A patient with hypokalemic familial periodic paralysis develops weakness of skeletal muscles at the end of an emergency appendectomy under spinal anesthesia. If the weakness is a result of the familial periodic paralysis, which of the following statements is true?
(A) Bicarbonate therapy is indicated
(B) Cardiac dysrhythmias are unlikely
(C) Initial treatment is intravenous edrophonium
(D) Potassium infusion is contraindicated
(E) The paralysis spares the diaphragm
E
When inspired anesthetic gases are humidified
(A) most particles 1 to 2 microns in size are deposited in the trachea
(B) respiratory epithelial cilia become less active
(C) alveolar water vapor pressure is unchanged
(D) respiratory heat loss is abolished
(E) sterilization of breathing apparatus is mandatory
C
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
A normotensive 66-year-old man undergoes total hip arthroplasty. Mean arterial pressure is maintained at 60 mmHg with isoflurane and labetalol; intraoperative FiO2 is 1.0. Eight units of red blood cells are administered intraoperatively because of an injury to the femoral artery. Five days later, the patient develops jaundice. Which of the following is the most likely cause of the jaundice?
A patient with a fasting blood glucose concentration of 100 mg/dl undergoes a four-hour operation under general anesthesia without intraoperative administration of glucose. On emergence the most likely finding will be
A 70-kg, 50-year-old man is scheduled for muscle flap closure of a decubitus ulcer over the sacrum. He has been quadriplegic at the level of C6-7 for six years. Which of the following is most likely to result from subarachnoid anesthesia with tetracaine 10 mg for this procedure?
A 50-year-old patient is undergoing middle ear exploration with isoflurane, nitrous oxide, and oxygen anesthesia. Ventilation is controlled; PetC02 is 35 mmHg, heart rate is 90 bpm, and blood pressure is 120/70 mmHg. Assistance is needed to minimize bleeding in the surgical field. Which of the following is the most appropriate next step in management?
(A) Addition of 5 cmH20 positive end-expiratory pressure
(B) Changing the anesthetic agent to halothane
(C) Hyperventilation to a PetC02 of 20 mmHg
(D) Placing the patient in reverse Trendelenburg position
(E) Titration of nitroprusside to a mean arterial pressure of 55 mmHg
D
Following antagonism of a nondepolarizing muscle relaxant with neostigmine, twitch height is normal. To achieve this effect, the percentage of the acetylcholine receptor pool that must be free of muscle relaxant is