Which of the following inhalational anesthetics best relieves left ventricular outflow obstruction in a patient with hypertrophic obstructive cardiomyopathy (IHSS)?
(A) Desflurane
(B) Halothane
(C) Isoflurane
(D) Nitrous oxide
(E) Sevoflurane
B
Which of the following statements concerning brain stem auditory evoked responses is true?
(A) They monitor cortical function
(B) They are not affected by changes in PaCO2
(C) They are not affected by mild hypothermia (34°C)
(D) They are more resistant to anesthetic effects than somatosensory evoked responses
(E) They are abolished coincident with flattening of the EEG
A 67-year-old man is undergoing total hip replacement under general anesthesia. He had a permanent endocardial VVI pacemaker placed two years ago for complete heart block, and since arrival in the operating room has been paced continuously. Use of the electrocautery causes the pacemaker to malfunction intermittently. The most appropriate management is to
(A) tape a magnet over the pacemaker generator and convert to asynchronous mode
(B) do nothing since the pacemaker is programmed to deal with this circumstance
(C) stop the surgeon from using the electrocautery
(D) limit the surgeon to 10 sec/min electrocautery bursts
(E) place the electrocautery indifferent lead as close as possible to the pacemaker
A 32-year-old man with acute aortic regurgitation is scheduled to undergo emergency aortic valve replacement. Heart rate is 110 bpm, blood pressure is 90/35 mmHg, and pulmonary artery occlusion pressure is 14 mmHg. Cardiac index is 2.2 L/min/m2. Which of the following is the most appropriate management?
(A) Administration of esmolol
(B) Administration of a fluid bolus before induction
(C) Infusion of dobutamine
(D) Infusion of phenylephrine
(E) Induction of anesthesia
E
Which of the following muscle relaxants in an ED95 dose would have the longest duration of action in a patient with renal failure?
During general anesthesia using a modern anesthesia machine, a patient's spontaneous ventilation is manually assisted with a fresh gas flow of 5 L/min. A sudden malfunction of the pressure-relief (pop-off) valve of the circle absorption system occurs, and the valve cannot be opened. The most appropriate next step is to