At the moment the abdomen is being insufflated, the heart rate abruptly falls from 72 to 38 and blood pressure drops. The first intervention is to:

During a parathyroidectomy, the surgeon has difficulty locating the gland and asks you to give methylene blue. Minutes later the SpO2 reads 85% with a blood pressure (124/78), EtCO2 of 38 mmHG and heart rate (66) are stable and breath sounds are clear. Which is the most appropriate action?

A patient with severe acute pancreatitis is hypotensive with a heart rate of 120, a high cardiac output, and low systemic vascular resistance. Which best explains the hemodynamic picture?

A cirrhotic patient has a coagulopathy from impaired hepatic synthesis. Which factor is preserved rather than reduced?

Which findings would appropriately shift a planned laparoscopic cholecystectomy to an open approach? (Select 2 of 4)

You relieve an SRNA you are precepting during a hepatic resection. Vitals: HR 72, BP 104/60, SpO₂ 99%, CVP 2 mmHg. The patient is at 0.7 MAC on a combination of sevoflurane and nitrous oxide with a remifentanil infusion. What change would you make?

A patient on warfarin and phenytoin needs preoperative acid suppression. Which agent is most likely to prolong the effects of these drugs, and why?

Which volatile agent is best avoided in a patient with significant liver disease?

During open common bile duct exploration the surgeon requests an agent to relax the sphincter of Oddi. Which agent would you give?

A 22-year-old with no known medical history presents for knee arthroscopy. You notice scleral icterus, and on interview the patient reports general fatigue over the past 3 days and right upper quadrant pain. Labs show AST 950 and ALT 1100. You decide to: