A 5-month-old infant with tetralogy of Fallot is scheduled for elective inguinal herniorrhaphy. Which of the following would require the operation to be postponed?
A morbidly obese patient is to undergo gastric stapling during general anesthesia. Following preoxygenation and induction, the oxygen saturation decreases after 40 seconds of laryngoscopy and attempted intubation. The rapid onset of arterial desaturation is most likely due to
In a 45-year-old patient with severe mitral regurgitation, which of the following is the most important hemodynamic condition to avoid during induction of anesthesia?
(A) Decreased heart rate to less than 60 bpm
(B) Increased heart rate to greater than 90 bpm
(C) Increased preload
(D) Increased afterload
(E) Enhanced myocardial contractility
D
A patient with chronic obstructive pulmonary disease is undergoing spinal anesthesia to a T6 sensory level. The most pronounced effect on pulmonary function will be a decrease in
Pulmonary artery diastolic pressure increases acutely from 10 to 20 mmHg in a 28-year-old man undergoing cervical laminectomy in the sitting position. The most appropriate first step in the management of this patient is to
(A) administer furosemide
(B) aspirate from the proximal port of the pulmonary artery catheter
(C) inflate the balloon on the pulmonary artery catheter
(D) place the patient in the left lateral decubitus position
During a right lower lobe resection, SpO2 decreases from 99% to 70% after institution of one-lung ventilation. FiO2 is 1.0. The most appropriate management is to
(A) administer an inhaled bronchodilator
(B) apply continuous positive airway pressure to the right lung
(C) apply positive end-expiratory pressure to the left lung
After the bronchial and tracheal cuffs of a right endobronchial tube are inflated, ventilation through the tracheal lumen is not possible. This finding is most consistent with
(A) cuff occlusion of the right upper lobe bronchus
A 72-year-old woman is somnolent one day after left carotid endarterectomy. She has smoked 2 packs of cigarettes daily for 50 years. Six weeks ago, she underwent right carotid endarterectomy. At this time, arterial blood gases while breathing room air are PO2, 45 mmHg, PCO2, 60 mmHg, and pH 7.30. Which of the following is the most likely cause of the increased PCO2?
A 27-month-old, 14-kg infant with intestinal obstruction is anesthetized with nitrous oxide at 1 L/min, oxygen at 0.4 L/min, and halothane at 0.8% using a Bain circuit. Ventilation is controlled at a rate of 30/min. The child's temperature is 39°C, and the PaCO2 is 65 mmHg. Which of the following is most likely?