Appropriate anesthetic management of a patient with hypertrophic cardiomyopathy includes each of the following EXCEPT
(A) maintaining normal or slightly greater than normal preload
(B) adjusting positive airway pressure to maintain near normal venous return
(C) preference for volatile agents rather than opiates for anesthesia
(D) use of beta-adrenergic blocking agents to increase ventricular wall compliance
(E) decreasing afterload with peripheral vasodilators
E
A 25-year-old woman is receiving magnesium sulfate for eclampsia at 36 weeks' gestation. Each of the following is a maternal effect of this treatment EXCEPT
(A) sedation
(B) sensitization to depolarizing muscle relaxants
(C) sensitization to nondepolarizing muscle relaxants
(D) decreased uterine blood flow
(E) loss of deep tendon reflexes prior to significant cardiac dysfunction
D
A 68-year-old patient is undergoing total hip replacement during general anesthesia using positive pressure ventilation and neuromuscular blockade. Intraoperative monitoring shows a gradual decrease in end-tidal CO2, an increase in exhaled tidal volume, and an increase in measured FiO2. Which of the following is the most likely cause of these changes?
(A) Air entrainment around a deflated endotracheal tube cuff
(B) Channeling of the exhaled air through the carbon dioxide canister
(C) Fat embolism
(D) Inadequate muscle relaxation with spontaneous patient ventilation
A 62-year-old man is in the intensive care unit after successful craniotomy for excision of a meningioma. Blood volume is normal; laboratory studies show serum sodium concentration of 120 mEq/L, serum osmolality of 260 mOsm/L, urine sodium concentration of 50 mEq/L, and urine osmolality of 820 mOsm/L. Which of the following is the most likely explanation?
(A) Fluid overload with 5% dextrose in water
(B) Inappropriate secretion of antidiuretic hormone
Following pneumonectomy, a paralyzed patient being mechanically ventilated has the following arterial blood gas values: PaO2 71 mmHg, PaCO2 55 mmHg, pH 7.29. SvO2 is 45%. The most likely explanation for this SvO2 is
A 60-kg, 17-year-old girl with severe idiopathic scoliosis is scheduled for Harrington rod fixation. Which of the following respiratory parameters is compatible with this disorder?
(A) Alveolar-to-arterial oxygen tension difference (A-aDO2) less than 100 mmHg while breathing pure oxygen