Anesthesiology 2019 Exam (NOTHING 2015 ONWARDS)

The leading cause of cardiac arrest in children is:

The leading cause of cardiac arrest in adults is

Brain stem reflexes include:

Which of the following investigations is the most important to perform immediately after hospital admission in a patient with clinical signs of stroke?

Acute Kidney injuryt is associated with

The typical pattern of hyperdynamic septic shock is

Which equation describes Cardiac output (CO)

ARDS is characterized by all except:

Early phase septic shock is characterized by

The initial MAP target values for the treatment of shock should be:

Risk of misdiagnosis of brain death according to circulatory criteria is possible in circumstances EXCEPT:

Gold standard for the diagnosis of death using confirmatory investigation is:

Calculate cerebral perfusion pressure (CPP) based on the following data: HR 75, BP 120/80 (MAP 65), CVP 15, ICP 15, Respiratory rate 25, Minute volume 10 l/min

Categories of ARDS:

Noninvasive mechanical ventilation (NIV) can be considered in patient:

65-year-old man with acute STEMI MI undergoes emergent cardiac catherization followed by PCI. A pulmonary artery cathartic is inserted for hemodynamic monitoring. Which of the following hemodynamic subsets satisfies the criteria for cardiogenic shock in this patient?

Which is the TRUE STATEMENT about insulin therapy in septic patient.

Vasopressors during septic shock resuscitation

Beside score – quick SOFA (qSOFA) includes the indicators described below with THE EXCEPTION of:

What does DO2 refer to?

All of following are examples of distributive shock EXCEPT:

Once the patient is defibrillated and high quality CPR is in progress, the first drug you would expect to give would be

You are working in emergency department. Your 69-years old patient who is being treated for chest pain. He has an IV in place and is on the bedside monitor. He is awaiting the arrival of the Cath Lab Team. Suddenly the patient loses consciousness. You look up at the monitor and see ventricular fibrillation. You are not sure whether you feel a pulse or not. You should immediately

Indicate A FALSE STATEMENT describing the principles of mechanical lung ventilation in the ARDS:

Indicate A FALSE STATEMENT describing the effect of inotropic drugs

According to international definition pain is:

The PCA analgetic therapy means:

What is not typical for the chronic pain syndrome:

In the learned chronic pain syndrome typical behavior called “five Ds” concerns following symptoms EXCEPT:

Basic goal after the recognition of sepsis is to administer the antimicrobials within:

In the sepsis Six algorithm of severe sepsis treatment, Step 1 is:

ET CO2 is increased in the following conditions EXCEPT:

45 year old man was admitted to the emergency department after a traffic accident. Physically examination: conscious, in a logical touch, suffering, heart rate of 120/min, blood pressure 80/50mmHg, major bleeding due to amputation of the right lower limb, VAS is 10. In CT: without head injury. What is the most appropriate anesthetic agent during transport the patient to operating theater?

Which of the following anesthetics is safe in patients with a history of malignant hyperthermia?

How to do assess ASA classification in the following patients?
I – 34 years old man with good control of diabetes mellitus
II – 86 years old with hypertension without treatment and creatinine level 1.2 mg/dL
III – 45 year old man with the diagnosis of brain death

Epidural anesthesia is contraindicated EXCEPT:

Hypotension is least likely to occur following induction with which of the following anesthetics agents?

Which of the following local anesthetics can cause most likely an allergic reaction?

Regarding to succinylcholine the following statements are true EXCEPT:

Regarding CVP find FALSE STATEMENT:

Find TRUE STATEMENT regarding pulsoximetry

CVP is typically elevated in all EXCEPT

Interpret the following blood gas: PaO2 78mmHg, PaCO2 29mmHg, pH 7.29, HCO3 14, BE -10

The patient with confirmed sudden cardiac arrest presents PEA on ECF tracing. You should:

The best indicator of adequate fluid resuscitation in the trauma patient is:

A 24-year-old man is brought to the emergency department following a car accident. He is unconscious and has an obvious fractured right femur, as well as a taut abdomen. His BP is 92/58 and pulse 110. Prior to going to CT, radiology, and then surgery, the anesthesiologist request that a PA catheter be inserted. This is done, and the following values are obtained:
SvO2 = 54%
Cl = 2.5/L/min/m2
PAOP = 3 mmHg

A 40-year old woman is undergoing an internal fixation of her tibia under general anesthesia. While the surgeon is inserting the implant she develops sudden hypotension and her EtCO2 shows
a sudden drop from 40 mmHg to 22 mmHg. What is the most likely diagnosis?

Which one of the following findings would be contraindication to spontaneous breathing?

You are in the library when a gentleman who was standing at the desk collapses. He falls to the ground and does not appear to be breathing. You ask the clerk to call for help and to get the AED. Because the man is not responding and does not appear to be breaking normally you should immediately

the FALSE STATEMENT concerning cardiogenic shock is:

Subarachnoid anaesthesia is contraindicated in:

Amiodarone is indicated for the treatment of:

The patient is admitted with cardiogenic shock and oliguric acute kidney injury. Hemodynamics parameters reveal the following:
BP 105/60 mmHg, Sinus rhythm (108/min), Cl 1.8 (CO2.4), CVP 23 mmhG, PCWP 25mmHg, SVRI 2088 (SVR 1566). Which one of the following interventions would you anticipate?

Calculate the PaO2: FiO2 ratio passed on the following data:
FiO2 1.0, PEEP 10, PaO2 65mmHg, pH 7.34 mmHg, PaCO2 45mmHg, SpO2 90%

The inotropic drug of the first choice for septic shock is:

Pneumothorax as a complication occurs more often during cannulation of:

What is the correct treatment of an adult patient with VF:

According to ERC guidelines for resuscitation 2010 (adults):
“Atropin is no longer recommended for routine use in asystole or pulseless electrical activity (PEA).
a) this sentence is false
b) forst part is true, and second part is false
c) atropine is not mentioned in the newest ERC Guidelines for Resuscitation 2010 (adults)
d) this sentence is true

The correct ratio of compression of chest to breaths in cardiac arrest in neonates is:
a) 15:2
b) 30:2
c) 3:1
d) 5:1

12) Tuohy needle is used to perform:
a) epidural anesthesia
b) spinal anesthesia
c) arterial puncture
d) central vein puncture

Spinal anesthesia results from the injection of a local anesthetic drug directly:
a) outside the dura
b) into spinal cord
c) to the nerve roots
d) into cerebrospinal fluid

The spinal needle can only be inserted below the second lumbar and above the first sacral vertebrae:
a) this sentence is true
b) this sentence is fasle
c) first part is true and, second is false
d) first part is false and, second is true

A patient with systemic disease that is a constant threat to life- is according to ASA classification:
a) I
b) II
c) III
d) IV

ANESTHESIOLOGY EXAM 2016/2017

1. A 16-year-old girl has intermittent bifrontal and occipital headaches, which she describes as “squeezing, bandlike, or vinelike” that are worse when she is at school. She has undergone counseling at school for depression and anxiety. Which of the following is the most likely diagnosis?
a. Temporal arteritis
b. Migraine headache
c. Malingering
d. Tension-type headache

2. A 55-year-old man has severe pain on gentle touching of the arm. Six months ago, the median n. was damage during creation of an arteriovenous fistula for dialysis. Which of the following terms best describes this phenomenon?
a. Hypesthesia
b. Hyperalgesia
c. Allodynia
d. Hypersensitivity

The placebo effect is mediated by:
a. Opioid mechanism
b. Oxytocin mechanism
c. Cannabinoid mechanism
d. All of them

According to international definition, pain is:
a. An unpleasant sensory or emotional experience described in terms of tissue damage
b. Actual or potential tissue damage associated with unpleasant experience
c. An acute sensory experience associated with local tissue damage
d. An unpleasant sensory and emotional experience associated with actual or potential tissue damage

The latest full definition of sepsis is as follows:

Patient with COPD: CO2 48 mm Hg, HCO3 - 28 mm Hg, pH 7.35

To qSOFA belong all EXCEPT:

65-year-old man. It shows the symptoms of cardiogenic shock. You're connecting a swann-Ganz catheter and what you see.

In sepsis, increased fibrin formation may impair the following:

Pathophysiological changes observed in sepsis are:

The term hypoxemia means a reduced content of oxygen in arterial blood. The causes of hypoxemia may be as follows:

Measuring the concentration of pro-calcitonin in patients treated in the intensive care unit is useful:

Cardiogenic shock (WK) from septic shock (WS) differs mainly:

If there are difficulties in ventilating the patient and the presence of a foreign body has been ruled out, which of the following may be helpful in providing ventilation to the mask?

Indicates a FALSE statement:

Treatment of life-threatening hyperkalaemia includes:
1. Magnesium IV
2. Calcium IV
3. IV glucose infusion with insulin
4. Lidocaine IV

Which of the painkillers can be used in the treatment of postoperative pain in children?

It is not true that: The dose of adrenalin in the treatment of anaphylactic shock:

In the course of resuscitation, the indication to be given adrenalin is:

The indication for defibrillation is:

Recommendations for the treatment of patients with carcinogenic shock include all of the below listed EXCEPT

Sepsis may develop:

The aim of CRRT therapy (continuously renal replacement therapy) is:

During ALS, persons performing external cardiac massage should change to ensure the best quality of pressure

Continuous monitoring of ET CO2 during CPR (cardiopulmonary resuscitation):

Adrenaline is:

In cardiac arrest in the VF / VT mechanism without heart rate monitored by the patient and witnesses

Amiodaron in sudden cardiac arrest

For the reversible causes of cardiac arrest, do not:

The cerebral blood flow (CBF) and brain oxygen supply depend on the brain's perfusion pressure(CPP), which we pour out:

In the treatment of increased intracranial pressure > 20mmHg does not include:

A patient's COPD test usually shows

Depression of the circulatory system during the induction of intravenous anaesthesia is mainly caused by:

Local aesthetic agents are compounds of:

Under epidural anesthesia, the extent of the anesthesia obtained depends mainly on:

Consequences regarding subarachnoid anaesthesia include:

We observe the monitoring of tissue perfusion by assessing:

In the treatment of pain, the administration of analgesics is standard:

Subarachnoid spinal anaesthesia is possible at the level of the spine

For the treatment of sepsis, immediate surgical control of the outbreak is always recommended, with the exception of:

In the ICU patient with suspected pre-hospital pulmonary infections, the following diagnostic tests should be performed:

Prevention of pneumonia in mechanically ventilated patients (VAP) is carried out through:

You collect an interview and examine a patient admitted to the emergency care system of your hospital diagnosed with STEMI. The patient is monitored (NIBP, EKG, SpO2), has peripheral venous access, receives oxygen therapy, awaits surgery, in the hemodynamic laboratory. During the examination, the patient loses consciousness, and on the cardiomonitator you can see the VF record. Give the order of handling.

A 68-year-old patient with a ruptured abdominal aortic aneurysm HR 120/min, BP 80/40, SpO2 95% without passive oxygen therapy requires immediate laparotomy. What drug do you choose to induce anaesthesia?

The inotropically positive drug of the first choice in the treatment of septic shock is

The leading cause of cardiac arrest in children is:

Indicate a false statement about central venous pressure (CVP)

Which of the following clinical conditions does not cause a shift in the haemoglobin dissociation curve to the left?

The trunk reactions evaluated in the second stage of recognition of the brainstem death in Poland are listed below with the exception

In an adult patient with SCC with clinical features of brain death, in order to find a permanent and irreversible cessation of brain function (brain death) one should:

After defibrillation, continuing CPR (cardiopulmonary resuscitation) the first drug that can be administered is:

Before diagnosing brain death, exclude EXCEPT

A 55-year-old man after successful CPR is admitted to the ICU. No data from the interview. The patient intubated, ventilated mechanic FIO2 O.6, creaks and croaking over the pulmonary fields. Due to the persistent hypotension with symptoms of hypo perfusion, a catheter was introduced into the pulmonary artery with the following values
SvO2 = 45%
CI = 2.2 L / min / M2
PAOP = 19 mm H
The most likely cause of this condition is:

You are called to the Hospital Rescue Department to an 18-year-old man brought by the Emergency Service Team after a traffic accident. The patient is unconscious, has a cool, pale, sweaty skin, cyanosis of lips and respiratory effort is visible 30 shallow breaths / min, the pulse on the radial artery is present, filamentous about 120min. The cervical veins are over-filled, the trachea is moved to the right. The thorax cage moves asymmetrically, with a lack of breathing noise on the left. The most probable diagnosis is

The following clinical conditions are associated with hypokalaemia, EXCEPT

Continuous renal replacement therapy (CRRT) it is used to:

During rescue compressions the change occurs:

What dose of lidocaine in cardiac arrest:

as you can not see the arches of the palate, what is the degree on the Mallapati scale?

The level of lactate typical for shock is:

How to calculate CO:

What drug we can give the earliest after defibrillation in the skin and...

Calculate cerebral blood flow, all parameters given: CV, HR, saturation, pressure, MAP 65, intracranial pressure 20

pH = 7.22; PaCO2 = 55; HCO3- = 25

What is it?

The latest complete definition of septic shock is as follows

In the study of placebo effect the highest decrease of pain intensity was observed in:
a. Open (expected) injection of analgetic
b. Hidden (unexpected) injection of analgetic
c. No difference between both interventions
d. Hidden injection was effective in neuropathic pain only

What kind of treatment is not used in the postoperative pain theory:
a. Epidural blockade
b. Intrapleural blockade?
c. Spinal blockade
d. Neurolytic blockade

Which of the following agents is an inotrope?
a. Metoprolol
b. Milrinone
c. Diltiazem
d. Ramipril

1. The patient is admitted with cardiogenic shock and oliguric acute kidney injury. Hemodynamics reveal the following: BP 105/60 mmHg, sinus rhythm 108/min, CI 1.8 (CO 2.4), CVP 23 mmHg, PCWP 25 mmHg, SVRI 2088 (SVR 1566). The most appropriate management is administration of:
a. Captopril 6.5 mg q6h
b. Dobutamine at 5 mcg/kg/min
c. Metoprolol 25 mg BID
d. Dopamine at 2 mcg/kg/min

Clopidogrel is classified as an:
a. Inhibitor of platelets’ aggregation
b. Factor Xa inhibitor
c. Vit. K antagonist
d. Anti-hypertensive

Dabigatran (Pradaxa) is classified as an:
a. Factor Xa inhibitor
b. Direct thrombin inhibitor
c. Inhibitor of platelets’ aggregation
d. Vit. K antagonist - warfarin

Which of the following information is TRUE about naloxone?
a. Naloxone is a pure opioid antagonist that competitively binds to u-opioid receptors
b. Naloxone has a short duration of activity about 30 to 90 minutes
c. No tolerance or dependence is associated with naloxone use
d. All information are true

In the Sepsis Six algorithm of severe sepsis treatment, Step 1 is:
a. 1000 mL crystalloids infusion
b. 100% oxygen via mask
c. Intravenous antibiotics
d. Dopamine IV

A patient with a spinal abscess is admitted to the ICU in septic shock and requires pressors. Which of the following agents would be most efficacious for increasing cardiac output while increasing mean arterial pressure (MAP)?
a. Digoxin
b. Phenylephrine
c. Dopamine
d. Norepinephrine (Noradrenaline)

Atypical bacterial pathogens that are associated with community-acquired pneumonia (CAP) include:
a. Chlamydia pneumoniae
b. Haemophilus influenzae
c. Streptococcus pneumoniae
d. Moraxella catarrhalis

CVP monitoring:
a. Indicated hypovolemia when CVP is low
b. Allows assessment of preload of the heart
c. May not reflect left heart filling pressures in patients with COPD
d. All are true

Which ONE of the following statements about vasoactive drugs is FALSE:
a. Adrenaline (epinephrine) has alpha and beta receptor agonist activity
b. Noradrenaline (Norepinephrine) is a vasoconstrictor
c. Dopamine has a specific renal protective action in critical care patients at risk of renal failure
d. Dobutamine is a systemic and pulmonary vasodilator

Which ONE of the following statements about PCWP (PAOP) is TRUE:
a. Measurement involves passage of pulmonary artery catheter across the interarterial septum
b. Is typically raised in ARDS
c. Is typically raised in septic shock
d. Is a reflection of left atrial pressure

Quantitative measurement of cardiac output can be made using all methods except:
a. An esophageal Doppler probe
b. Thermodilution techniques
c. Mixed venous saturation (SvO2) and heart rate
d. The Fick principle

Which ONE of the following statements about cardiogenic shock is FALSE:
a. Is characterized by inability of the heart to maintain the circulation
b. Is characterized by a low systemic vascular resistance
c. Can be caused by papillary muscle rupture
d. Is characterized by low cardiac output

The following are risk factors for pulmonary embolism except:
a. Immobilization after surgery
b. Clinically suspected DVT
c. Malignancy
d. Heart LBBB

Factors influencing preload are all except:
a. Atrial contraction
b. Systemic vascular resistance
c. Heart valves diseases
d. Intrathoracic pressure

Positive end-expiratory pressure can contribute to:
a. Increase in systemic venous return
b. FRC increase (prevention of airway collapse)
c. Decrease in airway pressure
d. Increase in work of breathing

Infant CPR should be considered for what age?
a. Under 6 months
b. Under 12 months
c. Under 18 months
d. Under 24 months

1. Criteria regarding apnea testing during brain death examination requires:
a. Hypoxemia below a specified PaO2 must be achieved to assure that no CNS hypoxia-sensing centers are active
b. A specified degree or change in blood pH (acidemia)must be achieved to confirm medullary respiratory center inactivation
c. Arterial PaCO2 must reach or exceed a specified level above baseline

The diagnosis of brain death:
a. Is primarily clinical and no other tests are required if the full clinical examination, including each of two assessments of brain stem reflexes and apnea tests, is conclusively performed - (Glasgow Coma Scale of 3, lack of brainstem derived reflexes, apnea test)
b. Ancillary instrumental tests are needed only in patients in persistent vegetative state
c. Always needs confirmation by ancillary instrumental tests (EEG, evoked potentials, cerebral angiography, transcranial Doppler, perfusion scintigraphy)

These are circulatory criteria for death except:
a. Loss of consciousness
b. Apnea
c. Loss of pulse on big arteries (carotid, femoral)
d. Stiffness

These are criteria for brain death except:
a. Loss of consciousness
b. Loss of all neurological reflexes
c. Loss of brainstem reflexes
d. Loss of capacity to breathe

During diagnosis of brain death the following brainstem reflexes are examined except:
a. Nasocranial
b. Oculocephalic
c. Vestibulo-ocular
d. Corneal

Identify the formula for minute volume:
a. Tidal volume X respiratory rate
b. Cardiac output X respiratory rate
c. Forced vital capacity X respiratory rate
d. Functional residual capacity – tidal volume

Administration of an agonist for which of the following autonomic receptors would be expected to cause airway resistance to decrease?
a. Histaminic
b. Cholinergic
c. Alpha-adrenergic
d. Beta-adrenergic

Immediately following intubation, the patient has an end tidal CO2 reading of 1 mmHg. This finding is consistent with:
a. Pulmonary embolism
b. Right mainstem bronchus intubation
c. Esophageal intubation
d. Correct placement of endotracheal tube

What is the PRIMARY purpose of preoxygenation (denitrogenation) prior to anesthetic induction?
a. Improving matching of ventilation and perfusion
b. Increasing oxygen reserve in the functional residual capacity
c. Increasing contribution of second gas effect to rate of induction
d. Maximizing arterial oxygen content

Two hours after a laparoscopic cholecystectomy, and obese 45-year-old woman is receiving intravenous patient-controlled analgesia with morphine. Her SpO2 is 92% on room air. Which of the following is the most likely cause?
a. Absorption of carbon dioxide from the abdomen
b. Increased dead space
c. Impaired oxygen diffusion
d. Hypoventilation

Use of a laryngeal mask airway during general anesthesia is most appropriate for which of the following patients?
a. A patient undergoing cesarean delivery who cannot be intubated after induction of anesthesia
b. A patient who has trachoesophageal fistula
c. A patient who has a peak inspiratory pressure greater than 30 cmH2O
d. A patient who requires emergency appendectomy 2 hours after eating

A patient has received atropine 1% eye drops after eye surgery. How many milligrams of atropine are in one drop of a 1% solution? 1 mL = 20 drops.
a. 0.05 mg
b. 0.1 mg
c. 0.5 mg
d. 1 mg

Which ONE of the following statements about postintubation croup is FALSE:
a. Almost always appears within 3 doses after intubation
b. Is associated with repeated intubation attempts
c. Is associated with early childhood
d. The only effective treatment is urgent trachestomy

Which ONE of the following statements about pediatric patients is FALSE:
a. Fluid deficits in infants are usually replaced with 5% glucose
b. Infants respond to dehydration with decreased blood pressure but without tachycardia
c. The cardiac output of neonates and infants is dependent on heart rate, since stroke volume is relatively fixed
d. Postoperative hypothermia in pediatric patients is associated with delayed awakening and respiratory depression

Risk Factors for bronchial aspiration like oesophageal hiatus , diabetes with stomach atony, obesities , pregnancy :
a. are indications to RSI ( Rapid sequence induction )
b. are absolute contraindication to general anaesthesia
c. do not constitute major aesthetic problem , because some of them are physiology .
d. do not present a problem if the patient is fasting for six hours before anaesthesia .

intravascular volume changes , electrolyte disturbances , anaemia are typical problem for the patient with :
a. Diabetes
b. Liver failure
c. Chronic renal failure
d. Hyperthyrodism

calcium homeostasis malfunction in sarcoplasmic reticulum of skeletal muscle , related to some anaesthetic usage can lead to :
a. Propofol syndrome .
b. Malignant hyperthermia .
c. Pheochromocytoma .
d. Takotsubo cardiomyopathy .

Capnography is used as
1. an indicator of adequacy of ventilation .
2. disconnection indicator .
3. an indicator of correct placement of tracheal tube .
4. an indicator of cardiac output .
a. All answers are true .
b. 4 is false .
c. 2 and 4 are false .
d. 1 is true .

how many fluids should be infused in the first hour of treatment of septic shock in children :
a. fluids are not important for this kind of treatment
b. 10 ml/kg/h
c. 20 ml/kg/h
d. 10-20 ml/kg / 20 min ( up to 60 ml/kg/h)

Which kind of approach of epidural block can be used in children :
a. thoracic and lumbar
b. cervical , thoracic and lumbar
c. thoracic , lumbar and sacral
d. only sacral

Hemodynamically stable 70 kg , 40 year old man with adult respiratory distress syndrome is being mechanically ventilated with the following settings :
Tidal volume 500 ml , Respiratory rate 12/ min. FiO2 0.80 , I:E ratio 1:2 positive , end- expiratory pressure 5 cmH2O
Analysis of arterial blood gases shows PaO2 50 mmHG , PaCO2 40 mmHG , and pH 7,42 , Which of the following changes in ventilators settings is most appropriate :
a. increase FiO2
b. increase positive end-expiratory pressure
c. increase tidal volume
d. increase ventilatory rate

Vasoconstrictors decrease the rate of vascular absorption which allows more anaesthetic to reach the nerve membrane and improved the depth of anaesthesia :
a. 1:200000 ( dosage 5 µg/ml ) epinephrin appear to be the best vasoconstrictor .
b. 1:20000 ( dosage 5 µg/ml ) epinephrin appear to be the best vasoconstrictor .
c. 1:200000000( dosage 5 µg/ml ) epinephrin appear to be the best vasoconstrictor .
d. 1:200 ( dosage 5 µg/ml ) epinephrin appear to be the best vasoconstrictor .

Vascular disease, Asymptomatic myocardial ischemia , Neuropathic sensation disturbances, Gastric atony , Chronic renal failure is common problems in patient with
a. Thyroid disorder .
b. Adrenal cortical disease .
c. Diabetes .
d. Addison disease .

The aim of early goal directed therapy in severe septic shock is to reach urine output ( ml/kg/h) values :
a. > 0.1
b. > 0.5
c. > 1.0
d. > 2.0