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Anaesthesiology Final MCQs- 5th Year PMU

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Anaesthesiology MCQs 1- 5th Year PMU

Frage 1 von 99

1

All but ONE of the following are predictors of a difficult intubation. Indicate the exception

Wähle eine der folgenden:

  • Mouth opening of only 3 fingerbreadths

  • Short, thick neck with limited mobility

  • Mallampati Class IV

  • Thyromental distance of 2 fingerbreadths

Erklärung

Frage 2 von 99

1

ALL BUT ONE of the following factors represent an indication for intubation in a patient who is about to undergo surgery. Indicate the exception

Wähle eine der folgenden:

  • Surgery is a lumbar laminectomy

  • Surgery is removal of a lymph node of the neck

  • Surgery is appendectomy

  • Surgery is tonsillectomy

Erklärung

Frage 3 von 99

1

Which ONE of the following structures is not encountered during direct laryngoscopy?

Wähle eine der folgenden:

  • Vallecula

  • Cricoid cartilage

  • Epiglottis

  • Arytenoid cartilage

Erklärung

Frage 4 von 99

1

The COMPLETE absence of a capnographic waveform immediately following endotracheal intubation may indicate ALL BUT ONE of the following. Indicate the exception

Wähle eine der folgenden:

  • Circuit disconnection

  • Cardiac arrest

  • Endobronchial intubation

  • Complete airway obstruction

  • Esophageal intubation

Erklärung

Frage 5 von 99

1

After induction of anesthesia, the anesthesiologist is unable to intubate the patient.
Which ONE of the following is the most important management priority?

Wähle eine der folgenden:

  • Ensuring that intubation is achieved as soon as possible

  • Inserting a laryngeal mask

  • Ensuring that bag-mask ventilation is achievable

  • Ensuring that the patient does not awaken until intubation is successfully achieved

Erklärung

Frage 6 von 99

1

Advantages of a Laryngeal mask airway include ALL BUT ONE of the following. Indicate the exception

Wähle eine der folgenden:

  • It frees up the anesthesiologist’s hands

  • It protects against aspiration

  • It can allow mechanical ventilation

  • It can be readily inserted without the use of muscle relaxants

Erklärung

Frage 7 von 99

1

ALL BUT ONE of the following are ways to confirm endotracheal intubation. Indicate the exception

Wähle eine der folgenden:

  • Auscultation of both lung fields and over the stomach

  • Visualization of the endotracheal tube through the vocal cords

  • Easy advancement of the endotracheal tube without resistance

  • Presence of a stable CO2 trace on the end-tidal capnography

Erklärung

Frage 8 von 99

1

The “transfusion trigger” (the lowest allowable hemoglobin level) intra-operatively is

Wähle eine der folgenden:

  • 100 g/L

  • 80g/L

  • 60g/L

  • Individualized to every patient

Erklärung

Frage 9 von 99

1

ALL BUT ONE of the following are early indicators of hypovolemia. Indicate the exception

Wähle eine der folgenden:

  • Tachycardia

  • Decreased pulse pressure

  • Decreased urine output

  • Lactic acidosis

Erklärung

Frage 10 von 99

1

The maintenance fluid requirement for an 80 kg man using the 4-2-1 rule is

Wähle eine der folgenden:

  • 100 cc/hr

  • 120 cc/hr

  • 150 cc/hr

  • 170 cc/hr

Erklärung

Frage 11 von 99

1

Milllilitre for millilitre, which of the following provides the most intravascular volume expansion?

Wähle eine der folgenden:

  • Packed red blood cells

  • Albumin (5%)

  • Pentaspan

  • Ringers Lactate

Erklärung

Frage 12 von 99

1

A patient has lost 500ml of blood during a low anterior bowel resection. His hemoglobin is 115 g/L.
What is the most appropriate volume replacement?

Wähle eine der folgenden:

  • Pentaspan 1500 mL

  • DSW 500 mL

  • Ringers Lactate 500 mL

  • Normal Saline 1500 mL

Erklärung

Frage 13 von 99

1

Regarding vascular access and fluid resuscitation, which ONE of the following statements is TRUE?

Wähle eine der folgenden:

  • An intravenous is required for procedures under local anesthesia such as carpal tunnel release or cystoscopy

  • Cannulation of a lower limb vein is inappropriate for use in the operating room

  • Cannulation of the jugular vein for central venous pressure monitoring is recommended in lengthy cases with the potential for significant fluid shifts.

  • A 14 gauge central line will allow more rapid fluid resuscitation than a 14 gauge peripheral canula

Erklärung

Frage 14 von 99

1

A patient receives 10 units of packed red blood cells. Which ONE of the following chemistry profiles is most likely?

Wähle eine der folgenden:

  • Hyperkalemia, hypercalcemia

  • Hypokalemia, hypocalcemia

  • Hyperkalemia, hypocalcemia

  • Hypokalemia, hypercalcemia

Erklärung

Frage 15 von 99

1

Which ONE of the following procedures would be associated with the most “third space" loss of fluid?

Wähle eine der folgenden:

  • Open reduction, internal fixation of the pelvis

  • Whipple resection of the pancreas

  • Resection of large frontal brain tumour

  • Caesarian section

Erklärung

Frage 16 von 99

1

Routine preoperative hemoglobin is NOT required for

Wähle eine der folgenden:

  • A healthy female over 50 years of age

  • A patient who has been crossmatched for surgery

  • A patient on anticoagulant medication

  • A young female patient with menorrhagia

Erklärung

Frage 17 von 99

1

Which ONE of the following is the most important determinant of peri-operative risk?

Wähle eine der folgenden:

  • Patient’s underlying health

  • Length of surgery

  • Duration of surgery

  • Emergency surgery

Erklärung

Frage 18 von 99

1

Which of these patients is NOT at increased risk of aspiration?

Wähle eine der folgenden:

  • A pregnant patient (32 weeks gestation) who has been NPO (nil per os) for 10 hours

  • A patient with fractured femur who has been NPO since the accident 12 hours ago

  • A healthy patient with appendicitis

  • A healthy patient who had 8 ounces of clear tea 4 hours pre-operatively

Erklärung

Frage 19 von 99

1

The following medication should be discontinued prior to surgery and anesthesia

Wähle eine der folgenden:

  • Anticonvulsants

  • Thyroid replacement

  • Monoamine-oxidase inhibitors

  • Antihypertensives

Erklärung

Frage 20 von 99

1

A patient with which ONE of the following conditions requires antibiotic prophylaxis prior to tonsillectomy?

Wähle eine der folgenden:

  • Uncorrected Tetralogy of Fallot

  • Aortic stenosis

  • Uncomplicated heart transplant

  • Prophylaxis is not required for tonsillectomy

Erklärung

Frage 21 von 99

1

A patient is on prednisone 30 mg daily for rheumatoid arthritis and presents for coronary bypass surgery. Which of the following best describes their peri-operative steroid requirements?

Wähle eine der folgenden:

  • 30mg prednisone orally on day of surgery

  • 25 mg hydrocortisone IV on day of surgery

  • 25 hydrocortisone IV for 72 hours

  • 100 mg hydrocortisone IV for 72 hours

Erklärung

Frage 22 von 99

1

A 60-year old man for minor surgery has a BP of 170/100 mmHg in the pre-operative clinic. In retrospect, he admits that his blood pressure has been consistently high when he checks it at the drugstore. Assign an ASA class.

Wähle eine der folgenden:

  • ASA 1

  • ASA 2

  • ASA 3

  • ASA 4

Erklärung

Frage 23 von 99

1

ALL BUT ONE of the following describes the CO2 absorber.
Indicate the exception

Wähle eine der folgenden:

  • Changes colour as the soda lime becomes exhausted

  • Is required if a circle circuit is being used

  • Allows for economical use of anaesthetic gases

  • Provides a waveform of exhaled carbon dioxide

Erklärung

Frage 24 von 99

1

Which ONE of the following statements regarding the peripheral nerve stimulator is true?

Wähle eine der folgenden:

  • Delivers four successive impulses at a rate of 2 per second

  • Is a sensitive indicator of neuromuscular blockade

  • Must be used on the awake patient to achieve a baseline

  • Is commonly applied to the radial nerve

Erklärung

Frage 25 von 99

1

A patient is receiving a balanced anesthetic with volatile anesthetic gases, opioids and muscle relaxants. Which ONE of the following monitors is required to be in continuous use during the care of this patient?

Wähle eine der folgenden:

  • Temperature probe

  • Agent-specific gas monitor

  • Peripheral nerve stimulator

  • Spirometer

Erklärung

Frage 26 von 99

1

ALL BUT ONE of the following interfere with accurate pulse oximetry measurements.
Indicate the exception:

Wähle eine der folgenden:

  • Nail polish

  • Peripheral vasoconstriction due to hypothermia

  • Severe anemia (Hg 60 g/L)

  • Methemoglobinemia

  • Carbon monoxide

Erklärung

Frage 27 von 99

1

ALL BUT ONE of the following conditions will cause the capnograph to give a reading that is much lower than the arterial CO2.
Indicate the exception

Wähle eine der folgenden:

  • Pulmonary embolus

  • Exhausted CO2 absorber soda lime

  • Cardiac arrest

  • Severe bronchospasm

Erklärung

Frage 28 von 99

1

The abbreviation “MAC” stands for

Wähle eine der folgenden:

  • Minimal arterial concentration

  • Minimal alveolar concentration

  • Maximal arterial concentration

  • Maximal alveolar concentration

Erklärung

Frage 29 von 99

1

Regarding awareness, ALL BUT ONE of the following statements are correct.
Indicate the exception

Wähle eine der folgenden:

  • There is no "gold" standard for measuring level of consciousness

  • Volatile agents are effective amnestic agents

  • Changes in heart rate and blood pressure can be used as surrogate indicators of level of consciousness

  • Opioids (in high doses) provide effective hypnosis

Erklärung

Frage 30 von 99

1

The immediate goals of emergence include ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • The ability of the patient to protect their airway

  • Stable cardiovascular status

  • Normal mental status examination

  • Effective analgesia

Erklärung

Frage 31 von 99

1

The advantages of regional anesthesia include ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Improved outcomes for certain procedures (e.g. thoracic surgery, Caesarean section

  • Ability to continue technique postoperatively to provide pain relief

  • A reliable option for patients not well enough to undergo general anesthesia

  • Avoidance of systemic administration of drugs and consequent side effects

Erklärung

Frage 32 von 99

1

Hypothermia is associated with ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Post operative hypoxemia

  • Decreased platelet function

  • Myocardial ischemia

  • Increased analgesic requirements

Erklärung

Frage 33 von 99

1

Adequacy of reversal of muscle relaxation can be assessed by ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Strong hand grip

  • The return of the eyelash reflex

  • Train of four shows 4 twitches with no fade

  • 5 second head lift

Erklärung

Frage 34 von 99

1

Tracheal intubation would be required in ALL BUT ONE of the following procedures. Indicate the exception:

Wähle eine der folgenden:

  • Open cholecystectomy

  • Laparoscopic cholecystectomy

  • Excision of lymph node from the neck

  • Tonsillectomy

Erklärung

Frage 35 von 99

1

Known complications related to positioning include ALL BUT ONE of the following. Indicate the exception

Wähle eine der folgenden:

  • Brachial plexus injury with arm abduction of 60°

  • Hypoxemia in the Trendelenburg position

  • Common peroneal nerve injury in the lithotomy position

  • Retinal ischemia in the prone position

  • Venous air embolus with the sitting position

Erklärung

Frage 36 von 99

1

Regarding the comparative considerations of epidural and spinal anesthesia, which ONE of the following is CORRECT?

Wähle eine der folgenden:

  • The lumbar puncture for a spinal anesthetic should be performed above L1 to avoid trauma to the cauda equina

  • The epidural space is identified by puncture of the dura and free flow of cerebral spinal fluid

  • A postdural puncture headache is a potential complication that occurs with both spinal and epidural techniques

  • Epidural anesthesia is usually faster in onset than spinal anesthesia

Erklärung

Frage 37 von 99

1

Early signs and symptoms of local anesthetic toxicity include ALL BUT ONE of the following. Indicate the exception

Wähle eine der folgenden:

  • Tinnitus

  • Perioral numbness

  • Dizziness

  • Hypertension

Erklärung

Frage 38 von 99

1

Shivering can lead to ALL BUT ONE of the following. Indicate the exception:

Wähle eine der folgenden:

  • Myocardial ischemia

  • Increased oxygen consumption

  • Decreased carbon dioxide production

  • Interference with monitor signal interpretation

Erklärung

Frage 39 von 99

1

Which ONE of the following statements about shivering is correct?

Wähle eine der folgenden:

  • Shivering is a response controlled by the brainstem

  • Shivering can occur in the absence of hypothermia

  • Shivering is effectively treated with small doses of naloxone

  • Shivering is an uncomfortable, though harmless, effect of anesthesia

Erklärung

Frage 40 von 99

1

ALL BUT ONE of the following are used as intravenous antiemetics. Indicate the exception

Wähle eine der folgenden:

  • Prochlorperazine

  • Ranitidine

  • Dimenhydrinate

  • Dexamethasone

Erklärung

Frage 41 von 99

1

Which of the following is a risk factor for PONV?

Wähle eine der folgenden:

  • History of gastroesophageal reflux

  • Smoking

  • Diabetes mellitus

  • Female gender

Erklärung

Frage 42 von 99

1

Which ONE of the following is part of a rational approach to post-operative nausea and vomiting?

Wähle eine der folgenden:

  • All patients should receive pharmacologic prophylaxis

  • Avoidance of anti-emetic anesthetic agents is an effective management strategy

  • Prophylaxis must be given prior to induction of anesthesia for maximal effectiveness

  • Dimenhydrinate remains the mainstay of PONV prevention and treatment

Erklärung

Frage 43 von 99

1

Which ONE of the following is least likely to be the cause of hypertension in the PACU?

Wähle eine der folgenden:

  • Pain

  • Airway obstruction

  • Prolonged spinal blockade

  • Full bladder

Erklärung

Frage 44 von 99

1

Which ONE of the following is a criteria that the patient must meet prior to transfer from the post-anesthetic care unit (PACU) to the ward?

Wähle eine der folgenden:

  • Normal cognitive function

  • Adequate pain control

  • Ability to hold down food

  • Ability to weight-bear

Erklärung

Frage 45 von 99

1

You see a patient in the preoperative assessment clinic prior to her laparotomy for colon cancer. If the patient has an epidural inserted for post-operative pain, she is likely to experience ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Reduced adrenal activation

  • Hypertension

  • Improved respiratory function

  • Excellent post-operative pain control

Erklärung

Frage 46 von 99

1

Your patient's most recent surgery was thirty years ago after which she received "conventional" nurse-administered opioid analgesia. For her upcoming lumbar spinal decompression and instrumentation, she will be receiving PCA (patient-
controlled analgesia). The comparative advantages of PCA morphine include ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Less labor intensive for nurses

  • More opioid delivered to the patient

  • Improved patient satisfaction

  • Small doses at frequent intervals minimizing the pharmacokinetic "peaks" and “valleys”

Erklärung

Frage 47 von 99

1

ALL BUT ONE of the following is a relative contraindication to post-operative epidural analgesia.
Indicate the exception

Wähle eine der folgenden:

  • Multiple sclerosis

  • Lumbar disc disease

  • Hypertrophic obstructive cardiomyopathy

  • Myasthenia gravis

Erklärung

Frage 48 von 99

1

All BUT ONE of the following are true regarding malignant hyperthermia (MH). Indicate the exception

Wähle eine der folgenden:

  • Newer volatile anesthetics such as desflurane are not believed to trigger MH

  • Nitrous oxide is safe

  • Dantrolene is the only therapeutic drug treatment

  • Mortality is as high as 10% even with prompt treatment

Erklärung

Frage 49 von 99

1

Which of the following is the first sign of a malignant hyperthemic reaction?

Wähle eine der folgenden:

  • Hyperthermia

  • Hypercarbia

  • Tachycardia

  • Ventricular arrhythmias

Erklärung

Frage 50 von 99

1

Treatment of a malignant hyperthermia crisis includes ALL BUT ONE of the following.
Indicate the exception

Wähle eine der folgenden:

  • Turning off the volatile anesthetic

  • Active cooling measures

  • Dantrolene

  • Beta blockers

Erklärung

Frage 51 von 99

1

Maternal hypotension in the supine position during pregnancy is most often due to

Wähle eine der folgenden:

  • Decreased blood volume

  • Decreased peripheral vascular resistance

  • Decreased hematocrit

  • Compression of the vena cava

Erklärung

Frage 52 von 99

1

ALL BUT ONE of the following represent relevant physiologic changes of pregnancy in the 40 week gestation parturient.
Indicate the exception

Wähle eine der folgenden:

  • Decreased cardiac output

  • Delayed gastric emptying

  • Increased blood volume

  • Decreased anesthetic requirements

Erklärung

Frage 53 von 99

1

In the obstetrical patient in her third trimester, the supine position

Wähle eine der folgenden:

  • Should be avoided by placing a pillow under her knees

  • Is detrimental due to the risk of causing excessive venous return to the right heart

  • Is harmful to the mother, but is harmless to the fetus

  • Is safe at 20 weeks of pregnancy

Erklärung

Frage 54 von 99

1

ALL BUT ONE of the following are part of rational fasting guidelines for pediatric patients. Indicate the exception

Wähle eine der folgenden:

  • Solids up to 8 hours pre-op

  • Clear fluids up to 3 hours pre-op

  • Breast milk up to 4 hours pre-op

  • Formula up to 2 hours pre-op

Erklärung

Frage 55 von 99

1

The narrowest portion of the neonate's airway is at the level of the

Wähle eine der folgenden:

  • Glottis

  • Cricoid

  • Trachea

  • Pharynx

Erklärung

Frage 56 von 99

1

The appropriate size endotracheal tube for a 4 year old child is

Wähle eine der folgenden:

  • 4.0

  • 4.5

  • 5.0

  • 6.0

Erklärung

Frage 57 von 99

1

ALL BUT ONE of the following represents attributes of the pediatric cardiovascular system. Indicate the exception

Wähle eine der folgenden:

  • Cardiac output is heart-rate dependent

  • Hypoxemia is an important cause of bradycardia

  • Blood volume is greater, relative to size

  • Vagal responsiveness is under-developed

Erklärung

Frage 58 von 99

1

Which ONE of the following is an explanation for rapid desaturation during apnea that is seen in the pediatric patient?

Wähle eine der folgenden:

  • Increased functional residual capacity (FRC)

  • Increased oxygen consumption

  • Increased minute ventilation

  • Obligate nasal breathing

Erklärung

Frage 59 von 99

1

ALL BUT ONE are features of the pediatric airway compared to the adult. Indicate the exception

Wähle eine der folgenden:

  • Larynx situated higher

  • Larynx situated more anteriorly

  • Epiglottis shorter and less mobile

  • Narrowest part of the airway at the cricoid

Erklärung

Frage 60 von 99

1

The use of epidural analgesia for labour is likely to result in which ONE of the following

Wähle eine der folgenden:

  • Prolonged second stage

  • Increased risk of operative delivery

  • Neonatal depression

  • Maternal sedation

Erklärung

Frage 61 von 99

1

ALL BUT ONE of the following is a disadvantage of general anesthesia for Caesarian section. Indicate the exception

Wähle eine der folgenden:

  • Increased risk of aspiration in the pregnant patient

  • Increased anesthetic requirements

  • Exacerbation of uterine atony

  • Increased risk of awareness under anesthesia

Erklärung

Frage 62 von 99

1

Which ONE of the following is an accurate statement regarding the use of spinal anesthesia for Caesarian section?

Wähle eine der folgenden:

  • Quick and easy in the setting of emergency Caesarian section

  • Associated with decreased maternal morbidity

  • Associated with increased neonatal depression

  • Presents less of a risk of maternal hypotension compared with general anesthesia

Erklärung

Frage 63 von 99

1

Nitrous oxide is contraindicated in ALL BUT ONE of the following settings. Indicate the exception

Wähle eine der folgenden:

  • Total hip arthroplasty in the lateral position

  • Laparotomy for bowel obstruction

  • Multiple trauma with pneumothorax

  • Patient with history of severe post operative nausea and vomiting

Erklärung

Frage 64 von 99

1

Which class of drugs is most commonly responsible for intraoperative anaphylactic (or anaphylactoid) reactions?

Wähle eine der folgenden:

  • Opioid analgesic agents

  • Induction agents

  • Muscle relaxants

  • Volatile anesthetic agents

Erklärung

Frage 65 von 99

1

Other than analgesia, what is the most important clinical effect of the opioid analgesics?

Wähle eine der folgenden:

  • Cardiac depression

  • Sedation

  • Nausea and vomiting

  • Respiratory depression

Erklärung

Frage 66 von 99

1

Which ONE of the following describes an advantage of sevoflurane over desflurane?

Wähle eine der folgenden:

  • Lower lipid solubility therefore quicker onset and offset of effect

  • Less pungent therefore more practical for mask induction

  • Can be used with lower flows therefore more economical

  • Mild sympathomimetic effect minimizes hypotension

Erklärung

Frage 67 von 99

1

Which ONE of the following best describes the reason for the rapid OFFSET of effect of the induction agents

Wähle eine der folgenden:

  • Ester hydrolysis

  • Liver metabolism

  • Redistribution

  • Renal excretion

Erklärung

Frage 68 von 99

1

ALL BUT ONE of the following conditions predisposes the patient to prolonged effect of non-depolarizing muscle relaxants. Indicate the exception

Wähle eine der folgenden:

  • Hyperkalemia

  • Hypothermia

  • Gentamycin administration

  • Myasthenia gravis

Erklärung

Frage 69 von 99

1

ALL BUT ONE of the following are contraindications to succinylcholine. Indicate the exception

Wähle eine der folgenden:

  • Cervical spinal cord injury (1 week ago)

  • Monoamine oxidase administration

  • Malignant hyperthermia susceptibility

  • Burn injury (24 hours ago)

Erklärung

Frage 70 von 99

1

Which of the following is the correct MAXIMUM safe dose of bupivacaine (plain)

Wähle eine der folgenden:

  • 1 mg/kg

  • 2 mg/kg

  • 5 mg/kg

  • 7 mg/kg

Erklärung

Frage 71 von 99

1

ALL BUT ONE of the following describes a feature of phenylephrine. INDICATE THE EXCEPTION

Wähle eine der folgenden:

  • Phenylephrine causes (reflex) bradycardia

  • Phenylephrine can be safely used in patients with cocaine intoxication

  • Phenylephrine acts directly at the alpha adrenergic receptor

  • Phenylephrine improves cardiac performance in cardiogenic shock

Erklärung

Frage 72 von 99

1

ALL BUT ONE of the following are effects of the synthetic opioids (fentanyl, sufentanil and remifentanil). Indicate the exception

Wähle eine der folgenden:

  • Muscle rigidity

  • Biliary spasm

  • Myocardial depression

  • Bradycardia

Erklärung

Frage 73 von 99

1

Which ONE of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?

Wähle eine der folgenden:

  • Desflurane 6%; Sevoflurane 1%; Isoflurane 2%

  • Desflurane 2%; Sevoflurane 6%; Isoflurane 1%

  • Desflurane 1%; Sevoflurane 2%; Isoflurane 6%

  • Desflurane 6%; Sevoflurane 2%; Isoflurane 1%

  • Desflurane 2%; Sevoflurane 1%; Isoflurane 6%

  • Desflurane 1%; Sevoflurane 6%; Isoflurane 2%

Erklärung

Frage 74 von 99

1

Which of the following opioids are most commonly administered into the intrathecal (spinal) space?

Wähle eine der folgenden:

  • Morphine and sufentanil

  • Fentanyl and sufentanil

  • Morphine and fentanyl

  • Fentanyl and remifentanil

Erklärung

Frage 75 von 99

1

Which ONE of the following receptors is NOT targeted in the treatment or prevention of post-operative nausea and vomiting?

Wähle eine der folgenden:

  • GABA

  • Histamine

  • Serotonin

  • Dopamine

Erklärung

Frage 76 von 99

1

Which ONE of the following sets correctly describes the cholinergic effects of neostigmine?

Wähle eine der folgenden:

  • Bradycardia and bronchospasm

  • Mydriasis and confusion

  • Urinary retention and constipation

  • Dry mouth and dry eyes

Erklärung

Frage 77 von 99

1

Which of the following correctly describes an important principle in the use of ketorolac as an adjunct for post-operative pain?

Wähle eine der folgenden:

  • IV therapy should be minimized to less than 5 days

  • Ketorolac must not be given to patients with renal insuffciency

  • Potentiation of opioid effect is a risk

  • Gastrointestinal bleeding is not a concern with the Cox 1 inhibitors such as ketorolac

Erklärung

Frage 78 von 99

1

What is the main advantage of the use of glycopyrrolate compared to atropine to counteract the cholinergic effects of anticholinesterase administration?

Wähle eine der folgenden:

  • Faster onset of action

  • Does not cross the blood brain barrier

  • More effective anticholinergic activity

  • Safe in patients with narrow angle glaucoma

Erklärung

Frage 79 von 99

1

Which statement about the distribution of water in the body Is true?

Wähle eine der folgenden:

  • Most of the body water content is located within the extracellular compartment

  • Water content in a newborn child is 30-60% of its body weight

  • Plasma water content is only 5% of the body weight

  • Total body water content in adult females is 60% of their body weight

Erklärung

Frage 80 von 99

1

Which of the following is not associated with high anion-gap metabolic acidosis

Wähle eine der folgenden:

  • Tissue hypoxia with hyperlactatemia

  • Kidney failure

  • Methanol intoxication

  • Diarrhea

Erklärung

Frage 81 von 99

1

Which of the following statements about ARDS in adults is NOT correct

Wähle eine der folgenden:

  • Bilateral opacities consistent with pulmonary edema on chest radiography or computed tomography (CT) scan that are not fully explained by pleural effusions, lobar/lung collapse, pulmonary nodules or heart failure are required for the diagnosis

  • Several conditions’can lead to the development of ARDS, including aspiration of gastric contents, pneumonia, sepsis (most common cause), trauma, transfusion of blood products (particularly plasma-rich products), pancreatitis, fat emboli, and drowning

  • Most patients with ARDS require intubation and mechanical ventilation with low tidal volumes (6 mL/kg predicted weight) and targeted plateau pressures of equal to or less than 30 cm H2O

  • Moderate to severe impairment of oxygenation ts defined by the ratio of arterial oxygen tension to fraction of inspired oxygen (PaO2/FiO2). In Severe ARDS (PaO2/FiO2) ts between 200 and 300 mmHg on PEEP >5 cm H2O

Erklärung

Frage 82 von 99

1

Which of the following drugs is of first therapeutic choice in managing anaphylactic shock?

Wähle eine der folgenden:

  • Methylprednisolone i.v.

  • Adrenaline i.m.

  • Diphenhydramine i.m.

  • Atropine i.v.

Erklärung

Frage 83 von 99

1

Which of the following suggested clinical and laboratory parameters are Not part of the SOFA score for sepsis?

Wähle eine der folgenden:

  • Bilirubin, creatinine and urine output

  • Blood pressure and PaO2/FiO2 ratio

  • Platelets and GCS

  • Body temperature and WBCs

Erklärung

Frage 84 von 99

1

Which of the statements about FAST is NOT correct?

Wähle eine der folgenden:

  • It is a rapid and noninvasive No to evaluate the abdomen for presence of pathological fluid collection in peritoneal and pericardial cavity

  • It is comparable to diagnostic peritoneal lavage (DPL) as a method for detecting peritoneal fluid

  • Abdominal areas to examine are three: right upper quadrant, left upper quadrant and subxyphoid

  • Extended FAST (E-FAST) examination includes views of the bilateral hemithoraces and the upper anterior chest wall

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Frage 85 von 99

1

20 year old male cyclist is hit by a car. On the primary evaluation the GCS was 9 points and quickly deteriorated to a maximum of 6, but the breathing and hemodynamic status were initially stable. The patient was intubated, mechanically ventilated and mannitol infusion was started during the transport. On emergent CT scan of the head only diffuse brain oedema is found with no focal lesions of the brain parenchyma or intracranial hematomas. CT scan of the neck, chest and abdomen shows clear spine, fractures of fourth and fifth ribs on the right, no pleural fluid or air collections, intact heart and great vessels, no injuries to the abdominal organs or free fluid in the abdominal cavity. The patient is admitted in the ICU. Which of the suggested monitoring is not part of the initial management of that patient?

Wähle eine der folgenden:

  • EEG

  • ETCO2 measurement

  • CVP measurement

  • Invasive arterial blood pressure measurement

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Frage 86 von 99

1

Generally accepted definition of coma includes a GCS score of

Wähle eine der folgenden:

  • < 6

  • < 8

  • < 10

  • < 12

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Frage 87 von 99

1

Augmenting O2, delivery to the tissues is undoubtedly one of the first and foremost priorities in the management of circulatory shock. Which of the following suggested measures cannot help for for that purpose?

Wähle eine der folgenden:

  • Administration of vasopressor drugs if no response to fluid therapy is achieved

  • HCO3 administration for correction of acidosis

  • Blood transfusion in case of hemorrhagic shock

  • Supplementary O2 administration

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Frage 88 von 99

1

Fülle die Lücken, um den Text zu vervollständigen.

Which drugs can be administered endotracheally during CPR if I.V. or I.0. access cannot be established?



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Frage 89 von 99

1

A characteristic feature of cerebral salt wasting syndrome (CSWS) that distinguishes it from the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is

Wähle eine der folgenden:

  • Pathological process affecting the brain

  • Decreased extracellular fluid volume (hypovolemia)

  • Increased Na+ loss with urine

  • Hyponatremia (serum (Na‘] <135 mmol/l)

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Frage 90 von 99

1

Which of the following statements about the acid-base disorders is false?

Wähle eine der folgenden:

  • Metabolic alkalosis is the most common acid-base disturbance in hospitalised patients

  • Successful treatment of all acid-base disorders depends on the identification and elimination of the cause

  • Most cases of respiratory acidosis are due to increased production of CO2

  • As a rule acid-base disorders of metabolic origin involve a respiratory compensatory response and vice versa

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Frage 91 von 99

1

Fülle die Lücken, um den Text zu vervollständigen.

List Pulmonary causes of ARDS

Severe
Inhalation

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Frage 92 von 99

1

Which of the following pairs of different types of hypoxia and possible causes does not match?

Wähle eine der folgenden:

  • Heart failure → Stagnant hypoxia

  • Acute hemolysis → Anemic hypoxia

  • Anaphylaxis → Cytopathic hypoxia

  • High altitude → Hypoxic hypoxia

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Frage 93 von 99

1

Microblologic analysis of blood cultures is

Wähle eine der folgenden:

  • Required for diagnosis of sepsis

  • Required before starting antimicrobial therapy for sepsis

  • Required for narrowing of the empiric antimicrobial therapy

  • Required for selection of the optimal route for antimicrobials administration

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Frage 94 von 99

1

Which of the following suggested compensatory responses to shock state does not increase the Frank-Starling mechanism in the heart (increased preload=increased cardiac output)

Wähle eine der folgenden:

  • Fluid redistribution to the vascular space

  • Decreased venous capacitance

  • Increased heart rate

  • Decreased renal losses of fluid

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Frage 95 von 99

1

Possible disastrous complication from overly rapid correction of hyponatremia is

Wähle eine der folgenden:

  • Cerebral edema and brain herniation

  • Insipid diabetes

  • Ischaemic Stroke

  • Central pontine myelinolysis

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Frage 96 von 99

1

A 12-year old boy with unremarkable previous medical history regularly vaccinated, was hospitalised two days ago with flu-like symptoms, abdominal pain and vomiting. His condition was gradually worsening with changes in, mentation (GCS initialty was 15 now is 12), rapid and noisy breathing arterial hypotension (BP 95/50 MmHg), oliguria (after initial polyuria), hyperthermia, with 38.8°C despite the antiviral (Oseltamivir) and the symptomatic therapy that were started initially. You run a blood and urine analysis and receive the following results: arterial blood pH 7.0, PaCO2 20 mmHg. BE (-16), [HCO3-] 10 mmol/L, blood glucose 2 mmol/L, [K+] 3.4 mmol/l, [Na+] 132 mmol/L, [Cl-] 90 mmol/L, and serum creatinine 60 μmol/l, urea 3 μmol/l, 4(+) glucose and 3(+) ketones in urine
What are the first therapeutic intervention you would start with in this case?

Wähle eine der folgenden:

  • Immediate administration of sodium bicarbonate to correct the acidosis

  • Aggressive restoration of extracellular fluid volume with balanced cystalloid solutions

  • Subcutaneous administration of insulin

  • Endotracheal intubation and Mechanical Ventilation

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Frage 97 von 99

1

All of the following are part of the therapeutic strategy for ARDS in adults, except

Wähle eine der folgenden:

  • Ventilation with low tidal volumes (6 ml/kg) and PEEP

  • Periodically switching to ventilation in prone position

  • Avoiding positive fluid balance

  • Administration of Surfactant and inhaled Nitric Oxide

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Frage 98 von 99

1

Which of the following statements about cyanosis is correct?

Wähle eine der folgenden:

  • It is a late sign of respiratory failure

  • It is characteristic for type 1 (hypoxemic) respiratory failure

  • It is caused by increased amount of reduced Hb (>50-60 g/l)

  • Patients with anaemia manifest cyanosis at higher SaO2 values (earlier) than patients with normal Hb values

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Frage 99 von 99

1

Fülle die Lücken, um den Text zu vervollständigen.

Name four major categories of circulatory shock and give examples for every type
Shock-
Shock- failure
shock- of the aorta
shock-

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