Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with
(A) longer duration
(B) more rapid onset
(C) more intense block
(D) more difficult reversibility
(E) similar pharmacokinetics
A
Administration of magnesium sulfate for treatment of preeclampsia results in a decreased dose requirement for each of the following drugs EXCEPT
A 40-year-old man is undergoing open reduction and internal fixation of a fractured femur. During anesthesia with fentanyl, sevoflurane, and oxygen, heart rate decreases to 20 bpm and 6 premature ventricular contractions per minute are noted. No pulse is detected. The most appropriate next step is to
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
The fail-safe mechanism on an anesthesia machine is activated by
(A) a wall-oxygen pressure of less than 25 psi
(B) a disconnection between the endotracheal tube and the machine
(C) a nitrous oxide concentration in excess of 85%
Which of the following is most likely to decrease in the affected area following a paravertebral lumbar sympathetic block?
(A) Cutaneous blood flow
(B) Pinprick sensation
(C) Sweating
(D) Temperature sensation
(E) Venous capacitance
C
A 33-year-old primigravid woman with myasthenia gravis, well-controlled with pyridostigmine, is in labor with the cervix dilated 7 cm. She has a headache and feels very nervous. Blood pressure is 160/115 mmHg, she has 3+ pitting edema, and urinalysis shows 4+ protein. Appropriate management of her labor should include
(A) lumbar epidural block with bupivacaine 8 ml of 0.5% solution
An infant with congenital lobar emphysema is scheduled for thoracotomy. Which of the following should be included in the anesthetic management of this infant?
(A) Helium-oxygen inspired gas mixture
(B) Nitrous oxide administration
(C) Positive pressure ventilation
(D) Prophylactic placement of a chest tube
(E) Spontaneous ventilation until the chest is opened
A 58-year-old man undergoes repeat coronary artery bypass grafting. Which of the following is LEAST likely to decrease the need for exogenous blood transfusion?
(A) Cell saver blood collection before and after cardiopulmonary bypass
(B) Epsilon-aminocaproic acid administered during cardiopulmonary bypass
(C) High-dose aprotinin administered during cardiopulmonary bypass
(D) Tranexamic acid infusion during cardiopulmonary bypass
(E) Desmospressin administered after cardiopulmonary bypass