An acutely ill 65-year-old man with sepsis has severe hypophosphatemia. Which of the following is most likely to result from this electrolyte disorder?
A 13-year-old African American boy has severe abdominal pain after debridement of an open fracture of the lower extremity. His hemoglobin concentration is 10 g/dl and a peripheral blood smear shows elongated crescent-shaped erythrocytes. The most appropriate initial therapy is
(A) sodium bicarbonate administration
(B) dopamine infusion
(C) blood transfusion
(D) volume loading with crystalloid
(E) high-dose corticosteroid administration
D
Which of the following is the most appropriate pharmacologic therapy for trigeminal neuralgia?
Five hours after intramuscular administration of morphine 15 mg to a healthy 80-kg man, residual effects are best demonstrated by measuring the
(A) resting tidal volume
(B) resting PaC02
(C) functional residual capacity
(D) ventilatory response to rebreathing
(E) alveolar ventilation
D
During an otherwise uneventful nitrous oxide-sevoflurane anesthetic in a spontaneously breathing patient, 85% nitrous oxide is accidently administered, resulting in a PO2 of 48 mmHg. Which of the following would be expected?
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
A 7-year-old, obese, 30-kg boy was anesthetized using an adult circle system containing a 3-liter bag and mask. Induction with nitrous oxide (2 liters), oxygen (1 liter), and enflurane 3% was characterized by three minutes of hyperventilation followed by apnea. Forty-five seconds later, the child moved and became difficult to control. The most likely cause of the movement is
(A) decreased alveolar concentration of enflurane during the period of apnea
(B) excessive uptake of enflurane by the child's fat
(C) higher fresh gas flows required with use of an adult circle system in a child