In a patient with adult respiratory distress syndrome who is being mechanically ventilated, which of the following findings indicates the most severe disease?
(A) Decreased functional residual capacity
(B) Decreased lung compliance
(C) Hypercarbia
(D) Hypoxemia
(E) Increased dead space
C
A 37-year-old woman with pregnancy-induced hypertension develops oliguria two hours after cesarean delivery during epidural .anesthesia. Despite infusion of 2000 mL of crystalloid solution, urine output remains 10 mL/hr. Which of the following laboratory findings is most suggestive of acute tubular necrosis?
(A) Blood urea nitrogen level of 30 mg/dL
(B) Serum creatinine level of 1.2 mg/dL
(C) Urinary/plasma osmolality of 1:1
(D) Urinary sodium level of 10 mEq/L
(E) Urinary specific gravity of 1.024
C
A patient who is scheduled for emergency laparotomy for bowel obstruction has had oliguria for three hours. She has had hypertension for 10 years. Which of the following laboratory findings would indicate preoperative fluid challenge?
(A) Urine osmolality: 300 mOsm/L
(B) Urine specific gravity: 1.015
(C) Urine sodium concentration: 35 mmol/L
(D) Fractional excretion of sodium: 0.5
(E) Ratio of urine-to-plasma creatinine concentrations: 8
A patient receives remifentanil 25 mcg just before retrobulbar block with 0.25% bupivacaine 4 mL. Over the next 10 minutes, he develops apnea and loses consciousness. Which of the following is the most likely explanation?
(A) Effects of remifentanil
(B) Injection of local anesthetic into cerebrospinal fluid
A healthy 30-year-old woman is undergoing laparoscopy with carbon dioxide insufflation under nitrous oxide 50% in oxygen, isoflurane 0.5%, fentanyl 150 u.g, and controlled ventilation. During the first 15 minutes of the procedure, blood pressure decreases 30%. The most likely cause is
(A) anesthetic overdose
(B) compression of the vena cava
(C) gas embolization
(D) hypercarbia
(E) hypoxemia
B
A 70-year-old patient has absence of the left radial pulse one month after repair of an aortic aneurysm. Arterial pressure was monitored perioperatively with a 20-gauge left radial artery catheter. Which of the following statements concerning this complication is true?
(A) A preoperative Allen's test would have predicted this complication
(B) Stellate ganglion block should be performed
(C) This complication would have been less likely with an 18-gauge catheter
(D) This patient has poor collateral circulation in the hand
(E) The pulse will likely return
E
The short clinical duration of action of a single dose of fentanyl is a result of its
In an infant, spinal anesthesia to a sensory level of T8 is achieved with tetracaine administered at the L2-3 interspace. Compared with spinal anesthesia to the same sensory level in an adult, this anesthetic is associated with a