A 45-year-old man is scheduled for exploratory laparotomy. Six months ago, he received doxorubicin (Adriamycin) therapy for testicular cancer. This patient is at increased risk for
A 35-kg child requires mechanical ventilation with pure oxygen at a tidal volume of 350 ml and a rate of 20/min during a severe asthma attack. The most likely cause of severe hypotension after initiating mechanical ventilation is
Postoperatively, a patient is being mechanically ventilated by a constant-flow, pressure-cycled ventilator with the following initial settings: inspiratory/expiratory (I/E) ratio of 1:2, peak inspiratory pressure (PIP) of 25 cmH2O, and rate of 10/min. One hour later, the I/E ratio is 1:4. Which of the following would ensure that the minute ventilation is the same as that initially set?
(A) Inflate the endotracheal tube cuff to prevent leakage
(B) Double the respiratory rate
(C) Decrease the expiratory pause until the I/E ratio is 1.0
A patient has seizure activity 30 seconds after injection of 0.25% bupivacaine 2 ml with epinephrine 1:200,000 for stellate ganglion block. The most likely cause is
(A) reaction to epinephrine in the anesthetic 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
Having received excessive intraoperative blood replacement, a patient anesthetized with fentanyl, diazepam, and nitrous oxide develops acute pulmonary edema. The drug most likely to have an immediate beneficial effect is
(A) nitroglycerin
(B) nitroprusside
(C) digoxin
(D) isoflurane
(E) mannitol
A
The short clinical duration of action of a single dose of fentanyl is a result of its