A 29-year-old man who has been nasotracheally intubated for two weeks following a motor vehicle accident has a fever (39C) and a constant headache. Leukocyte count is 18,000/mm3. The most likely cause is
A 58-year-old woman with rheumatoid arthritis and hyperactive gag reflex requires awake intubation prior to cervical spine stabilization. Which of the following regional nerve blocks is most appropriate?
A 16-year-old girl is receiving isoflurane, nitrous oxide, oxygen, and pancuronium for insertion of a Harrington rod. In order to perform a "wake-up test" the muscle relaxant was antagonized with neostigmine 2.5 mg and atropine 1 mg. The patient abruptly moved all extremities and was given thiopental 100 mg and succinylcholine 100 mg rapidly. Forty-five minutes later no twitch could be elicited with a nerve stimulator. The most likely explanation is
(A) a dibucaine number of 20
(B) incomplete antagonism of pancuronium
(C) prolongation of the action of succinylcholine by neostigmine
(D) spinal cord damage caused by the abrupt arousal
(E) synergism between succinylcholine and pancuronium
A 22-year-old woman at 33 weeks' gestation has abdominal pain and vaginal bleeding after sustaining blunt trauma to the abdomen. Heart rate is 125 bpm, blood pressure is 98/65 mmHg, and respiratory rate is 20/min. Fetal heart rate is 100 bpm. Which of the following is the most appropriate management?
(A) Conservative observation and monitoring if fetal immaturity is seen on ultrasound
(B) Increasing maternal blood pressure with a vasopressor
(C) Infusion of terbutaline
(D) Lumbar epidural anesthesia
(E) Urgent cesarean delivery
E
During laser excision of a vocal cord polyp, the tracheal tube ignites. Which of the following is the most appropriate next step?