A 2.3-kg 1-day-old term infant requires repair of a gastroschisis. Which of the following combinations is most appropriate for intraoperative fluid management?
(A) Dextrose 5% in water for maintenance and lactated Ringer's solution for replacement of third space losses
(B) Dextrose 10% in water for maintenance and lactated Ringer's solution for replacement of third space losses
(C) Lactated Ringer's solution for maintenance and replacement of third space losses
(D) Lactated Ringer's solution for maintenance and albumin 5% for replacement of third space losses
(E) Normal saline solution for maintenance and lactated Ringer's solution for replacement of third space losses
During cardiopulmonary resuscitation (CPR) in an adult, external chest compression is being performed at the rate of 90/min with 2 inches of sternal depression and a compression-relaxation ratio of 20:80. The most appropriate action is to
A patient undergoes thoracotomy in the lateral decubitus position. Which of the following maneuvers is most likely to increase PaO2 during one-lung ventilation?
(A) Applying continuous positive airway pressure to the nondependent lung
(B) Applying positive end-expiratory pressure to the dependent lung
A 65-kg 70-year-old man in the PACU is breathing spontaneously at 20/min through an endotracheal tube connected to a T-piece with a fresh gas flow of 5 L/min. He has a tidal volume of 350 mL and an FiO2 of 0.5. SpO2 decreases from 98% to 84% over one hour, then improves to 92% with an FiO2 of 1.0. Which of the following is the most likely cause of the hypoxemia?
(A) Decreased functional residual capacity
(B) Increased dead space ventilation
(C) Inhibition of hypoxic pulmonary vasoconstriction
Following a thyroidectomy, a patient develops severe dyspnea, inspiratory stridor, and cyanosis in the recovery room. On physical examination, the neck appears full. Attempts at bag-mask ventilation are unsuccessful. Immediate therapy is to
(A) administer calcium chloride
(B) perform an emergency tracheostomy
(C) open the wound and institute bag-mask ventilation
(D) return the patient to the operating room
(E) perform endotracheal intubation
C
Which of the following statements concerning cerebral blood flow (CBF) during anesthesia is true?
(A) CBF changes minimally when PaC02 increases from 30 to 40 mmHg
(B) CBF changes minimally when P02 decreases from 160 to 100 mmHg
(C) CBF is autoregulated when mean arterial pressure is 40 mmHg
(D) CBF is coupled to cerebral metabolism during isoflurane anesthesia
(E) CBF is unaffected by 1.2% isoflurane at a PaC02 of 40 mmHg
B
A parturient received 1000 ml of dextrose 5% in lactated Ringer's solution 20 minutes prior to delivery. Ten minutes later her blood glucose concentration is 580 mg/dl. In this situation
(A) the risk for fetal intraventricular hemorrhage is increased
(B) the risk for neonatal hypoglycemia is increased
(C) placental glucose transport is insulin dependent
(D) the neonate should be given dextrose 50% in water if depressed at delivery
(E) the mother should be given insulin prior to delivery
A patient who has severe pain from unresectable cancer of the base of the tongue is referred for a neurolytic block. A block of which of the following will be effective?