Canadian Anaesthetic MCQ Collection THREE
"The Toronto FRCP 1997 Collection"
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101.  Most common complication of transtracheal jet ventilation:
A.  pneumothorax
B.  subcutaneous emphysema
C.  mediastinal emphysema
D.  esophageal rupture
E.  arterial rupture

102.   When is the PAWP less than LVEDP:
A.  atrial myxoma
B.  acute aortic regurgitation
C.  pericarditis
D.  cardiac tamponade
E.  tachyarrythmia

103. With respect to Hepatitis A infection:
A.  associated with a prolonged viremia
B.  associated with a chronic carrier state
C.  transmitted by blood transfusion
D.  not associated with a chronic carrier state

104. Which of the following is true in RSD:
A.  IV guanethidine inhibits NE release
B.  stellate ganglion block is equally effective as IV sympathetic block
C.  IV bretylium causes transient increases in NE followed by NE depletion
D.  PO sympatholytics proven ineffective

105.   NIOSH guidelines for limit of N2O exposure:
A.  time weighted 8 hours of 10 ppm
B.  time weighted 8 hours of 25 ppm
C.  time weighted 8 hours of 50 ppm
D.  50 ppm per day
E.  100 ppm per case

106. Following an interscalene brachial plexus block, which nerve is not well blocked:
A.  median nerve
B.  ulnar nerve
C.  radial nerve
D.  musculocutaneous nerve
E.  axillary nerve

107.   Normal ICP range:
A.  5-10
B.  10-15
C.  25-40
D.  20-30
E.  20-40

108.   Which of the following is consistent with pheochromocytoma:
A.  decreased red cell mass
B.  decreased hematocrit
C.  decreased intravascular volume

109.   In a diabetic, autonomic neuropathy is predicted by the presence of:
A.  decrease in blood pressure on Valsalva maneuver
B.  CAD
C.  orthostatic hypotension

110.  Regarding ventilation and perfusion in a spontaneously breathing pt in the lateral decubitus position:
A.  ventilation preferentially to dependent lung and perfusion to nondependent lung
B.  bother preferentially to dependent lung
C.  both preferentially to non-dependent lung
D.  ventilation preferentially to nondependent lung and perfusion to dependent lung
E.  ventilation and perfusion equally distributed to both lungs

111.  Which of the following opioids has a toxic metabolite:
A.  morphine
B.  meperidine
C.  codeine
D.  fentanyl
E.  alfentanil

111.  Which of the following is true in regards to a pt with an epidural abscess:
A.  treatment is antibiotics only
B.  most common organism is staph aureus
C.  back pain is not a common finding
D.  most commonly associated with lumbar continuous epidural infusion

112.  What is true regarding NO:
A.  found exclusively in the vascular endothelium
B.  only 1 type of isoenzyme for nitric oxide synthetase
C.  inflammatory mediator in ischemic injury
D.  metabolism not decreased by hypoxia
E.  mediates the effects of nitroglycerin

113.  A man on Parnate comes into emerg with discomfort and is treated with meperidine. Subsequently, he develops a severe headache with photophobia. Vitals: HR 50, RR 20, BP 220/110. Treatment for this:
A.  propranolol
B.  verapamil
C.  phentolamine
D.  hydralazine
E.  naloxone

114.  A pt with a pacemaker set at DVIP has the following:
A.  ventricularly paced
B.  double sensed
C.  ventricle is triggered
D.  ventricle is inhibited by an intrinsic beat
E.  atrium and ventricle are asynchronously paced

115.  Old man for hip surgery; post-op has the following urine: hyaline membrane, slight proteinuria, urine osmol 600 and urine Na excretion of 0.8mEq/24hrs.  This is caused by:
A.  fluoride nephrotoxicity
B.  renal ischemia
C.  hypovolemia
D.  aminoglycoside nephrotoxicity

116.  Which is true of a pt on inverse ratio ventilation:
A.  long expiratory phase
B.  can potentially develop autopeep
C.  cannot be done with a pressure-controlled ventilation

117. Why is needlestick injury with Hep C less harzardous than Hep B ?
A.  not associated with chronic carrier state
B.  not associated with hepatocellular carcinoma
C.  seroconversion rate < 4 %
D.  immune globuline is effective

118. Why is ketamine preferred for induction with congenital cardiac disease
A.  less increase in cyanosis induced pulm. vascular constriction
B.  incidence of daydreams is only 25 - 30 %
C.  laryngeal reflexes reliably obtunded
D.  cardiac output is maintained by reducing afterload

119. Occulocardiac reflex
A.  blocked 100 % by atropine
B.  blocked 100 % with atropine and halothane
C.  made worse by sux
D.  is a trigeminal - vagal reflex
E.  thiopental is effective in reversing the bradycardia

120. Whole blood stored > 2 weeks, what would be decreased to levels less than required for hemostatic effect
A.  V
B.  Vll
C.  Vlll
D.  platelets
E.  fibrinogen

121. What is anatomical location of celiac plexus
A.  anterior to pancreas
B.  anterior to L 1 vertebral body
C.  lateral to kidneys and adrenals
D.  wrapped around inferior vena cava
E.  posterior to crus of diaphragm

122. What separates high pressure system from low pressure system in anesthetic machine
A.  DISS
B.  second stage regulator
C.  flow meter valves
D.  machine outlet check valve
E.  fresh gas flow outlet

123. Renal changes in response to hypoperfusion
A.  efferent vasoconstriction with severe alpha adrenergic input
B.  medullary vasodilation with angiotension ll release
C.  ADH mediated medullary vasoconstriction
D.  increased oxygen consumption in thick ascending loop of Henle

124. 70 y.o. male with renal failure on chronic hemodialysis sustains a closed head injury. GCS = 7.  Which will MOST effective in acutely reducing his ICP
A.  hyperventilation
B.  mannitol
C.  furosemide
D.  thiopental infusion

125. Changes associated with aging
A.  decreased stroke volume
B.  increased intra-cellular water
C.  increased sensitivity to baroreceptors.
D.  increased MAC requirements
E.  increased closing volume

126. Regarding epidural opioids
A.   need more than twice the dose for a caudal v.s. lumbar injection
B.  compared to infusion, bolus dose gives less side effects
C.  compared to infusion, bolus dose gives better analgesia
D.  more than 20 % of epidural morphine reaches the CSF
E.  epidural venous congestion increases systemic absorption

127. At 90 % FRC, which is most responsible for lung recoil
A.  chest wall
B.  lung parenchyma
C.  lung surface / air tension

128. Neonate % GFR compared to adults
A.  10
B.  25
C.  60
D.  75
E.  100

129. Non-shivering thermogenesis
A.  
B.  factors related to infant’s size
C.  decreased 02 consumption
D.  it is only method of thermoregulation under anaesthesia

130.  What is major source of heat loss during anesthesia
A.  evaporation
B.  
C.  IV fluids at room temperature
D.  radiation
E.  convection

131. Clipping of MCA aneurysm—bleeding – surgeon requests hypotension.
A.  increase MAC isoflurane

132. What regional anesthetic technique for TKA with use of tourniquet
A.   femoral N plus lateral femoral cutaneous N
B.  psoas compartment block  + ….
C.  lumbar plexus  + …
D.  transgluteal sciatic block + lumbar plexus + obturator N

133.  Which factor decreased in pregnancy.
A.  l
B.  Vll
C.  Vlll
D.  lX
E.  Xlll

134.  Dental damage during anesthesia:
A.  Incidence is 1/10,000 cases.
B.  Greater than 50% of cases occur at extubation.
C.  Greater than 50% of cases occur during intubation or during emergent surgery.
D.  It is more common to dislodge loose teeth than to chip or damage teeth.
E.  The lower right central incisor is the most commonly damaged.

135. In anesthetized adults a gradient in PaCO2 to EtCO2 of five:
A.  Is due to the Haldane effect.
B.  Is due to right to left shunting of blood
C.  Is normal in health people.
D.  Is due to bronchial arteries and Thebesian veins.

136.  In comparing propofol to STP during induction:
A.  There is less burning in peripheral veins
B.  There is less hypotension
C.  There is more tachycardia
D.  There is a shorter duration of apnea
E.  Coughing and hiccups are uncommon

137.  An anesthetist in Calgary (Pb 660 mmHg) is giving an oxygen/vapour anesthetic and sets the dial at 1.25%.  Two hours later the end tidal monitor reads 0.9 MAC.  What vapour was used?
A.  Halothane
B.  Enflurane
C.  Isoflurane
D.  Desflurane
E.  Sevoflurane

138.  Giving a 0.1% halothane/O2 anesthetic has the greatest effect on which of the following?
A.  Pa02
B.  Ventilatory response to hypoxia
C.  Cerebrovascular response to CO2
D.  Ventilatory response to an increased resistive expiratory load
E.  Ventilatory response to carbon dioxide.

139.    Which of the following decreases myocyte production of atrial naturietic factor?
A.  Decreased SVR
B.  Decreased CO
C.  Decreased CVP
D.  Atrial dysrthymias
E.  Acetylcholine

140A.    The most common complication in the recovery room is:
A.  Saturation less than 90%
B.  HR < 50
C.  BP drop of more than 20% of preop
D.  Nausea and vomiting
E.  shivering

140B  In statistical analysis the power of a study is defined as?
A.  
a
B.  
b
C.  1-
b
D.  1-
a
E.  1+
b

141.    A patient is scheduled for an elective femoral popliteal bypass procedure.  According
 to the Detsky criteria of cardiac risk, which of the following has the highest score?
A.  MI < 6 months ago and atrial fibrillation
B.  Emergency surgery and age > 70
C.  Emergency surgery and Pa02 < 60
D.  MI < 6 months ago and an S3 gallop

142.  During an elective C-section in a healthy term parturient the addition of 0.75 MAC
 of Isoflurane to a N2O/O2 anesthetic:
A.  Increases blood loss
B.  Increases incidence of fetal acidosis
C.  Decreases maternal awareness
D.  Prolongs awakening

143.  The final destination of a stimulus to the left arm is:
A.  left thalamus
B.  left precentral gyrus
C.  left periaqueductal grey
D.  right postcentral gyrus
E.  right periaqueductal grey

144.  Which intrathecal opioid has local anaesthetic properties?
A.  sufentanil
B.  morpine
C.  meperidine
D.  alfentanil
E.  fentanyl

145. In the upright lung at FRC, why are alveoli at the base of the lung smaller than at the top?
A.  increased alveolar pressure
B.  increased pleural pressure
C.  gravity dependent blood flow compressing alveoli
D.  less negative transpulmonary pressure at the base of lung
E.  regional decrease in pulmonary compliance

146.  What is the best first line treatment in a parturient with symptomatic asthma and uterine atony?
A.  ergot
B.  oxytocin
C.  prostaglandin F2
a
D.  prostacyclin
E.  adrenaline

147.  Long term infusions of oxytocin have which of the following side effects:
A.  diarrhea
B.  water retention
C.  vasoconstriction
D.  arrythmias
E.  hyponatremia

148.  Which of the following cause the hemoglobin dissociation curve to left shift
A.  
­ CO2
B.  
¯ pH
C.  
­ temperature
D.  
­ 2,3-DPG
E.  
­ Hb F

149.  Which test is most appropriate given a patient with sciatic nerve root pain and a L5
neurological deficit?
A.  X-rays
B.  EMG
C.  myelogram
D.  MRI

150.  The addition of N2O to high dose opiates causes:
A.  vasodilation and myocardial depression
B.  increased venous resistance and decreased SVR
C.  hypotension and decreased CO
D.  increased CVP and increased PCWP

151.  A hypothetical anaesthetic vapour has a blood:alveolar partition coefficient of 2. Given a 1% alveolar concentration what is the pulmonary venous partial pressure at equilibrium? (Patm 760 mmHg)
A.  2 mmHg
B.  3.8 mmHg
C.  7.6 mmHg
D.  15.2 mmHg
E.  38 mmHg

152.  With spinal anaesthesia in high risk neonates:
A.  Reduces the need to monitor cardiovascular status post-operatively
B.  Less arterial hypotension than adults
C.  Similar risk of apnea compared with general anesthesia with halothane
D.  If less than 52 weeks PCA, the lateral decubitus position is preferred.


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Last updated Saturday, 23 July 2005 02:14 PM - Kerry Brandis, 2001