The EEG of a patient undergoing anesthesia with high-dose fentanyl would most likely show
(A) the same pattern seen with enflurane 0.5 MAC
(B) cessation of low-frequency activity
(C) accentuation of high-frequency activity
(D) uniform depression of all frequencies
(E) low-frequency, high-amplitude activity
E
A 26-year-old woman comes to a pain clinic because of pain, swelling and limitation of motion in the right knee for six months following a blow to the knee. Findings on knee arthroscopy and leg roentgenograms are normal. The best trial of therapy is
(A) right paravertebral lumbar sympathetic nerve block
(B) epidural administration of a steroid
(C) intrathecal administration of an opioid
(D) tricyclic antidepressants for one month
(E) a nonsteroidal anti-inflammatory drug for five days
A conscious patient has an acute subdural hematoma that will require surgical evacuation. Which of the following interventions to be carried out in the emergency department is most likely to decrease intracranial pressure?
(A) Having the patient hyperventilate
(B) Intravenous administration of an opioid
(C) Intravenous administration of a corticosteroid
(D) Intravenous administration of nitroprusside
(E) Intravenous administration of furosemide
E
A 72-year-old man has had residual hemiparesis since having a cerebrovascular accident three years ago. Compared with the response of the unaffected limbs to nondepolarizing muscle relaxants, the hemiparetic limbs will show
(A) the same response
(B) greater depression of tetanus
(C) greater twitch depression
(D) less twitch depression
(E) less post-tetanic facilitation
D
An 18-year-old patient with hemophilia A is scheduled for inguinal hernia repair. Preoperatively, factor VIII concentration is 60% of normal. The most appropriate management is administration of
(A) fresh frozen plasma
(B) cryoprecipitate
(C) factor VIII concentrate
(D) vitamin K
(E) none of the above
E
The most effective treatment of severe carbon monoxide poisoning in a 2-year-old child is
A 65-year-old patient with hypertrophic cardiomyopathy has chest pain prior to induction of anesthesia. Pulse is 80 bpm and blood pressure is 130/80 mmHg. The ECG (V5) shows sinus rhythm and new ST-segment depression. The most appropriate management is administration of
A 72-year-old man has massive venous hemorrhage during a radical prostatectomy. Blood pressure decreases from 110/60 to 75/30 mmHg and central venous pressure decreases from 12 to 4 mmHg. End-expiratory carbon dioxide tension decreases from 34 to 24 mmHg during constant minute ventilation. The most appropriate next step should be to
(A) apply positive end-expiratory pressure to the breathing circuit
(B) attempt to aspirate air from the central venous catheter
(C) expand intravascular volume
(D) place the patient in the Trendelenburg position
(E) turn the patient to the left lateral decubitus position
In children with preoperative upper respiratory tract infection, which of the following is associated with the greatest risk for postoperative airway obstruction?
A waste-gas scavenger has an active disposal system. Which of the following safety features is necessary to prevent removal of excess gas from the breathing circuit?