Canadian Anaesthetic MCQ Collection TWO
"The FRCP 1997 Collection"
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201. All of the following statements EXCEPT ONE are true concerning an epidural blood patch (EBP) as therapy for a post-dural puncture headache.
1. Must wait until local anesthetic has worn off before placing EBP
2. recent studies suggest the optimal volume is 5-10 ml
3. The therapeutic effect of EBP is mediated through increased pressure in the subarachnoid and epidural aces
4. Commonest complication is back pain
5. prophylactic placement has not been proven beneficial

202. Which of the following is most likely to make you suspect an addicted colleague?
1. impeccable intraoperative charting
2. refusal to work late
3. refusal to give lunch breaks
4. insists on personally giving narcotics to his own patients in the recovery room
5. likes to work with residents

203. A longstanding left to right shunt results in all EXCEPT ONE of the following.
1. pulmonary hypertension
2. right ventricular failure
3. polycythemia
4. decreased ventricular afterload
5. jugular venous distention [?]

204. Which of the following is true of the effect of volatile anesthetics on the chemical control of ventilation
1. hypercarbia causes an increase in respiratory rate
2. effects of hypercarbia and hypoxia are additive
3. hypoxia causes hyperpnea
4. A decrease in PaCO2 of 4.5 mm Hg with the onset of surgical stimulation
5. Response to hypoxia is more important than response to raised PaCO2

205. Which of the following is not a precursor of epinephrine [different than on old exams]
1. dopamine
2. metanephrine
3. phenylalanine
4. norepinephrine
5. tyrosine   B2:329

206. Absolute alcohol for neurolysis procedures exerts its effect through
1. dissolving of cholesterol, phospholipids and cerebrosides
2. binding to acetylcholine receptors
3. binding to cytosolic receptors
4. interference with sodium channels
5. Interferes with mitochondrial function

207. All of the following statements EXCEPT ONE are true concerning reversal agents
1. neostigmine and pyridostigmine bind covalently and reversibly
2. edrophonium binds electrostatically and reversibly
3. onset of neostigmine is faster than that of pyridostigmine
4. edrophonium is the preferred agent for reversal of deep neuromuscular blockade
5.

208. All of the following statements EXCEPT ONE are true concerning side effects of protamine administration
1. decrease in left ventricular contractility  [definitely specified left side]
2. systemic hypotension
3. antigen-mediated anaphylaxis
4. Non cardiogenic pul edema
5. Complement activation

209. All of the following statements EXCEPT ONE are true concerning the pharmacokinetics of local anesthetics
1. pKa correlates with local anesthetic potency
2. lidocaine has a faster onset than bupivacaine
3. etidocaine is more potent than lidocaine because of greater lipid solubility
4. 
5. 

210. Which one of the following factors would NOT influence the amount of gas that dissolves in a liquid it is in contact with?
1. ambient temperature
2. partial pressure of the gas
3. critical temperature of the gas
4. ambient pressure
5. solubility of the gas in the liquid

211. Myasthenic syndrome
1. reduced forced vital capacity
2. exhibit a good response to anticholinesterase drugs
3. sensitive to depolarizing and nondepolarizing muscle relaxants
4. 
5. 

212. Which one of the following will give significant angina with normal coronary arteries
1. mitral stenosis
2. dilated cardiomyopathy
3. constrictive pericarditis
4. IHSS
5.

213. All are regarding a child with epiglottitis except
1. Lateral neck radiograph may be normal
2. Increased stridor with increased swelling and decreased airway diameter
3. Children usually 2-6 yoa
4. Intubate with out muscle relaxant
5. May get post-intubation pulmonary edema

214. Which is true regarding renal physiology?
1. Proximal nephron resorbs 30% of filtered fluid
2. Active chloride reabsorption occurs in the thick ascending limb of the loop of Henle
3. ADH makes the ascending loop impermeable to water
4. ADH makes the distal convoluted tubule and collecting duct impermeable to water
5. Majority of sodium is in collecting duct

215. All of the following statements EXCEPT ONE are true concerning the pathophysiology of pre-eclampsia
1. increased central venous pressure
2. decreased cardiac output
3. increased SVR
4. decreased production of prostacyclin
5. Increased colloid pressure

216. Which of the following is true regarding spinal anesthesia for neonates
1. hypotension occurs frequently
2. no risk of apnea for a neonate >46 weeks
3. administration of spinal anesthesia is best accomplished in the decubitus position for infants <52 weeks
3.
4. lower incidence of bloody tap than adults
5. 

217. Which of the following concerning CO poisoning is true?
1.   Unaffected arterial O2 content
2.   PaO2 unaffected
3.   Severe CO poisoning does not manifest cyanosis
4.   Effectively treated with 30 minutes of 100% O2 by mask
5.   Caboxyhemoglobin level 5%

218. Respiratory changes in the elderly: which is true?
1.   Increased TLC
2.   Maximum voluntary ventilation decreases to 100 litres/min.
3.   PaO2 unchanged
4.   Increased closing capacity
5.   Decreased tidal volume

219. Which complication occurs most frequently with the intraaortic balloon pump (IABP)?
1.  Decreased renal blood flow
2.   Small bowel ischemia
3.   Thrombocytopenia
4.   Obstruction of the internal mammary branch of the left subclavian artery
5.   Causes PVC's

220. The addition of N2O to a narcotic/100% O2 anesthetic in the presence of ischemic heart disease will:
1.   Increase cardiac output
2.   Cause myocardial depression
3.   Increase myocardial lactate extraction
4.   Decrease pulmonary vascular resistance
5.   Decrease systemic vascular resistance

221. With acute renal failure which is true?
1.   mannitol 1gm/kg just before aortic cross-clamping is protective
2.   non-oliguric failure is associated with a lower mortality than oliguric failure
3.   early hemodialysis yields a mortality rate less than 25%
4.   fractional excretion of Na+ is useful for managing these patients
5.  

222. Fentanyl as compared to Alfentanil
1.   t1/2 beta of Alfentanil< Fentanyl
2.   Alfentanil clearance is > Fentanyl
3.   Alfentanil has a greater volume of distribution
4.   Alfentanil is mor lipid soluable
5.   Alfentanil is less protein bound

223. Which one of the following disease states is commonly associated with cardiomyopathy?
1.   Multiple sclerosis
2.   Myasthenia gravis
3.   Fascioscapulohumeral muscular dystrophy
4.   Muscular dystrophy (Duchenne's)
5.   Charcot-Marie-Tooth disease

224. Which of the following statements concerning H2-receptor antagonists is TRUE?
1. decreased airway resistance
2. no drug interaction has been associated with their use
3. ranitidine has a longer half life than cimetidine
4. cimetidine is associated with significant fetal neurobehavioural abnormalities
5. decrease in gastric emptying time

225. All of the following statements EXCEPT ONE are true concerning physiologic changes of pre-eclampsia:
1. decreased prostacyclin
2. increased cardiac output
3. decreased plasma oncotic pressure
4. increased intravascular volume
5. increased systemic vascular resistance

226. Which of the following statements concerning sexual harassment in the workplaceis TRUE?
1. abuse is usually physical
2. affects men and women equally often
3. low level of reporting due to fear of inaction
4. most likely from patients
5. Rare event

227. Which of the following statements concerning the automatic implantable defibrillator device (AICD) is TRUE?
1. one need not wear gloves when implanting the device [yes, they really wrote that!]
2. the device must be shut off to prevent interference from electrocautery
3. a magnet must be immediately available during general anesthesia
4. is a contraindication to magnetic resonance imaging
5.

228. Which of the following temperatures best reflects core temperature?
1. Bladder
2. Tympanic membrane
3. Rectal
4. Distal 1/3 esophageal
5. Skin

229. During mediastinoscopy, which structure just anterior to the trachea is at risk of damage?
1. pulmonary artery
2. innominate artery
3. azygos vein
4. phrenic nerve
5. recurrent laryngeal nerve/ vagus
6. [ thoracic duct]?

230. Which of the following statements concerning ipratropium or Atrovent (r) is TRUE?
1. decreased viscosity of secretions
2. potentiates the action of inhaled sympathomimetics
3. stabilizes mast cells
4. Increases intracellular cyclic GMP
5. Enhances diaphragmatic contractility

231. Metoclopramide causes all of the following except
1. ? LES tone
2. ? barrier pressure
3. ? gastric motility
4. ? gastric pH
5. ? gastric volume

232. What is the best therapy for post herpetic neuralgia?
1. intercostal nerve blockade
2. tricyclic antidepressants
3. non-steroidal anti-inflammatory agents
4. narcotics
4.
5. antiviral agents

233. What proportion of body weight is the interstitial fluid volume in the neonate?
1. 3%
2. 10-12%
3. 20-25%
4. 45%
5. 80%

234. In the treatment of hyponatremia:
1. a serum sodium of 125 mEq/l requires emergency treatment
2. in emergency treatment, serum sodium can be increased by 3-5 mEq/l/hr safely
3. the total body sodium deficit can be calculated by TBW x serum sodium deficit
4. cerebral damage may occur from over-rapid correction
5. furosemide is not helpful

235. Which will increase a right-to-left shunt the least?
1. pulmonary lobectomy
2. pneumonectomy
3.
4.
5.

236. All of the following will inhibit hypoxic pulmonary vasoconstriction except:
1. metabolic alkalosis
2. respiratory alkalosis
3. 2 MAC halothane
4. ibuprofen
5. Prostaglandin

237. For the treatment of C. difficile diarrhea, the best treatment is:
1. oral erythromycin
2. IV Flagyl
3. IV cephalosporin
4. IV gentamicin
5. oral cholestyramine

238. With autonomic hyperreflexia which one of the following will be seen?
1. increased heart rate
2. decreased blood pressure below the lesion
3. flusing below the lesion
4. piloerection below the lesion
5. Sweating below the lesion

239. Comparing an ascending bellows with a descending bellows on a ventilator which is true?
1. cannot be used to detect spontaneous breathing
2. the disconnect alarm should be set just below the peak inspiratory pressure
3. does not create negative pressure in the circuit on expiration
4. worse for closed circuit anaesthesia
5. 

240. In a trauma victim with a head injury which of the following is true?
1. Ringer's lactate is the IV solution of choice
2. mannitol and furosemide act synergistically
3. PEEP is contraindicated
4. C-spine injury is indication for immediate intubation
5. MAP should be 50 mmHg

241. With severe scoliosis in a teenager, all of the following are seen but:
1. increased AaDO2
2. hypercarbia
3. decreased Vd/Vt
4. hypoxia
5. increased pulmonary vascular resistance

242. 2-chloroprocaine is not a good choice for ambulatory anaesthesia because:
1. can cause back pain
2. risk of neurological injury
3. is short acting
4. produces a greater motor block than sensory
5.

243. Which is true regarding tic doloureux?
1. Most common in V1 and V2
2. Burning pain
3. Absent ipsilateral corneal reflex
4. Responds immediately to carbemazepine
5. Hemifacial flushing

244. Surgeon requests flat EEG during craniotomy.  The most appropriate action is
1. Thiopental 30 mg/kg
2. Propofol 10 mg/kg
3. Isoflurane 2 MAC
4.  Mannitol
5. 

245. IABP will be of benefit in all except
1. Mitral stenosis
2. Aortic stenosis
3. Aortic regurgitation
4. Myocardial infarction
5.  

246. Muccopolysaccharidosis
1. Tonsillar/adenoid hypertrophy
2. Odontoid hyperplasia
3.  Microglossia
4.  Anaesthetic morbidity is rarely due to airway problems
5.  Increased potassium release with sux

247. Comparing regional and general for THA
1. ? bleeding introp with regional
2. ? post-op thromboembolic events
3. 
4. 
5. 

248. According to the NIOSH exposure to N2O should be limited to
1. Time weighted 8 hours of 10 ppm
2. Time weighted 8 hours of 25 ppm
3. Time weighted 8 hours of 50 ppm
4. 200 ppm per case
5. 50 ppm per day

249. Which of the following has been shown to be effective in acute c-spine injury?
1. Methylprednisolone
1.
2. Ca channel blockers
3. Glucose
4. NMDA
5. Naloxone

250. Radial nerve injury will result in a deficit in which of the following?
1. Anaesthesia over the deltoid muscle
2. Flexion of the carpo-phalangeal joint
3. Anaesthesia over the palmar aspect of the 4th and 5th digits
4. Extension of the DIP of the thumb
5. Adduction of the thumb

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Last updated Saturday, 23 July 2005 02:13 PM - Kerry Brandis, 2001