Canadian MCQs Flashcards
1
Q
Can10-01 Patient is brought to the hospital after smoke inhalation. The patient has a headache, dizziness, and is confused. What is the percentage of carboxyhemoglobin? A. 15% B. 25% C. 35% D. 45%
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2
Q
Can10-02 Regarding oxygenation and high altitude:
A. PaO2 can be increased by hyperventilation
B. The effect of H2O vapour pressure becomes LESS significant
C. Venturi Masks deliver LESS FiO2 than dialed
D. The O2 concentration required to maintain PaO2 becomes LESS
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3
Q
Can10-03 Which condition will change adult oxygen saturation curve to look like fetal saturation curve A. Increased temp. B. Metabolic alkalosis C. Increased 2,3 DPG D. Increased Hydrogen ion
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4
Q
Can10-04 Which of the following variables is required to calculate the physiologic dead space to tidal volume ratio?
A. mixed venous partial pressure of oxygen
B. Mixed venous partial pressure of carbon dioxide
C. End-tidal partial pressure of carbon dioxide
D. End-tidal partial pressure of oxygen
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5
Q
- Which is true regarding the respiratory system?
A. the first tracheal ring is just below the thyroid cartilage
B. the carina is at T7
C. the main bronchi have no cartilaginous support
D. the adult trachea is 15 cm long
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6
Q
- Transtracheal jet ventilation is contra-indicated in which one of the following?
A. aspiration of gastric content
B. spontaneous respiratory efforts
C. severe emphysema with chronic hypercarbia
D. complete upper air way obstruction
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7
Q
7. The Most common cause of hypoxia in the immediate post op. period is: A. Hypoventilation. B. Pulmonary edema C. Diffusion hypoxi:A. D. Atelectasis
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8
Q
8. Which of the following predicts postoperative acute respiratory failure in a patient with myasthenia gravis and a thymoma? A. Current daily steroid dose B. Size of thymoma C. Preoperative TLC D. Duration of myaesthenic symptoms
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9
Q
- Patient placed on volume assist controlled ventilation with TV 600 and frequency 16. If the patient’s own respiratory rate is 22, what will be the delivered tidal volume to the patient?
A. TV 600 for every breath
B. TV 600 for 16 breaths and the rest determined by patient effort
C. TV will vary based on the patient’s effort
D. TV will vary based on lung compliance
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10
Q
- Which one of the following values do you need to calculate the dead space ventilation?
A. mixed venous oxygen saturation
B. PaO2
C. mixed end-tidal carbon dioxide saturation
D. PaCO2
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11
Q
- Extubation criteria include all EXCEPT:
A. Tidal volume of > 10mL/kg
B. Respiratory rate less than 20.
C. Maximum inspiratory force more negative than 20cm water
D. Minute ventilation >20L/min
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12
Q
12. Which is the most important factor determining airway resistance? A. Density of the gas B. Viscosity of the gas C. Diameter of the airway D. Length of the bronchus
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13
Q
13. According to the A/AHA guidelines for cardiovascular testing for non-cardiac surgery, which of the following is considered a high risk surgery? A. CEA B. femoral-popliteal bypass C. left thoracotomy and lobectomy D. hemicolectomy
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14
Q
14. What is the best predictor of diastolic blood pressure? A. peripheral vascular resistance B. ventricular preload C. volume in the arterial system D. elasticity of the vessels
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15
Q
15. In a patient undergoing laparoscopy, CO2 is insufflated into the IV:C. What is the most likely consequence? A. Metabolic acidosis B. Increased dead space C. Increased end-tidal CO2 D. Paradoxical embolism
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16
Q
16. Which aortic surgery has the highest risk for post-operative paralysis due to spinal cord ischemia? A. repair of aortic coarctation B. thoracic aneurysm repair C. thoracoabdominal aneurysm D. thoracoabdominal dissection
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17
Q
17. What does the 'c' wave represent in a CVP tracing? A. atrial contraction B. tricuspid valve closure C. systolic filling of the atrium D. emptying of the atrium
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18
Q
- Regarding the transplanted heart?
A. resting ventricular function is depressed
B. cardiac output increases faster in response to exercise than a normal heart
C. lower heart rate at rest
D. Frank-Starling response is preserved
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19
Q
19. Which of the following combinations meets the standard for intra-operative monitoring of venous air embolism? A. Doppler and ETCO2 monitoring B. Doppler and ETN2 C. ECG and ETN2 D. ECG and CVP
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20
Q
- Which of the following most suggests a supraventricular tachycardia with aberrant conduction rather than a ventricular tachycardia??
A. Left bundle branch block
B. Absence of a P wave
C. Noncompensatory pause
D. Initial QRS deflection different from normal
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21
Q
21. Which of the following is not an indication of vertebrobasilar atheromatous disease A. Amaurosis fugax B. Postural hypotension C. Transient global ischemia D. Diplopia
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22
Q
- A patient develops new onset atrial fibrillation post-operatively. What should you do?
A. Everyone should get an Echo to rule out thromboembolism.
B. Amiodarone should be used for a patient with structural cardiac diseas:E.
C. No cardioversion if it’s a new onset WITHIN the last 48 hours.
D. If patient becomes hemodynamically unstable, proceed with pharmacological cardioversion.
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23
Q
23. In QT prolongation which is the best induction agent because of its ability to shorten QT interval: A. Ketamine B. Thiopentone C. Propofol D. Sevoflurane
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24
Q
24. Which point on CVP tracing corresponds to tricuspid closure in sinus rhythm? A. C wave B. V wave C. X descent D. Y descent
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25
Q
- Patient with cardiac tamponad:E. Which is true:
A. Decreased pressure gradient across the aortic valve
B. Increase in LVEDV
C. Increase in systolic BP with inhalation
D. Bradycardia
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26
Q
26. Calculation of mixed venous oxygen saturation requires all except A. Arterial oxygen saturation B. Hemoglobin C. Cardiac output D. Arterial partial oxygen pressure
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27
Q
- Most likely cause of post CEA hypertension all except for:
A. Hyperstimulation of the carotid bodies
B. Surgical denervation of carotid sinus baroreceptors
C. Hypercarbia
D. Bladder pain
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28
Q
28. All to the following are risk factors for postoperative Atrial Fibrillation except: A. DM B. Cardiac surgery C. Advanced age D. Preoperative AF
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29
Q
29. All of the following are associated with inaccuracy of the cardiac output measurement using the thermodilution technique except: A. ASD B. VSD C. Pulmonary Regurgitation D. Aortic Regurgitation
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30
Q
30. All of the following are associated with an increased risk of pulmonary artery rupture with a PA catheter except: A. Intraoperative hypothermia B. Anticoagulation C. Heparin bonded catheters D. Advanced age
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31
Q
- Regarding ECG monitoring in MRI, all are true except:
A. Poor adhesion of electrodes
B. Thermal injury from cable wires
C. ST and T wave changes from aortic flow in magnet
D. Baseline artifacts for rapidly changing magnetic field
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32
Q
32. What is the most common cause of blindness post CPB? A. corneal abrasion B. retinal artery emboli C. cerebral hypoperfusion D. occipital lobe emboli
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33
Q
- A patient has an ICD with rate adaptive pacemaker functions. What should be done intraoperatively?
A. place external defibrillator pads before deactivating the device
B. a magnet will revert the device to asynchronous mode
C. there is no need to alter the defibrillator settings
D. only unipolar electrocautery should be used intraoperatively
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34
Q
34. What is the most common cause of cardiac arrest attributable to anesthesia? A. drug error B. airway mismanagement C. circuit disconnect D. aspiration
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35
Q
35. What is true about the central aortic pressure versus peripheral arterial pressure? A. Systolic lower B. Diastolic lower C. Delayed upstroke D. delayed dicrotic notch
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36
Q
36. Which of the following POSSIBLY limits myocardial damage after ischemia/reperfusion injury? A. Thiopental B. Fentanyl C. Midazolam D. Isoflurane
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37
Q
- All of the following are true regarding Type 1 2nd degree Mobitz block EXCEPT:
A. Atrial rate > ventricular rate
B. QRS interval unchanged
C. regular rate of QRS complexes
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38
Q
- WPW EF
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39
Q
39. When measuring LV preload with a PAC, all of the following distort PCWP EXCEPT A. PAC tip in West Lung Zone III B. Decreased LV compliance C. Aortic Regurgitation D. Mitral Stenosis
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40
Q
40. What is the effect of Milrinone? A. increased PVR B. increased curve of LV end systolic pressure C. increased MVO2 D. decreased dP/dT
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41
Q
41. A patient is in V fi:B. What is the most important factor regarding success of the 1st shock? A. length of time in VF B. placement of paddles C. interference (gel/ pads) D. patient weight
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42
Q
42. Which of the following herbal medications causes withdrawal after long term use? A. valarian B. ephedra C. garlic D. st johns wort
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43
Q
43. Which of the following decreases LES tone? A. Atropine B. Neostigmine C. Succinylcholine D. Metoclopramide
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44
Q
44. Which pretreatment has the best success at treating myalgias after succinylcholine? A. lidocaine B. morphine C. rocuronium D. NSAID
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45
Q
45. Which will accumulate the least in a patient with renal failure? A. morphine B. hydromorphone C. fentanyl D. oxycodone
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46
Q
46. Which is not seen with organophosphate poisoning? A. Tachycardia followed by heart block B. Fasciculations C. Mydriasis D. Salivation
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47
Q
47. Which of the following will antagonize the reversal of neuromuscular blockade by neostigmine? A. metabolic alkalosis B. hyperkalemia C. respiratory acidosis D. hyperthermia
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48
Q
48. Which of the following receptors does ketamine exert the LEAST amount of action on? A. GABA B. NMDA C. opioid D. monoamine
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49
Q
- Comparing LMWH to UFH:
A. Shorter T1/2
B. No risk of HIT
C. Greater predictability with protamine neutralization
D. More consistent absorption following subcutaneous injection
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50
Q
50. The context-sensitive half time is longest for which of following, if the total duration of infusion is of less than 2 hours. A. Alfentanil B. Sufentanil C. Remifentanil D. Fentanyl
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51
Q
51. The volume of gas that will dissolve in a liquid at equilibrium is independent of which one of the following: A. Temperature of the liquid. B. Partial pressure of the gas C. Critical temperature of the gas. D. Ambient temperature.
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52
Q
- Pt receives IV unfractionated heparin for anticoagulation prior to CPB, followed by mild drop in MAP. Most likely reason:
A. Calcium chelation
B. Histamine release
C. Relaxant effect on vascular smooth muscle
D. ?
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53
Q
- A patient is on methadone 50mg tid for abdominal pain secondary to Crohn’s. What is true regarding post-operative pain management:
A. No PCA should be offered for fear of respiratory depression
B. No PCA should be offered as it will contribute to opioid addiction.
C. If regional anesthesia is utilized, opioids should be continued to avoid withdrawal
D. Substitution of methadone with other opioids will not avoid withdrawal
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54
Q
54. A healthy patient is given 100mg of lidocain:E. How long will it take for 90% to be eliminated? A. 1.5h B. 3.0h C. 4.5h D. 6.0h
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55
Q
55. What would increase the plasma potassium? A. epinephrine B. furosemide C. captopril D. salbutamol
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56
Q
56. What class of anesthetic agents is most likely to cause an allergic reaction? A. antiemetics B. opioids C. neuromuscular blockers D. induction agents
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57
Q
57. Which of the following correlate best with potency of inhaled anesthetics? A. Fluoride side chain B. Vapor pressure at 20 degrees C. Oil gas solubility coefficient D. Molecular weight
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58
Q
58. Which of these drugs is least protein bound? A. Morphine B. Fentanyl C. Alfentanil D. Remifentanil
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59
Q
59. Which is indicated in the treatment of cyanide toxicity? A. nitric oxide B. sodium bicarbonate C. sodium nitrate D. thiosulfate
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60
Q
60. Pt has taken an overdose of Amitriptylin:E. Initial blood level was 1000 ng/ml. After 96 hours the blood level has fallen to 63 ng/ml. What is the half life of Amitriptyline? A. 20 hrs B. 24 hrs C. 30 hrs D. 36 hrs
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61
Q
61. Which of the following is MOST commonly associated with clinically significant respiratory depression with PCA? A. Background Infusion B. Highly potent opioid C. pre-existing lung disease D. Programming error
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62
Q
62. All of these are inhibitory neurotransmitters EXCEPT? A. L-glutamate B. Epinephrine C. Enkephalins D. GABA
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63
Q
63. All of the following have an effect on potassium, except: A. epinephrine B. insulin C. serotonin D. aldosterone
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64
Q
- Protamine is associated with all of the following, except:
A. fish allergy
B. vasectomy
C. decrease in SVR and hypotension
D. increase in PVR and right heart failure
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65
Q
65. All of the following medications cause an immune mediated hypersensitivity reaction; EXCEPT FOR: A. Penicillin B. Bacitracin C. Cefazolin D. Vancomycin
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66
Q
66. All are adverse effects of intravenous morphine except: A. pruritis B. nausea and vomiting C. hypotension D. urinary retention
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67
Q
67. Which is least effective for post operative nausea and vomiting? A. Dexamethasone B. Metoclopramide C. Diphenhydramine D. Ondansetron
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68
Q
- All of the following are characteristics of Flumazenil except:
A. Low protein binding
B. Rapid onset
C. Short elimination half life
D. Clinically significant intrinsic activity
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69
Q
- Which is true about the duration of action of remifentanil?
A. increased duration with chronic renal failure
B. Increased duration with pseudocholinesterase deficiency
C. Increased duration with liver failure
D. The context sensitive half life is constant despite the duration of infusion
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70
Q
70. Which is consistent with carcinoid syndrome? A. bronchodilation B. peripheral vasoconstriction C. mitral valve disease D. hepatic metastases
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71
Q
71. In a patient with normal renal function, which of the following analgesics is least likely to cause ESRD with chronic use? A. Celecoxib B. acetaminophen C. ibuprofen D. ASA
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72
Q
72. Which of the following is most likely to cause a non anion gap metabolic acidosis? A. Salicylates B. HCl C. Paraldehyde D. Ethylene glycol
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73
Q
73. Which of the following is mostly likely to cause CRPS Type II (causalgia)? A. gun shot wound B. crush injury C. fracture D. ??
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74
Q
74. In the pre-operative clinic you suspect a patient has myxedem:A. All support this except: A. carpel tunnel syndrome B. somnolence C. Clubbing of digits D. OSA
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75
Q
- Diabetes insipidus post transphenoidal resection of pituitary tumour, which of the following is true?
A. due to trauma to the anterior pituitary
B. usually transient
C. usually occurs between 24-48 hours post op
D. treated with chlorpropamide
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76
Q
- Blood stored in CPDA at 4 :C. Which is true?
A. Erythrocyte pH decreases due to lactate accumulation
B. Erythrocyte potassium increases due to dysfunction of Na/K pump
C. Erythrocyte degradation in storage is similar to normal aging
D. 2,3 DPG levels stay stable for 3-4 weeks
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77
Q
77. Which of the following electrolyte disturbances is associated with the uremic syndrome? A. Hypermagnesemia B. Hypokalemia C. Hypernatremia D. Hypophosphatemia
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78
Q
78. GA may mask signs of immediate hemolytic transfusion reactions. All of the following are signs to watch for EXCEPT: A. hypotension B. diffuse bleeding C. haemoglobinuria D. fever
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79
Q
79. All of the following are clinical manifestations of sarcoidosis, EXCEPT ONE. Identify the exception. A. Pulmonary hypertension B. Hilar lymphadenopathy C. Hypocalcaemia D. Cardiomyopathy
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80
Q
80. All of the following reduce the allogeneic blood transfusion EXCEPT A. Preoperative Autologous Donation B. Acute Normovolaemic Haemodilution C. Erythropoietin D. Antifibrinolytic
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81
Q
81. 4 METs is equivalent to: A. Walk indoor B. Walk 2 block at 4km/hr C. Plays tennis D. Climb one flight of stairs
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82
Q
82. In a patient who is heterozygous for atypical pseudocholinesterase deficiency, the dibucaine number is expected to be? A. 80-100 B. 60-80 C. 50-60 D. 20-30
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83
Q
- Regarding a needle stick injury from a Hepatitis C positive patient, it is considered less hazardous because:
A. The chronic carrier state associated with Hepatitis C infection is
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84
Q
84. Clinician scientist is testing a new drug XYZ. After testing the drug on 2 groups of 3 people each, she finds no difference between XYZ and placebo. Subsequently a definitive study of 4000 patients is conducted and that study is stopped early because of the beneficial effect of XYZ. The first study which showed no effect when there was indeed a true beneficial effect to XYZ shows an example of what type of error? A. Alpha error B. Beta error C. Critical value error D. Effect size error
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85
Q
85. Which best describes the dispersion of data that follows a normal distribution: A. Confidence interval B. Standard deviation C. Median D. Standard error of mean
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86
Q
86. The O2 sat quality is not decreased by: A. Hypotension B. Vasoconstriction C. Anemia D. Hyperthermia
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87
Q
87. Spo2 is altered persistently by: A. Methemoglobin B. Carboxyhemoglobin C. Methylene blue D. Hemoglobin F
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88
Q
- In addition to increasing arterial oxygen tensions, hyperbaric has following advantages
A. decreases endothelial neutrophil adhesion in damaged tissue
B. enhances antibacterial action against anaerobes
C. causes vasoconstriction
D. changes gas volume proportional to pressure
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89
Q
89. A patient receiving an anesthetic with Desflurane develops carbon monoxide toxicity. The most likely day of the week is: A. Monday B. Tuesday C. Thursday D. Saturday
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90
Q
90. CAS guidelines: the following should be exclusively available for each pt, not necessarily in continuous us:E. Choose the exception: A. Capnograph B. Spirometry C. Temp monitoring D. Non invasive BP monitoring
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91
Q
91. Post-operative pain contributes to all except for: A. Decreased total lung capacity B. Decreased gastric mobility C. Hypocoagulopathy D. Increased circulating catecholamines
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92
Q
92. Aldrete score includes all except for: A. Activity B. Oxygenation C. Pain. D. Consciousness
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93
Q
93. All of the following are early signs of malignant hyperthermia A. Increased EtCO2 B. Increased temperature C. Tachycardia D. Muscle rigidity
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94
Q
94. Regarding MAC vs. GA for outpatient anesthesia, all are true except A. Less time in OR B. Lower mortality C. Less post-op pain D. Lower cost
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95
Q
- All of the following are true regarding admissions to hospital following ambulatory surgery except one. Indicate the exception:
A. occurs
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96
Q
96. Ambulatory surgery / anesthesia decreases all of the following EXCEPT. A. Patient satisfaction B. Cost of preoperative work up C. Post –Op respiratory complication D. ?
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97
Q
97. In Ambulatory surgery, a patient with an URTI is at risk for all EXCEPT FOR A. laryngospasm B. arterial desaturation C. bronchospasm D. aspiration
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98
Q
- A patient is in the lateral decubitus position with a BP cuff and an arterial line in the dependent arm. The transducer is correctly placed at the level of the right atrium.
A. As read by the arterial line, the supine blood pressure will be equal to the lateral decubitus BP
B. As read by the arterial line, the supine blood pressure will be lower than the lateral decubitus BP
C. As read by the BP cuff, the supine blood pressure will be equal to the lateral decubitus BP
D. As read by the BP cuff, the supine blood pressure will be lower than to lateral decubitus BP
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99
Q
99. Which of the following has opposing effects on CBF and CMRO2? A. Etomidate B. Ketamine C. Sevoflurane D. N2O
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100
Q
- You are performing neurosurgery in a patient with increased ICP and a “tight brain”, what would you do to decrease ICP?
A. increase MAC from 1 to 2
B. change inhalational anesthetic to TIVA
C. increase N2O
D. change from sevoflurane to desflurane
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101
Q
101. Which one of these acts on all components of the intracranial space to decrease ICP? A. remifentanil B. mannitol C. furosemide D. dexamethasone
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102
Q
102. Which one increases CMR02? A. Ketamine B. Propofol C. Thiopental D. Benzodiazepines
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103
Q
103. Which is the most likely abnormality to occur in a pediatric patient that undergoes massive transfusion? A. hyperkalemia B. pulmonary fibrotic deposits C. increased 2,3 DPG D. hypocalcemia
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104
Q
104. Infant is born blue, limp, HR 60, no reaction to tracheal suction, and irregular respiratory effort. Calculate Apgar score? A. 1 B. 2 C. 3 D. 6
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105
Q
- Regarding the pharmacology of local anesthetics, what is TRUE when comparing neonates to adults?
A. Increased Alpha-1 acid glycoprotein protects against amide anesthetic toxicity
B. ?
C. Greater susceptibility to methemoglobinemia
D. Requires greater minimum anesthetic concentration to block nerve fibers
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106
Q
106. What is the estimated blood volume of a healthy TERM 3.5kg neonate?? A. 85ml B. 200 ml C. 300 ml D. 400 ml
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107
Q
- There once were 2 preterm babies. One was born at 28 weeks and the other at 32 weeks. These babies are now 45 weeks post-conceptual age and both need surgery. Which statement is true?
A. They both have the same risk of postoperative apnea
B. If using a regional anesthetic, they will not need to be monitored for apneas
C. They should both have some caffeine
D. They should both have postoperative apnea monitoring
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108
Q
108. In a labour epidural all would suggest subdural injection except: A. hypotension B. higher than expected sensory block C. motor block D. negative aspiration for CSF
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109
Q
109. In a healthy pregnancy at 28 weeks normal cardiovascular changes include all except. A. increased HR B. increased CO C. decreased SVR D. decreased CVP
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110
Q
110. For a labouring woman, gastric emptying is most delayed with which form of pain management? A. Nitrous oxide B. IV PCA opioid C. Epidural with LA only D. Epidural with LA and opioid
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111
Q
111. All of the following are normal respiratory changes in pregnancy except? A. Increased pH B. Increased PaO2 C. Increased PaCO2 D. Decreased HCO3
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112
Q
- A term pregnant patient receives thiopentone bolus 4mg/kg for induction of GA. The reason the fetal brain levels remain low for all of the following reasons except one. Indicate the exception:
A. Metabolism of thiopentone by the fetal liver.
B. Dilution of thiopentone in the fetal blood volume
C. Placental metabolism of thiopentone
D. Inconsistencies in intervillous exchange surfaces at the placenta
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113
Q
113. All EXCEPT ONE of the following are risk factors for post partum hemorrhage. Indicate the exception A. preeclampsia B. macrosomia C. prolonged labor D. stimulated labor
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114
Q
- What is the anatomic location of the celiac plexus?
A. anterior to the body of L1
B. lateral to adrenals and kidneys
C. surrounding the IVC
D. posterior to the crus of the diaphragm
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115
Q
115. A patient presents with a herniated disc complaining of pain in the left buttock and posterior thigh, numbness on the left lateral malleolus and on exam has decreased left Achilles reflex. What level is the herniation? A. L2-L3 B. L3-L4 C. L4-L5 D. L5-S1
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116
Q
116. Name the most common complication of thoracic paravertebral block A. Pneumothroax B. IV injection C. Subarachnoid injection D. Epidural injection
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117
Q
- A patient is undergoing forearm surgery under axillary nerve block. What would indicate a failure of proximal spread within the axillary sheath??
A. Preserved sensation in the 5th and medial 4th digits
B. Preserved sensation of the lateral forearm
C. Preserved sensation of the medial forearm
D. Preserved sensation of the palmar surface of the hand excluding the medial 4th and 5th digits
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118
Q
- Advantages of RA vs. GA for TURP include:
A. Less post-operative confusion
B. Lower DVT risk
C. Less blood loss
D. Earlier recognition of electrolyte changes
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119
Q
- A patient develops a nerve injury post-operatively after a long surgery in the lithotomy position. What would you most likely see a loss of?
A. dorsi flexion
B. plantar flexion
C. inversion
D. sensation to the lateral aspect of the foot
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120
Q
120. While performing a popliteal block, how do you know that you are stimulating the common peroneal nerve? A. dorsiflexion B. plantarflexion C. inversion D. ?
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121
Q
121. The anterior divisions of which trunks of the brachial plexus form the lateral cord? A. Superior and inferior B. Superior, middle, and inferior C. Superior and middle D. Inferior
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122
Q
122. A patient is having surgery on the distal phalanx of his fifth digit. Which of the following regional techniques is the LEAST appropriate? A. Infraclavicular B. Digital C. Interscalene D. Axillary
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123
Q
123. What is the correct motor response to stimulation of the nerve? A. Radial nerve – pronation B. Ulnar nerve - finger extension C. Median nerve - wrist extension D. Musculocutaneous - elbow flexion
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124
Q
124. Which is the most important factor in determining the height of a spinal block? A. patient height B. volume of local C. concentration of local D. baricity of local
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125
Q
- With respect to the neurologic exam following brachial plexus block, which is correct?
A. Musculocutaneous nerve causes elbow flexion
B. Pronation is ulnar nerve
C. Supination is median nerve
D. ?
A
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126
Q
- All are advantages of spinal over general anesthesia for ambulatory surgery EXCEPT.
A. Superior analgesia in the early post-operative period.
B. Decreased stay in PACU.
C. Increased incidence of low back pain.
D. Decreased incidence of post-operative nausea and vomiting
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127
Q
127. All of EXCEPT ONE of the following is seen following stellate ganglion block. Indicate the exception A. mydriasis B. facial anhydrosis C. enopthalmos D. nasal congestion
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128
Q
128. All EXCEPT ONE are complications of a peribulbar block seen within the first 15 minutes. Indicate the exception A. occulocardiac reflex B. myotoxicity C. retrobulbar hemorrhage D. central nervous system (CNS) toxicity
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129
Q
129. Which is least significant indicator of a serious chest injury? A. Rib 7 and 8 fractures B. flail chest C. Widened mediastinum D. Massive hemothorax
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130
Q
- All of the following decrease the risk of ventilator associated pneumonia except:
A. Head of the bed elevated to 30 degrees
B. Increased gastric pH
C. Sucralfate
D. Frequent glottic suctioning
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131
Q
131. Neuroleptic Malignant syndrome includes aall except: A. Diaphoresis B. Rigidity C. HTN D. Urinary retention
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132
Q
132. A patient in ICU remains hyperglycemic despite being on a high insulin infusion. Which drug could be the cause for this: A. Midazolam B. Epinephrine C. Fentanyl D. ?
A
?
133
Q
133. A patient is in the emergency department and is no codes in chart. Which is not appropriate? A. go ahead and resuscitate B. negotiate with patient C. defer care to a colleague D. temporary removal of no codes status
A
?
134
Q
- Regarding pain transmission to the dorsal columns of the spinal cord, which of the following is true?
A. A-delta fibres conduct impulses which account for slow, or burning, pain
B. C fibres conduct impulses accounting for fast, or highly-localized, pain
C. Both A-delta and C fibres are part of neurons located outside the spinal cord and release a variety of neurotransmitters
D. The inflammatory component of pain is completely central
A
?
135
Q
- All are part of the ascending pain tract, except:
A. ventral posterior lateral thalamic nucleus
B. lateral cervical nucleus
C. postganglionic sympathetic fibers
D. dorsolateral funiculus
A
?
136
Q
Can09-01 What are the parameters are needed to calculate the SVR: A. MAP, CVP, CO B. PAP, PCWP, CO C. PCWP, MAP, CO D. ?
A
/
137
Q
Can09-02 Physical findings in tamponade include all except: A. Holosystolic murmur B. Electrical alternans C. Pulsus paradoxus D. Elevated JVP
A
/
138
Q
Can09-03 All of the following are indicated in managing/investigating an aortic dissection initially except A. ECG B. CT C. TEE D. dipyridamole-thallium scan
A
/
139
Q
Can09-04 Which of the following is associated with torsades de pointes? A. hypercalcemia B. hyperkalemia C. hypomagnesemia D. short QT syndrome
A
/
140
Q
- Regarding postoperative morbidity after carotid endarterectomy, all of the following are true, EXCEPT:
A. postoperative mortality is 3-5%
B. postoperative hypertension increases the incidence of perioperative stroke
C. the most common cause of perioperative morbidity is myocardial infarction
D. patients who are asymptomatic preoperatively are at highest risk of perioperative stroke.
A
/
141
Q
6. ST segment abnormalities may hinder the diagnosis of Myocardial Ischemia in all EXCEPT ONE of the following conditions: A. digoxin administration B. LBBB C. LVH with Strain D. Hyperkalemia
A
/
142
Q
7. Hypercarbia in a healthy patient causes an increase in all of the following, EXCEPT: A. SVR B. MAP C. Cardiac output D. Myocardial contractility
A
/
143
Q
8. Which is not an indicator of perioperative ischemia? Indicate the exception: A. flattened T waves B. ST depression downsloping, 1mm C. ST depression upsloping 2mm D. ST elevation in non Q lead
A
/
144
Q
9. Effect of ACE-I in heart failure A. ? B. something resistance C. lower cardiac index D. lower stroke work index
A
/
145
Q
10. You are presented with a patient with severe thoracic injury, as part of your primary survey you must diagnose and manage which life threatening condition: A. myocardial contusion B. aortic injury C. tension pneumothorax D. tracheobronchial disruption
A
/
146
Q
- An opioid addicted mother has received fentanyl during labor to prevent withdrawal. How should the apneic neonate be treated?
A. Stimulation and bag-mask ventilation
B. Ventilation with bag-mask and naloxone
C. Endotracheal intubation, controlled ventilation and naloxone
D. Endotracheal intubation, controlled ventilation and avoidance of naloxone.
A
/
147
Q
12. During neonatal resuscitation, after 30 seconds of bag mask ventilation and 30 seconds of chest compressions, the fetal hear rate remains less than 60. Which of the following meds would be appropriate? A. Atropine 0.01 mg/kg B. Nalaxone 0.1 mg/kg C. Epinephrine 0.01mg/kg D. Dopamine 5ug/kg
A
/
148
Q
13. You induce GA in a 56 yo male with a bowel obstruction. He aspirates particulate matter. After intubating and ventilating with 100% oxygen, what should be your next step? A. start antibiotics B. bronchoscopy C. give dexamethasone D. provide 10cm H2O peep
A
/
149
Q
- What is seen in a patient suffering from severe sepsis.
A. decreased antithrombin III
B. increased activated protein C
C. decreased plasminogen activator inhibitor-1
D. increased thrombomodulin
A
/
150
Q
- In the diagnosis of brain death, motor responses to the following stimuli are absent in all except:
A. Painful stimulus in sensory distribution of cranial nerves
B. Corneal reflex
C. Tracheal suctioning
D. Painful stimulus in lower limb
A
/
151
Q
16. 25 min after starting a laparoscopic appendectomy suddenly the BP, ETCO2, and SaO2 all drop. The airway pressure remains normal. what is the most likely? A. endobronchial intubation B. subcutaneous emphysema C. pneumothorax D. CO2 embolism
A
/
152
Q
17. Pralidoxime is given in organophosphate toxicity to antagonize: A. Muscarinic stimulation B. Nicotinic stimulation C. central sympatholysis D. Peripheral ganglion blockade
A
/
153
Q
18. Which is not an indication for dialysis A. Hyperkalemia B. Primary metabolic acidosis C. Uremic encephalopathy D. Hyperphosphatemia
A
/
154
Q
- All of the following decrease CVL infection except?
A. Wear a sterile gown during placement
B. Chlorhexidine instead of iodine skin prep
C. Antibiotic coated catheter
D. Change the catheter every 5 to 7 days routinely
A
/
155
Q
20. What is the initial treatment of hyperkalemic cardiotoxicity: A. sodium bicarbonate. B. Insuline&Glucose. C. Calcium. D. Furosemide.
A
/
156
Q
- All EXCEPT ONE of the following are appropriate management principles for acute cervical spine injury:
A. maintain cervical spine in traction
B. maintain normal blood pressure
C. hypothermia to a temperature
A
/
157
Q
22. Regarding ventilation in ARDS with VT = 10-12 ml/kg versus VT = 8 ml/kg, all EXCEPT ONE of the following is true: A. higher peak airway pressures B. increased mortality C. increased need for PEEP D. increased PaO2 to FiO2 ratio
A
/
158
Q
- All EXCEPT ONE of the following are appropriate modes for weaning of ventilatory support. Indicate the exception.
A. pressure control ventilation
B. pressure support ventilation
C. T piece
D. synchronized intermittent mandatory ventilation
A
/
159
Q
- After measuring the pulmonary arterial wedge pressure in a heparinized patient, there is brisk bleeding from the right lung. All except one are adequate management options. Indicate the exception.
A. insert a right bronchial blocker
B. apply continuous suction to the right lung
C. administer protamine
D. withdraw the pulmonary artery catheter
A
/
160
Q
25. Which of the following is NOT evaluated with the low pressure leak test? A. flow tubes B. vaporizer caps C. oxygen check valve D. O-rings
A
/
161
Q
26. Compared to cerebral salt wasting which is indicative of SIADH A. hypotension B. hypervolemia C. hypokalemia D. increased urine Na osmolarity
A
/
162
Q
27. In LV ischemia all for the follwing except one are present when using a PA catheter A. Tall V wave B. decreased wedge pressure C. ? D. tall A wave
A
/
163
Q
- For a side stream capnography an erroneous high reading in the EtCO2 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
/
164
Q
- What is TRUE regarding the CVP tracing?
A. A wave corresponds to atrial filling
B. X descent corresponds to RV systole
C. V wave corresponds with RV relaxation
D. Y descent corresponds to closure of tricuspid valve
A
/
165
Q
30. Which is the most sensitive in detecting a venous air embolism? A. ETN2 B. precordial Doppler C. TEE D. ETCO2
A
/
166
Q
31. You are transporting a patient by ambulance. The patient requires 4l/min O2. You are taking along a full O2 E tank. The trip takes 2 hours. At the end of the trip, how much O2 is left in the tank? A. 60 L B. 180 L C. 360 L D. 400 L
A
/
167
Q
- All increase accuracy of ECG monitoring except:
A. Scratching skin surface before electrode placement
B. Placement over muscle surface
C. Use of a high frequency filter
D. Use of low frequency filter
A
/
168
Q
- Concerning dead space of circle circuit, which statement is true:
A. It consists of the inspiratory limb
B. It is increased when the Y-piece has a septum
C. It consists of the Y-piece and the patient connector
D. it consists of the expiratory and inspiratory lim:B.
A
/
169
Q
34. CAS guidelines for scavenging in OR, can use: A. N2O B. CO2 C. Halogenated hydrocarbons D. Chlorofluorocarbons
A
/
170
Q
35. Filter for detecting ST segment changes on the ECG: A. low frequency 0.05 Hz B. Low frequency 0.5 Hz C. High frequency 60 Hz D. High frequency 100 Hz
A
/
171
Q
- All EXCEPT ONE of the following conditions will cause underestimation of the true blood pressure. Indicate the exception:
A. invasive pressure transducer positioned 10 cm above the right atrium
B. inappropriately large-sized cuff
C. bubbles in the intra-arterial pressure monitoring line
D. low damping coefficient
A
/
172
Q
- With regards to timing of the intra-aortic balloon pump, all of the following EXCEPT ONE is true. Indicate the exception:
A. inflation of the balloon should be timed to coincide with aortic valve closure
B. premature deflation limits the amount of afterload reduction
C. delayed inflation limits the augmentation of coronary perfusion
D. percutaneous insertion decreases the risk of vascular complications
A
/
173
Q
38. Degradation of sevoflurane to compound A is enhanced by all except: A. low fresh gas flow B. warm CO2 absorbent C. dry CO2 absorbent D. bain circuit
A
/
174
Q
39. All of the following except one put a patient with cirrhosis at higher risk during surgery A. increase billirubin B. decrease albumin C. elevated serum transaminases D. ascities
A
/
175
Q
40. Hepatorenal syndrome is often precipitated in end-stage liver disease by all the following except: A. hepatic encephalopathy B. bleeding from esophageal varices C. spontaneous bacterial peritonitis D. development of ascites
A
/
176
Q
41. All of the following are seen in Obese patients except: A. Cirrhosis B. Nephrotic Syndrome C. DVT D. increase body width
A
/
177
Q
42. What will worsen multiple sclerosis perioperatively? A. hypoxemia B. hypercarbia C. hyperthermia D. hypotension
A
/
178
Q
43. What drug should be avoided in porphyria? A. Atropine B. Isoflurane C. Succinylcholine D. Thiopental
A
/
179
Q
- All are appropriate preoperative optimization techniques in Cystic fibrosis except
A. Chest physiotherapy with postural drainage
B. bronchodilation with inhaled β2 agonists
C. decreasing secretions with anticholinergics
D. decreasing viscosity of secretions with recombinant deoxyribonuclease
A
/
180
Q
45. Atlanto-axial (C1-2. instability is assoc'd with: A. Scleroderma B. Achondroplasia C. Osteoarthritis D. Mucopolysaccharidosis
A
/
181
Q
- Diabetic patient, how to best predict autonomic neuropathy:
A. Peripheral neuropathy
B. Increased HR to response to valsalva manuever
C. Orthostatic hypotension
D. coronary artery disease
A
/
182
Q
47. Cocaine induced coronary vasospasm may be treated with which of the following? A. Metoprolol B. Phentolamine C. Hydralazine D. Midazolam
A
/
183
Q
48. Hypomagnesia is associated with all of the following cardiovascular complications EXCEPT: A. second degree heart block B. nodal tachydyrthmias C. enhancement of digoxin toxicity D. premature atrial beats
A
/
184
Q
- Failure to do all EXCEPT ONE of the following forms the basis for litigation arising from cases of death due to malignant hyperthermia:
A. obtain a thorough family anesthetic history
B. have an adequate supply of dantrolene
C. have a protocol for the management of malignant hyperthermia
D. investigate unexplained postoperative fevers
A
/
185
Q
50. All of the following diseases are associated with a life threatening increase in potassium with the use of Sux EXCEPT one. Name the exception. A. Duchenne Muscular Dystrophy B. Pregressive Neuromuscular Disease C. Cerebral Palsy D. Rhabdomyolysis
A
/
186
Q
51. Patient is on Zidovudine, what side effect would you expect to see? A. skin rash B. hyperglycemia C. pancreatitis D. neuropathy
A
/
187
Q
52. All are potential complications of shoulder arthroscopy in the beach chair position EXCEPT: A. Pneumothorax B. venous air embolism C. brachial plexus injury D. airway obstruction
A
/
188
Q
- In which circumstance would the use of a placebo in a study protocol be ethically justified?
A. Experts agree on a standard therapy
B. Standard therapy is better than placebo
C. Standard therapy is cheap and safe
D. Standard therapy does not exist
A
/
189
Q
54. In laparoscopic surgery, which is not related to PaCO2 levels in patient A. site of insufflation B. rate of insufflation C. duration of insufflation D. perfusion to body cavity wall
A
/
190
Q
- Proper safety regulations during intratracheal laser surgery include:
A. Maintain a minimum inspired oxygen of 0.3 to 0.4.
B. Use an endotrachial tube with a cuff made of PV:C.
C. Maintain a minimum inspired N2O concentration of 0.5
D. Filling the endotracheal tube cuff with nitrogen.
A
/
191
Q
56. All will decrease plasma potassium concentration in hyperkalemia except: A. Kayexcelate B. Epinephrine C. Na Bicarbonate D. Ca Chloride
A
/
