Canadian MCQs 2nd Flashcards
1
Q
- At what core temperature do the ACLS guidelines recommend limiting defibrillation to 3 stacked shocks prior to active rewarming?
a. 29 C
b. 30 C
c. 31 C
d. 32 C
A
x
2
Q
- What is the principal binding protein for basic drugs?
a. albumin
b. globulin
c. lipoprotein
d. alpha1-acid glycoprotein
A
x
3
Q
- Which of the following cardiac anomalies requires endocarditis prophylaxis for dental extraction?
a. mitral valve prolapse without regurgitation
b. isolated secundum atrial septal defect
c. implanted defibrillator
d. hypertrophic cardiomyopathy
A
x
4
Q
- According to the CAS document regarding testing of adequacy of operating room scavenging systems, which of the following can be used?
a. CO2
b. N2O
c. halogenated hydrocarbons
d. chlorofluorcarbons
A
x
5
Q
- Regarding anesthesia for morbid obese patient which of the following medications has to be calculated to lean body mass:
a. Midasolam
b. Fentanyl
c. Sux
d. Rocuronium
A
x
6
Q
- At atmospheric pressure 600 mm Hg, pCO2=40 and RQ=0.8, what is pAO2 in a healthy young man:
a. 56 mm Hg
b. 66 mm Hg
c. 76 mm Hg
d. 100 mm Hg
A
x
7
Q
- 12 y.o. patient weight 40 kg has 40 mcg/kg/hour continious i/v infusion of morphine for pain control after hand surgery. What would you prescribed to convert him to oral route?
a. 20 mg PO q 8 H
b. 20 mg PO q 4 H
c. 40 mg PO qid
d. 50 mg PO q 6 H
A
x
8
Q
- After major surgery, level of which of the following hormones will decrease?
a. Cortisol
b. Insulin
c. ACTH
d. ADH
A
x
9
Q
- Which of the following is a useful adjunct for post-deflation analgesia following IVRA with a local anesthetic?
a. clonidine
b. opioid
c. toradol
d. alkalinization of the local anesthetic with sodium bicarbonate
A
x
10
Q
- What is the major advantage of inhaled NO versus intravenous vasodilator agents for treating pulmonary hypertension?
a. pulmonary selectivity
b. absence of negative inotropic effect
c. absence of platelet effects
d. ease of administration
A
x
11
Q
- Which of the following is LEAST effort dependent?
a. FEV
b. FVC
c. FEF25-75
d. flow volume loop
A
x
12
Q
- Which of the following is LEAST effective in treating postoperative shivering?
a. clonidine
b. magnesium
c. demerol
d. alfentanil
A
x
13
Q
- Which of the following is most likely to cause anaphylaxis?
a. latex
b. propofol
c. bupivacaine
d. mivacurium
A
x
14
Q
- Following laceration to the forearm, which of the following causes ongoing widespread discomfort?
a. Type A fibre conduction leading to central sensitization
b. Substance P causing NMDA receptor stimulation
c. Repeated Type C fibre stimulation causing augmented response
d. Increased activity in the spinothalamic tracts
A
x
15
Q
- Complication of lateral decubitus position on the non-dependent side
a. suprascapular nerve injury
b. avascular necrosis femoral head
c. retinal ischemia
d. peroneal nerve injury
A
x
16
Q
- Pharmacokinetics of which opiod is least affected by hepatic failure?
a. fentanyl
b. alfentanyl
c. sufentanyl
d. remifentanyl
A
x
17
Q
- Which test most reliably confirms correct ETT placement?
a. auscultation
b. ETCO2 first exhaled breath
c. endoscopic inspection of the airway
d. observation of chest movement
A
x
18
Q
- When is use of Sux considered safe?
a. 40% burn, 3 days post injury
b. Duchene’s muscular dystrophy
c. Cerebral Palsy
d. Spinal cord injury with paraplegia, 10 days post trauma
A
x
19
Q
- All are features assoc with BPD in children except:
a. cor pulmonale
b. hypoxemia
c. reactive airways disease
d. often persists into adulthood
A
x
20
Q
- Hyponatremia occurs in all except:
a. 4% postop patients
b. always assoc with hypoosmolality
c. may be assoc with increased total body sodium
d. rapid correction can lead to quadriplegia
A
x
21
Q
- Chiari type 2 malformations is assoc with all of the following except:
a. Seizures
b. Latex allergy
c. Hydrocephalus
d. Syringomyelia
A
x
22
Q
- T5 spinal is assoc with decreases in all except:
a. Myocardial oxygen demand
b. Coronary blood flow
c. Hepatic blood flow
d. Resting ventilation
A
x
23
Q
- PCWP overestimates the LVEDP in which of the following circumstances:
a. LV Diastolic Dysfunction
b. Pneumonectomy
c. Aortic Insufficiency
d. CHF
A
x
24
Q
- What is the MOST reliable method of determining correct tube placement:
a. Auscultation of the chest
b. ETCO2 on FIRST breath
c. Endoscopic examination of the airway
d. Chest Movement
A
x
25
Q
- What proportion of deaths within 48hrs are attributable solely to the anesthetic provider?
a. 0.4%
b. 4%
c. 10%
d. 14%
A
x
26
Q
- The addition of 0.75% Isoflurane to a mixture of 50% N20/O2 will result in which of the following
a. Depression of the neonate
b. Increased blood loss
c. Reduced maternal awareness
d. Atonic uterus
A
x
27
Q
- Which of the following is an abolute indication for lung separation?
a. Thoracoscopy
b. upper lobectomy
c. pneumonectomy
d. giant unilateral bullae
A
x
28
Q
- For patients with severe COPD, which of the following best explains the predisposition to hypercarbia hours following an anesthetic?
a. Reduced responsiveness to CO2
b. Reduced Responsiveness to O2
c. Intercostal muscle weakness
d. ??something else
A
x
29
Q
- At what temperature does the ACLS guidelines recommend limiting defibrillation attempts?
a. 29
b. 30
c. 31
d. 32
A
x
30
Q
- Which of the following IS NOT a risk factor for Afib following non cardiac surgery
a. DM
b. Ischemic heart disease
c. Age
d. Previous AF
A
x
31
Q
- Which of the following best predicts renal failure follwoing a laparotomy?
a. Hypertension
b. Hypovolemia
c. Age>60
d. Coronary disease
A
x
32
Q
- Which is most commonly seen with hyperkalemia?
a. long QT
b. VF
c. Conduction Block (AV block)
A
x
33
Q
- Which is not part of the aldrete score
a. pain
b. activity
c. spo2
A
x
34
Q
- Which of the following drugs should be dosed on lean body mass for morbidly obese patients
a. midaz
b. fentanyl
c. sux
d. roc
A
x
35
Q
- In which of the following is amiodarone not indicated
a. polymorphic VT
b. rate control for SVT in patient with preexcitation
c. ?VF
d. Torsades
A
x
36
Q
- Which of the following drugs (?elimination/clearance) is effected most by renal failure
a. midaz
b. fent
c. roc
d. neostigmine
A
x
37
Q
- Patient with a severe blunt neck injury, hypoxic, hoarse, stridulous. WHich is least desirable method of securing the airway
a. Direct laryngoscopy with in line stabilization
b. blind nasal
c. fibreoptic
d. tracheostomy
A
x
38
Q
- Which of the following diuretics act at the collecting duct?
a. mannitol
b. spironolactone
c. hctz
d. furosemide
A
x
39
Q
- when does PAW mean overestimate LVEDP
a. tachycardia
b. AS
c. AI
d. pneumonectomy
A
x
40
Q
- With which of the following is bis unreliable
a. propfol
b. des
c. sevo
d. ketamine
A
x
41
Q
- Which is best at reducing gastic volume
a. ranidine
b. cimetidine
c. pantoloc
d. na citrate
A
x
42
Q
- which adjunt provides most reliable analgesia to IVRA
a. cloinidine
b. opiate
c. ketorolac
d. bicarb
A
x
43
Q
- which is least likely to impair lidocaine elimination?
a. elderly
b. hepatic disease
c. renal failure
d. chf
A
x
44
Q
- low Vt ventilation (6/kg) which is not a benefit
a. improved mortality
b. improved/fewer ventilator free days
c. improved/fewer days free of end organ failure
d. reduced barotraumas
A
x
45
Q
- All of the following occur during pregnancy, except
a. CO increases 50%
b. SVR decreases 20%
c. EF unchanged
d. CVP unchanged
A
x
46
Q
- Which lead is positioned at the 4th IC space Lt sternal border
a. v2
b. v3
c. v4
d. v5
A
x
47
Q
- Which epidural opiate lasts the longest
a. hydromorph
b. meperidine
c. two short acting lipophilic choices
A
x
48
Q
- What does teh CAS recommed as adequate monitoring for adequacy of scavenging
a. CFCs
b. halogenated hydrocarbons
c. nitrous
d. CO2
A
x
49
Q
- Which will depress the amplitude of SSEPs the most
a. 1.5 MAC isoflurane
b. 2.5 mg/kg propofol
c. .1 / kg midaz
d. ?fentanyl
A
x
50
Q
- What is the most common reason for malpractice claims against Canadian anesthesiologists
A
x
51
Q
- Ketamine works at all receptors, except
a. nmda
b. gaba
c. monoamine
d. opiate
A
x
52
Q
- which herbal causes hypoglycemia
a. st johns
b. kava
c. valerian
d. ginseng
A
x
53
Q
- Regarding factors that limit vapor output accuracy in a variable bypass vaporizor, pick the exception
a. Fresh gas flow rate less than 250 ml/min.
b. Ambient temperature
c. Intermittent Backpressure
d. Carrier gas composition
A
x
54
Q
- Regarding Low tidal volume venitlation (6ml/kg) in ARDS, all are true except
a. more ventilator-free days
b. more organ-failure free days
c. lower mortality
d. lower barotraumas
A
x
55
Q
- Which of the following volatiles produces the LEAST amount of fluoride?
a. sevoflurane
b. halothane
c. desflurane
d. isoflurane
A
x
56
Q
- Which of the following accounts for a faster rise in alveolar concentration of sevoflurane in neonates as compared to adults?
a. Neonates have a relatively greater cardiac output
b. Neonates have relatively greater body water
c. Neonates have a relatively smaller FRC per kg
d. Neonatal anesthetic delivery systems have much smaller volumes
A
x
57
Q
- The shorter duration of analgesia from a single dose of fentanyl compared to an equipotent dose of morphine can best be explained by?
a. Fentanyl has a smaller volume of distribution (Vd)
b. Fentanyl quickly redistributes from the CNS to other tissues
c. Fentanyl has a shorter elimination half time
d. Fentanyl is less lipid soluble
A
x
58
Q
- Resistance to the antagonism of neuromuscular blockade by neostigmine may be influenced by?
a. Metabolic alkalosis
b. Hyperkalemia
c. Respiratory acidosis
d. Hyperthermia
A
x
59
Q
- Regarding neurolytic celiac plexus blockade, which one of the following statements is TRUE:
a. Is MOST effective in Chronic Pancreatitis
b. Requires needle placement at L2
c. Is commonly blocked bilaterally
d. Requires the use of Phenol for neurolysis
A
x
60
Q
- What is the normal P50 of maternal hemoglobin at full term?
a. 18 mm Hg
b. 20 mm Hg
c. 27 mm Hg
d. 30 mm Hg
A
x
61
Q
- Which one of the following interventions is LEAST effective in preventing maternal hypotension after establishing a neuraxial blockade?
a. Avoidance of Aorto-caval compression
b. Administration of fluids
c. Frequent monitoring of blood pressure
d. Prophylactic use of ephedrine
A
x
62
Q
- Which of the following is MOST likely to render the BIS monitor unreliable?
a. Propofol
b. Ketamine
c. Sevoflurane
d. Desflurane
A
x
63
Q
- The clinical features of MVP may include which ONE of the following?
a. Associated mesenchymal and skeletal abnormalities
b. Most patients are symptomatic
c. Chest pain is anginal in nature
d. The murmur is an early systolic murmur
A
x
64
Q
- Which of the following would decrease the amplitude of SSEP waveforms the MOST?
a. Isoflurane 1.5 MAC
b. Propofol 2.5 mg/kg
c. Midazolam 0.1 mg/kg
d. Fentanyl 1 mcg/kg
A
x
65
Q
- For which of the following is TENS the LEAST helpful?
a. Phantom Limb Pain
b. Peripheral Nerve Injuries
c. Myofascial Pain
d. Central Pain
A
x
66
Q
- In a morbidly obese patient, which drug is most appropriately dosed by ideal body weight:
a. midazolam
b. fentanyl
c. Succinylcholine
d. Rocuronium
A
x
67
Q
- What is the Palveolar at atmospheric pressure 600 mmHg in an healthy patient with a PCO2 of 40 and a respiratory quotient of 0.8:
a. 66
b. 76
c. 88
d. 104
A
x
68
Q
- Which of the following decreased with surgical stress:
a. Cortisol
b. Growth hormone
c. ADH
d. insulin
A
x
69
Q
- 12 year old 40 kg boy has been receiving on average 40 mcg/kg/hr of morphine for an arm surgery. He is being switched to oral medication. What is the most appropriate oral conversion:
a. 20 mg PO q8h
b. 20 mg PO q4h
c. 40 mg PO qid
d. 50 mg PO q6h
A
x
70
Q
- All except one is associated with the use of NIPPV in a patient with acute respiratory distress secondary to an acute COPD exacerbation. Indicate the Exception
a. Reduced length of ICU stay
b. Increased patient comfort
c. Improved bronchial hygiene
d. Decreased need for sedation
A
x
71
Q
- I think the options were
a. more ventilator-free days
b. more organ-failure free days
c. reduced ICU admission
d. improved bronchial hygiene
A
x
72
Q
- All except one is associated with increase local anesthetic toxicity in respiratory acidosis. Indicate the exception.
a. Increased CBF
b. Increased drug trapping in neuron
c. Decreased protein binding
d. Increased transfer of drug into neuron
A
x
73
Q
- All are associated with tracheal complications except
a. Age
b. Gender
c. Duration of intubation
d. Low pressure cuff
A
x
74
Q
- All agent readily cross the placenta except
a. opioids
b. IV induction agents
c. Inhalational agents
d. Neuromuscular blockers
A
x
75
Q
- Which of the following will cause an overestimation of cardiac output using the thermodilution method:
a. Catheter tip in Zone 2 lung
b. Using half the required volume of injectate
c. The first few mintues off CPB
d. Using Dextrose and Saline mixed for injectate
A
x
76
Q
- Which of the following opioids has the LONGEST duration of action when used epidurally:
a. Meperidine
b. Sufentanil
c. Fentanyl
d. Hydromorphone
A
x
77
Q
- The amount of epinephrine in 0.1ml of 1:1000 solution is:
a. 1 mg
b. 1 mcg
c. 10 mcg
d. 100 mcg
A
x
78
Q
- A 28 year-old male with WPW presents with a 4-hour history of ATRIAL FLUTTER and a ventricular rate of 150 bpm. He is normotensive, and previously well. Which one of the following medications would be appropriate at this time:
a. Adenosine
b. Diltiazem
c. Esmolol
d. Amiodarone
A
x
79
Q
- Regarding risk factors for postop AFib, please indicate the exception
a. DM
b. Cardiac Surgery
c. Advanced Age
d. Pre op AFib
A
x
80
Q
- Regarding preop preparation of a pt with Cystic Fibrosis, please indicate the exception
a. Chest physio and positional drainage
b. Bronchodilation using B agonists
c. Decrease secretions with anticholinergics
d. Decrease viscosity of secretions with recombinant deoxyribonuclease
A
x
81
Q
- Which of the following has been associated with postoperative pain except
a. decreased total lung capacity
b. increased circulating catecholamines
c. increased coagulopathy
d. decreased gastric motility
A
x
82
Q
- Which of the following ECG changes is NOT seen in pulmonary hypertension?
a. biphasic p waves in V6
b. RBBB
c. p pulmonale (p wave greater than 2.5mm)
d. right axis deviation
A
x
83
Q
- A patient is having a one hour procedure on his forearm, and wants a regional anesthetic. Compared to an axillary block, an intravenous regional block will have all EXCEPT ONE of the following?
a. superior surgical conditions
b. equivalent risk of systemic local anesthetic toxicity
c. facilitation of post operative neurological assessment
d. higher success rate
A
x
84
Q
- What nerve originates from L2-L2, travels through groove between iliacus and psoas, gives articular branch to hip and supplies medial thigh?
a. saphenous
b. femoral
c. obturator
d. lateral femoral cutaneous
A
x
85
Q
- Max apnea from remifentanyl at (mins):
a. 1
b. 2
c. 5
d. 10
A
x
86
Q
- What is the most appropriate for an old patient with pain secondary to post herpetic neuralgia
a. Narcotics
b. TCA
c. local anaesthesia
d. steroids .
A
x
87
Q
- For a side stream capnography an erroneous high reading in the Et CO2 is secondary to a. very low sampling flow
b. very high sampling flow
c. inability to compensate for oxygen in the expiratory limb
d. Water condensation in the sampling line .
A
x
88
Q
- What is the terminal arrhythmia associated with hyperkalemia?
a. Prolonged QT
b. Ventricular fibrillation
c. Supraventricular tachycardia
d. Heart block
A
x
89
Q
- According to the 2004 CAS guidelines, anesthesia equipment is deemed required, exclusively available, or immediately available. Of the following, which is REQUIRED?
a. Temperature probe
b. Stethoscope
c. Capnography
A
x
90
Q
- All of the following EXCEPT ONE may be used for post operative nausea and vomiting:
a. Dexamethasone
b. Ketamine
c. Diphenhydramine
d. Ondansetron
A
x
91
Q
- All of the following EXCEPT ONE may be used as a weaning mode:
a. Pressure support ventilation
b. Pressure control ventilation
c. Synchronized intermittent mandatory ventilation
d. T piece
A
x
92
Q
- Amiodarone may be used for all of the following EXCEPT:
a. PSVT
b. Polymorphic VT
c. Rate control for atrial fibrillation and pre-excitation
d. Torsades de Pointes
A
x
93
Q
- Which of the following DOES NOT contribute to PaCO2 during insufflation of CO2 with pneumoperitoneum
a. Duration of inflation
b. Rate of inflation
c. Blood flow to the abdominal wall
d. Location of inflation (trochar?)
A
x