A 65-year-old patient with hypertrophic cardiomyopathy has chest pain prior to induction of anesthesia. Pulse is 80 bpm and blood pressure is 130/80 mmHg. The ECG (V5) shows sinus rhythm and new ST-segment depression. The most appropriate management is administration of
A 70-year-old patient has absence of the left radial pulse one month after repair of an aortic aneurysm. Arterial pressure was monitored perioperatively with a 20-gauge left radial artery catheter. Which of the following statements concerning this complication is true?
(A) A preoperative Allen's test would have predicted this complication
(B) Stellate ganglion block should be performed
(C) This complication would have been less likely with an 18-gauge catheter
(D) This patient has poor collateral circulation in the hand
(E) The pulse will likely return
E
Each of the following statements about the anatomy of the autonomic nervous system is true EXCEPT:
(A) Preganglionic cell bodies are located in the central nervous system
(B) Postganglionic neurons are located in outlying ganglia
(C) The parasympathetic ganglia are located near their target organs
(D) The adrenal gland is innervated only by the sympathetic nervous system
(E) The parasympathetic nervous system has thoracic and sacral segments
The illustration depicts flow-volume loops for the same person at two different times in his life. Which of the following is indicated by the dotted loop?
A 26-year-old woman is hospitalized in early labor at 38 weeks' gestation. Vaginal bleeding occurred prior to admission. Systemic blood pressure remains 140/80 mmHg during intravenous infusion of fluids. Which of the following factors would contraindicate epidural anesthesia for labor at this time?
(A) Early fetal heart rate decelerations
(B) Hematocrit of 29%
(C) Blood pressure of 110/75 mmHg when sitting
(D) Platelet count of 100,000/mm3
(E) Increased respiratory rate
C
The laryngeal mask airway
(A) causes more hemodynamic stimulation than an oropharyngeal airway
(B) is contraindicated in patients with cervical spine instability
(C) is more easily inserted when cricoid pressure is applied
(D) may serve as a temporary airway in case of a failed rapid sequence intubation
(E) requires administration of a muscle relaxant to avoid laryngospasm during insertion
D
A 20-year-old woman with poorly controlled diabetes mellitus is scheduled for urgent drainage of an abdominal abscess. She received an initial dose of regular insulin 10 units followed by regular insulin 5 units/hr for the past five hours. Laboratory studies show serum sodium concentration 128 mEq/L, potassium 5.4 mEq/L, chloride 80 mEq/L, and glucose 750 mg/dl. The most appropriate perioperative management is
(A) addition of subcutaneous NPH insulin
(B) administration of sodium bicarbonate to correct metabolic acidosis
(C) administration of normal saline solution to correct the presumed hypovolemia
(D) administration of furosemide to correct hyponatremia
(E) infusion of 5% dextrose in 0.2% saline solution to prevent hypoglycemia
Which of the following best describes the relationship between cerebral perfusion pressure and cerebral blood flow in a patient with untreated chronic hypertension?
(A) It is constant at mean blood pressures between 50 and 150 mmHg
(B) It is linear for all blood pressures
(C) Flow versus pressure curve is hyperbolic
(D) Flow versus pressure curve is shifted to the right
(E) Flow versus pressure curve is shifted to the left