A 30-year-old primiparous woman delivered a healthy infant by cesarean section during uneventful spinal anesthesia with tetracaine 10 mg in 2 ml of 5% dextrose solution. Twelve hours after delivery she has bilateral loss of pain and temperature sensibility, but not touch, below T8 and paralysis of both legs. The most likely cause of this complication is
A 45-year-old woman with mitral stenosis is scheduled for elective mitral valve replacement. Two minutes after tracheal intubation, she develops atrial fibrillation with a ventricular response rate of 150 bpm and a decrease in blood pressure to 75/45 mmHg. Which of the following is the most appropriate first step in management?
(A) Increasing the concentration of enflurane
(B) Increasing the infusion rate of lactated Ringer's solution
(C) Intravenous administration of digoxin
(D) Intravenous administration of propranolol
(E) Electrical cardioversion
E
A 45-year-old woman undergoes aortic valve replacement for aortic stenosis. Two minutes after removal of the venous cannulae, air is noted in the arterial inflow cannula. Heart rate is 80 bpm, blood pressure is 95/60 mmHg, and cardiac index is 1.5 L/min/m2. ST-segment elevation is noted in EKG leads II, III, and aVF. The most appropriate next step is to
(A) administer thiopental
(B) decrease left ventricular afterload
(C) increase arterial blood pressure
(D) replace the left ventricular vent
(E) resume cardiopulmonary bypass
C
In a patient with asthma, which of the following drugs used to treat supraventricular tachycardia is LEAST likely to induce bronchospasm?
(A) Adenosine
(B) Edrophonium
(C) Esmolol
(D) Propranolol
(E) Verapamil
E
Epidural administration of corticosteroids is most effective in relieving pain in patients with which of the following conditions?
A patient has a decrease in heart rate from 80 to 50 bpm and a decrease in blood pressure from 140/90 to 60/40 mmHg while in the recovery room after adrenalectomy for pheochromocytoma. The most appropriate treatment is administration of
A 72-year-old woman with stable angina is undergoing bowel resection. Anesthesia is induced with etomidate. Five minutes after starting isoflurane 1% in nitrous oxide 50%, her blood pressure decreases from 110/84 to 70/40 mmHg. The most likely cause is
(A) coronary steal produced by isoflurane
(B) direct myocardial depression produced by isoflurane
(C) vasodilation produced by isoflurane
(D) adrenocortical suppression produced by etomidate