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54 Cards in this Set
- Front
- Back
Doing an awake CEA. Patient becomes confused & combative after carotid clamped and opened. Priority is... |
Ans B |
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AT28 You intubate a young male patient for a left thoracotomy with a 39FG Robert Shaw tube. When you inflate both cuffs and ventilate the bronchial lumen you get left sided ventilation. When you attempt to ventilate the tracheal lumen the pressures are very high and you get no air entry. Yet when you deflate both cuffs you can ventilate the patient through the tracheal lumen. The most appropriate step to take next is: |
Ans C |
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AT A patient comes to see you in clinic for a pneumonectomy for SCLS. His spirometry shows an FEV1 of 2.5L (>40% predicted). What do you advise about his fitness for surgery? |
Answer is B |
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On bypass, for mitral stenosis repair immediately after cardioplegia the following happens: |
Answer A |
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Redo CABG following median sternotomy surgeon states he has accidentally cut a vein graft, immediately followed by ST elevation on ECG and VF, next action. |
Patients undergoing “redo” cardiac surgery (i.e., those who have previously had a median sternotomy) warrant special concern about the possibility of sudden massive hemorrhage. Frequently, the surgeon will elect to use an oscillating saw in these patients, but mediastinal structures adherent to the underside of the sternum may nevertheless be injured. If the RA, right ventricle, great vessels, or an existing coronary graft is cut, the surgeon may elect to initiate CPB on an emergency basis. Therefore, the anaesthesiologist should have a systemic dose of heparin prepared. As soon as the patient is heparinized, the femoral or aortic arterial cannula is inserted, and the cardiotomy suckers may be used to create venous return (the so-called sucker bypass). At least 2 units of blood should also be immediately available for all redo cases. |
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Mitral valve replacement for Mitral stenosis. Pulmonary artery catheter in situ. Following separation from bypass, copious frank haemoptysis via ETT. Next step in management" |
Answer B |
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Young man on the ward post ORIF # tib/fib. On morphine PCA, high demands/bolus given ratio, used 40mg morphine in last 2 hours (or something else high). Is a bit drowsy but has severe constant leg pain. Next step in management |
Answer D, |
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Patient with IV in right arm, has mediastinal mass and SVC compression undergoing mediastinal biopsy, suddenly uncontrolled surgical bleeding in mediastinum. Next step in management prior to thoractomy: |
Answer C |
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AZ ASA grading was introduced to |
Ans C |
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(Shown a CT slice of the neck with a massive tumour that is causing left sided tracheal deviation) The thing that is the most concern to the anaesthetist is: |
A? |
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Why does a proseal LMA provide a better airway seal? |
Ans B |
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Which of the following is the most frequent complication after use of LMA? |
Ans E |
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What is true regarding arterial pressure transducer systems |
Ans A |
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MM Features of eaton lambert include all EXCEPT... |
Ans E |
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MC 60 year old vascular patient. ECG given. |
Depend on ECG |
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Pulsus paradoxus is: |
answer B |
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What antibiotics are required for bacterial endocarditis prophylaxis in a woman with MV prolapse for cholecystectomy. |
answer - A- gb |
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Male 60’s sudden onset of chest pain , L arm weakness and hoarse voice, ECG is unchanged from old (T inversion laterally), CXR normal, BP135/80, Pulse 110/min. Next step in management: |
Ans D |
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Plasma glucose level compared to blood glucose level |
Ans B |
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You are called for a labour epidural. The woman is extremely distressed and in the middle of your consent process states “Just take my pain away” . You: |
Ans A |
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You are on call for a maternity hospital. Your junior registrar calls you after having inserted a labour epidural in an extremely anxious 19 yo parturient, and obtained blood in the catheter. He informs you the epidural space was found by LOR at 6cm and the catheter has been inserted to 12 cm. Your first instruction should be: |
Ans D |
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Pre-eclamptic woman BP 180/110. Aim to drop BP to |
Ans B. |
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Highest likelihood of motor block with labour epidural analgesia: |
Ans D |
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Trauma pregnant patient (?32wks) BP 70/40, P 50, intubated in emergency department, next management step: |
Ans A. |
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Emergency caesarean section for foetal distress (and foetal acidosis on scalp probe?). what is best option to raise gastric pH preop: |
A - citrate is best agent to raise pH in an emergency C-section. |
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70 year old man having lung resection for SCC of left lung FEV1 2.3L (? % predicted), FVC 3.5L (? % predicted). Do you... |
Ans A |
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NU Which distinguishes C8-T1 from an ulnar nerve lesion at elbow? |
Ans D |
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RH Asking the patient to look up and in during a retrobulbar block increases the risk of injury to: |
C |
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RL A man presents for an ankle fusion. Which of the following combinations will provide the best block: |
Ans A |
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RN18 Stellate ganglion block associated with all except: |
Ans C |
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Spinal anaesthesia, T3 level |
A |
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18yo patient in a psych unit, being treated for frequent vomiting. Collapses and found unconscious. |
Ans B |
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60yo with history of hypertension. Presents with chest pain, hoarse voice, left arm weakness. Has lateral T-wave changes on ECG, also present on an old ECG. Heart rate 110, BP 130/80 (definitely this value), SpO2 96% or something. First drug to give: |
B |
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Trauma patient with GCS 6 with hard collar. HR and BP unstable. What is the best way of clearing neck? |
Ans D |
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Patient (?48h post) SAH following bloods: |
Ans A |
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Alt 6 hour post pituitary surgery, Serum Na 153, next step in management |
Ans A or C depend on situation |
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Neonate if febrile with rash and periodic breathing. which is likely ABG? |
Ans B |
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2 month old systolic murmur heard at apex no change with posture, now on 5th percentile for weight after being on 30th at birth, mother states has difficulty feeding. Peripheral pulses reduced femoral more than upper body. Most likely cause: |
Answer C |
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4 yr old presents for elective surgery, otherwise fit healthy, murmur at left sternal edge on auscultation heard in systole and diastole, disappears on lying down. Most likely cause: |
Answer : D |
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18/12 old undergoing routine SV GA under LMA. Sudden onset SVT with HR 220 BP 84/60 ETCO2 32 SpO2 98.Management: |
Ans A, but suspect it should be 100mcg/KG |
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What is the appropriate LMA size for an 8kg child: |
Ans B |
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Neonate born to known drug abusing mother brought to emergency department by grandmother, unwell lethargic, slightly jaundiced, ABG shows following: |
Ans C |
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15kg child found fitting on paeds ward ?24h ?48h postop while on infusion of 60ml/h ½ NS + Dextrose. Now intubated. Na is 119, next management step: |
Ans B. |
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PN: A man on PCA controlled with 2 mg morphine bolus is having a lot of pruritus. You decide to switch him to fentanyl. Which dose is the most appropriate bolus to be equi-analgesic with morphine 2mg: |
Ans B |
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A patient with chronic pain using morphine PCA after lower limb orthopaedic surgery. Daily usage of IV morphine works out at about 400mg/day. What dose of oral methadone would you start him on to replace the morphine? |
Ans A |
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PR For muscle relaxant,placing the nerve stimulator to stimulate FPB (Flexor pollicis brevis) compared to Abductor pollicis brevis is likely to |
Ans B |
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EM66 Aneursym clipping, BEST monitor of depth of block during this is |
D |
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Closed circuit anaesthesia with 70%N2O,70kg man (low flow i think) what is the uptake of N2O after 90 mins anaesthesia: |
Ans B |
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Rapid infusion of mannitol IV initially causes: |
Ans A |
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Granisitron, which is incorrect: |
A |
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Who has got minimum effect on ICP at 1 MAC |
B |
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PH An ABG showing a raised anion gap. Which of the following would explain this ABG? |
A,B,C can all cause an raised anion gap but salicylate poisoning is the weird one that causes a respiratory alkalosis beyond what is expected in compensation. |
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Young woman with subarachnoid haemorrhage, hyponatraemia and increased urinary sodium (did not specify if high sodium concentration or total amount lost). What is likely cause? |
Ans A or B |
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Which of the following can be used to describe the spread of non-parametric data? |
B |