26. Sedatives, as premedication, must be avoided in which of the following patients?
D. Patients with alcohol abuse
27. As per the American Society of Regional Anesthesia (ASRA) guidelines, which of
the following drugs can be continued preoperatively in patients planned for neuraxial
blockade for an elective procedure?
D. Low-molecular-weight heparin
28. As per ASA classification, a controlled hypertensive patient with no target end-organ
damage scheduled for elective surgery will be classified as
29. A brain-dead organ donor undergoing laparotomy for “kidney harvesting” will be
30. A moribund patient who is not expected to survive without the operation is
31. A patient with a history of uncontrolled hypertension, diabetes, and angina, who is to
undergo a laparoscopic cholecystectomy, will be classified as an
32. A 65-year-old male with a history of mitral valve replacement 2 years back presents
for a knee replacement. He is on warfarin since the time of valve replacement. As
per ASRA guidelines, the ideal time to stop his warfarin prior to surgery would be
33. A 26-year-old female, with a history of rheumatic mitral stenosis, is scheduled for an
elective cesarean section at 38 weeks of gestation. Just prior to surgery, she is
diagnosed to have atrial fibrillation (AF) with no hemodynamic instability. The first
step in preparation for surgery is
A. Perform an echocardiogram to rule out left-atrial clot
B. Synchronized DC cardioversion under sedation
D. Plan for therapy postdelivery
34. A 72-year-old patient with a history of hypertension and angina at moderate activity
is to undergo a laparoscopic cholecystectomy. Due to decreased effort tolerance and
a significant blockade of left anterior descending coronary artery onstress thallium, a
preprocedure coronary intervention is planned. Which of the following procedures
performed prior to the elective surgery is least likely to delay the laparoscopic
A. Coronary artery bypass graft (CABG)
B. Percutaneous coronary stenting—bare-metallic stent
C. Percutaneous coronary stenting—drug-eluting stent
D. Percutaneous balloon dilatation
35. Which of the following is not seen as a result of primary renal disease in patients
36. A 2-year-old child is to undergo a tonsillectomy. The child had formula milk 2 hours
ago. As per ASA guidelines, optimal NPO status would be to wait another _____
A. No waiting, since it is a child
37. A 45-year-old patient is scheduled for an abdominal hysterectomy. She states that
her aunt had a severe reaction to anesthesia and was in the ICU for 1 week. You
would avoid which of the following drugs for her general anesthesia?
38. Elective surgery should be postponed after a myocardial infarction for at least
39. The most significant risk factor for developing pulmonary complications is
A. Site of surgery (abdominal/thoracic)
B. Presence of respiratory infection
C. Presence of obstructive sleep apnea
40. Maximum international normalized ratio (INR) before proceeding for elective
41. A 73-year-old patient has residual weakness on the right arm and leg following a
stroke 5 years ago. He is now scheduled for laparoscopic cholecystectomy under
general anesthesia. Which of the following sites should be preferably used to monitor
the train of four muscle twitches for estimating neuromuscular blockade?
A. Right ulnar nerve–innervated muscles
B. Right posterior tibial nerve–innervated muscles
C. Left ulnar nerve–innervated muscles
42. A 32-year-old patient after being involved in a road traffic accident due to alcohol
intoxication is taken to the operating room for open fracture reduction of an ankle
fracture. His blood alcohol level is above the legal limit. Compared to a patient who
is not intoxicated with alcohol, you would expect the minimum alveolar
concentration (MAC) of sevoflurane to be
D. Unpredictable due to pharmacodynamic variations
43. A 55-year-old patient with a history of asthma and heart failure is to undergo a
hernia repair. On physical examination, you notice that the patient is wheezing.
Following treatment with albuterol, the patient should be monitored for which
44. Smoking cessation for 24 hours before a scheduled surgery will lead to
A. Improvement of ciliary function
B. Decrease in mucous production
C. Decrease in airway irritability
D. Decrease in level of carboxyhemoglobin
45. Which of the following tests is likely to detect clinically relevant bleeding tendency
A. Activated partial thromboplastin time
46. As per AHA guidelines, which of the following is not a major clinical risk predictor
in a patient with cardiac disease scheduled for noncardiac surgery?
A. Recent myocardial infarction
B. Symptomatic mitral stenosis
C. Presence of congestive cardiac failure
D. Uncontrolled systolic hypertension
47. Glycopyrrolate, when given preoperatively, can cause all of the following, except
48. Which of the following is true about metoclopramide?
A. Decreases lower esophageal sphincter tone
C. Can cause extrapyramidal side effects
D. Useful in preventing postoperative nausea
49. Which of the following occurs during the preoxygenation of a patient?
A. Increase in functional residual capacity
C. Increase in CO2 clearance from lungs
D. Increase in closing capacity of lungs
50. Which of the following agents is associated with the highest incidence of hepatitis
51. The inhalation agent of choice in a 2-year-old child for ophthalmologic surgery is
52. Which of the following is true of nitrous oxide?
A. Acts on central nervous system GABA receptors
B. Lowers pulmonary vascular resistance
C. Suppresses EEG pattern in the cerebral cortex
D. Precipitates vitamin B12 deficiency anemia
53. The antiemetic effect of propofol is thought to occur due to
A. Depressant effect on the chemoreceptor trigger zone
B. Inhibition of dopamine activity
C. Inhibition of glutamate release
54. Which of the following is the preferred intravenous agent of induction of anesthesia
for maintaining spontaneous breathing and airway tone?
55. Succinylcholine is contraindicated in a patient with
56. A 75-year-old patient with a history of hypertension is to undergo laparoscopic
colectomy for carcinoma colon. Continuing of which of the following
antihypertensive drugs, preoperatively, in the geriatric age group, can be associated
with profound hypotension on induction of general anesthesia?
B. Angiotensin-converting-enzyme (ACE) inhibitors
57. Which of the following findings in the preoperative evaluation cannot be attributed to
obesity with obstructive sleep apnea (OSA) in a patient planned for bariatric
A. Pulmonary artery hypertension
58. All of the following medications can be administered via an epidural anesthesia,
59. Ondansetron causes its antiemetic effect by acting as an
60. Which of the following statements is false regarding scopolamine patch applied
B. Decreases the risk of nausea
D. Inhibits muscarinic receptors
61. Overdose with dexmedetomidine results
Overdose with dexmedetomidine results in
C. Hypertension and bradycardia
D. Hypotension and bradycardia
62. Abrupt withdrawal of steroids can lead to
63. Promethazine primarily inhibits which of the following receptors?
64. All of the following surgeries are associated with an increased risk of postoperative
65. Abrupt stoppage of total parenteral nutrition (TPN) would most likely cause
66. Glycopyrrolate causes all of the following, except
D. Lowers lower esophageal sphincter tone
67. In general, herbal medications should be stopped before surgery for at least _____
68. Which of the following antibiotics can prolong the action of neuromuscular-blocking
69. Estrogen in birth control pills increases the perioperative risk of
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