Cardiothoracic Anaesthesia (Textbook) MCQs

Question 1

A peanut lodged in a child’s main bronchus commonly shows:

a) pneumonia
b) lung collapse
c) haemoptysis
d) chronic cough
e) emphysema.

Answer 1

a) pneumonia
b) lung collapse
d) chronic cough

Question 2

Six hours after thoracotomy for oesophageal resection:

a) vital capacity is reduced
b) FRC is reduced
c) peak expiratory flow is reduced
d) venous admixture is reduced
e) PaO2 on air is reduced

Answer 2

a) vital capacity is reduced
b) FRC is reduced
c) peak expiratory flow is reduced
e) PaO2 on air is reduced

Question 3

Goldman Cardiac Risk criteria include:

a) previous cardiac surgery
b) mitral valve disease
c) hypertension
d) atrial fibrillation
e) previous myocardial infarction

Answer 3

d) atrial fibrillation
e) previous myocardial infarction

Question 4

During one-lung anaesthesia the Pa
O2 is influenced by:

a) the amount of blood flow in the upper lung
b) the cardiac output
c) the mixed venous oxygen concentration
d) the haematocrit
e) the FiO2

Answer 4

ALL answers are correct!

Question 5

In one-lung ventilation, hypoxic vasoconstriction is enhanced by:

a) volatile agents
b) intravenous anaesthetics
c) sodium nitroprusside
d) administering oxygen to the non-dependent lung
e) metabolic alkalosis.

Answer 5

NONE of the answers are correct!

Question 6

In the normal pulmonary vascular bed:

a) the mean pulmonary arterial pressure is half the mean aortic pressure

b) the pulmonary vascular resistance is lower than the systemic vascular resistance

c) there is always 50% of the blood volume

d) the pulmonary capillary wedge pressure equals capillary pressure

e) hypoxia causes dilatation of blood vessels

Answer 6

b) the pulmonary vascular resistance is lower than the systemic vascular resistance

d) the pulmonary capillary wedge pressure equals capillary pressure

Question 7

Physiological right-to-left shunt (venous admixture) is:

a) partly flow from bronchial veins into pulmonary veins
b) partly from Thebesian veins
c) 20% of total pulmonary blood flow
d) mainly through giant subpleural capillaries
e) increased during general anaesthesia.

Answer 7

a) partly flow from bronchial veins into pulmonary veins

b) partly from Thebesian veins
e) increased during general anaesthesia.

Question 8

Lung compliance is increased in:

a) the presence of intra-alveolar fluid
b) ARDS
c) idiopathic pulmonary fibrosis
d) emphysema
e) fibrosing alveolitis.

Answer 8

d) emphysema

Question 9

Ventricular arrhythmias are more common in the presence of:

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

Answer 9

ALL answers are correct!

Question 10

During one-lung anaesthesia the following influence the arterial PO2:

a) haemoglobin concentration
b) airway pressure
c) the degree of perfusion of the non-ventilated lung
d) inspired oxygen concentration
e) blood pressure.

Answer 10

b) airway pressure
c) the degree of perfusion of the non-ventilated lung
d) inspired oxygen concentration
e) blood pressure.

Question 11

Pulmonary stenosis as an isolated finding is associated with:

a) central cyanosis
b) a large ‘a’ wave in the CVP waveform
c) a loud P2
d) a systolic murmur at the left sternal edge with a thrill
e) a parasternal heave

Answer 11

b) a large ‘a’ wave in the CVP waveform

d) a systolic murmur at the left sternal edge with a thrill

e) a parasternal heave

Question 12

Rheumatoid arthritis is associated with:

a) aortic valve disease
b) pericardial effusion
c) constrictive pericarditis
d) renal failure
e) tricuspid incompetence.

Answer 12

a) aortic valve disease
b) pericardial effusion
c) constrictive pericarditis
d) renal failure

Question 13

Fallot’s tetralogy includes:

a) pulmonary stenosis
b) right ventricular hypertrophy
c) overriding aorta
d) atrial septal defect (ASD)
e) patent ductus arteriosus (PDA)

Answer 13

a) pulmonary stenosis
b) right ventricular hypertrophy
c) overriding aorta

Question 14

Pulmonary arterial hypertension may be caused by:

a) patent ductus arteriosus
b) pulmonary regurgitation
c) mitral stenosis
d) recurrent pulmonary emboli
e) hypoxaemia.

Answer 14

a) patent ductus arteriosus
c) mitral stenosis
d) recurrent pulmonary emboli
e) hypoxaemia.

Question 15

Radiographic enlargement of the pulmonary artery is seen in:

a) atrial septal defect (ASD)
b) ventricular septal defect (VSD)
c) patent ductus arteriosus (PDA)
d) Fallots’ tetralogy
e) pulmonary stenosis.

Answer 15

a) atrial septal defect (ASD)
b) ventricular septal defect (VSD)
c) patent ductus arteriosus (PDA)

Question 16

A large A–V shunt causes:

a) increased cardiac output
b) increased total systemic vascular resistance (SVR)
c) cold extremities
d) tachycardia
e) heart failure.

Answer 16

a) increased cardiac output
c) cold extremities
d) tachycardia
e) heart failure.

Question 17

Pulmonary hypertension is caused by:

a) multiple pulmonary emboli
b) mitral stenosis
c) chronic obstructive airways disease
d) volatile anaesthetic agents
e) ascent to high altitude.

Answer 17

a) multiple pulmonary emboli
b) mitral stenosis
c) chronic obstructive airways disease
e) ascent to high altitude.

Question 18

Coarctation of the aorta:

a) is a congenital condition
b) produces upper-limb hypertension
c) may be associated with a displaced apex beat
d) produces a diastolic murmur over the precordium
e) produces skeletal abnormalities on a plain chest x-ray.

Answer 18

a) is a congenital condition
b) produces upper-limb hypertension
c) may be associated with a displaced apex beat
e) produces skeletal abnormalities on a plain chest x-ray.

Question 19

Atrial flutter:

a) is caused most commonly by ischaemic heart disease
b) is identified by ‘f’ waves at 20/s
c) is characterised by a regular arterial pulse
d) contraindicates DC cardioversion
e) may be converted to atrial fibrillation by digoxin.

Answer 19

a) is caused most commonly by ischaemic heart disease

c) is characterised by a regular arterial pulse

e) may be converted to atrial fibrillation by digoxin.

Question 20

The following are indicated in the treatment of superventricular tachycardia (SVT):

a) verapamil
b) carotid sinus massage
c) nifedipine
d) digoxin
e) lignocaine

Answer 20

a) verapamil
b) carotid sinus massage
d) digoxin

Question 21

Pericarditis may occur with:

a) uraemia
b) coxsackie B virus
c) tuberculosis
d) Staph. aureus infection
e) systemic lupus erythematosus (SLE).

Answer 21

ALL answers are correct!

Question 22

Significant stenosis at the origin of the internal carotid artery:

a) may have no symptoms
b) can cause ipsilateral hemiplagia
c) can cause tunnel vision
d) can cause transient ipsilateral amylobia
e) always requires carotid endarterectomy

Answer 22

a) may have no symptoms
d) can cause transient ipsilateral amylobia

Question 23

Following a myocardial infarction:

a) cardiac index (CI) = 2.2L/mm/m2 hypotension PCWP = 10 mmHg is compatible with left ventricular failure (LVF)

b) a left ventricular aneurysm results in persistence of ST segment elevation

c) beta-blockers reduce mortality
d) SNP reduces cardiac output.
e) ACE inhibitors are contraindicated.

Answer 23

b) a left ventricular aneurysm results in persistence of ST segment elevation

c) beta-blockers reduce mortality

Question 24

The following are true of cardiopulmonary resuscitation (CPR):

a) 40% of patients leave hospital alive
b) outcome is related to delay in initiation
c) ‘new’ CPR increases coronary blood flow
d) organ perfusion is due to pressure transmitted to great vessels via raised
intrathoracic pressure
e) internal cardiac massage is required in cases of aorbic stenosis

Answer 24

b) outcome is related to delay in initiation

c) ‘new’ CPR increases coronary blood flow

d) organ perfusion is due to pressure transmitted to great vessels via raised intrathoracic pressure

e) internal cardiac massage is required in cases of aorbic stenosis