2014 B August Mcq

Front 1

Transdermal fentanyl patch peak effect

A 1hr

B 2hr

C 4 hr

D 12 hr

E 24 hr

Back 1

E

24-72 hrs

Front 2

Q2: Pharmacological studies are undertaken in several phases. A phase 3 study involves:
▪ A Animal studies
▪ B Testing of drug on healthy volunteers
▪ C Observational studies on patients with disease
▪ D Post marketing surveillance
▪ E Randomised controlled trials on target population

Back 2

E

Front 3

Q3: A pregnant patient 28/40 gestation is involved in a high-speed MVA. On admission to the DEM she complains of sudden onset severe chest pain. Her vital signs show HR 120, BP 160/100, SpO2 95% RA and her ECG shows ST depression. Most likely diagnosis is:
▪ A. Cardiac contusion
▪ B. Tension pneumothorax
▪ C. Aortic dissection
▪ D. Sternal fracture
▪ E. Myocardial infarction

Back 3

C

Front 4

Q4: A 5 year-old child with recently diagnosed Duchenne muscular dystrophy has an inhalation induction with sevoflurane for closed reduction of a distal forearm fracture. No other drugs have been given. 10 minutes later the child suffers a cardiac arrest. After a further 5 minutes a venous blood sample shows a potassium level of 8.5mmol/L. The most likely mechanism for the hyperkalaemia is:
▪ A MH
▪ B ARF
▪ C Cardiomyopathy
▪ D Rhambdomyolysis
▪ E Crush injury

Back 4

D

Front 5

Q5: A 30yr old pregnant patient develops contractions at 30/40 gestation. Which of the following can not be used for tocolysis?
A. Clonidine
B. Indomethacin
C: Magnesium
D. Salbutamol
E. Nifedipine

Back 5

A

Front 6

Q6: In a patient with intraorbital haemorrhage, following local anaesthetic injection, the adequacy of occular perfusion is best assessed by:
▪ A. Angiography
▪ B. Indirect opthalmoscopy
▪ C. Direct opthalmoscopy
▪ D. Intra-occular pressure tonometry
▪ E. Palpation of the globe by an experienced physician

Back 6

C

Front 7

Q7:What is the appropriate post-operative ibuprofen dosage for a one year old child tds?
▪ A. 5mg/kg
▪ B. 7.5mg/kg
▪ C. 10mg/kg
▪ D. 15mg/kg
▪ E. 20mg/kg

Back 7

C

Front 8

Q8:You are inducing a 4yr old child with Arthrogrophysis multiplex congenita. After you administer the induction agents, you find it difficult to place the laryngoscope. What is the likely complication?
▪ A. Malignant hyperthermia
▪ B. Neuroleptic malignant syndrome
▪ C. TMJ rigidity
▪ D. Opioid-induced rigidity
▪ E. Inadequate depth of anaesthesia

Back 8

C

Front 9

Q9: What is the best measure of the anticoagulant effect of Dabigatran?
▪ A. APTT
▪ B. Dilute thrombin time
▪ C. Prothrombin time
▪ D. Bleeding time
▪ E. TEG

Back 9

B

APTT not linear

ECT Ecarin clotting time can also be used

Front 10

Q10: What is the ratio of compression to breaths for neonatal resuscitation?
▪ A. 3:1
▪ B. 15:1
▪ C. 30:1
▪ D. 15:2
▪ E. 30:2

Back 10

A

Front 11

Q11: In patients with refractory elevated ICP, bilateral decompressive craniectomy is associated with reduction in ICP and also results in:
▪ A. Reduced duration of ventilation
▪ B. Reduced duration of hospitalisation
▪ C. Improved overall mortality
▪ D. Worse long-term neurological outcome
▪ E. Unchanged long-term neurological outcome

Back 11

D

Front 12

Q12:Tumour lysis syndrome causes all of the following biochemical abnormalities EXCEPT:
▪ A. Hyperkalaemia
▪ B. Hypernatraemia
▪ C. Hyperphosphataemia
▪ D. Hyperuricaemia
▪ E. Hypocalcaemia

Back 12

B

Causes hypo Na

Front 13

Q13: A patient has suffered flash burns to half of the left upper limb, all of the left lower limb and the anterior surface of the abdomen. The approximate percentage of the body surface which has been burnt is:
▪ A. 18%
▪ B. 23%
▪ C. 32%
▪ D. 41%
▪ E. 48%

Back 13

C

4.5 + 18 + 18

Front 14

Q14: You are anaesthetising an ASA 1 woman for a laparoscopic gynaecological procedure. How long does it take for the PaCO2 to peak?
▪ A. <15min
▪ B. 15-30min
▪ C. 30-60min
▪ D. 60-90min
▪ E. >90min

Back 14

B

Front 15

Q15: Anaemia post partial gastrectomy is most likely due to:
▪ A folate deficiency secondary to steatorrhea
▪ B ongoing haemorrhage from stomal ulcer '(yes Stomal not stomach)'
▪ C malabsorption of iron
▪ D Vit B deficiency due to loss of intrinsic factor
▪ E folate deficiency due to lack of appetite

Back 15

C

Front 16

Q16: 65year old for video assisted thoracoscopic lower lobe wedge resection. Surgeon requests lung isolation and one lung ventilation.
Predictors of intraoperative hypoxia are:
▪ A central rather than peripheral lesion
▪ B left sided lesion
▪ C low Aa Oxygen gradient when ventilating both lungs
▪ D right sided lesion
▪ E supine rather than lateral position

Back 16

C D and E

Front 17

Q17: Small air bubbles in the arterial line system will reduce
▪ A. Dampening coefficient
▪ B. ?Extrinsic Coefficient
▪ C. Measured systolic pressure
▪ D. Measured MAP
▪ E. Resonant frequency

Back 17

E

Front 18

Q18: RPT. Capnograph trace form a patient that is intubated and ventilated. What does it indicate
See previous paper for a picture, it was the same
▪ A. Endotracheal intubation
▪ B. Gas sample line leak
▪ C. ETT cuff leak
▪ D. Obstructive disease
▪ E. Spontaneous breaths

Back 18

B

Front 19

Q19: Lateral CXR given. Can see lower half of thorax and vertebrae but upper half is all black with clear demarcation
▪ A ?
▪ B Artifact caused by patient's arm
▪ C Left lower lobe consolidation
▪ D Right middle lobe consolidation
▪ E Right lower lobe consolidation

Back 19

?

Front 20

Q20: 12 year-old with idiopathic scoliosis, most likely have associated
▪ A Phaemochromocytoma
▪ B Renal artery stenosis
▪ C Mitral valve prolapse
▪ D Diabetes insipidus
▪ E

Back 20

C

Front 21

Q21: Term neonate, noted to have intermittent stridor few days after birth, then parents also notice stridor during feeding and sleep. Otherwise normal and healthy. Most likely condition is
▪ A Cri-du-chat syndrome
▪ B Laryngomalacia
▪ C Tracheomalacia
▪ D
▪ E

Back 21

B

Front 22

Q22: A picture of an echo 4 chambers view
▪ A Anterior mitral valve leaflet
▪ B Posterior mitral valve leaflet
▪ C
▪ D
▪ E

Back 22

?

Front 23

Q23: Cryoprecipate, once thawed must use within
▪ A 30 minutes
▪ B 2 hours
▪ C 4 hours
▪ D 6 hours
▪ E 12 hours

Back 23

D

Front 24

Q24: Glycine 1.5% used for TURP, osmolality is
▪ A 200
▪ B
▪ C
▪ D 300
▪ E 320

Back 24

A

hypotonic

Front 25

Q25: Sick ICU patients seem to have moderate - severe ARDS PaO2/FIO2 ratio of 200, C.I. 1.7 (cardiac function seems okay). Decided to have ECMO, best mode is
A AV
B VA
C VV
D. ?

Back 25

C

Front 26

Q26: Middle age women c/o pain in hands when hanging out washing. Also found to have muscle wasting on one of the hand associated with weaker radial pulse.
▪ A CRPS
▪ B Lateral medullary syndrome
▪ C Thoracic outlet syndrome
▪ D Paraneoplastic syndrome

Back 26

C

Front 27

Q27: Same radial nerve question with photos of a probe over postero-lateral upper arm and ultrasound image that show a triangular shape nerve, most likely the radial nerve. Injecting 5 ml of 0.75% [ropivacaine] will produce sensory block over
▪ A Medial forearm
▪ B Lateral forearm
▪ C Dorsum part of hand
▪ D Plantar surface of ring and little finger
▪ E Plantar surface of middle and ring finger

Back 27

C

Front 28

Q28: Blue urticaria is a complication of
▪ A
▪ B Methylene blue
▪ C Patent blue something
▪ D
▪ E

Back 28

C

PB V injection or isosulfan blue

Front 29

Q29: Intraosseous sampling - least accurate on
▪ A Albumin
▪ B Urea
▪ C
▪ D Chloride
▪ E

Back 29

B - Urea best choice of those 3

Not good for - Na, K, Ca, CO2, plus, WCC

Front 30

Q30: Subtenon's block - muscle most likely to have inadequate block
▪ A Medial rectus
▪ B Lateral
▪ C Superior
▪ D Superior oblique
▪ E Inferior

Back 30

D

Front 31

Q31: In patients with inoperable AS, compared to medical treatment TAVI has significantly lower incidence in 30 days of
▪ A Stroke
▪ B MI
▪ C Mortality
▪ D Atrial fibrillation
▪ E AKI

Back 31

None ….

Maybe D

Front 32

Q32: EVAR, best method to reduce risk of renal impairment
▪ A Sodium bicarbonate
▪ B N-acetylcysteine
▪ C Normal saline
▪ D
▪ E

Back 32

C

Front 33

Q33: EVAR is preferred over open AAA repair because
▪ A Lower cost
▪ B Lower mortality
▪ C Less follow up
▪ D Less re-intervention
▪ E Less need for critical care

Back 33

B and E

B more correct if lower operative mortality, as has same long term mortality as open

Front 34

Q34: Laser flex tube with double cuffs - how to inflate cuff(s)?
▪ A Inflate proximal then distal
▪ B Inflate distal then proximal
▪ C
▪ D Inflate distal only
▪ E Inflate proximal only

Back 34

E

Front 35

Q35: Forceps delivery. Loss of sensation medial thigh with loss of adduction at hip joint - resulted from injury to
▪ A Sciatic nerve
▪ B lumbosacral plexus
▪ C Lateral cutaneous nerve of thigh
▪ D Obturator nerve
▪ E

Back 35

D

Front 36

Q36: Called to cath lab because patient became agitated. Unstable angina having PCI, difficult right coronary stenting. Patient was hypotensive 80/40, HR 80/min in SR. What is the next best management step?
▪ A Transfer to operating theater immediately
▪ B Sedate and intubate
▪ C ?crack on
▪ D Transthoracic echocardiography

Back 36

D

Front 37

Q37: A printout of 12-lead ECG
▪ A Atrial fibrillation with BBB
▪ B Sinus tachycardia with BBB
▪ C Torsades de pointes
▪ D VT
▪ E VF

Back 37

Apparently wide complex tachycardia …. ? VT, Torsades

Front 38

Q38: Diagram about 3-bottle underwater seal drain, with the height of the fluid level in the suction bottle indicates
▪ A Maximal suction applied to the system
▪ B
▪ C
▪ D
▪ E

Back 38

A

Front 39

Q39: Photo of a patient with tongue deviation post cervical spinal fusion. Which nerve is damaged?
▪ A Glossopharyngeal nerve
▪ B Vagus nerve
▪ C Hypoglossal nerve
▪ D Accessory nerve
▪ E

Back 39

C

Front 40

Q40: Post cardiac surgery. Rhythm strip to assess pacing on AOO. What is the diagnosis?
▪ A Pacing spikes with loss of capture
▪ B
▪ C
▪ D
▪ E

Back 40

?

Front 41

Q41: Young male with MVA + femur # on traction. More than 24 hours. Became confused and drowsy, BP normal, crackles both lung fields with worsening O2 saturation despite increasing oxygen flow. Diagnosis?
▪ A Fat embolism
▪ B Compartment syndrome
▪ C Pulmonary embolism
▪ D
▪ E

Back 41

A

Front 42

Q42: G5P5 in third stage labour. Found to be unresponsive, cyanosed, faint pulse. On oxytocin induction and epidural infusion 10ml/hour. Also oozing from previous IV or blood sampling sites. Diagnosis?
▪ A High spinal
▪ B AFE
▪ C PE
▪ D
▪ E Massive haemorrhage

Back 42

B

Front 43

Q43: In iron deficiency anaemia, one will expect a serum ferritin level to be less than
▪ A 300mg/L
▪ B 30mg/L
▪ C 30mcg/L
▪ D 300mcg/L
▪ E

Back 43

C

Front 44

Q44: Treatment for patients with congenital long QT syndrome
▪ A Pacemaker/defibrillator
▪ B Accessory pathway abalation
▪ C Beta blocker
▪ D Calcium channel blocker
▪ E

Back 44

C

Then an ICD if fails

Front 45

Q45: What can not be used for tocolysis in a 30/40 (NOT 34/40) pregnant lady?
▪ A Clonidine
▪ B Indomethacin
▪ C Salbutamol
▪ D
▪ E

Back 45

A

Front 46

Q46: 18 month old child with VF arrest, shock with
▪ A 10J
▪ B 30J
▪ C 50J
▪ D 100J
▪ E

Back 46

C

12kgs approx x 4 = 48

Front 47

Q47: Endovascular coiling of cerebral aneurysm under GA, patient suddenly develop hypertension. What is the most likely cause?
▪ A Acute hydrocephalus
▪ B Rupture of aneurysm
▪ C Contrast reaction
▪ D Cerebral embolism
▪ E

Back 47

B

Front 48

Q48: A patient on citalopram. Post-op in PACU given tramadol. Developed fever, tremor, restlessness, confusion, hyperreflexia. Diagnosis is
▪ A Neuroleptic malignant syndrome
▪ B MH
▪ C Serotonin syndrome
▪ D

Back 48

C

Hyperreflexia not in NMS

Front 49

Q49: Best drug to reduce both gastric acidity and volume
▪ A Ranitidine
▪ B PPI
▪ C Sodium citrate
▪ D
▪ E

Back 49

A

Front 50

Q50: Patient on moclobemide came in for surgery. In view of the use of vasopressor to treat hypotension one will give judicious amount of
▪ A
▪ B Metaraminol
▪ C Adrenaline
▪ D Noradrenaline
▪ E Phenylephrine

Back 50

E

Front 51

Q51: Patient with hyperthyroidism - proceed with elective surgery only if normal level of these hormones is seen
▪ A TSH
▪ B T4
▪ C T3
▪ D T3 & T4
▪ E

Back 51

D

Front 52

Q52: In pregnant women the durac sac ends at
▪ A S2
▪ B L3
▪ C L5
▪ D S1
▪ E S3

Back 52

A

Front 53

Q53: The following capnography trace was observed in an intubated and ventilated patient. The most likely explanation for this respiratory pattern is
▪ A endobronchial intubation
▪ B endotracheal cuff leak
▪ C gas sampling line leak
▪ D obstructive airways disease
▪ E spontaneous ventilatory effort

Back 53

C

Front 54

Q54: Full size oxygen cylinder providing 10L/min of oxygen flow to a patient during transport. How long will this cylinder last?
▪ A
▪ B
▪ C 45 minutes
▪ D
▪ E

Back 54

C

C cylinder is 400L.

Front 55

Q55: Why is echinacea contraindicated post renal transplant
• A immune system
• B bleeding risk
• C nephrotoxicity

Back 55

A

Front 56

Q56: Jehovah's witness having a TKR. You agree to proceed with surgery. Which ethical principle are you honouring?
▪ A Autonomy
▪ B Non-maleficence
▪ C Beneficence
▪ D Justice
▪ E Fidelity

Back 56

A

Front 57

Q57: Red-man syndrome secondary to vancomycin is due to
▪ A Type II hypersensitivity reaction
▪ B Vasodilation
▪ C Mast cell degranulation
▪ D IgE immediated response
▪ E Serotonin release

Back 57

C

Front 58

Q58: A 40 y.o. female newly diagnosed ITP. Retinal detachment for surgery in 2 days. Platelets 40 and blood group A+. Management of her ITP:
▪ A Administer Anti-D antibodies 6 hrs pre op
▪ B Admister desmopressin one hour pre op
▪ C Administer methylpred and IVIg 2 days pre op
▪ D Recheck platelet count morning of surgery and if not dropped continue
▪ E Platelet transfusion morning of surgery

Back 58

C

Front 59

Q59: Absolute contraindication to ECT
▪ A Cochlear implants
▪ B Epilepsy
▪ C Pregnancy
▪ D Raised intracranial pressure
▪ E Myocardial infarction

Back 59

D

Front 60

Q60: 40yr old male for craniotomy case on Propofol and Remi TIVA. MAP 70mmHg, HR 70, Sata 98%. State entropy is 50 and response entropy is 70. Most appropriate next step is?
a) Check TOF with NM monitor
b) Increase propofol TCI by 0.5
c) Do nothing
d) Change to volatile anaesthetic
e) Give metaraminol 0.5mg IV

Back 60

A

Front 61

Q61 : The Characteristic respiratory pattern in a patient with an acute C5 spinal cord injury is

▪ A) Rapid respiratory rate
▪ B) Arterial hypoxaemia
▪ C) Chest wall immobility
▪ D) Preserved cough
▪ E) Preserved inspiratory force

Back 61

?A

Front 62

Q62: Percentage population heterozygous for pseudocholinesterase deficiency (dibucaine number 30-70)?
a) 0.04%
b) 0.4%
c) 4%
d) 14%
e) 40%

Back 62

C

Front 63

Q63: CO2 laser causes less damage
a) Long IR wavelength

Back 63

A

Front 64

Q64: Decreased MA on TEG correlates best to needing to give
a) Platelets
b) TXA
c) FFP
d) Cryoprecipitate
e) PCC

Back 64

A

Front 65

Q65: MELD score consists of INR + bilirubin +
a) Albumin
b) Creatinine
c) Urea
d) AST
e) Ammonia

Back 65

B

Front 66

Q66: Which is the least likely fraudulent research reduction strategy?
a) Backing of a major research institute
b) Multiple authors
c) Published in a peer review journal
d) Department director sole author
e) Research findings similar to previous studies

Back 66

D

Front 67

Q67: An 80 year old man undergoes a unilateral lumbar sympathetic block. The most likely side effect that he experiences is
a) Haematuria
b) Genitofemoral neuralgia
c) Postural hypotension
d) Lumbar radiculopathy
e) Psoas haematoma

Back 67

C

?B

Front 68

Q68: The most important effect of Luggol’s iodine before thyroid surgery is
a) Reduces vascularity of thyroid gland
b) Reduces incidence of thyroid storm
c) Reduces incidence of vocal cord palsy
d) Increases likelihood of preserving parathyroid glands
e) Pigmentation of the thyroid gland to help identify gland

Back 68

A

Front 69

Q69: Best indicator that ICP is not elevated in an awake patient
a) No headache
b) No diplopia
c) No vomiting
d) Pulsatile retinal vein
e) No papilloedema

Back 69

D

Front 70

Q70: What % of patients with SAH are troponin positive?
a) <5%
b) 15-30%
c) 40-60%
d) 70-90%
e) 100%

Back 70

B

Front 71

Q71: What is the most accurate way to determine the heart rate in a neonate?
a) Palapate umbilical artery pulse
b) Palpate the femoral artery
c) Auscultate the chest with a stetescope
d) Pulse oximeter

Back 71

C

Front 72

Q72: Optimal fluid management during laparotomy
a) PPV
b) TOE
c) CVP
d) Art pulse contour analysis
e) HR

Back 72

D

Front 73

Q73: 50yr old man for AVR. Stable on bypass initially. first dose of cardioplegic given. MAP 25, CVP 1, MVO2 80%. What is the best management of this situation?
a) Obtain IV access and crossmatch
b) Commence a vasopressor and support circulation
c) Increase oxygen flow rate
d) Increase pump flow rate
e) IV crystalloid bolus

Back 73

B

Front 74

Q74: Maximum recommended time for torniquet
a) 90 minutes
b) 120 minutes

Back 74

B

Front 75

Q75: Best way to achieve perfusion during aortic arch repair
a) Anterograde via carotids

b) Retrograde

c) Deep hypothermic arrest at 20 degrees

Back 75

A

Front 76

Q76: Post R pneumonectomy on ward becomes acutely unwell. Hypotensive, raised JVP. What do you do ?
a) turn L lateral

Back 76

A

Front 77

Q77: Venous air embolism during liver surgery. What is the most appropriate position to place them in?
a) Trendelenburg and R side up
b) Trendelenburg and L side up
c) Reverse trendelenburg and R side up
d) Reverse trendelenburg and L side up

Back 77

A

Front 78

Q78: Hours for tryptase to peak
a) 24
b) 48
c) 12

Back 78

None - 4 hrs

Front 79

Q79: TBI. What fluid not to give?
a) NACL
b) Hartmanns
c) Albumin
d) Colloids

Back 79

C

Front 80

Q80: Which population is more liable to CNS damage from hyponatraemia?
a) Children
b) Young males
c) Young females
d) Old males
e) Old females

Back 80

C

Front 81

Q81: Hb 86 in post TKR in asymptomatic patient with stable angina. What do you do?
a) Transfuse to 120
b) Transfuse to 100
c) Observe overnight and repeat mane

Back 81

C

Front 82

Q82: Healthcare worker with Hep B exposure. Known to have immunization titres. What do you do?
a) booster dose of immunization
b) HBV immunoglobulins
c) Pegylated interferon
d) Aciclovir

Back 82

A

Front 83

Q83: HIV seroconversion post needle stick injury
a) 0.3%
b) 3%
c) 30%

Back 83

A

Front 84

Q84: ABG with diagnosing intraoperative MH
a) High Pco2
b) Alkalosis

Back 84

A

Front 85

Q85: Balloon pump trace. Does it show?
a) Early inflation
b) Lare inflation
c) Early deflation
d) Late deflation

Back 85

?

Front 86

Q86: A 6 week old baby is booked for an elective right inguinal hernia repair. An appropraite fasting time is
a) 2 hours for breast milk
b) 4 hours for formula
c) 5 hours of breast milk or formula
d) 6 hours for solids
e) 8 hours for solids and 4 hours for fluids

Back 86

None

D technically correct

Front 87

Q87: Hyperkalaemia of 7 or 8. Most appropriate therapy
a) Insulin and glucose
b) Bicarb
c) Salbutamol

Back 87

A

Front 88

Q88a: CTG with early decelerations. Most likely due to
a)
Q88b : CTG with late decelerations. Most likely due to
a) Foetal asphylaxia
b) Head compression
c) Cord compression
d) Uteroplacental deficiency

Back 88

88a Head compression

88b D if late prolonged, if just late then A

Front 89

Q89: Stellate Ganglion block
a) Aim C6 transverse process

Back 89

A

Front 90

Q90: CVC relatively contraindicated in
a) RBBB
b) LBBB
c) AS

Back 90

B

Front 91

Q91a: Infective endocarditis prophylaxis indicated in
a) Uncorrected CHD
Q91b: Infective endocarditis in patient with MVR appropriate for
a) Dental procedure
b) Rigid bronch
c) Upper endoscopy with Bx
d) D and C
e) Lithotripsy

Back 91

91a A

91b E

Front 92

Q92: Max dose of lignocaine in tumescence technique
a) 35mg

Back 92

A

Front 93

Q93: You are performing an interscalene nerve block using a nerve stimulator when your patient begins to hiccough. You should aim to position the tip of your needle more
▪ A) Anterior
▪ B) Posterior
▪ C) Cephalad
▪ D) Caudal
▪ E) Superficial

Back 93

B

Front 94

Q94 Humidity question. 100% saturated air at 20 degrees is what relative humidity a 37 degrees?

A. 20%

B. 30%

C. 40%

D. 50%

E. 60%

Back 94

C

Front 95

Q95 Medial peribulbar block tip max distance past equator for minimal vein injury
▪ A. 5
▪ B. 10
▪ C. 15
▪ D. 20
▪ E. 25

Back 95

B

Front 96

Q96 Prothrombinex VF is useful in the perioperative period to correct the coagulopathic defect of all of the following except

▪ A. Isolated factor II deficiency
▪ B. Isolated factor VII deficiency
▪ C. Isolated factor IX deficiency
▪ D. Isolated factor X deficiency
▪ E. Warfarin

Back 96

B

Front 97

Q97 A 65 year old man otherwise fit and healthy is having a TKR under GA (O2, N2O, sevoflurane and fentanyl). His blood pressure has been stable through-out the case at 130/80. Before the orthopaedic surgeons start reaming and bone cemetation you should

▪ A. Give heparin 5000 iu
▪ B. Give a corticosteroid
▪ C. Cease N2O
▪ D. Induce hypotension
▪ E. Give a vasopressor to increase blood pressure

Back 97

?E

Front 98

Q98 Craniotomy, MAP 80, Transducer 13 cm below. CVP 5, CPP = ?

A. 75

B. 65

Back 98

A or B

Front 99

Q99 Physiological responses to hemodilution include all except

Back 99

Usual answer is increased CO

Front 100

Q100 ABG to diagnose introp MH

Back 100

Raised CO2, raised K

Front 101

Q 101 Parkland formula burns volume. 20kg child, 15% full thickness. 6 hours ago

A. 360

Back 101

A

20 x 15 x 4 = 1200 total

600 first 8 hours. 6 hours past

So 300 one hr, 300 next hr

(plus maintenance)

Front 102

Q102 Agitated with swollen neck post ant cervical surgery. Resp distress, SaO2 96%

A. Gas induction and direct laryngoscopy

B. AFOI

C. Aspirate with 19g needle

D. Intubate with intubating LMA

E. IV induction and direct karyngoscopy

Back 102

A

Front 103

Q103 Asthmatic paediatric patient for tonsillectomy. Desaturates and stiff to bag. What do you to first?

A. Salbutamol

B. Tell surgeon to release clamp

C. Suction

Back 103

B

Front 104

Q104 Phaeo hypertensive. Intraop Mx

A. Magnesium

Back 104

A

Front 105

Q105 Negative lapaortomy. 3L NS given. ABG shows

A. Hyperchloraemic metabolic acidosis

Back 105

A

Front 106

Q106 Paced ECG showing

Back 106

?

Front 107

Q107 You extubate a young woman after a dental procedure under GA. She has a history of hereditary angioedema and in recovery develops airway oedema. Best treatment

A. FFP

B. IV adrenaline

C. IV corticosteroids

D. IV promethazine

E. Nebulised adrenaline

Back 107

A

Front 108

Q 108 A previously well 65 yo woman develops acute SOB 3 days post hip replacement. Most appropriate Ix to confirm PE is

A. CTPA

B. D dimer

C. ECHO

D. ECG

E. VQ scan

Back 108

A

Front 109

Q 109 20 yr old female with 20% burns to her body. She weighs 80kgs. How much fluid should she have in the next 8 hours?

A. 4L

B. 4.8L

C. 5L

D. 6L

E. 8L

Back 109

A

Front 110

Q 110 50yo female with Hx of menorrhagia is having a hysterectomy. Pre op Hb is 95. What serum ferritin would confirm iron def anaemia?

A. 30mcg/L

B. 3mg/L

C. 3 mcg/L

D. 0.3 mg/L

E. 30000mcg/L

Back 110

C

Front 111

Q111 Max cumalitive dose of intralipid

A. 10

B. 12

C. 15

D. 20

Back 111

B

Front 112

Q 112 60yo alcoholic with HT, has abdo pain. No finding on laparotomy. 12 hrs later

Na 140, K 5, Cl 115, HCO3 18. Most likely Dx?

A. ARF
B. DKA

C. Lactic acidosis

D. Methanol

E. NaCl infusion

Back 112

D

Front 113

Q 113 Paediatric patient. What can you do to lower risk of laryngospasm?

A. Thio induction VS propofol

B. ETT va LMA

c. IV versus inhalational

Back 113

? C

Front 114

Q114. Paeds pt # arm 2 days ago. Current URTI. lowest risk of laryngospasm.

A. ETT

B. LMA with IPPV

C. LMA with spont vent

D. Mask with spent vent

Back 114

?D

Front 115

Q115 Mid procedure patient with CVC in situ. LIM alarms indicate loss of floating circuit. What is most appropriate mx?

A. Stop surgery

B. Disconnect with CVC

C. Immediately ground the patient

D. Disconnect non essential equipment from circuit until fault identified

Back 115

D

Front 116

Q 116 Target INR for mechanical valve replacement

A. 2-3

B. 2.5-3.5

C. 3-4

Back 116

B if MV, A if AV

Front 117

Q 117 Hunt and Hess classification in woman who is confused and has ocular palsy

A. 0

B. 1
C. 2

D. 3

E. 4

Back 117

C

Front 118

Q118 Patient who is estimated to be AHA/ACC cardiac risk moderate. Risk in percentage is

A. 1-5%

B. 5-10%

C. 10-15%

Back 118

? B

Front 119

Q119 What is the mechanism for heat loss under GA?

A. Redistribution of body heat

B. Decreased production

C. Increased heat loss

Back 119

A

Front 120

Q120 Flow volume loop showing flattening insp portion

A. Variable IT obstruction

B. Variable ET obstruction

Back 120

B

Front 121

Q 121 FAST scan

A. Perihepatic space, perisplenic space, pericardium, pelvis

B. Various combos with paracolic gutter

Back 121

A

Front 122

Q 122 Fat man. CO

A. Decreased

B. Same

C. Increased 10%

D. Increased 20%

E. Increased 30%

Back 122

C

Front 123

Q123 4 mets is how many mls of O2
A. 10
B. 12
C. 14
D. 16

Back 123

C

Front 124

Q124 A 30 year old multi trauma patient one week post injury has severe ARDS. He is currently ventilated at 6ml/kg tidal volume, PEEP of 15cm H20 and pa02/Fi02 is less than 150. The next step to improve oxygenation is:
▪ A. increase PEEP to 20cmH20
▪ B. increase tidal volume to 10mls/kg
▪ C. initiate nitrous oxide therapy
▪ D. commence high flow oscillatory ventilation
▪ E. ventilate in the prone position

Back 124

A or E

Front 125

Q125 When topping up a labour ward epidural to an epidural for lower segment caesarean section, the optimum level of block when assessed for light touch is to:
▪ A. T2
▪ B. T4
▪ C. T6
▪ D. T8
▪ E. T11

Back 125

?C

Front 126

Q 126 You are involved in research and as part of data collection you collect ASA scores. This type of data is:
▪ A. Categorical
▪ B. Nominal
▪ C. Non-parametric
▪ D. Numerical
▪ E. Ordinal

Back 126

E

Front 127

Q127 During a pneumoperitoneum, at what level of intra-abdominal does cardiac output fall?
▪ A. 10 mmHg
▪ B. 20 mmHg
▪ C. 30 mmHg
▪ D. 40 mmHg
▪ E. 50 mmHg

Back 127

B

Front 128

Q128 Best option to reduce risk of ventilator induced pneumonia?
▪ A. Nurse in supine position
▪ B. Early spontaneous ventilation through ETT
▪ C. Oral hygiene
▪ D. Use antacids
▪ E. Regularly change breathing circle

Back 128

C

Front 129

Q129 Which drug should be avoided both intra- and post operatively in a woman having surgery who is breast feeding a 6 week old baby?
▪ A. codeine
▪ B. morphine
▪ C. paracetamol
▪ D. parecoxib
▪ E. tramadol

Back 129

A

Front 130

Q131 The normal physiological response following ECT is
▪ A. transient tachycardia followed by bradycardia and hypotension
▪ B. transient bradycardia followed by tachycardia and hypertension
▪ C. unpredictable
▪ D. transient tachycardia followed by bradycardia and hypertension
▪ E. tachycardia and hypotension

Back 130

B

Front 131

Q132 In preadmission clinic with patient with a tracheostomy. To enable patient to talk you would-
▪ A. Deflate tracheostomy cuff, insert one-way valve, insert fenestrated piece
▪ B. Deflate tracheostomy cuff, remove one-way valve, insert fenestrated piece
▪ C. Inflate tracheostomy cuff, remove one-way valve, insert fenestrated piece
▪ D. Inflate tracheostomy cuff, insert one-way valve, insert fenestrated piece

Back 131

-

Front 132

Q 133 What is NOT a contraindication to MRI?
▪ A. Pulmonary artery catheter
▪ B. Arterial line
▪ C. Scissors
▪ D. Coiled ECG cable
▪ E. Laryngoscope

Back 132

B

Front 133

Q134 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

Back 133

E

Front 134

Q135 Which volatile contributes most to greenhouse gases / environmental pollutant ?
▪ A Desflurane
▪ B N2O
▪ C Sevoflurane
▪ D Isoflurane
▪ E Halothane

Back 134

A

Front 135

Q136 The clinical sign that a lay person should use to decide whether to start CPR is:
▪ A. Absent central pulse
▪ B. Absent peripheral pulse
▪ C. Loss of consciousness
▪ D. Obvious airway obstruction
▪ E. Absence of breathing

Back 135

E

Front 136

Q137 A patient's competence to give informed consent is determined by all the following except:
▪ A. Ability to communicate a choice
▪ B. Ability to apply reasoning
▪ C. Ability to understand consequences
▪ D. The provision of significant information
▪ E. ?

Back 136

? A

Front 137

Q138 Patient with Haemophilia A with known high titres of inhibitors to factor 8. What would you give to prevent bleeding in the patient for OT
a. FVIIa
▪ b. High dose FVIII concentrate
▪ c. FFP
▪ d. Cryo
▪ e. Platelets

Back 137

? A

Front 138

Q130 Q 130 A patient is in Class 4 haemorrhagic shock, secondary to a gunshot wound to the abdomen. He is clinically coagulopathic 30 minutes later. He has received intravenous Hartmann's 1L. The coagulopathy is likely related to:
▪ A. acidosis
▪ B. dilution of clotting factors
▪ C. hypothermia
▪ D. systemic release of tissue factor
▪ E. tissue hypoperfusion

Back 138

?D