** Special Clinical Problems (Textbook) MCQs Flashcards
Recommendations to protect medical staff from AIDS include:
a) gloves
b) resheathing needles
c) gowns
d) goggles
e) autoclaving breathing systems.
a) gloves
c) gowns
d) goggles
A man who is paraplegic because of a T4 injury is to undergo cystoscopy. A safe and effective management could be:
a) no anaesthesia
b) diazepam sedation
c) local analgesia to urethra
d) spinal (subarachnoid) block
e) thiopentone, nitrous oxide/oxygen, halothane general anaesthetic.
c) local analgesia to urethra
d) spinal (subarachnoid) block
e) thiopentone, nitrous oxide/oxygen, halothane general anaesthetic.
In anaemia:
a) Pa O2 is reduced
b) blood is more saturated than blood at Hb 12g/dL
c) 2,3-DPG is reduced
d) blood should always be transfused prior to elective operation
e) elective operation can satisfactorily proceed 12 hours after blood transfusion.
b) blood is more saturated than blood at Hb 12g/dL
The following are associated with difficult intubations:
a) rheumatoid arthritis
b) ankylosing spondylitis
c) sickle cell anaemia
d) Marfan’s syndrome
e) acromegaly.
a) rheumatoid arthritis
b) ankylosing spondylitis
d) Marfan’s syndrome
e) acromegaly.
Sudden blood loss of 30% during surgery results in:
a) immediate fall in CVP
b) reduced urine output despite adequate maintenance of systolic BP
c) stimulation of baroreceptors
d) should be replaced if blood loss >15% blood volume
e) transfusion is only required if blood pressure falls.
a) immediate fall in CVP
b) reduced urine output despite adequate maintenance of systolic BP
c) stimulation of baroreceptors
d) should be replaced if blood loss >15% blood volume
An elderly man given atropine becomes excited and confused; appropriate treatment includes:
a) morphine
b) physostigmine
c) intubation and ventilation
d) droperidol
e) chlorpromazine
b) physostigmine
In dental anaesthesia:
a) oral debris inhalation is unlikely if the patient is supine
b) intermittent methohexitone is a satisfactory technique for the operator anaesthetist
c) the number of dental GAs is steadily increasing
d) demand flow anaesthetic systems result in economy of gases
e) simple monitoring is not essential.
d) demand flow anaesthetic systems result in economy of gases
In the elderly:
a) systolic hypertension is common
b) ventilatory response to CO2 is normal
c) Pa O2 is less than in young adults
d) upper-airways reflexes are impaired
e) postoperative analgesic requirements are increased.
a) systolic hypertension is common
c) Pa O2 is less than in young adults
d) upper-airways reflexes are impaired
Spinal anaesthesia for fractured neck of femur repair compared with general anaesthesia:
a) decreases mortality
b) reduces hospital stay
c) decreases the incidence of thromboembolism
d) provides better immediate postoperative pain relief
e) decreases intraoperative blood loss
b) reduces hospital stay
c) decreases the incidence of thromboembolism
d) provides better immediate postoperative pain relief
e) decreases intraoperative blood loss
Goldman Cardiac Risk criteria include:
a) previous cardiac surgery
b) mitral valve disease
c) hypertension
d) atrial fibrillation
e) previous myocardial infarction.
d) atrial fibrillation
e) previous myocardial infarction.
Warming blood to 37°C during massive blood transfusion:
a) decreases the risk of citrate toxicity
b) increases plasma potassium concentration
c) increases plasma carbon dioxide tension
d) decreases the incidence of arrhythmia
e) increases CO2 buffering capacity of cells.
a) decreases the risk of citrate toxicity
d) decreases the incidence of arrhythmia
e) increases CO2 buffering capacity of cells.
Neuropraxia:
a) is more common after long operations
b) does not occur with local anaesthetics
c) does not occur with muscle relaxants
d) only occurs when previous neuropathy is present
e) takes a long time to recover from
a) is more common after long operations
Factors leading to hypothermia include:
a) vasodilation
b) exposure of abdominal contents
c) neuromuscular blockers
d) spinal anaesthesia
e) dry gases.
ALL answers are correct!
Concerning hip arthroplasty:
a) methyl-methacrylate is a cardiac inotrope
b) hypoxia may be caused by marrow embolisation
c) regional techniques are associated with a greater overall survival rate
d) subcutaneous heparin will completely prevent DVTs
e) hypocapnia produced by IPPV is beneficial.
b) hypoxia may be caused by marrow embolisation
Concerning postoperative nausea and vomiting:
a) it is more common in women than men
b) the incidence is 80% with general anaesthesia
c) it is more common with thiopentone than with propofol
d) butyrophenones can decrease the incidence
e) it is more common with ear surgery
a) it is more common in women than men
c) it is more common with thiopentone than with propofol
d) butyrophenones can decrease the incidence
e) it is more common with ear surgery
Concerning day-case surgery:
a) only ASA grade one patients are suitable
b) the operation should be performed in such a way that no postoperative opiods are needed
c) the patient should be accompanied home by an adult
d) a laparoscopic procedure is not suitable
e) tracheal intubation is not appropriate.
c) the patient should be accompanied home by an adult
Agents used to decrease the pressure response to intubation include:
a) ACE inhibitors
b) calcium antagonists
c) thiopentone
d) beta-blockers
e) fentanyl.
ALL answers are correct!
In patients with pacemakers:
a) diathermy use should be avoided
b) hypovolaemia is poorly tolerated
c) electrolytes should be ‘normalised’ prior to surgery
d) suxamethonium should be avoided
e) use of volatile agents can cause deterioration of function
a) diathermy use should be avoided
b) hypovolaemia is poorly tolerated
c) electrolytes should be ‘normalised’ prior to surgery
d) suxamethonium should be avoided
TURP syndrome:
a) is associated with hypokalaemia
b) may present with convulsions
c) is prevented by spinal anaesthesia
d) is caused by blood loss
e) requires treatment with diuretics.
b) may present with convulsions
e) requires treatment with diuretics.
The most common site of laryngeal granuloma after short-term intubation is:
a) the piriform fossa
b) the epiglottis
c) anterior one-third of the vocal cords
d) posterior one-third of the vocal cords
e) trachea
d) posterior one-third of the vocal cords
A patient with vomiting, respiratory distress, cyanosis, epigastric tenderness and subcutaneous emphysema in the neck may be suffering from:
a) ruptured oesophagus
b) ruptured diaphragm
c) ruptured trachea
d) spontaneous pneumothorax
e) pulmonary embolus
a) ruptured oesophagus
b) ruptured diaphragm
c) ruptured trachea
In patients with porphyria:
a) griseofulvin may precipitate an acute attack
b) glycine should not be used during TURP
c) dysautonomia may occur
d) preoperative fluid restriction is beneficial
e) fentanyl may safely be used.
a) griseofulvin may precipitate an acute attack
c) dysautonomia may occur
e) fentanyl may safely be used.
For a patient suffering from Parkinson’s disease on L-dopa, the following agents should NOT be used:
a) enflurane
b) droperidol
c) nitrous oxide
d) morphine
e) fentanyl.
b) droperidol
Cricoid pressure:
a) is effective in the presence of a nasogastric tube
b) requires a complete cricoid cartilage to be effective
c) should be performed with the neck extended
d) should be performed after 5 minutes’ pre-oxygenation
e) compresses the oesphagus against the cervical vertebrae.
b) requires a complete cricoid cartilage to be effective
c) should be performed with the neck extended
e) compresses the oesphagus against the cervical vertebrae.
