..\..\TheBlackBank\BlackBankMCQ.phpCanadian Anaesthetic MCQ Collection FOUR
"The Toronto-McMaster 2000 Collection"
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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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Last updated Saturday, 23 July 2005 02:21 PM - Kerry Brandis, 2001