A 20-year-old patient undergoes a thoracic vertebral stabilization procedure six hours after sustaining an acute transection of the spinal cord at T4. The risks of general anesthesia are greater in this patient than in a patient with an intact spinal cord because of
(A) autonomic hyperreflexia
(B) increased sensitivity to vasoconstrictor agents
(C) increased venous capacitance
(D) interruption of cardiac sympathetic reflexes
(E) hyperkalemia induced by succinylcholine
C
Preoperative evaluation of a patient who has marked malnutrition will demonstrate each of the following EXCEPT
Phantom limb pain is an example of which of the following types of pain?
(A) Central pain
(B) Nociceptive pain
(C) Psychosomatic pain
(D) Sympathetically mediated pain
(E) Vasospastic pain
A
An obese, 35-year-old man had an episode of coughing followed by vomiting during induction of anesthesia for arthroscopy of the left knee. Intense wheezing developed bilaterally over five minutes. PaO2 is 60 mmHg, PaCO2 is 42 mmHg, and pH is 7.35. Optimal management following intubation of the trachea includes
(A) mechanical ventilation with positive end-expiratory pressure (PEEP), cancellation of surgery, and transfer to the intensive care unit
(B) saline lavage and continuation of surgery using halothane anesthesia
(C) cancellation of surgery and administration of corticosteroids and antibiotics
(D) thorough suctioning and proceeding with halothane anesthesia
(E) cancellation of surgery, vigorous mechanical ventilation, thorough suctioning, and administration of aminophylline
An obese, 70-year-old woman with a long history of tobacco abuse is awake and semirecumbent after uneventful anesthesia with isoflurane for a ventral hernia repair. During the first hour in the recovery room while breathing 50% oxygen by face mask, her arterial oxygen saturation decreases to 90% while other vital signs remain satisfactory. Which of the following is most likely to be effective in the management of this situation?
After an uncomplicated cesarean delivery, a full-term neonate has intermittent cyanosis. Diaphragmatic effort is vigorous and respiratory distress is relieved while crying. The most likely diagnosis is
During carotid endarterectomy, blood pressure suddenly decreases from 140/90 to 80/50 mmHg. The EKG shows a heart rate of 42 bpm, with normal sinus rhythm and occasional premature ventricular contractions. The most appropriate therapy is intravenous administration of
(A) atropine
(B) epinephrine
(C) isoproterenol
(D) lidocaine
(E) phenylephrine
A
Which of the following drugs has the shortest elimination half-life?
An otherwise healthy 20-year-old man undergoes laser surgery for vocal cord polyp removal. During jet ventilation with 100% oxygen, arterial blood gas analysis shows PaO2 90 mmHg, PaCO2 40 mmHg, and pH 7.40. Which of the following is the most likely explanation?