MCQ Flashcards
Minimum fatigue achieved by; Avoid sleep Avoid sunlight Napping before shift Using benzodiazepines Use caffeine
Nap before shift
Safe antiemetic in porphyria; Metoclopramide Prochlorpromazine Tropisetron Ondansetron Droperidol
Metoclopride
What agent safe for BP with moclobemide; Adrenaline Dobutamine Ephedrine Meteraminol Phenylephrine
Phenylephrine
When topping up a labour epidural optimum level for light touch;
T6
15yo new mediastinal mass for supraclavicilar lymph node biopsy. Most important investigation; CXR CT chest MRI PET TOE
CT
CTG with late decelerations cause; GA Head compression Uteroplacental insufficiency Acute asphyxia Umbilical cord compression
Uteroplacental insufficiency
New antiemetic decreases PONC by 33%. 8% who receive new treatment still get PONV. The # of patients who must get new Rx instead of old before one patient will benefit is;
25
Previous anaphylaxis to ? Roc, no testing, what is appropriate drug to use; Vec Cis Panc Atracurium Sux
Cis
Increase bleeding except; Garlic Ginger Ginkgo Fish oil Echinacea
Echinacea
Commonest complication after hip ORIF;
Delirium
Carcinoid tumour, persistent intraop HTN non responsive to fluid and octreotide 50mcg. Treatment likely to be effective is; Adrenaline Dobutamine Levosimenden Milrinone Vasopressin
Vasopressin
CS5 configuration. Lead I monitors;
Anterior
Pringles procedure involves clamping of;
Portal pedicle
Before starting gabapentin it's important to; Cease PPI Check hepatic transaminases Check renal function Check QT interval Decrease oxycodone
Renal
39yo with # arm. Confused and agitated with temp tachy HTN - likely cause; Heat stress Encephalopathy NMS serotonin Pain
NMS
CO2 penetrates tissue with little underlying tissue damage because; Well absorbed Hb Poorly absorbed h2o Disseminated in tissue Long wavelength Short wavelength
Long wavelength
80yo TURP, diathermy lateral bladder wall, thigh adduction. Nerve involved;
Obturator
ASA scores are what type of data; Categorical Nominal Non parametric Numerical Ordinal
Ordinal
Healthy man with anaemia - a test that most reliably indicates iron deficiency is; MCV Serum ferritin Serum iron Serum transferrin Total iron binding capacity
Ferritin
Max allowable atmospheric pressure from nitrous in OT in ppm is;
25
What is associated with down regulation of nicotinic acetylcholine receptors; GBS Organophosphate od Spinal cord injury Stroke Prolonged neuromuscular blockade
Organophosphate poisoning
And MG and anticholinesterase poisoning
RA most common c spine abnormality is anterior subluxation. What is next most common;
Vertical (10-20%)
MS pt needs GA. Most likely precipitant; Hyperthermia Hypocarbia Muscle relaxant TIvA Volatile
Volatile
Reduction in DLCO can be caused by; Asthma Emphysema Left to right shunt Pulm haemorrhage Bronchitis
Emphysema
Size (in French) if largest suction catheter that can be passed through size 8 tube they will not take up more than half internal diameter;
12
Pneumoperituneum causes a decrease in cardiac output at what pressure;
10mmHg
Patient with HITS (dvt on LMwH - plat from 300 -> 150). What is not acceptable;
Warfarin
Maximum dose of lignocaine with adrenaline for liposuction with tumescence technique;
35mg/kg
6yo, 20kg, unable to place 5.5 or 4.5 tube. What next;
LMA
What drug to avoid in women breast feeding 6/52 old baby;
codeine
3yo for elective hernia repair had 200mls apple juice 2 hours ago. What to do;
Continue
Aortic valve velocity 4m/s. What is peak pressure using Bernoulli principle;
64mmHg
New cardiac output monitor called WaCCO. Want to compare readings with gold standard. Best statistical method;
Bland-Altman plot
40yo pulm HTN 80/60 preop. Lap chole. Suddenly sats 87% sbp 80/40 etCo2 ? Cause; Gas emboli Left heart failure MI PTx Righ heart failure
Right heart failure
60yo ihd for CABG post CPB hypotensive ST elevation II avF cvp 15, pcwp 25, normal pulm and svr. tOe will show;
Left inferior hypokinesis
Max amplitude teg or totem decreased give;
Platelets
IVDu on 100mg methadone for em laparotomy with effective epidural. Amount IV morphine needed per hour;
16mg
100mg methadone = 400mg morphine
10l /min via facemask size c cylinder 15,000kp lasts;
45mins
Ibuprofen dose 1yo
10mg/kg
To prevent transmission CJD airway contaminated equipment;
134 degrees C for 3min
Brugada syndrome;
Mutation in cardiac Na channel gene.
ST elevation >2mm in V1-3 followed by inverted T wave
Management to reduce intraop haemorrhage in liver surgery: High CVP Decreased MaP Deceased CVP Normal MAP Normal CVP
Low CVP
Max rise in Na over 24 hours from 105mmol/hr;
10mmol
Retro bulbar block - sign of brainstem spread- Atonic pupil Blind ipsilateral Blind contra lateral Diplopia Nystagmus
Contra lateral blindness
Distance from lips to carina in 70kg man;
27cm
Which muscle opens the cords;
Posterior cricoarytenoid
Arthrogrophylis multiplex congenita may make it difficult to place a larygoscope due to;
TMJ rigidity
MELd score is calculated using;
Bilirubin, creatinine and INR
Child Pugh is calculated using;
INR Albumin Bilirubin Ascites Encephalopathy
After resus of a newborn at what time do you like arterial sats to be 85-90;
10 mins
60-70 1mim 65-85 2min 70-90 3 min 75-90 4 min 80-90 5min 85-90 10 min
Dibucaine number of 30-80;
4
What manoeuvre causes mac distension if IJV;
Valsalva
Best way to reduce VAP
Oral hygiene
Chronic AF with Hx HTN, DM, CVA has annual stoke risk of;
8.5%
Chads score 4 (risk approx double score)
Airway equipment sterilisation with CJD;
Sterilise with heat at 134 degrees for 3 mins
What is neuropathic pain;
Pain initiated or caused by a primary lesion or dysfunction in the nervous system
- causes may be iatrogenic, traumatic, inflammatory or infective
Is a risk factor for developing chronic pain
Causes of blindness after surgery;
Direct trauma Acute glaucoma CVA Ischaemic optic neuropathy - low flow Central retinal artery occlusion - pressure
AHA guidelines for 4 Mets
Light housework (dish washing)
Climbing flight of stairs (5mets)
Walking on ground level at 4mph (6mets)
7yo with closed head injury, I&V in ICU, serum sodium 142. Most appropriate fluid is;
0.9% saline
Pneumoperituneum for laparoscopy is commonly associated with each of the following except; Arterial pressure Vasopressin secretion Inotropic action SVR Venous resistance
Inotropic action
Marfans syndrome, thoracoabdominal aortic aneurysm repair. 24 hours later blood noted in CSF drain and patient obtained. Most appropriate urgent management;
CT head
Most likely resp pattern seen in acute c5 spinal cord injury is;0
Increased resp rate
After load reduction is most useful in which of the following;
TOF
Mitral incompetence
Aortic valve incompetence
Aortic valve incompetence
Anaphylaxis, when to check tryptase;
Between one and 3 hours
Anzca;
1,4 >24 hours
Management of DBS in middle aged patient with Parkinson’s disease;
Turn off DBS for duration of surgery but reactivate prior to emergence
Method for treating raised INR
Prothrombinex and vit k
Patient with metastatic cancer. What’s not a useful way to increase ca excretion;
Bispihophonates
108 2014a
Postpartum. Numbness over posterior thigh, lateral leg and foot. Weakness on flexion of knee. Had an epidural and instrumental delivery. Likely site of injury;
Lunbosacral plexus
Sciatic nerve
Sciatic nerve
Management of patient on 2l O2, on pca, mildly febrile, rr14, sats 88%, mildly sedated. Incentive spirometry Diuresis Abx Naloxone
Spirometry
0.75% ropivocaine placed around structure shown. Triangle structure…. Likely radial;
Unable to extend wrist
Misculocutaneous - lateral
Median next to it
Ulnar superficial
Radial under
Isoflurane is administered in a hyperbaric chamber at 3 atmospheres using a variable bypass vaporiser at a constant fresh gas flow and vapour dial setting the vapour produced will be;
The same partial pressure as is obtained at 1 atmosphere
Most likely to occur if the earth/grounding plate that is attached to the patient for use with diathermy malfunctions;
Electrical burns
25/40 BP 150/90 on 4 occasions, no signs PET. Which anti HTN not appropriate;
Enalapril
Why do infants desaturated faster than adults;
More difficult to preoxygenate
Patient with class 4 shock after gunshot. Clinically coagulopathic 30mins later, has been given 1l hartmanns. Coagulopathy likely related to; Acidosis Dilution of clotting factors Hypothermia Release of tissue factor Tissue hypoperfusion
Hypoperfusion
20kg child suffered 15% full thickness burns 6 hours ago. Optimum fluid resus for first hour is;
360mls
Normal response after ECT is;
Transient Brady followed by tachy and hypertension
50yo on bypass for AS. mAP 25 after cardioplegia- what to do?
Meteraminol
80yo ruptured AAA. GCS 12 HR 104, BP 80/50, temp 35, sats 92%. next step is;
Obtain IV access and crossmatch
PICCo works via;
Pulse contour analysis and thermodilution
Targin offers benefit of;
Less constipation
Immunity to hep B demonstrated by;
Hep B surface antibodies
Adult with advances cirrhosis. Best predictor of bleeding is;
Dysfibrinogenaemia
Hypercalcaemia. Initial treatment is with;
IV fluids
OD with 500mg/kg aspirin. Efficient therapy for elimination is;
Haemodialysis
To visualise a superficial peripheral nerve you should use a;
High frequency probe at 90 degrees to skin
80kg pt 30% burns how much fluid in 8 hours
4.8l csl
Regional for em LSCS. C/I chest pain, dyspnoea then loses consciousness. Most likely cause;
AFE
Faster desaturation in fatties due to;
Decreased FRC
Patient with tracheostomy. How to allow to talk;
Deflate cuff, one way valve, fenestrated
Triangle looking nerve = radial
Reduced wrist extension
Earliest sign of high block in neonate post caudal;
Desaturation
Effective method to reduce risk AKI post AAA;
Minimise clamp time
Porphyria patient given thiopentone. Then has a seizure. Which drug should not be given;
Pethidine
What test is decreased in iron deficiency anaemia;
Serum ferritin
Full size c cylinder has pressure regulated from;
1600kpa to 400kpa
MRI tesla 3 least likely to cause harm;
Mechanical heart valve
What happens with magnet over no ventricular ICD;
Switch of antitachycardia function
AFOI via nose. What nerves innervate;
(Olfactory) trigeminal glossopharyngeal vagus p
Cs5 configuration, lead 1;
Anterior
Lead 2; inferior
Lowest extension thoracic paravertebral space;
T12
Systemic sclerosis. Which is least likely cardiac manifestation.
Valvular regurgitation
Reason desflurane needs heated vaporising chamber;
High saturated vapour pressure
Delivery with forceps. Loss of sensation over anterior arterial aspect of her left thigh. No motor symptoms. Best explanation is;
Lateral cutaneous nerve of the thigh
ANZCA approved labelling;
Yellow - regional/epidural Beige - subcutaneous Pink - other Blue - venous Red - arterial
8yo 30kg for OT, starting hct is 35% and transfusion trigger is 25%. Amount of blood to lose before transfusion;
Blood volume x (starting hct- target hct)/starting hct
600ml
Porphyria pt given this. C/o ANSI pain and has a seizure then LOC. What drug not to give;
Pethidine
Diaz,sux, pregabalin ok
Haematin given for an attack
HOCM presents with SOB and angina. What is the best agent to give; GTN Metoprolol Morphine Salbutamol
Metoprolol
Murmur in HOCM will increase in intensity with Valsalva
Pt has a fempop bypass and has a mildly elevated troponin day 1 post op. No other signs or symptoms, what do you do?
Arrange for a cardiology follow up and outpatient angiogram because he is at increased risk for future MI
40 yo lady with a history of bleeding diathesis presents for tonsillectomy. What is the most likely cause?; Factor V Leiden Protein S deficiency Haemophilia B Anti thrombin III deficiency Protein C deficiency
Haemophilia B
Rest are pro coagulant
Most cephalad space for a spinal in a neonate where risk to cord minimal;
L3/4
St Johns wart potentiates effects of; Dabigatran Heparin Warfarin Aspirin Clopodogrel
Clopidogrel
Reduced effect on warfarin, heparin, Dabigatran
No effect on aspirin
AFOI through nose. Nerves encountered;
Trigeminal, glossopharyngeal, vagus
Most powerful predictor of AF post cardiac surgery; Age HTN CVA Diabetes Time on bypass
Age
Other; Male Hx AF Valvular OT COPD Renal failure Rheumatic heart disease
Parkinson’s PONV.
What can you give;
Ondansetron
Pt who can shower self and manages other ADLs but get dyspnoea on mowing the lawn. NYHA class;
2
% PDPH that resolve spontaneously by one week is;
70%
70% 1 week and 95% by 6 weeks
Which piece of equipment is designed for use with a fibre optic bronchoscope;
Aintree
Cook exchange catheter
Frova introducer
Aintree
Possible change on ECG on methadone;
Long QTc
Current guidelines regarding CPR include all of the following EXCePT; Allow equal time compress and relax 2 rescue breaths before CPR Compressions 100/min Compression at least 5cm Ratio 30:2
2 rescue breaths before CPR
CS5 lead II
Inferior
Carcinoid tumour persistent hypotension despite fluids and octreotide 50mcg. Should use;
Vasopressin
Supraclavicular block, inject 20mls 0.375% ropivacaine, agitated seizure loc. 1st step is; Intralipid Midas Prop Airway and 100% Feel radial and give 100mcg adrenaline
Airway
Which organ is least tolerant of ischaemia following removal for transplantation.
Heart
Performing a TAP block. If needle correctly positioned where will you deposit LA;
Between internal oblique and transversus abdominus
DLT in 140kg 160cm. Which depth at incisors would be most likely;
28cm
Which of the following decrease during pregnancy; FRC FEV1 Vt RR Bc
FRC
What is not appropriate for treatment if thyroid storm; Carbimoazole Beta blocker Propythiouracil Plasmapheresis Hydrocortisone
Plasmaphoresis
Young pt with anorexia. After three days of eating found to have cardiac failure. Which is important to correct;
Phosphate
What is the mechanism of central sensitisation;
Increased intracellular Mg
Antagonism if NMDA receptor
Glycerine is main neurotransmitter recurrent a delta fibre activation
Alteration of gene expression
Alteration of gene expression
Glutamine is main neurotransmitter
C fibres are activated
NMDA activated
Mg is decreased
Lung reduction surgery main contraindication/? Poor prognosis;
Chronic asthma
Contraindications; Previous major thoracic surgery Prior pleurodesis Bronchitis;asthma;bronchospasm Rehab resistant Pulm HTN FEV1 20mg/day DLCO
Metastatic lung cancer hypercalcaemia, all would help except; Bisphosphonates Calcitonin Furosemide Na chloride IV crystalloids
Bisphosphonates
What potentiates/interacts with adenosine;
Dipyridamole
What has weakest evidence for prevention of postop infection; Low inspired 02 Intraop transfusion Hypothermia Hyperglycaemia Smoking
Blood transfusion
Good evidence;
Abx
Hand hygiene
Thermoreg
Mid evidence;
Sats
Sugar
Paediatric trauma. Breslow tape used to estimate;
Weight and drug dosages
PICCO determines CO using;
Thermodilution and pulse contour analysis
During scoliosis surgery with monitoring if SSEP which tract is being monitored;
Dorsal columns
Complications of mediastinoscopy include all except;
Cardiac laceration
Complications; Haemorrhage Stroke Air embolism PTx Arrhythmias Phrenic nerve injury RLN injury Oesophageal tear Thoracic duct injury
The MAC awake:MaC ratio of sevo is closest to;
0.34
Numbness in anterior tongue following LMA due to injury of;
Mandibular (“lingular)
70yo non valvular AF off warfarin for 7 days. Daily stroke rate
0.01%
ank spond incorrect;
Normocytic anaemia occurs in 85% cases
What is not useful in Mx of torsades de pointes;
Procainamide
Thermoneutral zone in neonate is;
32-34
Which aortic dissection is managed conservatively;
Stanford B
Stanford A and B
Debakey 1-3
Essential criteria for LBBB;
Loss of Q waves in V5/6
Parasthesia in little finger during supraclavicilar block, needle is close to;
Lower trunk
Which is seen in conns syndrome;
Hypernatraemia, hypokalamia and normoglucaemia (or hyperglycaemia if anything…)
Commonest valvular disease seen in pregnancy;0
Mitral stenosis
Vasospasm following SAH seen maximally at;
6-8days
Predominant pathology seen in restrictive heart disease;
Diastolic dysfunction
First symptom inadvertent total spinal following caudal
Desaturation
30yo, severe hypertension post topical anaesthesia placed for nasal ot. Least appropriate Mx; GTN Esmolol Labetolol Snp Deepen anaesthesia
Labetolol
8yo 30kg starting hct 35%, happy down to 25%. How much loss ok;
600mls
Smoked cannabis prior to OT. May lead to;
Decreased anaesthetic requirement
MVA BP 100/60 HR 100 with cxr widened mediastinum. Next appropriate investigation; Aorthography Ct chest MRI Toe Tte
CT chest
Slow AF on warfarin INR 2.2 for pacemaker. Prior to insertion;
Continue warfarin
Marfans post thoracoabdominal aneury. Blood in CSF drain. Next course of action;
CT head
Electrical requirement that distinguishes cardiac protected area from body protected area is the;
Equipotentiality
Ingestion 500mg/kg aspirin, most efficient to enhance elimination;
Haemodialysis
Most cephalon interspace in neonate while minimising the possibility of spinal cord puncture;
L3/4
For PCA earliest sign of resp depression is;
Sedation score
6 week old for elective procedure. Appropriate fasting is; 2 breast 4 formula 5 both 6 solids 8 solid, 4 fluids
4 hours formula
Reduction DLCO caused by;
COPD
INR 4.5. Needs urgent OT. Vit K already given. What to give;
FFP and prothrombin x
How to differentiate between narrow angle glaucoma and corneal abrasion;
Relieved by topical anaesthesia
Post spinal OT. Parasthesia right arm. Surgeon thinks due to poor positioning. What distinguishes c8-T1 nerve root lesion from ulnar nerve neuropathy;
Weakness in abductor pollisis brevis (median)
Dilutional anaemia compensated by;
Increased cardiac output
Approx BP in awake neonate;
70
Volatile most likely associated with carbon monoxide poisoning with soda line scrubber;
Desflurane
Principle resistance to airflow in ETT is;
Diameter of tube
Primary pulmonary hypertension (80/60), during procedure desats to 87% BP 89/40, etco2 45mmHg. TOE findings;
Increased RV:LV area, abnormal septal wall motion, TR, RA dilation
Revised trauma score;
GCS
BP
Resp rate
Apnoeic oxygenation expected rise in CO2 is;
3mmHg
Decrease PONv 33% vs conventional treatment. 8% still get PONv with new treatment. NNT;
25
Absolute contraindication to ECT is;
Raised ICP
40yo ITP. Retinal detachment OT in 2 days. Platelets 40. Mx of ITP is;
Methylpred and iVIg 2 days preop
Obese man with headache, weakness and polyuria. BP 150/70, displaced apex. Na 145, K2.8, cl 101, most likely Dx;
Primary hyperaldosteronism
Compare new with gold standard using;
Bland-Altman
Thoracic epidural. On waking, pt is weak. Can breath, flex Biceps but can’t extend triceps. Level of block will be;
C7
You man describes throat swelling and difficulty breathing following minor dental procedures. Brother had similar episodes. Most likely mechanism;
C1 esterase deficiency
Use c1 inhibitor concentrate or FFP to treat
5yo duchenne muscular dystrophy. Inhalation with sevo. 10 mins later arrest with K 8.5. Likely mechanism;
Rhabdomyolisis
6/12 old VSD. Inhalation 8% sevo and 50% nitrous. Trying to get Iv access, sats 85%. Next step;
Reduce sevoflurane
Drug to best reduce post op pain following amputation; Amitripyline GABA Tramadol Pethidine
Gabapentin
How to assess pain 3yo;
FLACC
Bupremorphine. When does plasma level reach half original;
24 hours
When to start CPR lay person;
Loss of consciousness
Central centizisation due to;
Increased intracellular gene expression
IO cannula correct statement is;
Drug reaction time same as central
Highest risk vasoapasm post SAH is at days;
6-8
Endovascular aneurysm repair GA preferred due to;
Long duration of Apnoeic time
35yo G1P0 dilated cardiomyopathy for LSCS. EF 35%, benefits of regional;
Increaed EF
All of the following are found in hyper parathyroid disease except; Decrease urinary calcium Expraossius calcifications Increased plasma calcium Increased urinary phosphate Renal calculi
Decreased urinary calcium
Which volatile is the worst for greenhouse gas;
Desflurane
St Johns wart will reduce the effect of;
Warfarin
Normal sensation medial forearm following brachial plexus block. Which part is missed;
Inferior trunk
Prothrombin x useful in period period correct all except;
Isolated factor 7 deficiency
CCf, dyspnoea with mowing lawn, but ok with shower and ADLs;
Class 2
RLL lobe tony. Preop spiro FEV1 2.4l FVC 2.4l. Predicted postop FEV1;
1.7
How does insulin work;
Increases glucose uptake into skeletal muscle
Features of severe AS
Peak velocity 4.2m2
Area 40
Which regarding ank spond is false;
Normochromic anaemia in 85% cases
Pain from 1st stage labour is from;
T10-L1
2nd stage; S2-4
Sens and spec 90%, prevalence 10%
What is PPV;
50%
Type 1 vWillenbrand disease for d&c. Is a JW. In regards to desmopression, all are true except; Synthetic and acceptable to JW Likely to reduce haemorrhage Given as infusion 30mins prior to OT Effect will last 5 days Dose is 0.3mcg/kg
Effect will only last 6 hours
Ventilating neonates to target 85-89% desaturation, vs 91-95 associated with;
Increased mortality
BOOST2 study
Post lumbar sympathetic block most likely side effect is;
Genitofemoral neuralgia
Regarding la forte fractures;
Le fort 3 associated with fracture cribiform plate
Transient neurological syndrome occurs only with;
Compete resolution of motor blcokadep
Prolonged trendelenberg causes;
Increased myocardial work
Brachial plexus block. Normal sensation medial forearm, which part likely missed;
Inferior trunk (medial cutaneous nerve)
Absolute contraindication to sitting position for posterior fossa surgery;
Patent ventriculo-atrial shunt
And large PFO, cerebral ischaemia upright and team not familiar
4yo with murmer. Which feature warrants investigation; Loudness 4/6 Decrease on inspiration Vibratory quality ESM Louder when supine
Loudness 4/6
Other; Symptomatic Diastolic, pan systolic, late systolic Variable or harsh Percordial thrill No chance with posture
Autonomic supply of ciliary ganglion is such that;
Receives parasympathetic nerve supply from Edinger-Westphalia nucleus (via occulomotor)
One of 4 parasympathetic ganglion in head.
Located in apex of orbit (ie posterior)
It constricts the pupil
Regarding thallium stress testing in predicting periop cardiac events;
High negative predictive value
Meconium delivery Apnoeic cyanotic HR 90. What to do first;
Suction trachea
What happens with magnet over ICD;
Turns off antitachycardia function
Full size c cylinder has pressure regulated from;
16000kpa to 400kpa
Asthmatic give. Salbutamol and atrovent and steroid. Next treatment;
Mg
Ulcerative colitis is associated with all except; Cirrhosis Iritis Psoriasis Arthritis Sclerosing cholangitis
Psoriasis
Regarding rotameters;
Constant pressure difference across the bobbin at all flows
Dilated cardiomyopathy with EF 30%. Best treatment is;
Enalapril
Best clinical indicator of severe AS is;
Prescience of a thrill
Mean gradient > 40
Areas
ASS murmur heard due to blood flow through;
Pulmonary valve
What area do you get symptoms at rest with Mitral stenosis;
1
Nitrous oxide anaesthesia may cause all of the following except;
Reversible inhibition of methionine synthestase
It is irreversible
Diagnosis of neuroleptic malignant requires the presence;
Muscle rigidity
Criteria;
Major - fevers, rigidity, increase CK
Minor - tachy, hypotension, low GCs, increased lymphocytes
Regarding tryptase level testing for suspected anaphylaxis. All true except;
Levels peak within one hour
Increased anaphylactoid and anaphylaxis reactions
99% found in mast cells
Levels >20ng/ml suggestive of anaphylaxis
Test repeated 24-48 hours
Levels peak within an hour - it is 1-2 hours
Incidence of FES following unilateral closed femoral fracture;
0-3%
Thoracodorsal nerve arises from;
Posterior cord of brachial plexus
Which of the following is least likely to cause hypoxia in aRDS; NORAD Milrinone Isoprenaline Isoflurane SNP
NORAD
Best predictor of poor prognosis with AS;
PND (2 yr mortality 50%)
Syncope 50% 3yr
Chest pain 50% 5 yr
Pierre Robin sequence is cleft palate, miccrognathia and
Glossoptosis
2ml 0.75 ropiv injected for interscalene block. Then LOC. Most likely place for inadvertent injection is;
Subdural
18month old SVT 220, otherwise stable BP 84/60. Management;
Adenosine 100mcg/ml
BP in children 80+ age(2)
If hypotensive DCCV 2j/kg
When stimulating ulnar nerve which muscle twitches;
Adductor pollicus brevis
Circuit disconnection during spont breathing detected by;
Unexpected drop in end tidal volatile anaesthetic agent concentration
Patient undergone lung transplant. All impaired except; Mucociliary clearance Fought reflex distal to anastomosis HPV Response to CO2 Lymphatic drainage
HPV
Long QT. How to know if treatment effective;
No further prolongation of QT with Valsalva
Neonate born with Meconium. Otherwise ok: don’t suction trachea due to;
Bradycardia
Organism most commonly causes meningitis post spinal;
Strep salivarius
Male patient Hb 8, reticulocyte count 10%. Most likely diagnosis is;
Hereditary spherocytosis
Advantage of supraclavicilar block over interscalene is;
Less phrenic nerve block
Head injury. Unilateral dilated pupil with no direct or consensual response to light. Most likely;
Transtentorial herniation
In an arterial line system;
Wide range of damping coefficient associated with good performance if system has high natural frequency
Commonest post op complication of NOf is;
Delirium
Then UTi, LRTI, MI
What is advantage of BB over DLT;
Able to isolate separate lobes
Pulsus paradoxus is;
Larger drop in BP than usual with inspiration
Laparotomy for pt with Hx pulm HTN. Regarding Mx; Alpha agonist inotrope of choice Hypothermia protective ISO will decrease PAP Ketamine ok
Iaoflurane will decrease PAP
Severe RA. what radiological finding is most consistent with severe Atlantoaxial instability;
9mm gap between anterior arch c1 and odontoid peg
Dose of IV GtN for uterine relaxation;
50mcg
Accurate method of HR in neonate;
Auscultation with stethoscope
60yo having mediastinoscopy. Lose CO, desats and drop CO2. Best Mx,
Place prone
Definitive evaluation of MH does not include;
Abnormalities on MRI spectroscopy
Ca release from B lymphocytes to caffeine
Certain mutations on ryanodine receptor
Myofibrillar necrosis on muscle biopsy plasma
CK levels above 800u/l
CK levels
What is true of eaton lambert syndrome that differentiates it from
mg;
Repeated excercise -> improves
Presented to ED with heel ulcer, BP 100/60, hr 110, temp 35.8, Na 125, K 2.7, BSL 55, creat 180. Most urgent treatment;
Crystalloids
Cause of hypoxia during OLV;
Perfusion of unventilated lung
Child with intraop blood loss. Cardiac arrest most likely because of;
Underestimated blood loss
Lobar plexus supplies all of following except;
Sub costal nerve
Contains; Femoral Obtrurator Ilioinguinal Iliohypogratric Genitofemoral Lateral cutaneous Long saphenous
To determine specificity of a new test it should be administered to;
A series of people know to not suffer from disease
Pt after anterior cervical fusion. Resp distress and bulge under incision. Combative and removing oxygen. Appropriate management is;
? Gas? Iv
Hypercalcaemia due to hyperparathyroidism associated with;
Polyuria and polydipsia
Story QT
Muscle weakness
Cause of early mortality in AFE;
Pulmonary hypertension
Best predictor of DI in overweight;
Pretracheal fat
Endocarditis prophylaxis given to;
In repaired CHD
Previous IE
Mechanical valve
Repaired CHD
Best aspiration prophylaxis for urgent OT;
Ranitidine
Most common cause of mortality post transfusion;
TRALI
Most common cause of awareness,
Human error
Apnoeic oxygenation in obese aided by;
Head up tilt
Best renal protection for endoluminal AAA;
NaCl
White cylinder grey shoulder;
CO2
Indicator in soda lime;
Ethyl violet
Intubation over a boogie. Rotate ETT
90 anticlockwise
What is not advantage of drawover vaporiser;
Basic flow compensation
Which does not have abnormal q waves;
Digoxin toxicity
Troponin remains elevated for how long;
5-14 days
Inverted p waves in II can be caused by;
Junctional rhythm
When do most SAh bleed;
First 24 hours
Contraindications IA BP;
AR
Irreversible
aortic stent
Aortic dissection
Relative; sepsis
Which tract monitored with SSEP
Dorsal column
Incidence of headache postpartum;
38%
What proportion people AV node supplied by RCA;
80%
Less blood wastage if;
Low transfusion threshold
How long prior to spinal should Dabigatran be ceased,
7 days
When can you remove epidural after prophylactic LMWH dose give;
10-12 hours
Eclampsia dose Mg is;
4-5g over 5 mins
Endocarditis in pt with MVR approapite;
Lithotripsy
Some dental providers; extraction, root, replanting teeth
D&c if infected
Long labour
What is a specific PDE inhibitor;
Milrinone (3)
Aminophylline non selective
Dipyridamole 1&5
Loading dose for Iv paracetamol;
15mg/kg ie no load Iv
If
Caudal block with clonidine what is increased;
Hypotension and Brady
New onset AF. When can you shock without tOe;
48 hours
Cerebral oximetry measures;
Mostly venous, some arterial saturation
