(A) metabolites contribute more significantly to the sedative effect
(B) elimination is less dependent on hepatic metabolism
(C) has more predictable action after intramuscular administration
(D) produces less respiratory depression
(E) produces less hypotension during induction of anesthesia with opioids
C
In the PACU after resection of an occipital astrocytoma, a patient has a urine output greater than 300 ml/hr, serum osmolality of 310 mOsm/L, and a hematocrit of 40% (equal to the preoperative value). Intraoperative blood loss was estimated to be 750 ml; furosemide and mannitol were administered during the procedure. The most appropriate next step is
(A) restriction of free water
(B) administration of 0.9% saline solution
(C) administration of desmopressin
(D) administration of dexamethasone
(E) CT scan of the brain
B
A 70-year-old patient has absence of the left radial pulse one month after repair of an aortic aneurysm. Arterial pressure was monitored perioperatively with a 20-gauge left radial artery catheter. Which of the following statements concerning this complication is true?
(A) A preoperative Allen's test would have predicted this complication
(B) Stellate ganglion block should be performed
(C) This complication would have been less likely with an 18-gauge catheter
(D) This patient has poor collateral circulation in the hand
(E) The pulse will likely return
E
A 26-year-old man is in the ICU one hour after sustaining a displaced cervical fracture at the level of C7-8 in a diving accident. Each of the following findings is consistent with this patient's injury EXCEPT
(A) bilateral paralysis of the vocal cord adductors
(B) gastric dilatation
(C) hypotension without tachycardia
(D) inward movement of the chest with inspiration
(E) normal tidal volume
A
A 45-year-old man is scheduled for exploratory laparotomy. Six months ago, he received doxorubicin (Adriamycin) therapy for testicular cancer. This patient is at increased risk for
Each of the following conditions is a cause of agitation in a patient following transurethral resection of the prostate EXCEPT
(A) bladder distention
(B) glycine absorption
(C) inadequate analgesia
(D) serum sodium concentration of 127 mEq/L
(E) systolic pressure of 60 mmHg
D
Compared with healthy persons, patients with myasthenic (Eaton-Lambert) syndrome have increased
(A) resistance to vecuronium
(B) response to neostigmine during reversal of muscle paralysis
(C) sensitivity to succinylcholine
(D) susceptibility to development of malignant hyperthermia
(E) weakness with repetitive activity
C
A previously healthy 46-year-old woman has severe substernal chest pain one hour after receiving morphine sulfate 10 mg intramuscularly for an elective cholecystectomy. Vital signs, SpO2, and findings on a five-lead ECG on the operating room monitor are within normal limits. Which of the following is the most appropriate next step?
A patient with jaundice who has a minimally elevated SGOT (AST), markedly elevated alkaline phosphatase, and normal prothrombin time is to receive a muscle relaxant. Which of the following is most likely in this patient?