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
Preoperative administration of alpha-adrenergic inhibitors will usually reverse ECG changes due to
(A) catecholamine myocarditis
(B) Preoperative administration of alpha-adrenergic inhibitors decreases operative mortality
(C) Beta-adrenergic inhibitors should be administered preoperatively only in conjunction with alpha-adrenergic
inhibitors
(D) Vasopressor therapy may be necessary postoperatively for treatment of hypotension
E
During isoflurane anesthesia, a 45-year-old patient with chronic asthma has wheezing, prolonged expiration, sinus tachycardia of 120 bpm, and premature ventricular contractions. Preoperative medication included cromolyn and theophylline. The most appropriate treatment is to administer
Following a thyroidectomy, a patient develops severe dyspnea, inspiratory stridor, and cyanosis in the recovery room. On physical examination, the neck appears full. Attempts at bag-mask ventilation are unsuccessful. Immediate therapy is to
(A) administer calcium chloride
(B) perform an emergency tracheostomy
(C) open the wound and institute bag-mask ventilation
(D) return the patient to the operating room
(E) perform endotracheal intubation
C
Three hours after total thyroidectomy, a 33-year-old man develops inspiratory stridor. The most likely cause is
(A) hematoma formation
(B) tracheomalacia
(C) tetany
(D) recurrent laryngeal nerve injury
(E) superior laryngeal nerve injury
A
Which of the following statements concerning the management of diabetes mellitus during pregnancy is true?
(A) Insulin requirements remain essentially unchanged during pregnancy
(B) Maternal blood glucose concentration of 200 mg/dL is optimal
(C) Maternal hyperglycemia may cause neonatal acidosis
(D) Neonatal hyperglycemia is common
(E) Infants delivered under general anesthesia have lower Apgar scores than those delivered under spinal anesthesia
One week after sustaining third-degree burns over 40% of his body surface area, a patient requires general anesthesia for debridement and skin grafting. Which of the following responses to neuromuscular blockers is most likely?
(A) Clinically insignificant increases in serum potassium concentration after administration of succinylcholine 1 mg/kg
(B) Increased risk of hyperkalemia after administration of succinylcholine 1 mg/kg
(C) Increased sensitivity to vecuronium
(D) Laudanosine toxicity after administration of atracurium 0.4 mg/kg
(E) Normal serum potassium concentration if administration of succinylcholine is preceded by d-tubocurarine 3 mg