MCQ 2 Flashcards
In the resuscitation of a 55 year old man in asystolic cardiac arrest, it is appropriate to:
Start CPR - 5 cycles of 15:2 at a rate of at least 100/min
A cardiac arrest patient arrives to the Emergency Department with PEA. The ECG monitor shows
a rate of 30 beats per minute. CPR continues and IV access is established. Which medication is
most appropriate to give next?
Epinephrine 1 mg IV
What is a common but sometimes fatal mistake in cardiac arrest management?
Prolonged interruptions in chest compressions
Hypothermia is associated with:
Increased postoperative infection
A patient with COPD with an acute exacerbation of his symptoms suffers a cardiorespiratory
arrest in the A&E. You would now give him oxygen using:
24% venturi mask
A 58 year old known alcoholic who has had frequent admissions to hospital was found on the corridor just outside the busy A&E department. He was unresponsive with no pulse so cardiopulmonary resuscitation was started immediately. He was found to be in ventricular fibrillation. The LEAST likely cause of the cardiac arrest could be:
Hypothermia
Capnography may be useful in the following situations EXCEPT:
Decreased oxygen saturation
A 3 year old child, weighing 15kg, had bilateral hernia repair. Surgeon requests local anaesthesia
for wound infiltration. The maximum dose of plain bupivacaine that can be used will be:
12 mL of 0.25%
A 75 kg 1.8 m tall basketball player sustained a laceration to his leg during practice. The wound
is clean and requires suturing under local anaesthesia. The emergency department only has 1.5%
lignocaine available. A 1.5% solution of lignocaine has:
15 mg per mL
Which of the following induction agents has a bronchodilator effect?
Ketamine
A 6 year old is having squint surgery. Whenever the ocular muscle is pulled, the patient develops
bradycardia. Which drug do you choose to manage this event?
Atropine
A pre-med student accompanies her mother and 5 year old brother to the Anaesthesia Assessment
Clinic. He is booked for an umbilical hernia repair. She has questions about the planned
anaesthetic technique. Which statement regarding inhalation anaesthetic agents is TRUE?
They may potentiate the effect of neuromuscular blocking agents
ECG may be useful in the following situations EXCEPT:
Bronchospasm
Pulse oximetry
Is less accurate when oxygen saturation is less than 70%
A 55 year old poorly controlled asthmatic patient is under GA for a laparotomy and pelvic
exenteration. The surgeon is having difficulty resecting the ovarian carcinoma. The capnograph
trace shows an elevated inspired CO2 level. The likely cause is:
Exhaustion of soda lime
Regarding oxygen therapy:
Nasal cannulae depend on patient characteristics for delivering FiO2
Pre-oxygenation is performed for all the reasons EXCEPT:
It prevents diffusion hypoxia
Postoperative nausea and vomiting may be treated with all of the following EXCEPT:
Ibuprofen
A 73 year old woman is booked for a nephrolithotomy. She has had two previous uneventful
general anaesthetics in the past for LSCS. Her youngest child is 35 years old. A potential difficult
intubation may be anticipated by all EXCEPT:
She has congestive heart failure
A 50 year old man is booked for a partial thyroidectomy as an elective procedure. The potential
difficulty in performing endotracheal intubation may be anticipated by all EXCEPT:
He is edentulous
A 30 year old G2P1 patient with mild preeclampsia requests an epidural for anaesthesia for her
caesarean section. Which statement about epidural anaesthesia is TRUE:
It may cause urinary retention
Bupivacaine:
Compared to lignocaine has more cardiovascular toxicity than neurotoxicity
A 35 year old man has a diagnosis of a right tension pneumothorax from a flail chest following a
motor vehicle accident. What is the appropriate immediate management?
Large cannula in 2nd right intercostal space mid clavicular line
Midazolam:
May cause anterograde amnesia
Propofol:
Is one of the ideal drugs for infusion
Fentanyl citrate:
May attenuate the hemodynamic response to intubation
Suxamethonium:
May cause postoperative myalgia
A 20 year old university student is having a breast reduction done under general anaesthesia. The
plastic surgeon proceeds to infiltrate the operation site with adrenaline to decrease blood loss.
Infiltration with adrenaline during anaesthesia may easily produce cardiac dysrhythmias with:
Halothane
The following statement about vecuronium is TRUE:
Its effect can be reversed by neostigmine
Hartmann’s solution (Ringer’s lactate) contains:
2 mmol/L Ca2+
Administration of a large volume of normal saline (0.9%) is likely to produce:
Hyperchloraemic metabolic acidosis
Which of the following is an amide local anaesthetic drug?
Lignocaine
A 17 year old student is booked for a ureteroscopy under general anaesthesia. He is a known
epileptic since the age of 5 years, is compliant with his medication, but last had a seizure 6
months ago. In view of his history, which anaesthetic agents should be avoided?
Enflurane
The following drugs may cause hypotension by histamine release:
Atracurium
Which of the following about pulse oximetry is TRUE?
The presence of methaemoglobin in blood (metHb) may affect it
With regard to capnography:
The normal range is approximately 35-45 mmHg
With regard to haemorrhage:
Beta-blockers may mask the early signs of hypovolemic shock
What cardiovascular changes can occur with the Trendelenberg (head-down) position?
Increased cardiac output
A 79 year old diabetic hypertensive man with a hiatus hernia is booked for an above knee
amputation. The anaesthetist is considering performing spinal anaesthesia for the procedure. With
regard to spinal anaesthesia, it:
Causes hypotension
A 76 year old diabetic patient with pneumonia is admitted to hospital in extremis, needing
intubation. The following statement about intermittent positive ventilation is FALSE:
It is easily tolerated without sedation
A patient is intubated and ventilated on intensive care after being admitted with shortness of
breath. He has a blood pressure of 70/40 mmHg, heart rate 120 bpm, central venous pressure
20mmHg and a pulmonary capillary wedge pressure of 25mmHg. He has a PaO2 of 60mmHg
(normal > 300mmHg) on a FiO2 of 1.0. What is the likely diagnosis?
Pulmonary oedema
A cardiac arrest patient arrives to the Emergency Department with no pulse and an ECG monitor
shows a rate of 30 beats per minute. CPR continues and IV access is established. Which
medication is most appropriate to give next?
Epinephrine 1 mg IV
A patient presents to accident and emergency with a head injury. His eyes open to pain, he is
making incomprehensible sounds, his left upper limb demonstrates flexing and the right upper
limb demonstrates localising. What is his GCS?
9
A 2.5 kg premature neonate intraoperatively has a nasal temperature of 34 degrees Celsius. What
is the most likely postoperative complication experienced in this age group?
Increased oxygen uptake
Capnography may be least useful in the following situation:
Decreased oxygen saturation
A patient is admitted through accident and emergency with a self inflicted stab wound to his
groin. His heart rate is 110 bpm, blood pressure 110/90 mmHg, respiratory rate of 20 breaths per
minute and is mildly anxious. What is the likely blood loss?
750 - 1500 mL
A 3 year old child, weighing 15kg, had bilateral hernia repair. Surgeon requests local anaesthesia
for wound infiltration. The maximum dose of plain bupivacaine that can be used will be:
6 mL of 0.5%
An epidural for Caesarean section is “topped up” with 20 ml of 2% lignocaine and 100
micrograms of fentanyl. Shortly afterwards, the patient becomes agitated and then loses
consciousness. She then develops bradycardia and suffers a tonic-clonic seizure. She has a past
history of epilepsy and her pregnancy was complicated by pregnancy-induced hypertension. What
is the most likely diagnosis?
Local anaesthesia toxicity
A 93 year old lady is scheduled to undergo fixation of a fractured neck of femur and you review
her on the ward. Which of the following is not an acceptable reason for postponing surgery?
Reversible coagulopathy
With regard to capnography:
The normal range is approximately 35-45 mmHg
Postoperative nausea and vomiting is least likely treated by which agent in the recovery
room?
Propofol
What cardiovascular changes can occur with the Trendelenberg (head-down) position?
Increased cardiac output
How much adrenaline does 2% lignocaine with 1:200000 adrenaline contain?
5 mcg/mL
A 24 year old patient undergoes diagnostic laparoscopic surgery for suspected endometriosis.
Which of the following physiologic complications is LEAST likely to occur?
Increase in renal blood flow
Suxamethonium
Causes postoperative myalgia
The following statement about vecuronium is true:
Its effect can be reversed by neostigmine
