59、 During spine surgery, which monitor is most reliable to avoid spinal cord injury secondary to distraction of the spine?
(A) Wake-up test
(B) Somatosensory evoked potential (SSEP)
(C) Electromyogram (EMG)
(D) Motor evoked potentials (MEP)
(E) Auditory evoked potential (AEP)

55、 A 45-year-old male patient received laparoscopic cholecystectomy. After60-min CO2 insufflation, intra-abdominal pressure was 14 mmHg. End-tidal CO2 was found to increase from 30 to 50 mmHg. SpO2 was 80% with airway pressure soared up to 40 cm H2O. Physical examination showed a reduction of breathing sound with hyperresonance over the right lung. In addition, slight swelling and crepitus were noted over anterior chest wall. The most likely diagnosis is: (A) Endobronchial intubation (B) Massive CO2 embolism (C) Pneumothorax (D) Capnothorax (E) Subcutaneous emphysema

56、 Postoperative delirium in the elderly is common. Which statement is least appropriate? (A) Hemodynamic complications such as hypotension, dysrhythmia are associated with its occurrence (B) Hypoactive type is more common than hyperactive type (C) Incidence is 5-10 % (D) The type of anesthesia is not related to the occurrence of delirium (E) Routine preoperative testing is not necessary

57、 At the end of the operation, neuromuscular blockade was antagonized under monitoring with a nerve stimulator. Unfortunately, your stimulator does not have a recording function. You have to combine other clinical tests for your judgment. Which of the following clinical test is least reliable to exclude the residual neuromuscular blockade? (A) Sustained head-lift for 5 seconds (B) Sustained hand-grip for 5 seconds (C) Maximum inspiratory pressure ≧ 40-50 cmH2O (D) Normal tidal volume (E) Sustained “tongue depressor test”

58、 A 68-year-old businessman was scheduled for laparoscopic cholecystectomy under general anesthesia. He had history of coronary artery disease and rheumatic heart disease with moderate mitral regurgitation. Preoperative cardiac evaluation showed ejection fraction of 40%. In consideration of anesthnetic care, which one is least appropriate? (A) Pre-operative preload augmentation (B) Nitroglycerin can be chosen to correct the reduction of cardiac output secondary to an increase of systemic vascular resistance. (C) Increased afterload is a major contributor to the altered hemodynamics seen during pneumoperitoneum (D) Normalization of hemodynamic is immediate soon after operation was completed (E) Accentuated vagal stimulation should be considered in patient taking β-blockers.

60、 To prevent vasovagal reaction secondary to interscalene nerve block in arthroscopic shoulder surgery, which one is least appropriate? (A) Fluid loading (B) Intravenous atropine (C) Intravenons β-blocker (D) Intravenous glycopyrrolate (E) Abort the procedure

61、 Which one is least likely to be the systemic effects of tourniquet release in total knee replacement(TKR)? (A) Transient metabolic acidosis (B) Transient fall in central venous oxygen tension (C) Increased oxygen consumption (D) Release of acid metabolites into central circulation (E) Transient rise in core temperature

62、 In performing axillary plexus block, which of the following is the most likely structure marked “X” in the picture on the right : (A) Ulnar nerve (B) Radial nerve (C) Median nerve (D) Musculocutaneous nerve (E) Coracobrachialis muscle

63、 Which one is least likely to be the independent predictor of postoperative pulmonary complications in elective non-cardiac surgery? (A) Longer duration of general anesthesia (B) Age (C) Obesity (D) Surgical procedure (E) Postoperative nasogastric intubation

64、 Which of the following best describes the antagonization of non-depolarizing muscle relaxants? (A) Prolonged administration of cholinesterase inhibitors can lead to a myasthenia-like state (B) There is only one class of drug to reverse non-depolarizer-induced paralysis (C) Neostigmine has prejunctional effect to enhance the release of acetylcholine (D) An atropine-like drug is not necessarily administered (E) Mechanisms of all acetylcholinesterase inhibitors are identical

65、 A 3-year-old patient, body weight 12 kg, received right inguinal hernioplasty. The surgeon request that the anesthesiologist should use laryngeal mask airway (LMA) for anesthesia . Which one is the most appropriate size of LMA for this patient? (A) 1 (B) 1.5 (C) 2 (D) 2.5 (E) 3