Following pneumonectomy, a paralyzed patient being mechanically ventilated has the following arterial blood gas values: PaO2 71 mmHg, PaCO2 55 mmHg, pH 7.29. SvO2 is 45%. The most likely explanation for this SvO2 is
A 34-year-old man has hyperkalemia-induced asystole. After initiating cardiopulmonary resuscitation, which of the following is the most appropriate next step in management?
(A) Administration of atropine
(B) Administration of calcium chloride
(C) Administration of sodium bicarbonate
(D) Transcutaneous pacing
(E) DC countershock at 200 joules
B
Each of the following statements about the blood supply of the spinal cord is true EXCEPT:
(A) The anterior spinal artery is made up of branches from the vertebral, intercostal, and iliac arteries
(B) The segmental blood supply of the cord depends upon the location of the arteria radicularis magna (Adamkiewicz)
(C) The posterior spinal arteries supply most of the spinal cord
(D) Obstruction of the inferior vena cava increases blood flow through the epidural venous plexus
(E) The spinal cord is supplied by one anterior spinal artery and two posterior spinal arteries
A 55-year-old patient with hypertrophic cardiomyopathy (IHSS) is undergoing bladder suspension with enflurane 1%, nitrous oxide 50%, and oxygen 50%. Junctional tachycardia and hypotension develop suddenly immediately after skin incision. The most appropriate management is to
(A) decrease enflurane concentration
(B) administer an intravenous fluid bolus
(C) administer intravenous esmolol
(D) administer intravenous phenylephrine
(E) begin nitroglycerin infusion
C
A 1150-g, 10-day-old infant is undergoing a bowel resection for necrotizing enterocolitis. Heart rate is 200 bpm and blood pressure measured through a femoral artery catheter is 45/24 mmHg. The most appropriate next step is administration of
A 68-year-old man who is scheduled for outpatient cystoscopy has non-insulin-dependent diabetes mellitus controlled with glipizide (Glucatrol) 5 mg twice daily. He has had nothing to eat since awakening this morning and has not taken glipizide today. His blood glucose level is 185 mg/dl. Before proceeding, the most appropriate management is to administer
At induction, the inspired concentration of a volatile anesthetic agent will approach its dialed concentration most rapidly if
(A) the anesthetic circuit is made of rubber rather than polyethylene
(B) the patient breathes more deeply
(C) fresh soda lime is used
(D) fresh gas flow rate is increased
(E) nitrous oxide is added to the inspired gas mixture
D
Which of the following statements concerning use of temperature-corrected blood gas measurement (pH-stat) during hypothermic cardiopulmonary bypass is true?
(A) Blood gas analysis is performed at the patient's temperature
(B) Carbon dioxide should not be added to the bypass circuit
(C) The carbon dioxide content of the patient's blood is greater than it would be without temperature correction
(D) The incidence of postoperative neurologic deficits is increased compared with the alpha-stat method
(E) The patient's temperature should be maintained above 25°C