A 32-year-old man with acute aortic regurgitation is scheduled to undergo emergency aortic valve replacement. Heart rate is 110 bpm, blood pressure is 90/35 mmHg, and pulmonary artery occlusion pressure is 14 mmHg. Cardiac index is 2.2 L/min/m2. Which of the following is the most appropriate management?
(A) Administration of esmolol
(B) Administration of a fluid bolus before induction
(C) Infusion of dobutamine
(D) Infusion of phenylephrine
(E) Induction of anesthesia
E
A 40-year-old woman with Graves' disease is undergoing thyroidectomy with 1% isoflurane, 60% nitrous oxide, and oxygen. During surgical manipulation of the thyroid, temperature increases to 38.5°C, heart rate to 160 bpm, and blood pressure to 150/100 mmHg. The most appropriate initial treatment is to
A 72-year-old man has had residual hemiparesis since having a cerebrovascular accident three years ago. Compared with the response of the unaffected limbs to nondepolarizing muscle relaxants, the hemiparetic limbs will show
(A) the same response
(B) greater depression of tetanus
(C) greater twitch depression
(D) less twitch depression
(E) less post-tetanic facilitation
D
Intrabiliary pressure will be increased to the greatest extent by intravenous administration of
You see a flash of fire from the endotracheal tube of a patient undergoing carbon dioxide laser excision of laryngeal polyps. The immediate response should be to
(A) discontinue the fresh gas flow
(B) increase the nitrous oxide concentration
(C) spray water down the endoscope
(D) insert wet pads into the pharynx
(E) remove the endotracheal tube
E
In a spontaneously breathing patient, each of the following increases the work of breathing EXCEPT
(A) an increase in respiratory rate by 10/min
(B) a decrease in lung-thorax compliance by 10 cmH2O
(C) an increase in carbon dioxide production by 1 ml/kg/min
(D) a decrease in PaO2 from 80 to 65 mmHg
(E) a 0.1 increase in the ratio of dead space to tidal volume