Which of the following findings is an early indication of cyanide toxicity?
(A) Bronchospasm
(B) Cardiac dysrhythmias
(C) Decreased mixed venous P02
(D) Increased intracranial pressure
(E) Metabolic acidosis
E
Four days after mitral valve replacement, a 49-year-old, 70-kg woman who has had oliguric renal failure since the operation requires insertion of a Schribner shunt for hemodialysis. Her BUN concentration is 104 mg/dl, serum creatinine is 9.3 mg/dl, serum sodium is 130 mEq/L, and serum potassium is 6.7 mEq/L. During the operation under local anesthesia, diazepam 7.5 mg and morphine 10 mg are administered intravenously to control agitation. Five minutes later while she is sleeping quietly, unifocal premature ventricular contractions appear at a rate of 10 per minute on the ECG monitor. The most appropriate therapy is to
(A) administer calcium gluconate 250 mg intravenously
Following blunt trauma to the chest, a patient has tachycardia, hypotension, and markedly distended neck veins. Each of the following is expected EXCEPT
(A) cardiac output of 2.1 L/min
(B) mixed venous oxygen saturation of 75%
(C) pulmonary artery occlusion pressure of 25 mmHg
(D) pulmonary artery diastolic pressure of 25 mmHg
An air/oxygen blender with E-size cylinders is supplying gas to a Mapleson D circuit being used to ventilate a neonate during transport. The air tank is full (psi= 1900/625 L) and flow is 4 L/min. The oxygen tank flow is 5 L/min and the pressure gauge indicates 500 psi. If the flow rates remain unchanged, which of the following statements is correct?
(A) The air tank will be empty in 90 minutes
(B) The oxygen tank will be empty in 30 minutes
(C) The concentration of oxygen in the circuit is 60%
(D) The oxygen tank will fill with air when the pressure gauge falls below 50 psi
(E) The volume of oxygen remaining can be determined only by weighing the tank
Which of the following factors will slow the induction of anesthesia in patients receiving volatile anesthetics?
(A) Addition of 70% nitrous oxide
(B) Increased cardiac output
(C) Increased minute ventilation
(D) Low blood/gas solubility coefficient
(E) Previous pneumonectomy
B
A 62-year-old man is undergoing elective coronary artery bypass grafting and aortic valve replacement for three-vessel coronary artery disease and aortic stenosis. Shortly after intubation, heart rate increases from 75 to 100 bpm and blood pressure decreases from 130/70 to 70/40 mmHg with acute, severe ST-segment depression in lead V5. Which of the following is the most appropriate management?
A 40-year-old woman receives alfentanil 75 mcg/kg followed by an infusion of 1.5 mcg/kg/min for a one-hour cholecystectomy and cholangiogram. This regimen could be associated with each of the following EXCEPT