QoD 18.1

A 5 kg 3-month-old full term boy presents for right inguinal hernia repair. A caudal block is performed with 1 ml/kg 0.25% bupivacaine during sevoflurane anesthesia via an endotracheal tube. The infant's vital signs prior to injection reveal a HR of 133 bpm, SBP 83 mmHg, upright T-waves in lead II. Which of the following is the MOST appropriate test dose of epinephrine?

A 3-month-old full term boy presents for right inguinal hernia repair. He experiences an intravascular injection during the administration of a caudal the test dose. Atropine was administered 5 minutes prior to the test dose. What is the EARLIEST clinical marker of this intravascular injection of epinephrine?

A 28-year-old G1P0 woman with a history of multiple sclerosis presents to the labor and delivery unit after rupture of membranes. She is currently suffering from lower extremity sensory changes and requires an urgent cesarean section. Which of the following is the BEST option for her anesthetic?

Prostaglandin E1 is MOST appropriate for which of the following congenital cardiac lesions?

You are called to the NICU to perform an anesthetic on a 3.5 kg neonate with congenital diaphragmatic hernia. The patient is intubated with conventional mechanical ventilation. The most recent arterial blood gas reveals a pH 7.38, PaCO2 45 mmHg, PaO2 89 mmHg, HCO3 29 mEq/L, SaO2 of 97% on an FiO2 of 0.6. Peak airway pressures are 32 cmH2O with 5 cmH2O PEEP. Expiratory tidal volume is 45 ml. Which of the following is the MOST appropriate ventilatory management for this patient?

A 67-year-old, 96-kg man underwent ultrasound-guided supraclavicular blockade for a 2-hour right wrist surgery. Forty ml of 0.5% bupivacaine was injected under ultrasound guidance. In the recovery room the patient reports that his breathing does not feel "normal" and you notice that his pupil diameter is unequal with the right pupil being smaller. Vital signs include HR 65 bpm, BP 117/68 mmHg, SpO2 98% on room air. Which of the following is the BEST course of action?

According to the 2010 American Society of Regional Anesthesia (ASRA) guidelines, epidural catheter placement in obstetric patients should be delayed for at least how long after administration of a therapeutic dose of low-molecular weight heparin?

A 68-year-old man undergoes right colectomy for colorectal cancer. He had been taking clopidogrel, which was held for one week prior to surgery. Intraoperatively he is transfused one unit of PRBCs and one unit of platelets. On post-operative day 3, his hemoglobin drops from 10 to 8.2 mg/dL. He is hemodynamically stable and only complains of mild back pain. He is transfused 1 unit of PRBCs and follow-up Hgb is 8.4 mg/dL. What is the MOST likely cause for his anemia?

Two days after resection of a brain tumor through a right frontal craniotomy, a 70-year-old man has persistent postoperative delirium with waxing-waning mental status. His sodium is 136 mEq/L and glucose is 123 mg/dL. A head CT reveals some residual pneumocephalus but no hemorrhage. Which of the following is the MOST appropriate next step in his care?

A patient with an acute subdural hematoma is brought to the operating room for emergent clot evacuation. He is intubated and has a large, non-reactive right pupil suggestive of an uncal herniation syndrome. Which of the following anesthetic approaches is MOST appropriate?

In the obstetric patient, which of the following is the MOST common side effect of 100 mcg of epidural fentanyl?

An otherwise healthy 45-year-old woman is seen at an ambulatory surgical center for release of Dupuytren's contracture. A brachial plexus block is performed using the axillary approach. Assuming that no other nerve blocks are performed, and that the axillary block successfully achieves a complete motor and sensory block in its intended distribution, which of the following motor responses in the blocked extremity would MOST likely still be present?

A patient with an acute subdural hematoma is brought to the operating room for emergent clot evacuation. He is intubated and has a large, non-reactive right pupil suggestive of an uncal herniation syndrome. Which of the following anesthetic approaches is MOST appropriate?

A 26-year-old woman presents for laparoscopic cholecystectomy. She has a family history of sudden death and was found to have hypertrophic cardiomyopathy (HCM). Which of the following is a MOST correct regarding hypertrophic cardiomyopathy?

A 60-year-old man is emergently brought to the OR for right a hemicraniectomy. The patient had a right middle cerebral artery stroke two days ago and now has clinical uncal herniation syndrome (coma with blown right pupil). What are the anesthetic considerations for this procedure?