Following induction of anesthesia with sufentanil and pancuronium, a patient with left main coronary artery disease has a decrease in blood pressure from 110/70 to 60/40 mmHg. There is no change in heart rate or ECG. The most appropriate management of the hypotension is administration of
(A) calcium chloride
(B) ephedrine
(C) epinephrine
(D) isoproterenol
(E) phenylephrine
E
A 60-year-old man undergoing resection of an abdominal aortic aneurysm has an increase in measured mixed venous oxygen saturation from 70% to 90%. Which of the following is the most likely cause?
(A) Decreased cardiac output
(B) Decreased hematocrit
(C) Intrapulmonary shunting
(D) Right to left shunting at the atrial level
(E) Wedging of the pulmonary artery catheter
E
The primary purpose of denitrogenation prior to anesthetic induction is to
(A) blunt hypoxic pulmonary vasoconstriction
(B) improve ventilation and perfusion matching
(C) increase contribution of second gas effect to rate of induction
(D) increase oxygen reserve in the functional residual capacity
A healthy, 18-year-old, 65-kg woman undergoing diagnostic laparoscopy is being monitored with a properly functioning and calibrated capnograph. The end-tidal carbon dioxide concentration is 6%, and the inspired carbon dioxide concentration is 1%. This may be caused by each of the following EXCEPT
(A) malfunction of the expiratory valve in a circle system
(B) low gas inflow with a Bain circuit
(C) exhausted soda lime within a circle system
(D) absorption of carbon dioxide from carbon dioxide laparoscopy
Which of the following is greater in an obese patient than in a nonobese patient of equal height?
(A) Milliliters of local anesthetic required for epidural block
(B) Milligrams of succinylcholine required for intubation
(C) Clearance of diazepam
(D) Clearance of fentanyl
(E) Oxygen consumption per body surface area
B
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
A 64-year-old man with a large pancreatic tumor has severe abdominal pain that radiates to the low back. Which of the following is the most appropriate management?
(A) Bilateral LI rhizotomy
(B) Dorsal column stimulation
(C) Hypogastric plexus block
(D) Neurolytic celiac plexus block
(E) Patient-controlled analgesia
D
A 60-year-old obese man who has an antithrombin III deficiency is scheduled for radical prostatectomy. Prior to the operation this patient should receive