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Part 2 MCQ > 2021.1 > Flashcards

2021.1 Flashcards

1
Q

The optimal position, under ultrasound guidance, to place a catheter tip to provide continuous erector spinae plane block for post-thoracotomy analgesia is

A. Superficial to erector spinae
B. Tip of transverse process?
C. Midpoint of transverse process

A

B. Tip of transverse process?

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2
Q

A structure that is NOT clamped during a Pringle manoeuvre is the

-Hepatic artery
-Portal vein
-Hepatoduodenal ligament
-Hepatic vein

A

Could have been any other structure than:
-Hepatic artery
-Portal vein
-Hepatoduodenal ligament

Structures not clamped:
-IVC
-Hepatic vein

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3
Q

The muscle or muscle group with the greatest sensitivity to the action of non-depolarising neuromuscular blocking agents is/are the

a. Abdominal muscles
b. Adductor pollicis
c. Pharyngeal muscles
d. Diaphragm

A

c. Pharyngeal muscles

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4
Q

The most common cause of mortality in children with diabetic ketoacidosis is

Cerebral oedema
Central pontine demyelination
Septic chock

A

Cerebral oedema

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5
Q

The intubating dose of atracurium in a patient with post-polio syndrome should be

A

Reduced – unclear by what degree

Probably 50% reduction

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6
Q

In the morbidly obese the induction dose of propofol should be calculated based on

Lean body weight
Total body weight
Ideal body weight
Ideal body weight + 70%

A

Lean body weight

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7
Q

All of the following conditions are associated with acromegaly EXCEPT
Depends

A

Depends

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8
Q

The composition of blood returned to the patient from intraoperative cell salvage shows

A

Cell-salvaged blood contains no platelets or coagulation factors

Bad things can also be in there – air/fat/microaggregates

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9
Q

When performing a brachial plexus block at the level of the axilla, the structure indicated by the arrow is the (ultrasound image shown)

Could be any structure – no picture provided

A

Could be any structure – no picture provided

From previous MCQs seems to be musculocutaneous nerve
Remember MUR from top to bottom around AA for individual nerves

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10
Q

Severe obstructive sleep apnoea in a 6-year-old child is confirmed if during polysomnography the apnoea/hypopnea index (AHI) is greater than or equal to

AHI >5
AHI >10
AHI >15
AHI >30

A

AHI >10

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11
Q

Predictors of successful awake extubation after volatile anaesthesia in infants include

2ml/kg tidal volume
Grimacing
Coughing
RR >20
CO2 >60

A

Grimacing

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12
Q

Major international guidelines recommend maintaining the core body temperature between 32°C and 36°C in comatose patients after

A

Comatose patient post cardiac arrest

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13
Q

A man presents with a fractured tibia. He has increasing pain in his leg, loss of sensation on the plantar surface of his foot and weakness of toe flexion. This is most consistent with a compartment syndrome of the leg in the

Anterior compartment
Lateral compartment
Deep posterior compartment
Superficial posterior compartment

A

Deep posterior compartment

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14
Q

The coagulopathy that can result from intrahepatic cholestasis of pregnancy is due to

Deficiency all hepatic synthesised enzymes
Deficiency II, V, VII, IX

A

Deficiency II, V, VII, IX

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15
Q

The best patient position to evaluate the gastric contents with ultrasound is

A

Right lateral decubitus position

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16
Q

A 50-year-old man is seen prior to his hip revision surgery. His blood results are (FBE and Iron Studies shown). The most likely diagnosis is

?Depends on results

A

Given FBE and iron studies provided likely related to IDA

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17
Q

Of the following, allergy based on cross reaction to penicillin sensitivity is most likely with

A

Depends on options provided, table to right might help (from Anaesthesia + Analgesia 2019: Misconceptions surrounding penicillin allergy: implications for anesthesiologists)

Probably something with same R1 side chain:
-Cephalexin

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18
Q

In maternal cardiac arrest the most common arrhythmia is

VT
VF
Asystole
PEA
SVT

A

PEA

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19
Q

You are performing a regional block for analgesia following knee surgery. You have an ultrasound probe scanning the anterior mid-thigh. The muscle indicated by the arrow in the ultrasound image below is the

A

Could be anything
Sounds like Femoral nerve/Saphenous nerve block depending on position of thigh

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20
Q

The recommended antibiotic prophylaxis for insertion of an intrauterine device is

None
Cephalexin 500 mg
Doxycycline 400
Cephazolin 2g
Cephazolin 2g and metronidazole

A

None

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21
Q

The independent predictors for severe bone cement implantation syndrome (BCIS) in cemented hemiarthroplasty for hip fracture do NOT include

Male sex
GA
Previous history of same
Diuretic use
Age

A

GA

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22
Q

The 12 lead ECG shown is most consistent with acute total occlusion of the

Depends on which vessel affected

A

Depends on which vessel affected

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23
Q

A 45-year-old man has poor oxygenation in the post-anaesthesia care unit after a low anterior resection. His chest x-ray is below. The most likely diagnosis is

A

Depends on CXR findings

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24
Q

According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia using a non-relaxant technique with a volatile agent is

A

1:136,000

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25
Q

The drug which has the LEAST impact on somatosensory evoked potentials (SSEPs) monitored in a 15-year-old patient undergoing scoliosis surgery is

Propofol
Fentanyl
Desflurane
Midazolam
Sevoflurane

A

Fentanyl

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26
Q

Toxicity of methylene blue is likely to be seen after single bolus dose (in mg/kg) greater than

1mg/kg
3mg/kg
5mg/kg
7mg/kg

A

7mg/kg

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27
Q

A woman is having a potentially curative primary breast cancer resection. Compared with a sevoflurane and opioid technique, using a regional anaesthesia-analgesia technique with paravertebral block and a propofol infusion will result in

Decreased cancer recurrence
Decreased pain and recurrence
Decreased incision pain at 6 months
Decreased neuropathic pain at 6 months
Decreased neuropathic pain at 12 months

A

Uncertain/ No difference
?Not remembered properly

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28
Q

A normal 75 kg term parturient may be expected to have a total blood volume of

5250
6000
6750
7500

A

7500

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29
Q

A patient undergoing robotic prostatectomy with controlled mandatory volume ventilation has the following measurements: (plateau pressure, PEEP, autoPEEP, peak pressure, tidal volume given) The static compliance is

Plateau pressure 32 cmH2O
PEEP 8 cmH2O
AutoPEEP 4 cmH2O
Peak pressure 38 cmH2O
Tidal volume 600mL

20 ml/cmH2O
23 ml/cmH2O
25 ml/cmH2O
30 ml/cmH2O
38 ml/cmH2O

A

30 ml/cmH2O

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30
Q

A 30-year-old professional athlete who underwent a knee arthroscopy under general anaesthesia becomes tachycardic in the recovery room. His non-invasive systolic blood pressure is 90 mmHg. A 12-lead ECG is obtained. The most appropriate therapy is

A

Depends on ECG!
?some sort of SVT
?delta waves

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31
Q

A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is:

3 months
6 months
9 months
12 months

A

9 months

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32
Q

The direct physiological effects of electroconvulsive therapy include

A

Answer –

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33
Q

A man is brought into hospital after a motor vehicle accident 45 minutes ago. His chest x-ray is shown. This is most consistent with a left-sided

A

Answer -

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34
Q

A common electrolyte disturbance following the administration of ferric carboxymaltose is

A

Answer - Hypophosphataemia

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35
Q

Globe perforation during eye block is more common in myopic eyes because

Higher incidence of staphyloma
Globe is too short
Higher rate of increased IOP
Corneal is less thick

A

Higher incidence of staphyloma

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36
Q

A five-year-old child weighing 25 kg is to be strictly nil by mouth overnight following a laparotomy. The most appropriate fluid prescription is

65ml/hr N Saline
45ml/hr N Saline w 5% dextrose
45ml/hr N Saline w 2.5% dextrose
65ml/hr 0.45% Saline w 2.5% dextrose
65ml/hr 0.45% Saline w 5% dextrose

A

45ml/hr N Saline w 5% dextrose

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37
Q

A four-year-old boy with a history of waddling gait, larger than normal calves and frequent falls receives a spontaneously breathing volatile-based anaesthetic with sevoflurane. One hour into the case he develops peaked T waves and then the end-tidal CO2 begins to rise. The most appropriate immediate treatment is to

Temp probe, and go from there
Cool + dantrolene
Stop volatile, cool + dantrolene
Stop volatile, calcium
Stop volatile

A

Stop volatile, calcium

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38
Q

The substance that should be avoided in a patient with history of anaphylaxis to

MMR vaccine is
Protamine
Gelofusine
Sulphonamides
Penicilins

A

Gelofusine

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39
Q

A patient with a history of hereditary angiooedema requires an appendectomy for acute appendicitis. The most effective therapy for the prevention of an acute attack in the perioperative period is

Danazol
FFP
Icatibant
Hydrocort

A

Danazol

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40
Q

Sensory innervation of the cornea is by the

Nasociliary nerve
Optic nerve
Trigeminal nerve *
Frontal nerve

A

Nasociliary nerve

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41
Q

Local anaesthetic-induced myotoxicity is most likely to be associated with

Bier’s block
Adductor canal
Sciatic nerve block

A

Adductor canal

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42
Q

The minimum microshock current required to elicit ventricular fibrillation is

10μA
100μA
10 mA
100 mA
1A
10 A

A

100μA

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43
Q

You give a dose of intravenous indocyanine green to facilitate videoangiography during cerebral aneurysm surgery. The displayed pulse oximetry (SpO2) and cerebral oxygen tissue saturation (SctO2) changes you expect to see are

Increases NIRS, decreases peripheral
Decreases NIRS, decreases peripheral
No change NIRS, decreases peripheral
Increases NIRS and peripheral
Decreases NIRS, increases peripheral

A

Increases NIRS, decreases peripheral

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44
Q

Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of

6 weeks
3 months
6 months
12 months

A

3 months

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45
Q

Of the following classes of medication for diabetes mellitus, the most likely to cause hypoglycaemia in the fasted patient are the

A

Answer – sulfonylureas

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46
Q

A 25-year-old ASA I patient develops ongoing seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is

Midazolam
Intralipid
Propofol
Levetiracetam
Phenytoin

A

Midazolam

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47
Q

A 50 year old man has the following pulmonary function test result. The most consistent diagnosis is

A

Answer -

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48
Q

You have been asked to anaesthetise a patient with a history of severe depression which has been well controlled on moclobemide. The most appropriate medications in combination with propofol are

Sevoflurane, morphine, phenylephrine
Sevoflurane, pethidine, phenylephrine
Midazolam, fentanyl, ephedrine
Midazolam, fentanyl, metaraminol

A

Sevoflurane, morphine, phenylephrine

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49
Q

Infection control management of patients with carbapenemase-producing Enterobacteriaceae (CPE) infection should include all of the following EXCEPT

A

Answer -

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50
Q

Blocking the sciatic nerve results in loss of function of all of the following EXCEPT

A

Answer – hamstring + entire lower leg anaesthetised so depends what is listed

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51
Q

Benztropine ameliorates the side effects of drugs that antagonize

Muscarinic receptors
Nicotic receptors
Dopamine receptors
Serotonin receptors
Noradrenaline receptors

A

Dopamine receptors

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52
Q

You are anaesthetising a 35-year-old woman undergoing a laparoscopic appendectomy. She uses a levonorgestrel-releasing intrauterine device (Mirena®) for contraception and you have used sugammadex for reversal of neuromuscular blockade at the end of the procedure. Your postoperative advice to her regarding contraception should state that

Barrier protection for a week
Barrier protection until the next period.
The mirena is sufficient
OCP for a week
OCP until next period

A

Barrier protection for a week

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53
Q

You are resuscitating a 60 kg man in cardiac arrest secondary to severe hyperkalaemia. You decide to give intravenous sodium bicarbonate. Australian and New Zealand resuscitation guidelines state the initial dose of 8.4% sodium bicarbonate should be

30ml
40 ml
50 ml
60 ml
70ml

A

60 ml

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54
Q

Regarding healthcare research, the SQUIRE guidelines describe

A

Answer – a framework for reporting new knowledge about how to improve healthcare

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55
Q

A 30-year-old woman is administered an anaesthetic for a laparoscopic cholecystectomy for acute cholecystitis. She is breastfeeding her six-week-old infant. During anaesthesia she receives the following drugs: propofol, fentanyl, sevoflurane, rocuronium, oxycodone, parecoxib, ondansetron, sugammadex and cefuroxime. The best advice regarding breastfeeding after anaesthesia is to

A

Answer – continue breastfeeding and monitor infant for signs of respiratory depression and drowsiness

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56
Q

The most common cause of postoperative visual loss after spinal surgery is

Central retinal artery occlusion
Central retinal vein occlusion
Ischemic optic neuropathy
Haemorrhage

A

Ischemic optic neuropathy

57
Q

A baby is brought to the emergency department three days after a term home birth. It has not been feeding well and has had few wet nappies. The child is grey in appearance and femoral pulses are difficult to palpate. You note an enlarged liver and marked tachycardia. Pulse oximetry reveals saturations of 75% despite oxygen being administered. You suspect a duct-dependent circulation. The best initial management is

A

Answer -Prostaglandin E1

58
Q

A patient with a history of restless leg syndrome is experiencing significant agitation in the postanaesthesia care unit. After excluding other precipitating causes, the best treatment of the agitation in this patient is

Midazolam
Olanzepine
Haloperidol
Clozapine
Droperidol

A

Midazolam

59
Q

During trauma resuscitation in adults, contraindications to blind nasogastric tube insertion include all of the following EXCEPT
Answer -

A

Answer -

60
Q

Cardiovascular effects of hyperthyroidism include

Decreased diastolic relaxation
Decreased SVR
Decreased PVR
Increased diastolic BP

A

Decreased SVR

61
Q

Effective pharmacotherapy options to support smoking cessation in the perioperative period include all of the following EXCEPT

A

Answer - Effective pharmacotherapy options include nicotine replacement therapy, nicotine partial agonists such as varenicline (Champix), bupropion (Zyban), nortryptilline and clonidine.

Answer probably SSRI

62
Q

The main advantage of using norepinephrine (noradrenaline) over phenylephrine for the prevention of hypotension as a result of spinal anaesthesia for elective caesarean section is

Better APGAR
Better foetal acid/base
Less nausea/vomiting
Less maternal bradycardia

A

Less maternal bradycardia

63
Q

The atmospheric lifetime of nitrous oxide (in years) is approximately

A

Answer: 114yrs

64
Q

The risk of a perioperative respiratory adverse event in a child is least likely to be increased by

A

Answer – URTI > 2 weeks prior

65
Q

In elderly patients without diabetes mellitus the use of aspirin in primary prevention of disease

Increased risk of bleeding
Reduced overall mortality
Reduced CVS mortality
Reduced cancer mortality

A

Increased risk of bleeding

66
Q

You are involved in the care of a two-year-old child who has ingested a button battery in the last four hours. You would consider giving

Honey
Milk
Water
Bicarb

A

Honey

67
Q

The most likely cause of hip adduction in a patient undergoing transurethral resection of a bladder tumour is

A

??obturator jerk/reflex

68
Q

In critically ill patients undergoing mechanical ventilation, energy dense enteral nutrition (1.5 kcal/mL/kg) compared to routine (1 kcal/mL/kg) enteral feeding provides

A

Answer – No difference

69
Q

Chronic recreational use of nitrous oxide may lead to

Anaemia due to decreased EPO
Anaemia from glutathione deficiency
Neurological damage due to methionine deficit
Pulmonary hypertension

A

Neurological damage due to methionine deficit

70
Q

Risk factors for chronic postsurgical pain do NOT include

Smoking
Pre-existing pain
High level of anxiety
Young age
High level of education

A

High level of education

71
Q

A drug which is likely to slow the heart rate in a patient with a heart transplant is

Adenosine
Metaraminol
Phenylephrine

A

Adenosine

72
Q

The following is an image from a focussed cardiac ultrasound in a patient with dyspnoea presenting for thoracic surgery. The diagnosis is
Answer -

A

Answer -

73
Q

Once a unit of fresh packed red blood cells has been removed from controlled refrigeration the transfusion should be completed within

A

Answer - Once a unit of red cells has been out of temperature-controlled storage for more than 30 minutes: transfusion of the unit must be completed within 4 hours (as per Section 6.10.1)

74
Q

The abnormality shown in this image is LEAST likely to be caused by an injury to the (image of a patient’s back shown)
Answer -

A

Answer - Apparently winged scapula - serratus anterior (long thoracic nerve) or spinal accessory nerve

75
Q

When commencing treatment of proximal deep vein thrombosis or pulmonary embolus, factor Xa inhibitors (apixaban, rivaroxaban) are preferred to dabigatran or warfarin because they do not require

A

Answer - Rivaroxaban or apixaban are generally favoured over dabigatran or warfarin as they do not require a period of parenteral anticoagulation or routine laboratory monitoring

76
Q

A neonate born by emergency caesarean section is limp, pale, has a weak grimace and weak cry, and a heart rate of 60 beats per minute. The Apgar Score is

A

Answer – 3

77
Q

Of the following, the LEAST likely cause of high anion gap metabolic acidosis is

Pancreatic fistula
DKA
Cardiac failure
Antiretroviral
Methanol

A

Pancreatic fistula

78
Q

A patient presents with a serum sodium of 110 mmol/L. A feature NOT consistent with a diagnosis of syndrome of inappropriate antiduretic hormone (SIADH) is

A

Answer – Dehydration/hypovolaemia (this is seen in cerebral salt wasting syndrome)

79
Q

A patient with C6 tetraplegia is undergoing removal of bladder stones under general anaesthesia. The blood pressure rises to 166/88 mmHg. The appropriate response is to

Clonidine
Hydralazine
Decompress the bladder
Fentanyl
Deepen your anaesthetic

A

Decompress the bladder

80
Q

A 26-year-old man is brought into the Emergency Department four hours after an accidental chemical exposure during crop spraying. His clinical signs include bradycardia, vomiting, diarrhoea, coughing, miosis and weakness. A drug which is NOT recommended during his resuscitation and treatment is

Diazepam
Pralidoxime
Glycopyrrolate
Rocuronium
Suxamethonium

A

Suxamethonium

81
Q

A 30-year-old previously healthy woman is four days post-caesarean section. You are asked to see her to manage her abdominal pain. Over the last two days she has had increasing abdominal pain, increasing abdominal distension, tachycardia and nausea. An abdominal x-ray shows a caecal diameter of 9 cm. After excluding mechanical obstruction, an appropriate management option is

A

Answer – Colonic decompression ?Neostigmine

82
Q

The following ECG is consistent with

A

Answer -

83
Q

A 40-year-old man suffers a hydrofluoric acid burn to 60% of his total body surface area in an industrial accident. An expected electrolyte disturbance is

Hypocalcemia
Hyponatremia
Hypophosphatemia
Hypomagnesemia

A

Hypocalcemia (1st option)
Hypomagnesemia (2nd option)

84
Q

The lung ultrasound finding most consistent with atelectasis is three or more

A

Answer - ?No air bronchograms

85
Q

If group A RhD negative fresh frozen plasma is not available for use in an A RhD positive patient, of the following your next best choice should be

a. AB +
b. A+
c. A- (why is this an option)
d. O+
e. O-

A

A+

86
Q

Perioperative overheating is most likely to cause worsening of symptoms of

Duchenne Muscular dystrophy
Myasthenia gravis
Multiple sclerosis
Myotonica dystrophia
Eaton Lambert syndrome

A

Multiple sclerosis

87
Q

A transhiatal oesophagectomy is performed via a

Laparotomy left thoracotomy
Laparotomy, left neck incision
Left thoracotomy, left neck incision
Left thoracotomy

A

Laparotomy, left neck incision

88
Q

A 69-year-old woman has a recent onset of dyspnoea and undergoes a right heart catheterisation, with results displayed below. Her pulmonary capillary wedge pressure is 10 mmHg. The most likely diagnosis is

COPD
MR
PE
AS
MS

A

PE

89
Q

The modified Aldrete scoring system uses all of the following EXCEPT

A

Answer – for paeds – DC from PACU: Activity, respiration, circulation, consciousness & O2 sats

90
Q

A woman with preeclampsia presents with a blood pressure of 150/100 mmHg. An appropriate first line treatment to reduce the blood pressure is

Labetalol
Nifedipine
Magnesium

A

Labetalol

91
Q

The ANZCA Choosing Wisely recommendations advise avoiding all of the following EXCEPT
Answer -

A

Answer -
1. Avoid routinely performing preoperative blood investigations, chest X-ray or spirometry prior to surgery, but instead order in response to patient factors, symptoms and signs, disease, or planned surgery
2. Avoid ordering cardiac stress testing for asymptomatic patients prior to undergoing low to intermediate risk non-cardiac surgery.
3. Avoid administering packed red blood cells (blood transfusion) to a young healthy patient with a haemoglobin of ≥70g/L who does not have on-going blood loss, unless the patient is symptomatic or haemodynamically unstable.
4. Avoid initiating anaesthesia for patients with limited life expectancy, at high risk of death or severely impaired functional recovery, without discussing expected outcomes and goals of care.
5. Avoid initiating anaesthesia for patients with significant co-morbidities without adequate, timely preoperative assessment and postoperative facilities to meet their needs.

92
Q

A 55-year-old man with no past history of ischaemic heart disease is three days post-total hip replacement surgery. He has an episode of chest pain characteristic of angina which began at rest and lasted thirty minutes before resolving fully. There are no ECG changes. Six hours later there is a troponin rise above the 99th percentile upper reference limit. The diagnosis is

A

Answer - NSTEMI

93
Q

Consideration for same-day discharge in an ex-premature infant after orchidopexy for undescended testis would be suitable at a minimum postmenstrual age of

A

Answer – 54 weeks

94
Q

The implementation of comprehensive multidisciplinary geriatric assessments in the peri-operative period has been shown to

Less duration in hospital
Less in aged care
More alive and at home at 12 months

A

More alive and at home at 12 months

95
Q

The advantage of the Mapleson E circuit in paediatric anaesthesia is due to its

Can use low gas flows
Tactile feel of compliance
Assess tidal volume
Rapidly change CPAP
Low resistance

A

Low resistance

96
Q

A 30-year-old woman, gravida 2, parity 1, undergoes an elective lower segment caesarean section for breech presentation. The international consensus statement on the use of uterotonic agents recommends that the first line uterotonic management is

Oxytocin 1 unit
Oxytocin 3 units
Oxytocin 5 units
Oxytocin 10 units

A

Oxytocin 1 unit

97
Q

An 84-year-old woman with dementia presents for surgery for a breast lump. She lives in a care facility and is accompanied by the nurse manager from the facility and her son. Neither have a written legal authority to act on her behalf. Regarding consent for her surgery
Answer -

A

Answer -

98
Q

The apical four–chamber view of a transthoracic echocardiogram below shows
Answer -

A

Answer -

99
Q

A man who had successful treatment of a germ cell tumour 10 years ago presents for laparoscopic appendectomy. Your intraoperative management should consider

A

Lowest FiO2 possible

100
Q

A 100 kg 32-year-old male presents two hours after suffering a 30% total body surface area electrical burn. He has had no resuscitation fluids. The infusion rate of isotonic crystalloid resuscitation fluid required for this man for the next six hours is

500 ml/hr
750 ml/hr
1000 ml/hr
1200 ml/hr

A

1000 ml/hr

101
Q

Intraoperative lung protective ventilation strategies include all of the following EXCEPT

Vt 6-8ml/kg
Patient titrated PEEP
Recruitment manoeuvres
I:E ratio 1:3

A

I:E ratio 1:3

102
Q

An ECG abnormality which is NOT usually associated with severe anorexia nervosa is

Resting tachycardia
Wandering pacemaker
ST depression
T-wave inversion
Prolonged QT

A

Resting tachycardia

103
Q

Of the following, the lifestyle modification that is least effective in reducing essential hypertension is

Stopping caffeine
Low salt diet
High potassium diet
Exercise
Stop alcohol

A

Stopping caffeine

104
Q

A 25-year-old man suffers a 30% total body surface area burn. A cardiovascular physiological change expected within the first 24 hours is

Increased CI
Decreased SVR
Increased PVR
Increased hepatic flow
Increased stroke volume

A

Increased PVR

105
Q

Hepcidin production is inhibited in response to

Anaemia
Inflammation
Acute leukemia
Infection
Excess iron stores

A

Anaemia

106
Q

The function of the bottle labelled ‘D’ in the diagram below is to protect against the consequences of (diagram of chest drain bottles)
Answer -

A

Answer -

107
Q

The domains described in the Edmonton Frail Scale do NOT include

Cognition
Mental illness
Weight
Age
Functional assessment

A

Age

108
Q

Unsupported ventilation in a non-anaesthetised patient with long-standing tetraplegia is improved when

Supine
Standing
Reverse Trendelenburg

A

Supine

109
Q

The breast does NOT receive sensory innervation from the

Supraclavicular
Anterior intercostal
Posterior intercostal
Pectoral

A

Posterior intercostal

110
Q

A respiratory effect of high flow nasal oxygen therapy is

Reduced respiratory rate
Reduced minute ventilation
Increased work of breathing
Increased deadspace

A

Reduced respiratory rate

111
Q

A condition or therapy that is NOT a contraindication to hyperbaric oxygen therapy is
Answer -

A

Answer -

112
Q

In patients without other co-morbidities, bariatric weight loss surgery is indicated when the body mass index (kg/m2) is greater than

35
40
50
60

A

40

113
Q

The image below shows a normal central venous pressure (CVP) trace on the left. The CVP trace shown on the right is most consistent with

Tricuspid regurg
Mitral stenosis
Mitral regurg
Pericarditis
tamponade

A

Unclear what trace is shown

114
Q

Of the following, the device that delivers the greatest flow when using ‘Level 1® Fast Flow Fluid Warmer’ rapid fluid infuser system is a (list of intravascular catheters)

6.5 Fr sheath
8.5 Fr MAC Multilumen line
8.5 Fr Swan Ganz Sheath
14G IVC
8.5 Fr Peripheral RICC line

A

8.5 Fr Peripheral RICC line

115
Q

The most reliable clinical indicator of opioid-induced ventilatory impairment (OIVI) is decreased

Conscious state
Respiratory rate
Oxygen saturations
Tidal volume

A

Conscious state

116
Q

A patient had prolonged surgery with a laryngeal mask airway in situ. The following day she reports a problem with her tongue. You examine her and see the following when she protrudes her tongue: The most likely cause of the abnormality is

R hypoglossal nerve injury
L hypoglossal
R glossopharyngeal
L glossopharyngeal

A

R hypoglossal nerve injury

117
Q

A 10-year-old boy (weight 30 kg) has a displaced distal forearm fracture that requires manipulation and application of plaster. The volume of 0.5% lidocaine (lignocaine) that should be used for intravenous regional anaesthesia (Bier block) is

6ml
12ml
18ml
30ml
40ml

A

18ml

118
Q

Local anaesthetic systemic toxicity does NOT manifest as
Answer -

A

Answer -

119
Q

A patient has bipolar disorder and is on long term lithium therapy. An analgesic which should be avoided is

Diclofenac
Tramadol
Oxycodone
Methadone

A

Diclofenac

120
Q

According to the ANZCA ‘Guideline on infection control in anaesthesia’, skin preparation prior to central neuraxial blockade should be performed using

A

0.5 per cent chlorhexidine in alcohol

121
Q

The following muscles of the larynx are all innervated by the recurrent laryngeal nerve, EXCEPT

A

Cricothyroid muscle

122
Q

A patient who usually takes oral morphine 50 mg bd develops a bowel obstruction and experiences withdrawal symptoms. They may be described as having

Tolerance
Physical dependence
Addiction
Opiate dependence

A

Physical dependence

123
Q

The most common cause of cor pulmonale is

A

COPD

124
Q

The management of a patient who has experienced a cardiac arrest within 10 days of cardiac surgery should NOT routinely include

A

Adrenaline in conventional ALS doses

125
Q

A third heart sound at the apex may be heard with

A

Physiological (young fit or 3rd trim preg) or pathological (volume loaded-LVF/RVF/MR/AR)

126
Q

A patient presents for endovascular clot retrieval after experiencing a right hemisensory loss and right homonymous hemianopia. The vessel most likely occluded is the left

Anterior cerebral artery
Anterior inferior cerebellar artery
Posterior cerebral artery
Posterior inferior cerebellar artery
Superior cerebral artery

A

Posterior cerebral artery

127
Q

A 45-year-old man has the following results on his blood biochemistry testing (Liver function tests shown). The most likely diagnosis is

A

Answer - ? sick liver

128
Q

In cardiac surgery, volatile-based anaesthesia compared to total intravenous anaesthesia
Answer – Dependant on options

A

Answer – Dependant on options

129
Q

Suxamethonium may be safely given to patients with

A

Answer –

130
Q

A patient has numbness and weakness in her hand postoperatively. You are trying to distinguish between an ulnar nerve lesion and a C8-T1 radiculopathy. You can diagnose a C8-T1 radiculopathy if she has weakness

Thumb adduction
Thumb abduction
Fingers adduction
Fingers Abduction
Little finger flexion

A

Thumb abduction

131
Q

The recommended cleaning protocol for a laryngoscope handle which has been used but which has no visible soiling is

A

Detergent and water

132
Q

Considering emergency front-of-neck airway access, the major blood vessel that is most likely to lie anterior to the trachea above the sternal notch is the

A

?Brachiocephalic artery

133
Q

Of the following, the incidence of venous air embolism is considered highest for

LUSCS
Prostatectomy
Coronary artery surgery
Spinal surgery
Gastric endoscopy

A

LUSCS

134
Q

In the treatment of persistent mucosal bleeding in patients with von Willebrand disease type 3, desmopressin (DDAVP) is

A

Useless

?TXA ?vWF/FVIII concentrate instead

135
Q

High-risk transthoracic echocardiogram findings associated with aortic dissection include all of the following EXCEPT

AR
RV dilatation
Regional wall motion abnormality
Pericardial effusion

A

RV dilatation

136
Q

A 48 year old male is day two post-laparoscopic high anterior resection. He has used 42 mg of intravenous morphine in the past 24 hours. You wish to start him on oral tapentadol immediate release. The most appropriate equianalgesic dosage would be

A

42mg IV morph = 126mg PO morph (@3) = 420mg Tapentadol (@0.3)

137
Q

A patient with a purely metabolic acidosis has a serum bicarbonate of 14 mmol/L and a lactate of 3.8 mmol/L. The expected PaCO2 is

A

Answer - 29

138
Q

The part of the lung that is typically divided into superior, medial, anterior, lateral and posterior segments is the

A

Answer - RLL

Part 2 MCQ (7 decks)

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