A 32-year-old man with acute aortic regurgitation is scheduled to undergo emergency aortic valve replacement. Heart rate is 110 bpm, blood pressure is 90/35 mmHg, and pulmonary artery occlusion pressure is 14 mmHg. Cardiac index is 2.2 L/min/m2. Which of the following is the most appropriate management?
(A) Administration of esmolol
(B) Administration of a fluid bolus before induction
(C) Infusion of dobutamine
(D) Infusion of phenylephrine
(E) Induction of anesthesia
E
If administered epidurally in equipotent doses, which of the following opioids will produce analgesia over the greatest number of dermatomes?
(A) Fentanyl
(B) Hydromorphone
(C) Meperidine
(D) Morphine
(E) Sufentanil
D
After the first 70 minutes of a transurethral resection of the prostate, a 70-year-old man becomes confused and has tachycardia, hypertension, and shortness of breath. Serum sodium concentration is 116 mEq/L. After informing the surgeon that the procedure should be terminated as soon as possible, the most appropriate next step would be to
(A) administer furosemide
(B) administer labetalol
(C) administer 3% sodium chloride
(D) change the irrigating solution to normal saline
A 54-year-old man is scheduled for open reduction of a fracture sustained when he jumped from a burning building. The carboxyhemoglobin concentration is 25%. Which of the following is the most reliable indicator of adequate oxygenation during general anesthesia?
(A) PaO2 of 300 mmHg
(B) pH of 7.38 with a PaCO2 of 41 mmHg
(C) Mixed venous PO2 of 45 mmHg
(D) Oxyhemoglobin saturation of 100% measured by co-oximeter
A patient is scheduled for right pneumonectomy. A left-sided double-lumen endobronchial tube is inserted. After the endobronchial side is clamped and both cuffs are inflated, breath sounds are heard only on the left. Which of the following is the most likely cause?
(A) Herniation of the endobronchial cuff over the carina
(B) Occlusion of the right upper lobe bronchus
(C) Placement of the endobronchial lumen in the left mainstem bronchus
(D) Placement of the endobronchial lumen in the right mainstem bronchus
(E) Placement of the endobronchial lumen in the trachea