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4862 Surgery

An 85-year-old ventilator-dependent male was endotracheally intubated 10 days ago. He remains unresponsive and is not a candidate for early extubation. The intensive care unit (ICU) attending elects to perform tracheostomy at the bedside. During the procedure, copious dark blood is encountered. This is most likely due to transection of which of the following:

AAnterior jugular vein
BExternal jugular vein
CInternal jugular vein
DMiddle thyroid vein
Surgery
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4867 Surgery

A 55-year-old man with type II diabetes mellitus, essential hypertension, and ischemic heart disease comes to the physician for a routine examination. Laboratory studies show high serum potassium of 6 mEq/L. He has no muscle weakness and there are no changes in the ECG except for evidence of a prior inferior wall myocardial infarction. There is a mild compensated metabolic acidosis with normal serum anion gap Urine examination shows a significantly lower than expected urine potassium excretion (as measured by daily urine potassium excretion) despite an elevated serum potassium concentration. Which of the following is most likely to explain the hyperkalemia observed in this patient?

ADecreased insulin secretion
BDecreased renin secretion
CIncreased blood glucose
DIncreased BNP secretion
Surgery
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