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9830 Surgery

A 54-year-old diabetic patient complaints of an unresolved skin lesion on his foot. The lesion began several weeks ago as a blister and has since become a painful, erosive, expanding sore. On examination, the affected site is now 5 cm in diameter, with a black necrotic center and raised red edges. Which toxin has a mechanism of action most similar to the toxin responsible for tissue damage in this patient?

AAnthrax toxin
BBotulinum toxin
CCholera toxin
DDiphtheria toxin
Surgery
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9837 Surgery

A 56-year-old man undergoes a left upper lobectomy. An epidural catheter is inseed for postoperative pain relief. Ninety minutes after the first dose of epidural morphine, the patient complains of itching and becomes increasingly somnolent. Blood gas measurement reveals the following: pH 7.24; PaCO2 58; Pa02 100; HCO3:28 Initial therapy should include:

AEndotracheal intubation
BIntramuscular diphenhydramine
CEpidural naloxone
DIntravenous naloxone
Surgery
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