A 69-year-old woman with mitral stenosis and atrial fibrillation is scheduled for mitral valve replacement and removal of a left atrial thrombus. After administration of pancuronium, heart rate increases to 140 bpm and blood pressure decreases to 70/40 mmHg. Which of the following is the LEAST appropriate treatment?
A moderately obese 38-year-old woman is using patient-controlled morphine analgesia one day after open cholecystectomy. While breathing room air, oxygen saturation is 85%, Pa02 is 48 mmHg, PaC02 is 42 mmHg, and pH is 7.36. In addition to administration of oxygen, the most effective management is to
(A) decrease the dosage of opioids
(B) change to epidural morphine
(C) administer an inhaled bronchodilator
(D) initiate 4 cm of nasal continuous positive airway pressure
(E) initiate incentive spirometry therapy
E
Which of the following is the most important function of temperature compensation in anesthetic vaporizers?
(A) Compensation for changes in the specific heat of the anesthetic during vaporization
(B) Delivery of diluent gas at a constant temperature regardless of flow rate
(C) Increase of bypass flow when the vaporizer is cooled by high fresh gas flow
(D) Maintenance of constant anesthetic vapor output over a range of vaporizer temperatures
(E) Maintenance of constant vapor concentrations at low flow rates
A 60-year-old man undergoing resection of an abdominal aortic aneurysm has an increase in measured mixed venous oxygen saturation from 70% to 90%. Which of the following is the most likely cause?
(A) Decreased cardiac output
(B) Decreased hematocrit
(C) Intrapulmonary shunting
(D) Right to left shunting at the atrial level
(E) Wedging of the pulmonary artery catheter
E
When performed with identical doses, which of the following types of regional block is associated with the highest plasma concentration of the drug?
After brachial plexus block via an axillary approach, a patient has sensation on the dorsum of the second and third digits and is able to extend the distal phalanx of the thumb. To block the unaffected nerve, anesthetic should be injected at which of the following sites?
(A) 2 Cm lateral to the biceps tendon at the level of the elbow
(B) At the radial border of the palmaris longus tendon
(C) Between the medial epicondyle and the olecranon
(D) Between the radial artery and the styloid process
(E) Just medial to the brachial artery at the elbow