A patient undergoes differential spinal block for evaluation of persistent foot pain. If the pain returns coincident with a decrease in skin temperature, which of the following is the most appropriate conclusion?
A patient who is scheduled for a parathyroidectomy for a parathyroid adenoma has a preoperative serum calcium concentration of 13.5 mg/dl. The ECG shows no acute changes. The most appropriate preoperative management is administration of
(A) calcitonin
(B) hydrocortisone
(C) intravenous saline solution
(D) mannitol
(E) potassium phosphate
C
A patient has fever and chills in the recovery room following an abdominal hysterectomy that required the intraoperative administration of whole blood 1 unit. A blood sample drawn in the recovery room shows no free hemoglobin. Subsequently, packed red blood cells 1 unit and fresh frozen plasma 1 unit are administered, and the fever and chills recur. The most likely cause of the fever and chills is
(A) an allergic-type transfusion reaction
(B) a hemolytic transfusion reaction to untested antibodies
(C) bacterial contamination of blood
(D) a reaction to leukocytes contained in the plasma
(E) the presence of cold agglutinins in the patient
D
A 1150-g, 10-day-old infant is undergoing a bowel resection for necrotizing enterocolitis. Heart rate is 200 bpm and blood pressure measured through a femoral artery catheter is 45/24 mmHg. The most appropriate next step is administration of
An 8-kg, 5-month-old infant undergoes craniotomy for an arteriovenous malformation. During the procedure, severe hemorrhaging occurs and packed red blood cells 3 units are transfused rapidly. During infusion of the third unit, hypotension, nodal bigeminy, and prolongation of the QT interval are noted. The most appropriate management includes administration of