Which of the following statements best describes the decrease in cerebral metabolic rate that occurs with administration of volatile anesthetics?
(A) It is independent of anesthetic dose
(B) It is maximal when the EEG is isoelectric
(C) It is more profound with halothane than isoflurane at equipotent doses
(D) It is not affected by enflurane-induced EEG hyperactivity
(E) It parallels changes in cerebral blood flow at mean arterial pressures of 50 to 150 mmHg
B
Each of the following conditions is a cause of agitation in a patient following transurethral resection of the prostate EXCEPT
(A) bladder distention
(B) glycine absorption
(C) inadequate analgesia
(D) serum sodium concentration of 127 mEq/L
(E) systolic pressure of 60 mmHg
D
A patient with chronic paraplegia (T4 level) is undergoing cystoscopy and removal of bladder calculi without anesthesia. After 10 minutes, blood pressure is 240/100 mmHg and pulse is 50 bpm. The most appropriate management is administration of
Which of the following findings necessitates the preoperative insertion of a ventricular pacemaker in a 48-year-old man scheduled to undergo cholecystectomy?
(A) Atrial flutter with 3:1 atrioventricular block
(B) Bifascicular (right bundle branch block and left anterior hemiblock) block
(C) Left bundle branch block with first-degree atrioventricular block
Which of the following statements concerning use of temperature-corrected blood gas measurement (pH-stat) during hypothermic cardiopulmonary bypass is true?
(A) Blood gas analysis is performed at the patient's temperature
(B) Carbon dioxide should not be added to the bypass circuit
(C) The carbon dioxide content of the patient's blood is greater than it would be without temperature correction
(D) The incidence of postoperative neurologic deficits is increased compared with the alpha-stat method
(E) The patient's temperature should be maintained above 25°C
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 75-year-old man received an uneventful epidural anesthetic for total knee arthroplasty. Twenty-four hours later he has a painless flaccid paralysis in both legs. This clinical presentation is most consistent with