ACE 2014-11B

Question 1

Most prominent side effect of cisplatin

Answer 1

Renal toxicity

Question 2

Most prominent side effect of vincristine

Answer 2

Neurotoxicity

Question 3

Most prominent side effect of cyclophosphamide

Answer 3

Myelosuppression

Question 4

Most prominent side effect of bleomycin

Answer 4

Pulmonary toxicity

Question 5

Anatomic reference point of zero for transducer for a lumbar CSF drain

Answer 5

External auditory meatus

Question 6

Omphalocele or gastroschisis is associated with congenital cardiac anomalies

Answer 6

Omphalocele

Question 7

FRC is how many mL per kg?

Answer 7

30 mL/kg

Question 8

Risk of meconium stained amniotic fluid is related to gestational age and birth weight in proportion or inverse proportion

Answer 8

Proportion

Question 9

Recommendations for presence of meconium stained amniotic fluid in a vigorous term neonate

Answer 9

No intervention required

Question 10

Most likely clinically significant electrolyte abnormality to occur with prolonged infusion of oxytocin

Answer 10

Hyponatremia because of water retention from the vasopressin-like anti diuretic actions of oxytocin

Question 11

How does increased gastric pH affect the GI absorption of methadone?

Answer 11

Increases (eg patient taking a PPI will have increased plasma methadone levels)

Question 12

Glycine is inhibitory or excitatory neurotransmitter?

Answer 12

Inhibitory

Question 13

Glutamate is inhibitory or excitatory neurotransmitter?

Answer 13

Excitatory

Question 14

Chassaignac tubercle is at what cervical level?

Answer 14

It’s the C6 transverse process.

Question 15

First rib, lung apices usually are located at what cervical level

Answer 15

C7

Question 16

Stellate ganglion lies on what border of the longus colli muscle

Answer 16

Lateral border

Question 17

Suprascapular nerve originates from which nerve roots?

Answer 17

C5-6 with variable contribution from C4

Question 18

Nerve that innervates supraspinatus and infraspinatus muscles

Answer 18

Suprascapular nerve

Question 19

Three parts to evaluating postoperative respiratory function in patient undergoing lung resection

Answer 19

Respiratory mechanics (FEV1)
Gas exchange (DLCO)
Cardiopulmonary function (VO2 max)

Question 20

Climbing 2 flights of stairs corresponds to what VO2 max?

Answer 20

12 mL/kg/min

Question 21

Manifestation of acute acetaminophen overdose in the first 24 hours

Answer 21

Nausea/vomiting, abdominal pain, pallor, diaphoresis, fatigue

Question 22

Primary treatment for acetaminophen toxicity

Answer 22

N-acetylcysteine, which increases synthesis of glutathione which is essential to detoxification of acetaminophen

Question 23

How are the effects of nondepolarizing neuromuscular blockade changed when a patient has burns on more than 30% of body surface

Answer 23

Decreased sensitivity (larger dose needed)
Prolonged onset of action 
Shortened duration of action

Question 24

Methemoglobin shifts oxyhemoglobin dissociation curve in what direction

Answer 24

Left

Question 25

Sulfhemoglobin shifts oxyhemoglobin dissociation curve in what direction

Answer 25

Right

Question 26

What’s the antidote for sulfhemoglobin?

Answer 26

None, elimination of sulfhemoglobin occurs with the destruction of the red blood cell

Question 27

Pain relief from codeine comes from metabolism of codeine to what?

Answer 27

Morphine

Question 28

Codeine is metabolized by what enzyme?

Answer 28

P450 enzyme, specifically cytochrome CYP2D6

Question 29

Medications that are best known as CYP2D6 inhibitors

Answer 29

SSRI (fluoxetine, paroxetine), diphenhydramine, bupropion.

Question 30

Medications that are best known as CYP2D6 inducers

Answer 30

Dexamethasone, rifampicin.

Question 31

Antibiotics that prolong neuromuscular blockade

Answer 31

Aminoglycosides, penicillins, polymyxins, bacitracin

Question 32

Proposed mechanism for prolonged neuromuscular blockade by aminoglycosides

Answer 32

Decreased release of acetylcholine: 1) competition with calcium 2) modification of prejunctional membrane

Question 33

Bier block is safer with lidocaine or prilocaine

Answer 33

Prilocaine

Question 34

Disorder of pregnancy with severe hypoglycemia and elevated serum ammonia levels.

Answer 34

Acute fatty liver of pregnancy