Thirty-six hours after primary repair of meningomyelocele, a term newborn has frequent periods of apnea lasting 25 seconds and associated with oxygen desaturation to 80%. The most likely explanation is
In a patient with chronic congestive heart failure, the safest pharmacologic approach to brain swelling during a craniotomy is
(A) dexamethasone
(B) furosemide
(C) mannitol
(D) thiopental
(E) urea
B
An otherwise healthy 42-year-old woman is referred for management of pain associated with adenocarcinoma of the breast and metastasis to the anterior body of L3. She perceives the pain as moderate and currently takes no pain medication. Her oncologist estimates her life expectancy to be 18 months. The most appropriate initial management is
(A) a benzodiazepine as needed and at bedtime
(B) an oxycodone preparation as needed and a tricyclic antidepressant at bedtime
(C) intravenous patient-controlled analgesia
(D) morphine infusion via an implanted epidural catheter
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
During axillary block of the brachial plexus, which nerve is most likely to be encountered if the needle is inserted through the posterior wall of the artery?
A patient who has severe pain from unresectable cancer of the base of the tongue is referred for a neurolytic block. A block of which of the following will be effective?