A 14-month-old child has tetralogy of Fallot with dynamic obstruction to right ventricular outflow. Which of the following is most likely to decrease cyanosis in this child?
A 62-year-old man, who had a myocardial infarction three years ago, complicated by congestive heart failure and renal failure, is undergoing a colectomy. A pulmonary artery catheter demonstrates a cardiac output higher than measurements recorded during a cardiac catheterization two months after the infarction. Which of the following most likely contributes to the increased cardiac output?
(A) Creation of an arteriovenous fistula
(B) Increased hemoglobin concentration from 10 to 12 g/dl
(C) Stimulation of carotid body receptors
(D) Transcutaneous nitroglycerin
(E) Use of a beta-adrenergic blocker to prevent myocardial reinfarction
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
(A) administer thiopental
(B) decrease left ventricular afterload
(C) increase arterial blood pressure
(D) replace the left ventricular vent
(E) resume cardiopulmonary bypass
C
The initial reduction in core temperature during general anesthesia is caused by
(A) ablation of thermoregulatory vasoconstriction
(B) conductive heat loss
(C) evaporative heat loss in the respiratory tract
(D) neuromuscular blockade
(E) redistribution of heat from the core to the periphery
E
A 32-year-old woman sustains an injury to the left recurrent laryngeal nerve during thyroidectomy, Which of the following is the most likely postoperative finding?
(A) Adduction of the left vocal cord at rest
(B) Aphonia
(C) Aspiration caused by glottic incompetency
(D) Impaired coughing
(E) Paralysis of the left cricothyroid muscle
A
Which of the following factors is LEAST predictive of postoperative cardiac complications?
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 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