During postoperative indirect laryngoscopy, the vocal cords appear symmetric during quiet breathing and approximate to the left of midline during phonation. The most likely cause is
(A) pure abductor paralysis of the left cord
(B) pure abductor paralysis of the right cord
(C) abductor and adductor paralysis of the left cord
(D) abductor and adductor paralysis of the right cord
A neurologically intact 48-year-old woman is scheduled for removal of a parietal lobe arteriovenous malformation. The relative risk for complete resection is to be determined by a test occlusion of the feeding artery. Which of the following intraoperative monitoring techniques is most appropriate for this test?
(A) Brain stem auditory evoked potentials
(B) Cerebral blood flow using radioactive xenon
(C) EEG
(D) Evoked potentials elicited by stimulating the posterior tibial nerve
Measurement of mixed expired carbon dioxide concentration is necessary for the determination of
(A) dead space
(B) lung-thorax compliance
(C) physiologic shunt fraction
(D) diffusing capacity of the lungs
(E) ventilatory response to carbon dioxide
A
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
A 26-year-old woman has headache, nausea, and photophobia 36 hours after cesarean delivery for chorioamnionitis using subarachnoid block. Temperature is 38.8°C and leukocyte count is 14,200/mm3. Which of the following is the most appropriate next step in management?
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