Which of the following is the most common cause of coagulopathy occurring during massive blood transfusion?
(A) Decreased serum fibrinogen concentration
(B) Decreased serum ionized calcium concentration
(C) Dilutional thrombocytopenia
(D) Disseminated intravascular coagulation
(E) Hypothermia
C
A 40-year-old patient has pain following injection of 8 ml of thiopental 2.5% through a right radial artery catheter. His hand remains pink. Which of the following is the most appropriate next step?
(A) Injection of lidocaine through the catheter
(B) Injection of nitroglycerin through the catheter
A 22-year-old woman with preeclampsia has undergone emergency cesarean delivery during general anesthesia. At the completion of the surgery, attempts at reversal of vecuronium are unsuccessful. Each of the following could be a cause of this failure EXCEPT
(A) hypoalbuminemia
(B) hypothermia
(C) perioperative administration of gentamicin
(D) perioperative administration of magnesium sulfate
(E) respiratory acidosis
A
A 40-year-old woman receives alfentanil 75 mcg/kg followed by an infusion of 1.5 mcg/kg/min for a one-hour cholecystectomy and cholangiogram. This regimen could be associated with each of the following EXCEPT
A patient has an anterior neck injury, hoarseness, labored respirations, subcutaneous emphysema, and laryngeal crepitus following a motor vehicle accident. Which of the following is the best method of securing the airway in this situation?
(A) Blind nasotracheal intubation
(B) Lightwand intubation
(C) Retrograde wire-guided intubation
(D) Tracheostomy
(E) Transtracheal jet ventilation
D
During general anesthesia using a modern anesthesia machine, a patient's spontaneous ventilation is manually assisted with a fresh gas flow of 5 L/min. A sudden malfunction of the pressure-relief (pop-off) valve of the circle absorption system occurs, and the valve cannot be opened. The most appropriate next step is to
A healthy 60-kg 52-year-old woman undergoing reduction mammoplasty is anesthetized with isoflurane and oxygen, and deliberate hypotension to 80/40 mmHg is induced with nitroprusside. Urine output through an indwelling urethral catheter has been 10 mL during the past hour. You should now
(A) administer furosemide 40 mg intravenously
(B) infuse normal saline solution until urine output reaches 35 mL/hr
(C) administer dopamine at 3 mcg/kg/min
(D) expect normal urine flow with restoration of normal blood pressure