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101. Which is true regarding the TEC 6 vapourizer?
A. single resistor to control output
B. OK to use if tipped >10 degrees from horizontal
C. need heated sump due to low vapour pressure of desflurane
D. calibrated with 100% N2
E. at increased altitude the output partial pressure of desflurane is
decreased
102. High pressure system is separated from
low pressure system by:
A. DISS line insertion
B. flow control valves
C.
check valve
D. fresh gas flow outlet
E. second stage pressure regulator
103. Advantage of CO2 laser includes:
A. no risk of airway fire
B. no risk of eye injury to operating room personnel
C. significant hemoglobin absorption
D. minimal edema
104. Corneal burns can result from stray light waves from which form
of light?
A. CO2 laser
B. argon laser
C. Nd-Yag laser
D. ruby red laser
E. infrared light
HEMATOLOGY
105. A
patient with a normal INR and increased PTT has a deficiency of what:
factor 7
factor 12
platelets
AT-III
Fibrinogen
106. Hemolytic reactions under GA: all except:
fever
increased bleeding
hemoglobinuria
rigidity
hypotension
107. In many blood banks, a group and screen is often utilized
preoperatively instead of a full cross match.
All of the following are true except:
it may result in more available resources (blood products) in the blood
bank
should detect antibodies in the patient's plasma
will determine the patient's Rh type
is as safe as a full crossmatch in all circumstances
108. Regarding
antithrombin III:
A. is a naturally occurring serine protease inhibitor
B. increased levels with prolonged iv heparin infusion
C. decreased levels causes heparin sensitivity
D. selectively inhibits coagulation proteins
E. is inhibited by heparin
109. Which component of whole-banked blood that is 2 weeks old has
the LEAST therapeutic activity?
A. platelets
B. factor VII
C. factor V
D. factor X
E. fibrinogen
110. What causes the hemoglobin dissociation curve to be shifted to
the left?
A. fetal hemoglobin
B. increased
2,3 DPG
C. increased temperature
D. decreased pH
E. increased pCO2
111. A
patient with post-op bleeding has the following lab results: INR 1.6, PTT
32, Plt 270. What is the most likely diagnosis?
A. vitamin K deficiency
B. anemia
C. heparin contamination
D. DIC
E. Von Willebrand's disease
112. Which is true regarding von Willebrand disease?
A. sex-linked recessive pattern of inheritance
B. higher incidence in Caucasians (?especially northern Europe)
C. increased bleeding time
D. all patients require DDAVP prior to vaginal delivery
E. main cause of bleeding is a deficiency in Factor VIII levels
113. Cryoprecipitate is the best therapeutic agent for which of the
following factor deficiency:
A. I
B.
platelets
C. VII
D. IX
E. XI
f) XIII
114. Thrombocytopenia
resulting from massive transfusions results from:
increased consumption at trauma/surgical site
packed red blood cells contain almost no platelets
decreased levels of 2,3 DPG result in increased platelet destruction
destruction of platelets in IV filter
increased uptake of damaged platelets in reticuloendothelial system
115. Which
is true regarding LMWH:
A. saturable hepatic enzyme elimination
B. more Ia than Xa activity
C. decreased activity secondary to increased protein binding
D. PTT is insensitive
E.
116. IgA deficiency, which is false?
A. incidence 1/600
B. hard to find blood
C. have IgE and IgM
D. increased respiratory tract infections
E. no problems with transfusion reactions
NEPHROLOGY
117. Which
part of the kidney is impermeable to water?
descending limb of loop of henle
thick ascending limb of loop of henle
ascending vasa recta
proximal convoluted tubule
118. Dialysis is associated with all except:
improves platelet function
hypoxemia
hyperventilation
encephalopathy
seizures
119. All of the following are causes of hypokalemia except:
primary hyperaldosteronism
lactic acidosis
renal tubular acidosis
ureteral diversion
cushing's
120. Trace proteinuria, hyaline casts; plasma osmolarity 600; FENa 0.8. This is
consistent with which of the following?
A. fluoride toxicity
B. volume depletion
C. ATN
D. aminoglycoside nephrotoxicity
E. prostatic hypertrophy with urinary obstruction
121. Which of the following is found in renal failure patients on
hemodialysis?
A. iron deficiency anemia of 50-80 g/L
B. elevated INR
C. autonomic neuropathy
D. decreased levels of 2,3 DPG
E.
122. Nephrogenic DI caused by:
A. head injury
B. brain tumour
C. SIADH
D. Fluoride nephrotoxity
E. meningioma
123. Which
of the following is seen in prerenal
failure (all EXCEPT):
A. urine/plasma cr < 20:1
B. urine Na < 20
C. urine osmolarity <350
D. urine specific gravity >1.02
E. urine: plasma osmolarity >1.1
124. In the presence of decreased renal perfusion which is seen?
A. efferent vasoconstriction with severe alpha adrenergic input
B. medullary vasodilation with angiotensin II release
C. increased oxygen consumption in thick ascending loop of Henle
D. ADH mediated medullary vasoconstriction
E. alpha agonist acitivity causes efferent arteriole vasoconstriction
125. Which
is seen in ATN?
A. urine osmolality>600
B.
urine osmolailty < 350
C. urine to plasma creatinine >2.5:1
D. urinary sodium <20
E. K > 7
NEUROLOGY & NEUROSURGERY
126. All
of the following decrease the incidence of venous air embolism in the
sitting position except:
use of bone wax by the surgeon
positive pressure ventilation
hypovolemia
decreased gradient from head to heart
avoidance of nitrous oxide
127. Which of the following is safe for ECT?
increased ICP
pregnancy
pacemaker
recent MI
128. Vasospasm
is associated with:
A. coma 1-2 days post SAH
B. increased ICP
C. DIC
D. increased velocity on transcranial doppler
E. neurogenic pulmonary edema
129. Regarding ICP:
A. optimal PaCO2 = 20
B. CBF decreases 6-8% per 1 decrease in PaCO2
C. lasix works to decrease ICP primarily by decreasing CSF production
D. mannitol is better than lasix to decrease ICP
E. ICP compliance is linear with respect to cerebral volume
130. A patient is scheduled for craniotomy for removal of a
supratentorial tumor. Pre-op
treatment of intracranial hypertension will lead to which of the
following?
A. hypoglycemia
B. hypovolemia
C. hyperkalemia
D. anemia
E. hypoosmolarity
131. All of the following ECG findings may be associated with
intracranial hemorrhages EXCEPT:
A. T wave inversion
B. VT
C. voltage proven LVH
D. ST changes
E. U waves
f) prolonged
QT
132. Regarding ICP monitoring:
A. normal ICP is 15-20 mmHg
B. ICP can be measured from subdural, intraventricular, and
intraparenchymal sites
C. plateau wave is a normal component of the ICP waveform
D. intracranial pressure increases linearly with volume
E. Xenon inhalation is a non invasive way to measure ICP
133. What problems do you anticipate on induction in a patient who
has received preoperative treatment for increased ICP?
A. hypotension
B.
C.
D.
E.
134. What vapour increases cerebral blood flow the most?
A. halothane
B. enflurane
C. isoflurane
D. sevoflurane
E. desflurane
135. Which agent increases CBF the most?
A. STP
B. propofol
C. fentanyl
D. ketamine
E. midazolam
136. In carotid endarterectomy, which is the least sensitive sign of
decreased cerebral blood flow?
A. EEG
B. SSEP
C. transcranial doppler
D. stump pressure
E. awake patient
137. Unilateral transection of posterior (dorsal) nerve roots of
C5-T1 causes:
A. loss of shoulder abduction
B. paralysis of muscles controlling elbow movement
C. loss of deep tendon reflex at wrist
D. sympathetic paralysis
E. loss of sensation over acromion
138. 3 days following a severe closed head injury, a patient has
vomiting, irritability, a low serum osmolality and high urine sodium.
What is the most likely diagnosis?
A. intracranial hemorrhage resulting from DIC
B. SIADH
C. nonketotic hyperosmolar hyperglycemic coma
D. posttraumatic diabetes insipidus
E. acute neurogenic renal failure
139. The final destination in the brain of a sensory stimulus from
the left arm is:
A. left thalamus
B. left precentral gyrus
C. left dorsal root ganglion
D. right postcentral gyrus
E. right periaqueductal gray matter
140. During MCA aneurysm surgery, the
aneurysm suddenly ruptures. The surgeon
requests induced hypotension. The best method to achieve that:
A. NTG
B. nipride
C. increase volatile agent
D. calcium channel blocker
E. beta blocker
141. What
would be inappropriate in the management of a supratentorial tumour
resection:
A.
0.5 mg/kg mannitol
B. lumbar drain 100-150ml
C. lasix 40mg
D. decreases PaCO2 to 28 mmhg
E. Hyperventilate to ETCO2 of 28
142. Which of the following measures for lowering ICP causes an
increase in cerebral vascular resistance?
A. thiopental
B. furosemide
C. mannitol
D.
E.
143. What is the GCS for a patient who opened eyes to pain, no
verbal response, with flexion postures?
A. 4
B. 5
C. 6
D. 7
E. 8
OBSTETRICS
144. What
is the first line treatment for uterine atony in a patient with asthma:
oxytocin
PGF2 alpha
ergotamine
Fluids
Calcium
145. Magnesium in pregnant patients causes:
incrased uterine tone leading to decreased uterine blood flow
increased deep tendon reflexes
increased sensitivity to catecholamines
decreased release of presynaptic Ach
decreased sensitivity to neuromuscular blockers
146. All of the following are causes of seizures in pregnancy except;
abruption
eclampsia
cerebrovascular access
amniotic fluid embolism
local anesthetic toxicity
147. Twin
gestation vs single gestation:
A. increased incidence of retained placenta
B. increased incidence of prolonged labour
C. increased incidence of PIH
D. decreased incidence of postpartum hemorrhage
E. placenta previa
148. Early sign consistent with HELLP:
A. RUQ abdo pain
B. headache
C. visual changes
D. seizure
E. edema
149. All of the following conditions may be associated with seizures
in a pregnant patient EXCEPT:
A. abruptio placenta
B. eclampsia
C. amniotic fluid embolism
D. intracranial hemorrhage
E. local anaesthetic toxicity
150. All are definitive diagnostic signs of severe pre-eclampsia
EXCEPT:
A. oliguria (<400cc/24hr)
B. increased systolic arterial pressure (> 160mmHg)
C. increased diastolic blood pressure (> 105 mmHg)
D. proteinuria (> 5 grams / 24 hr)
E. pulmonary edema
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