Nine months after sustaining an injury to the left forearm, a 30-year-old woman has diffuse, burning pain on the anterior aspect of the forearm and posterior aspect of the hand and discoloration of the skin in the affected areas. The patient should be informed that
(A) if left untreated, muscle atrophy may develop in the involved limb
(B) if left untreated, the pain will remain well localized
(C) physical therapy is not indicated
(D) the symptoms are directly related to the severity of the initial injury
(E) the symptoms are most likely secondary to underlying peripheral vascular disease
A 68-year-old man who is scheduled for outpatient cystoscopy has non-insulin-dependent diabetes mellitus controlled with glipizide (Glucatrol) 5 mg twice daily. He has had nothing to eat since awakening this morning and has not taken glipizide today. His blood glucose level is 185 mg/dl. Before proceeding, the most appropriate management is to administer
A 33-year-old woman is scheduled for emergency appendectomy under general anesthesia. She has hypertrophic cardiomyopathy and has had two episodes of syncope in the past year. Which of the following statements concerning anesthetic management is true?
(A) Spinal anesthesia is preferred to general anesthesia
(B) Deep levels of isoflurane anesthesia are appropriate
(C) Fluid administration should be restricted
(D) Phenylephrine is preferred to ephedrine to treat hypotension
(E) Positive end-expiratory pressure will decrease left ventricular outflow obstruction
A patient spontaneously breathes nitrous oxide 60%, oxygen 40%, and enflurane for one hour. The nitrous oxide is then replaced with oxygen, and the inspired enflurane concentration is increased from 1% to 2%. Over 10 minutes, the end-tidal carbon dioxide tension increases from 30 to 40 mmHg. The most likely cause is