During repair for coarctation of the aorta in a healthy 13-year-old patient, right radial artery pressure increases from 100/60 to 105/70 mmHg after the aorta is cross clamped. This most likely indicates that
(A) collateral blood flow has decreased the hemodynamic consequences of cross-clamping
(B) left ventricular hypertrophy has decreased left ventricular compliance
(C) spinal cord blood flow is impaired
(D) the coarctation has decreased aortic diameter less than 50%
(E) the coarctation involves the origin of the right subclavian artery
A 36-year-old woman who undergoes peritoneal dialysis for chronic renal failure requires emergency surgical exploration for bowel obstruction. Serum creatinine concentration is 9.8 mg/dl and BUN concentration is 124 mg/dl. The most likely abnormality of coagulation is
(A) decreased euglobulin lysis time
(B) decreased platelet count
(C) prolonged activated partial thromboplastin time
Following cardiopulmonary bypass, right ventricular distention is noted after infusion of protamine 40 mg. Pulmonary artery pressure has increased from 25/18 to 50/30 mmHg and systemic arterial pressure has decreased from 110/65 to 0 mmHg. Which of the following is the most appropriate treatment?
(A) Administration of amrinone
(B) Administration of nitroglycerin
(C) Administration of phenylephrine
(D) Initiation of intra-aortic balloon pump assist
(E) Reheparinization and resumption of cardiopulmonary bypass
A man with alcoholic cirrhosis and a hemoglobin concentration of 10 g/dl has an intraoperative PaO2 of 75 mmHg at an FiO2 of 0.5. Which of the following is the most likely cause of the low PaO2?
The following hemodynamic values are obtained two hours after coronary artery bypass surgery: Cardiac index 1.7 L/min/m2; Pulm Art. Occ. Pressure 22 mmHg; MAP 60 mmHg; Urine volume 0.2 ml/kg/hr. The most appropriate management is
A 73-year-old woman with a preoperative serum creatinine concentration of 2.1 mg/dl develops oliguria during enflurane anesthesia. Urine sodium concentration is 10 mEq/L and urine osmolality is 450 mOsm/L. The most likely cause of these findings is