During laparotomy for a ruptured spleen, unexplained oozing occurs after infusion of 2 liters of crystalloid and 3 units of blood. The most likely cause is
During a right lower lobe resection, SpO2 decreases from 99% to 70% after institution of one-lung ventilation. FiO2 is 1.0. The most appropriate management is to
(A) administer an inhaled bronchodilator
(B) apply continuous positive airway pressure to the right lung
(C) apply positive end-expiratory pressure to the left lung
In the PACU after resection of an occipital astrocytoma, a patient has a urine output greater than 300 ml/hr, serum osmolality of 310 mOsm/L, and a hematocrit of 40% (equal to the preoperative value). Intraoperative blood loss was estimated to be 750 ml; furosemide and mannitol were administered during the procedure. The most appropriate next step is
(A) restriction of free water
(B) administration of 0.9% saline solution
(C) administration of desmopressin
(D) administration of dexamethasone
(E) CT scan of the brain
B
A parturient received 1000 ml of dextrose 5% in lactated Ringer's solution 20 minutes prior to delivery. Ten minutes later her blood glucose concentration is 580 mg/dl. In this situation
(A) the risk for fetal intraventricular hemorrhage is increased
(B) the risk for neonatal hypoglycemia is increased
(C) placental glucose transport is insulin dependent
(D) the neonate should be given dextrose 50% in water if depressed at delivery
(E) the mother should be given insulin prior to delivery
A patient with jaundice who has a minimally elevated SGOT (AST), markedly elevated alkaline phosphatase, and normal prothrombin time is to receive a muscle relaxant. Which of the following is most likely in this patient?
(D) Inhibiting sodium ion influx across the neuronal cell membrane
(E) Opening sodium channels at the nodes of Ranvier
D
Compared with a person of normal weight, which of the following findings are most likely on pulmonary function testing of a patient with morbid obesity? (FVC, FEV/FVC, FRC, A-a DO2)?