Anesthesiology Flashcards
1
Q
Rohypnol is a: Flunitrazepam Nitrazepam Flumazenil Propofol
A
Flunitrazepam
2
Q
The oculocardiac reflex (Aschner reflex) may be induced in what procedure: Ocular surgery Open heart surgery Open chest surgery During manipulation of cardiac arteries
A
Ocular surgery
3
Q
Which of the following drugs acts as the fastest: Sevofluran Desfluran Izofluran Enfluran Halotan
A
Desfluran
4
Q
At what concentration is oxygen toxic: 80% 70% 60% 50% 20-35%
A
60%
5
Q
The nasal catheter: Dries the mucous Causes (roztrenn) liver ???? Amount of oxygen depends on patient’s breathing All of above None of above
A
All of above
6
Q
How much blood has an adult (in kg/m²):
A
70 ml/kg
7
Q
How many chest compressions are performed in BLS with two rescuers:
A
100/min
8
Q
Pulsoxymetry: Increases O2 in smokers Decreases O2 in smokers Increases O2 in CO poisoning Decreases O2 in CO poisoning
A
Increases O2 in smokers
Increases O2 in CO poisoning
9
Q
Laryngeal mask can be used in: Surgery in patients with a full stomach In pulmonectomy Mouth surgery None All
A
None
10
Q
When in reanimation not performed: Wide, stiff (unresponsive) pupil Hypothermia Drowning None All
A
None
11
Q
What drugs can be used in ZOP: Lidocaine, bupiwacaine Morfine, fentanyl Ketonal, pyralgine A and B All
A
A and B
12
Q
Amount of CO2 we exhale depends on: Ventilation Perfusion CO2 production A and B All
A
All
13
Q
Fentanyl can be administered: iv im sc plaster All of above
A
All of above
14
Q
Sudden cardiac arrest is defined according to ERC:
Mechanical heart disturbance due to sudden and potentially reversible causes
Mechanical disturbances of the circulatory system and the heart due to sudden and potentially reversible causes
Mechanical failure of the circulatory system and the heart due to sudden causes which may be not reversible
Mechanical failure of the heart due to sudden and potentially reversible causes
A
Mechanical disturbances of the circulatory system and the heart due to sudden and potentially reversible causes
15
Q
Arterial gazometry after 15min CPR: pO2 100mmHG, pCO2 75mmHG, pH 7.01, HCO3 19.3, BE -5.0:
Is an indication to admin 50ml 8.4% sodium bicarbonate
Is an indication to admin 25ml 8.4% sodium bicarbonate
Is an indication for intervention without sodium bicarbonate and to repeat gazometry
Is an indication to admin 25ml 8.4% sodium bicarbonate + additional interventions + repeated gazometry
A
Is an indication to admin 25ml 8.4% sodium bicarbonate + additional interventions + repeated gazometry
16
Q
According to the ERC (BLS in adults) CPR is started when (outside hospital): Patient not reactive Patient does not breath normally Absent pulse in radial artery A and B
A
A and B
17
Q
According to ERC (BLS in adults) the proper way to start CPR is:
2 initial breaths followed by 30 compressions immediately after SCA diagnosis
5 initial breaths followed by 30 compressions immediately after SCA diagnosis
No initial breath and 30 compressions immediately after SCA diagnosis
2 initial breaths, lasting no longer than 1s, followed by 30 compressions immediately after SCA diagnosis
A
No initial breath and 30 compressions immediately after SCA diagnosis
18
Q
Proper use of amiodarone during CPR (according to ERC):
If VF/VT persists after 3 defibrillations, admin a bolus of 300mg amiodaron
If VF/VT persists after 5 defibrillations, admin 300mg amiodaron iv. Over 2 hours, then an additional bolus of 300mg
Admin a bolus of 300mg amiodarone prior to first defibrillation
The dose used for amiodarone depends on times of defibrillations and the energy used, there is no written algorithm
A
If VF/VT persists after 3 defibrillations, admin a bolus of 300mg amiodaron
19
Q
Safe position for intubation of a patient that is unconscious, "with a full stomach" is by : a placing head down b placing head up c Place "flat" d placing on its side e placing on its stomach
A
b placing head up
20
Q
In shock, drugs should be given by which route: a intra arterial b oral c intramuscular d intravenous e subcutaneous
A
d intravenous
21
Q
Complication of subclavian vein cannulation can be: a pneumothorax b toxic reaction c clotting disorders d "cauda equina" syndrome e Anaphylactic reaction
A
pneumothorax
22
Q
Not given by peripheral veins:
a NSAIDs / inflammatory (Ketonal, pargyline)
b catecholamines (dopamine, norepinephrine)
c opioids (morphine, dolantina)
d corticoids (hydrokortison)
e-hypertensive Drugs (ebrantil, nitroglycerin)
A
catecholamines (dopamine, norepinephrine)
23
Q
A characteristic symptom of toxicity of local anesthetics:
a breathing disorder
b arrhythmias of ventricular fibrillation in the form of
c impaired consciousness and convulsions
d hypertension
e rash and itching
A
impaired consciousness and convulsions
24
Q
The rapid drop in blood pressure during administration of local anesthesia may indicate the occurrence of: a toxic Reaction b anaphylactic reaction c spastic reaction d pain reaction e stress reaction
A
anaphylactic reaction
25
```
Contraindication to regional anesthesia are:
a No consent
b Liver Disease
c Respiratory Diseases
d Kidney
e Diseases of the pancreas
```
No consent
26
```
Due to the systemic action of lignocaine, it is used in the treatment of:
a emphysema
b inflammation of bronchi
c Liver Failure
d Disorders of heart rhythm
e Kidney Failure
```
Disorders of heart rhythm
27
If the shock causes primary respiratory arrest, the next step
is:
a The administration of oxygen through a nasal cannula
b The administration of oxygen by mask,
c Ventilation of patient with Ambu bag
d Indirect cardiac massage
e Direct cardiac massage
Ventilation of patient with Ambu bag
28
```
In the treatment of hypertensive crisis are used:
a dopamine
b nitroprusside
c hydrokortison
d lignocaine
e noradrenaline
```
nitroprusside
29
```
The cause of rapidly increasing respiratory failure in a patient after injury
chest can be:
a Emphysema
b Bronchitis
c Pneumothorax
d Tuberculosis
e Lung Atelectasis
```
Pneumothorax
30
```
Not used In the treatment of chronic pain:
a alfentanil
b fentanyl
c morphine
d Ketonal
e ibuprofen
```
alfentanil
31
```
In septic shock, systemic vessel resistance is:
a unchanged
b unchanged or slightly increased
c unchanged or slightly reduced
d Significantly reduced
e Significantly elevated
```
Significantly reduced
32
```
The increase in the release of endogenous catecholamines in shock causes:
a circulatory centralization
b The decrease in renal blood flow
c The increase in renal blood flow
D. correct(a + b)
E correct (a + c)
```
correct(a + b)
33
```
Segmental intravenous anesthesia is called:
a trimalleolar block
b Winni block
c Bier block
d Oberst block
e Moore block
```
Bier block
34
adrenaline is added to local anesthesia in order to:
a Raise blood pressure
b Prevention of bradycardia
c Slows absorption into the systemic circulation
d acceleration of action of anesthesia drug
Slows absorption into the systemic circulation
35
```
In the prevention of seizures, resulting from the toxic action of regional
anesthesia, the following is used:
a catechol amines
b benzodiazepines
c opioids
d ketamine
e adrenal steroids
```
benzodiazepines
36
Contraindication to spinal anesthesia are:
a History of myocardial infarction within the last two years
b Asthma
c Pneumothorax
d a history of tuberculosis
e tumor in the central nervous system
tumor in the central nervous system
37
Contraindication to infiltration anesthesia is:
a patient Age> 65 years
b Acute myocardial infarction
c Inflammatory changes in the area in which you perform anesthesia
d Treatments in the extremities
e facial region treatments
Inflammatory changes in the area in which you perform anesthesia
38
Inflammatory changes in the area, which is carried out infiltration, are
cause:
a Increased binding of drug with receptor
b reduced binding of drug with the receptor
c Reduced dissociation and faster decay of drug
D. increased dissociation and the decreased migration to intracellular space
e Increased dissociation and increased migration to receptor
increased dissociation and the decreased migration to intracellular space
39
```
regional Anesthetics pass into the cell in the following form“
a sulfuric acid bond
B. hydrochloric acid bond
C. glucose bond
d dissociated
e undissociated
```
undissociated
40
Spinal subarachnoid space puncture may be a complication of the following anesthesia:
a regional vein block
b epidural block
c sciatic nerve block
d jaw block
e brachial plexus block via axillary access
epidural block
41
Cocaine, an ester anesthesia agent, is currently not used in
regional anesthesia due to:
a rapid vasodilating action
b causing bronchospasm
c central nervous system stimulatory action
d nephrotoxicity
e hepatotoxicity
central nervous system stimulatory action
42
```
Ester local anesthetics are broken down by:
a Liver enzymes
b plasma cholinesterase
c Hofmann reaction
d glucuronic acid reaction
e do not decompose
```
plasma cholinesterase
43
In hemorrhagic shock fluid replacement therapy is controlled by the following measurement:
a intraocular pressure
b partial pressure of carbon dioxide in arterial blood
c intracranial pressure
d partial pressure of oxygen in arterial blood
e central venous pressure
central venous pressure
44
```
The fastest and shortest-acting relaxant agent is:
a rocuronium
b pancuronium
c pipecuronium
d succynylocholine
e atracurium
```
rocuronium
45
```
The means used for the reversal of neuromuscular block is:
a atropine
b prostygmine
c scopolamine
d polokaina
e lignocaine
```
prostygmine
46
Indicate true sentence, concerning epidural anesthesia“
a can be carried out on any part of the spine, with the exception of the
cervical
b only local anesthetics can be given tot he epidural space
C. drugs given through the epidural catheter may be used to treat
pain in the postoperative period
d epidural anesthesia is the best way of
patients in hypovolemic shock
e epidural anesthesia cannot be performed in children
drugs given through the epidural catheter may be used to treat
pain in the postoperative period
47
Actions referred to as "pediatric basic life suport" are made in
cases of cardiac arrest and no breathing in children up to:
a 1 year
b 5 years
c 8 years
d 15 years
E. 18 years
8 years
48
Respiratory alkalosis can be:
a Caused by excessive intravenous bicarbonate
b Caused poor lung perfusion in patients with atelectasis
C. The cause of the increase in the concentration of ionized calcium in the blood of patients
d reason of cerebral vasospasm and ischemia of the brain
e reason of hyperkalemia
reason of cerebral vasospasm and ischemia of the brain
49
```
The cause of acute respiratory failure, peripheral is not:
a epiglottitis
b laryngitis
c Tension pneumothorax
d myasthenia gravis
e Hemorrhagic stroke
```
Hemorrhagic stroke
50
Indicate false statement about malignant hyperthermia (HZ):
a drug of choice in the HZ is dantrolene
b HZ can be induced by the use of inhaled anesthetics
c HZ is a very rare complication of general anesthesia
d perioperative hyperthyroidismcan cause false identification of
HZ
e local anesthesia to the same extent as a general anesthetic
may lead to HZ
local anesthesia to the same extent as a general anesthetic
| may lead to HZ
51
```
Mark the druk of the longest relaxant action:
a succynylocholina
b vecuronium
c mivacurium
d pipecuronium
e rocuronium
```
pipecuronium
52
```
inhalation induction is used:
a thiopental
b hypnomidat
c midazolam
d sevoflurane
e ketalar
```
sevoflurane
53
```
Intravenous anesthetic with analgesic properties is:
a thiopental
b metoheksital
c hypnomidat
d propofol
e ketamine
```
ketamine
54
Midazolam is not used for:
a sedation
b monoanestezji (anesthesia with the use of one measure)
c induction of complex general anesthesia
d premedication
e analgosedation for diagnostic procedures
monoanestezji (anesthesia with the use of one measure)
55
```
In the treatment of hypertensive crisis is not used:
a nitrendipine
b vasopressin
c nitroglycerin
d sodium nitroprusside
e urapidil
```
vasopressin
56
```
The most common cause of cardiogenic shock is:
a burn over 50% of the body surface
b Myocardial infarction
c carbon monoxide poisoning
d overdose of calcium channel blockers
e long bone injuries
```
Myocardial infarction
57
After the introduction of the endotracheal tube into the respiratory tract, in the first instance
should be performed:
a blood pressure measurement
b blood gases
c evaluation for ECG arrhythmias
d Evaluation of ECG for ST-segment abnormalities
e chest auscultation
chest auscultation
58
```
For the assessment of proper endotracheal tube position is not useful:
a Observation of movement of the chest
b auscultation of the chest
c percussing the chest
d evalutaing capnography curve
e pulsoxymetry
```
percussing the chest
59
```
the End of the endotracheal tube should be inserted:
a piriform sinus
b between the vocal cords
c the bifurcation of the trachea
d in the right main bronchus
e in the left main bronchus
```
the bifurcation of the trachea
60
```
In order to open the airway is used:
a facial mask
b laryngeal mask
c nasal cannula
d mustache cannula
e Oxygen mask with reservoir
```
laryngeal mask
61
```
Endotracheal tube can be inserted:
a in mouth
b in the nose
c The opening of a tracheotomy
d (a + c)
e all true
```
all true
62
```
The prerequisite is general anesthesia:
a endotracheal intubation
b the use of muscle relaxants
c breath replacement measures
d abolition of consciousness
e ensure backward oblivion
```
abolition of consciousness
63
Select the false statement about endotracheal intubation:
a is the surest way to ensure a patent airway
b can be made through the nose or through the mouth
c enables positive-pressure ventilation of
d Requires striated muscle relaxation
e can be made using bronchofiberoskopu
Requires striated muscle relaxation
64
In the case of cardiac arrest, if an automatic defibrillator is available
(AED) rescuer should:
a Turn defibrillator (AED), connect the defibrillator electrodes, adhere to
the voice or visual instructions on the screen;
b Immediately call an ambulance and wait quietly for the
arrival;
c Connect the defibrillator (AED), and as soon as possible press
defibrillation;
d Perform basic life support until the arrival of an ambulance, and
then connect the defibrillator (AED),
e Turn on the defibrillator (AED), connect the defibrillator electrodes and
not shock, until the arrival of an ambulance.
```
Turn defibrillator (AED), connect the defibrillator electrodes, adhere to
the voice or visual instructions on the screen
```
65
Indication for precordial thump is:
a cardiac arrest in a patient who is in the hospital;
b patient cardiac arrest outside the hospital;
c Cardiac arrest in the presence of witnesses, or the patient
monitored;
d Cardiac arrest in asystole;
e Cardiac arrest
Cardiac arrest in the presence of witnesses, or the patient
| monitored
66
The advantages of the Combitube tube:
a Simple technique
b can be effective ventilation even with esophageal tube position;
c Always an effective hedge against the possibility of regurgitation and aspiration;
d a and b;
e a and c
a and b
67
```
During CPR, you can use the following routes of administration:
a Intravenous;
b endotracheal;
c intramedullary;
d a and b;
e a, b and c
```
a, b and c
68
```
Spinal anesthesia was performed for the first time by:
a Augusta Bier! Spinal anesthesia
b William Morton! first used ether
c Horace Wells! first coined N2O
d William Clarke! ?
e Carl Koller! cocaine to the eye
```
Augusta Bier! Spinal anesthesia
69
```
the increse in release of endogenous catecholamines in shock causes:
a. circulatory centralization
b. the decrease in renal blood flow
c. the increase in renal blood flow
d. a+b
e a+c
```
a+b
70
adrenaline is added to the anesthesia in order to:
a. raise the BP
b. prevent cardiac release
c. prevent absorption into the systemic circulation
d. acceleration of the anesthesia
e. its not given at all
prevent absorption into the systemic circulation
71
in the prevention of seizures resulting in toxic action of anesthesia, are used:
a. cathecholamines
b. benzodiazepines
c. opioids
d. ketamine
e. steroids
benzodiazepines
72
following the introduction of an endotracheal tube into the airways, first thing that should be done is:
a. BP assessment
b. blood gas and acid-base balance
c. ECG evaluation for arrhythmia
d. evaluation of ST-segment abnormalities
e. chest auscultation
chest auscultation
73
at the end of the endotracheal tube if inserted properly you should find:
a. piriform sinus
b. between the vocal cords
c. above the bifurcation of trachea
d. the right main bronchus
e. the left main bronchus
above the bifurcation of trachea
74
the endotracheal tube can be made for:
a. the mouth
b. the nose
c. open tracheotomy
d. a+c
e. all of above
all of above
75
ASA scale is used for:
a. rating the capacity of organs in a sepic shock
b. evaluation of trauma caused by multiple injuries
c. assessment of the patients stat of consciousness
d. assesses the physical condition of the patient
e. evaluation of the difficulties with intubation
assesses the physical condition of the patient
76
which premedication isn’t used:
a. benzodiazepines
b. opioids
c. anticholinergic
d. medications that reduce the volume and acidity of gastric contents
e. muscle relaxants
muscle relaxants
77
an endotracheal tube cuff in a patient with a full stomach should be inflated when:
a. after removal out of the sterile package
b. after entering the trachea
c. after introducing it into the oral cavity
d. after 5 breaths
e. after the connection to a fan
after entering the trachea
78
if you anticipate difficulties in intubation before induction of anesthesia, you should use:
a. bronchofiberoscope
b. camera with x-ray fluoroscope
c. usg with Doppler
d. pleural drainage set
e. variable volume ventilator
bronchofiberoscope
79
A complication of the laryngeal mask may be
a. pneumothorax
b. damage to the trachea
c. damage to the main bronchus
d. bleeding from the nasal cavity
e. aspiration of gastric contents
aspiration of gastric contents
80
a characteristic symptom of toxic effects of anesthesia are:
a. breathing disorder
b. cardiac arrhythmias in the form of ventricular fibrillation
c. distorted consciousness and convulsions
d. hypertension
e. rash and itching
distorted consciousness and convulsions
81
contraindications to regional anesthesia are:
a. no consent of the patient
b. liver disease
c. respiratory disease
d. kidney disease
e. pancreatic disease
no consent of the patient
82
whats true about NO
a. it’s a powerful anesthetic and weak analgesic
b. it’s a weak anesthetic and strong analgesic
c. doesn’t affect the CVS
d. it doesn’t cause diffusion hypoxia
e. if used at the same time is increases the MAC of inhaled anesthetics
it’s a weak anesthetic and strong analgesic
83
For nonbarbiturate IV anesthetic we shouldn’t use:
a. propofol
b. ketamine
c. midazolam
d. thiopental
e. etomidate
thiopental
84
Patients undergoing reposition of the jaw need during the surgery:
a. Oropharyngeal intubation with a zbrojona tube
b. Tracheostomy
c. Nasal intubation
d. Local anesthesia
Tracheostomy
85
Patients having major difficulties in opening the mouth due to changes in the temporomandibular joint/ degenerative processes, fractures, metastatic infiltrations, etc./ require for intubation:
a. Tracheostomy prior to surgery
b. Wykonania na oddechu własnym, po zsedowaniu chorego i znieczuleniu przewodu nosowego i gardzieli, intubacji „na ślepo” przez nos
c. Fiberoptic intubation
d. B and C
Tracheostomy prior to surgery
86
Patients after extensive surgery of the inferior part of the oral cavity and the neck need after the surgery:
a. Leave the intubation tube for several days
b. Extubation after the surgery and give oxygen via mask
c. Extubation when patient regains full consciousness and putting him into recovery position
d. Try to extubate the patient after surgery; in case of respiratory tract obstruction reintubate
Leave the intubation tube for several days
87
To the group of causes of SCA there are 4 Ts:
a. Mechanical obstruction of respiratory tract is not included
b. Hypovolemia has been changed as a factor of arterial pressure
c. Acidosis has been changed to not have an effect on the perfusion caused by hypovolemia
d. Effect of toxic substances has been added as a factor
Acidosis has been changed to not have an effect on the perfusion caused by hypovolemia
88
Proper relation between ventilation and chest compressions during CPR is:
a. Patient intubated: 100 chest compressions/min and 10 ventilations/min synchronized
b. Patient not intubated: 30 chest compressions/min and 2 breaths/min synchronized
c. Patient not intubated: 2 breaths and than 15 chest compressions if only one rescuer
d. Patient intubated: 100 chest compressions/min and 12 ventilations/min synchronized
Patient intubated: 100 chest compressions/min and 10 ventilations/min synchronized
89
The cvp is the hydrostatic pressure generated by the blood in the great veins. It can be used as a surrogate by the right atrial pressure.
A. Both sentences a true
B. the first sentence is true and the second sentence false
C. Both sentences are false
D. The first sentence is also and the second true
Both sentences a true
90
The PAWD may be used as a surrogate to left atrial pressure, therefore LVEDP
A. Both parts of the sentence are true
B. both parts of the sentence are false
C. The first part of the sentence is true, not the second part
D. The second part of the sentence is true, not the fist part
Both parts of the sentence are true
91
```
The correct placement of the S-G catheter is
A. Right atrium
B. right ventricle
C. Pulmonary artery
D. Left atrium
```
Pulmonary artery
92
```
In the case of metabolic alkalosis with rise in HCO3- concentration compensation occurs by
A. Hypoventilation
B. hyperventilation
C. No change in ventilation
D. Loss of HCO3- to normalize pH
```
Hypoventilation
93
```
Capnography is used as
1. An indicator of adequate ventilation
2. a disconnection indicator
3. Indicator of correct placement of the endotracheal tube.
4. An indicator of CO
A. All answers are true
B. 4 is false
C. 2 and 4 are false
D. 1 is true
```
All answers are true
94
Mixed venous oxygen saturation is a measure of
A. Adequacy of tissue perfusion
B. adequacy of aerobic metabolism
C. Adequacy of tissue anaerobic metabolism
D. Of tissue metabolic acidosis
Adequacy of tissue perfusion
95
```
Contraindications to enteral feedings are1
1. Irretractable vomiting
2. shock
3. Bowel obstruction
4. GI bleeding
A. 1,2,3
B. 2,3
C. 1,3,4
D. 1,2,3,4
```
1,2,3,4
96
```
Direct lung injury that cause ARDS are
1. Pneumonia
2. Aspiration
3. Pulmonary contusion
4. Lung transplantation
A. 1,2,3
B.1,2
C.2,4
D. 1,2,3,4
```
1,2,3,4
97
Hypoxemia defined as pO2FiO2
A.<300 in ARDS and <200 in ALI
B. <300 in ALI and <200 in ARDS
C. <300 in ARDS and <200 in ALI in the absence of left atrial hypertension
D. <300 in ALI and <200 in ARDS in the absence of left atrial hypertension
<300 in ALI and <200 in ARDS in the absence of left atrial hypertension
98
```
Type 2 respiratory failure is defined as
A. Hypoxia without hypercapnia
B. hypoxia with hypercapnia
C. Hypercapnia without hypoxia
D. None of the above
```
hypoxia with hypercapnia
99
```
The recommended dose of atropine given IV in adults CPR is
A. 1 mg
B. 2 mg
C. 3 mg
D. 30 mg
```
3 mg
100
```
The recommended dose of adrenaline given IV in adults CPR is
A. 1 mg
B. 0,1mg/10kg
C. 10 mg
D. 0,5 mg
```
1 mg
101
```
Indications for giving calcium during CPR is
1. Hyperkalemia
2. Hypokalemia
3. Hypercalcemia
4. Overdose of CCBs
A. 1,2,3,4
B. 1,2,3
C. 1,2,4
D. 1,4
```
1,4
102
```
Tuchy needle is used to perform
A. Epidural anesthesia
B. spinal anesthesia
C. Arterial pressure
D. Central vein puncture
```
Epidural anesthesia
103
```
Spinal anesthesia results from the injection of a local anesthetic directly
A. Outside dura
B. into spinal cord
C. To the nerve roots
D. Into the CSF
```
Into the CSF
104
The spinal needle can only be inserted below the second lumbar and above the first sacral vertebrae
A. This sentence is true
B. this sentence is false
C. First part is true, second part is false
D. First part is false, second part is true
This sentence is true
105
```
A patient with systemic disease that is a constant threat to life is according to ASA classification
A. 1
B. 2
C. 3
D. 4
```
4
106
```
Gastric fluid pH elevation (1) and volume reduction (2) are some of the aims of preoperative medications
A. 1&2 are true
B. 1&2 are false
C. 1 is false and 2 is true
D. 1 is true and 2 is false
```
1&2 are true
107
```
System of CO measurement used in PiCCO or S-G catheter is
A. Thermomodulation
B. dye dilution
C. Both
D. None
```
Thermomodulation
108
The current chain of survival is composed of the following, EXCEPT:
Early recognition and call for help
Early CPR initiation
Early defibrillation
Early initiation of advanced resuscitation procedures
Early initiation of advanced resuscitation procedures
109
Steps of action with unconscious victim during basic resuscitation procedures are:
Asses safety of the surroundings, call for help, asses breathing
Asses level of consciousness, call for help, asses breathing
Asses safety of surroundings, asses level of consciousness and breathing, call for help
Asses safety of surroundings, asses level of consciousness, call for help, asses breathing
Asses safety of surroundings, asses level of consciousness, call for help, asses breathing
110
In adult circulatory-respiratory resuscitation we start from:
30 chest compressions
2 breaths
15 chest compressions
30 chest compressions (1 rescuer) or 15 chest compressions (2 rescuers)
30 chest compressions
111
For chest compressions we place our hands:
Mid sternal
Lower sternum
Middle of the chest
To the left from mid sternum over the heart
Middle of the chest
112
Chest compressions should be done as the following, EXCEPT
Depth of 4-5cm
100/minute
Time of relaxation to compression should be 2:1
In adults done with both hands
Time of relaxation to compression should be 2:1
113
The ratio of compressions to breaths in adult should be:
50: 2
30: 2
15: 2
10: 1
30:2
114
During CPR asses the state of the patient
Every 1 minute
Every 5 cycles
When patient starts to breathe on their own
Before sticking on the electrodes
When patient starts to breathe on their own
115
Rescue breaths should be done using all, EXCEPT:
Open victims airway
Pinch the nose closed, and seal the victims lips with your own
Exhale into the victim for 1 second
Observe if during inhalation the chest wall falls
Observe if during inhalation the chest wall falls
116
If the 1st rescue breaths does not raise the chest wall, do the following, EXCEPT:
Check if the head is tilted back and chin lifted
Check with your hand, and remove any foreign bodies
Remove only the visible foreign bodies
Every time perform no more than 2 ties of ventilation
Check with your hand, and remove any foreign bodies
117
```
Continue resuscitation until, EXCEPT:
Rescue worker arrives
AED prompts you to stop
The victim begins to breathe on their own
Till you succumb to exhaustion
```
AED prompts you to stop
118
```
Adult CPR begins with resuscitation breaths when:
Cardiac arrest caused by trauma
Cardiac arrest caused by pregnancy
Cardiac arrest caused by poisoning
Cardiac arrest caused drowning
```
Cardiac arrest caused drowning
119
```
Secondary position (on one’s side) is determined safe for the patient because all of the below, EXCEPT
It’s stable
Allows for easier breathing
Ensures open airways
Protects against aspiration
```
Allows for easier breathing
120
In case of a patient with symptoms of airway obstruction, the rescuer should
Encourage the victim to cough
Perform 5 hits to the inter-scapular space on the back
Perform 5 hits to the upper abdomen
Perform 5 hits inter-scapular and then 5 hits to the upper abdomen
Encourage the victim to cough
121
AED is made up of all the following elements, EXCEPT:
Module analyzing cardiac rhythm
“spoons” used for defibrillation
Memory recording the course of the incident
Voice commands
“spoons” used for defibrillation
122
```
Space suitable for the implementation of the public access to defibrillation can be determined based on the probability of at least one case of cardiac arrest within:
1 year
2 years
3 years
5 years
```
2 years
123
```
After the AED defibrillation operating in accordance with the guidelines of 2005, should advise:
Heart rate assessment
Circulatory assessment
Respiratory assessment
Begin CPR
```
Begin CPR
124
```
If the AED recommends defibrillation in the first place:
Press the defibrillation button
Check if the victim has a pulse
Make sure no one is touching the victim
Check if the victim is breathing
```
Make sure no one is touching the victim
125
Proceedings during defibrillation with AED requires additional measures or modifications in the following cases, EXCEPT:
Obese patients
Patients with pacemakers implanted under the right clavicle
Patients recovered from the water with a wet chest
Patients with a very hairy chest
Obese patients
126
In case the AED defibrillation is not recommended, then the following:
Check for pulse or signs of circulation, because the patient may have a rhythm that gives the pulse
Peel off the electrodes, and place the victim in a recovery position
Do not peel off the electrodes and place the victim in a recovery position
Follow the commands of the AED defibrillator
Follow the commands of the AED defibrillator
127
```
Mechanisms of cardiac arrest are the following, EXCEPT:
Ventricular fibrillation
Tachycardia with narrow QRS
PEA
Pulseless ventricular tachycardia
```
Tachycardia with narrow QRS
128
```
Rhythms for defibrillation in cases of cardiac arrest are all, EXCEPT:
VF
Tachycardia with narrow QRS
Torsade de pointes
Ventricular tachycardia
```
Tachycardia with narrow QRS
129
The assessment of heart rate during advanced life support is done, EXCEPT
If the patient shows signs of circulation
Every 4 minutes
Before every defibrillation
Every two minutes in the case of a shock rhythms and at four minutes (prior to each dose of adrenaline) for defibrillation rhythms
Every two minutes in the case of a shock rhythms and at four minutes (prior to each dose of adrenaline) for defibrillation rhythms
130
```
In a patient with cardiac arrest in asystole, the treatment will include all the following EXCEPT:
Adrenaline
Amiodarone
Atropine
Oxygen
```
Amiodarone
131
During resuscitation you give:
Adrenaline 10ml solution 1:1000 every 3-5 minutes
Adrenaline 10ml solution 1:10 000 every 3-5 minutes
Amiodarone 200mg in 10 ml 5% glucose
Amiodarone 3mg/kg in 10ml 5% glucose
Adrenaline 10ml solution 1:10 000 every 3-5 minutes
132
```
The patient has cardiac arrest in ventricular fibrillation, in the treatment the following drugs can be used, EXCEPT:
Adrenaline
Amiodarone
Atropine
Oxygen
```
Atropine
133
```
Recommended defibrillator shock energy of the first-phase is:
150-200 J
200 J
360 J
200-360 j
```
360 J
134
The recommended first defibrillation energy is (this was hard to translate…)
120 J if you're using the energy biphasic truncated exponential shape of the wave
300 J if you’re using the biphasic (If you're using the energy 300J biphasic waveform with rektalinearnym.???)
200J if you are using a single-phase power
200J biphasic energy if you are using an unknown waveform
200J biphasic energy if you are using an unknown waveform
135
Consider the application of sodium bicarbonate in the following cases, EXCEPT;
Cardiac arrest in the course of hyperkalemia
Cardiac arrest in the course of metabolic acidosis
Always when treating cardiac arrest
Cardiac arrest in the course of tricyclic antidepressant overdose
Always when treating cardiac arrest
136
Consider administration of thrombolytic agents during cardiac arrest if:
Before cardiac arrest, there were symptoms of stroke
Cardiac arrest was caused by trauma
Before the arrest, there were symptoms of acute pulmonary embolism
Cardiac arrest was due to suffocation
Before the arrest, there were symptoms of acute pulmonary embolism
137
```
The asynchronous massage and ventilation can be started after securing the airway with all, EXCEPT:
Laryngeal mask
Laryngeal tube
Oro-pharyngeal tube
Endotracheal tube
```
Oro-pharyngeal tube
138
```
Intratracheally, the following drugs may be administered, EXCEPT:
Adrenaline
Amiodarone
Atropine
Lignocaine
```
Amiodarone
139
Reversible causes of cardiac arrest (4H, 4T) are:
Tension pneumothorax, cardiac tamponade, hypoglycemia, hypoxia
Hypoxia, hypovolemia, hypotension, cardiac tamponade
Pulmonary embolism, Tension pneumothorax, metabolic disorders, hypovolemia
Metabolic disorders, hyperventilation, Tension pneumothorax, hypoxia
Pulmonary embolism, Tension pneumothorax, metabolic disorders, hypovolemia
140
Self-inflating bag, has the following advantages, EXCEPT:
It can be connected to a face mask, endotracheal tube or alternative devices for airway
Achieves inspiratory oxygen concentration at about 85%
Achieves inspiratory oxygen concentration of not more than 75%
Protects against infection leading rescuer ventilation
Achieves inspiratory oxygen concentration of not more than 75%
141
```
The recommended frequency of asynchronous ventilation during CPR is:
10 breaths/minute
12 breaths/minute
14 breaths/minute
16 breaths/minute
```
10 breaths/minute
142
While performing CPR on a 68 year old patient, who is in cardiac arrest due to ventricular fibrillation, after 2 defibrillations, intubation, and intravascular access has been attained, 2 minutes after the last defibrillation, continuing CPR, next steps include:
Assessment of rhythm and, if still present performance of defibrillation
Administration of epinephrine (1 mg) and performed defibrillation
Assessment of rhythm, and if still present administration of adrenaline ventricular fibrillation (1mg) and performed defibrillation
Performed defibrillation and administration of adrenaline (1 mg)
Assessment of rhythm, and if still present administration of adrenaline ventricular fibrillation (1mg) and performed defibrillation
143
An emergency rescuers reach the scene to the patient who called due to chest pains. When they arrive, the patient is laying on the floor and the witness is performing chest compressions. Diagnosis of cardiac arrest is present, rhythm is assessed, the monitor showed ventricular tachycardia. The next of the rescuers should be:
Start 2 minute CPR, intubate and attain vascular access
Perform cardioversion
Perform defibrillation
Administer 300mg of amiodarone in 10ml of 5% glucose
Perform defibrillation
144
An emergency rescue team is called to a patient with cardiac arrest. The drive to the patient was 5 minutes long. When they arrive they find the patient on the floor with no signs of life. They diagnose cardiac arrest and begin to analyze the rhythm, the monitor shows low voltage ventricular fibrillation. The next step should be:
Start of 2 minute CPR which attaining intubation and vascular access
Immediate cardioversion
Immediate execution of percutaneous stimulation
Start CPR during which intubation and vascular access is attained, and give drugs to increase the amplitude of ventricular fibrillation, and perform defibrillation
Start of 2 minute CPR which attaining intubation and vascular access
145
You are resuscitating a 27 year old patient with a chest trauma, during your examination you notice high resistance in the airways, asymmetric chest movement, subcutaneous emphysema, no breath sounds. In order to get this patient breathing again, you must:
Attain vascular access and administer adrenaline (1mg)
Attain 2 large vascular accesses to start fluid therapy
Intubate the patient and begin resuscitation
Needle punctures the chest in the second intercostal space in the mid clavicular line on the left side
Needle punctures the chest in the second intercostal space in the mid clavicular line on the left side
146
```
During resuscitation you realize you are out of amiodarone, which drug is appropriate for replacement?
Sotalolem
Lignokainą
Bretylium
Tiopentalem
```
Lignokainą
147
You are in the ICU when one of the monitors starts demonstrating ventricular fibrillation, you should:
Immediately hit the precardial area
Turn on the defibrillator and start defibrillation and resuscitation
Immediately begin CPR and call for help
Asses the state of the patient and act accordingly
Asses the state of the patient and act accordingly
148
Preliminary proceedings for administration of ACS include:
Oxygen, metoprolol, epinephrine, nitroglycerin
Oxygen, nitroglycerin, dopamine, morphine
Oxygen, morphine, dopamine, metoprolol
Oxygen, nitroglycerin, aspirin, morphine
Oxygen, nitroglycerin, aspirin, morphine
149
Implementation of a 12-lead ECG in a patient with coronary pain and with the exception of:
Possibility of early recognition of STEMI
Possibility of early recognition of any MI
Possibility of recognition of which part of the heart is being infarcted
Shorten the time of recognition of MI to reperfusion therapy
Possibility of early recognition of any MI
150
Indications for reperfusion therapy is:
Fresh right bundle branch block
Elevation of ST segment by 0.1mV in at least 2 limb leads
Inversion of T wave in 2 precordial leads
Depression of the ST segment by 0.2mV in at least 2 precordial leads
Elevation of ST segment by 0.1mV in at least 2 limb leads
151
Contraindications to nitroglycerin administration are the following, EXCEPT:
Systolic blood pressure less than 90mmHg
Bradycardia
Anterior myocardial infarction in a 12-ECG
Features of congestive heart failure in physical examination
Anterior myocardial infarction in a 12-ECG
152
Absolute contraindications for fibrinolytic therapy are all of the following, EXCEPT:
History of ever hemorrhagic stroke or stroke of unknown etiology
Oral Anticoagulant Therapy
CNS trauma or tumor
Dissecting aneurysm of the aorta
Oral Anticoagulant Therapy
153
```
The following is:
Ventricular tachycardia
Ventricular fibrillation
Atrial fibrillation
Asystole
```
Ventricular fibrillation
154
Dopamine acts on which catecholamine receptors:
a) α-adrenergic
b) β-adrenergic
c) Dopaminergic
d) all
all (+)
155
hypoproteinaemia can cause:
a) coagulation disorders
b) an increase in infections
c) increase proneness to pulmonary edema
d) all complications
all complications (+)
156
Uncompensated respiratory acidosis in the study gazometry:
a) ↑ pH, pCO2 standard, ↑ HCO3-
b) pH ↑, ↓ pCO2, HCO3-standard
c) ↓ pH, ↑ pCO2, HCO3-standard
d) ↓ pH, pCO2 standard, ↓ HCO3-
↓ pH, ↑ pCO2, HCO3-standard (+)
157
Dobutamine is:
a) vasodilator
b) catecholamine
c) a diuretic
catecholamine (+)
158
pneumothorax may be a complication of which venous puncture:
a) the cranial
b) subclavian
c) the external jugular
subclavian (+)
159
Which of the following arteries may be catheterized in order to create direct measurement of RR
a) a axillaris
b) a femoral
c) a dorsalis pedis
d) correct a, b, c
e) none of the above-mentioned
correct a, b, c (+)
160
Pupils dilate:
a) immediately after cardiac arrest
b) 60 - 90 sec. after cardiac arrest
c) in 3 min. after cardiac arrest
60 - 90 sec. after cardiac arrest (+)
161
do not start resuscitation if:
a) cardiac arrest occurred in acute myocardial infarction
b) cardiac arrest occurred as a result of injury
c) cardiac arrest is the result of an incurable disease
d) In all cases, the
In all cases, the (+)
162
Which of the drugs we use in resuscitation:
a) hydrocortisone
b) digoxin
c) adrenaline
d) all
adrenaline (+)
163
Defibrillation electricity during resuscitation can be performed:
a) 1 time
b) 3 times
c) repeatedly
repeatedly (+)
164
```
xylocaine use in resuscitation at :
a) asystole
b ) PEA (pulsless electrical activity)
c ) shock -resistant ventricular fibrillation
d) In all cases,
```
shock -resistant ventricular fibrillation (+)
165
Atropine in cardiac arrest should be used at a dose of :
a) 0.5 mg s.c. or i.m and repeated every 3 - 5 minutes .
b ) 0.5 mg i.v. and repeated every 3 - 5 minutes .
c) 3 mg i.v. once
d ) 1 mg in 10 ml of intratracheal saline
3 mg i.v. once ( + )
166
in adult cardiac massage should be performed with a frequency of :
a) 60 / min .
b ) 80 - 90 / min .
c) 100 / min .
d ) with such frequency to obtain a detectable pulse and pinking eyelids
100 / min . (+)
167
```
When two rescuers the rhythm of resuscitation are:
a) 5 chest compressions - 1 breath
b) 15 chest compressions - 1 breath
c ) 15 chest compressions - 2 breaths
d ) 5 chest compressions - 2 breaths
```
15 chest compressions - 2 breaths (+)
168
```
The patient after myocardial infarction can be handled in an elective :
a) one month after myocardial
b ) 3 months after MI
c ) area. 6 months after infarction
d ) there is no time limit
```
3 months after MI (+)
169
cardioversion therapy is used :
a) sinus bradycardia
b ) ventricular tachycardia and atrial fibrillation
c ) ventricular fibrillation and flutter
ventricular tachycardia and atrial fibrillation (+)
170
Succinylcholine ( Scoline ) is a drug belonging to the group :
a) an acetylcholinesterase inhibitor
b ) depolarizing muscle relaxants with a shorter duration of action
c ) depolarizing relaxants an average of short -acting
d) the shocking coils
depolarizing muscle relaxants with a shorter duration of action (+)
171
The period of complete emptying of the stomach with gastric contents of an adult patient (patient fasting ) includes:
a) 6 h . prior to surgery , both for solids and liquids
b) 4 hrs . prior to surgery , both for solids and liquids
c ) 6 hours . before surgery , which relates to solid foods , and 4 hours . prior to surgery , which relates to drink 500 ml of fluid
6 hours . before surgery , which relates to solid foods , and 4 hours . prior to surgery , which relates to drink 500 ml of fluid (+)
172
performing a classic endotracheal intubation :
a) in the left hand hold the laryngoscope , endotracheal tube in the right ; nurse opens the mouth of the patient and helping us to make laryngoscope , then takes it from us and we are introducing between the vocal cords endotracheal tube
b ) in the left hand holding the laryngoscope right open the patient's mouth , put a laryngoscope and the visualization of the larynx right hand introducing given by a nurse endotracheal tube into the trachea
c) in the right hand hold the laryngoscope , left open the patient's mouth , insert the laryngoscope and the visualization of the larynx with his left hand given by the nurse introduce endotracheal tube into the trachea
d ) the patient's mouth open with his left hand and then with both hands introduce laryngoscope visualizing the larynx , at the moment the nurse introduces the endotracheal tube into the trachea
b ) in the left hand holding the laryngoscope right open the patient's mouth , put a laryngoscope and the visualization of the larynx right hand introducing given by a nurse endotracheal tube into the trachea (+)
173
20) The maximum dose oral morphine in cancer pain are :
a) 20 mg every 4 hours .
b) 100 mg 3 times a day
c ) there is no ceiling dose
there is no ceiling dose
174
```
1 g of fat provides :
a) 3.75 kcal
b ) 4.00 kcal
c ) 7.00 kcal
d ) 9.00 kcal
```
9.00 kcal ( + )
175
```
Sodium bicarbonate Overdose leads to:
a) metabolic alkalosis
b ) hemoglobin dissociation curve shifts to the left
c ) serum hiperosmolarity
d ) all these complications
```
all these complications (+)
176
The term " cardiac output " defines:
a) the amount of blood ejected by the contraction of the right ventricle
b ) the amount of blood ejected by the contraction of the left ventricle
c ) the flow of blood in one hour
d ) blood flow in one minute
blood flow in one minute (+)
177
Mechanical ventilation and PEEP causes :
a) increases the venous blood flow to the heart
b ) improves oxygenation ( PaO 2 increase ) arterial blood
c) increase cardiac output
d ) reduces the risk of pneumothorax
improves oxygenation ( PaO 2 increase ) arterial blood (+)
178
```
Swann -Ganz catheter measures the pressure :
a) within the aorta
b ) in the pulmonary artery
c ) in the femoral artery
d ) carotid
```
in the pulmonary artery (+)
179
```
Treatment of hypovolemia start from :
a) provide adequate amounts of colloid and crystalloid solutions
b) the use of catecholamines
c ) forcing diuresis via diuretics
d ) the use of alkalizing agents
```
provide adequate amounts of colloid and crystalloid solutions (+)
180
A pulse oximeter is used to measure :
a) the oxygen content of the respiratory mixture
b ) Hb oxygen saturation
c ) partial pressure of oxygen in arterial blood
d ) oxygen in the mixed
Hb oxygen saturation (+)
181
```
The end of the catheter to measure CVP should be located in :
a) the right ventricle
b ) subclavian vein
c ) SVC
d ) IVC
```
SVC (+)
182
```
Dimension cardiac preload is :
a) the normal length of the segment QS
b) the peripheral vascular resistance
c ) filling of the left ventricle
d ) conduct the electrical stimulation of the left ventricle
```
filling of the left ventricle (+)
183
```
The most common way transmission of nosocomial infections are :
a) tap water
b ) the hands of medical personnel
c ) Dust
d ) dressing material
```
the hands of medical personnel (+)
184
The decrease in peripheral vascular resistance , cardiac output:
a) increasing
b ) drops
c ) remains unchanged
d ) varies depending on the frequency of breathing
increasing ( + )
185
Which of the following does not belong to invasive methods of monitoring :
a) central venous pressure
b ) examination of blood gases
c ) intracranial pressure
d ) the pressure in the pulmonary artery
e ) the concentration of respiratory gases
the concentration of respiratory gases (+)
186
```
Which of the above is not an indication for the direct measurement of blood pressure :
a) mechanical ventilation
b ) hypertensive crisis
c ) extensive surgery
d ) correct a, b, c
e) to b and c
```
mechanical ventilation (+)
187
The benefits of direct measurement of blood pressure are:
a) continuous analysis of the pressure
b ) repeated arterial blood gas tests
c) assessment of the shape of the pressure curve
d ) the correct b and c
the correct b and c ( + )
188
The most accurate indicator of proper tube placement
endotracheal intubation in the course is to:
a) electrocardiogram
b ) monitor
c ) capnograph
d ) ultrasonography
capnograph (+)
189
The value of central venous pressure do not affect :
a) the volume of blood
b ) right ventricular function
c) the tension of the walls of large veins
d) the core temperature
e ) intrathoracic pressure
the core temperature (+)
190
There is a chance of full resuscitation from cardiac arrest when to start resuscitation passed :
a) no more than 1 min .
b ) not more than 3 - 4 min.
c) no more than 15 seconds .
not more than 3 - 4 min. (+)
191
The most common form of cardiac arrest in adults is :
a) asystole
b ) ventricular fibrillation
c ) PEA
ventricular fibrillation (+)
192
```
Mydriasis during resuscitation may caused by ( in addition to hypoxia) :
a) calcium salts
b ) lignocaine
c ) bretylium tosylate
d ) large doses of catecholamines
```
large doses of catecholamines (+)
193
The classic arrangement of electrodes for defibrillation are:
a) left subclavian space - apex
b ) the right subclavian space - apex
c) a bridge - axillary line
d ) the left supraclavicular space - right axillary line
the right subclavian space - apex (+)
194
An indication for the administration of epinephrine during cardiac arrest is :
a) cardiogenic shock
b ) hypovolemic shock
c ) anaphylactic shock
d ) always used , regardless of the cause
always used , regardless of the cause (+)
195
Oxygen in resuscitation :
a) should be avoided
b ) administered in a concentration of 50 %
c ) administered at a maximum concentration
administered at a maximum concentration (+)
196
```
Epinephrine is a catecholamine acting on receptors :
a) α - adrenergic
b ) α - and β -adrenergic
c ) α - , β - and γ - adrenergic
d ) α1 - and β2 - adrenergic
```
α - and β -adrenergic ( + )
197
The mechanism for ejection of blood from the heart using an external massage consists in:
a) compression of the heart between the spine and sternum
b ) an increase in intrathoracic pressure
c ) both of the above -mentioned mechanisms
both of the above -mentioned mechanisms (+)
198
The standard dose of adrenaline and the correct way to serve the SCA contains the point :
a) 0.1 mg i.v. then flushed with 20 ml saline and elevate the leg
b) 1 mg i.v. then flushed with 20 ml saline and elevate the leg
c ) 1 mg s.c. or i.m
d ) 1 mg intracardially
e) in cardiac arrest each method of administration of adrenaline is good
1 mg i.v. then flushed with 20 ml saline and elevate the leg (+)
199
in adult ventricular fibrillation defibrillation energy should be carried out :
a) 50 J , 100 J , 200 - 300 J , 400 J
b ) 200 J , 200 J , 360 J
c ) 2 J / kg , 4 J / kg
d) ventricular fibrillation cardioversion should be used 200J
200 J , 200 J , 360 J ( + )
200
```
Compressions should be initiated when:
a) can not measure blood pressure
b ) the patient is unconscious
c ) you can not feel the pulse in the carotid artery or the femoral , the patient is unconscious
d ) in all the above cases
```
you can not feel the pulse in the carotid artery or the femoral , the patient is unconscious (+)
201
```
In the event of a sudden life-threatening bradycardia, cardiac electrical stimulation should be carried out by :
a) epidural
b ) transdermal
c ) intravascular
d ) intubation
```
transdermal ( + )
202
The recommended dose of adrenaline in resuscitation are:
a) ½ mg once , max. 10 mg daily
b) 1 mg once , max. 5 mg
c ) 2 mg in a single dose without limits of total dose
d ) 1 mg in a single dose , without limitation of the total dose
1 mg in a single dose , without limitation of the total dose (+)
203
```
electrical defibrillation in children is with a load of :
a) 0.1 - 0.5 J / kg of body weight
b ) 0.5 - 1 J / kg of body weight
c ) 2 - 4 J / kg of body weight
d ) 5 - 10 J / kg of body weight
```
2 - 4 J / kg of body weight (+)
204
Dopamine is used in small doses in order to:
a) increase cerebral blood flow
b) the reduction in pulmonary artery pressure
c) a reduction in peripheral vascular resistance
d) an increase in urine output
an increase in urine output (+)
205
we achieve a patent airway in resuscitation by:
a) chin lift and tilt the head back
b) positioning the patient in recovery position
c) endotracheal intubation
d) a and b are correct
e) a and c correct
a and c correct (+)
206
According to the so-called. new, modified, the definition of death for recognize death in a person who:
a) ceased circulation
b) ceased breathing
c) death of brainstem
d) death of the cerebral cortex
death of brainstem (+)
207
The following test is not used to determine brain death:
a) attempt of apnea
b) vestibulo-ocular reflexes
c) examination of the ocular reflex-brain
d) examination of motor response to pain stimulus
e) examination of tendon reflexes, Babinski reflex abdominal and
examination of tendon reflexes, Babinski reflex abdominal and (+)
208
Death of brain states:
a) the head of the ICU
b) a committee of three doctors
c) the transplantology doctor
a committee of three doctors (+)
209
Suspicion of brain death can not be stated in a patient:
a) who is poisoned
b) with metabolic disorders
c) with ruptured brain aneurysm
d) all of the above real answers
e) a and b are true
a and b are true (+)
210
Death of the brain cannot be confirmed if:
a) the patient does not meet the criteria for stage I and II.
b) the committee questions the validity of studies
c) the patient's organs are not suitable for transplantation
d) all real
e) a and b are true
a and b are true (+)
211
As a "time of death" when determining brain death consider:
a) the time eject suspected brain death
b) the completion of the protocol by the commission
c) disconnect the respirator
the completion of the protocol by the commission (+)
212
epidural anesthesia:
a) prior to drug administration should get the flow of CSF
b) the epidural space are identified by the disappearance of resistance
c) coagulation disorders are not a contraindication
d) proper b and c
e) A and C are correct
the epidural space are identified by the disappearance of resistance (+)
213
necessary to monitor the patient in any type of anesthesia that:
a) bloody blood pressure, pulse oximeter, ECG, capnograph
b) ECG, pulse oximeter, blood pressure, CVP
c) ECG, pulse oximeter, CVP measurement, measurement of hourly diuresis, capnograph
d) ECG, blood pressure, pulse oximeter
e) ECG, capnograph, hourly diuresis, CVP
ECG, blood pressure, pulse oximeter (+)
214
Muscle relaxants used in anesthesia affect the following neurotransmitter:
a) Dopamine
b) adrenaline
c) acetylcholine
d) serotonin
acetylcholine (+)
215
Capnography is the monitoring to assess:
a) the patient's ventilation
b) SCA
c) the patient's metabolism
d) none of the above
e) all true
all true (+)
216
feeding break before the scheduled surgery should be in adults:
a) 2 h
b) 12 h
c) at least 24 h
d) 6 h
6 h (+)
217
The patient is being treated for hypertension. Prior to elective surgery he should:
a) continue treatment until surgery
b) discontinue medication two days before surgery
c) medications discontinued 7 days prior to surgery
d) does not operate on a patient
continue treatment until surgery (+)
218
Scale ASA is:
a) the scale of the evaluation of difficulty in intubation
b) the scale of the assessment of peri operative risk
c) the scale of pain assessment
d) the scale of the respiratory function
the scale of the assessment of peri operative risk (+)
219
The pharmacological premedication is:
a) the elimination of pain during surgery
b) calming the patient down
c) reduction of the voltage of the lower esophageal sphincter
d) reducing the total dose of relaxant drugs
calming the patient down (+)
220
The purpose of premedication is not:
a) the elimination of anxiety, pain or anxiety before surgery
b) the weakening of undesirable reflexes
c) initial local anesthetic around the treated area
d) to facilitate the introduction of anesthesia
initial local anesthetic around the treated area (+)
221
In the course of epidural analgesia in addition to anasthesia the following symptoms are observed:
a) sympathetic blockade
b) parasympathetic blockade
c) epidural anesthesia has no effect on the autonomic nervous system
d) 50% of the observed convulsions
sympathetic blockade (+)
222
Laying the patient in the Trendelenburg position is:
a) laying on his stomach
b) elevation of the head
c) lowering the head
d) laying on its side
lowering the head (+)
223
Reduction of hourly diuresis in critically ill patients is most often a consequence of:
a) hypoalbuminemia
b) hypovolemia
c) hypoproteinaemia
d) hyponatremia
hypovolemia (+)
224
Continuous epidural anasthesia can be made to:
a) analgise the patient to perform prolonged surgery
b) conduct postoperative analgesia
c) treat ischemic changes in the lower limbs
d) labor analgesia
e) In all cases
In all cases (+)
225
intubation is performed in which phase?:
a) the introduction of anesthesia
b) premedication
c) the maintenance of anesthesia
d) none of these
the introduction of anesthesia (+)
226
Which of the following is not anesthetic drugs used intravenously:
a) ketamine
b) etomidate
c) halothane
d) propofol
halothane (+)
227
In which type of anesthesia the intended puncture the dura mater of the spinal cord is reached:
a) continuous epidural
b) subarachnoid
c) a single epidural
d) the celiac plexus blockade
subarachnoid (+)
228
The patient with the value of Hb 8.5 g%:
a) can be operated (elective surgery)
b) may be operated only if life is in danger
c) the value of hemoglobin requires an absolute correction
d) can be operated on a schedule if this value is an expression of chronic anemia
e) none of the above is true response
can be operated on a schedule if this value is an expression of chronic anemia (+)
229
The greatest risk of aspiration of gastric contents during induction of general anesthesia is in patients
a) with low gastrointestinal obstruction
b) with high gastrointestinal obstruction
c) pregnant women
d) the correct b and c
the correct b and c (+)
230
Risks to the anesthetised patient during emergency surgery are highest because of intestinal obstruction due to:
a) hypovolemia and electrolyte disturbances
b) the possibility of aspiration upon induction of general anesthesia
c) hypervolemia and electrolyte disturbances
d) the correct A and B
e) correct b and c
the correct A and B (+)
231
Measurement of SvO2 (mixed venous oxygen saturation) is possible with:
a) monitor
b) capnograph
c) catheter Swan - Ganz
d) Foley catheter
catheter Swan - Ganz (+)
232
APACHE scale is a measure of:
a) neurological status
b) the degree of pain
c) the depth of anesthesia
d) the clinical status of the patient
the clinical status of the patient (+)
233
Venous blood - mixed blood is taken from:
a) femoral vein
b) cubital fossa vein
c) pulmonary artery
d) superior vena cava
pulmonary artery (+)
234
Rohypnol is
b) Flunitrazepam
c) Nitrazepam
d) Flumazenil
e) Propofol
Flunitrazepam (+)
235
The oculo-cardiac reflex can be triggered in operations:
a) Ophthalmic
b) In an open heart
c) At the open-chest
d) During the manipulation of the carotid
Ophthalmic (+)
236
Which of the medication works the fastest (the fastest induction):
a) Sevofluran
b) Desflurane
c) Isoflurane
d) Enflurane
e) Halothane
Desflurane (+)
237
Evaluation of heart rhythm during ALS should be done, except:
a. confirm signs of circulation (pulse)
b. every 2 minutes
c. before each defibrilation
d. every 2 minutes in shockable rhythms and every 4 mintues (before each adrenaline dose) in nonshockable rhythms
every 2 minutes in shockable rhythms and every 4 mintues (before each adrenaline dose) in nonshockable rhythms
238
Match the scheme of procedures used in ALS to the correct course of resuscitation in the patient: CPR – adrenaline – CPR – defib – CPR – adrenaline – CPR – continous adrenaline infusion
Aystole – vf – pea - cardiogenic shock
Cardiogenic shock – pea- vf – cardiogenic shock
Vf – cardiogenic shock
Aystole – pea – vf –shock
Aystole – vf – pea - cardiogenic shock
239
```
Defibrilation is defined as termination of fibrillation (1), meaning the lack of vf/vt during 5 seconds from the administration oft he shock (2)
Both true
1 true, 2 false
1 and 2 false
2 true, false
```
Both true
240
Dosing of amiodarone in nonresponding VF follows the following sheme:
1. 300mg, 2. 150 mg, next 900mg/d
1. 150 mg, 2. 300 mg, next 900mg/d
1. 150mg, 2. 150 mg, next 900mg/d
1. 300 mg, 2. 300 mg, next 600mg/d
1. 300mg, 2. 150 mg, next 900mg/d
241
Overdosing of bicarbonate during cpr causes:
Metabolic alkalosis, left shift of hemoglobin curve and decreased oxygen to tissue
mixed acidosis, hb curve shift to left, increased O2 to tissue
metabolic alkalosis, right shift of hb curve, decreased O2 to tissue
mixed alkalsosis, left shift of hb curve, increased O2 to tissue
Metabolic alkalosis, left shift of hemoglobin curve and decreased oxygen to tissue
242
```
Ratio of compressions to breaths in a newborn:
5:1
15:2
30:2
3:1
none oft he above
```
3:1
243
```
Dose afadrenaline in child during CPR:
1000 microg/kg
1. Dose 10 micro/kg, next 100micro/kg
10 micro/kg every 3-5 min
100 micro/kg
none oft he above
```
10 micro/kg every 3-5 min
244
```
For diagnosing primay, subtentorial damage tot he brain, you need the following examinations for confirmation:
Eeg
Angiography of brain
Auditory evoked potentials
A and b
A,b and c
```
A,b and c
245
The team to pronouncea patient brain dead consists oft he following in poland:
2 doctors: anes and neuro
2 doctors: anes and surg
3 doctors: anes, neuro, neurosurg
3 doctors: anes. Neur or neurosurge and 3.
3 doctors: neuro or neurosurg, internal, surgeon
3 doctors: anes. Neur or neurosurge and 3.
246
```
The interval between two examinations to determine brain death in an adult on clinical basis alone, should be:
2 h
3h
6h
12h
24h
```
6h
247
```
The same amount of time between two examinations in determing brain death like in adults, applies to children from 24h of age up to:
7d
1year
2years
7years
```
2 years
248
```
The Lazarus sign in a brain dead patient is described as:
Presence of babinski reflex
Presence of patellar reflex
Periodic facial reflexes
Trunk reflex
Reflex of extremities
```
Reflex of extremities
249
```
Confirmation of irreversible changes when diagnosin brain death is required in:
Only newborn
Children up to 1 year
Children up to 2 years
Children up to 7 years
Until 18 years of age
```
Children up to 2 years
250
```
What % of water in an adult is located in the intracellular space:
60
55
40
35
20
```
60
251
```
massive packed red blood cell transufions are associated with
coagulopathy
decrease of temp
acidosis
bleeding
all of the above
```
all of the above
252
Diagnosing DIC relies on following parameters:
Low fibrinogen, low PLT, low ATIII, high PTT
Low fibrinogen, low PLT, high prothrombin, low PTT
High fibringoen, low PLT, low ATIII, low PTT
High fibrinogen, low PLT, high prothrombin, high PTT
Low fibrinogen, low PLT, low ATIII, high PTT
253
```
Danger of v-fib could be a consequence of hypothermie when:
<35 C
<33 C
<31 C
<29 C
none oft he above
```
<29 C
254
```
When administering fluids via a central venous catheter and peripheral catheter with the same diameter, the rate of infusion will be:
Faster in central
Faster in peripheral
16 times Faster in longer catheter
16 times faster in shorter catheter
```
16 times faster in shorter catheter
255
Mark the false answer concerning invasive hemodynamic monitoring
The bigger SV of RV, the more flat ist he thermodilution curve and smaller the field below the curve
Preload is a volume and not a pressure
The less the fluid is cooling the blood in the right atrium, the less blood flows through the RV and the less the SV
ITBV is used to estimate preload
SVR is not a marker of afterload
SVR is not a marker of afterload
256
```
Toxicity of oxygen can be expected when using it:
At 60% for 24h
At 40% for 24h
At 60% for 48h
At 70% for 48h
At 80% for 48h
```
At 60% for 48h
257
Phosphodiesterase III inhibitors cause:
Decrease of intracellular Calcium
Positive inotropic effect, increase in afterload
Increase in intracellular calcium, decrease in afterload
Thrombocytopenia, negative chronotropic effect
Bradycardia, positive chronotropic effect
Increase in intracellular calcium, decrease in afterload
258
```
Effect of stimulation of beta-3 receptors is:
Vasodilation
Lipolysis
Vasoconstriction
Positive chronotropic effect
Positive inotropic effect
```
Lipolysis
259
```
Which beta blocker has an alpha blocking activity
Carvedilol
Esmolol
Metoprolol
Atenolol
Bisprolol
```
Carvedilol
260
```
Visible: part of tongue and posterior arch of pharynx according to mallapti scale:
1
2
3
4
5
```
1
261
```
Obese patient, with diabetes requiring treatment with insulin should be classified according to ASA in:
1
2
3
4
```
3
262
indication for laryngeal mask for a planned procedure is
surgery of thorax with neuromuscular block
surgery of pregnant woman (4thmonth)
surgery lasting more than 3 hours
short surgery of hiatal hernia
catarct surgery in a pt treated with LMWH
surgery lasting more than 3 hours
263
Patients with risk of PONV and Apfel scale >2 the treatment of choice should be:
Regional anesthesia or TIVA
Dexamethasone during induction or afterwards
Administration of serotonin receptor blockers
A and c
A b and c
A b and c
264
Show correct statement concerning the action of dopamine an ddobutamine
Dobuatime in dose of 1-2 microg/kg/min leads to increased GFR and increased natriuresis
Dopamine is less selective for beta 1 than dobutamine
Dopamine crosses BBB
Dobutamine never causes increase in BP because it is sympathomimetic for both beta1 and beta2 receptors
Dobutamine activated D1 at 1/3 the strength of dopamine, but does not work on D2
Dopamine is less selective for beta 1 than dobutamine
265
TRALI means:
Preparation containing vit k dependent factor, protein c, z and s
Transfusion realted acute lung injury
Transfusion after hypervolemic hemodilution
Transfusion related thrombocytopenia
Transfusion realted acute lung injury
266
```
Contraindication to regional anesthesia for C/S is:
Insulin dependent DM
Leg edema
Hypertension
Asthma
Hellp
```
Hellp
267
```
Match the drugs in realtion to their influence on Cardiac output acording tot he following scheme: lowlow, low, no influence, high
Propofol, etomidat, midazolam, ketamin
Etomidate, ketamin, midazolam, propofol
Midazolam, propofol, ketamin, etomidat
Ketamin, propofol, midazolam, etomida
Propofol, midazolam, etomadat, ketamin
```
Propofol, midazolam, etomadat, ketamin
268
```
Opiod action on delta receptors:
Analgesia
Tachycardia
Hallucination
Mood disturbances
All of the above
```
Analgesia
269
```
Opiod that is metabolized in plasma, independent of liver function:
Morphine
Buprenorphine
Sulfentanyl
Remifentanyl
```
Remifentanyl
270
```
Which drug relaeses histamine:
Etomidate
Mivacurium
Propofol
Pancuronium
Vecuronium
```
Mivacurium
271
```
Factor not influencing length of action of neurmuscular blocking agent is:
Hipothermia
Respiratory acidosis
Hypermagnesemia
Sex
```
Sex
272
```
Depolarizing neurmuscular blockers:
Bind to ACh receptors without ccausing contraction
Compete with Ach
Action is irreversible
Action is reversible
```
Action is irreversible
273
```
Odourless, colorlous gas, acts sedating and analgetically. MAC 71%, increases ICP, otherwise no CV influence. Which one is it:
Sevoflurane
Nitric oxide
Xenon
Helium
Desflurane
```
Xenon
274
```
Which drug hast he highest cardiotoxicity
Procaine
Lignocaine
Ropivacaine
L-bupivacaine
Bupivacaine
```
Bupivacaine
275
```
What acces can be used to get epidural blockade in children
Lumbar
Sacrum
Thoracic
None oft he above
A,b,c
```
A,b,c
276
```
Which is not a peripheral side effect of central anticholinergic syndrome:
Miosis
Anuria
Ataxia
Dry mouth
```
Miosis
277
Of the drugs used to treat POP
Methamizol has also spasmolytic action
Methamizol ist he longest acting non-opiod analgesic
Paracetamol can cause red discoloration of urine
Morphine can be given in porphyria pts
Diclofenac cannot be given iv
Morphine can be given in porphyria pts
278
```
Pulomanry edema parameter is:
GEDV
ITBV
SVV
Dp/dt max
EVLW
```
EVLW
279
Parameters obtain from Swan Ganz Catheter:
CVP, PAP, CO, PCWP, SVR, SvO2, SV, Temperature
CVP, PAP, CO, PCWP, SVR, EVLW, PVR, CI
CO, EVLW, ITBV, GEDV
CVP, CO, PCWP, PAP, ITBV
CVP, PAP, CO, PCWP, SVR, SvO2, SV, Temperature
280
Please choose the results typical for pulmonary artery embolism (PAP – pulmonary artery pressure)
PAP increased, PVR increased, CO decreased, PCWP normal or increased
PAP normal, PVR increased, CO decreased, PCWP normal or increased
PAP normal, PVR normal, CO decreased, PCWP normal or increased
PAP increased, PVR decreased, CO decreased, PCWP normal or increased
PAP decreased, PVR decreased, CO decreased, PCWP normal or increased
PAP increased, PVR increased, CO decreased, PCWP normal or increased
281
```
Howoritz index in ARDS is:
<400
<350
<300
<250
<200
```
<300
282
```
Methods of ventilation with preservation of self breathing:
CPAP PEEP IMV
CPAP, BIPAP, IPPV
CPAP, BIPAP, SIMV
BIPAP, IPPV, IMV
IMV, PEPP, PCV
```
CPAP, BIPAP, SIMV
283
```
The system for monitoring liver function by use of ICG is:
PiCCO
LiMON
MARS
CARS
ECMO
```
LiMON
284
```
What is not characterisitc for ARDS:
PaO2/FiO2 <200 mmHg
PCWP <18mmHg
Pulmonary leakage >10%
Signs of pulmonary hypertension
SvO2 >80%
```
SvO2 >80%
285
```
Mechanical ventilation in ARDS should be performed according to ARDSNet. Volume of breath in the beginning should be:
6ml/kg
10-12ml/kg
13ml/kg
14-16ml/kg
16-20ml/kg
```
6ml/kg
286
The mechanism of Ventilation induced lung injury VILI is:
Direct damage to lung tissue
Decrease surfactant production and function
Stimulating local and systemic inflammatory response
Toxic effects of O2 of less than 40% concentration
A b c
A b c
287
```
When Noradrenaline is used in the treatment of septic schock, then after pRBC transfusion to reach a Hat of 30% with a saturation of mixed venous blood of less than 70%, we add:
Adrenaline
Dopamine
Dobutamine
None of the above
```
Dobutamine
288
```
The aminoacid with anticacechtic action, improving intestinal function and immunity, and insufficiency during severe sepsis is:
Proline and arginine
Glutamine
Valine
Carnitine
```
Glutamine
289
```
According tot he Surviving Sepsis Campaign of 2008, resuscitation treatment should be accomplished withing:
1hour
4hours
6h
24h
```
6h
290
```
Another name for endotoxin
LBP
LPC
LAT
LPS
```
LPS
291
Discoverin bacterial carbapenemase KPC (K. pneumeoniae carbapenemase) indicates:
We cannot use carbapenems and other beta lactams
We can use colistin, tygecycline and gentamycin
We can observe lack of efficacy of all antibitiotics
All answers are true
All answers are true
292
```
Severe sepsis in pts treated in ICUs occurs:
16%
28%
34%
5%
```
16%
293
```
When sepsis is recognized,, according to guidelines, tha antiobiotic should be given within
60min
90min
120min
240min
```
60min
294
```
Contraindication for enteral nutrition is
Acute abdomen
MEchanical obstruction
Liver insufficiency
Intestinal ischemia
Chronic diarrhea
```
Acute abdomen
| MEchanical obstruction
295
Please mark the incorrect answer
Hypothermia ist he only reason for chills
Hypothermia leads to coagulopathy
Indication for ventilation support is <34C
During chills, oxygen consumption can go up 400%
Hypothermia is the only reason for chills
296
```
For treatment of chills:
Atropine
Pethidine
Succhinylcholine
CaCl
```
Pethidine
297
```
Current definition of acute renal insufficiency is:
GUN
COLT
RIFLE
ROCKET
RUMBLE
```
RIFLE
298
III degree of hepatic encephalopathy means:
Lack of awareness, euphoria, anxiety, shortened attention
Lethargy apathy, minimal disorientation
Anxiety, sleep disturbances
Somnolence, semistupor, confusion
Somnolence, semistupor, confusion
299
```
Mydriasis is not characteristic for:
LSD
Cocaine
Amphetamine
Hypoglycemia
Clonidine
```
Cocaine
300
```
In treatment of Brain head trauma, CPP should be kept at the level of:
>10mmHg
>15
>20
>35
the level of ICP
```
>35
301
```
Silent lung phenomenon is typical for:
Pneumothorax
Asthma
emphysema
Tuberculosis
```
Pneumothorax
302
```
Please indicate the paramter not included in APACHE II
Arterial pH
Ht
PEEP
Respiratory rate
Creatinine in plasma
```
PEEP
303
```
Who is the author of the pain specificity theory
Arystoteles
Seneca
Descartes
Mikulicz
```
Descartes
304
```
Development of spinal sensitization is connected with the following receptor:
Histamine
Dopamine
5-ht
Nmda
```
Nmda
305
```
Characteristics of „taught“ pain are:
Five D’s
Four B’s
Six C’s
Seven P’
```
Five D’s
306
```
% of pts in adulthodd, suffering from chronic pain (michigan pain study):
20
40
44
52
```
40
307
```
In most populations, blue colors of tablets have a sedating effect like placebo, except:
In Germans
In Hispanics
In French
In Italians
```
In Italians
308
```
In a 2002 NEJM publication, results comparing operative intervention to placebo did not show a difference in the relif of chronic pain in the follwing body part:
Elbow
Knee
Shoulder
Thumb
```
Knee
309
```
In severe pain, no due to neoplasm, recommended drug is:
Paracetamol w NSAID
NSAID plus supportive mediaction
Strong opiods
Rehabilitiona and NSAIDs
```
Strong opiods
310
Chronic pain in cancer is usually of a prolonged character; therefore, the concentration of a drug in the blood should be kept at an appropriate level. This can be achieved only by:
Keeping the patient in the hospital to monitor the blood concentration
By keeping appropriate doses and time intervals between them
Choosing an appropriate anti-inflammatory drug
Administering the drug to the patient when he/she is in pain
By keeping appropriate doses and time intervals between them
311
```
Metabolic-hormonal reaction to pain stimuli in neonates is:
Same as in older kids and adults
Less than in adults
3-5x stronger than in adults
none oft he above
```
3-5x stronger than in adults
