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110 Cards in this Set

  • Front
  • Back
1. A patient undergoing liver surgery has a venous air embolism, what is the most appropriate position to place them in:

a. Reverse trendelenburg, right side up
b. Reverse trendelenburg left side up
c. Reverse trendelenburg, neutral
d. Trendelenburg right side up
e. Trendeleburg left side up
A - operative site lower than heart; left lateral decubitus to trap air in RV so it doesn't go to lungs
2. Which of the following is NOT a side effect of cyclosporine

a. Alopecia
b. Hypertension
c. Renal impairment
d. Gum hyperplasia
a
What is the half life of clopidogrel

a. 6 hours
b. 14 hours
c. 24 hours
d. 7 days
a
When administering adrenaline and atropine via ETT dose compared with IV should be

a. Same dose
b. Double
c. Quadruple
d. Six times
b
Atropine 2-2.5x, adrenaline 3-10x
What splitting ratio gives a 3% concentration of isoflurane

a. 1/5
b. 1/9
c. 1/13
d. 1/20
e. 1/23
c. 1:13
What transfusion related complication is the commonest cause of mortality

a. Bacterial infection
b. TRALI
c. ABO incompatibility
d.
b
Which of the following is not included in the DHATS2 AF thromboembolic risk scoring system

a. Age
b. Gender
c. Diabetes
d. Heart failure
e. Previous TIA
b
What is the ratio of breaths to compressions in neonatal resuscitation

a. 1:3
b. 1:5
c. 2:15
d. 2:30
a
What is the innervation of the hard palate

a. Greater palatine and nasopalatine
a
a
Which of the following is suggesting of an inhaled foreign body in a child on chest x ray

a. Foreign body visible in front of airway
b. Hyper-expanded hemithorax
c. Collapse
b
or ? all of the above
What is the distance from the lips to the carina in an 70kg adult male in cm

a. 21
b. 23
c. 25
d. 27
e. 29
D. 27cm - it is 29cm to end of DLT (2cm into L main bronchus!)
What colour is the label for subcutaneously administered drugs

a. Pink - antibiotics?
b. Yellow – IV induction agents
c. Brown (beige)
d. Red – muscle relaxants
e. Blue - opioids
c
How much air is the maximum to that should be used to inflate a 5 LMA classic cuff

a. 15
b. 20
c. 25
d. 40
e. 45
d
Where should the tip of an IABP lie

a. 2cm distal to the left subclavian
b. 2 cm proximal to the left subclavian
c. 2cm proximal to the renal artery
d. 2 cm distal to the renal artery
a
A 60kg female is given 50 mg of rocuronium, she is unable to be intubated, what dose of sugamadex is required to reverse the rocuronium

a. 240
b. 800
c. 960
c
In a penetrating chest injury what part of the heart is most likely to be injured

a. Left ventricle
b. Right ventricle
c. Right coronary artery
d. Right atrium
e. Sinus node
b
What is the maximum recommended dose of intralipid in local anesthetic toxicity (ml/kg)

a. 6
b. 8
c. 10
d. 12
e. 14
d
What is a contraindication to an IABP

a. Aortic regurgitation
b. Aortic stenosis
a
An infant is born with meconium stained liquor and is apnoeic and floppy… your first step should be

a. Stimulate and dry
b. Positive pressure ventilation
c. Suction the trachea
c
Central sensitization occurs due to

a. Primary events mediated by the NMDA receptor
b. Alterations in gene expression
c. Increased magnesium
b
What volume of FFP is required to increase fibrinogen level by 1g/L (I think it was FFP or did it say cryoprecipitate?)
a. 10-15ml/kg
b. 30ml/kg
c. 40ml/kg
B
If Cryo the answer is 10-15ml/kg. We're unsure if FFP.
An epidural in a healthy individual causes all EXCEPT

a. Raised Co2
b. Bradycardia
c. Vasodilation
d. Dyspnea
a
In the Revised Trauma Score includes GCS, Blood pressure and what other parameter?

a. HR
b. Saturation
c. Respiratory rate
d. Urine output
c
Autologous transfusion results in less

a. Cost
b. Blood waste
c. Incompatible transfusion
d. Unrequired transfusion
c
After an infusion of normal saline causing isovolumetric haemodilution what occurs?

a. Increased cardiac output
b. Increase oxygen extraction
c. Capillary vasodilatation
a
Bleeding in trauma has been shown to be reduced by

a. Tranexamic acid
b. Recombinant factor VIIa
c. DDAVP
d. Prothrombinex
a
The time constant of the lung is calculated by

a. Compliance x resistance
b. Compliance plus resistance
c. Compliance /resistance
d. Resistance/compliance
a
The commonest post operative complication in a patient with a # NOF is

a. UTI
b. Pneumonia
c. Delirium
d. Myocardial infarction
c
In an infant the intercristine line is at the level of

a. L1-L2
b. L2-L3
c. L3-L4
d. L4-L5
e. L5-S1
e
Which of the following is a contra-indication to a left DLT

a. Left pneumonectomy
b. Tumour in the left main stem bronchus
B
What is the commonest symptomatic cardiac condition in pregnancy

a. Mitral stenosis
b. Aortic stenosis
c. Eisenmengers
d. Tetralogy of fallot
a
What is the ratio of MAC awake:MAC of sevoflurance

a. 0.2
b. 0.34
c. 0.5
b
Pain from the uterus during labour is transmitted via

a. From the anterior roots of T10-L1
b. Parasympathetic fibres
c. The inferior hypogastric plexus
d. Via grey rami communicantes
c
Pierre robin syndrome is characterized by micrognathia and

a. Macroglossia
b. Glossoptosis
b
A size C oxygen cylinder that reads 5000kpa contains approximately how many litres of oxygen

a. 100
b. 150
c. 200
d. 350
e. 600
b

(1/3 full, carries 450L usually therefore 1/3 of 15000 = 5000, 1/3 of 450 = 150L)
A patient having a craniotomy has the CVP/arterial transducers at the level of the right atrium. The head is 13cm above the level of the heart. If the MAP is 80mmHg and the CVP is 5mmHg what is the cerebral perfusion pressure in mmHg

a. 60
b. 62
c. 65
d. 70
e. 75
c
After a procedure with an LMA in situ a patient complains of loss of sensation to the anterior part of the tongue. What nerve is likely damaged?

a. Facial
b. Lingual
c. Greater palatine
d. Glossopharyngeal
b
What statistical test would be best to evaluate the effects of ? 2 drugs in patients at ? 3 different points in time

a. ANOVA
b. Mantel Hantzel
c. Crusckall Wallis
d. Students t test
a
A man is working with electrical appliances at home with a residual current device. If he touches the active and the neutral (was it neutral or earth) wire he will suffer

a. A microshock
b. A macroshock
c. Nothing happens because the fuse blows
d. The RCD will protect him from macroshock
d

If it is neutral + earth= nothing will happen
An infant with failure to thrive is noted to have an apical systolic murmur weak pulses, with the femoral felt most easily. They most likely have

a. Patent ductus arteriosis
b. Ventriculoseptal defect
?
Coarctation if femoral is weak
Which radiological finding is most consistent with atlantoaxial instability in a patient with rheumatoid arthritis

a. A 9mm gap between the anterior arch of C1 and the odontoid peg
a
(> 3mm)
What is the most accurate method of determining fetal heart rate in a neonate

a. Palpation of an umbilical vein pulse
b. Auscultation with a stethoscope
c. Palpation of femoral pulse
d. Pulse oximetry
b
In acute liver injury what causes the highest risk of bleeding

a. Thrombocytopenia
b. Coagulopathy
c. Portal hypertension
d. Platelet dysfunction
b

Another person has "Prolonged PT" as an option. Quote from Pakistani Journal...
The PT is considered as a simple, inexpensive, qualitative and accurate prognostic marker of liver impairment and also a predictor of bleeding.1 The degree of PT impairment an expression of decreased liver synthesis predicts the severity of portal hypertension and the presence of esophageal varices.6 PT is related both to bleeding risk and mortality. Patients with moderately or severely prolonged PT have 5 to 10 fold higher mortality rates than patients with normal PT.8 The aPTT is also prolonged in advance chronic liver disease.9
Thrombocytopenia is a common feature of chronic liver disease and is seen in 30 to 64% of cirrhotic patients.10,11 Splenomegaly secondary to portal hypertension is considered the main cause of low platelet count in cirrhosis. The relationship between portal hypertension and thrombocytopenia is documented by the association between a low platelet count and the presence of gastrointestinal bleeding.12,13
Fibrinogen level is also considered as an evidence of increased fibrinolytic activity. Fibrinogen increases bleeding tendency in patients with chronic liver disease. Fibrinogen levels are within normal range in patients with stable chronic liver disease but decreased levels are found in patients with advance cirrhosis.1
A patient in recovery post op total hip replacement develops crushing central chest pain, ECG shows ST segment elevation (NB- no BP etc given, beta blockade was not an option). The most appropriate action is to give

a. Aspirin
b. IV GTN
c. IV heparin
d. Calcium channel blocker
e. T/L
a or b. Debates!
Stellate ganglion blockade causes

a. Conjunctival injection
b. Dry eyes
c. Decreased axillary sweating
All?
Features of ventricular tachycardia DO NOT include

a. Absence of p waves
b. Monophasic waves
c. Prominent R wave in V1
d. A-V dissociation
a
An inpatient becomes hyponatraemic 48 hours post op and has a seizure. The most appropriate treatment is

a. Fluid restriction
b. Normal saline ?ml/hr
c. Hypertonic saline
d. Salt tables
c
A child with 10% dehydration is likely to have

a. Bradycardia
b. Rapid deep breathing
b
When stimulating the ulnar nerve with a nerve stimulator, which muscle do you see twitch?

A. opponens abducens
B. abductor pollicis brevis
C. adductor pollicis brevis
D. extensor pollicis
E. flexor pollicis brevis
c
When analyising a study containing a control and two test groups, the best statistical method to use is....

A. Analysis of variance
B. Chi squared with Bonnferoni correction
C. ?
D.
E.
a
Acromegaly due to excess of growth hormone. Why is it difficult to do a direct laryngoscopy?

A: Distorted facial anatomy
B: Macroglossia
C: Glottic stenosis
D: Prognathe mandible
E: Arthritis of the neck
b
Post CEA on ward, patient seizes. BP has been hard to control. What to do to prevent further seizures?

A: Add another antihypertensive
B: Start antiplatelet drugs
C: Start anticonvulsants
D: Do angio and stent
E: Nimodipine
a
Main heat loss in anaesthetic for neonate

A. vasodilatation
B. radiation
C. convection
D. conduction
E. evaporative
b
Patient with aortic stenosis, the signs indicate poor prognosis

A. Palpitation
B. Radiation to carotid arteries
C. Paroxysmal nocturnal dyspnoea
D. Angina
E. Syncope
c
Circuit disconnection during spontaneous breathing anaesthesia

A. will be reliably detected by a fall in end-tidal carbon dioxide concentration
B. will be detected early by the low inspired oxygen alarm
C. will be most reliably detected by spirometry with minute volume alarms
D. may be detected by an unexpected drop in end-tidal volatile anaesthetic agent concentration
E. can be prevented by using new, single-use tubing
d
Which drugs below does not need dose adjustment in renal failure patient

A. Buprenorphine
B. Morphine
C. Tramadol
D. ?
E. ?
a
Fat: blood coefficient- N2O, Desflurane, Sevoflurane, Isoflurane

A. N2O ~ D > S > I
B. N2O > D > S > I (signs should be reversed)
C. D > N2O > S > I
D. N2O > D > S ~ I
E . D > N2O > I > S
b
The average expected depth of insertion of an oral endotracheal tube, from the lip, in a normal newborn infant is

A. 7.5 cm
B. 8.5 cm
C. 9.5 cm
D. 10.5 cm
E. 11.5 cm
c
Patient with severe Rheumatoid arthritis. Has C1/C2 instability. Most likely C-spine Xr finding would be

A. Anterior Atlantoodental interval >9 ?
B. Increased sagittal diameter
C. Posterior atlantodental interval >14
D. Midpart of C1 over C2 ?
E. Tear drop sign of C2
?
Subluxation greater than 3mm is significant
Patient complains of numbness of the anterior third of his tongue following GA with LMA. Which nerve is involved?

A. Glossopharyngeal
B. Facial nerve
C. Superior vagus
D Mandibular n.
d
Increased risk of post-partum haemorrhage in:

A. Nulliparous patient
B. Patient < 20 years old
C. Factor V Leiden deficiency
D. Oligohydramnios
E. Prolonged labour
e
Which of the following are feature of Conn’s syndrome?

A. Normoglycaemia, hypernatremia , hypokalemia
B. Hypoglycaemia, hypernatremia, hypokalemia
C. Hyperglycaemia, hyponatremia, hyperkalemia
D. Normoglycaemia, hyponatremia, hyperkalemia
E. Hypoglycaemia, hyponatremia, hyperkalemia
a

Excess aldosterone
Unequal consolidation on CXR can be caused by all except:

A. Pleural effusion
B. Pulmonary infarction
C. Pulmonary haemorrhage
D. APO
E. Pneumonia
d?
What is the mechanism of central sensitisation?

A. Increased intracellular magnesium
B. Antagonism of the NMDA receptor
C. Glycine is the major neurotransmitter involved
D. Recurrent a-delta fibre activation
E. Alteration in gene expression
e
A home handyman leaves his electricity turned on whilst fiddling with wires [repairing a power outlet]. He has a RCD. What happens if he touches the neutral and ground wires?

A. Nothing will happen
B. Receives macroshock
C. Protected from macroshock by RCD
D. Protected from microshock by domestic fuse
E Receives microshock
A

(C if it is active + neutral wires)
If a patient experiences parasthesia in the little finger during supraclavicular brachial plexus block, the needle is in proximity to the

A. posterior cord
B. middle trunk
C. Ulnar nerve
D. lower trunk
E. medial cord
d
What is the best predictor of severe bleeding in cirrhosis?

Thrombocytopaemia
Hypofibrinogenaemia
Prolonged PT
Hypoalbuminaemia
Pulmonary hypertension
b
What is the oxygen concentration in a standard bottle of heliox?

21%
25%
30%
33%

28% was NOT an option
28%
Some are 21%
Patient undergoing partial hepatic resection develops Venous Air Embolism. Best position should be

A. Head down left side up
B. Head down right side up
C. Head up right side up
D. Head up left side up
C
The pain of the first stage of labour is transmitted by:


A. Grey rami communicantes

B. T10-L1 anterior roots
C. The hypogastric plexus

D. Inhibitory nerves to the internal vesical sphincter

E. Parasympathetic nerves
c
You are asked by an Obstetrician to help relax a uterus in labour and deliver for manual removal of placenta. What is a safe and effective dose of IV GTN to be delivered?

5 mcg
50 mcg
250 mcg
400 mcg
500 mcg
b
Middle-aged male with severe MS having general anaesthesia for repair of fractured ulna / radius. 10 minutes into the case you notice a tachyarrythmia with his HR 130 and BP 70. He is normally in sinus. What do you do?

A. Adenosine
B. Amiodarone
C. Shock
D. :Volume
E. Metaraminol
c
A lady with a Fontan’s circulation for tricuspid atresia presents for caesarian section. What is the best way of maintaining her cardiac output?

Trendelenburg
Epidural contraindicated
Allow pCO2 to rise to 50 to vasodilate her
Short inspiratory time
Allow hypovolaemia
d
What is the best way to measure neonatal heart rate during resus?

Palpate a femoral artery
Palpate a carotid artery
Auscultate the precordium
Palpate the umbilical stump
ausc
The Revise Trauma Score includes the first measures of GCS, BP and:

HR
RR
SpO2
Temp
CVP
RR
During prolonged trendelenburg positioning there is:

No change in ICP
No change in IOP
Increased pulmonary compliance
Increased myocardial work
No increased pulmonary venous pressures
increase myocardial work
Alcoholic patient undergoes unremarkable anaesthesia for explorative laparotomy for investigation of abdominal pain. No pathology is found. However, in recovery the following electrolyte disturbances found:

Na 140
K 5.0
CL 115
HCO 18

What is the most likely cause

A. Acute renal failure
B. Lactatic acidosis
C. Methanol ingestion
D. Chloride [N/saline resuscitation]
E DKA
? DKA
In a neonate the main resistance in a circle system with CO2 absorber

APL valve
Expiratory and inspiratory unidirectional valves
tubing
ETT
HME filter
ETT
Blood flow across which of the following is used to estimate pulmonary artery pressures during echocardiography?

A. Tricuspid valve

B. Pulmonary valve

C. Mitral Valve
a
Which patient do you not put a left-sided Robert-Shaw DLT into?

A. Left pneumonectomy

B. Left main bronchial lesion

C. There is a right-sided broncho-pleural fistula

D. The patient has s hunt > 10%

E. The left lung is to be collapsed
b
You are asked by an Obstetrician to help relax a uterus in labour and deliver for manual removal of placenta. What is a safe and effective dose of IV GTN to be delivered?

5 mcg
50 mcg
250 mcg
400 mcg
500 mcg
b
Middle-aged male with severe MS having general anaesthesia for repair of fractured ulna / radius. 10 minutes into the case you notice a tachyarrythmia with his HR 130 and BP 70. He is normally in sinus. What do you do?

A. Adenosine
B. Amiodarone
C. Shock
D. :Volume
E. Metaraminol
c
A lady with a Fontan’s circulation for tricuspid atresia presents for caesarian section. What is the best way of maintaining her cardiac output?

Trendelenburg
Epidural contraindicated
Allow pCO2 to rise to 50 to vasodilate her
Short inspiratory time
Allow hypovolaemia
d
What is the best way to measure neonatal heart rate during resus?

Palpate a femoral artery
Palpate a carotid artery
Auscultate the precordium
Palpate the umbilical stump
ausc
The Revise Trauma Score includes the first measures of GCS, BP and:

HR
RR
SpO2
Temp
CVP
RR
During prolonged trendelenburg positioning there is:

No change in ICP
No change in IOP
Increased pulmonary compliance
Increased myocardial work
No increased pulmonary venous pressures
increase myocardial work
Alcoholic patient undergoes unremarkable anaesthesia for explorative laparotomy for investigation of abdominal pain. No pathology is found. However, in recovery the following electrolyte disturbances found:

Na 140
K 5.0
CL 115
HCO 18

What is the most likely cause

A. Acute renal failure
B. Lactatic acidosis
C. Methanol ingestion
D. Chloride [N/saline resuscitation]
E DKA
? DKA
In a neonate the main resistance in a circle system with CO2 absorber

APL valve
Expiratory and inspiratory unidirectional valves
tubing
ETT
HME filter
ETT
Blood flow across which of the following is used to estimate pulmonary artery pressures during echocardiography?

A. Tricuspid valve

B. Pulmonary valve

C. Mitral Valve
a
Which patient do you not put a left-sided Robert-Shaw DLT into?

A. Left pneumonectomy

B. Left main bronchial lesion

C. There is a right-sided broncho-pleural fistula

D. The patient has s hunt > 10%

E. The left lung is to be collapsed
b
A machine with a soda lime absorber was left on overnight with oxygen running at 6 litres per minute. In the morning a desflurane vaporiser is connected. What toxic substance may be produced?

A. Substance A
B. Carbon monoxide
C. Carbon dioxide
D. Calcium hydroxide
E. Substance B
b
A post-op child being given 2.5%D + 1/2NS on the ward seizes, is intubated and ventilated and transferred to ICU. Sodium is 116. What do you do?

A. Give phenytoin
B. Give hypertonic saline
C. Give normal saline
D. Give frusemide
E. Give normal saline
b
Which two nerves are most reliably blocked in a fascia iliaca block?

Various combinations of femoral, obturator, lateral cutaneous and sciatic
Femoral
Lateral cutaneous
Poor prognosis of AS

A. PND
B. Chest pain
C. Palpitation
D. Syncope
E. Malaise
PND - CCF
Required for diagnosis of Neuroleptic Malignant Syndrome
All except?
A. Diaphoresis
B. ↑ CK
C. Rigidity
D. Hypertension
E. ↑ HR
D?
Atrial septal defect, where is the murmur heard the loadest?

A. PV
B. MV
C. ASD
D. AV
E. TV
A
Young infant with Failure to Thrive. Born on the 20th percentile now is on the 5th percentile. Found to have a systolic murmur, tachynpnea with weak femoral pulse. The most likely diagnosis is

a. Coarctation
b. HOCM
c. PDA
d. AS
a
Myasthenia gravis, Eaton Lambert Syndrome What happens with exercise?

a. MG better, EL worse
b. EL better, MG worse
c. Both EL and MG get worse
d. Both EL and MG get better
b
Cephalothin doesn't cover:

a. Proteus
b. E coli
c. Staph
d. Strep
e. Pseudomonas
e
Regarding PS9 safe provision of anaesthesia for Colonoscopy:

A. Medical Practitioner to providing sedation with a skilled assistant who is not assisting the proceduralist.
B. Medical practitioner alone
C. Specialist Anaesthetist
D. Skilled nurse with airway experience
E. Skilled bogan
a? depends if 'anaesthetic' given
You see a man in his 60s in clinic 1 week prior to laparoscopic cholecystectomy. He has dilated cardiomyopathy with an ejection fraction of 30%, but does not get dyspnoeic with normal activities of daily living. What is the most appropriate management of his heart failure?

a. Frusemide
b. Amiodarone
c. ACE
d. Digoxin
e. Biventricular pacemaker
c
Young child with WPW undergoes general anaesthesia. Intra operatively developed tachycardia. HR 220, BP 80/40. Best drug to cardiovert

A. Adenosine
B. Amiodarone
C.
b?
Finding on haemophilia A patient

A. Female haemarthrosis
B. Male haemarthrosis
C. Normal PT, abnormal APTT
D. Abnormal PT, normal APTT
b or c
32 y/o male. Weakness distal and prox muscles, infection 10 days ago, no sensory involvement, temp 37.8, facial weakness. Cause:

A. Guillian Barre
B. Myasthenia Gravis
D. Poliomyelitis
E. ?Acute encephalitis
F. ?Polymyositis
a
What gestation to monitor uteroplacental flow

A 20 weeks

B 24 weeks

C 28 weeks

D 32 weeks

E 36 weeks
nfi
Endocarditis prophylaxis

A Bicuspid valve
B Congenital repair > 12 months ago
C Rheumatic heart valve
D Uncorrected cyanotic heart disease
E MVP + ?MR
d
Air bubble in arterial line. Causes decreased:

A Damping (increased)
B Resonant freq of system
a
Area burnt in adult male - upper half of upper limb, anterior abdo, whole left leg:

A 23% [changed figure compared to prev years]

B 32%
a
VT features:

A monophasic V6

B QRS > 0.14

C Right axis deviation
b
70 y/o postop in recovery following hip surgery. Develops severe chest pain, ST elevation. Immediate mx:

A Beta blocker

B Aspirin

C GTN infusion

D Heparin infusion
b