A patient with a fasting blood glucose concentration of 100 mg/dl undergoes a four-hour operation under general anesthesia without intraoperative administration of glucose. On emergence the most likely finding will be
Which of the following is the most important factor affecting the incidence of postoperative pulmonary complications?
(A) Age of the patient
(B) Anesthetic technique
(C) Duration of surgery
(D) Obesity
(E) Site of the operation
E
A pulmonary artery catheter is placed in an awake patient breathing room air. Typical right ventricular and pulmonary artery pressure tracings are obtained. With the catheter balloon inflated, blood drawn from the distal port has a PaO2 of 100 mmHg, while a simultaneous radial artery sample has a PaO2 of 90 mmHg. These data indicate that the
An 8-kg, 1-year-old boy is scheduled for a bilateral inguinal hernia repair. If regional anesthesia is to be used for post-operative analgesia, which of the following statements is true?
(A) Caudal administration of 0.25% bupivacaine will provide analgesia without evidence of motor block
(B) Caudal administration of 0.125% bupivacaine is as effective as caudal administration of 0.25% bupivacaine
(C) Caudal analgesia is more difficult to achieve in young children than in adults
(D) The recommended volume of local anesthetic used for caudal analgesia in children is 3 ml per year of age
(E) The volume of 0.25% bupivacaine required for bilateral ilioinguinal and iliohypogastric nerve blocks would be too large
A 60-kg 25-year-old woman is undergoing laparoscopy in the Trendelenburg position during general anesthesia. Five minutes after peritoneal inflation, the peak airway pressure required to deliver a tidal volume of 800 ml increases from 25 cmH2O to 60 cmH2O. SpO2 decreases from 100% to 80% and systolic blood pressure increases from 110 mmHg to 140 mmHg. Which of the following is the most likely cause?
A comatose 40-year-old man is to undergo evacuation of an acute subdural hematoma. His left pupil is dilated and blood is present behind the left tympanic membrane. Each of the following is an acceptable intervention EXCEPT
(A) application of 5 cm H20 positive end-expiratory pressure
(B) blind nasotracheal intubation
(C) use of isoflurane
(D) use of nitrous oxide
(E) use of succinylcholine
B
The alveolar concentrations of anesthetics increase more rapidly in children than in adults because of a greater
(A) blood volume (per kg body mass)
(B) cardiac index
(C) MAC
(D) ratio of alveolar ventilation to functional residual capacity
A 62-year-old woman with polycythemia vera is scheduled to undergo total knee arthroplasty using a tourniquet. Preoperative hematocrit is 60%. Which of the following is the most appropriate action?
(A) Perform total knee arthroplasty without use of a tourniquet
(B) Preoperative reduction of the hematocrit to 45% to 50%
(C) Prophylactic administration of aprotonin during surgery
(D) Prophylactic administration of epsilon-aminocaproic acid during surgery
(E) Prophylactic administration of low-dose heparin during surgery
B
After two hours of anesthesia with halothane 1.2% and oxygen, nitrous oxide 75% is added to the inspired gas mixture. This addition would
(A) increase the alveolar halothane and oxygen concentrations above inspired
(B) increase the alveolar halothane concentration only
(C) cause no change in alveolar gas concentrations compared with inspired
(D) decrease alveolar oxygen concentration compared with inspired
(E) decrease alveolar oxygen and halothane concentrations below inspired