A 50-year-old patient is undergoing middle ear exploration with isoflurane, nitrous oxide, and oxygen anesthesia. Ventilation is controlled; PetC02 is 35 mmHg, heart rate is 90 bpm, and blood pressure is 120/70 mmHg. Assistance is needed to minimize bleeding in the surgical field. Which of the following is the most appropriate next step in management?
(A) Addition of 5 cmH20 positive end-expiratory pressure
(B) Changing the anesthetic agent to halothane
(C) Hyperventilation to a PetC02 of 20 mmHg
(D) Placing the patient in reverse Trendelenburg position
(E) Titration of nitroprusside to a mean arterial pressure of 55 mmHg
D
Which of the following is the most likely cause of postural headache following spinal anesthesia?
(A) Meningeal traction
(B) Parasympathetic (vagal) block
(C) Sympathetic block-induced hypotension
(D) Transtentorial cerebral herniation
(E) Vasopressin-induced vasoconstriction
A
Which the following findings is most hazardous in premature infants?
(A) Hematocrit of 55%
(B) Rectal temperature of 35 degrees C
(C) Umbilical arterial blood PO2 of 50 mmHg
(D) Umbilical arterial blood PCO2 of 45 mmHg
(E) Umbilical arterial systolic pressure of 60 mmHg
A patient with jaundice who has a minimally elevated SGOT (AST), markedly elevated alkaline phosphatase, and normal prothrombin time is to receive a muscle relaxant. Which of the following is most likely in this patient?
A radial artery catheter is to be used for blood pressure measurement during a sitting craniotomy. When zeroing the transducer, which of the following describes the best levels for placement of the transducer and opening of the system to air? (Transducer, Opening to Air)
A patient who is scheduled for a gastrectomy had abnormal liver function tests for four days following a prior cholecystectomy. In your consultation note, you should
(A) recommend sevoflurane anesthesia since abnormal postoperative liver function tests are unlikely with this drug
(B) recommend subarachnoid anesthesia since changes in hepatic blood flow would be less than with general anesthesia
(C) indicate that abnormal liver function tests are likely to follow this operation regardless of the anesthetic drugs used
(D) require preoperative screening for hepatitis B antigen and antibodies
(E) recommend avoiding halothane since it is more likely to produce hepatitis in patients who had previous upper abdominal surgery