ephedrine 5 mg IV | Norepinephrine 4 µg IV | Phenylephrine 100 µg IV | 4 | D | 3 | null | null | null | null | null |
491ee193-a732-5189-a24f-de27591ee8c4 | Which of the following statements is true with regard to anesthetic management of patients with HCM? | Patients without outflow obstruction at rest are at low risk for dynamic obstruction with administration of anesthetic agents. | Negative inotropic agents may be useful to attenuate sympathetic stimulation perioperatively. | Hypovolemia is better tolerated than hypervolemia. | Lethal arrhythmias do not occur in hypertrophic obstructive cardiomyopathy patients without signs of inducible obstruction on echocardiography. | 4 | B | 2 | null | null | null | null | null |
ffa98143-17c7-51fa-9ad9-70fd65848de0 | A 69-year-old woman becomes hypertensive to 207/109 upon emerging from a general anesthetic for laparoscopic hysterectomy. She is subsequently hypoxic and her endotracheal tube has frothy clear secretions. Which of the following is the most likely diagnosis? | Volume overload | Negative pressure pulmonary edema | Flash pulmonary edema | Transfusion-associated circulatory overload | 4 | C | 3 | null | null | null | null | null |
18d7b990-5550-5a2a-8d4a-4aa877b6f069 | A 54-year-old woman who was previously healthy presents with severe malaise and light-headedness 2 weeks after her husband died unexpectedly. Her extremities are cool and clammy, she is found to be profoundly hypotensive, and transthoracic echocardiogram shows global LV hypokinesis with apical ballooning. Which of the following statements is correct about her condition? | Postmenopausal women are at highest risk for this condition. | ECG changes are uncommon at presentation. | This condition is unlikely to resolve over time. | Most patients affected by this condition have underlying coronary artery disease. | 4 | A | 1 | null | null | null | null | null |
fde7962a-930b-57ac-96b1-764338e6e667 | 30. A 74-year-old man with diabetes mellitus and poorly controlled hypertension has undergone robotic prostatectomy over a course of 8 hours, during which he received 4 L of Lactated Ringer and 500 cc of 5% albumin. Blood loss was approximately 200 cc, and urine output was 320 cc. His oxygen saturation is 93%-95% despite FiO2 of 100% and positive end-expiratory pressure of 8 cm H2O. On auscultation, bibasilar crackles are present. Which of the following is the best next step in management? | Emerge the patient and extubate to noninvasive positive pressure ventilation (PPV) in the OR. | Keep the patient intubated and admit to the surgical intensive care unit. | Administer a loop diuretic. | Initiate therapy with inhaled nitric oxide. | 4 | C | 3 | null | null | null | null | null |
d2e1d308-7d3d-5e4d-8799-021db5c4636a | Which of the following signs or symptoms is more likely to be a presenting feature when cardiac tamponade develops chronically, rather than acutely? | Hypotension | Edema | Light-headedness | Cough | 4 | B | 1 | null | null | null | null | null |
2b582a3d-ff9e-500a-8eb5-b28ca84c8cd4 | Which of the following causes of cardiac tamponade is an indication for immediate surgical intervention? | Viral pericarditis | Metastatic lung cancer | Free wall rupture following MI | Systemic lupus erythematosus | 4 | C | 1 | null | null | null | null | null |
9edb7abf-89c3-5ae0-b8d5-f6c86d2012e9 | Which of the following conditions will mask the pulsus paradoxus commonly seen in cardiac tamponade? | Positive pressure ventilation | Mucous plug | Stridor | Chronic obstructive pulmonary disease (COPD) | 4 | A | 1 | null | null | null | null | null |
d361dfe0-2565-56f7-a3c6-9db07e4beca4 | A 67-year-old man presents with progressive dyspnea on exertion and intermittent positional chest discomfort. His past medical history is significant for coronary artery disease for which he underwent a 3-vessel CABG 2 years ago. Coronary catheterization shows patent grafts. Transthoracic echocardiography demonstrates evidence of increased ventricular interdependence and dissociation of intrathoracic-intracardiac pressures. Which of the following is the most likely cause of this patient's constrictive pericarditis (CP)? | Tuberculosis | Rheumatologic | Postradiation | Postcardiac surgical | 4 | D | 2 | null | null | null | null | null |
cba61d18-0a02-583f-8ffc-1fb090d9280e | The presence of which of the following findings is more consistent with a diagnosis of restrictive cardiomyopathy (RCM) as compared with CP? | Expiratory flow reversal in the hepatic vein | Respirophasic septal shift | Moderate pulmonary hypertension | Elevated medial mitral annulus velocity (e,) ≥ 8 cm/s | 4 | C | 2 | null | null | null | null | null |
f575a4f4-9039-5720-b3fb-b413557cd49e | 36. Which of the following statements is true of perioperative venous | Novel oral anticoagulants are more effective than once-daily enoxaparin in VTE prophylaxis without increased rates of postoperative bleeding. | Major trauma increases VTE risk to a greater degree than postpartum status. | The VTE prophylactic effects of aspirin and warfarin are synergistic. | Neuraxial anesthesia initiated before surgical incision reduces rates of perioperative VTE. | 4 | D | 1 | null | null | null | null | null |
97054359-6ab8-526b-bc0c-65839ca1417b | A 48-year-old man presents for retroperitoneal sarcoma resection. Pharmacologic VTE prophylaxis should be continued postoperatively for what length of time? | 3 days | 14 days | 28 days | 60 days | 4 | C | 1 | null | null | null | null | null |
ea276da0-28b5-50f3-b24f-c92c55858e8d | Which of the following pathophysiologic changes occurs with a pulmonary embolism? | Increased dead space | Increased shunt | Reduced pulmonary vascular resistance | Reflex bronchodilation | 4 | A | 1 | null | null | null | null | null |
7b0e1ea1-18d4-581b-995e-3ea08520c51a | Which of the following arterial blood gas results, on an FiO2 of 0.4, is most consistent with a diagnosis of acute, submassive pulmonary embolism? | | pH 7.39 | PaCO2 44 | PaO2 90 | HCO3 26 | | | pH 7.47 | PaCO2 40 | PaO2 74 | HCO3 28 | | | pH 7.59 | PaCO2 28 | PaO2 90 | HCO3 26 | | | pH 7.50 | PaCO2 32 | PaO2 74 | HCO3 24 | | 4 | D | 2 | null | null | null | null | null |
8d05f78c-6eba-5231-b10c-821f718861ce | Which of the following ECG findings is most sensitive for acute pulmonary embolus? | Incomplete right bundle branch block | Rightward axis | Sinus tachycardia | Large S wave in lead I, combined with Q wave and inverted T wave in lead III | 4 | C | 1 | null | null | null | null | null |
236acb71-5de5-5419-8b82-68c16984c8de | A 59-year-old woman with a history of hypertension presents for total abdominal hysterectomy for endometrial cancer. She has continued her home amlodipine and metoprolol up until the day of surgery but has held her lisinopril for 2 days. In the preoperative day, she is very anxious and her blood pressure is 179/88. Which of the following is the most appropriate next step? | Cancel the case. | Administer home lisinopril dose. | Proceed with the case and maintain blood pressure within high-normal range. | Administer appropriate anxiolysis and reassess. | 4 | D | 3 | null | null | null | null | null |
267ee312-185e-599d-87b0-3870db66530b | 42. Which of the following statements is true with respect to essential hypertension? | Systolic dysfunction will precede diastolic dysfunction in the progression. | LV eccentric hypertrophy is likely to occur. | Essential hypertension accounts for >80% of all hypertension diagnoses. | Cerebral autoregulation is unchanged with long-standing essential hypertension. | 4 | C | 1 | null | null | null | null | null |
7f9598b0-ffb9-5a36-916c-025aca7ead3f | Which of the following antihypertensives should be held for 12-24 hours preoperatively? | Captopril | Labetalol | Amlodipine | Clonidine | 4 | A | 1 | null | null | null | null | null |
c7516c0a-2568-54ec-a17c-944974bedb1a | In which of the following scenarios should a β-blocker be initiated preoperatively? | A 60-year-old woman presenting for bilateral mastectomy with poorly controlled hypertension on lisinopril, amlodipine, and hydrochlorothiazide | A 48-year-old man with 100-pack-year smoking history presenting for thoracoscopic lobectomy | A 74-year-old man with coronary artery disease presenting for endovascular aortic aneurysm repair (EVAR) | A 65-year-old woman with hypertension and hyperlipidemia presenting for laparoscopic cholecystectomy for acute cholecystitis | 4 | C | 2 | null | null | null | null | null |
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