When treating reflex sympathetic dystrophy of an arm, which of the following is the best indicator of a successful sympathetic blockade?
(A) A pinprick sensory deficit in the distribution of C6
(B) A 5°C increase in the temperature of the skin of the hand
(C) An accentuated psychogalvanometric response in the forearm
(D) An ipsilateral positive Horner's syndrome
(E) Decreased temperature sensation in the hand
B
A 20-kg, 5-year-old boy under treatment for five days for a cerebral contusion not requiring an operation is still unconscious. After three days of mechanical ventilation, humidified oxygen 40% via T-tube is started. Arterial blood gas analysis shows PaO2 120 mmHg, PaCO2 44 mmHg, pH 7.48, and base excess +6. A nasogastric tube is in place and draining to gravity. Daily fluid therapy has been 5% dextrose in 0.5 normal saline solution 500 ml and 5% dextrose in lactated Ringer's solution 500 ml. Serum electrolyte concentrations are sodium 140, potassium 3.2, and chloride 91 mEq/L. Serum osmolality is 300 mOsm/L. Urine output averages 15 ml/hour. Dexamethasone 8 mg/day has been the only drug therapy. This patient most likely requires
A patient receiving propranolol and nifedipine is scheduled for elective coronary artery bypass surgery. During induction with fentanyl and oxygen, heart rate decreases from 52 to 36 bpm and blood pressure decreases from 130/85 to 80/50 mmHg. Administration of atropine 2 mg intravenously has no effect. The most appropriate treatment at this time is administration of
A 25-year-old woman undergoes a difficult open cholecystectomy during anesthesia with isoflurane, nitrous oxide, fentanyl, and vecuronium. Five units of blood are administered intraoperatively. Two days later, the patient has mildly increased serum transaminase concentrations and markedly increased alkaline phosphatase and direct bilirubin concentrations. Which of the following is the most likely cause?
During acute normovolemic hemodilution in an adult, which of the following compensatory mechanisms is most important in maintaining tissue oxygenation?
A newly developed inhalational anesthetic has a blood-gas partition coefficient of 0.2. Which of the following statements best describes this drug compared with isoflurane?
(A) MAC is lower
(B) The difference between Fa and Fl during maintenance of anesthesia is greater
(C) Time to emergence is shorter
(D) Rapid induction requires greater overpressure
(E) Equilibrium in a circle system with the same flow of fresh gas is slower