In a patient with a history of grand mal seizures, which of the following is most useful in distinguishing a seizure from normal anesthetic emergence?
(A) Mydriasis
(B) Myoclonic activity
(C) Nystagmus
(D) Positive Babinski sign
(E) None of the above
E
Which of the following is the most likely effect of intramuscular ketamine used for induction of anesthesia in a 2-year-old child undergoing elective surgery?
A 70-year-old man undergoes cross clamping of the aorta for repair of an abdominal aneurysm. Which of the following methods is most appropriate for decreasing hypotension associated with removal of the cross clamp?
(A) Administration of a phenylephrine bolus when the cross clamp is removed
(B) Correction of any base deficit with sodium bicarbonate during clamping
(C) Decrease of anesthetic to allow blood pressure to increase to 20% above preclamp levels
(D) Volume loading to increase pulmonary artery occlusion pressure prior to removal
(E) Infusion of dopamine 10 minutes prior to removal
A direct 5-joule shock is unsuccessful in converting ventricular fibrillation occurring after discontinuation of cardiopulmonary bypass. The most appropriate next step is to
(A) administer calcium chloride
(B) administer bretylium
(C) administer regular insulin
(D) administer sodium bicarbonate
(E) increase shock energy
E
During general anesthesia using a modern anesthesia machine, a patient's spontaneous ventilation is manually assisted with a fresh gas flow of 5 L/min. A sudden malfunction of the pressure-relief (pop-off) valve of the circle absorption system occurs, and the valve cannot be opened. The most appropriate next step is to
A child undergoing general anesthesia is breathing spontaneously using the Jackson-Rees modification of the Ayres T-piece. Respiratory rate is 20/min and tidal volume is 75 ml. What is the minimum fresh gas flow required to prevent rebreathing?
A 32-year-old woman sustains an injury to the left recurrent laryngeal nerve during thyroidectomy, Which of the following is the most likely postoperative finding?
(A) Adduction of the left vocal cord at rest
(B) Aphonia
(C) Aspiration caused by glottic incompetency
(D) Impaired coughing
(E) Paralysis of the left cricothyroid muscle
A
A 26-year-old man is in the ICU one hour after sustaining a displaced cervical fracture at the level of C7-8 in a diving accident. Each of the following findings is consistent with this patient's injury EXCEPT
(A) bilateral paralysis of the vocal cord adductors