Diffuse microvascular bleeding is noted in a patient who has received 25 units of whole blood for a liver resection. Platelet count is 40,000/mm3, prothrombin time is 18 sec, activated partial thromboplastin time is 54 sec, and serum fibrinogen concentration is 60 mg/dl. The most likely cause of the bleeding is
You are called to a witnessed cardiac arrest where cardiopulmonary resuscitation is being performed. After successful intubation, arterial blood gas values are PaO2 86 mmHg, PaCO2 63 mmHg, and pH 7.25 at an FiO2 of 1.0. The most appropriate management at this time is to
(A) repeat arterial blood gas analysis using a new specimen
(B) administer sodium bicarbonate
(C) administer fluid challenge with 500 ml of normal saline solution
A healthy, spontaneously breathing, supine, anesthetized patient has an arterial to end-tidal carbon dioxide tension difference of 3 mmHg. Following institution of mechanical ventilation the value increases to 12 mmHg. The most likely cause of this change is
(A) cephalad displacement of the diaphragm
(B) decreased production of carbon dioxide
(C) increased cardiac output
(D) increased shunting of blood through dependent lung zones
(E) increased ventilation of nondependent lung zones
A child has tachypnea immediately after reintubation for intractable laryngospasm. Oxygen saturation is 78% at an FiO2 of 1.0. A radiograph of the chest taken 15 minutes later is most likely to show
(A) bilateral pleural effusions
(B) diffuse homogenous pulmonary infiltrates
(C) patchy central infiltrates of the right upper lobe