A jaundiced patient requires general anesthesia for portocaval shunt. He has a long history of alcohol abuse and is cirrhotic with ascites. Special considerations relevant to induction of anesthesia for this patient include each of the following EXCEPT:
(A) Denitrogenation by mask may be more rapid than expected
(B) The risk of aspiration is increased
(C) The dose of thiopental necessary for induction will be predictably reduced
(D) The duration of succinylcholine action may be prolonged
(E) Alfentanil would be an appropriate supplement
C
Compared with midazolam, diazepam has which of the following characteristics?
A patient develops urticaria and pruritus while receiving a blood transfusion in the PACU. Blood pressure and heart rate are unchanged from pretransfusion values. The most appropriate action is administration of
In a patient receiving an epidural analgesic infusion postoperatively, clear fluid is noted to drip back freely from the epidural catheter. Each of the following findings correctly identifies the associated fluid EXCEPT
(A) precipitation when mixed with an equal volume of thiopental — local anesthetic
To measure the contribution of intrapulmonary shunting to arterial hypoxemia, which of the following measurements are necessary? (Assume normal cardiac output and anatomy.)
(A) PaC02 and PeC02
(B) PaC02 and Pe02 while breathing pure oxygen
(C) Pa02 and Pv02 while breathing pure oxygen
(D) Pa02 while breathing both room air and pure oxygen
(E) Pa02 and PaC02 while breathing room air
C
A 27-year-old man with chronic renal failure is to undergo revision of an arteriovenous graft. He insists on general anesthesia. Hemodialysis was completed two hours ago, and serum potassium concentration is now 5 mEq/L. Which of the following statements concerning anesthetic management of this patient is true?
(A) Enflurane is contraindicated
(B) Succinylcholine is contraindicated
(C) Neostigmine will be required in larger than usual dosage
(D) The duration of action of atracurium will be prolonged
(E) The duration of action of propofol will be unchanged
E
Nine months after sustaining an injury to the left forearm, a 30-year-old woman has diffuse, burning pain on the anterior aspect of the forearm and posterior aspect of the hand and discoloration of the skin in the affected areas. The patient should be informed that
(A) if left untreated, muscle atrophy may develop in the involved limb
(B) if left untreated, the pain will remain well localized
(C) physical therapy is not indicated
(D) the symptoms are directly related to the severity of the initial injury
(E) the symptoms are most likely secondary to underlying peripheral vascular disease
A 70-year-old man sustains injuries to both carotid bodies during bilateral carotid endarterectomies performed four days apart. Two hours after the second procedure, the patient is breathing room air in the PACU. Which of the following sets (pH, pCO2, pO2) of arterial blood gas values is LEAST likely?