Upon removal of the epidural catheter after uneventful labor and delivery in a 25-year-old primiparous woman, approximately 1.2 cm of the Teflon catheter is left behind in the epidural space. The patient is informed of the complication. The most appropriate management is
(A) immediate surgical removal
(B) prophylactic antibiotics
(C) lumbar myelogram
(D) monthly neurologic examinations
(E) no intervention
E
Which of the following statements concerning the risk of acquiring hepatitis from a blood transfusion is true?
(A) Most patients with post-transfusion hepatitis become clinically jaundiced
(B) Most cases of post-transfusion hepatitis are caused by the hepatitis B virus
(C) The risk for hepatitis is less than the risk for AIDS
(D) The risk for post-transfusion hepatitis is less than 1% per unit transfused
(E) The incidence of post-transfusion hepatitis has remained unchanged over the past decade
The central anticholinergic syndrome is LEAST likely to occur after administration of
(A) atropine
(B) chlorpromazine
(C) diphenhydramine
(D) glycopyrrolate
(E) scopolamine
D
A 32-year-old man with acute aortic regurgitation is scheduled to undergo emergency aortic valve replacement. Heart rate is 110 bpm, blood pressure is 90/35 mmHg, and pulmonary artery occlusion pressure is 14 mmHg. Cardiac index is 2.2 L/min/m2. Which of the following is the most appropriate management?
(A) Administration of esmolol
(B) Administration of a fluid bolus before induction
(C) Infusion of dobutamine
(D) Infusion of phenylephrine
(E) Induction of anesthesia
E
During laser excision of a vocal cord polyp, the tracheal tube ignites. Which of the following is the most appropriate next step?
During transurethral resection of the prostate under spinal anesthesia with a sensory level to T10, a patient has sudden onset of sharp upper abdominal pain and nausea. Arterial blood pressure increases from 120/80 to 150/90 mmHg; the patient becomes diaphoretic. Which of the following is the most likely diagnosis?
In a 45-year-old patient with severe mitral regurgitation, which of the following is the most important hemodynamic condition to avoid during induction of anesthesia?
(A) Decreased heart rate to less than 60 bpm
(B) Increased heart rate to greater than 90 bpm
(C) Increased preload
(D) Increased afterload
(E) Enhanced myocardial contractility
D
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