MCQ 25.1 Flashcards
. “E” in GOLD ABE for COPD means at least how many exacerbations/hospitalisations per year?
a. Options - 1, 2, 3, 4
. “E” in GOLD ABE
1 hospitalisation
2 exacerbations
What percentage of Takotsubo cardiomyopathy patients fully recover to normal LVEF?
10%
25%
50%
75%
90%
90%
Which risk factor is the LEAST associated with extravasation of vasopressors?
Elderly
Neonate
Low infusion rate
Drugs below pH 5.5
Diabetes
Low infusion rate
Which one is mitral stenosis?
E
What nerve is blocked by injection between thyrohyoid membrane that targets above cords and epiglottis?
Superior laryngeal nerve (internal branch)
What is not a part of ANcA PG58A guidelines for QA & QI?
Planning
Acting
Doing
Benchmarking
Checking
Benchmarking
Child in ED needs procedural sedation. Unable to gain IV access what is the ketamine IM dose?
1
2
3
4
5mg/kg
4mg/kg
Best NNT for prevention of post amputation pain
a. Neuraxial
b. Peripheral catheter
c. Ketamine
d. Gabapentinoid
?ketamine
Best NNT for post operative pain
a. Ibuprofen
b. Codeine
c. Paracetamol
d. Paracetamol/ibuprofen combo
E. Paracetamol/codeine combo
D. Paracetamol/ibuprofen
Painless POVL with intact pupillary reflex, is due to
Vertebrobasilar ischemia, posterior ION
retinal detachment
corneal abrasion
Vertebrobasilar ischemia
Potential effects of GLP1RA include all EXCEPT
reduced HR,
weight loss,
pancreatitis,
reduced myocardial adverse events
Reduced HR
Paediatric maximum safe dose for lignocaine topicalisation of airway?
3mg/kg
4mg/kg
5mg/kg
7mg/kg
9mg/kg
4mg/kg
For Hyperkalaemia treatment - what is the duration of action for nebulised salbutamol?
15 min,
30min
1 hour
1.5 hours
2 hours
2-3hrs (RCH website)
Paediatric potential C-spine trauma in 3 year old, what’s the best management
a. Sedate the child until C-spine is adequately aligned
b. Use Hard collar
c. Use thoracic elevation device
d. Restrain child to hard board
e. CT as first line imaging
Use thoracic elevation device
SCH website https://www.rch.org.au/clinicalguide/guideline_index/cervical_spine_assessment/
Dose of synchronised cardioversion for SVT in paediatrics
a. 1J/kg
b. 2J/kg
c. 3J/kg
d. 4J/kg
1J/kg first
Then 2 and 4.
Max safe dose for ropivacaine per 24h period
450mg
650mg
770mg
1080mg
770mg
Dyspnoea happens due to which position change in hepatopulmonary syndrome?
a. Left lateral to right lateral
b. Right lateral to left lateral
c. Supine to sitting
d. Sitting to supine
e. Supine to prone
c. supine to sitting (platypnea)
RANZCOG guidelines for prophylactic antibiotics after instrumental vaginal delivery
a. IV Augmentin
b. IV cephazolin + metronidazole
c. IV cephazolin
d. IV metronidazole
e. Nothing
a. IV Augmentin
https://ranzcog.edu.au/wp-content/uploads/Prophylactic-Antibiotics-Obstetrics-Gynaecology.pdf
Indocyanine green is contraindicated in
a. Iodide allergy
b. G6PD
c. Porphyria
d. Methylene blue allergy
a. Iodide allergy
Which one is not high risk for cardiac adverse events?
Uncontrolled HTN
Previous history of cardiac failure
Ischemic heart disease
Diabetes
CKD
Uncontrolled HTN - not in RCRI
Mild cystic fibrosis causes what kind of PFT?
Mixed obstructive/restrictive
Obstructive only
Restrictive only with normal DLCO
Restrictive only with low DLCO
Obstructive only
Leukodepletion reduces the risk of
a. CMV transmission
b. HIV transmission
c. ABO incompatibility
a. CMV transmission
Bivalirudin mechanism of action
a. Thrombin inhibitor
b. Factor Xa inhibitor
c. Antifibrinolytic
d. Factor V inhibitor
e. Factor I inhibitor
a. Thrombin inhibitor
What is the likelihood of a p value equal to or greater than 0.05 for a study repeated with exactly the same conditions and same sample size for a study that produced a p value of 0.05?
5%
20%
50%
80%
95%
50%
Anatomical structure (arrow pointing to part labelled “posterior arch” in image below)
atlas,
axis,
occipital protuberance
Atlas
What is not a risk factor for emergence delirium?
Ent surgery
Young age
Parental anxiety
Volatile anaesthetic
Negative interaction with health professionals
Parental anxiety
https://pubmed.ncbi.nlm.nih.gov/38676358/
What does ANZCA recommend about GLP1 agonists for non-endoscopy surgeries
a. Stop for 2 weeks and treat as fasted
b. Stop for 2 weeks and treat as unfasted
c. Stop for 4 weeks, extended fasting time, treat as fasted
d. Stop for 4 weeks and treat as unfasted
e. Continue, normal fasting time, treat as unfasted
e. Continue, normal fasting time, treat as unfasted
What is the recommendation for DDP-4 (options) preoperatively?
Withhold due to risk of
-hypoglycemia
-lactic acidosis
-delayed gastric emptying
-euglycemic ketoacidosis
-don’t withhold
Don’t withhold
If a statistical test was required to look at the similarity between two outcomes below (in a similar graph), which analysis is required
T-test
P-test
Logistic regression,
Pearson coefficient, Spearman coefficient
Pearson coefficient
What does ANZCA say is NOT the purpose of open disclosure after something goes wrong
a. To allow doctors to fulfil medicolegal obligations
b. To allow patients to tell their experience from their POV
c. To allow doctors to tell their experience from their POV
d. To apologise and express regret
e. To disclose what harm has happened or potential harm that could happen
a. To allow doctors to fulfil medicolegal obligations
Dose of amiodarone for ventricular arrhythmia in paediatrics
3mg/kg,
4mg/kg,
5mg/kg,
6mg/kg
5mg/kg
Mammalian meat allergy (Alpha-Gal syndrome) has lowest risk with which drug
a. Heparin
b. LMWH
c. Recombinant 7
d. Human albumin
e. Protamine
e. Protamine (salmon)
Conn syndrome
a. Normoglycaemia, hypokalaemia, hypernatraemia
b. Hyperglycaemia, hypokalaemia, hypernatraemia
c. Hypoglycemia, hyponatremia
Hyperkalemia
d. Hypoglycemia,
Hypernatremia, hypokalemia
a. Normoglycaemia, hypokalaemia, hypernatraemia
5% albumin should be avoided in
a. Hypernatraemia
b. Hyperkalemia
c. Hypercalemia
d. Hyperphosphetemia
Hypernatremia
Which hyponatraemic state has euvolaemia
a. CCF
b. Hypothyroidism
c. Cerebral salt wasting
d. Cirrhosis
Hypothyroidism
To do a sphenopalatine ganglion block, the LA needs to pass through
a. Greater palatine foramen
b. Lesser palatine foramen
c. Sphenopalatine foramen
d. Foramen rotundum
c. Sphenopalatine foramen
https://www.bjanaesthesia.org/article/S0007-0912(20)30164-1/fulltext
2 year old child spontaneously breathing on Mapleson F running at 3L/min. High CO2. You want to transfer patient. What’s the best management for CO2?
a. Increase FGF
b. Paralyse patient
c. Assist ventilation
d. Salbutamol
Assist ventilation
2yo is 12kg. Recommended FGF for spont breathing is 3x MV or 150ml/kg = 3L/min
Which of these is NOT a risk factor for Myaesthenia gravis for prolonged ventilation
a. Pyridostigmine 500mg/day
b. BMI 30
c. VC <1.8
d. Thoracic surgery
e. Pre-existing COPD
Pyridostigmine
Leventhal criteria is >750mg/day
Smallest weight for microcuff ETT
a. 1kg
b. 3kg
c. 5kg
d. 10kg
e. 20kg
b. 3kg
Lambert-Eaton Syndrome is associated with
increased or decreased sensitivity to depolarising/non depolarising paralytics
increased sensitivity to both
Upper BP threshold if CVA and not thrombolyzed or clot retrieved
160mmHg,
180mmHg,
200mmHg,
220mmHg
220mmHg
Gastric ultrasound, what is this image (similar to below)
empty stomach with clear fluid,
early emptying phase of solids,
intermediate emptying phase of solids,
late emptying phase of solids
Empty
Identify which line is mode/median/mean
If patient is taking fluoxetine, which drug has the lowest risk of serotonin syndrome
tramadol,
oxycodone,
morphine,
fentanyl
pethidine
Morphine
What electrolyte is most inaccurate with VBG taken from IO?
Potassium
SBP target if 55 year old male with TBI
SBP 90,
SBP 100,
SBP 110
SBP 100
What is the dose (mg/kg) of methyl-prednisone in patient with TBI?
None
5
10
15
20
None
Duration of action of IV Carbetocin
a. 30 mins
b. 1 hour
c. 2 hour
d. 4 hour
1 hour
Location of PENG block
a. Between psoas tendon and pubic ramus
- Addition of IV vancomycin to routine IV cephazolin for surgical site infection
a. Reduces SSI by 20%
b. Reduces SSI by 40%
c. No change
No Change
https://www.nejm.org/doi/full/10.1056/NEJMoa2301401
How do SGLT2i work?
Causing glycosuria
- Drug that reduces the efficacy of methadone
a. Phenytoin
- Which group of patients is there a lower BSL target, that’s not BSL 8-12?
pregnant patients,
poorly controlled DM
recent hypoglycemia,
emegency surgery
pregnant patients (4-6)
ADS ANZCA Perioperative Diabetes Guidelines (2022)
- Peak onset IM suxamethonium (repeat)
a. 4 min
- What is the difference between AIR compared to MH (repeat)
a. No increased muscle rigidity
- What does an inverted U wave signify (repeat)
a. Myocardial ischemia
- ESPB location (repeat)
a. Anterior to erector spinae and posterior to TP
Mild Cystic fibrosis shows what PFT?
Obstructive FEV1 with normal FVC
- NSAID with the worst profile for GI ulceration
a. Naproxen
(https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)60900-9.pdf)
- Which one is a risk factor for bone cement implantation syndrome
a. Diuretics
- Oxygen pin index
a. 2,5
- Manujet maximum pressure
a. 3.5 bar
- Intralipid 20% maximum dose
a. 12mL/kg
- Cause of 4th heart sound (repeat)
a. HTN
- Delay brain death testing after cardiac arrest for (repeat)
a. 24hrs
- Medical air gas cylinder colour
a. Black and white
- Carcinoid syndrome has highest risk of which cardiac murmur?
MR
AR
TR
MS
AS
a. Tricuspid regurg
- Dose for macroshock for VF
a. 100mA
- Risk of microshock is eliminated by
a. Equipotent earthing potential
- ECG in young person with collapse
- likely WPW
- ECG in middle age person with dizziness on exercise + anteroseptal TWI and large QRS complexes
- likely HCM
- ECG with 3rd degree HB
- How long before starting clexane after removal of epidural catheter
4 hours
- Brain death testing, which is NOT a method of imaging
a. Intracerebral arterial catheter
b. Radionucleotide scan
c. CT angiogram
d. MRI
MRI
- During CICO when you inflate for 2s breaths via Rapifit inhaler, how frequently do you cycle breaths
a. 30 seconds
- Which drug crosses the BBB
a. Pyridostigmine
b. Edrophonium
c. Neostigmine
d. Physostigmine
d. Physostigmine
- Addison’s syndrome electrolytes and BSL
a. Hypoglycaemia, Hyperkalaemia, hyponatraemia
- Purpose of this part of the chest drain
Records air leak
- Stimulation of the posterior cord in infraclavicular block causes
a. Wrist extension - answer
- Amount of FFP to increase fibrinogen by 1g/L
a. 30mL/kg
- Capnograph waveform indicates what
a. ETT cuff leak
b. Gas analyser partial disconnection
c. Unilateral Lung transplant
d. Spontaneous breathing during PPV
b. Gas analyser partial disconnection
- Antiemetic choice in parkinsons patient taking apomorphine
a. Cyclizine
- Pressure in oxygen piping tube if oxygen tube kinked
a. 400kPa
- Musculocutaneous nerve innervates
a. Elbow flexion
- Which surgery has highest risk of awareness as per NAP
a. Cardiac surgery
- Which block does NOT cover sternal fractures
a. PECS 1
b. PECS 2
c. Parasternal block
d. Transversus thoracic muscle plane block
e. Pectointercostal fascial plane block
a. PECS 1
- Classic LMA cuff pressure max
a. 60cmH2O
- Which valve is labelled (arrow pointing to aortic valve) - a picture of both mitral and aortic valve replacements in CXR
- Brachial plexus photos arrow pointing towards ulnar nerve
- The correct blood collection tube for a mast cell tryptase test is a
a. Serum tube
- The rank of volatile anaesthetic agents from highest to lowest derived global warming potential over 100 years (GWP100) is
a. Desflurane > isoflurane > nitrous > sevoflurane