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CRITICAL CARE & COMPLICATIONS
51. Regarding blood stored in CPDA-1 at 4 Co, which of
the following statements are true?
A. RBC pH decreases as a result of lactate production
B. RBC K+ increases due to Na-K pump inhibition
C. RBC glucose metabolism ceases
D. similar effects as aging occur
E. 2,3-DPG levels remain stable for 3-4 weeks
52. A trauma patient has sustained a bronchial injury.
The best method for ventilation is:
A. positive pressure ventilation after placement of thoracostomy tube
B. pressure-cycled ventilation through an ETT
C. volume-cycled ventilation through an ETT
D. selective pulmonary ventilation
E. high frequency ventilation
53. A trauma victim suffers a bronchial tree disruption (location not
specifieD. and requires ventilatory support.
Which is the best course of action?
A. pressure cycled ventilation via ETT
B. volume cycled ventilation via tracheostomy
C. positive pressure ventilation after tube thoracostomy
D. differential lung ventilation
E.
single lumen tube
54. Giving H1 blockers to a critically ill patient results in:
A. pulmonary edema
B. bradycardia
C. hypertension
D. ventricular ectopy
E. peripheral vasoconstriction (Raynaud's)
55. Regarding herpes simplex infection:
A. epidural morphine causes reactivation of genital herpes simplex
B. HSV infection is usually with maternal history
C. infection to fetus is usually transplacental
D. spinal anesthesia is safe during active genital herpes
E. lesion occurs with primary infection with equal incidence compared with
recurrent infection
56. All
are true in early septic shock except
hypoxemia
increased cardiac output
hypercarbia
decreased SVR
decreased blood pressure
57. First
treatment of severe allergic reaction:
A. epinephrine 5 mcg/kg
B. solumedrol 500
mg
C. benedryl 0.5
mg/kg
D. cimetidine 5mg/kg
E. aminophylline 5mg/kg
58. Regarding TCA overdose, which of the following can be used to
attenuate cardiac effects?
A. physostigmine
B. hemodialysis
C. alkalinization of the plasma
D. forced diuresis
E. induced vomiting
59. Regarding traumatic aortic dissection:
A. most commonly occurs in the ascending aorta
B. NG tube is deviated to the left
C. useful to monitor the left radial arterial line
D. vasodilator and beta-blocker is useful
E. avoid one-lung ventilation if using nitropruside
60. What is the osmolality of normal saline?
A. 308
B.
C.
D.
E.
61. Osmolality of 8.4% sodium bicarbonate is:
A. 84 mOsm/l
B. 84 mmol/l
C. 1000 mOsm/l
D. 2000 mmol/l
E.
308 mOsm/L
62. Which of the following is seen in the reconstructive phase of
burn injuries?
A. increased GFR
B. increased sensitivity to NMB's
C. decreased sensitivity to IV anesthetics
D. decreased MAC
E. O2 dissociation curve shifted to right .
increased 2,3 DPG
63. Which is true regarding pressure-control ventilation with inverse
ratio?
A. auto-PEEP occurs
B. I:E < 1:1
C. can breathe spontaneously in all phases of the respiratory cycle
D. can trigger the ventilator
E. consistent tidal volumes
64. Glycine toxicity in TURP procedures is associated with which one
of the following?
A. hypotension
B. blurred vision
C. abdominal pain
D. confusion
E. convulsions
65. The latest recommendation from the centre for disease control
regarding prophylaxis to HIV exposure:
A. prophylactic multidrug regimen when exposed to high ANTI HIV titres
B. no prophylaxis until exposed status known
C. multidrug prophylaxis to all contacts
D. No prophylaxis needed
E. Treat based on titres of person who was exposed
66. Regarding hepatitis C, which of the following is true?
A.
Carriers have high viremia
B. is a 3 stranded RNA molecule
C.
large molecule (>80000
nucleotides)
D. Alpha interferon is a long term cure
E. diagnosed by serum antibodies
67. Which of the following serological markers will be seen both
after resolution of an acute self-limiting episode of hepatitis B and
during the course of chronic hepatitis B? (these were definitely the
choices given!)
A. anti-HBs
B. HBeAg
C. anti-HBc
D. HBcAg
E. increased aminotransferase levels
68. Chronic exposure to Fi O2 > 0.6 is associated with all EXCEPT:
A. pulmonary fibrosis
B. tracheitis manifesting as sternal chest pain
C. interstitial pulmonary edema
D. absorption atelectasis
E. sloughing of Type II alveolar cells
69. Regarding negative pressure pulmonary edema, all are true EXCEPT:
A. reports in adults and children are frequently
associated with a history of epiglottitis or laryngospasm
B. can be managed conservatively in most cases (maintain patent airway,
provide oxygenation)
C. related to the duration and severity of obstruction
D. may occur after relief of the obstruction
E. most common in patients after laryngospasm and epiglottitis
70. Which of the following intraoperative events is predictive of
adverse cardiac outcome?
A. hypertension
B. tachycardia
C. mild hypothermia (<36C, >35.5C)
D. inhalational anesthesia
E. high dose narcotic based anesthetic
71. All are consistent with organophosphate poisoning EXCEPT:
A. flushed faces
B. miosis
C. muscle fasciculations
D. bronchorrhea and bronchoconstriction
E. incontinence of stool and urine
72. Patient
with anaphylaxis, heart rate =120, BP=80/40.
What should you give:
phenylephrine to vasoconstrict and decrease the heart rate
epinephrine
corticosteroids
ephedrine
cimetidine
73. All
are true with anaphylaxis EXCEPT:
A. may occur within 20 minutes of exposure
B. triggered by antigen binding to IgE
C. may not have had a previous allergic response
D. clinically identical to an anaphylactoid reaction
E. complement is activated C3a
and C5a
ENDOCRINE AND METABOLISM
74. What
does not cause non ketotic hyperosmolar coma in mild diabetics:
beta blockers
steroids
TPN
metformin
sepsis
75. Which of the following hemoglobins is used to monitor glucose
control in diabetics:
Hb F
Hb A1C
Hb S
Hb A
met Hb
76. All of the following are associated with diabetes except:
autonomic dysfunction is more common in hypertensive vs. non hypertensive
increased creatinine is the first sign of renal failure
silent MI is more common
autonomic dysfunction is more common in patients with other end organ
disease
77. Regarding pheochromocytoma:
50% are associated with MEN syndrome
plasma catecholamines will be decreased by 12 hours post op
most common catecholamine released is epinephrine
may see left ventricular outflow tract obstruction on echo
should be blocked with beta blocker prior to alpha blocker
78. Patient
with hypercalcemia, peptic ulcer disease, multinodular goiter and severe
hypertension, administer:
A. phentolamine
B. esmolol
C. propranolol
D. hismanal
E. hydralazine
79. Regarding carcinoid syndrome:
A. occurs with metastatic liver involvement
B. treat hypotension with catecholamines
C. bronchospasm most common presentation
D. use histamine blockers preoperatively to prevent complications
E. carcinoid syndrome is associated with right heart disease
80. Which
of the following is true regarding central diabetes insipidus?
A. nocturia is rare
B. requires greater than 50% residual neurohypophiseal function for
maximum urine concentrating ability
C. majority of cases are idiopathic
D. DDAVP has a high pressor: anti-diuretic effect
E. usually acute onset
81. Treatment of a 60 year old woman who presents for an emergency
laparotomy with severe untreated myxedema:
A. subcutaneous TRH
B. IV L-thyroxin and hydrocortisone
C. p.o. propylthiouracil
D. IV potassium iodide
E. IV propranolol
82. Which is true regarding diabetic autonomic neuropathy?
A. gastropathy
B. orthostatic HYPERtension
C. absent resting tachycardia
D. long QT
E. beat to beat variability present
83. What is the effect of propranolol in the treatment of
hyperthyroidism?
A. converts atrial fibrillation to sinus rhythm
B. decreased T4 production
C. decreased peripheral SNS effects
D. decreased synthesis of thyroid hormone
E.
84. Nonketotic-hyperosmolar coma in a mild diabetic is not
precipitated by:
A. propranolol
B. metformin
C. steroids
D. sepsis
E.
EQUIPMENT AND MONITORING
85. Negative
pressure test is for:
high pressure circuit
low pressure circuit
leak in scavenging
leak in oxygen analysis
86. What is the least likely cause of decreased ETCO2:
endobronchial intubation
hypothermia
hyperventilation
increased cardiac output
pulmonary embolism
87. Modern vaporizer should have
low specific heat
high thermal conductivity
no temperature compensation
constant flows
increased pumping effect
88. What is seen when the CVP tip is in the mid right atrium?
biphasic p wave
inverted p wave
dual p waves
inverted t waves
89. All of the following are associated with increased risk of
pulmonary artery rupture except:
age > 60
hypothermia
pulmonary hypertension
catheter tip located > 5 cm from
lateral border of heart on CXR
1.5 ml of air in balloon during insertion
90. When measuring blood pressure with oscillimetry, which pressure
correlates best with intraarterial pressure:
Pulse pressure
MAP
SBP
DBP
91. What
is the human threshold limit for sensing a 60Hz AC shock for 1 second?
A. 1 uA
B. 10 uA
C. 100 uA
D. 1000 uA
E. 0.1 mA
92. According to the CAS guidelines of anesthetic practice which of
the following is not routinely required?
A. temperature monitor
B. nerve stimulator
C. backup laryngoscope
D. stylet
E. oral airway
93. Regarding the CVP tracing:
A. a wave indicates ventricular systole
B. c wave indicates tricuspid valve closure
C. v wave indicates atrial systole
D. y descent indicates ventricular relaxation
E. x descent indicates atrial relaxation
94. Which is true regarding ECG monitoring?
A. the lowest frequency of monitor mode is lower than the lowest frequency
of diagnostic mode
B. the bandwidth of monitor mode is greater than that of diagnostic mode
C. the low frequency filter of monitor mode reduces artifact from skeletal
muscle
D. the high frequency filter of monitor mode reduces artifact from poor
ECG lead connection
E. ST segment elevation is greater in monitor mode than diagnostic mode
95. Which is true regarding activation of the oxygen flush valve?
A. 15 L/min O2 delivery to the low pressure circuit
B. barotrauma can occur during expiration phase of ventilatory cycle
C. provides a reliable leak check of the low pressure circuit
D. patient awareness can occur with repeated overzealous flushing
E. communication occurs between high and low pressure circuits at the flow
meters
96. What is the size of the internal lumen of each lumen in a #39
French left-sided double lumen tube?
A. 4.0 mm
B. 4.5 mm
C. 5.0 mm
D. 5.5 mm
E. 6.0 mm
97. The largest endotracheal tube that can
pass through a size 4 LMA is
A. 4.0
B. 5.0
C. 6.0
D. 7.0
E. 8.0
98. 19.7g of Halothane (MW=197) is
vaporized in a total volume of 224
liters of O2. What is the final concentration?
A. 22.4%
B. 10%
C. 2.24%
D. 5%
E. 1%
99. Regarding scavenging / OR pollution /
acceptable levels:
A. nitrous oxide 30ppm with use of volatile agents
B. nitrous 100ppm when used alone
C. volatile agents <2 ppm
D. volatile agents <1ppm, when used with nitrous
E. no need for scavenging if proper measurement equipment in use
100. A full standard E tank of O2 is being used at 10 L/min. How long
will it last?
A. 15 min
B. 30 min
C. 45 min
D. 60 min
E. 120 min
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