A 34-year-old woman is recovering in the post-operative unit following a laparoscopic procedure for chronic endometriosis. She had initially presented with complaints of painful menstrual cramps that kept her bedridden most of the day. She also mentioned to her gynecologist that she had been diagnosed with endometriosis 4 years ago, and she could not find a medication or alternative therapeutic measure that helped. Her medical history was significant for surgery she had 6 years ago to remove tumors she had above her kidneys, after which she was prescribed hydrocortisone. An hour after the laparoscopic procedure, she calls the nurse because she is having difficulty breathing. The nurse records her vital signs include: blood pressure 85/55 mm Hg, respirations 20/min, and pulse 115/min. The patient suddenly loses consciousness. Intravenous fluids are started immediately. She gains consciousness, but her blood pressure is unchanged. Which of the following is the most likely cause of the hypotension?
ABleeding profusely through the surgical site
BImproper supplementation of steroids
CInfection involving the suture line
DHigh doses of anesthetic drugs
ELoss of fluids during the procedure
During a thyroidectomy, a surgeon must carefully identify and preserve the parathyroid glands. These glands are most commonly located posterior to which part of the thyroid gland?
ASuperior poles
BInferior poles
CPyramidal lobe
DMiddle third
An endocrine surgeon wants to evaluate the risk of multiple endocrine neoplasia (MEN) type 2 syndromes in patients who experienced surgical hypertension during pheochromocytoma resection. She conducts a case-control study that identifies patients who experienced surgical hypertension and subsequently compares them to the control group with regard to the number of patients with underlying MEN type 2 syndromes. The odds ratio of MEN type 2 syndromes in patients with surgical hypertension during pheochromocytoma removal was 3.4 (p < 0.01). Given the rare disease assumption, this odds ratio can be interpreted as an approximation of the relative risk. The surgeon concludes that the risk of surgical hypertension during pheochromocytoma removal is 3.4 times greater in patients with MEN type 2 syndromes than in patients without MEN syndromes. This conclusion is best supported by which of the following assumptions?
AThe case-control study used a large sample size
BThe relationship between MEN syndromes and surgical hypertension is not due to random error
CPheochromocytoma is common in MEN type 2 syndromes
DThe 95% confidence interval for the odds ratio does not include 1.0
ESurgical hypertension associated with pheochromocytoma is rare
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