Compared with the response of a normal patient, administration of a bolus dose of pancuronium (0.15 mg/kg) to a patient with cirrhosis and ascites would be associated with
(A) longer duration
(B) more rapid onset
(C) more intense block
(D) more difficult reversibility
(E) similar pharmacokinetics
A
Which of the following statements concerning the risk of acquiring hepatitis from a blood transfusion is true?
(A) Most patients with post-transfusion hepatitis become clinically jaundiced
(B) Most cases of post-transfusion hepatitis are caused by the hepatitis B virus
(C) The risk for hepatitis is less than the risk for AIDS
(D) The risk for post-transfusion hepatitis is less than 1% per unit transfused
(E) The incidence of post-transfusion hepatitis has remained unchanged over the past decade
A 30-year-old woman is undergoing laparoscopic tubal ligation. Thirty minutes after induction of general anesthesia, arterial oxygen saturation has decreased to 89%. Arterial blood gases at an FiO2 of 1.0 are PaO2 63 mmHg and PaCO2 40 mmHg; PetCO2 is 32 mmHg. Which of the following is the most likely cause?
(A) Carbon dioxide embolus
(B) Endobronchial intubation
(C) Hypoventilation
(D) Inadvertent application of high levels of positive end-expiratory pressure
Nine months after sustaining an injury to the left forearm, a 30-year-old woman has diffuse, burning pain on the anterior aspect of the forearm and posterior aspect of the hand and discoloration of the skin in the affected areas. The patient should be informed that
(A) if left untreated, muscle atrophy may develop in the involved limb
(B) if left untreated, the pain will remain well localized
(C) physical therapy is not indicated
(D) the symptoms are directly related to the severity of the initial injury
(E) the symptoms are most likely secondary to underlying peripheral vascular disease
A 52-year-old man develops oliguria 24 hours after left hemicolectomy. Urinalysis shows a specific gravity of 1.028, an osmolality of 650 mOsm/L, and a sodium concentration of 10 mEq/L. Which of the following is the most likely diagnosis?
(A) Acute tubular necrosis
(B) Hypoaldosteronism
(C) Hypovolemia
(D) Interstitial renal disease
(E) Obstructive uropathy
C
A 45-year-old patient with chronic alcoholism develops jaundice four days after a cholecystectomy under halothane/morphine general anesthesia. Bilirubin and alkaline phosphatase are elevated, but ALT is only slightly above normal. All values were within normal limits preoperatively. The most likely cause of jaundice is
(A) opioid-induced spasm of the sphincter of Oddi
(B) hepatic dysfunction secondary to halothane exposure
If a patient with chronic obstructive pulmonary disease is uncooperative during pulmonary function testing, the most accurate assessment of his disease will be derived from the