A child has tachypnea immediately after reintubation for intractable laryngospasm. Oxygen saturation is 78% at an FiO2 of 1.0. A radiograph of the chest taken 15 minutes later is most likely to show
(A) bilateral pleural effusions
(B) diffuse homogenous pulmonary infiltrates
(C) patchy central infiltrates of the right upper lobe
A 75-year-old man with a left bundle branch block is undergoing placement of a pulmonary artery catheter through the right internal jugular vein. He becomes pale and his heart rate decreases to 40 bpm when the catheter tip enters the right ventricle. The most likely cause is
A combined epidural and general anesthetic is used for aortofemoral bypass surgery. Just prior to extubation, the patient received morphine 5 mg through the epidural catheter. Eleven hours later, he is unresponsive while breathing 40% oxygen from a face mask. Respiratory rate is 6/min and SpO2 is 92%. Arterial blood gas analysis shows PaO2 80 mmHg, PaCO2 84 mmHg, and pH 7.16. Which of the following statements concerning this patient is true?
(A) Hypercarbia is contributing to the decreased level of consciousness
(B) Naloxone is ineffective for reversing the respiratory depression
(C) The oxygen saturation is higher than expected because of the pH
(D) The risk for respiratory depression would have been lower with subarachnoid administration of 0.5 mg morphine
(E) Residual local anesthetic is contributing to the respiratory depression
A 70-year-old patient is shivering and has chest pain in the PACU following a cholecystectomy. Heart rate is 120 bpm, and blood pressure is 220/120 mmHg. SpO2 is 97% at an FiO2 of 0.4. An ECG shows ST-T wave changes, which are not affected by intravenous administration of nitroglycerin. Which of the following is the most appropriate next step?
Characteristics of postdural puncture headache include
(A) incidence unrelated to the timing of ambulation
(B) increased severity with addition of vasoconstrictors to the anesthetic
(C) less frequent occurrence if the needle bevel is perpendicular to the direction of dural fibers
(D) more frequent occurrence in men
(E) prevention by prophylactic epidural blood patch
A
During protamine administration following separation from cardiopulmonary bypass, blood pressure decreases from 100/70 to 60/30 mmHg and peak inspiratory pressure increases from 26 to 60 cm H2O. The most appropriate next step in management is administration of
A 5-month-old infant with tetralogy of Fallot is scheduled for elective inguinal herniorrhaphy. Which of the following would require the operation to be postponed?
During rapid-sequence induction prior to an emergency surgical procedure, a 20-year-old patient vomits gastric contents containing particulate matter. An endotracheal tube is easily inserted and ventilation with pure oxygen is initiated. Despite the presence of bilateral breath sounds, SpO2 is 90%. Which of the following is the most appropriate next step?
(A) Administration of broad-spectrum antibiotics
(B) Intravenous administration of high-dose methylprednisolone