Undesirable muscarinic effects of anticholinesterase agents used for antagonism of muscle relaxants include each of the following EXCEPT
(A) increased secretions
(B) bradycardia
(C) increased gastrointestinal motility
(D) increased urinary sphincter tone
(E) bronchoconstriction
D
A 64-year-old, 87-kg woman in good general health is undergoing a right knee arthroplasty while in the supine position with general anesthesia consisting of enflurane 2% and nitrous oxide 50% in oxygen. She is breathing spontaneously through a 7-mm endotracheal tube. During the first 30 minutes of the procedure, the arterial oxygen saturation measured by pulse oximetry decreases from 98% to 92%. The most likely cause of the desaturation is
(A) decreased functional residual capacity
(B) diffusion hypoxia
(C) hypercarbia
(D) increased airway resistance produced by the endotracheal tube
(E) inhibition of hypoxic pulmonary vasoconstriction
A 70-kg patient is anesthetized for a craniotomy in the sitting position. Minute ventilation through a circle system is 15 L/min; PetC02 is 65 mmHg. Which of the following is the most likely cause of the increased PetC02?
(A) Inadequate flow of fresh gas
(B) Incompetent expiratory valve
(C) Intubation of the right mainstem bronchus
(D) Light anesthesia
(E) Venous air embolism
B
When antagonizing neuromuscular block produced by pancuronium, the combination of simultaneously administered anticholinergic and anticholinesterase drugs that is most likely to produce bradycardia is
A patient who is receiving ventilatory support after coronary artery bypass grafting has a PaO2 of 132 mmHg, a PaCO2 of 19 mmHg, and a pH of 7.57. Which of the following is most likely to result from this level of hypocarbia?
You are called to a witnessed cardiac arrest where cardiopulmonary resuscitation is being performed. After successful intubation, arterial blood gas values are PaO2 86 mmHg, PaCO2 63 mmHg, and pH 7.25 at an FiO2 of 1.0. The most appropriate management at this time is to
(A) repeat arterial blood gas analysis using a new specimen
(B) administer sodium bicarbonate
(C) administer fluid challenge with 500 ml of normal saline solution
A 35-year-old man has acute onset of low back pain, lower extremity weakness, and bladder dysfunction. He had a lumbar laminectomy two years ago. A myelogram shows disk herniation at L4-5. The most appropriate management is
(A) bed rest
(B) administration of a nonsteroidal anti-inflammatory agent