A 40-year-old man is undergoing open reduction and internal fixation of a fractured femur. During anesthesia with fentanyl, sevoflurane, and oxygen, heart rate decreases to 20 bpm and 6 premature ventricular contractions per minute are noted. No pulse is detected. The most appropriate next step is to
After an uncomplicated cesarean delivery, a full-term neonate has intermittent cyanosis. Diaphragmatic effort is vigorous and respiratory distress is relieved while crying. The most likely diagnosis is
A 50-year-old man with severe coronary artery disease undergoes coronary artery bypass grafting. Five minutes after successful termination of cardiopulmonary bypass, ST-segment elevation is noted in lead II of the ECG, and the following findings are noted: BP 70/40, Pulse 80, CVP 16 cmH2O, PAp 25/10. Appropriate management is to
A 48-year-old woman with von Willebrand's disease is scheduled for a hysterectomy. The most appropriate initial preoperative therapy to decrease bleeding is administration of
A 24-year-old woman with abruptio placentae at 38 weeks' gestation has bleeding at the site of the intravenous catheter. Which of the following is the most likely cause?
(A) Diffuse vasculitis
(B) Disseminated intravascular coagulation
(C) Isolated factor VIII deficiency
(D) Primary fibrinolysis
(E) Vitamin K deficiency
B
Which of the following statements concerning functional residual capacity is true?
(A) It decreases linearly during a three-hour anesthetic
(B) It decreases in pregnancy primarily because of a decrease in the expiratory reserve volume
(C) It increases in patients with a history of heavy smoking
(D) It increases with pulmonary contusions
(E) It is smaller (ml/kg) in children than in adults
Which of the following laboratory studies is most reliable in differentiating prerenal azotemia from acute tubular necrosis?
(A) Creatinine clearance
(B) Fractional excretion of sodium
(C) Urine/plasma urea ratio
(D) Urine sodium content
(E) Urine specific gravity
B
During a reoperative total hip arthroplasty requiring transfusion of 8 units of packed red blood cells, blood begins to ooze from the operative field and intravenous catheter sites. Urine is pink. The most likely cause is