Following paravertebral blocks of the second through fifth intercostal nerves, numbness is noted on the medial aspect of the ipsilateral arm. The most likely cause is
(A) anesthesia of the intercostobrachial nerve
(B) anxiety-induced hyperventilation
(C) injection into a dural cuff
(D) intravascular injection of local anesthetic
(E) partial block of the brachial plexus
A
A rapid shallow ventilatory pattern is most energy efficient for a patient who
(A) has a low ratio of forced expiratory volume in one second to vital capacity (FEV^VC)
(B) has a high ratio of tidal volume to vital capacity, and diminished vital capacity
(C) has increased pulmonary compliance
(D) is using the accessory muscles of respiration
(E) has increased airway resistance
B
Anesthesia is induced with halothane in a 3-year-old girl. Sixty seconds after administration of succinylcholine 1 mg/kg intravenously, heart rate decreases rapidly from 120 to 60 bpm. The most likely cause is
(A) acute hyperkalemia
(B) failure to pretreat with a nondepolarizing relaxant
Six months after repair of a lacerated peroneal nerve, a patient has electric-shock-like pain when pressure is applied to the middle of the gastrocnemius muscle. The most appropriate initial management is
An obese, 35-year-old man had an episode of coughing followed by vomiting during induction of anesthesia for arthroscopy of the left knee. Intense wheezing developed bilaterally over five minutes. PaO2 is 60 mmHg, PaCO2 is 42 mmHg, and pH is 7.35. Optimal management following intubation of the trachea includes
(A) mechanical ventilation with positive end-expiratory pressure (PEEP), cancellation of surgery, and transfer to the intensive care unit
(B) saline lavage and continuation of surgery using halothane anesthesia
(C) cancellation of surgery and administration of corticosteroids and antibiotics
(D) thorough suctioning and proceeding with halothane anesthesia
(E) cancellation of surgery, vigorous mechanical ventilation, thorough suctioning, and administration of aminophylline
Prior to occlusion of any major pulmonary blood vessels during a thoracotomy, applying positive end-expiratory pressure to ventilation through the dependent lumen of a double-lumen tube and occluding the upper lumen of the tube will
(A) increase blood flow to the dependent lung
(B) increase the alveolar-arterial oxygen tension difference
A 77-year-old woman is still intubated and breathing spontaneously following a total hip replacement. The muscle relaxant has been reversed. Tidal volume is 400 ml, end-tidal carbon dioxide tension is 45 mmHg, and SpO2 is 98% at an FiO2 of 1.0. On transfer from the operating table to the gurney, heart rate increases from 65 to 100 bpm and blood pressure decreases from 130/80 to 80/50 mmHg. End-tidal carbon dioxide tension is 30 mmHg and SpO2 is 94%. The most likely diagnosis is