Which of the following statements concerning cerebral vasospasm following intracranial hemorrhage is true?
(A) It is accompanied by paradoxical intracranial hypotension
(B) It responds to nitroprusside therapy
(C) It persists more than 48 hours after hemorrhage
(D) It is exacerbated by intravascular volume expansion
(E) It is confirmed by ST-T wave changes in the absence of myocardial ischemia
C
A 25-year-old woman undergoes a difficult open cholecystectomy during anesthesia with isoflurane, nitrous oxide, fentanyl, and vecuronium. Five units of blood are administered intraoperatively. Two days later, the patient has mildly increased serum transaminase concentrations and markedly increased alkaline phosphatase and direct bilirubin concentrations. Which of the following is the most likely cause?
A 52-year-old man develops oliguria 24 hours after left hemicolectomy. Urinalysis shows a specific gravity of 1.028, an osmolality of 650 mOsm/L, and a sodium concentration of 10 mEq/L. Which of the following is the most likely diagnosis?
(A) Acute tubular necrosis
(B) Hypoaldosteronism
(C) Hypovolemia
(D) Interstitial renal disease
(E) Obstructive uropathy
C
Which of the following is the most likely cause of the increased incidence of right ventricular failure in patients with morbid obesity?
Which of the following is the most likely effect of long-term exposure to nitrous oxide at a concentration of 50 ppm?
(A) Impaired cognitive function
(B) Inhibition of vitamin B-12 absorption
(C) Megaloblastic changes in bone marrow
(D) Teratogenesis
(E) Thrombocytopenia
C
An infant with congenital lobar emphysema is scheduled for thoracotomy. Which of the following should be included in the anesthetic management of this infant?
(A) Helium-oxygen inspired gas mixture
(B) Nitrous oxide administration
(C) Positive pressure ventilation
(D) Prophylactic placement of a chest tube
(E) Spontaneous ventilation until the chest is opened