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1. All of the following nerve blocks are useful for awake intubations
EXCEPT?
A. hypoglossal nerve
B. lingual nerve
C. recurrent laryngeal
D. superior laryngeal nerve
E.
inferior laryngeal nerve
2. Which of the following involves muscarinic receptors?
A. parasympathetic ganglia
B. sympathetic ganglia
C. postsynaptic adrenal medulla
D. presynaptic sympathetic myocardial terminals
E. postsynaptic neuromuscular junction
3. Innervation of the superior larynx involves which nerve?
A. hypoglossal
B. recurrent laryngeal
C. internal branch of superior laryngeal
D. trigeminal
E. external branch of superior laryngeal
4. Which of the following is a descending inhibitory pathway:
A. neurons in laminae I and V
B. dorsolateral funiculus
C. ventroposterolateral thalamus
D.
medullary neurons locus
ceruleus
E. spinoreticular pathway
5. All are true regarding the intrinsic muscles of the larynx EXCEPT:
A. They assist in phonation
B. they open the vocal cords during respiration
C. they assist in closure of the larynx during deglutition
D. they are all innervated by the recurrent laryngeal nerve
E.
6. Which
is true regarding the brachial plexus:
A. anterior to subclavian artery
B. posterior to mid scalene muscle
C. composed of posterior rami
D. provides sensory innervation to shoulder joint
E. does not innervate latissimus dorsi
CARDIOVASCULAR
7. All
are important in determining RCA flow except:
A. RCA autoregulation
B. diastolic time
C. adenosine level
D. epicardial blood flow
E. peak RV systolic pressure
8. Atrial natriuretic peptide causes all except:
A. inhibition of ADH in response to dehydration
B. decreased aldosterone secretion
C. peripheral vasodilation
D. increased GFR
E. direct positive inotropy
9. All of the following are known complications of thoracic cross
clamping except:
paraplegia
renal failure
liver failure
left ventricular overload
myocardial ischemia
10. Intraoperative ischemia is best diagnosed with:
ECG changes
V waves on PA tracing
hypotension
new wall motion abnormality on TEE
increased CVP
11. Can see T wave peaking or inversion in lead 2 in all except:
K+ > 7.0
acute MI
subarachnoid hemorrhage
hypocalcemia
rewarming post CPB
12. PAC's can be associated with all except:
normal QRS
normal p wave
compensatory pause
RBBB configuration
13. All of the following are seen with cardiac tamponade except:
Electrical alternans
pulsus paradoxus
hypotension
bradycardia
increased JVP
14. All of the following are seen on an ECG with pulmonary
hypertension except;
RVH
biphasic p wave in V6
RBBB
RAD
tall p wave (>2mm) in lead II
15. Which is true regarding cardiac cell physiology:
threshold potential is -90 mV
sodium
influx occurs in phase 1
calcium maintains isoelectric but depolarized
state
potassium efflux occurs during depolarization
16. Which
will decrease obstruction in HOCM?
A. increased contractility
B. nitroprusside
C. decreased preload
D. volatile anesthetic
E. tachycardia (?)
17. An ECG shows Q’s and inverted T’s in II and III, and atrial
fibrillation.
Which vessel is most likely blocked?
A. LAD
B. Cx distal
C. Cx proximal
D. RCA
E.
18. What is the SVR? (We were given a table with the following values
to use in the calculation: MAP 90, CVP 10, CO 5, PCWP 10, mean PA 15 and
conversion factor 80).
A. 1280
B.
C.
D.
E.
19. Calculate PVR from the data listed: MAP 90, RAP 10, CO 5 l/min,
Wedge 8, Mean pulmonary pressure 12, Conversion factor 80.
A. 2000
B. 100
C. 193
D. 32
E. 64
20. 55
year old anaesthetized patient developed PSVT. Despite vagal maneuvers and
adenosine 6mg iv the PSVT persists. The BP is now 80/40, dropped from
120/80. What is your next intervention?
A. adenosine 12 mg iv
B. bretylium 5 mg/kg
C. verapmail 2.5 mg
D. lidocaine 1 mg/kg
E. procainamide 100 mg
21. Most common ECG finding with mitral valve prolapse:
A. normal
B. PAC's
C. PVC's
D. Flattened T waves
E. ST depression
22. In cardiac patients going for non-cardiac surgery, incidence of
myocardial infarction is related to:
A. absence of chest pain
B. occurs most often post-operative day 3
C. beta-blocker decrease incidence
D. incidence is 10-15%
E. usually non-Q
23. In chronic left to right intracardiac shunt, all of the following
may occur EXCEPT?
A. RV failure
B. increased work
of breathing
C. polycythemia
D. LV failure
E. pulmonary hypertension
24. Which
of the following requires a pacemaker inserted preoperatively?
A. RBBB with LAD
B. RBBB with RAD
C. type II, second degree AV block
D. resting HR < 40
E. first degree AV block
25. Cardiac effects from ECT includes which of the following?
A. increased CM-MB
B. increased LDH-2
C. increased risk of ventricular arrhythmias with non-preoxygenation
D. decreased risk of cardiac complications with elderly patients
E. decreased hemodynamic complications when bilateral leads used
26. Which of the following agents causes direct vasoconstriction in
normal coronary arteries ?
A. adenosine
B. prostaglandin E1
C. acetylcholine
D. hyperoxia
E. histamine (H2-receptor antagonist)
27. In a patient with diastolic dysfunction, which best improves
cardiac output?
A. increased diastolic filling volume
B. decrease afterload
C. increase inotropy
D. phosphodiesterase inhibitors for a lusiotropic effect
E. use of beta-1 selective agents
f) norepinephrine to increase perfusion pressure
28. After 2 hours of using a leg tourniquet which of the following is
seen?
A. increased PaCO2
B. hypertension
C. increased O2 consumption from anaerobic metabolism
D. increased airway pressures
E. bradycardia
29. WPW is best treated with which of the following drugs:
A. digoxin
B.
propranolol
C. verapamil
D. diltiazem
E. lidocaine
30. End-tidal CO2 increases with all EXCEPT:
A. release tourniquet
B. CO2 insuflation
C. malignant hyperthermia
D. decrease CO
E. IV sodium bicarbonate administration
31. ECG findings post cardiac transplant:
A. duplicate P waves
B. LBBB
C. slow R wave progression
D. Q-T prolongation
E. P-R prolongation
32. Which of the following causes left axis deviation:
A. ascites
B. pulmonary embolism
C. right ventricular hypertrophy
D. left bundle branch block
E. pulmonary hypertension
33. What
is the appropriate antibiotic prophylaxis for a patient with no drug
allergies and a mechanical valve undergoing a bowel resection?
A. ampicillin + gentamycin
B. vancomycin
C.
vancomycin and gentamycin
D. cefazolin
E. no prophylaxis
34. Which arrhythmia post CV surgery may be treated with magnesium?
A. atrial fibrillation
B. atrial flutter
C. PVC's
D. PAC's
E. PSVT
35. Angina in IHSS caused by all EXCEPT:
A. abnormal coronaries
B. systolic time shortening
C. abnormal metabolism of myocytes
D. increased LV mass
E. increased LVEDP
36. Which of the following is associated with increased LV
compliance?
A. aortic stenosis
B. aortic regurgitation
C. pericardial effusion
D. obstructive cardiomyopathy
E. myocardial ischemia
37. Which of the following is the most sensitive and specific
noninvasive test for coronary artery disease?
A. stress test electrocardiogram
B. exercise stress echocardiography
C. exercise thallium scan
D. persantine thallium scan
E. 24 hour Holter monitor
38. Regarding IABP all are true EXCEPT:
A. can be timed with ECG
B. can be timed with art line
C. balloon inflated before systole
D. balloon deflated in diastole
E. should not be triggered less then every 2 beats
39. Cardiovascular effects of hypomagnesemia include all EXCEPT:
A. premature atrial contraction
B. nodal dysrhythmias
C. ventricular ectopy
D. digoxin toxicity
E. second degree AV block
40. Pulmonary Artery Catheters proper placement in Zone III can be
confirmed by all EXCEPT:
A. AP chest x ray
B. wedge tracing
C. mixed venous oxygen from blood aspirated from the distal catheter tip
D. wedge pressure greater than PA diastolic pressure
E. wedge tracing only reflects changes in ventilatory pressure
41. All inhibit HPV EXCEPT:
A. ibuprofen
B. metabolic alkalosis
C. nitroglycerin
D. volatile anesthetics
E. respiratory alkalosis
42. Congenital QT syndrome management includes all EXCEPT:
A. avoid hyperventilation
B. lidocaine infusion
C. left stellate sympathectomy
D. beta-blocker
E. give anxiolytic and analgesis pre op
43. All increase flow via PFO right to left shunt EXCEPT:
A. pneumonectomy
B. lobectomy
C. respiratory distress
D. LV failure
E. pulmonary embolism
44. Reason for decreases BP after release of an infrarenal AAA clamp
include all EXCEPT:
A. sudden blood loss
B. myocardial depression because of acid metabolites
C. reactive hyperemia
D. citrate toxicity from transfused pRBC's
E. sequestration in lower extremities
45. In
a post heart transplant patient, which of the following will have the most
effect on heart rate?
A. atropine
B. pancuronium
C. edrophonium
D. adenosine
E. digoxin
46. Which
of the following is not required for calculation of myocardial oxygen
delivery?
A. P50
B. Hb
C. solubility of oxygen
D. saturation
E. PaO2
47. Significant Q waves are seen, T wave inversion in II and III.
Where is the expected lesion?
A. disease in first diagonal branch
B. in the LAD occlusive disease
C. in RCA
D. proximal circ
E. marginal circ
48. Assuming
adequate oxygenation, which substrate is preferentially used by myocardial
cells for oxidative phosphorylation?
A. fatty acids
B. amino acids
C. glucose
D. ketones
E. lactate
49. LIMA is a branch of:
A. subclavian
B. vertebral
C. thyrocervical
D. brachcephalic
E. intercostal
50. The least significant risk factor for perioperative cardiac
event:
A. controlled CHF
B. stable angina
C. controlled moderate hypertension
D. symptomatic AS
E. MI in last 6 mo
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