During pulmonary artery catheterization, a 65-year-old man receives morphine 6 mg and scopolamine 0.4 mg intravenously. The pulse oximeter indicates desaturation, which quickly resolves with stimulation. When the drapes are removed, he has unilateral eye pain, decreased visual acuity, and dilated and irregular pupils. These eye symptoms are most likely caused by
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
(A) administer thiopental
(B) decrease left ventricular afterload
(C) increase arterial blood pressure
(D) replace the left ventricular vent
(E) resume cardiopulmonary bypass
C
Each of the following is a characteristic of prostaglandin E1 (alprostadil) pharmacology in an infant EXCEPT:
(A) It is effective in the treatment of large left-to-right shunts
If administered prior to induction of anesthesia, which of the following drugs is most likely to cause tachycardia?
(A) Fentanyl
(B) Meperidine
(C) Midazolam
(D) Morphine
(E) Sufentanil
B
An anesthetized, paralyzed patient is placed in the lateral position and mechanically ventilated. End-tidal PCO2 is 34 mmHg and PaCO2 is 43 mmHg. This gradient
(A) increases during spontaneous breathing
(B) indicates increased dead space ventilation
(C) is caused by increased intrapulmonary shunt
(D) reflects inhibition of hypoxic pulmonary vasoconstriction
A 67-year-old man is undergoing total hip replacement under general anesthesia. He had a permanent endocardial VVI pacemaker placed two years ago for complete heart block, and since arrival in the operating room has been paced continuously. Use of the electrocautery causes the pacemaker to malfunction intermittently. The most appropriate management is to
(A) tape a magnet over the pacemaker generator and convert to asynchronous mode
(B) do nothing since the pacemaker is programmed to deal with this circumstance
(C) stop the surgeon from using the electrocautery
(D) limit the surgeon to 10 sec/min electrocautery bursts
(E) place the electrocautery indifferent lead as close as possible to the pacemaker