20608919
Descripción
Test por Med Student , actualizado hace más de 1 año
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Creado por Med Student
hace casi 5 años
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Pregunta 1
Pregunta
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?
Respuesta
-
Hydrophilic with a high degree of plasma protein binding
-
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
Pregunta 2
Pregunta
Each of the following drugs causes enhanced activity of the gamma-aminobutyric acid receptor EXCEPT:
Respuesta
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Etomidate
-
Midazolam
-
Ketamine
-
Propofol
Pregunta 3
Pregunta
What is the primary purpose of denitrogenation prior to anesthetic induction?
Respuesta
-
Improving matching of ventilation and perfusion
-
Increasing oxygen reserve in the functional residual capacity
-
Increasing contribution of second gas effect to rate of induction
-
Maximising arterial oxygen content
Pregunta 4
Pregunta
Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?
Respuesta
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Patient position
-
Barbotage
-
Added epinephrine
-
Total dose of drug
Pregunta 5
Pregunta
Which one of the following best describes the reason for the rapid offset of effect of the induction agents?
Respuesta
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Ester hydrolysis
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Liver metabolism
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Renal excretion
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Redistribution
Pregunta 6
Pregunta
If 50% Nitrous oxide is inhaled for 3 days
Respuesta
-
The lymphocyte count falls
-
Vit B12 deficiency anaemia develops
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Megaloblastic bone marrow changes occur
-
Peripheral neuropathy develops
Pregunta 7
Pregunta
Which one of the following structures is not encountered during direct laryngoscopy?
Respuesta
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Vallecula
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Cricoid Cartilage
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Epiglottis
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Arytenoid Cartilage
Pregunta 8
Pregunta
Regarding the comparative consideration of epidural ad spinal anaesthesia, which one of the following is CORRECT?
Respuesta
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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
Pregunta 9
Pregunta
The narrowest portion of the neonate's airway is at the level of the
Respuesta
-
Glottis
-
Pharynx
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Trachea
-
Cricoid
Pregunta 10
Pregunta
All but one of the following are contraindications to succinylcholine. Indicate the exception
Respuesta
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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)
Pregunta 11
Pregunta
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?
Respuesta
-
Administration of albuterol
-
Positive-pressure ventilation
-
Infusion of nitroglycerin
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Administration of furosemide
Pregunta 12
Pregunta
Which one of the following conditions is not associated with upregulation of the postjunctional acetylcholine receptors at the neuromuscular junction?
Respuesta
-
Myasthenia gravis
-
Burn injuries
-
Prolonged bed rest
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Prolonged use of neuromuscular blocking agents
Pregunta 13
Pregunta
The right lung has
Respuesta
-
One fissure
-
No Sibson’s fascia
-
Seven bronchopulmonary segments
-
Two pulmonary veins
Pregunta 14
Pregunta
At 30°C
Respuesta
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Oxygen consumption is one-third that at 37°C
-
Active rewarming should be commenced
-
Oxygen solubility is raised
-
Carbon dioxide solubility is reduced
Pregunta 15
Pregunta
If 50% nitrous oxide is inhaled for 3 days
Respuesta
-
The lymphocyte count falls
-
Peripheral neuropathy develops
-
Vit. B12 deficiency anaemia develops
-
Methionine svnthetase activity is reduced
Pregunta 16
Pregunta
A volatile liquid is allowed to equilibrate with a mixture of gases.
The resulting partial pressure of the vapour will depend on
Respuesta
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Atmospheric pressure
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The surface area of the liquid
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Ambient temperature
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The volume of liquid
Pregunta 17
Pregunta
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?
Respuesta
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Carbon dioxide embolus
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Decreased diaphragmatic excursion
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Compression of the vena cava
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Pnemnothorax
Pregunta 18
Pregunta
Which one of the following best explains the failure of nondepolarizing neuromuscular blocking agents to produce fasciculation?
Respuesta
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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
Pregunta 19
Pregunta
About Nitrous oxide we can say
Respuesta
-
N2O forbidden in low flow anesthesia
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It can stabile the patient with increased intracranial pressure
-
N2O reduces the preen house effect
-
It leads to a reduction of supplementary opioids and anesthetics
Pregunta 20
Pregunta
Hypotension is least likely to occur following induction with which of the following anesthetic agents?
Respuesta
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Midazolam
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Methohexital
-
Etomidate
-
Propofol
Pregunta 21
Pregunta
The complete absence of a capnographic waveform immediately following endotracheal intubaion may indicate all but one of the following.
Indicate the exception:
Respuesta
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Cardiac arrest
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Endobronchial intubation
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Complete airway obstruction
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Esophageal intubation
Pregunta 22
Pregunta
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.
Respuesta
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Exhausted CO2 absorber soda lime
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Pulmonary embolus
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Cardiac arrest
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Severe bronchospasm
Pregunta 23
Pregunta
Early signs and symptoms of local anesthetic toxicity include all but one of the following.
Indicate the exception:
Respuesta
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Tinnitus
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Perioral numbness
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Dizziness
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Hypertension
Pregunta 24
Pregunta
Which one of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?
Respuesta
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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%
Pregunta 25
Pregunta
In a patient receiving pressure support ventilation, pressure support breaths are triggered by achieving which of the following preset milestones?
??
Respuesta
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An increase in airway pressure
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A decrease in airway pressure
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An inspiratory flow rate
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An inspired volume
Pregunta 26
Pregunta
In the early detection of an air embolism, the following is useful
Respuesta
-
PetCO2
-
ECG
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Fall in blood pressure
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Change in ventilatory pattern
Pregunta 27
Pregunta
The right lung has
Respuesta
-
One fissure
-
No Sibson’s fascia
-
Seven bronchopulmonary segments
-
A direct relationship to the azygos vein
Pregunta 28
Pregunta
Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?
Respuesta
-
Added epinephrine
-
Barbotage
-
Total dose of drug
-
Patient position
Pregunta 29
Pregunta
All but one of the following describe the CO2 absorber. Indicate the exention
Respuesta
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Changes colour as the soda lime becomes exhausted
-
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
Pregunta 30
Pregunta
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?
Respuesta
-
Absorption of carbon dioxide from the abdomen
-
Hypoventilation
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Impaired oxygen diffusion
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Increased dead space
Pregunta 31
Pregunta
About N2O we can say
Respuesta
-
It leads to a reduction of supplementary opioids and anesthetia
-
The use prevents vomiting!
-
N2O is forbidden in low flow anesthsia
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N2O reduces the green house effect
Pregunta 32
Pregunta
Suxamethonium does not cross the placenta because of
Respuesta
-
Placental cholinesterase
-
High protein binding
-
It being an elongated molecule
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Its high degree of ionization
Pregunta 33
Pregunta
Isoflurane
Respuesta
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Has a similar boiling point to enflurane
-
Has a MAC of 0.56% in oxygen
-
Has a lower blood/gas coefficient than halothane
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Is extensively metabolised
Pregunta 34
Pregunta
After induction of anesthesia, the anesthesiologist is unable to intubate the patient. Which one of the following is the most important management priority?
Respuesta
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Ensuring that intubation is achieved as soon as possible
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Ensuring that bag-mask ventilation is achievable
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Inserting a laryngeal mask
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Ensuring that the patient does not awaken until intubation is successfully achieved
Pregunta 35
Pregunta
The abbreviation “MAC” stands for
Respuesta
-
Minimal alveolar concentration
-
Minimal arterial concentration
-
Maximal arterial concentration
-
Maximal alveolar concentration
Pregunta 36
Pregunta
Shivering can lead to all but one of the following. Indicate the exception:
Respuesta
-
Interference with monitor signal interpretation
-
Increased oxygen consumption ,
-
Increased anesthesia requirements
-
Decreased carbon dioxide production
Pregunta 37
Pregunta
(Var 4 10) All but one of the following are disadvantages of general anesthesia for Caesarian section. Indicate the exception
???
Respuesta
-
Increased rise of inspiration in the pregnant patient
-
Increases risk of unawareness under anesthesia
-
Increased anesthesia requirements
-
Exacerbation of ?
Pregunta 38
Pregunta
Pressure support ventilation
Respuesta
-
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
Pregunta 39
Pregunta
The following commonly contributes to poor oxygenation during general anaesthesia
Respuesta
-
Atelectasis
-
Hyperventilation
-
Hypersensitive chemoreceptors
-
Increased metabolic rate
Pregunta 40
Pregunta
The trachea
Respuesta
-
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
Pregunta 41
Pregunta
An adult breathing 100% oxygen at sca level may suffer from
Respuesta
-
Permanent visual damage
-
Convulsions
-
Retrosternal chost pain
-
Dizziness
Pregunta 42
Pregunta
Immediately after complete transection of the spinal cord, the following occur
Respuesta
-
Loss of sensation but no loss of power
-
Flaccid paralysis with loss of sensation end reflexes
-
Loss of motor function and sensation with no loss of reflexes
-
Loss of power but no loss of sensation
Pregunta 43
Pregunta
All but one of the following are contraindications to post-operative epidural analgesia. Indicate the exception
Respuesta
-
Multiple sclerosis
-
Myasthenia gravis
-
Hypertrophic obstructive cardiomyopathy
-
Lumbar disc disease
Pregunta 44
Pregunta
The primary toxic effect of Bupivacaine on the cardiovascular system is
Respuesta
-
Blockade of norepinephrine release
-
Coronary vasoconstriction
-
Delay of ventricular repolarization
-
Increased atrial excitability
Pregunta 45
Pregunta
Redistribution from the brain to which of the following sites is primarily responsible for emergence after a single dose of Propotol?
Respuesta
-
Fat
-
Skeletal muscle
-
Lung
-
Liver
Pregunta 46
Pregunta
About the MAC we can say
???
Respuesta
-
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
Pregunta 47
Pregunta
Suxamethonium does not cross the placenta because of
Respuesta
-
Placental cholinesterase
-
High protein binding
-
Insufficient maternal concentration
-
Its high degree of ionization
Pregunta 48
Pregunta
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
Respuesta
-
Reduced adrenal activation
-
Improved respiratory function
-
Hypertension
-
Excellent post-operative pain control
Pregunta 49
Pregunta
All but one of the following are ways to confirm endotracheal intubation. Indicate the exception
Respuesta
-
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
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