The primary mechanism for pharmacologic reduction of intraoperative blood loss is
(A) decreased blood viscosity
(B) decreased cardiac output
(C) decreased venous return
(D) direct myocardial depression
(E) hypotension
E
Following paravertebral blocks of the second through fifth intercostal nerves, numbness is noted on the medial aspect of the ipsilateral arm. The most likely cause is
(A) anesthesia of the intercostobrachial nerve
(B) anxiety-induced hyperventilation
(C) injection into a dural cuff
(D) intravascular injection of local anesthetic
(E) partial block of the brachial plexus
A
Pain and spasm due to injury of the deltoid muscle is most effectively relieved by
(A) axillary block
(B) cervical sympathetic block
(C) interscalene brachial plexus block
(D) paravertebral block at C4
(E) superficial cervical plexus block
C
A 38-year-old woman with B-positive blood requires immediate blood transfusion during abdominal hysterectomy. No B-positive blood is available; O-negative blood is used. Three minutes after starting transfusion of packed red blood cells, the patient develops tachycardia, bronchospasm, and hypotension. Which of the following is the most likely cause?
(A) Anaphylactic reaction to donor IgA
(B) Bacterial contamination of transfused blood
(C) Hemolysis resulting from ABO incompatibility
(D) Hypocalcemia
(E) IgG-mediated reaction to Rh antigens
A
A 30-year-old woman undergoes thyroidectomy under general endotracheal anesthesia. Immediately after extubation while breathing spontaneously, she has laryngospasm that resolves after 60 seconds of continuous positive airway pressure applied by face mask. In the PACU, she develops shortness of breath, tachypnea, hypoxemia, and rales. Which of the following is the most likely diagnosis?
A celiac plexus block effectively relieves pain at which of the following sites?
(A) Abdominal viscera above the pelvis
(B) Parietal peritoneum above the pelvis
(C) Pelvic parietal peritoneum
(D) Pelvic viscera
(E) Visceral pleura
A
A 70-year-old man who has just undergone an abdominal aortic aneurysm repair under halothane anesthesia develops hypertension, dyspnea, and cyanosis shortly after awakening in the recovery room. Administration of furosemide 20 mg intravenously improves the cyanosis within 10 minutes. This immediate effect of furosemide is best explained by