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Q1. What is the best airway management for
sleeve resection of the right upper lobe?
1. Endotracheal tube
2. Right sided DLT
3. Left sided endobronchial tube
4. Univent tube (i.e. single lumen ETT with internal bronchial blocker)
5. Left sided single lumen endobronchial tube
2. All of the following affect vapourizer output except
1. Temperature
2. Flow
3. Barometric pressure
4. Intermittent back pressure
5. Composition of the carrier gas
3. Which is a reason why FA/FI rises faster in pediatric patients?
1. Smaller volume of vessel rich tissues
2. Lower minute ventilation per kilo
3. Higher cardiac output
4. Lower FRC
5.
4. Why is ketamine a good drug to use in congenital heart disease?
1. Causes minimal increase in hypoxic pulmonary vasoconstriction
2. Incidence of dreams is only 25-30%
3. Maintains cardiac output by reducing afterload
4. Reliably blunts airway reflexes
5.
5. Which of the following is not useful in the management of a child
with a TET spell?
1. Bicarbonate
2. Morphine
3. Neosynephrine
4. Propranolol
5. Furosemide
6. Which of the following is most sensitive to the effects of
halothane / oxygen anaesthesia?
1. PaCO2
2. Response to hypercarbia
3. Ventilatory response to hypoxia
4. Minute ventilation
5. Apneic threshold
7. All are true of untreated pyloric stenosis except
1. Hypovolemia
2. Distended stomach
3. Metabolic alkalosis
4. Hyperkalemia
5. Metabolic acidosis
8. A head trauma patient in the ICU opens eyes to pain, has no verbal
response and flexes to pain. What
is the GCS?
1. 3
2. 4
3. 5
4. 6
5. 8
9. What is the mechanism of action of mannitol in decreasing cerebral
edema?
1. ? intravascular volume with volume depletion and dehydration
2. ? fluid from edematous, damaged tissue
3. ? fluid from normal brain tissue
4. ? viscosity
10. What nerve leaves the brachial plexus from the superior trunk
before it divides into the anterior and posterior divisions?
1. Long thoracic n.
2. Axillary n.
3. Musculocutaneous n.
4. Subscapular n.
5. Suprascapular n.
11. The effects of anaesthesia on FRC.
1. FRC declines gradually during anaesthesia
2. FRC takes 30 to 60 minutes to decline maximally
3. ? activity of expiratory muscles will ? the reduction in FRC
4. Effect on FRC is independent of muscle relaxant being present
5. Inhalational of high FiO2 accelerates the fall in FRC
12. A PA catheter is inserted with the patient in the supine position
for right pneumonectomy / ?lobectomy.
Which of the following is true when the patient is in the left
lateral decubitus position with the right lung deflated?
1. The tip of the catheter is in zone 3
2. The tip of the catheter will be in the dependent lung
3. Thermodilution CO will be increased
4.
5.
13. The most likely cause for a decreased SvO2.
1. Anemia
2. Cirrhosis
3. Sepsis
4. Cyanide toxicity
5. Inadvertent wedging of the PA catheter
14. All of the following are associated with hypokalemia except
1. Primary hyperaldosteronism
2. Cushings disease
3. RTA
4. Lactic acidosis
5. Ureterosigmoidostomy
15. Which of the following is associated with a non-anion gap
acidosis.
1. Hyperosmolar ketosis
2. Chronic carbonic anhydrase use
3. Salicylates
4. Acute renal failure
5. Vomiting
16. All contibute to a ? saturation in an infant vs. an adult except.
1. ? FRC
2. ? closing capacity
3. ? physiologic deadspace
4. ? physiologic shunt
5. ? O2 consumption
17. Which is least likely to increase physiologic deadspace?
1. High tidal volumes
2. Low CO
3. Amniotic embolism
4. Severe anemia
5. PEEP
5.
18. Appropriate management of the airway in a right pneumonectomy
patient who develops a right bronchopleural fistula 3 days post-op.
1. Single lumen tube
2. Left sided DLT
3. Right sided DLT
4. Univent tube (i.e. internal bronchial blocker)
5. Single lumen tube with an external bronchial blocker (Fogarty catheter)
19. Which is not an antifibrinolytic?
1. Aprotinin
2. Aminocaproic acid
3. Transexamic acid
4. DDAVP
5. Erythropoitin
20. What is the landmark separating the high pressure from the low
pressure system in the anaesthetic machine?
1. DISS line insertion
2. 2nd stage pressure regulator
3. Flow meters
4. Machine outlet check valve
5. FGF outlet
21. Which of the following may result when the
O2 flush valve is activated
1. Barotrauma during the expiration phase of the ventilator cycle
2. Get 15 L/min O2 from the FGF outlet
3. Expose the flowmeter to high pressure
4. ? patient awareness with overzealous flushing
5. Good check of the low pressure system
22. Regarding a Hep C needlestick.
1. Chronic carrier state in < 20%
2. Transmission < 4%
3. No association with hepatocellular carcinoma
4. No chronic carrier state exists
5. Ig therapy is ineffective
23. Hemodynamic instability on dialysis contributed to by
1. HCO3 in dialysate
2. Severe anemia
3. Histamine response
4. ? baroreceptor response in uremic patients
5.
24. In order to adequately block the shoulder you need
1. C3-6, T1-2
2. C3-7,
3. C3-8, T1-2
4. C5-8
5. C5-8, T1-2
25. Where can the musculocutaneous nerve be blocked?
1. At the elbow lateral to the olecranon
2. At the elbow lateral to the biceps tendon
3. At the elbow medial to the brachial artery
4. At the wrist between the palmaris longus and the flexor carpi radialis
5. At the wrist by the extensors of the thumb
26. Concerning the epidural opioids
1. Infusion has less side-effects than bolus
2. Bolus provides better analgesia than infusion
3. Distension of the epidural space will ? uptake
4.
5.
27. Regarding HIV transmission in the medical community.
1. Recombinant DNA vaccine exists
2. Anaesthesia has the highest incidence
3. Aerosol transmission is common in the operating room
4. Incubation period is 60-180 days
5.
28. At anesthetic doses thiopental causes and increase in
1. Cerebral blood volume
2. CPP
3. CBF
4. ICP
5. CMRO2
29. All of the following would be appropriate in the management of an
elective cerebral aneurysm clipping in a patient with normal ICP except
1. Hyperventilation
2. Mannitol after the dura is opened
3. Avoid precipitous ? in blood pressure
4. Hypotension prior to aneurysm clipping
4.
5. Osmotherapy
30. In left to right shunt all except
1. Hypoxia
2. Faster IV induction
3. Faster inhalational induction
4. ? pulmonary blood flow
5. LV overload
31. Hypocalcaemia during blood transfusion is most likely to occur
with
1. Transfusion at 100 cc/h
2. Hyperthermia
3. Shortened QT interval
4. Hypovolemic shock
5. Clamping of the porta hepatis
32. Regarding cranial nerve IX all true EXCEPT
1. Supplies sensation to the entire pharynx except the tonsils
2. Passes through the jugular foramen
3. Sensory to the posterior 1/3 of the tongue
4. carries nerve supply to otic ganglion
5.
33. All of the following are true concerning the muscles of the
pharynx except
1. Close during deglutination
2. Aid with coughing
3. All are innervated by the recurrent laryngeal nerve
4.
5.
34. During retrobulbar block, the risk of ocular damage is decreased
by
1. Looking superior/nasal during the block
2. Using a sharp long beveled needle
3. Short ocular axis
4. Previous scleral buckle
5. Deeper needle penetration
35. What is the GFR of a term infant compared with an adult?
1. 5%
2. 25%
3. 75%
4. 100%
5. 125%
5.
36. Ischemia in the RCA shows up in which ECG lead?
1. AVL
2. I
3. II
4. V5
5. V6
37. Captopril in CHF - CVS effects
1. ? MVO2
2. ? SV
3. ? CO
4. ? EF
5. ? SWI
38. Amrinone in CHF - CVS effects
1. ? dP/dT
2. ? slope (left shift) LV end systolic pressure/volume curve
3. ? MVO2
4.
5.
39. An AV sequential pacemaker which senses the ventricle and does
not pace when an R wave is present. It
also monitors patient activity and adjusts the rate accordingly.
1. VDIR
2. DVIR
3. VVIR
4. DDDM
5. DVIM
40. Which of the following factors is important in the spread of
local anaesthetics in the intrathecal space?
1. Patient height
2. Needle direction
3. Dose
4. Intra-abdominal pressure
5. Volume
41. Comparing alcohol with phenol neurolytic
blocks
1. Must wait 24 hours to determine the final effect of the block
2. Alcohol is more painful than phenol
3. Compared with phenol, an alcohol block is more permanent
4. Neurolytic block damages neural tissue indiscriminantly
5. Neurolysis may cause a denervation dysesthesia which is worse than the
original pain
5.
42. All of the following are true concerning the flowmeter
arrangement except
1. All are colour coded
2. The O2 knob does not protrude more than the others
3. As you look at the machine the O2 is on the far right
4. Each flow meter tube is uniquely fluted
5.
43. Given the following data what FiO2 is required to give a PaO2 =
100mmHg if the A-a gradient remains unchanged?
FiO2 = 1.0 PaO2 = 200 mmHg Pb = 760 PH2O = 50 PaCO2
= 40 R = 0.8
1. .7
2. .45
3. .85
4. .9
5. .5
44. Given SaO2 = 100%, SvO2 = 40%, CO = 5L/min, Hb = 100g/L what is
the approximate VO2?
1. 250 ml/min
2. 300 ml/min
3. 350 ml/min
4. 400 ml/min
5. Need more information to calculate
45. Which of the following would be unusual in a 3.5 kg term baby
born 5 minutes ago by c-section?
1. Minute ventilation = 600 ml/min
2. Umbilical artery gases with pH = 7.35 and PaCO2 = 39
3. Acrocyanosis
4.
5.
46. What is the first step in the metabolism of amide local
anaesthetics?
1. Plasma hydolysis
2. Glucuronidation
3. N-methyl reduction
4. ...oxidation
5.
47. Regarding the median nerve at the wrist
1. Lies between the flexor carpi ulnaris and palamaris longus
2. Superficial to the flexor retinaculum
3. A paresthesia should be elicited to ensure adequate block
3.
4. Supplies all the muscles of the thenar eminence
5. Block causes complete anaesthesia of the 2nd and 3rd fingers
48. Intravenous Adenosine
1. Need less if pt is on
methylxanthines
2. Interferes with persantin
3. Causes hyperpolarization
of cardiac membrane to potassium
4.
5.
49. The rate of alveolar rise in anaesthetic agent concentration
will be increased in all except
1. High inspired concentration
2. High alveolar ventilation
3. Increased CO
4. Decreased CO
5.
50. Which local anaesthetic has the smallest protein binding?
1. Mepivicaine
2. Lidocaine
3. Prilocaine
4. Bupivicaine
5.
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