A 38-year-old woman with hyperthyroidism is undergoing open reduction and internal fixation of a fractured humerus with isoflurane anesthesia. Intraoperatively her heart rate increases to 120 bpm with occasional premature ventricular contractions. The most appropriate therapy at this time is to
Which of the following will have the LEAST effect on the shape of the autoregulatory curve for cerebral blood flow?
(A) Isoflurane
(B) Nitroprusside
(C) Hypercarbia
(D) Essential hypertension
(E) Cerebral infarction
D
If administered epidurally in equipotent doses, which of the following opioids will produce analgesia over the greatest number of dermatomes?
(A) Fentanyl
(B) Hydromorphone
(C) Meperidine
(D) Morphine
(E) Sufentanil
D
A 46-year-old man is scheduled for repair of an inguinal hernia. Six years ago, he had an episode of malignant hyperthermia during cholecystectomy. Which of the following is the most appropriate perioperative management?
(A) Administration of a regional anesthetic
(B) Administration of dantrolene orally for two days prior to surgery
(C) Avoidance of all inhalational anesthetics except isoflurane
(D) Avoidance of ester local anesthetics
(E) Flushing the anesthesia machine with oxygen 10 L/min for a minimum of 12 hours
During surgery of the forearm under axillary block, a patient has pain in the lateral aspect of the forearm and responds by flexing the elbow. The most likely cause is inadequate block of which of the following nerves?
In a patient with adult respiratory distress syndrome who is being mechanically ventilated, which of the following findings indicates the most severe disease?
Mepivacaine 40 ml of a 1% solution with epinephrine 1:200,000 is injected into the brachial plexus sheath at the axilla after eliciting a paresthesia in the ulnar nerve distribution. Which of the following is most likely to remain intact?
(A) Adduction of the thumb
(B) Flexion at the wrist
(C) Sensation of the lateral forearm
(D) Sensation on the palmar surface of the lateral three and one half fingers
(E) Sensation on the palmar surface of the medial one and one half fingers