19.2 Flashcards
19.2 the anti-emetic action of aprepitant is via receptors for
a) serotonin
b) dopamine
c) Nmda
d) Neurokin A
e) Substance P
19.2 In patients with cephalosporin cross reactivity to penicillin, what is the causative component?
a) Thiazolidine ring
b) Beta lactam ring
c) R1 chain on the beta lactam ring
d) R2 chain on the thiazelidine ring
e) Dihydrothiazine ring
19.2 Commonest cause of peri-operative stroke
a) Hypotensive
b) Embolic
c) Thrombotic
d) Hypertensive
e) Haemorrhagic
19.2 Which has the highest capacity to absorb infrared radiation in the atmosphere?
a) Nitrous oxide
b) Sevoflurane
c) Desflurane
d) Isoflurane
e) CO2
19.2 When do spinal reflexes normally return after an acute spinal injury?
A. 1-3 days
B. 7 days
C. 28-40 days
D. 120 days
E. 365 days
19.2 What are the minimum PACU nurse to patient ratios?
a) 1 nurse of each patient that has not regained airway reflexes, 1 nurse for 2 awake patients who have regained airway reflexes
b) 1 nurse of each patient that has not regained airway reflexes, 1 nurse for 3 awake patients who have regained airway reflexes
c) 1 nurse of each patient that has not regained airway reflexes, 1 nurse for 4 awake patients who have regained airway reflexes
d) 1 nurse of 2 patients that has not regained airway reflexes, 1 nurse for 2 awake patients who have regained airway reflexes
e) 1 nurse of 2 patients that has not regained airway reflexes, 1 nurse for 3 awake patients who have regained airway reflexes
19.2 The backboard of the anaesthetic machine is on fire.
What is the best way to put it out?
a) CO2
b) Fire blanket
c) Wet chemical powder
d) Foam
e) Water
19.2 20 year old man has suffered a TBI. What SBP (mmHg) would you aim for?
a) 90
b) 100
c) 110
d) 120
e) 140
19.2 The substance that should be avoided in a patient with history of anaphylaxis to MMR vaccine is?
a) Penicillin
b) Gelofusin
c) Sulphonamides
d) Hydrolase
19.2 Thirteen year old boy playing sport collapses. Sweaty, abdominal pain, headache, palpitations and hyperglycaemic.
What is the most likely cause?
a) Phaeochromocytoma
b) Insulinoma
c) Hyperthyroidism
d) Hypothyroidism
e) Carcinoid syndrome
19.2 What is the corrected QTc for someone with QT interval of 420ms at a rate of 60bpm?
a) 360 ms
b) 380 ms
c) 420 ms
d) 460 ms
e) 480 ms
19.2 What is the cause?
a) Hypothermia
b) Hypocalcaemia
c) Hypomagnesaemia
d) Hyponatraemia
e) Hypothyroid
Hypothermia J wave
19.2 An 80-year-old woman is admitted to hospital with respiratory failure. Her arterial blood gas on oxygen 4 litres per minute via a Hudson mask is as follows: Ph 7.2
P02 91
Pc02 84
BE 16
HCO3 43
NA 145
Which of the following most accurately describes this blood gas result?
a) Metabolic alkalosis, acute resp acidosis + normal AG
b) Metabolic alkalosis resp acidaemia + abnormal AG
c) Mixed acidaemia
d) Respiratory Acidosis with incomplete compensation
e) Compensated Respiratory acidosis
19.2 A 65 year old female is having a knee arthroplasty. What is the most predictive factor for chronic post operative pain?
a) Anxiety
b) Catastrophising
c) Depression
d) Female
e) Pain at other sites
19.2 A size 9 SLT is closest in external diameter to what size DLT?
a) 27Fr
b) 35Fr
c) 37Fr
d) 39Fr
e) 41Fr
19.2 Soon after a peribulbar block, the patient’s eye rapidly becomes proptosed and tense, and the visual acuity is markedly decreased. A lateral canthotomy is indicated to:
a) Allow globe to continue to swell
b) Drain blood from behind eyeball
c) Allow the eye to proptose
d) Reduce pressure on the optic nerve
19.2 Patient had a hysteroscopy and is now woken up in PACU. ABG done with Na 118, K 3.1. Patient is orientated to person but not to time and place. What is the best management?
A. Frusemide 40mg IV stat
B. Potassium 40mmol over 4 hours
C. 500ml normal saline
D. 100ml 3% saline
E. Fluid restrict
19.2 A stroke patient presenting for clot retrieval with a right hemisensory loss and right homonymous hemianopia most likely has occlusion of the left .
Most likely lesion is in right:
a.anterior cerebral artery
b.anterior inferior cerebellar artery
c.posterior cerebral artery
d.posterior inferior cerebellar artery
e.superior cerebral artery
19.2 If a women being treated for neuropathic pain becomes pregnant, what is the safest neuropathic analgesic to use in pregnancy?
A. Carbamazepine
B. Lamotrigine
C. Gabapentin
D. Sodium valproate
E. Phenytoin
19.2 When to medically intervene in seizure post ECT?
A. 30 seconds
B. 60 seconds
C. 90 seconds
D. 120 seconds
E. 150 seconds
19.2 WHO essential services criteria (i.e. procedure that is indication of provision…) Bellwether Procedure
A. Manual removal of placenta
B. Laparotomy
C. Cleft palate
D. Skin grafts
E. Cataracts
19.2 When using ROTEM, the APTEM relates to:
A. Clotting factors
B. Hypofibrinoginaemia
C. Direct thrombin inhibition
D. Decreased platelets
E. Fibrinolysis
19.2 Where is the tip of this PICC line?
A. Azygous vein
B. Coronary sinus
C. RA
D. LA
E. SVC
19.2 Which brachial plexus block has the highest chance of a paralysed hemidiaphgram?
A. Interscalene
B. Supraclavicular
C. Infraclavicular
D. Axillary
E. Cervical
19.2 69-year-old lady has a right heart catheter for new onset dyspnoea. PCWP 10mmHg.
[Waveform showing PAP 74/28 consistently throughout cycle]
What is the most likely diagnosis?
A. Aortic stenosis
B. Mitral regurgitation
C. Mitral stenosis
D. Pulmonary embolism
E. Emphysema
19.2 Post scoliosis repair, decreased movement in legs bilaterally with decreased pain and temperature sensation. Spared proprioception and vibration sense. What is at fault?
A. Posterior spinal arteries
B. Anterior spinal arteries
C. Epidural haematoma
D. Misplaced pedicle screw
E. Lateral cord syndrome
19.2 Which of the following drugs does not decrease mortality in heart failure?
A. ACE inhibitors
B. Beta blockers
C. Angiotensin receptor blockers
D. Spironolactone
E. Digoxin
19.2 ? year old male on digoxin 125mcg daily for AF having ?surgery. Bronchospasm post induction so given salbutamol via ETT successfully. Shortly thereafter in AF with rapid ventricular rate (or just ‘tachycardic’) rate of 120bpm BP 90/60mmHg with EtCO2 40mmHg. What do you use to treat?
a. Amiodarone 150/300 mg over 20 minutes then 0.5-1mg/minute
b. Cardioversion at 50J
c. Digoxin 250/500microg over 20 minutes
d. Esmolol 500 mcg and then run an infusion at 50mcg/kg/min
e. Metoprolol (something bolus and infusion rate)
f. Lignocaine also an option?
19.2 A 29 year old otherwise fit healthy man has the following anaesthetic:
Propofol 180mg / Rocuronium 50mg / Cefazolin 2g / Morphine 8mg
Immediately after he develops tachycardia, hypotension, red rash on chest and lip swelling. Initial blood results:
Tryptase at 1 hour 321 >11
Tryptase at 3 hours 58 >11
RAST Morphine 29 >15
Serum IgE 88 <300
A. IgE mediated anaphylaxis to cefazolin
B. IgE mediated anaphylaxis to morphine
C. IgE mediated anaphylaxis to rocuronium
D. Opioid induced histamine release
E. Mastocytosis
19.2 What is the outcome for early use of tranexamic acid in trauma patients?
A. No change in all-cause mortality, no change in transfusion rates
B. No change in all-cause mortality, decreased transfusion rates
C. Decreased mortality of all cause, no change in transfusion rates
D. Decreased mortality from bleeding but not all cause, no change in transfusion rates
E. Decreased mortality of all cause, decreased transfusion rates
19.2 During endovascular repair of an aneurysm the proceduralist expresses concern about rupturing the aneurysm. Each of the following could be part of your management except?
A. Mannitol
B. Protamine
C. Mild induction of hypotension
D. Immediately transfer to theatre
E. Continue coiling
19.2 Dental damage risk to be determined in your department. 100 cases reviewed, zero cases of dental damage. What is the 95% confidence interval?
A. 0/100
B. 1/100
C. 3/100
D. 5/100
E. 9/100
19.2 What does this ECG show?
A. Viral myocarditis
B. HOCM
C. Acute inferior ischaemia
19.2 What is the estimated RVSP? CVP is 5mmHg (Picture had velocity of 3 m/s)
A. 39 mmHg
B. 41 mmHg
C. 45 mmHg
D. 50 mmHg
E. 61 mmHg
19.2 4-year-old having a tracheostomy – what structure is most likely to be damaged?
18B-099 What structure are you most likely to damage in elective tracheostomy in a 4 yo?
A. Brachiocephalic artery
B. Phrenic nerve
C. Vagus nerve
D. Vertebral artery
E. Thoracic duct
19.2 Which of the following is associated with increased risk of AFE?
A. LSCS
B. Induction of labour
C. Oxytocin infusion
D. Forceps delivery
E. Pre-eclampsia
19.2 When performing a breast block, what structure is marked X?
A. Pectoralis minor
B. Latissimus dorsi
C. Serratus anterior
D. Pectoralis major
E. Teres major
F. Teres minor
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