A 21-year-old athlete has laryngospasm following extubation after undergoing repair of an inguinal hernia during general anesthesia. Bag and mask ventilation relieves the patient's symptoms. In the PACU 15 minutes later, he has dyspnea; Sp02 is 85% at an Fl02 of .40. Which of the following is the most likely cause?
(A) Atelectasis
(B) Decreased cardiac output
(C) Pulmonary edema
(D) Pulmonary embolism
(E) Residual paralysis
C
On routine inspection of an anesthesia machine, the nitrous oxide E cylinder pressure is 360 psi. This indicates that the
(A) pressure in the cylinder is 16 atm
(B) cylinder contains no liquid nitrous oxide
(C) cylinder is half full
(D) cylinder contains enough nitrous oxide for one hour of anesthesia at a flow rate of 3 L/min
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?
An otherwise healthy 70-year-old man receives 12 units of packed red blood cells for persistent diffuse bleeding during suprapubic prostatectomy. Hemoglobin concentration is 11 g/dL, platelet count is 55,000/mm3, plasma fibrinogen concentration is 180 mg/dL, protime is 14 sec, and partial thromboplastin time is 35 sec. The most appropriate therapy is administration of
A 52-year-old woman undergoes facial surgery during general endotracheal anesthesia. The ventilator is set to deliver a tidal volume of 600 ml and a respiratory rate of 10/min at an FiO2 of 1.0. SpO2 is 100%, peak inspiratory pressure is 18 cmH2O, and PetCO2 is 40 mmHg. The surgeon flexes the patient's head so the chin touches the chest. Which of the following findings indicates that endobronchial intubation has NOT occurred?
(A) Fluctuating capnographic waveform
(B) Greater expiratory volume than inspiratory volume
A patient with hypokalemic familial periodic paralysis develops weakness of skeletal muscles at the end of an emergency appendectomy under spinal anesthesia. If the weakness is a result of the familial periodic paralysis, which of the following statements is true?
(A) Bicarbonate therapy is indicated
(B) Cardiac dysrhythmias are unlikely
(C) Initial treatment is intravenous edrophonium
(D) Potassium infusion is contraindicated
(E) The paralysis spares the diaphragm
E
After inserting a left-sided double-lumen endotracheal tube, both cuffs are inflated. When the right (tracheal) lumen is clamped, breath sounds are heard only in the lower right lung field. When the left (bronchial) lumen is clamped, breath sounds are heard over the entire left lung field. Where is the tube positioned?
(A) Tracheal orifice above the carina and bronchial limb in the right bronchus
(B) Tracheal orifice above the carina and bronchial limb in the left bronchus
(C) Tracheal orifice and bronchial limb both above the carina
(D) Tracheal cuff and bronchial limb both in the right bronchus
(E) Tracheal orifice and bronchial limb both in the left bronchus
A
During anesthesia using the Bain circuit
(A) PaCO2 is independent of minute volume if fresh gas flow is greater than 17 ml/kg
(B) PaCO2 is independent of fresh gas flow if minute volume is greater than 100 ml/kg
(C) PaCO2 may be normal in the presence of rebreathing
(D) carbon dioxide removal is more efficient during spontaneous ventilation than during controlled ventilation
(E) less body heat is lost than with a circle system