In a patient with severe mitral stenosis, induction of anesthesia must include avoidance of increased
(A) airway pressure
(B) heart rate
(C) myocardial contractility
(D) right ventricular preload
(E) systemic vascular resistance
B
A 72-year-old woman with stable angina is undergoing bowel resection. Anesthesia is induced with etomidate. Five minutes after starting isoflurane 1% in nitrous oxide 50%, her blood pressure decreases from 110/84 to 70/40 mmHg. The most likely cause is
(A) coronary steal produced by isoflurane
(B) direct myocardial depression produced by isoflurane
(C) vasodilation produced by isoflurane
(D) adrenocortical suppression produced by etomidate
During uncomplicated mask induction with halothane and 50% nitrous oxide in oxygen in a 6-month-old infant with a large ventricular septal defect and valvular pulmonic stenosis, SpO2 decreases from 85% (room air) to 60%; heart rate is 100 bpm and blood pressure is 62/40 mmHg. The most appropriate management is to
A 14-month-old child has tetralogy of Fallot with dynamic obstruction to right ventricular outflow. Which of the following is most likely to decrease cyanosis in this child?
A patient with lumbar disk disease requires lumbar epidural injection of a corticosteroid for control of low back pain. Which of the following statements concerning this treatment is true?
(A) Maximum effect occurs one hour after injection
(B) Maximum effect occurs when drug concentration peaks in cerebrospinal fluid
(C) Maximum effect occurs during the acute phase of the disease
(D) The beneficial effect results primarily from sympathetic neurolysis
(E) It is contraindicated if the patient has had prior surgical procedures on the lumbar disks
C
Uterine blood flow is
(A) autoregulated in normal unanesthetized parturients
(B) decreased by the addition of epinephrine 1:200,000 to lidocaine administered epidurally
(C) decreased by intravenous infusion of ritodrine in unanesthetized parturients
(D) increased by administration of magnesium sulfate to patients with preeclampsia
(E) unchanged after paracervical injection of lidocaine without epinephrine
The severity of chronic bronchitis is best assessed by measuring
(A) tidal volume
(B) carbon dioxide diffusion capacity
(C) sputum production over 24 hours
(D) forced vital capacity
(E) arterial blood gases
E
In a patient who is receiving nitroglycerin intravenously after a coronary artery operation, peripheral oxygen saturation is 85% and PaO2 is 200 mmHg. The most appropriate management is administration of
An 18-year-old patient with hemophilia A is scheduled for inguinal hernia repair. Preoperatively, factor VIII concentration is 60% of normal. The most appropriate management is administration of