You are called to anesthetize a patient for an emergency pericardial window for a large pericardial effusion. Which of the following drugs is most appropriate for initiation of anesthesia?
A previously healthy 28-year-old man is admitted to the emergency department with a probable opioid overdose. Arterial blood gas values are: PaO2 49 mmHg, PaCO2 76 mmHg, and pH 7.12 while breathing room air. Which of the following statements is true?
(A) Aspiration of gastric contents must have occurred
(B) Hypoventilation alone can explain the acidosis and hypoxemia
(C) The hypoxemia is probably due to noncardiogenic pulmonary edema
(D) Naloxone should be administered only if the patient is normothermic
In a patient with adult respiratory distress syndrome who is being mechanically ventilated, which of the following findings indicates the most severe disease?
A 4-month-old child undergoing a craniectomy for craniosynostosis is anesthetized with nitrous oxide and halothane. Suddenly the systolic blood pressure decreases from 75 to 30 mmHg, and the PetCO2 decreases from 35 to 6 mmHg. Which of the following maneuvers is LEAST likely to have a beneficial effect?
(A) Administration of a fluid bolus
(B) Administration of a vasopressor
(C) Application of positive end-expiratory pressure
(D) Discontinuation of nitrous oxide
(E) Flooding the surgical wound with saline solution
A previously healthy 26-year-old man sustains massive soft tissue injury in a motor vehicle accident. He appears to be well for 48 hours after initial resuscitation, then develops marked tachypnea. Arterial blood gas analysis would be most likely to show which of the following values? (pH, PaCO2, PaO2, FiO2)
(A) 7.53 60 75 .21
(B) 7.12 25 110 .30
(C) 7.09 60 90 .40
(D) 7.53 25 55 .80
(E) 7.28 40 195 .80
D
Nine months after sustaining an injury to the left forearm, a 30-year-old woman has diffuse, burning pain on the anterior aspect of the forearm and posterior aspect of the hand and discoloration of the skin in the affected areas. The patient should be informed that
(A) if left untreated, muscle atrophy may develop in the involved limb
(B) if left untreated, the pain will remain well localized
(C) physical therapy is not indicated
(D) the symptoms are directly related to the severity of the initial injury
(E) the symptoms are most likely secondary to underlying peripheral vascular disease