Action Plans (Textbook) MCQs

Question 1

In the early detection of an air embolism, the following are useful:

a) ECG
b) ultrasound
c) end-tidal CO2
d) fall in blood pressure
e) change in ventilatory pattern

Answer 1

b) ultrasound
c) end-tidal CO2

Question 2

High central venous pressure, low blood pressure and acute circulatory failure are found in:

a) tension pneumothorax
b) pulmonary embolism
c) congestive cardiac failure
d) venous air embolism
e) haemorrhage.

Answer 2

a) tension pneumothorax
b) pulmonary embolism
c) congestive cardiac failure
d) venous air embolism

Question 3

In acute cardiac tamponade there is:

a) ascites
b) hypotension
c) bradycardia
d) a prominent ‘a’ wave in the CVP trace
e) cyanosis and cold extremities.

Answer 3

b) hypotension
d) a prominent ‘a’ wave in the CVP trace
e) cyanosis and cold extremities.

Question 4

Immediate treatment of venous air embolism during posterior fossa surgery should include the following:

a) turn the patient right side down
b) give mannitol
c) raise the intracranial venous pressure
d) give a rapid fluid infusion
e) turn off nitrous oxide

Answer 4

c) raise the intracranial venous pressure
d) give a rapid fluid infusion
e) turn off nitrous oxide

Question 5

Recognised features of fat embolism include:

a) mental confusion
b) bradycardia
c) petechial rash
d) respiratory distess syndrome
e) pyrexia.

Answer 5

a) mental confusion
c) petechial rash
d) respiratory distess syndrome
e) pyrexia.

Question 6

In cardiopulmonary resuscitation:

a) lignocaine should be given before adrenaline in ventricular fibrillation
b) the optimal treatment of ventricular tachycardia involves synchronised
50-joule DC shock
c) the tracheal dose of adrenaline is 0.5mg
d) 50mL NaHCO3 should be given every 10 minutes
e) calcium should be given to renal failure patients on dialysis.

Answer 6

e) calcium should be given to renal failure patients on dialysis.

Question 7

Hypokalaemia

a) causes ST segment depression on the ECG
b) causes mental depression
c) precipitates digoxin toxicity
d) may precipitate muscle paralysis
e) occurs in untreated hyperosmolar non-ketotic diabetic coma

Answer 7

a) causes ST segment depression on the ECG
c) precipitates digoxin toxicity
d) may precipitate muscle paralysis
e) occurs in untreated hyperosmolar non-ketotic diabetic coma

Question 8

After massive inhalation of gastric acid one would expect the following:

a) lung abscess
b) severe hypercapnia
c) bacteraemia
d) hypovolaemia
e) destruction of surfactant

Answer 8

d) hypovolaemia
e) destruction of surfactant

Question 9

Postoperative hypoxia at 15 minutes may be due to:

a) mild hypercapnia
b) nitrous oxide diffusion
c) central depression
d) increased V/Q scatter
e) shivering.

Answer 9

a) mild hypercapnia
c) central depression
d) increased V/Q scatter
e) shivering.

Question 10

Ventricular arrhythmias are more common in the presence of:

a) hypokalaemia
b) hypoxia
c) thyrotoxicosis
d) cardiopulmonary bypass and digoxin treatment
e) essential hypertension

Answer 10

ALL Answers are correct!

Question 11

Treatment of acute anaphylaxis includes:

a) IM adrenaline
b) H1 and H2 antagonists
c) hydrocortisone
d) IM chlorpromazine
e) IV salbutamol

Answer 11

a) IM adrenaline
b) H1 and H2 antagonists
c) hydrocortisone
e) IV salbutamol

Question 12

Air embolus is signified by:

a) ECG changes
b) Doppler ultrasound
c) pulsus paradoxus
d) raised CVP
e) decreased end-tidal CO2.

Answer 12

a) ECG changes
b) Doppler ultrasound
d) raised CVP
e) decreased end-tidal CO2.

Question 13

The following can be given by inhalation without causing systemic effects:

a) adrenaline
b) orciprenaline
c) isoprenaline
d) beclomethasone
e) sodium cromoglycate

Answer 13

d) beclomethasone
e) sodium cromoglycate

Question 14

Complications of dextran-70 include:

a) hypocoagulability
b) interference with cross-matching
c) hypervolaemia
d) renal failure
e) antigenic reaction

Answer 14

a) hypocoagulability
b) interference with cross-matching
c) hypervolaemia
e) antigenic reaction

Question 15

Recognised causes of urinary retention include:

a) ketamine
b) morphine
c) amitriptyline
d) ephedrine
e) frusemide.

Answer 15

b) morphine
d) ephedrine
e) frusemide.

Question 16

In epiglottitis the following are true:

a) IV access and oxygen are essential first-line treatment

b) immediate lateral neck x-ray is needed to aid diagnosis

c) IV chlorpromazine is the treatment of choice

d) tracheostomy should be performed if the patient is still intubated after 72 hours

e) patient is likely to be intubated for 5 days

Answer 16

NONE of the answers are correct!

Question 17

Causes of prolonged postoperative recovery of consciousness are:

a) acromegaly
b) intraoperative intracerebral event
c) myxoedema
d) prolonged action of muscle relaxants
e) hypoventilation.

Answer 17

ALL Answers are correct!

Question 18

TURP syndrome:

a) is associated with hypokalaemia
b) may present with convulsions
c) is prevented by spinal anaesthesia
d) is caused by blood loss
e) requires treatment with diuretics.

Answer 18

b) may present with convulsions
e) requires treatment with diuretics.

Question 19

A young man admitted to casualty following a road traffic accident is found to have central dislocation of the hip and is shocked. Likely causes are:

a) ruptured bladder
b) ruptured urethra
c) blood loss
d) neurogenic shock
e) fat embolism

Answer 19

c) blood loss

Question 20

A patient with vomiting, respiratory distress, cyanosis, epigastric tenderness and subcutaneous emphysema in the neck may be suffering from:

a) ruptured oesophagus
b) ruptured diaphragm
c) ruptured trachea
d) spontaneous pneumothorax
e) pulmonary embolus.

Answer 20

a) ruptured oesophagus
b) ruptured diaphragm
c) ruptured trachea

Question 20

Cricoid pressure:

a) is effective in the presence of a nasogastric tube

b) requires a complete cricoid cartilage to be effective

c) should be performed with the neck extended

d) should be performed after 5 minutes of pre-oxygenation

e) compresses the oesophagus against the cervical vertebrae.

Answer 20

b) requires a complete cricoid cartilage to be effective

c) should be performed with the neck extended

e) compresses the oesophagus against the cervical vertebrae.