A 75-year-old man with aortic stenosis and coronary artery disease has a preinduction heart rate of 68 bpm and blood pressure of 125/70 mmHg. After induction of anesthesia with fentanyl, midazolam, and pancuronium, heart rate is 90 bpm and blood pressure is 85/45 mmHg. ECG shows a new ST-segment elevation in lead II. Which of the following is the most appropriate initial management?
A 50-year-old man with severe coronary artery disease undergoes coronary artery bypass grafting. Five minutes after successful termination of cardiopulmonary bypass, ST-segment elevation is noted in lead II of the ECG, and the following findings are noted: BP 70/40, Pulse 80, CVP 16 cmH2O, PAp 25/10. Appropriate management is to
A 35-year-old man has acute onset of low back pain, lower extremity weakness, and bladder dysfunction. He had a lumbar laminectomy two years ago. A myelogram shows disk herniation at L4-5. The most appropriate management is
(A) bed rest
(B) administration of a nonsteroidal anti-inflammatory agent
Which of the following is characteristic of low back pain associated with myofascial pain syndrome but not of pain associated with a herniated lumbar disk?
(A) Loss of reflexes in the lower extremities
(B) Pain along the distribution of nerve roots
(C) Responsiveness to epidural corticosteroids
(D) Sensitivity to injection at trigger points
(E) Trophic alteration in the sympathetic nervous system
A 26-year-old patient with multiple trauma is admitted to the intensive care unit postoperatively. The early development of polyuria, hypotension, low urine sodium excretion, high serum osmolality, and normal serum creatinine concentration is best explained by
An acutely ill 65-year-old man with sepsis has severe hypophosphatemia. Which of the following is most likely to result from this electrolyte disorder?
When treating reflex sympathetic dystrophy of an arm, which of the following is the best indicator of a successful sympathetic blockade?
(A) A pinprick sensory deficit in the distribution of C6
(B) A 5°C increase in the temperature of the skin of the hand
(C) An accentuated psychogalvanometric response in the forearm
(D) An ipsilateral positive Horner's syndrome
(E) Decreased temperature sensation in the hand
B
Which of the following changes in pulmonary function best explains the more rapid rate of rise of alveolar concentration of volatile anesthetics in pregnant women than in nonpregnant women?