In a patient with sickle cell anemia, which of the following is LEAST likely to trigger sickling?
(A) Hypothermia
(B) Increased systemic vascular resistance
(C) Low central venous pressure
(D) Low mixed venous P02
(E) Metabolic alkalosis
E
A 57-year-old man has back pain, a heart rate of 90 bpm, decreased pulse in the left arm, and blood pressure of 200/110 mmHg. During infusion of nitroprusside, heart rate increases to 115 bpm and blood pressure decreases to 140/80 mmHg. The most appropriate management at this time is administration of
Prior to occlusion of any major pulmonary blood vessels during a thoracotomy, applying positive end-expiratory pressure to ventilation through the dependent lumen of a double-lumen tube and occluding the upper lumen of the tube will
(A) increase blood flow to the dependent lung
(B) increase the alveolar-arterial oxygen tension difference
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
Alveolar partial pressure of an inhaled anesthetic rises more rapidly in a parturient at term than in a nonpregnant woman because
(A) functional residual capacity is decreased
(B) PaC02 is decreased
(C) uptake of inhaled agents by tissues is decreased
(D) cardiac output is increased
(E) physiologic dead space is increased
A
A 62-year-old patient undergoes resection of a descending thoracic aneurysm under anesthesia with morphine, nitrous oxide, oxygen, and pancuronium. In spite of normal somatosensory evoked potentials (SSEP) during the procedure, the patient has paraplegia postoperatively. The factor most likely responsible for failure to note the deficit intraoperatively is