A 45-year-old woman with mitral stenosis is scheduled for elective mitral valve replacement. Two minutes after tracheal intubation, she develops atrial fibrillation with a ventricular response rate of 150 bpm and a decrease in blood pressure to 75/45 mmHg. Which of the following is the most appropriate first step in management?
(A) Increasing the concentration of enflurane
(B) Increasing the infusion rate of lactated Ringer's solution
(C) Intravenous administration of digoxin
(D) Intravenous administration of propranolol
(E) Electrical cardioversion
E
When PaO2 is increased to 300 mmHg in a healthy parturient at term, the umbilical vein PCs will
During induction of anesthesia, a 56-year-old man with small bowel obstruction vomits a large quantity of undigested food particles and presumably aspirates. After instituting ventilation with pure oxygen, the most appropriate management is to
(A) administer dexamethasone
(B) administer penicillin G
(C) perform bronchoscopy
(D) ventilate with positive end-expiratory pressure 15 cmH2O
(E) proceed with the anesthesia plan if the tracheal pH is greater than 2.5
Which of the following findings on the left is most likely to be associated with an increased risk of complications with cannulation of the left internal jugular vein compared with cannulation of the right internal jugular vein?
(A) Longer recurrent laryngeal nerve
(B) Lower location of the cupola of the pleura
(C) More acute angle between the internal jugular and innominate veins
An 8-year-old child with chronic renal failure is scheduled for an operation to create an arteriovenous fistula. Laboratory studies include: Hemoglobin 6.5 g/dl, Blood gases (breathing air) : PaO2 97 mmHg, PaCO2 29 mmHg, pH 7.30 Sodium 129 mEq/L Potassium 5.5 mEq/L Chloride 101 mEq/L Bicarbonate 15 mEq/L. Before inducing general anesthesia, which of the following abnormalities should be corrected?
(A) Anemia
(B) Metabolic acidosis
(C) Potassium concentration
(D) Anemia, metabolic acidosis, and potassium concentration
During emergency laparotomy, a patient who has been taking a monoamine oxidase inhibitor for six months develops hypotension despite adequate fluid therapy. The most appropriate management is administration of