After weaning from cardiopulmonary bypass following mitral valve replacement, a patient's cardiac output is reported to be 3.7 L/min measured by thermodilution technique using 5% dextrose in water 10 ml at room temperature as injec-tate. This value could be falsely high if
A 58-year-old man undergoes repeat coronary artery bypass grafting. Which of the following is LEAST likely to decrease the need for exogenous blood transfusion?
(A) Cell saver blood collection before and after cardiopulmonary bypass
(B) Epsilon-aminocaproic acid administered during cardiopulmonary bypass
(C) High-dose aprotinin administered during cardiopulmonary bypass
(D) Tranexamic acid infusion during cardiopulmonary bypass
(E) Desmospressin administered after cardiopulmonary bypass
E
An 80-kg, 70-year-old woman is scheduled for a mastectomy. She has a history of congestive heart failure treated with digoxin 0.25 mg daily. Preoperative examination shows a sinus rhythm at 80 bpm and blood pressure of 110/70 mmHg. Laboratory studies show a serum potassium concentration of 4.2 mEq/L and a serum digoxin concentration of 1.5 mcg/ml. Five minutes after induction of general anesthesia, ventricular bigeminy is noted; blood pressure is 85/65 mmHg, SpO2 is 97%, and PetCO2, is 20 mmHg. Which of the following is the most appropriate management?
During open reduction of a tibial fracture, a tourniquet cuff is applied around the proximal thigh and inflated to 300 mmHg. Which of the following is most likely to prevent pain and hypertension caused by the tourniquet?
(A) Intravenous administration of fentanyl during subarachnoid block
A 45-year-old woman who sustained a subarachnoid hemorrhage 18 hours ago develops a severe headache and becomes unresponsive. Which of the following is the most likely cause of this patient's change in mental status?
During laser microsurgery of the larynx, a rubber endotracheal tube wrapped with aluminum-foil tape starts to smolder and give off smoke. The first step is to
(A) suction the endotracheal tube
(B) add helium to the inspired gas mixture
(C) remove the endotracheal tube
(D) turn off the fresh gas flow
(E) pack a saline-soaked gauze sponge into the hypopharynx