(A) injection of sulfur hexafluoride for retinal tamponade
(B) repair of open eye injury
(C) scleral buckling with synthetic bands
(D) strabismus surgery
(E) trabeculectomy for glaucoma
A
Fetal distress is noted after administration of an epidural local anesthetic during labor. Fetal scalp pH is 7.0. Compared with a fetus with a scalp pH of 7.3, in this fetus the local anesthetic is present in
(A) a higher concentration, with a larger fraction in the ionized form
(B) a higher concentration, with a larger fraction in the unionized form
(C) the same concentration, with a larger fraction in the ionized form
(D) the same concentration, with a larger fraction in the unionized form
(E) a lower concentration, with a larger fraction in the ionized form
Two days after coronary artery bypass grafting, a 62-year-old man remains sedated, tracheally intubated, and mechanically ventilated with full neuromuscular block. Over the next three hours, Pa02 decreases from 90 to 70 mmHg at an Fl02 of 0.7, peak inspiratory pressure measured proximally in the ventilatory circuit increases from 40 to 66 cmH20, and plateau pressure remains unchanged at 30 cmH20. Which of the following is the most likely cause of these changes?
(A) Adult respiratory distress syndrome
(B) Bronchial mucus plugging
(C) Left ventricular failure
(D) Lobar pneumonia
(E) Tension pneumothorax
B
Which of the following is most likely to increase hepatic blood flow during general anesthesia?
(A) Addition of positive end-expiratory pressure
(B) Discontinuation of isoflurane and administration of enflurane
A 75-year-old man with aortic stenosis and coronary artery disease has a preinduction heart rate of 68 bpm and blood pressure of 125/70 mmHg. After induction of anesthesia with fentanyl, midazolam, and pancuronium, heart rate is 90 bpm and blood pressure is 85/45 mmHg. ECG shows a new ST-segment elevation in lead II. Which of the following is the most appropriate initial management?