Which of the following produces falsely high Sp02?
(A) Carboxyhemoglobin
(B) Fetal hemoglobin
(C) Hematocrit less than 20%
(D) Indigo carmine
(E) Methylene blue
D
A 66-year-old patient with aortic stenosis is scheduled for aortic valve replacement. Examination shows blood pressure of 110/60 mmHg and sinus rhythm at a rate of 75 bpm. Pulmonary artery occlusion pressure (PAOP) is 20 mmHg with a prominent a-wave on the tracing. Which of the following is the most appropriate management?
(A) Increasing myocardial contractility
(B) Maintaining PAOP below 20 mmHg
(C) Maintaining sinus rhythm
(D) Promoting mild tachycardia
(E) Decreasing peripheral resistance
C
Pulmonary artery diastolic pressure increases acutely from 10 to 20 mmHg in a 28-year-old man undergoing cervical laminectomy in the sitting position. The most appropriate first step in the management of this patient is to
(A) administer furosemide
(B) aspirate from the proximal port of the pulmonary artery catheter
(C) inflate the balloon on the pulmonary artery catheter
(D) place the patient in the left lateral decubitus position
(E) start an infusion of nitroglycerin
B
A 68-year-old man with severe depression is scheduled for electroconvulsive therapy. He had a myocardial infarction two years ago and continues to have angina on exertion. Pretreatment with which of the following drugs is most likely to maintain stability during the procedure?
(A) Esmolol
(B) Fentanyl
(C) Hydralazine
(D) Lidocaine
(E) Midazolam
A
In a patient with peripheral vascular disease, the most likely result of lumbar sympathetic block is
(A) increased blood flow to skin and decreased blood flow to muscle
(B) increased blood flow to skin and unchanged blood flow to muscle
(C) increased blood flow to skin and muscle
(D) decreased blood flow to skin and muscle
(E) decreased blood flow to skin and unchanged blood flow to muscle
Which of the following is characteristic of low back pain associated with myofascial pain syndrome but not of pain associated with a herniated lumbar disk?
(A) Loss of reflexes in the lower extremities
(B) Pain along the distribution of nerve roots
(C) Responsiveness to epidural corticosteroids
(D) Sensitivity to injection at trigger points
(E) Trophic alteration in the sympathetic nervous system