Compared with the use of epidural bupivacaine 0.25% alone, the addition of fentanyl will result in
(A) increased vagal activity
(B) increased motor block
(C) increased sympathetic block
(D) more rapid onset of analgesia
(E) no change in duration of analgesia
D
A 19-year-old college student is brought to the emergency department cyanotic and incoherent. Respiratory rate is 48/min, pulse is 140 bpm, and blood pressure is 140/85 mmHg. The only history obtainable is that he was at a party and suddenly felt sick. Cyanosis persists despite administration of pure oxygen by mask. A venous blood sample is chocolate-brown. The action most beneficial to the patient is to
(A) intubate the trachea and control ventilation
(B) perform bronchoscopy to treat foreign body aspiration
(C) obtain a pulmonary ventilation-perfusion scan
(D) administer methylene blue intravenously
(E) administer thiosulfate in normal saline solution intravenously
During rapid-sequence induction prior to an emergency surgical procedure, a 20-year-old patient vomits gastric contents containing particulate matter. An endotracheal tube is easily inserted and ventilation with pure oxygen is initiated. Despite the presence of bilateral breath sounds, SpO2 is 90%. Which of the following is the most appropriate next step?
(A) Administration of broad-spectrum antibiotics
(B) Intravenous administration of high-dose methylprednisolone
During cardiopulmonary bypass, the perfusionist notes that the mixed venous oxygen saturation has decreased from to 55%. Which of the following is the most likely cause?
(A) Administration of a nitroprusside bolus
(B) Administration of a thiopental bolus
(C) Decrease in rectal temperature from 34°C to 28°C
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 5-year-old boy is to undergo microlaryngeal carbon dioxide laser vaporization of laryngotracheal papillomas under halothane administered through a small polyvinylchloride (PVC) endotracheal tube. The diluent gas mixture LEAST likely to support laser combustion of the PVC tube is
Following extubation after nasotracheal intubation for seven days, a 35-year-old man has fever, facial pain, nasal stuffiness, and purulent nasal secretions. The most likely cause is