Two hours after a colon resection, a 60-year-old woman with adult-onset diabetes mellitus is somnolent and has a blood glucose concentration of 612 mg/dl. Which of the following findings are most likely? (Sodium, Osmolality, Intravascular volume)
(A) 127, 280, High
(B) 127, 310, High
(C) 127, 330, Low
(D) 140, 280, Normal
(E) 140, 300, Low
C
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
Which of the following statements concerning the ventilatory effects of inhalational anesthesia is true?
(A) Assisted ventilation is not an effective technique to achieve normocarbia
(B) Surgical stimulation does not affect ventilation
(C) Combined doses of nitrous oxide and isoflurane depress ventilation the same as an equipotent dose of isoflurane alone
(D) The ventilatory response to increasing carbon dioxide concentration is normal
(E) The ventilatory response to hypoxemia is preserved
A
Following transfusion of packed red blood cells during general anesthesia, the patient's blood pressure decreases, heart rate and temperature increase, and hemoglobinuria and diffuse oozing are observed. Which of the following is the most appropriate first step in management?
A moderately obese 38-year-old woman is using patient-controlled morphine analgesia one day after open cholecystectomy. While breathing room air, oxygen saturation is 85%, Pa02 is 48 mmHg, PaC02 is 42 mmHg, and pH is 7.36. In addition to administration of oxygen, the most effective management is to
(A) decrease the dosage of opioids
(B) change to epidural morphine
(C) administer an inhaled bronchodilator
(D) initiate 4 cm of nasal continuous positive airway pressure
(E) initiate incentive spirometry therapy
E
An infant becomes cyanotic and hypotensive after ventilatory pressures increase to 45 cm H2O during closure of the abdominal wall at the end of a gastroschisis repair. The most appropriate next step is to
(A) administer a muscle relaxant
(B) administer 5% dextrose in lactated Ringer's solution 10 ml/kg
Ninety minutes after administration of succinylcholine 1 mg/kg to a 28-year-old woman, the train-of-four shows a T4:T1 ratio of 25%. This is most consistent with