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Equipment/Physics

1. What is the internal diameter of a 39F Double Lumen Tube?
A. 4.0
B. 4.5
C. 5.0
D. 5.5
E. 6.0

2. What is the threshold for perception with AC, 60 Hz current in 1 second
A. ?mA
B. 1000 μ amp
C. 100 μ amp
D. 10 μ amp
E. ?μ amp.

3. What is true regarding the Desflurane Tec6 Vaporizer?
A. Delivered partial pressure of vapor will be LOWER at high altitude
B. Will still work if tilted more then 10 degrees
C. Output is regulated by a single resistance transducer
D. Is heated because of the LOW vapor pressure of desflurane

4. Which would be desirable on a modern anesthesia vaporizer?
A. High metal thermoconductivity
B. Low metal specific heat
C. Constant flow

5. The negative pressure test of the anesthetic machine is for what purpose?
A. to test the integrity of the low pressure circuit
B. to test the integrity of the high pressure circuit
C. must be done with the vaporizers in the open position
D. ?

6. CAS guidelines, all EXCEPT?
A. temperature monitor
B. stylet
C. oropharyngeal airway
D. nerve stimulator
E. back up laryngoscope

7. The biggest ETT than can pass inside a #4 LMA: ?
A. 4
B. 5
C. 6
D. 7
E. 8

8. Known problems with LMA, EXCEPT :
A. Not good for repeated autoclaving
B. Not good for palate surgery
C. Can cause airway obstruction

9. Full “E” cylinder, on at 10 L/min/ How many minutes does it last :
A. 15
B. 30
C. 40
D. 60
E. 90

10. BiPAP is :
A. Fixed insp press/var exp press
B. Fixed exp press/var insp press
C. Fixed insp and exp press
D. Fixed volume ventilation
E. ?

11. Inverse ratio ventilation :
A. Cannot be used with pressure control
B. Prolonged expiratory phase
C. Associated with autopeep
D. Allows for decrease in FiO2 for the same pO2
E. Increased peak airway pressures

12. What separates the high and low pressure sides of the machine ?
A. Flush valves
B. Flow meters
C. ?

13. Flush valve:
1. 15 L/ min
2. risk barotrauma on expiration
3. risk of awareness.

14. High to low pressure system:
1. flow meters
2. ??

Intensive Care

1 Inverse ratio ventilation
A. increased peak airway pressures
B. associated with autopeep
C. allows for decrease in Fi O2 for same PaO2
D. prolonged expiratory phase
E. cannot be used with pressure control.

2. What is true with PEEP?
A. with unilateral lung disease may cause blood to be
B. shunted away from good lung
C. decreased resistance to venous return
D. can increase CVP
E. ?

3. PEEP, all EXCEPT :
A. Increases LV afterload
B. Decreases LV preload
C. Decreases RV preload
D. Increases RV afterload
E. Decreases venous return

4. BIPAP INDICATION
1. sepsis
2. gi bleed with aspiration
3. sat 85% with bacterial resp. infection
4. diazepam and alcohol overdose
5. ?

5. Right bronchopleural fistula
A. Left endobronchial tube
B. Right endobronchial tube
C. Endotracheal tube
D. Univent tube
E. Endotracheal tube & Fogarty catheter

6. Motor vehicle accident with disruption of bronchial tree
A selective ventilation
B jet ventilation
C positive P ventilation
D chest tube before PPV
E volume controlled ventilation

7. CO poisoning
A. Normal PaO2
B. ?

8. TCA overdose Tx : Which decreases cardiac toxicity ?
A. Alkalinize plasma
B. Dialysis
C. Induce emesis
D. Force diuresis
E. Physostigmine

9. Flexor posturing, eyes open to pain, no verbal response. GCS score?
A. 4
B. 5
C. 6
D. 7
E. 8

10. Smoke inhalation. All are causes of increased morbid/mortality EXCEPT :
A. Supraglottic injury
B. Subglottic injury
C. CO poisoning
D. Pulmonary edema
E. Direct parenchymal injury

11. Organophosphate poisoning, all EXCEPT:
1. diarrhea and incontinence
2. flushed face
3. fasciculations
4. bronchoconstriction and bronchorrea
5. miosis

12. Early changes with Sepsis, ALL EXCEPT:
1. hypercapnia
2. dec. svr
3. dec.co
4. hypoxemia
5. ?

13. Traumatic aortic rupture:
1. a-line on left
2. more common ascending
3. ng tube to left
4. vasodilators and beta blockers
5. no nipride if 1 lung ventilation

14. Sign of vasospasm after SAH :
A. Increased velocity blood flow on Doppler
B. Two days post-bleed decreased LOC
C. Increased ICP
D. Neurogenic pulmonary edema
E. Coagulopathy/DIC

15 Which may be found in a critically ill patient who has received an H1 Antagonist?
A. Bradycardia
B. Ventricular ectopy
C. Hypertension
D. Pulmonary hypertension
E. Raynauld’s phenomenon

16 All are complications of hemodialysis except:
A. Hypoxia
B. Seizures
C. Hyperventilation

17 What is the most common cause of hypotension during hemodialysis in a renal
failurepatient?
A. Iron deficiency anemia (Hgb 50-80)
B. Autonomic dysfunction
C. Decrease levels of 2-3 DPG

18 Burn patient in reparation phase
A. increased GFR
B. resistant to thiopental
C. increased sensibility to non-depol. NMB
D. Right shifting of O2 dissociation curve

19. What causes hyperosmolar non-ketotic coma ?
A. β -blockers
B. Metformin
C. Steroids
D. Sepsis


Medicine

Medicine: Investigations

1. What is the most sensitive, non-invasive test for ischemia
A. Dipiridamole/Thalium
B. Exercise EKG
C. Exercise Echo
D. Holter monitor
E. Exercise/Thalium

2. In a patient with goiter and tracheomalasia, in the flow volume loops there is a
A. Decreased inspiratory and normal expiratory phase
B. Decreased expiratory and normal inspiratory phase
C. Expiratory//Inspiratory ratio < 0.5.
D. Decreased inspiratory and expiratory phase

3. Left Axis Deviation is found in a patient with
A. Ascitis
B. Cor-Pulmonale
C. Pulmonary Embolism
D. Right Ventricular Hypertrophy
E. Left Posterior Hemiblock

4. Most sensitive for myocardial ischemia
A. New LWMA on TEE
B. ST upsloping
C. Tachycardia with PVC’s
D. v waves in PAC
E. Increased CK.

5. Which is the least effort-dependant pulmonary function test?
A. PEFR
B. MMV
C. Flow-volume loops
D. MMEF 25-75%
E. FVC

Medicine: Cardiovascular

1. You will find either peaked T waves or inverted T waves in the following
conditions, EXCEPT
A. SAH
B. MI
C. Hypocalcemia
D. Hyperkalemia

2. Less likely symptom of Cardiac Tamponade
A. Bradycardia
B. Increased CVP
C. Hypotension
D. Pulsus Paradoxus
E. Decreased pulse pressure

3. What medication is indicated in a patient with Mitral Stenosis, who drops the Blood
pressure
A. Ephedrine
B. Cacl2
C. Epinephrine
D. Phenylephrine

4. Which does not increase an existent Right to Left shunt
A. PEEP
B. Left ventricular failure
C. Lobectomy
D. Pneumonectomy.

5. Which is not found in left to right shunts?
A. polycythemia
B. RV failure
C. Pulmonary hypertension

6. All of the following are mechanism of angina in the patient with IHSS EXCEPT
A. hypertrophic left ventricle
B. short systolic ejection time
C. abnormal intramyocardial coronary circulation
D. increased wall tension
E. altered metabolism of LV muscle.

7. Q-waves II, III, and “atrioventricular waves” (sic). Where is ischemia?
A. LAD
B. Prox circumflex
C. Left main
D. RCA
E.

8. Associated with increased ventricular compliance :
A. AI
B. AS
C. Pericardial tamponade
D. LVH
E. Myocardial ischemia

9. What causes constriction of normal coronary arteries ?
A. PGE1
B. Acetylcholine
C. Adenosine
D. Hyperoxia
E. Histamine

10. EKG signs of the transplanted heart :
1. p waves
2. (various other incorrect and complex answers)
3. ?

11. In prolonged QT syndrome, all of the following decrease chances of exacerbation EXCEPT:
1. sedation and narcotics
2. left stellate block
3. esmolol drip
4. lidocaine infusion
5. ventilator setting so that no hypocarbia

12. Exacerbation of mitral valve prolapse:
1. fentanyl
2. phenylephrine
3. ephedrine
4. droperidol
5. ?

Medicine: Other

1. Cystic fibrosis is :
A. Mixed obstructive-restrictive PFTs
B. Affects lower>upper airways
C. Patients do not survive past the second decade
D. More likely to have hyperthermia with exocrine dysfunction
E. ?

2. Regarding Pheochromocytoma
A. Most secrete epinephrine
B. 50% are associated with familiar syndromes
C. Catecholamine levels return to normal in 12 hours
D. Echo shows LVOT.

3. Three days posttrauma, a patient has nausea and vomiting, irritability, decreased
plasma osmalarity and increase urine Na. Most likely diagnosis
A. SIADH
B. Diabetes insipidus

4. Signs of ATN
A. Osmolality <300
B. Osmolality > 600
C. Na in the urine < 10
D. U/P Osmolality >2.05

5. Characteristics of the Myofascial Syndrome
A. Increased ESR
B. Trigger point pain without irradiation
C. Weakness without atrophy
D. Abnormal muscular biopsy

6. Carcinoid syndrome
A occurs with liver mets
B presents with severe bronchospasm
C treat decreased BP with catecholamines

7. Regarding von Willebrand’s disease, which is true?
A. More common in Caucasians/ Northern race
B. Sex linked autosomal recessive
C. Give desmopressin routinely peri-partum
D. Bleeding time is best indicator of severity
E. Due to factor VIII deficiency

8. End-organ damage in diabetes. What is false ?
A. Increased serum creatinine is the first sign of renal disease
(There were other answers, but all were WRONG!)

9. Juvenile onset diabetes with autonomic dysfunction is associated with all EXCEPT
A. decreased beat to beat variation with respiration
B. increased resting heart rate
C. orthostatic hypotension
D. prolonged QT
E. predisposition to PSVT

10. All are true of neuroleptic malignant syndrome EXCEPT?
A. dry flushed skin
B. hyperthermia
C. labile blood pressure
D. muscle rigidity
E. ?

11. All are associated with hypokalemia EXCEPT :
A. Ureterosigmoidostomy
B. Cushing’s syndrome
C. Primary hyperaldosteronism
D. Renal tubular acidosis
E. Lactic acidosis

12. Regarding the hepatitis C virus which is true?
A. large, greater than 80,000 Daltons
B. triple stranded DNA
C. high viremia
D. detected by antibodies to hep C
E. interferon gives lasting cure

13. Hepatitis B marker present during both acute and chronic disease?
A. HbcAg
B. Anti-HBcAg
C. HbsAg
D. Anti-HBsAg

14 What is true for Central DI?
A. Idiopathic is most common
B. Abrupt onset of polyuria and polydipsisa
C. Nocturia is rare
D. 50% neurohypophysis is necessary for maximal urinary concentration
E. DDAVP has high vasopressor to antidiuretic effect ratio

15 Which factor deficiency is consistent with an Increased PTT and a normal INR?
A. VII
B. VWF
C. XII
D. Platelets
E. Fibrinogen

16. Normal PTT, INR=1.6, plates=230k. Compatible with :
A. Decreased vitamin K
B. Heparin in the sample
C. Von Willebrand’s
D. Hemophilia A
E. ?

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