Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
138 Cards in this Set
- Front
- Back
|
1) A 120kg lady34/40 is admitted to the ward with threatened pre-term labour. What dose of s/cClexane do you prescribe her for thromboprophylaxis? a) 20mg b) 40mg c) 60mg d) 100mg e) 120mg |
B - 40mg |
|
|
1) What is thearrangement of 3 lead ECG: a) Left arm –black, right arm – white, left leg – green b) Left arm –red, right arm – white, left leg – black c) Left arm –black, right leg – white, left leg – red d) Left arm –black, right arm – white, left leg – red e) Left arm –black, right arm – white, right leg – red |
D |
|
|
1) What is youraim for systolic blood pressure in a closed head injury a) 80 mmHg b) 90 mmHg c) 100 mmHg d) 110 mmHg e) 120 mmHg |
Best outcomes if >120mmHg (best practice BMJ) |
|
|
1) The vocalcords are lax after an LMA anaesthetic. What nerve has been injured? a) Superior laryngeal b) Inferior laryngeal c) Recurrent laryngeal d) |
A – superiorlaryngeal nerve supplies cricothyroid muscle which tenses the VC. Palsy resultsin cords that have difficulty closing. RLN palsy, cords cannot abduct and areclosed |
|
|
1) What is the1st line treatment of a young man in ED with recently diagnosedphaeochromocytoma who has presented with severe hypertension andtachycardia? He is not on anycurrent treatment. a) Esmolol b) Phentolamine c) Phenoxybenzamine d) GTN |
? b or C (Cis the standard starting med for alpha blocking. Not sure if phentolamine would be more appropriate in ED management |
|
|
1) What is thesafest duration between ceasing Ticagrelor and performing a neuraxial block? a) 1 day b) 3 days c) 5 days d) 7 days |
C 5 days –ASRA and AAGBI |
|
|
1) You are aconsultant anaesthetist asked to help a junior registrar who is havingdifficulty siting a labour epidural. In assisting them site the epidural allyou do is place on sterile gloves. This is known as a: a) Slip b) Lapse c) Violation d) Deviation e) ?Mistake |
C) violation |
|
|
1) You arecalled to assist a registrar in the next theatre who is having difficultyintubating a patient. On arrival,the nurse tells you he has been trying for 5 minutes and you notice the satsare 70%. You place an LMA easilyand ventilate the patient back to normal saturations. According to Crisis Resource Management principles, theerror the registrar was displaying is… a) Fixationerror b) Failure touse cognitive aids c) d) |
A |
|
|
1) What is nota feature of Horner’s Syndrome?a) Exophthalmos b) Anhydrosisetc c) Miosis d) |
a Horners: miosis, ptosis, anhidrosis, with or w/out enophthalmos |
|
|
1) Troponinrise in SAH occurs in what percentage of patients? a) 5-15% b) 15-30% c) 30-45% d) 45-60% e) 60-75% |
B 17-28 % Br J Anaesth (2007) 99 (1): 102-118. |
|
|
1) Accidentalneedlestick injury with a hollow bore needle. Likelihood of Hepatitis C transmission? a) 0.3% b) 2% c) 10% d) 20% e) 30% |
B – can’tspecifically find info about hollow bore needle, but risk of HCV following needlestick is 2% (CDC) and 1.5-3% elsewhere,so 2%sounds good. Rule of 3s HIV 0.3%,HCV 3%, HBV 30% |
|
|
1) Emergencedelirium in paediatric patients occurs most commonly after what type of surgery: a) Adenotonsillectomy b) Circumcision c) Closedreduction of fracture d) Colonoscopy e) Inguinalhernia repair |
A - Surgical risk factors include ENT and ophthalmology surgery |
|
|
1) The PinIndex System for nitrous oxide on a size C cylinder: a) 1, 5 b) 1, 6 c) 2, 5 d) 3, 5 e) 3, 6 |
D – N2O2 -3,5 -- > air is 1, 5, O2 is 2,5 |
|
|
1) 70 year oldmale in the emergency department with a ?small bowel obstruction. On candesartan, an NSAID and adiuretic. His serum potassium is7.0mmol/L. What is thefirst/initial step for lowering his potassium? a) Slow IVinjection of 10ml calcium gluconate 10% b) Salbutamol5mg nebuliser c) 15IU insulinin 50ml of 50% dextrose d) Sodiumbicarbonate 50ml e) Calcium resonium |
C – loweringpotassiumWould needcalcium too though |
|
|
1) A patienthas a tumour of some sort. He is hypokalaemicand has a metabolic alkalosis. What is the tumour most likely secreting? a) Adrenocorticotropichormone b) Antidiuretichormone c) Parathyroid-typesecreting hormone d) Glucocorticoid e) Thyroidstimulating hormone |
A – ACTH - Cushing Syndrome – hypokalaemia, hypertension, metabolicalkalosis |
|
|
1) The nerveintegrity monitor (NIM) endotracheal tube works by monitoring: a) Electromyographyof internal laryngeal muscles b) Recurrent laryngeal nerve action potential c) Movement ofthe vocal cords on the endotracheal tube d) Pressure ofthe vocal cords on the endotracheal tube e) Recurrentlaryngeal nerve action potential |
A |
|
|
1) External andinternal diameter of the common gas outlet a) 30mm and15mm b) 22mm and15mm c) 30mm and20mm d) 32mm and20mm |
B |
|
|
1) Adult maleis anaesthetised with a CVC in situ. Just before the surgeon starts the Line Isolation Monitor alarms about aleak of 5mA. What do you do? a) Check thediathermy pad b) Ensure thepatient is earthed/grounded c) Unplug theCVL to isolate the patient until the fault is identified d) Sequentiallyremove non-essential monitors from the circuit until the fault is identified e) Stop theprocedure and move the patient to a safe location |
D |
|
|
1) In a patientwith rheumatoid arthritis, what is the most common direction of atlanto-occipitalsubluxation? a) Anterior b) Posterior c) Vertical d) Rotatory e) Lateral |
A – 80% ofAO subluxation – CEACCP – laxity of transverse ligamentPosterior 5% vertical 10-20% - worse prognosisthe cordlies behind the dens |
|
|
1) An interosseusaspiration is least accurate for measuring: a) Albumin b) Creatinine c) Chloride d) Sodium e) Potassium |
Comparablevenous measurements for albumin, creatinine, chloride, RBC, HCT, glu, ureaNotcomparable for WBC, plt, potassium, sodium, calcium E - I’d probably go with potassium as ithas the narrowest margin Alsoconsider haemolysis |
|
|
1) You arecalled to assist your registrar who is administering an interscalene nerveblock. After injection of 2ml0.75% ropivacaine the patient has a grand-mal seizure. The local anaesthetic has likely beeninjected into the: a) Dural cuff b) Internaljugular vein c) Internalcarotid artery d) Externaljugular vein e) Vertebralartery |
E |
|
|
1) A patienthas an above the elbow ulnar nerve palsy following a procedure. They a) Reducedsensation of posterior arm b) Arm held inpersistent supination c) Unable toflex wrist d) Weakness ofthumb abduction e) Weakness offinger adduction |
Ulnar nerve– sensation medial arm, thumb adduction, finger adduction, flex and abductwrist, flex little finger,e |
|
|
1) You’ve beenasked to set up an outside area recovery room. All of the following are essential in each bay except: a) ECG b) Sphygmanomanometer c) Stethoscope d) Pulseoximetry e) Thermometer |
A - ANZCA professional document |
|
|
1) Patientasked to look straight ahead. Picture of eyes with lateral deviation of right eye. What is his abnormality? a) CN II palsy b) CN III palsy c) CN IV palsy d) CN V palsy e) CN VI palsy |
B |
|
|
1) A 63 yo ladyhas known chronic atrial fibrillation, hypertension, previous stroke, type 2diabetes. What is her annualstroke risk if she is not on anticoagulation? a) 1.3% b) 4.0% c) 5.8% |
8.5% risk CHADs2 =4 |
|
|
1) A patient withcardiac disease gets short of breath moving around their house. What is their New York HeartAssociation classification? a) Class I b) Class II c) Class III d) Class IV e) Class V |
C |
|
|
1) Patienthaving resection of a lesion from the lateral border of their lower rightlip. The surgeon does not want toperform local infiltration and the patient refuses a GA. Which nerve will you block? a) Infraorbital b) Mental |
B |
|
|
1) The afferentlimb of the occulocardiac reflex is mediated by: a) Long and shortciliary nerves b) Facial nerve c) Vagus nerve d) Optic nerve e) Ophthalmicnerve |
E ciliary ganglion to ophthalmic nerve division of trigeminal nerve |
|
|
1) Patient’score temperature drops 1 degree 20 minutes after induction of generalanaesthesia. What is the mostlikely cause: a) Redistributionfrom core to peripheries b) Radiation c) Conductionfrom body to operating table/bed d) Evaporation |
a |
|
|
1) Well childfor closed reduction of a fracture sustained 2 days ago. Well controlled asthma (on inhalers),current URTI. Chest sounds clear,systemically well. What is thebest option for managing his airway? a) Controlledventilation via ETT b) Spontaneousventilation via ETT c) Spontaneousventilation via face mask d) Spontaneousventilation via Laryngeal Mask Airway e) Spontaneousventilation via Proseal Laryngeal Mask Airway |
C |
|
|
1) Pressurecomparison, list in order from highest to lowest (different combos of 10 kPa/10atm/10 psi/10 mmHg/10 cmH2O) |
10 ATM > 10PSI > 10kPa >10 mmHg >10cmH20 |
|
|
1) How muchfibrinogen will it take to increase fibrinogen by 1g/L a) 1ml/kg b) 5ml/kg c) 10ml/kg d) 20ml/kg e) 30ml/kg |
C 11 unit of whole blood cryoprecipitate per 5-10kg will incr fibrinogen 0.5-1g/L 10ml/kg |
|
|
1) Time takenfor plasma and brain equilibration of methadone a) 3 minutes b) 8 minutes c) 20 minutes d) 60 minutes e) 120 minutes |
B Te = 8min can be detected in blood in 30 min peak levels after 2-4 hrs |
|
|
1) Septic elderlypatient with multiorgan failure requiring laparotomy for suspected deadgut. INR 2.1, Hb 90, Platelets105, Fib 4 (?or 1.5). Whatproducts to give? a) 2 units FFP,1 unit platelets b) 2 units FFP,1 unit blood c) 50IU/kg Prothrombinexto correct INR d) Platelets e) Fibrinogento aim fib >2 |
C |
|
|
1) BIS change whensuxamethonium given to an awake patient: a) Decrease b) Increase c) Increasethen decrease d) Decreasethen increase e) Nothing |
D |
|
|
1) Drug leastlikely to interfere with MEP monitoring during scoliosis surgery a) N2O b) Non-depolarisingneuromuscular blocker c) Opioids d) Propofol e) Volatile |
C |
|
|
1) Morbidlyobese lady in ICU with pneumonia, elective tracheostomy placed 8 hoursago. On rolling for pressure care,started desaturating and you suspect dislodgement of the tracheostomy. What is your immediatemanagement? a) Readvance tracheostomyover gum elastic bougie b) Usefibreoptic bronchoscope c) Intubatefrom the mouth d) Insertairway exchange catheter e) Perform needlecricothyroidotomy |
C |
|
|
1) A 53 year old man is having majorurological surgery. The surgeon asks you to give methylene blue to help avoidureteric injury. What drug interacts with methylene blue? a) Droperidol b) Prazocin c) Fluoxetine d) Oxybutynin e) Risperidone |
C -fluoxetine - risk of serotonin syndrome as methylene blue is like MAOI |
|
|
1) You review a patient 12 hours post rightpneumonectomy on the ward. He is hypoxic, distressed with distended neck veins.What is the best IMMEDIATE management? a) Clamp chest tube to prevent more airleakb) Place patient left lateral c) Place another chest tube on the rightside d) Perform urgent pericardiocentesis e) Urgently transfuse 2 units packed redblood cells |
b |
|
|
1) What is a positive endotracheal tubecuff leak test? a) >110ml leak with cuff deflated b) >110ml leak with cuff deflated c) Audible leak with cuff deflated d) No audible leak with cuff deflated e) No audible leak with cuff pressure<30cm H2O |
A |
|
|
1) Horner's syndrome results from blockadeof which structure? a) Ciliary ganglion b) Stellate ganglion c) Pterygopalatine ganglion d) Otic ganglion e) Submadibular ganglion |
B - stellate ganglion |
|
|
1) According to PS09, the minimumrequirement for administering propofol for conscious sedation is a) Medical practitioner with a skilledassistant that is separate from the assistant to the proceduralist b) Medical practitioner c) Nurse supervised by proceduralist withrecent ALS training d) Specialist anaesthetist e) Nurse with advanced airway skills |
A |
|
|
1) The characteristic respiratory pattern in a patient with an acute C5spinal cord injury is a) Rapid respiratory rate b) Arterial hypoxaemia c) Chest wall immobility d) Preserved cough e) Preserved inspiratory force |
A |
|
|
1) What is the mechanism of central sensitisation? a) Increased intracellular magnesium b) Antagonism of the NMDA receptor c) Glycine is the major neurotransmitterinvolved d) Recurrent a-delta fibre activation e) Alteration in gene expression |
E |
|
|
1) What is the reason infants desaturatefaster than adults on induction with rapid sequence intubation? a) More difficult to preoxygenate b) More rapid detection of hypoxia c) FRC decreased more than adults d) Drugs work more rapidly e) Persistent R to L shunt |
A or C |
|
|
1) A woman complains of paraesthesia in herhands when hanging out the washing. She also has muscle wasting on her handsand a weak radial pulse. What is the most likely diagnosis? a) Thoracic outlet syndrome b) Brachial plexus injury c) Paraneoplastic syndrome d) Lupus e) Coarctation of the aorta |
A |
|
|
1) A neonate is born floppy and apnoeic.They do not start breathing following stimulation. What FiO2 should youinitially perform bag-mask ventilation with? a) 0.21 b) 0.3 c) 0.5 d) 0.7 e) 1 |
A |
|
|
1) Which would be consistent with deep partial thicknessburns? a) Pain to deep pressure only, decreased capillary refill b) Blanches to pressure, very painful c) Painful to air, red and wet, blanches to pressure d) Not painful, does not blanch |
A |
|
|
1) Backgroundradiation is 2.5mSv per annum. Howmuch ionising radiation in a CTPA? a) 0.15mSv b) 0.5mSv c) 5mSv d) 15mSv e) 50mSv |
D (as per Tyler) |
|
|
1) Youassist a junior to do spinal. Instead of gown and gloving, you put on gloves. Whatcatergory of error is this? a) deviation b) lapse c) mistake d) slip e) violation |
E |
|
|
1) Difficultintubation least likely in a) Apertsyndrome b) Down’ssyndrome c) Hurlersyndrome d) PierreRobin syndrome e) TreacherCollin’s syndrome |
B |
|
|
1) Thefollowing have been found to decrease the incidence of spinal cord ischaemiaEXCEPT a) CSFdrainage b) highdose IV methylprednisolone c) maintainingMAP > 80 d) monitoringmotor evoked potentials e) preopidentification of intercostal lumbar arteries supplying artery of Adamkiewizcs |
B |
|
|
57) The musculocutaneousnerve is difficult to block because a) arises from C6 b) arises from lateral head of median nerve c) arises from medial head of median nerve d) congenitally absent in 10% of thepopulation e) located outside the axillary sheath |
E |
|
|
58) 0.5mg/kgmannitol for kidney transplant a) increases survival of graft b) increases renal tubular necrosis c) reduces post-transplant dialysisrequirements d) no change in urine output |
A – early onset urine output improves graftsurvival Improves renal blood flow by stimulating releaseof intrarenal vasodilators (PGs, and ANP). Also acts as free radical scavenger.Incr urine output flushes out cellular debris. |
|
|
59) Accordingto the ATACAS trial, aspirin causes a) increased red blood cell transfusion b) increased platelet transfusion c) increased return to theatre forhemorrhaged) no change in myocardial infarct e) reducedrate of thromboembolic events f) ?noincrease in the risk of bleeding |
D – holding or giving aspirin made no differenceTXA arm showed reduction in transfusion but nodifference in outcomeSeizures more common in TXA |
|
|
60) SAH,delayed ischaemia most common a) 24-28hours b) 4-10days c) 10-14days d) 14-21days |
B |
|
|
1) In RBC transfusions in Aus/NZ, the mostcommon infection transmitted: a) hep A b) hep B c) hep C d) HIV 1 e) HIV 2 |
B |
|
|
62) 52. repeatAug 15 You suspect your patientjust had anaphylactic reaction. The optimal time to take blood for tryptaseestimation a) within15min of onset of event b) 1-3hours after event c) 3-6hours after event d) 6-12hours after event e) 24 hoursafter event |
B – peak is at 1-2 hours. Measureable tryptase ismore limited after 4 hours |
|
|
1) 66 yearold with moderate AS (AV area 1.1cm2). You see him in preadmission clinic forelective THR. Aside from mild dyspnoea on exertion, he is asymptomatic. What isappropriate management? a) acceptfor surgery b) betablock and accept for surgery c) organisemyocardial perfusion scan d) postponeuntil AV replacement e) postponeuntil percutaneous aortic valvotomy |
A – non severe disease + asymptomatic à only indication for AVR isother cardiac surgery (based on AHA) |
|
|
64) Glycineirrigation is required for TURP if the resection is performed with a) greenlightlaser b) heliumlaser c) monopolardiathermy d) Nd:Yaglaser e) plasmakinetic diathermy |
C - monopoly requires on-conductive irrigation fluid Glycine is useful as it is non-conductive. PKD isa bipolar resectoscope and can use electrolyte containing irrigation fluid.Laser resection does not require glycine, but they use Holmium: YAG or KTPlasers.KTP lasers are “greenlight lasers”. Nd:YAG alsoused. |
|
|
65) 56yomale with chronic T6 injury undergoes cystoscopy and TURBT under GA. In PACU,he is hypertensive, bradycardic has chest tightness and is sweating. Mostlikely cause: a) blockedcatheter b) fluidoverload c) myocardialischaemia d) perforatedbladder e) serotoninsyndrome |
A – blocked catheter can precipitate autonomic dysreflexia |
|
|
66) Yousee your trainee self-injecting propofol while at work. What is the bestimmediate action?a) notifytrainee’s next of kin b) notifymedical board c) notifytrainee’s supervisor of training d) relievetrainee of clinical duties e) terminatetrainee’s employment |
d – ANZCA guideline· Ifdirect evidence: emergency medical team if necessary à do not leave doctor alone à immediately relieve of clinicalduties à tell head of dept à tell duty psychiatrist à notification to AHPRA |
|
|
67) Man undergoing transcatheter aortic valve replacement,ECG shown with two broad complex beats (LBBB pattern) and clear p waves approx.Rate of 100 but no ventricular beats. What is the best way of managing this (Ithink it was thisECG, but correct me please if I am wrong.complete heart block --> p-wave systole (aka ventricular standstill -- CPRwas NOT an option)" a) atropine b) external pacing c) adrenaline d) isoprenaline e) transvenous pacing |
E – high risk of AV block and LBBB associated withTAVIs. High incidence of post op pacemakers. B/c they need to rapidly paceduring valve placement,transvenous pacing wires are already likely to be in place. |
|
|
68) Risk ofanaphylaxis recurring post-rocuronium anaphylaxis is greatest with a) atracurium b) cisatracurium c) pancuronium d) vecuronium e) none,as cross sensitivity is unpredictable |
D – VEC 40% cross reactivity, SUX – 40%, Panc20%, ATRAC 20%, Cisatrac 5% |
|
|
69) 60.elderly undergoing orthopaedic surgery for acute hip fracture requires thromboprophylaxisin the perioperative period. Best pharmacological option: a) LMWHor aspirin b) LMWHor unfractionated heparin c) LMWHor fondaparinux d) UFHor fondaparinux e) unfractionatedheparin or warfarin |
B short acting or reversible |
|
|
1) Spirometrycan measure a) TLV b) RV c) FRC d) TLC e) VC |
E – measured values: VC, FVC, FEV, Maximumvoluntary ventilationRV, FRC, TLC, TLV are calculated or measured byother means |
|
|
1) Pulmonaryfunction tests:FEV1 82% predictedFVC 86% predictedFEV1/FVC 81% predictedFEV25-75 80% predictedTLC 81% predictedRV 94% predictedDLCO 102% predictedMVV 42% predictedWhat is the diagnosis? a) asthma b) emphysema c) interstitialfibrosis d) myastheniagravis e) pulmonaryhypertension |
D – MVV is a measure of neuromuscular aspect ofrespiration. Respiratory muscle strength can also be determined with maximal inspiratoryand expiratory pressures |
|
|
72) 27weeks gestation. BP 165/105. Best treatment: a) atenolol b) candesartan c) labetalol d) magnesiumsulphate e) nifedipine |
is is moderate hypertension. Recommended firstline treatment is methyldopa or labetalol so answer C. Nifedipine is the first line treatment for acutesevere HTN – sBP >170 or dBP >110 |
|
|
1) 40yearold short of breath (flow-volume loop shown) a) artefactof equipment failure b) fixedintra and extra thoracic obstruction c) normal d) variableextrathoracic obstruction e) variableintrathoracic obstruction |
d |
|
|
1) Postdental surgery, resident prescribes 1L 0.9% saline + 5% dextrose. Registrarasks if he should amend the order? a) no,maintain oncotic activity b) no,prevent hyponatraemia c) onlyif child >2 years old d) yes,will cause hyperglycaemia e) yes,fluid is hypertonic |
B |
|
|
1) 87yofor selective neck dissection for laryngeal cancer with musculocutaneous flaprepair. He is awake and sitting up. BP 120/70. Flap capillary refill time<1sec. What is best management?a) IVfluid bolus b) intra-arterialstreptokinase c) IV dextran40 d) IVheparin e) Re-exploreflap surgically |
E – re-explore· Venouscompromise à brisk cap refill, rapidbleeding, bluish colour, warm, loss of venous doppler· Arterialcompromise à slow cap refill, no bleeding,cool to touch, white, loss of arterial Doppler· Treatmentof any potentially compromised graft is re-exploration. High salvage rate (75%)if before 6 hours. Thrombosis also possibility, but not first line |
|
|
1) 75.During CPR, What percentage of pre-arrest cardiac output is achieved byeffective external cardiac compression? a) <20 b) 20-30 c) 40-50 d) 60-70 e) >70 |
WJEM suggests 20-30% so B |
|
|
78) Patientis nil by mouth. 2L Hartmann’s, 1L NS over 24 hours. How much Na in mmol did hereceive? a) 390 b) 410 c) 430 d) 440 e) 460 |
B -410 |
|
|
79) Whatcharacteristic of local anaesthetic influences or increases duration of nerveblock? a) lipidsolubility b) molecularweight c) pKa d) presenceof amide bond e) proteinbinding |
E lipid solubility, MW, pKA affect onset of action |
|
|
80) Latestguidelines regarding Breast milk: a) Discard12 hours post procedure b) discard24 hours post procedure c) discard1st feed d) discardfirst 2 feeds e) discardingnot required |
e |
|
|
81) Stabbinginjury to lateral half of spinal cord. What are the classical signs 3 segmentsbelow lesion? a) ipsilateralloss of light touch sensation, contralateral loss of temperature sensation b) ipsilateralloss of motor, contralateral loss of light touch sensation c) ipsilateralloss of pain sensation, contralateral loss of light touch sensation d) ipsilateralloss of pain sensation, contralateral loss of motor e) ipsilateralloss of temperature sensation, contralateral loss of pain sensation |
A– Brown Sequard - ipsilateral paralysis, light touch, vibration,proprioception and contralateral temp/pain |
|
|
82) Dentalextraction of right lower 3rd molar (48). Patient complains of paraesthesia to thechin. This is most likely neuropraxia to a) glossopharyngealn b) inferioralveolar n c) lingualn d) longbucchal nerve e) mentalnerve |
e |
|
|
83) 85 yofor ORIF NOF. No medical past history. Exam normal. FBE, Electrolytes, ECGyesterday normal. Now in rapid AF with ventricular rate 110-145. BP 130/80.Best management: a) amiodarone b) directcurrent cardioversion after inductionc) digoxin d) heparin e) metoprolol |
a or e |
|
|
84 Sub-Tenonblock. Which muscle is most likely to be missed a) internaloblique b) lateralrectus c) medialrectus d) superioroblique e) superiorrectus |
d |
|
|
85) Adenosine can be used to terminate an arrhythmia dueto: a) Atrial fibrillation b) Atrial flutter c) WPW d) VT e) Torsades |
c |
|
|
86) PACXR. What is enlarged (CXR with enlarged LA) a) aorta b) LA c) LV d) RA e) RV |
b |
|
|
87) Thefollowing are consistent with acute systemic inflammatory response except a) hypotension b) hypothermia c) leukopenia d) tachycardia e) tachypnoea |
A – hypotensionSIRS incluBody temp <36 or >38, RR >20 or pCO2<32, HR >90, WBC <4000 or >12 000 |
|
|
88) Apatient undergoing elective coiling of cerebral aneurysm has an abrupt rise inMAP. This is most likely due to a) acutehydrocephalus b) contrastreaction c) emboliccomplication d) vascularrupture e) vesselthrombosis |
d |
|
|
89) Apatient with a haemopneumothorax has a chest drain in situ. The chest drain isattached to a 3 bottle underwater seal drain apparatus, and the system isattached to the wall suction at -80cmH2O. Omission of water from the wetsuction bottle of this apparatus will cause a) excessivenegative pressure in the water seal bottle, resulting in loss of the water seal b) failureof the water seal chamber to oscillate c) inabilityto apply negative pressure to the pleural cavity d) possiblereturn of drain contents into the pleural space |
C – if no water in met suction bottle, suctionwill pull from vent tube àtherefore no ability to apply negative pressure to water seal. Will just becomea 2 bottle system |
|
|
90) Amulticentre trial reports that using N2O as part of general anaesthesia has arelative risk of morbidity of 0.96 (95% confidence interval 0.82-1.13). Thismeans a) thereis 95% confidence that N2O is assoc with an increased risk of morbidity b) theresult is significant as the confidence interval range is very small c) thesample mean has a 95% chance of being between 0.82 to 1.13 d) thestudy size was not large enough to find a difference e) thetrue relative risk has a 95% chance of being between 0.82 to 1.13 |
e |
|
|
91) 125.Following donation after cardiac death, the maximum warm ischaemic timeacceptable for procuring the lungs is a) 30min b) 45min c) 60min d) 90min e) 120min |
d) 90 min LITFL Warm ischaemia time = time from w/drawal oftreatmentMost important phase is when sBP <60mmHgLiver and pancreas <30, kidney 60 min, lung 90min |
|
|
92) R)lower lip 10mm cancer. Surgeon doesn’t want to infiltrate the area with localanaesthetic. Patient refuses general anaesthetic. Which block do you need todo? a) facialn b) hypoglossaln c) infraorbitaln d) lingualn e) mentaln |
e |
|
|
93) 63 yoright pneumonectomy for malignancy. 12 hours post op, profound hypotensive andshock. Raised CVP. Immediately: a) clampany open chest drains to minimise leak b) insertnew chest drain on operative side c) performurgent pericardiocentesis d) placepatient in L) lateral position e) urgentlytransfuse 2 units of packed blood cells |
d |
|
|
94) Open AAA repair, best method to reduce risk of renalimpairment? a) Sodium bicarbonate b) N-acetylcysteine c) Maintainingintravascular volume d) Minimise crossclamp time e) ?mannitol |
d |
|
|
95) Yougive a transfusion of 1u PRBC. What is the maximum duration of time in which itmust it be completed? a) 2hours b) 4hours c) 6hours d) 8hours e) 10hours |
b |
|
|
96) Patientwith chronic liver failure. Coagulation factor least likely to be affected: a) I b) VII c) VIII d) XII |
C – factor 8 is not affected by liver disease.Levels can actually go up |
|
|
97) An 80 year old man undergoes a unilateral lumbarsympathetic blockade. The most likely side effect that he experiences is: a) Genitofemoral neuralgia b) Haematuria c) Postural hypotension d) Lumbar radiculopathy e) Psoas haematoma |
a |
|
|
98) Patienthaving a craniotomy, MAP 80, CVP 5. Both transducers are at the level ofthe heart, 13cm below the level of the tragus. What is theCPP? a) 60mmHg b) 65mmHg c) 70mmHg d) 75mmHg e) 80mmHg |
c |
|
|
99) Urosurgicalprocedure. Surgeon wants to give methylene blue. This is contraindicated ifpatient is taking: a) Fluoxetine b) Droperidol c) Risperidone d) Oxybutinin e) Prazosin |
A – risk of serotonin syndrome becauseof MAO inhibition |
|
|
100) You are the anaesthetist at a Caesarean Section for a36/40 gestation pregnancy. The baby at birth is floppy and apnoea. You decidethat positive pressure ventilation via mask is necessary. The recommended FiO2is: a) 0.21 b) 0.4 c) 0.6 d) 0.8 e) 1.0 |
a |
|
|
101) 64 year old male in preoperative clinic. HR 60. FreeT4 is normal. TSH high. This is consistent with: a) non compliance with thyroxine treatment b) autoimmune thyroiditis c) sick euthyroid d) previous hypophysectomy e) subclinical hyperthyroidism |
b |
|
|
102) Patient receives 1 unit packed red blood cells. 1 hourlater becomes hypoxic, febrile, higher airway pressure and copious frothysputum. a) ABO incompatibility b) Sepsis c) Transfusion related overload d) Transfusion related acute lung injury e) Transfusion related sepsis |
d |
|
|
103) What is the maximum Intralipid 20% dose? a) 6ml/kg b) 8ml/kg c) 10ml/kg d) 12ml/kg e) 14ml/kg |
d |
|
|
104) How many vials of dantrolene should be kept at aremote hospital which has general anaesthesia services? a) 2 b) 6 c) 12 d) 24 e) 36 |
E – large and isolated hospitals shouldhave 36 20mg vials of dantrolene. 24 ampules should be available to alllocations within an institution. Basically enough to provide an initial supplyfor implementing treatment |
|
|
105) Which volatile agent has the longest time to environmentaldegradation a) Desflurane b) Sevoflurane c) Isoflurane d) Enflurane e) Xenon |
a |
|
|
106) 20 yr old male 80 kg in a house fire sustained25% burns. Using the Parkland formula, what is his fluid resuscitation requirementfor the first 8 hours? a) 3L of 0.9% Normal Saline b) 3L of Hartmann’s solution c) 3L of colloid d) 4L of 0.9% Normal Saline e) 4L of Hartmann’s solution |
e |
|
|
107) 3 yr old child with # forearm, best way to valid painassessment a) the reported severity from the child b) the reported severity from the parent c) the reported severity from the nursing staffd) using the FLACC scale e) the Wong-Baker Faces scale |
d – (2-7 yo) or e |
|
|
108) Female singer underwent GA with LMA. Next daycomplains of voice/singing impairment. Nasendoscopy shows one vocal cordin the paramedian position. What nerve is affected? a) lingual b) hypoglossal c) glossopharyngeal d) recurrent laryngeal e) superior laryngeal |
d |
|
|
109) According to NAP4 what is the rate of failure for emergencycannula cricothyroidotomy? a) 10% b) 20% c) 40% d) 60% e) 80% |
d |
|
|
110) Blalock-Taussig shunt inserts into the right pulmonaryartery, originating from the: a) Right subclavian artery b) IVC c) SVC d) Aorta e) Axillary artery |
a |
|
|
111) A patient has come in with TCA overdose. Wide QRS on ECG(Torsades). How do you treat them? a) calcium gluconate b) amiodarone c) lignocaine d) magnesium e) atropine |
d |
|
|
112) What protective mask to wear in laparoscopy forpatient with disseminated TB a) N95 b) P99 c) R95 d) None e) Surgical mask |
a |
|
|
113) According to the ARC, precordial thump is onlyindicated for: a) monitored pulseless VF if defibrillator notimmediately available b) monitored pulseless VT if defibrillator notimmediately available c) unwitnessed cardiac arrest d) witnessed onset of asystole caused by AV conductiondisturbance e) unwitnessed unmonitored cardiac arrest |
b |
|
|
115) 4month old Term neonate, noted to have intermittent stridora few days after birth, then parents also notice stridor during feeding andsleep. Otherwise normal and healthy. Most likely condition is: a) Cri-du-chat syndrome b) Laryngomalacia c) Tracheomalacia d) Laryngocoele e) ? something to do with cord paralysis |
b |
|
|
116) You notice a fire from the anaesthetic machine. Which is the most useful extinguisher? a) CO2 b) blanket c) fire hose d) foam extinguisher e) wet chemical extinguisher |
a |
|
|
117) Randomised controlled trial means: a) Patients randomly allocated to treatment groups b) Patients randomly allocated to treatment or placebo c) Patients allocated randomly to groups before treatmentarms decided d) Neither the patient nor the investigator knows whichgroup the patient is in |
a |
|
|
118) Young man in theemergency department. Opens hiseyes to voice, removes his tie when instructed to and is speaking, butconfused. What is his GCS? a) 10 b) 11 c) 12 d) 13 e) 14 |
d Eyes3, V – 4, M -6 |
|
|
119) Patient with respiratory failure, low PaO2/FiO2 ratio,cardiac index of 1.7, PCWP of 25. Which mode of ECMO would be most appropriate? a) VA b) VV c) AV d) |
a - bad lungs and bad heart |
|
|
1) What is the largest size suction catheter that can fitthrough a size 4.0 ETT? a) 6F b) 8F c) 10F d) 12F |
12 is largest that will fit, but willcompletely occlude tube. 6F will be 50% of ETT |
|
|
1) In an infant, the intercristal line corresponds to a) L1-2 b) L2-3 c) L3-4 d) L4-5 e) L5-S1 |
e |
|
|
122) You area trialling a new drug for hypertension in onegroup of patients and comparing it to placebo (given to another group). Inthree months time you will measure the blood pressure and want to compare thetwo groups. Knowing that the sample is non-parametric, Which test would be mostappropriate? a) Chi squared b) Fishers exact test c) Student's t-test d) Mann-whitney U test e) Bland Altman test- |
d |
|
|
1) What is the best indication of fluid responsiveness a) b) BP change when legs are raised c) d) |
b |
|
|
124) What is the timing of peak respiratory depression post300 mcg morphine intrathecally? a) < 3.5 hours b) 3.5 – 7.5 hours c) 7 - 12.5 hours d) 12.5 -18 hours e) > 18 hours |
b |
|
|
125) Pregnant patient with BP 140/. What is indication forMgSO4? a) seizure prophylaxis b) anti-hypertensive c) foetal neuroprotection d) e) |
a |
|
|
126) Maximum level of serum Mg after administration of MgSO4? a) 1 mmol/l b) 2 mmol/l c) 3 mmol/l d) 4 mmol/l e) 5 mmol/l |
d |
|
|
127) Patient with traumatic brain injury patient. Cerebralangiogram shows Cerebral perfusion = 15mL/100g/min, cerebral oxygen consumption3.5mL/100g/min. This is consistent with: a) Cerebral hyperperfusion b) Reperfusion injury c) Cerebral ischaemia d) Appropriate autoregulation e) Cereberal vasoconstriction |
c 15ml/100g/min - ischaemia 10ml/100g/min - infarct |
|
|
128) What is the mechanism of Trauma induced coagulopathy a) acidosis b) hypothermia c) endothelial damage from ischaemia d) dilution of coagulation factors from resuscitationfluids |
c actuallyan imbalance of the dynamic equilibrium between procoagulant factors,anticoagulant factors, platelets, endothelium and fibrinolysis |
|
|
129) You are inserting a right internal jugular vein CVL.Why is it important to avoid turning the patient's head extremely to the left? a) Uncomfortable for the patient b) Increases risk of internal carotid artery puncture c) Compresses internal jugular vein and makes it moredifficult to puncture d) Distorts the anatomy, making the vein more difficultto correctly identify e) Increases risk of external jugular vein puncture |
c |
|
|
130) What happens with oxygen flush is pressed? a) oxygen 20-30L/min b) oxygen 50-70L/min c) oxygen and volatile at 20-30L/min d) oxygen and volatile at 50-70L/min |
b oxygen flow rates of 30-70L/min. b isprobably best |
|
|
131) Intubation view: Little space between epiglottis andposterior pharyngeal wall. What is the modified C&L classification? a) 2A b) 2B c) 3A d) 3B e) 4 |
c |
|
|
132) Relative contraindications to mediastinoscopy include a) Cervical spondylosis b) Emphysema c) Mediastinal lymphadenopathy d) Poor left ventricular function e) Superior vena cava syndrome |
e |
|
|
133) Asystolic arrest adrenaline just given, how often doyou give adrenaline? a) 2 min b) 3 min c) after 1 loop of ACLS algorithm d) after 2 loops of ACLS algorithm |
d |
|
|
134) Tumour lysis syndrome causes all of the followingbiochemical abnormalities EXCEPT: a) Hyperkalaemia b) Hypernatraemia c) Hyperphosphataemia d) Hyperuricaemia e) Hypocalcaemia |
b LITFL |
|
|
135) Balloon pump trace 1:2 a) Early inflation b) Late inflation c) Early deflation d) Late deflation e) No problem |
a |
|
|
136) Healthymother undergoing surgery 4 months post-partum. What are current recommendations regarding when to resumebreast feeding post-surgery? a) 12 hoursafter procedure b) 24 hoursafter procedure c) Discardfirst feed post procedure d) Discardfirst two feeds post procedure e) No need todiscard |
e |
|
|
137) Complicationsof patient with anorexia nervosa include all except a) Cardiomyopathy b) Delayedgastric emptying c) Hypokalemia d) Hyperclacemia e) Prolonged QT |
d |
|
|
138) 8 year old boy under general anaesthetic,BP about 85/40. ECG trace givenshowing SVT. What is theappropriate treatment? a) IV Adenosine100ug/kg b) IV Amiodarone5mg/kg c) IV Esmolol0.5mg/kg d) Sync DCShock 1J/kg e) IV verapimil |
a |
|
|
139) 22. Propofol is a Category (...) drug inpregnancy: (gave the full definition of each category) a) A b) B1 c) B2 d) B3 e) C |
e C (Australian websites)FDA B |
|
|
140) In a patient with severe hepaticfibrosis. An increased risk of life threatening haemorrhage is best indicatedby: a) dysfibrinogenaemia b) hypoalbuminaemia c) portal HTN d) increased PT time e) thrombocytopaenia |
c |
|
|
141) The Swan Ganz catheter is unreliable formeasurements of Pulmonary Artery SBP and DBP due to length and compliance oftubing. This affects the measuring system by: a) decreasing resonant frequency b) decreasing frequency response c) decreasing damping coefficient d) inducing zero error e) inducing baseline drift |
a |
|
|
142) Woman for LUSCS. Allergic to Amoxycillin.Reaction is limited to a rash. For surgical antibiotic prophylaxis consider:(definitely said "consider") a) Cefazolin b) Cefoxitime c) Clindamycin d) Gentamicin e) Vancomycin |
c |
|
|
143) In a patient taking dabigatran prior tosurgery: a) Stop 7 days in advance b) Stop 3 days in advance c) Stop 3 days in advance and bridge with clexane d) Continue until day of surgery e) Check INR on day of surgery |
b |
|
|
144) In patients with an opioid PCA, adding aNSAID will reduce the rate of PONV by a) 5% b) 10% c) 15% d) 20% e) 25% |
e another Effects of nonsteroidal antiinflammatory drugs onpatient-controlled analgesia morphine side effects: meta-analysis of randomizedcontrolled trials. Also said 30% |
