(A) metabolites contribute more significantly to the sedative effect
(B) elimination is less dependent on hepatic metabolism
(C) has more predictable action after intramuscular administration
(D) produces less respiratory depression
(E) produces less hypotension during induction of anesthesia with opioids
C
A 75-year-old man is confused, restless, and disoriented two days after an aortic aneurysm repair. Serum sodium concentration is 112 mEq/L, serum osmolality is low, and urine is hypertonic. The most appropriate treatment is
(A) restriction of fluid intake
(B) administration of isotonic saline solution
(C) administration of hypertonic (3%) saline solution
(D) administration of spironolactone
(E) infusion of mannitol 25 g
C
A 60-kg, 38-year-old woman undergoes laparoscopic tubal ligation. Paralysis is maintained for one hour with infusion of succinylcholine at a rate of 10 mg/min. At the end of the procedure, respirations are shallow and tetanic fade is noted on neuromuscular stimulation. In addition to continued mechanical ventilation, which of the following is the most appropriate next step in management?
(A) Observe until the patient recovers spontaneously
Which of the following statements concerning anesthetic management for MRIs is true?
(A) ECG wires are associated with patient burns
(B) Mechanical ventilation of the lungs is not feasible
(C) Monitors with ferromagnetic components may be used
(D) Oxygen analysis of inspired gas is inaccurate
(E) Pulse oximetry is not reliable near the MR scanner
A
You see a flash of fire from the endotracheal tube of a patient undergoing carbon dioxide laser excision of laryngeal polyps. The immediate response should be to
(A) discontinue the fresh gas flow
(B) increase the nitrous oxide concentration
(C) spray water down the endoscope
(D) insert wet pads into the pharynx
(E) remove the endotracheal tube
E
Which of the following results in the greatest increase in right-to-left shunting in an infant with cyanotic heart disease?
A 55-year-old man undergoes abdominal perineal resection in the lithotomy position during combined epidural (bupivacaine 0.5%) and isoflurane anesthesia. The epidural catheter is left in place with an infusion of fentanyl 50 jug/hr. Twelve hours after surgery, the patient has left footdrop. Which of the following is the most likely explanation?
(A) Epidural hematoma
(B) Epidural opioid
(C) Inadequate padding of the knee during surgery
(D) Nerve injury from the epidural catheter
(E) Residual effects of the local anesthetic
C
Hyperkalemia in response to the administration of an intubating dose of succinylcholine is associated with each of the following disorders EXCEPT