A 15-kg, 3-year-old child is anesthetized for an inguinal hernia repair with halothane and nitrous oxide. The trachea is intubated after administration of succinylcholine 30 mg. At the conclusion of the 45-minute procedure, the child is not breathing; a peripheral nerve twitch monitor indicates no response to a train-of-four stimulus. Further investigation is most likely to show
(A) abnormal response to nondepolarizing muscle relaxants
(B) a low dibucaine number
(C) a low plasma cholinesterase concentration
(D) an underlying myopathy
(E) a positive halothane-caffeine contracture test
After a gastric stapling procedure, a 150-kg woman is extubated and breathing spontaneously in the recovery room at a rate of 26/min and an FiO2 of 0.5. Arterial blood gas analysis shows PaO2 96 mmHg, PaCO2 44 mmHg, and pH 7.37. The parameter most closely related to her increased alveolar-arterial oxygen tension gradient is
A newborn is in respiratory distress. Examination shows a scaphoid abdomen, cyanosis while breathing oxygen by mask, and heart sounds in the right hemithorax. Which of the following is the most appropriate next step?
(A) Assisted ventilation with a bag and face mask
(B) Insertion of a chest tube on the left side
(C) Insertion of a nasogastric tube
(D) Tracheal intubation and assisted ventilation
(E) Tracheal intubation and expansion of the left lung
A 30-year-old woman develops urticaria immediately after administration of 2% 2-chloroprocaine for removal of a nevus on the chest wall. This reaction resolves with administration of diphenhydramine and the surgery is rescheduled. During the second procedure, a field block is performed using 10 ml of 1% lidocaine from a multidose vial. Within 10 minutes the patient develops urticaria and wheezing and has difficulty breathing. These symptoms resolve with administration of epinephrine. Which of the following substances is the most likely cause of these reactions?
(A) A paraben derivative
(B) Povidone-iodine
(C) Ethylenediaminetetraacetic acid (EDTA)
(D) Propylene glycol
(E) Sodium bisulfite
A
When compared with a healthy 30-year-old man, which of the following respiratory parameters is decreased in an otherwise healthy 80-year-old man?
(A) Alveolar to arterial oxygen gradient
(B) Lung compliance
(C) Ratio of functional residual capacity to total lung capacity