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part 2 mcq > 2021.2 > Flashcards

2021.2 Flashcards

1
Q

A pregnant woman requires a caesarean section delivery within 30 minutes for fetal distress. Her body mass index (BMI) is 26 kg/m2. She has multiple sclerosis with lesions in her brain and spinal cord and receives monthly injections of the disease-modifying drug of ofatumumab. The most appropriate plan for her delivery is

Spinal
CSE
GASpinal
CSE
GA

A

Spinal

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2
Q

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

Tricuspid regurg
Mitral stenosis
Mitral regurg
Pericarditis
tamponade

(Apperently Image of TR, although in previous recalls has been reported as a high a wave)

A

?

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3
Q

A 65 year old woman is dyspnoeic after a total hip replacement. A lung ultrasound is performed in the post-anaesthesia care unit, with a still image shown below. The likely cause of the dyspnoea is:

(this picture was in the recall) - lung point

Effusion
Embolism
Pneumothorax
Pneumonia”

A

Pneumothorax

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4
Q

A 25-year-old male has continued post operative bleeding after an extraction of an impacted third molar tooth under a general anaesthetic. The patient mentions that his father bruises quite easily. His coagulation screen reveals: (Coagulation tests provided). The most likely diagnosis is :

Nil recalled coags

Factor V Leiden
Haemophilia A
Haemophilia B
Von Willebrand’s Disease.

A

?

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5
Q

The cardiac axis of this electrocardiogram is:

(?repeat – no indication of what was shown)

A

?

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6
Q

Findings associated with massive pericardial tamponade include:

Pulsus alternans
Electrical alternans

A

Electrical alternans

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7
Q

Analysis of variance (ANOVA) is a statistical test to determine

A

?

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8
Q

A 25-year-old ASA (American Society of Anesthesiologists) physical status classification 1 patient develops 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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9
Q

A ten year old child (weight 30 kg) presents to the emergency department in status epilepticus. He has received one dose of 15 mg midazolam buccally prior to his arrival. According to Advanced Paediatric Life Supprt, Australia (APLS) guidelines the next drug treatment should be intravenous:

Midazolam
Propofol
Levetriacetam
Phenytoin

A

Midazolam

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10
Q

An awake patient in the post-anaesthesia care unit complains of breathlessness. The FiO2 is 0.4 via a facemask. An arterial blood gas taken at the time shows PaO2 135 mmHg, PaCO2 48 mmHg, and SpO2 100% The alveolar-arterial gradient (in mmHg) is approximately:

90
110
50
30

FiO2 0.4, paO2 135, pCO2 48

A

90

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11
Q

A patient undergoing robotic prostatectomy with volume-controlled ventilation has the following ventilatory measurements: (Ventilator parameters 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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12
Q

?removed from exam report
Paediatric patient least likely to have OSA

Down’s syndrome
Spina bifida
Tetralogy of Fallot
Pierre Robin
Ducschene Muscular Dystrophy

A

Spina bifida

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13
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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14
Q

A patient with known type 3 von Willebrand disease presents with persistent epistaxis. Firstline medical therapy should:

DDAVP
Prothrombinex
Factor VIIa
Factor VIII?
TXA?

A

Factor VIII?
TXA?

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15
Q

The CRASH-2 trial showed tranexamic acid administration to trauma victims results in a reduction in

A. Decreased mortality
B. Increased mortality
c. Decreased blood product use
D. No change mortality
E. Increased bleeding

A

A. Decreased mortality

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16
Q

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

?TR Jet

A

?

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17
Q

The diffusing capacity of the lungs for carbon monoxide (DLCO) is likely to be decreased with

Sarcoid
Asthma
Obesity

A

Sarcoid

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18
Q

?Removed from report
Panel of RFTs, normal FEV1, FVC and ratio with reduced dlco

?Obesity hypoventilation
COPD
Pulm HTN
Pulm fibrosis

A

Pulm HTN

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19
Q

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

(?transanimase up and bilirubin, albumin down)Hepatitis
Alcoholic liver disease
Paracetamol overdose
Cholecystitis

A

?

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20
Q

Hepcidin production is inhibited in response to

Anaemia
Inflammation
Acute leukemia
Infection
Excess iron stores

A

Anaemia

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21
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

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22
Q

The most likely complication from ultrasound guided left internal jugular central venous line insertion is:

Arterial puncture
Thoracic duct
Pneumothorax
Haemothorax

A

Arterial puncture

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23
Q

The most common complication of extracorporeal membrane oxygenation (ECMO) in adults is:

Bleeding
Vascular damage
Embolism
Inadvertent decannulation

A

Bleeding

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24
Q

A ten-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:

6
12
18ml
30
40

A

18ml

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25
Q

You administer a dose of intravenous indocyanine green to facilitate video-angiography during cerebral aneurysm surgery. The changes in pulse oximetry (SpO2) and cerebral oxygen tissue saturation (SctO2) you expect to see on your monitors 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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26
Q

The medical laser LEAST likely to cause eye injury is:

CO2
Green light
Lead

? Hol Yag

A

Green light

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27
Q

?Removed from exam report

Green handle on laryngoscope blade means:

Re-usable
Single use

A

?

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28
Q

?Removed from exam report

ANZCA recommended cleaning of USS probe/proe preparation before performing a block:

Probe cover only
Low level decontamination and cover ?
High level decontamination and cover
Sterilisation

A

Low level decontamination and cover ?

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29
Q

Regarding healthcare research, the PICO framework describes:

Stats analysis
Lit review ?
Guide reporting of a study

A

Lit review ?

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30
Q

A forest plot is a commonly used tool in meta-analysis. It presents

Shows study results and metaanalysis results
Shows study structure and results

A

Shows study results and metaanalysis results

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31
Q

The image below shows results from non inferiority trials. The trial labelled ‘M’ is best described as:

Not inferior
Superior
Indeterminate
Inferior

A

?

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32
Q

A 76 year old woman who is spontaneously breathing through a tracheostomy tube with an inner cannula becomes acutely breathless. Despite application of high flow oxygen, her respiratory rate is 40 breaths per minute and her SpO2 is 82%. The next most appropriate step in her airway management is to:

Hand bang ventilate
Sit up
Take cuff down
Remove inner cannula
Remove trache

A

Remove inner cannula

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33
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

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34
Q

A 59-year-old lady presents for elective coronary artery graft surgery. She has a pulmonary artery catheter inserted with the waveforms displayed below. Her cardiac output is 4.5 L/min. Her mean pulmonary artery pressure is 33 mmHg. The most likely explanation for the waveforms seen is that she has

MR
AS
MS

A

?

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35
Q

The most common cause of cor pulmonale is

A

COPD

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36
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:

(in other recalls – waveform showing PAP 74/28 consistently through cycle)

COPD
MR
PE
AS
MS

A

PE

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37
Q

The condition in which volatile anaesthesia is least appropriate is:

Muscular Dystrophy
Multiple Sclerosis
Myaesthenia gravis
Guillan Barre

A

Muscular Dystrophy

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38
Q

When performing a brachial plexus block at the level of the axilla, the structure indicated by the arrow is the:

(apparently median nerve?)Median nerve
Radial nerve
Ulnar nerve
Musculocutaneous nerve

A

Median nerve

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39
Q

When performing cannulation of the median cubital vein the structure that is LEAST likely to be inadvertently punctured or damaged is the:

Ulnar artery
Brachial artery
Median nerve
MCN of forearm
Radial nerve

A

Radial nerve

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40
Q

A 50-year-old man is admitted with a stroke and undergoes cerebral angiography. The artery marked with an arrow on the angiogram below is the:

Vertebral artery
Basilic artery
Posterior cerebral
Inferior cerebral

A

?

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41
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

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42
Q

A patient with a history of restless leg syndrome is agitated in the post-anaesthesia care unit. After excluding other causes, the best treatment of the agitation in this patient is:

Midazolam
Olanzepine
Haloperidol
Clozapine
Droperidol

A

Midazolam

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43
Q

Benzatropine ameliorates the side effects of drugs that antagonise:

-musc
-nic
-d2
-ser
-nadr

A

D2

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44
Q

A 25-year-old woman is administered two doses of aprepitant for postoperative nausea and vomiting after a sleeve gastrectomy. She normally takes the oral contraceptive pill. You should advise her to use alternative contraception for the next:

3 days
7 days
14 days
28 days

A

28 days

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45
Q

A trainee becomes aware that a patient they have just anaesthetised for emergency surgery is breastfeeding and seeks your advice regarding recommencement of breast feeding. You advise that breast feeding is contraindicated because during the admission today the patient received:

Tramadol
Codeine
Ketamine
Midazolam

A

Codeine

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46
Q

You have been asked to provide general anaesthesia for a complex thoracic endovascular aortic aneurysm repair. After the placement of a lumbar drain the recommended safe time before the administration of intravenous heparin is:

30 minutes
1 hours
2 hours
4 hours

A

1 hours

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47
Q

A derived value from an arterial blood gas sample is:

PO2
PCO2
pH
Base excess

A

Base excess

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48
Q

An electrocardiogram (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

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49
Q

A 30 year old athlete undergoing a knee arthroscopy under general anaesthesia becomes tachycardic intraoperatively. A 12-lead electrocardiogram (ECG) is obtained. The most likely diagnosis is:

(apparently delta waves present)AVNRT
AVRT (WPW)
AF
Flutter

A

AVRT (WPW)

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50
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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51
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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52
Q

Stellate ganglion block is NOT contraindicated in patients with

Contralateral phrenic nerve palsy
Glaucoma
Recent MI
Arrythmia
Refractory arrhythmia

A

Refractory arrhythmia

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53
Q

Painless post-operative visual loss with preserved pupillary reflexes is most likely due to

Retinal detachment
Anterior ischaemic optic neuropathy
Corneal abrasion
Posterior ischaemic optic neuropathy
Posterior cerebral ischaemia

A

Posterior cerebral ischaemia

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54
Q

Sensory innervation of the cornea is by the

Nasociliary nerve
Optic nerve
Trigeminal nerve *
Frontal nerve

A

Nasociliary nerve

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55
Q

Risks associated with robot-assisted laparoscopic prostatectomy surgery in comparison with open prostatectomy include all of the following EXCEPT

Major haemorrhage
Corneal burn
Cerebral oedema
CO2 embolism

A

Major haemorrhage

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56
Q

A risk factor which increases the likelihood of developing local anaesthetic systemic toxicity is

Hypoxia
Alkalaemia
High alpha-1-acid glycoprotein
Hypocarbia
Increased carnitine levels

A

Hypoxia

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57
Q

Post-dural puncture headache in obstetric anaesthesia is associated with a greater likelihood of all of the following EXCEPT

Depression
Bacterial meningitis
Chronic back pain
Cerebra venous thrombosis
?Other

A

?

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58
Q

Your patient has been administered 50 mL of oral 5–aminolevulinic acid hydrochloride (Gliolan) three hours prior to her scheduled craniotomy for resection of a glioblastoma. Care should be taken perioperatively to avoid the adverse effect of:

Photosensitivity
Renal injury

A

Photosensitivity

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59
Q

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

A

Lowest FiO2 possible

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60
Q

Complications of hyperbaric oxygen therapy include all of the following EXCEPT:

Hypoglycaemia
Cataracts
Worsening CCF
Seizures
Reversible hypermetropia

A

Reversible hypermetropia

61
Q

The risk of postoperative respiratory failure in myasthenia gravis is increased by the administration of:

Gentamycin
Teicoplanin
Cefazolin
Vancomycin

A

Gentamycin

62
Q

In pulmonary function testing the presence of airflow limitation is defined by a postbronchodilator FEV1/FVC ratio less than:

50
60
70
80
90

A

70

63
Q

?removed from exam report

BMI 45 best way to improve PaO2:

a Recruitment
b. Peep 10
c. Increase TV
d. Increase RR
e. Increase Minute ventilation

A

?

64
Q

The equipment shown in the picture below is a:

(apparently a NIM tube)

A

NIM Tube

65
Q

?removed from exam report

Size 9 Arndt bronchial blocker – what size of tube needed?

6
7
8

A

8

66
Q

?removed from exam report

Winging of scapular what nerve not involved?

Suprascapular nerve
Long thoracic nerve
Accessory nerve
Dorsal scapular nerve

A

Suprascapular nerve

67
Q

The breast does NOT receive sensory innervation from:

Supraclavicular
Anterior intercostal
Posterior intercostal? (misremembered? This is not a nerve)
Pectoral?

A

Posterior intercostal? (misremembered? This is not a nerve)

68
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:

A

repeat

69
Q

The estimated proportion of human induced climate change attributable to nitrous oxide is:

0.01
0.06
1
6

A

6

70
Q

The size 5 i-gel® supraglottic airway is recommended for patients who weigh over:

50
60
70
80
90

A

90

71
Q

A new volatile agent is developed. The property it shares with sevoflurane that will enable it to be used in a sevoflurane vapouriser and deliver an accurate concentration is its:

Saturated vapour pressure
Oil:gas partition coefficient
Blood:gas partition coefficient

A

Saturated vapour pressure

72
Q

The use of erythropoietin before major surgery results in

:Less transfusion same thrombosis
Less transfusion more thrombosis
No change in transfusion or thrombosis
No change in transfusion, more thrombosis

A

Less transfusion same thrombosis

73
Q

International guidelines state that patients presenting for major surgery have inadequate or low iron stores if their serum ferritin level is less than

20
30
40
50
100

A

100

74
Q

In a patient with anaemia of chronic disease, of the following the most likely to be elevated is:

MCV
Transferrin saturation
Soluble Transferrin receptor
Ferritin
Total iron binding capacity

A

Ferritin

75
Q

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

Hepatic vein
Hepatic artery
Portal vein
Round ligament ? incorrectly remembered

A

Hepatic vein

76
Q

The muscle or muscle group with the greatest resistance to the action of non-depolarising neuromuscular blocking agents is the:

Diaphragm
Pharyngeal
Adductor pollicis

A

Diaphragm

77
Q

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

Cerebral oedema
Central pontine demyelination
Septic shock

A

Cerebral oedema

78
Q

A 30-year-old man with morbid obesity (body mass index [BMI] 55 kg/m2) presents for middle ear surgery. The most appropriate bolus dose of propofol for induction should be based on:

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

A

Lean body weight

79
Q

Predictors of successful awake extubation after volatile anaesthesia in infants include:

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

A

Grimacing

80
Q

The most common presenting rhythm associated with maternal cardiac arrest is:

VT
VF
Asystole
PEA
SVT

A

PEA

81
Q

A 74-year old man in the post-anaesthesia care unit complains of chest pain. An electrocardiogram (ECG) is performed. The occluded coronary artery is the :

(apparently showed ST elevation V1-3)

Left anterior descending
Right coronary
Posterior descending
Left circumflex
Ostial something

A

Left anterior descending

82
Q

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

5250
6000
6750
7500

A

7500

83
Q

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

Adenosine
Metaraminol
Phenylephrine

A

Adenosine

84
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

85
Q

A patient presents for a trans-urethral resection of the prostate (TURP). He had a single drug eluting coronary stent for angina pectoris inserted six months ago and is taking clopidogrel and aspirin. The most appropriate preoperative management of his medications is to:

A) Stop aspirin, continue clopidogrel
B) Stop aspirin 10 days prior, and clopidogrel 5 days prior
C) Stop clopidogrel 10 days prior
D) Stop clopidogrel 5 days prior
E) Continue both

A

D) Stop clopidogrel 5 days prior

86
Q

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

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

A

Higher incidence of staphyloma

87
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

88
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

89
Q

The nerve labelled by the arrow in the diagram below is the

(apparently diagram of upper lumbar plexus? With iliohypogastric being the answer?)

Iliohypogastric
Ilioinguinal
Obturator

A

?

90
Q

Of the following, the deficit that DOES NOT result from damage to the common peroneal nerve is:

Loss of foot dorsiflexion
Loss of dorsal foot sensation
Loss of knee flexion
Loss of knee extension

A

Loss of knee extension

91
Q

The most common type of perioperative stroke is:

Thrombotic
Ischaemic
Embolic
Haemorrhagic
Hypotension

A

Embolic

92
Q

The drug of choice for the treatment of duct dependent congenital heart disease is:

Alprostadil
Prostacyclin
Sildenafil
NSAID

A

Alprostadil

93
Q

Of the following drugs, the least likely to cause pulmonary vasodilation when used at low doses in patients with chronic pulmonary hypertension is:

Dopamine
Dobutamine
Vasopressin
Milrinone

A

Dopamine

94
Q

? removed from exam report
Least risky heart condition in a neonate (or infant?) with congenital cardiac disease undergoing a non-cardiac procedure

Left to right shunt
Right to left shunt
Single ventricle with palliative fontan
Tetrallogy of fallot
BT or TOF repair
?Option of severe pulm HTN
?Option of systemic to pulmonary arterial chunt

A

Left to right shunt

95
Q

Cardiovascular effects of hyperthyroidism include

Decreased diastolic relaxation
Decreased SVR
Decreased PVR
Increased diastolic BP

A

Decreased SVR

96
Q

A 25-year-old man suffers a burn involving 30% of his total body surface area. A cardiovascular physiological change expected within the first twenty-four hours is:

(repeat question but with different options?)

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

A

?

97
Q

You are involved in the care of a two-year-old child who ingested a button battery within the last 4 hours. You should consider giving

Honey
Milk
Water
Bicarb

A

Honey

98
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

99
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:

Urine osmolarity <100
Euvolaemic state
Urine Na >40
Increased cortisol

A

Urine osmolarity <100

100
Q

In a patient with tetraplegia who develops autonomic dysreflexia, the expected haemodynamic response is:

Hypertension from splanchnic vasoconstriction below lesion
Hypotension from uncontrolled vagal stimulation

A

Hypertension from splanchnic vasoconstriction below lesion

101
Q

The domains described in the Edmonton Frail Scale do NOT include:

Cognition
Mental illness
Weight
Age
Functional assessment

A

Age

102
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

103
Q

When performing a paediatric pain assessment, the five elements assessed to obtain the FLACC score are:

A

?

104
Q

Identified risk factors for opioid-induced ventilatory impairment DO NOT include :

Opiate use pre-op

A

Opiate use pre-op

105
Q

The oral morphine equivalent of tapentadol 50 mg (immediate release) is:

5mg
10mg
20mg
25mg
30mg

A

20mg

~3 x less potent

106
Q

?removed from exam report

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

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

107
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

108
Q

Intraoperative lung protective ventilation strategies include all of the following EXCEPT:

Vt 6-8ml/kg
Patient titrated PEEP
Recruitment manoeuvres – recommended in surgical vent BJA int guideline
I:E ratio 1:3

A

I:E ratio 1:3

109
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

110
Q

The function of the bottle labelled ‘D’ in the diagram below is to protect against the consequences of:

(picture of 4 bottle system)
Suction failure
Excess positive pressure
Drain kinking
Excess negative pressure

A

Suction failure

111
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

112
Q

A peripheral intravenous cannula is being inserted in the forearm of a man having a hemicolectomy. The skin asepsis preparation NOT suitable for this procedure is

Povidone iodine 10% prep
Chlorhex 2%
EtOH 70%
Chlorhex in EtOH
Iodine tincture

A

Chlorhex 2%

113
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

114
Q

You are examining the precordium of a patient in the preadmission clinic and hear a fourth heart sound at the apex. This finding is consistent with:

AR
Athlete
Normal
Hypertension

A

Hypertension

115
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

116
Q

The number of segments in the lower lobe of the left lung is:

2
3
4
5
6

A

4

117
Q

Allergic cross-reactivity between penicillins and cephalosporins is mediated by the:

Thiazolidine ring
Beta lactam ring
R1 chain on the Beta Lactam ring
R2 chain on the thiazelidine ring
Dihydrothiazine ring

A

R1 chain on the Beta Lactam ring

118
Q

A patient with a history of paroxysmal atrial fibrillation and chronic obstructive airways disease develops a wheeze intraoperatively which resolves with administration of salbutamol via the endotracheal tube. Soon after, he develops rapid atrial fibrillation with a ventricular rate of 120 beats per minute, a BP of 90/60 and an ETCO2 of 40mmHg. His regular medications are inhaled salbutamol, inhaled salmeterol and digoxin 125mcg daily. The next most suitable treatment is:

A) Amiodarone 150 mg over 10 mins and cont with infusion 0.5-1mg/min
B) DC shock at 50J (weak!! Should cardiovert with at least 100J biphasic!?)
C) Esmolol 0.5mg per kg followed by an infusion 0.1mg/kg/min
D) 2.5-5mg metoprolol q3-5 mins max attempts x 3.
E) Digoxin 500mcg

A

Amiodarone 150 mg over 10 mins and cont with infusion 0.5-1mg/min

119
Q

A patient has blunt chest trauma. A thoracotomy is indicated if the immediate blood drainage after closed thoracostomy is greater than

500ml
1000ml
1200ml
1500ml

A

1500ml

120
Q

The anion which contributes the most to the anion gap is:

Albumin
Chloride
Phosphate
HCO3
Urate

A

Albumin

121
Q

Intraoperative cell salvage is contraindicated in

LUSCS
Infected hip revision
Heparin allergy
Severe coagulopathy
Phaeochromocytoma

A

Phaeochromocytoma

122
Q

Techniques to improve the speed of onset and spread of a peribulbar block include all of the following EXCEPT:

Honan balloon
Digital pressure
Ocular massage
Hyalase

A

Ocular massage

123
Q

Performing a superficial cervical plexus block will block all of the following nerves EXCEPT the

Greater auricular nerve
Supraclavicular
Lesser occipital
Greater occipital
Transverse cervical

A

Greater occipital

124
Q

A man with atrial fibrillation has no valvular heart disease. According to joint American Heart Association (AHA), American College of Cardiology (ACC) and Heart Rhythm Society (HRS) guidelines, oral anticoagulants are definitely recommended if his CHA2DS2-VASc score is greater than or equal to:

1
2
3
4
5

A

2

125
Q

The maximum warm ischaemia time acceptable for procuring the kidney following donation after circulatory death (DCD) is:

30 minutes
60 minutes
90 minutes
120 minutes

A

60 minutes

126
Q

ANZCA fasting guidelines classify all of the following as clear fluids EXCEPT

Water
Black coffee
Strained broth
Clear cordial
Pulp free juice

A

Strained broth

127
Q

The main advantage of using noradrenaline (norepinephrine) 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

128
Q

The power board on the back of the anaesthesia machine has caught fire during an elective case.

CO2 extinguisher
Fire blanket
Fire hose
Foam extinguisher
Wet chemical extinguisher

A

CO2 extinguisher

129
Q

With regard to the risk of postoperative surgical-site infection, 8 mg dexamethasone administered intraoperatively has

No change in infection
Increased infection in diabetics
Increased infection in non diabetics

A

No change in infection

130
Q

Cryoprecipitate contains all of the following EXCEPT:

Factor II
Factor VII ? misremembered
Factor XIII
VWF
Fibronectin

A

Factor II

131
Q

The intrinsic muscles of the larynx do NOT include

Suprahyoid
Cricothyroid
Thyroarytenoid
Transverse arytenoid

A

Suprahyoid

132
Q

Suxamethonium causes a sustained contraction of the extraocular muscles for up to:

2 minutes
3 minutes
5 minutes
10 minutes
20 minutes

A

10 minutes

133
Q

A factor that is NOT used to calculate the Child-Pugh score is

Albumin
Ascites
INR
Creatinine
Bilirubin

A

Creatinine

134
Q

A patient with an acute subarachnoid haemorrhage arrives in the emergency department. Her Glasgow Coma Scale is 10 and she has no motor deficit. A CT brain shows diffuse subarachnoid haemorrhage with no localised areas of blood > 1mm thick, and no intracerebral nor intraventricular blood. Her World Federation of Neurosurgical Societies (WFNS) grade of subarachnoid haemorrhage is:

1
2
3
4
5

A

4

135
Q

An adult with renal failure on regular haemodialysis has an ASA (American Society of Anesthesiologists) physical status classification of at least:

1
2
3
4
5

A

3

136
Q

Not required to diagnose DCD

?removed from exam report
Feel like the question would have been more specificApnoea
Art line flat 2 mins
Immobility
No skin perfusion
Absence of drugs causing sedation or coma

A

Absence of drugs causing sedation or coma

137
Q

Of the following, the procedure that is most commonly associated with chronic pain after surgery is:

A

?

138
Q

What do you do with a patient with sickle cell disease for surgery with Hb 80

?removed from exam report

A)Group and screen
B) Exchange transfusion to HbSS <30%
C) Transfuse to Hb 100

A

Transfuse to Hb 100

139
Q

A woman experiences a post-partum haemorrhage associated with uterine atony that is unresponsive to oxytocin and ergometrine. The recommended intramuscular dose of carboprost (15-methyl prostaglandin F2 alpha ) to be administered is

50mcg one dose
50mcg repeated to max
250mcg single dose
1g

A

250mcg single dose

140
Q

Methylene blue may be used in the treatment of all of the following conditions EXCEPT

repeat

G6P deficiency
Priapism
Methaemoglobinaemia
Portopulmonary hypertension
Protamine allergy

A

G6P deficiency

141
Q

?not in exam report

Which of the following is (is not?) associated with worse outcomes to anaphylaxis

High ASA score
Concurrent beta blocker dose
Ischaemic heart disease
Anaphylaxis to specific drug ?

A

Anaphylaxis to specific drug ?

142
Q

(not listed in recall)

The relatively slower onset of action of bupivacaine with adrenaline in brachial plexus anaesthesia compared to other local anaesthetics relates to:

High pH
High pKa
High protein binding
Additional of adrenaline
High lipid solubility

A

High pKa

143
Q

(not listed in recall)

A patient has return of spontaneous circulation (ROSC) but remains unresponsive after cardiac arrest. ANZCOR Guidelines recommend all the following measures EXCEPT

A

?

144
Q

(not listed in recall)

The oculocardiac reflex results in:

A

?

145
Q

(not listed in recall)

The abnormality shown in this image is LEAST likely to be caused by an injury to the

A

?

146
Q

(not listed in recall)

The Vortex Approach to airway management does all of the following EXCEPT

A

?

147
Q

(not listed in recall)

Local anaesthetic blockade of the sciatic nerve results in loss of function of all of the following EXCEPT

A

?

148
Q

(not listed in recall)

A bleeding patient has ROTEM results including (results displayed). The most appropriate treatment is:

A

?

part 2 mcq (7 decks)

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