Question 1
Question
A new intravenous anaesthetic is found to have a very large volume of distribution. This drug is most likely to have which of the following properties?
Answer
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Hydrophilic with a high degree of plasma protein binding
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Hydrophilic with a large non-ionized fraction
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Hydrophilic with a low degree of tissue protein binding
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Lipophilic with a high degree of tissue protein binding
Question 2
Question
Each of the following drugs causes enhanced activity of the gamma-aminobutyric acid receptor EXCEPT:
Answer
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Etomidate
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Midazolam
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Ketamine
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Propofol
Question 3
Question
What is the primary purpose of denitrogenation prior to anesthetic induction?
Answer
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Improving matching of ventilation and perfusion
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Increasing oxygen reserve in the functional residual capacity
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Increasing contribution of second gas effect to rate of induction
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Maximising arterial oxygen content
Question 4
Question
Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?
Answer
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Patient position
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Barbotage
-
Added epinephrine
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Total dose of drug
Question 5
Question
Which one of the following best describes the reason for the rapid offset of effect of the induction agents?
Answer
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Ester hydrolysis
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Liver metabolism
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Renal excretion
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Redistribution
Question 6
Question
If 50% Nitrous oxide is inhaled for 3 days
Answer
-
The lymphocyte count falls
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Vit B12 deficiency anaemia develops
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Megaloblastic bone marrow changes occur
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Peripheral neuropathy develops
Question 7
Question
Which one of the following structures is not encountered during direct laryngoscopy?
Answer
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Vallecula
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Cricoid Cartilage
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Epiglottis
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Arytenoid Cartilage
Question 8
Question
Regarding the comparative consideration of epidural ad spinal anaesthesia, which one of the following is CORRECT?
Answer
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A postdural puncture headache is a potential complication that occurs with both spinal and epidural techniques
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The epidural space is identified by puncture of the dura and free flow of cerebral spinal fluid
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The lumbar puncture for spinal anesthesic should be performed above L1 to avoid trauma to the cauda equina
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Epidural anaesthesia is usually faster in onset than spinal anaesthesia
Question 9
Question
The narrowest portion of the neonate's airway is at the level of the
Answer
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Glottis
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Pharynx
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Trachea
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Cricoid
Question 10
Question
All but one of the following are contraindications to succinylcholine. Indicate the exception
Answer
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Cervical spinal cord injury (1 week ago)
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Malignant hyperthermia susceptibility
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Monoamine oxidase administration
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Burn injury (24 hours ago)
Question 11
Question
A 17-year-old boy develops pulmonary edema after resolution of postoperative laryngospasm. While breathing 100% oxygen, SpO2 is 80%.
Which of the following is the most appropriate management?
Answer
-
Administration of albuterol
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Positive-pressure ventilation
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Infusion of nitroglycerin
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Administration of furosemide
Question 12
Question
Which one of the following conditions is not associated with upregulation of the postjunctional acetylcholine receptors at the neuromuscular junction?
Question 13
Question
The right lung has
Question 14
Answer
-
Oxygen consumption is one-third that at 37°C
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Active rewarming should be commenced
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Oxygen solubility is raised
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Carbon dioxide solubility is reduced
Question 15
Question
If 50% nitrous oxide is inhaled for 3 days
Answer
-
The lymphocyte count falls
-
Peripheral neuropathy develops
-
Vit. B12 deficiency anaemia develops
-
Methionine svnthetase activity is reduced
Question 16
Question
A volatile liquid is allowed to equilibrate with a mixture of gases.
The resulting partial pressure of the vapour will depend on
Question 17
Question
A 36-year-old woman is receiveing general anesthesia for a diagnostic laparoscopy in the Trendelenburg position with carbon dioxide insufflation. During a 15-minute period after induction. her SpO2 decreases from 99% to 90% and PetCO2 increases from 38 to 43 mmHg. FiO2 is 0.3; all ventilator settings have been constant.
Which of the following is the most likely cause of the decrease in SpO2?
Question 18
Question
Which one of the following best explains the failure of nondepolarizing neuromuscular blocking agents to produce fasciculation?
Answer
-
Absence of acetylcholine receptor activation
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Binding in the ion channel of the acetylcholine receptor
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Binding to agonist and antagonist sites on the acetylcholine receptor
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Binding to presynaptic and postsynaptic acetylcholine receptors
Question 19
Question
About Nitrous oxide we can say
Answer
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N2O forbidden in low flow anesthesia
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It can stabile the patient with increased intracranial pressure
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N2O reduces the preen house effect
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It leads to a reduction of supplementary opioids and anesthetics
Question 20
Question
Hypotension is least likely to occur following induction with which of the following anesthetic agents?
Answer
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Midazolam
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Methohexital
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Etomidate
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Propofol
Question 21
Question
The complete absence of a capnographic waveform immediately following endotracheal intubaion may indicate all but one of the following.
Indicate the exception:
Question 22
Question
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.
Question 23
Question
Early signs and symptoms of local anesthetic toxicity include all but one of the following.
Indicate the exception:
Answer
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Tinnitus
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Perioral numbness
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Dizziness
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Hypertension
Question 24
Question
Which one of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?
Answer
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Desflurane 6%: Sevoflurane !%; Isoflurane 2%
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Desflurane 2%: Sevoflurane 6%; Isoflurane 1%
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Desflurane 6%: Sevoflurane 2%; Isotlurane 1%
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Desflurane 2%: Sevoflurane 1%: Isoflurane 6%
Question 25
Question
In a patient receiving pressure support ventilation, pressure support breaths are triggered by achieving which of the following preset milestones?
??
Question 26
Question
In the early detection of an air embolism, the following is useful
Question 27
Question
The right lung has
Question 28
Question
Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?
Answer
-
Added epinephrine
-
Barbotage
-
Total dose of drug
-
Patient position
Question 29
Question
All but one of the following describe the CO2 absorber. Indicate the exention
Answer
-
Changes colour as the soda lime becomes exhausted
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Is required if a circle circuit is being used
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Provides a waveform of exhaled carbon dioxide
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Allows for economical use of anaesthetic gases
Question 30
Question
Two hours after a laparoscopic cholecystectomy, an obese 45-year-old woman is receiving intravenous patient-controlled analgesia with morphine. Her SpO2 is 92% on room air. Which ONE of the following is the most likely?
Question 31
Question
About N2O we can say
Answer
-
It leads to a reduction of supplementary opioids and anesthetia
-
The use prevents vomiting!
-
N2O is forbidden in low flow anesthsia
-
N2O reduces the green house effect
Question 32
Question
Suxamethonium does not cross the placenta because of
Question 33
Answer
-
Has a similar boiling point to enflurane
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Has a MAC of 0.56% in oxygen
-
Has a lower blood/gas coefficient than halothane
-
Is extensively metabolised
Question 34
Question
After induction of anesthesia, the anesthesiologist is unable to intubate the patient. Which one of the following is the most important management priority?
Answer
-
Ensuring that intubation is achieved as soon as possible
-
Ensuring that bag-mask ventilation is achievable
-
Inserting a laryngeal mask
-
Ensuring that the patient does not awaken until intubation is successfully achieved
Question 35
Question
The abbreviation “MAC” stands for
Answer
-
Minimal alveolar concentration
-
Minimal arterial concentration
-
Maximal arterial concentration
-
Maximal alveolar concentration
Question 36
Question
Shivering can lead to all but one of the following. Indicate the exception:
Answer
-
Interference with monitor signal interpretation
-
Increased oxygen consumption ,
-
Increased anesthesia requirements
-
Decreased carbon dioxide production
Question 37
Question
(Var 4 10) All but one of the following are disadvantages of general anesthesia for Caesarian section. Indicate the exception
???
Answer
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Increased rise of inspiration in the pregnant patient
-
Increases risk of unawareness under anesthesia
-
Increased anesthesia requirements
-
Exacerbation of ?
Question 38
Question
Pressure support ventilation
Answer
-
Delivers a specified volume regardless of airway pressure
-
Can only be used in a spontaneously breathing patient
-
Can not be used in conjunction with continuous positive airway pressure
-
Increases the work of breathing
Question 39
Question
The following commonly contributes to poor oxygenation during general anaesthesia
Question 40
Answer
-
Begins at C4 and ends at T6
-
Is supplied entirely by the bronchial arteries
-
Is lined by transitional epithelium
-
Is narrowest at the level of the cricoid in a child
Question 41
Question
An adult breathing 100% oxygen at sca level may suffer from
Answer
-
Permanent visual damage
-
Convulsions
-
Retrosternal chost pain
-
Dizziness
Question 42
Question
Immediately after complete transection of the spinal cord, the following occur
Answer
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Loss of sensation but no loss of power
-
Flaccid paralysis with loss of sensation end reflexes
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Loss of motor function and sensation with no loss of reflexes
-
Loss of power but no loss of sensation
Question 43
Question
All but one of the following are contraindications to post-operative epidural analgesia. Indicate the exception
Question 44
Question
The primary toxic effect of Bupivacaine on the cardiovascular system is
Answer
-
Blockade of norepinephrine release
-
Coronary vasoconstriction
-
Delay of ventricular repolarization
-
Increased atrial excitability
Question 45
Question
Redistribution from the brain to which of the following sites is primarily responsible for emergence after a single dose of Propotol?
Answer
-
Fat
-
Skeletal muscle
-
Lung
-
Liver
Question 46
Question
About the MAC we can say
???
Answer
-
To low level (< 0,7 MAC) can lead to awareness
-
To high level (> 1,3 MAC) can lead to postoperative delirium
-
To low level (< 1,3 MAC) can lead to postoperative vomiting
-
The MAC depends on the gender and the body weight of the patient
Question 47
Question
Suxamethonium does not cross the placenta because of
Question 48
Question
You see a patient in the preoperative assessment clinic prior to her laparatomy 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
Answer
-
Reduced adrenal activation
-
Improved respiratory function
-
Hypertension
-
Excellent post-operative pain control
Question 49
Question
All but one of the following are ways to confirm endotracheal intubation. Indicate the exception
Answer
-
Auscultation of both lung fields and over the stomach
-
Easy advancement of the endotracheal tube without resistance
-
Visualisation of the endotracheal tube through tube through the vocal cords
-
Presence of a stable CO2 trace on the end-tidal capnography