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MBBS VI - SpC - Emergency Medicine > Anaesthesiology CCT > Flashcards

Anaesthesiology CCT Flashcards

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1
Q

Which of the mallampati scores indicates that a patient is likely to be extremely difficult to intubate?
A. 1
B. 2
C. 3
D. 4

A

Ans: D

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2
Q

Which of the following devices is not an advanced airway used during cardiopulmonary resuscitation?
A. Combitube airway
B. Endotracheal tube
C. Laryngeal mask airway
D. Oropharyngeal airway

A

D. Oropharyngeal airway

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3
Q

After successful resuscitation to VF arrest, the patient was found unable to obey commands. Which specific intervention must be instituted?
A. Mechanical ventilation with 100% flow for 24 hours
B. Mechanical ventilation to keep paco2 <3.0 kPa for 24 hours
C. Insulin infusion to keep plasma glucose level 4-5 mmol/l for 24 hours
D. Keep body temperature at 32-36 for 24 hours

A

Ans: D (target temperature management after ROSC)

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4
Q

A pre-dialysis patient was in the recovery room after emergency surgery for a fractured hip. He requested analgesic. Which of the following drugs are the safest to the patient?
A. Diclofenac
B. Fentanyl
C. Morphine
D. Pethidine

A

Ans: B (fentanyl can be used in renal impaired patients, NSAIDs and morphine are not as tolerated)

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5
Q

Which of the following is not an extracorporeal treatment method?
A. venoarterial ECMO for refractory cardiogenic shock
B. renal replacement therapy for renal failure
C. venesection for polycythemia vera
D. therapeutic plasma exchange for myasthenia gravis

A

C. venesection for polycythemia vera

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6
Q

Which of the following drugs can be used to treat opioid overdose?

A. Tranexamic acid
B. Adrenaline
C. Naloxone
D. Flumazenil

A

C. Naloxone

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7
Q

Which of the following is a sign of LA toxicity?
A. Pinpoint pupils
B. Bronchospasm
C. Fever
D. Convulsion

A

Ans: D

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8
Q

A 50 kg man is undergoing open cholecystectomy. What is the maximum safe volume of 0.5% bupivacaine injected via local wound?
A. 10ml
B. 20ml
C. 30ml
D. 40ml

A

Ans: B (bupivacaine max dose: 2mg/kg)

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9
Q

Bilateral total knee replacement. Epidural anaesthesia used. Which level should it be applied to?
A. C7-8
B. T10-T11
C. L3-4
D. L5-S1

A

Ans: C

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10
Q

Pulseless, which of the following can defib

A. Ventricular tachycardia
B. Supraventricular tachycardia
C. Asystole
D. Atrial fibrillation

A

A. Ventricular tachycardia
and VFib

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11
Q

A young man is about to undergo laparotomy for acute appendicitis. He mentioned that his father died suddenly after experiencing high temperature following general anesthesia. Which of the following induction agents is definitely safe for this patient?

A. Sevoflurane
B. Propofol
C. Desflurane
D. Suxamethonium

A

B. Propofol

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12
Q

PONV. Which of the following does not increase the risk of PONV?
A. Laparoscopic surgery
B. Gynecological procedure
C. Young age
D. Chronic smoking history

A

D. Chronic smoking history

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13
Q

Which of the following statements best describes mechanical ventilation (IPPV) and non-invasive ventilation (NIV)?

A. An airtight face mask is commonly used for IPPV.
B. NIV provides airway protection.
C. Both requires an intact respiratory drive.
D. Both provides positive pressure support.

A

D. Both provides positive pressure support.

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14
Q

Which of the following drug is used to treat anaphylaxis?

A. Tranexamic acid
B. Adrenaline
C. Naloxone
D. Flumezenil

A

B. Adrenaline

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15
Q

Which of the following is most likely to be opioid overdose features?

A. fever
B. convulsion
C. pinpoint pupil
D. bronchspasm

A

C. pinpoint pupil

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16
Q

A 55 year old man has collapsed in the ward. He has no palpable pulse and is not breathing. You see the following ECG pattern upon attaching the cardiac monitor. (ventricular fibrillation)
What is your IMMEDIATE management?

A. 1mg IV adrenaline
B. continue CPR
C. Defibrillation
D. 300mg amiodarone

A

C. Defibrillation

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17
Q

33 yo female underwent laparoscopic appendicectomy. 4mg Dexamethasone and 5mg morphine given intraoperatively. She complained of nausea and vomiting post-op.

What is the most appropriate management for pnov for her.

A. Dexamethasone
B. Naloxone
C. Ondansetron
D. Gelofusin

A

C. Ondansetron

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18
Q

Compression of which anatomical structure can prevent aspiration of reflux of gastric contents

A cricoid cartilage
B lower esophageal sphincter
C trachea
D thyroid cartilage

A

Ans: A

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19
Q

A 52-year old male requires emergency endotracheal intubation for respiratory failure. You plan to use suxamethonium to facilitate intubation. Which of the following blood electrolyte level should you check prior to giving suxamethonium?

A. Na+
B. Ca 2+
C. K+
D. Mg 2+

A

C. K+

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20
Q

Man with chronic obstructive pulmonary disease received pancreatic surgery. Which is the most appropriate postoperative regional anaesthetic approach?
A. Caudal anaesthesia
B. Epidural anaesthesia
C. Lumbar plexus block
D. Spinal anaesthesia

A

B. Epidural anaesthesia

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21
Q

Which one is not the feature of septic shock?
A. SBP<100
B. HR >120
C. Hypolactaemia
D. GCS<=14

A

C. Hypolactaemia

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22
Q

What is the most appropriate treatment of massive bleeding?
A. TXA
B. Adrenaline
C. Naloxone
D. Flumazenil

A

A. TXA

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23
Q

Pulseless VT most appropriate treatment
A. Defibrillate once at 200J
B. Defibrillate once at 300J
C. Defibrillate twice at 200J
D. Defibrillate twice at 300J

A

A. Defibrillate once at 200J (biphasic)

Or puleseless VF

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24
Q

Which venous access is associated with the highest risk of pneumothorax?
A. internal jugular vein
B. Femoral vein
C. subclavian vein
D. axillary vein

A

C. subclavian vein

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25
Q

A 21-year-old male with good past health needs to undergo general anaesthesia for laparoscopic appendicectomy. After endotracheal intubation the patient desaturates. On examination there is reduced left chest expansion and air entry. Trachea is normal. Which of the following is the most likely diagnosis?
A. Left endobronchial intubation
B. Right endobronchial intubation
C. Left tension pneumothorax
D. Right tension pneumothorax

A

B. Right endobronchial intubation (obtuse angle)

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26
Q

A 25-year-old man with obstructive sleep apnea (OSA) and asthma is listed for wisdom tooth extraction. Which of the following indicates difficult direct laryngoscopy and intubation?
A. Young age
B. Male
C. OSA
D. Asthma

A

C. OSA

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27
Q

Rapid sequence induction is used in a 72-year-old man for emergency laparotomy. Direct laryngoscope revealed a Grade 4 airway. Attempted intubation with a size 7 tube fails. What is the immediate management?
A. Face mask and manual ventilation
B. Laryngeal mask airway
C. Cricothyroidotomy
D. Attempt intubation with a size 6 endotracheal tube

A

A. Face mask and manual ventilation

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28
Q

Which one is definitive confirmation for correct ET tube placement?
A. Breath sound in bilateral lung field?
B. No audible sound in epigastrium
C. No desat for 3/5 minutes?
D. Continuous CO2 waveform on capnography

A

D. Continuous CO2 waveform on capnography

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29
Q

What fasting advice would you give to the mother of a 8-month-old boy who is going to have circumcision?
A. Drink formula milk up to 4 hours then clear fluid up to 2 hours before the surgery
B. Drink breast milk up to 4 hours then clear fluid up to 2 hours before the surgery
C. Clear fluid until surgery
D. No food by mouth up to 6 hours

A

B. Drink breast milk up to 4 hours then clear fluid up to 2 hours before the surgery

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30
Q

Spinal anaesthesia not performed in
A. Inguinal hernia repair
B. Varicose veins surgery
C. Total bilateral knee replacement
D. Distal gastrectomy

A

D. Distal gastrectomy

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31
Q

Man to undergo surgery, long term asthma in control, takes a puff of salbutamol before exercise, can walk up 5 flights of stairs, ASA status
A. ASA1
B. ASA2
C. ASA3
D. ASA4

A

B. ASA2

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32
Q

Surgery for colorectal cancer, developed itchy rash after cefazolin, swollen lips and shortness of breath, BP 70/50, pulse 120, SaO2 93%, management?
A. 500mL gelofusine
B. Amiodarone 300mg IV
C. 100% O2 on BVM
D. Adrenaline 0.5 mg IM

A

D. Adrenaline 0.5 mg IM

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33
Q

On-call, 4am, found a patient collapsed in front of you at the entrance of the hospital, no carotid pulse + no spontaneous breathing, what is the NEXT thing you should do?
A. Call the hospital cardiac arrest team
B. Start CPR and wait for someone to come
C. Recovery position
D. Precordial thump

A

A. Call the hospital cardiac arrest team

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34
Q

Px with history of mitral valve disease, after induction for GA, the patient develops AF with heart rate wavering at 130-150bpm, bp 80/60, what is the best management?
A. Defibrillation
B. Synchronised DC cardioversion
C. IV 0.9% NS
D. IV adrenaline

A

B. Synchronised DC cardioversion

The underlying hypotension is caused by AF (when bpm >150 most likely the cause)

If BPM <150 think about treating the underlying cause i.e. sepsis, hemorrhage first

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35
Q

Which of the following conditions predispose difficult direct laryngoscopy?
A. A man with ankylosing spondylitis
B. A man with DM
C. A woman with small thyroid nodule
D. A woman with SLE

A

A. A man with ankylosing spondylitis

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36
Q

Which of the following conditions predict difficult bag valve mask ventilation
a. Mallampati 2
b. Edentulous
c. Receding chin
d. Reduced neck flexion

A

c. Receding chin

  • Obese (BMI over 26kg/m2)
  • Beard
  • Absence of teeth
  • Facial abnormalities
  • Mallampati 3-4
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37
Q

Which of the following set of patient characteristics are suggestive of a difficult airway
a. Mallampati 2, thyromental distance 6cm, inter-incisor distance 3cm
b. Mallampati 2, thyromental distance 6cm, inter-incisor distance 4cm
c. Mallampati 3, thyromental distance 7cm, inter-incisor distance 3cm
d. Mallampati 3, thyromental distance 7cm, inter-incisor distance 2cm

A

d. Mallampati 3, thyromental distance 7cm, inter-incisor distance 2cm (<3cm: intubation more difficult, <2.5cm: SAD insertion more difficult)

38
Q

Ambu bag, optimal seal, connected to high flow O2 15L/min, what is the fraction of inspired oxygen delivered to the patient?
a. 50%
b. 70%
c. 90%
d. 100%

A

d. 100%

39
Q

What size of endotracheal tube (internal diameter) is used for a chinese adult female?
A. 5mm
B. 6mm
C. 7mm
D. 8mm

A

C. 7mm

40
Q

A 50 year old male undergoing colonoscopy with propofol infusion and fentanyl for sedation and is on 3L/min O2 via nasal cannula. He develops noisy breathing and oxygen saturation drops to 90%. What is the MOST APPROPRIATE management?
A. Endotracheal intubation
B. Give bag mask ventilation
C. Perform head tilt, chin lift and jaw thrust
D. Stop propofol infusion

A

C. Perform head tilt, chin lift and jaw thrust

This is done to assess airway first (ABC no matter what)

41
Q

Which of the following structures will not be transversed during epidural anaesthesia?
A. Dura mater
B. Supraspinal ligament
C. Interspinal ligament
D. Ligamentum flavum

A

A. Dura mater (surrounds the spinal cord)

Ligamentum flavum (yellow) is the last structure to be transversed and there is loss of pressure when inserted

42
Q

Patient on dialysis after 4-hour nephrectomy. Post anaesthetic care unit. Given remifentanil, morphine, acetaminophen, atracurium, propofol, oxygen saturation 90%, respiratory rate 6 , cause?

A. Propofol
B. Atracurium
C. Remifentanil
D. Morphine

A

D. Morphine (respiratory depression)

43
Q

Ketamine physical side effects (or complications)?
1. Reduced functional capacity of the bladder
2. Enlarged bile duct on ultrasound
3. Elevated ALT & ALP with normal bilirubin
4. Rhinitis and sinusitis

A. 1 and 3
B. 1 and 4
C. 1, 3 and 4
D. 1, 2, 3 and 4

A

D. 1, 2, 3 and 4

44
Q

50/M on 50mg twice daily metoprolol. Scheduled Right hemicolectomy. Which of the following is appropriate for cardioprotection.

A. Continue 50mg twice daily.
B. Increase to 100mg twice daily 3 days before surgery.
C. Change metoprolol to atenolol one week before surgery
D. Stop metoprolol the day before surgery

A

A. Continue 50mg twice daily.

45
Q

IV maintenance agent in GA for laparoscopic myomectomy.

A. Etomidate
B. Propofol
C. Ketamine
D. Thiopentone

A

B. Propofol

46
Q

An obese patient requires laparoscopic repair of his hiatus hernia. Which of these airway devices is INDICATED?

A. Endotracheal tube
B. Laryngeal mask airway
C. i-gel
D. Combitube

A

A. Endotracheal tube

Combitube – oesophageal tracheal double-lumen airway used in the pre-hospital and emergency setting; does not allow for long term airway control

47
Q

A child is about to undergo an operation, which requires pre-op fasting. His mother is worried that the child will be dehydrated. What would you advise the mother?

A. Can drink black tea up to 2 hours before operation
B. Can drink milk up to 2 hours before operation
C. Can drink orange juice up to 2 hours before operation
D. Can drink watery congee up to 2 hours before operation

A

A. Can drink black tea up to 2 hours before operation

48
Q

You performed rapid sequence induction on a patient, with propofol and succinylcholine. You found that the patient had a difficult airway, and you have failed intubation 3 times. The patient’s pulse oximetry reading is now dropping. You have called senior but they cannot come immediately, what is your next step?

A. Fiberoptic larygoscopy
B. Laryngeal mask airway
C. Tracheostomy
D. Cricothyroidotomy

A

B. Laryngeal mask airway

  • If patient not desaturating (e.g. SpO2 97%) → reattempt with video laryngoscopy
  • Can then try laryngeal mask airway
49
Q

Which of the following is true about pulse pressure?

A. It is the median of systolic blood pressure and diastolic blood pressure
B. It reduces in tachycardia
C. decreases with age
D. it is the same at a given time in the arterial tree

A

B. It reduces in tachycardia

50
Q

Normal inspiration increases:

A. Intra pleural pressure
B. Alveolar pressure
C. Intra abdominal pressure
D. Partial pressure of O2 in trachea

A

C. Intra abdominal pressure

51
Q

Most important landmark for epidural anaesthesia?

A. Supraspinous ligament
B. Ligamentum flavum
C. Posterior longitudinal ligament
D. ?

A

B. Ligamentum flavum

Sudden loss of pressure when having pierced the ligamentum flavum (yellow appearance)

52
Q

You are asked to perform rapid sequence induction on a patient in status epilepticus. Which drug would be your induction agent of choice?

A. Ketamine
B. Sodium thiopental
C. Etomidate
D. Propofol

A

D. Propofol
After BDZ (1st line)

A bolus of propofol ~1.5 mg/kg will suppress vomiting and cause some muscle relaxation, usually producing good intubating conditions
Furthermore, has anti-epileptic effect. Has reduced risk of epileptic episode.

There are risks: hypotension and shortened window time (if intubation not done in 1st or 2nd pass, propofol wears off)

53
Q

Patient inserted with drug eluting stent 1 year before, He also have hypertension and DM. Which drugs should not be stopped perioperatively?
A: Aspirin
B: atenolol
C: Amlodipine
D: Panadol
E : All of the above

A

E : All of the above

54
Q

Which of the following statement regarding patient positioning during laryngoscopy is correct
A. Sniffing position best align three anatomical axes
B. patient’s head should be placed on firm 7-9cm pillow
C. External auditory meatus align with sternal notch
D. Obese patient on ramped position so that flexion of lower cervical spine
E. All of the above

A

E. All of the above

55
Q

What should be equipped at post anaesthetic unit?
A. Oxygen supply
B. Suction
C. Pulse oximetry
D. Defibrillator
E. All of the above

A

E. All of the above

56
Q

An OT patient on afternoon list (OT at 1400) should not be allowed which of the following?
A. A cup of green tea at 1030
B. A cup of black coffee at 1030
C. A glass of milk at 1000
D. A sip of water for taking medication at 1200
E. A light breakfast at 0630

A

C. A glass of milk at 1000

Clear fluid 2 hours before, non human milk 6 hours before

57
Q

What is the amount of adrenaline in 1 mL of 1:1000 solution?
A. 0.1 mg
B. 0.01 mg
C. 1 mg
D. 10 mg
E. 100 mg

A

C. 1 mg

58
Q

55/M, IO with repeated vomiting, require urgent OT with GA. Rapid sequence induction is indicated. Which of the following is NOT done in RSI?
A. Applycricoidpressure
B. Pre-oxygenation
C. Inhalation induction
D. Endotracheal intubation
E. NO test ventilation

A

C. Inhalation induction

59
Q

Which of the following is the best indicator of easy intubation?
A. Mallampati3
B. Mouthopening>3fingerbreadth
C. Thyromentaldistance6.1cm
D. Previoushandandnecksurgery E. Fullycrownedupperteeth

A

B. Mouth opening> 3 finger breadth

60
Q

Amount of adrenaline in 30 ml 1:10000 solution?
A. 0.03mg
B. 0.3mg
C. 3mg
D. 30mg
E. 300mg

A

D. 30mg

61
Q

Soft palate, fauces seen with part of uvula obscured when patient is opening mouth with protruding tongue and sitting upright. Mallampati score.
A. 1
B. 2
C. 3
D. 4
E. 5

A

B. 2

62
Q

Patient with epidural block after surgery, breathing difficulty, left arm and shoulder loss of sensation, HR 53. Cause?
A. LAtoxicity
B. Anaphylaxis
C. Highepiduralblock
D.
E. Pneumothorax

A

C. Highepiduralblock

63
Q

1 year old boy, need to do circumcision. Surgery in 4 hours, what can he eat?
A. Breastmilk
B. Formulamilk
C. Waterycongee
D. Freshorangejuice
E. Babyfood

A

A. Breastmilk

2-4-6-8 rule
clear fluids 2 hours
breast milk 4 hours
light meal 6 hours (non breast milk)

64
Q

An old man underwent surgery. Before intubation, the patient received pre-oxygenation with 100% O2. What is the aim of this?
A. Ensure the reading of SaO2 is 100%.
B. De-nitrogenation of alveoli.
C. Prevent hypercapnea.
D. Prevent atelactasis.
E. Prevent aspiration.

A

B. De-nitrogenation of alveoli.

65
Q

M/59, lose 500 mL blood during a right hepatectomy, BP 100/55, Pulse 100 bpm, SpO2 99%. What volume of lactated ringer’s solution needed intravenously to replace the lost blood volume?
A. 500mL B. 750mL C. 1000mL D. 1500mL E. 2000mL

A

D. 1500mL

66
Q

30/M. I&D for forearm abscess. After local infiltration of 8ml of 2% lignocaine, he reported numbness around the mouth and metallic taste. Stable vitals. What is the most probable cause?
A. Anaphylaxis B. LAtoxicity
C. MI
D. Thyroidstorm E. TIA

A

B. LA toxicity

Initial signs and symptoms include agitation, confusion, dizziness, drowsiness, dysphoria, auditory changes, tinnitus, perioral numbness, metallic taste, and dysarthria. Without adequate recognition and treatment, these signs as symptoms can progress to seizures, respiratory arrest, and/or coma.

67
Q

You are rescuing a man. He has history of ischemic heart disease and peripheral vascular disease. You can not feel for his carotid pulse. Cardiac monitoring shows the following rhythm (Monomorphic VT). Which of the following is the MOST appropriate drug to terminate the arrhythmia?
A. Amiodarone
B. Calciumchloride(10%)
C. Lignocaine
D. Procainamide
E. Sotalol

A

A. Amiodarone

68
Q

25-year old female weighing 80kg given epidural for pain relief during labour:
20mL of 1.5% lignocaine with 1:200,000 adrenaline. 3 min later developed convulsion and coma.
What has happened?
A. Adrenaline toxicity
B. Anaphylactic reaction
C. Intravascular injection of lignocaine
D. Lignocaine overdose

A

C. Intravascular injection of lignocaine

69
Q

The basilic vein is used more often than the cephalic vein for measurement of central venous pressure because
A. The cephalic vein increases in diameter from the cubital fossa to the axilla and, while the basilic vein
B. The cephalic vein is continuous with the axillary vein, while basilic vein joins axillary vein perpendicularly
C. The basilic vein is continuous with the axillary vein, while the cephalic vein has several branches at the end

A

C. The basilic vein is continuous with the axillary vein, while the cephalic vein has several branches at the end

70
Q

A patient was receiving epidural infusion of local anaesthetic and opioid for pain control after open
hemicolectomy. However, he complained of sudden onset bilateral lower limb weakness and loss of sensation 4 hours afterwards. Which of the following is the most serious which you need to consider?
A. Central nervous system infection
B. Epidural haematoma
C. Local anaesthetic overdose
D. Prolonged position
E. Spinal cord injury during operation

A

B. Epidural haematoma

71
Q

The anaesthetist decided to use the saphenous vein for intravenous access.
At which location should the saphenous vein be punctured?
A. Dorsal of foot, lateral to the hallucis longus
B. Anterior to the lateral malleolus
C. Anterior to the medial malleolus
D. Posterior to the lateral malleolus
E. Posterior to the medial malleolus

A

C. Anterior to the medial malleolus

72
Q

Which induction agent is used for a woman with hypotension?
A. Etomidate
B. Propofol

A

A. Etomidate

73
Q

Why does the anesthetic effect of propofol wear off after a few minutes if only a bolus is given?
A. rapidly excreted
B. rapidly metabolised in the blood
C. redistributed out of effector site into less vascular sites
D. rapid inactivation of GABA receptors in the brain so that they cannot be stimulated further
E. high hepatic first past effect

A

C. redistributed out of effector site into less vascular sites

74
Q

What is the most common S/E of opioid analgesics?
A. Addiction
B. Constipation
C. N+V
D. Respiratory depression

A

B. Constipation

75
Q

Early signs of lignocaine overdose
A. Loss consciousness
B. Convulsion
C. Respiratory depression
D. Tinnitus or cicumoral tingling sensation
E. Hypotension

A

D. Tinnitus or cicumoral tingling sensation

76
Q

A 72 year-old patient in your ward develop a rash, shortness of breath and feels very unwell, shortly after receiving a dose of IV Antibiotics. He has a blood pressure of 78/42 mmHg. Which would be the most appropriate management if you suspect anaphylaxis?
A. 1L of Normal Saline IV
B. Morphine 2mg IV and an inotropic infusion
C. 1mg IM adrenaline
D. Start an infusion of noradrenaline
E. 5mg IV metoprolol

A

A. 1L of Normal Saline IV (IM adrenaline max dose is at 0.5mg)

77
Q

In an uncooperative patient with very difficult access, an appropriate alternative to IV infusion of anesthesia would include:
A. Inhalational induction with desflurane
B. Inhalational induction with sevoflurane
C. IM induction with propofol
D. IM induction with thiopentone

A

B. Inhalational induction with sevoflurane (maintenance can be desflurane: induction not indicated (respiratory adverse reactions: coughing, laryngospasm)

78
Q

During airway assessment, what can you see in a Mallampati Grade II airway?
A. Soft palate, base of uvula
B. Only soft palate can be visualized
C. Soft palate, tonsillar fauces, uvula
D. Soft palate, tonsillar pillars, tonsillar fauces, uvula
E. Soft palate cannot be visualized

A

C. Soft palate, tonsillar fauces, uvula

79
Q

A 78 year old female had mild to moderate pain postoperatively after a mastectomy. She had a history of gastric ulcer and mild renal problems. Which of the following analgesics would you recommend for her?
A. 25 mg of pethidine
B. 75 mg of morphine
C. 1 g of paracetamol 4 times daily prn
D. Diclofenac
E. Fetanyl patch

A

C. 1 g of paracetamol 4 times daily prn

4g is max

80
Q

An 80-year-old man with background history of hypertension is under general anaesthesia for surgical repair of fractured neck of femur. The end-tidal CO2 was noted to be rising from 32 mmHg to 44 mmHg since the start of the operation. The blood pressure was 180/110 mmHg; the pulse was 125 per minutes. What is the most likely cause of the findings?
A. Breathing circuit disconnection
B. Cardiac arrest
C. Fat embolism
D. Malignant hyperthermia
E. Severe bronchospasm

A

D. Malignant hyperthermia

81
Q

You are called to attend to a patient with cardiac arrest. The ECG monitor shows atrial fibrillation at a rate of 120 per minute. You cannot feel the carotid pulse. The team has initiated cardiopulmonary resuscitation (CPR). What is the next appropriate management?
A. IV adrenaline
B. IV amiodarone
C. IV lignocaine
D. Synchronized electrical cardioversion
E. Defibrillation

A

A. IV adrenaline

82
Q

Which of the following maneuvers is the most likely to cause damage to the cervical spine?
A. Head tilt
B. Chin lift
C. Jaw thrust
D. Nasopharyngeal airway
E. Oropharyngeal airway

A

A. Head tilt

83
Q

F/55 after open lobectomy, now on thoracic epidural analgesia by ropivacine infusion. Ward nurse calls urgently as the patient develops difficulty in breathing, unable to swallow and no sensation in shoulders & arms. HR 55. BP 85/55. RR 26. SpO2 93%. What is the most likely cause?
A. Anaphylaxis
B. LA toxicity
C.
D. High thoracic block
E. Pneumothorax

A

D. High thoracic block

84
Q

Contraindication for spinal anaesthesia
A. Previous lumbar spinal surgery
B. Pre-existing hemiparaplegia
C. Having clopidogrel
D. having aspirin
E. Hep C positive

A

C. Having clopidogrel

85
Q

You are a medical officer on a cardiac arrest call of a 4 year old child with no IV access. which of the following would you like most for the administration of drug/ fluid?
A. Intramuscular
B. Subcutaneous
C. Intraosseous
D. Endotracheal
E. Rectal

A

C. Intraosseous

86
Q

An obese woman came for pre op assessment for elective cholecystectomy 4 weeks later, which physical signs would you examine?
A. Dentation, thyromental distance, mouth opening, Mallampati score
B. Dentation, neck extension, mouth opening, maxilla circumference
C. Dentation, neck circumference, thyromental distance, maxilla circumference, Mallampati score
D. Dentation, neck extension, neck circumference, maxilla circumference

A

A. Dentation, thyromental distance, mouth opening, Mallampati score

87
Q

Deep peroneal nerve block is used for anaesthesia and post-operative analgesia for the first web space and adjacent dorsum of the foot. What is the artery running closely with deep peroneal nerve?
A. Lateral tarsal artery
B. Dorsal metatarsal artery
C. Arcuate artery
D. Deep plantar artery
E. Dorsalis pedis artery

A

E. Dorsalis pedis artery

Deep peroneal (fibular) nerve is a branch of the common peroneal nerve (branches at the top of fibula)

88
Q

55/M 1000ml blood loss post hepatectomy. BP 110/55 HR 100 etc etc. How much fluid (normal saline) should be replaced
A. 1000
B. 1500
C. 2000
D. 2500
E. 3000

A

E. 3000

Fluid to blood replacement post op is 3:1

89
Q

M/45 Good past health just have IV induction of anaesthesia. Before intubation you re-checked the vitals and found BP rises from 120/80 to 160/95 mmHg and PR is 100 now. SpO2 is 99%. Which of the following drug is responsible?
A. Etomidate
B. Ketamine
C. Propofol
D. Midazolam
E. Thiopental

A

B. Ketamine

90
Q

Someone trapped under rubble for 4 hours already, need 2 more hours to rescue him.
A. 1000 ml/hr D10 + 5 mg morphine
B. 1000 ml/hr D5 + 10 mg morphine
C. 1000 ml/hr NS + 5 mg morphine
D. 125 ml/hr NS + 10 mg morphine
E. Amputation to rescue him within 30 minutes

A

C. 1000 ml/hr NS + 5 mg morphine

91
Q

A 75 year old patient with a history of hypertension, renal failure and asthma complains of severe wound pain after open gastrectomy. He has no acute abdominal signs and his vital signs are stable. Which of the following opioids is not suitable for pain management?
A. Buprenorphine
B. Fentanyl
C. Morphine
D. Oxycodone
E. Pethidine

A

C. Morphine

morphine is contraindicated in renal failure

92
Q

You are asked to assess a patient for surgery for fractured mandible. Which of the following signs would concern you MOST in the airway management?
A. Mallampati score of 2
B. Thyromental distance of 7cm
C. Interincisor distance of 3cm
D. Loose lower molar
E. Trismus

A

E. Trismus

MBBS VI - SpC - Emergency Medicine (28 decks)

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