3915652
Descripción
Test por Branden Emmerson, actualizado hace más de 1 año
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Creado por Branden Emmerson
hace alrededor de 9 años
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Pregunta 1
Pregunta
A young man has removed his buprenorphine patch on the morning of surgery. How long will it be before his plasma level reaches half its original level?
Respuesta
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12 hours
-
18 hours
-
24 hours
-
30 hours
-
36 hours
Pregunta 2
Pregunta
A young man has removed his fentanyl patch on the morning of surgery. How long will it be before his plasma level reaches half its original level?
Respuesta
-
12 hours
-
18 hours
-
24 hours
-
30 hours
-
36 hours
Pregunta 3
Pregunta
A 58 year old with a solitary hepatic metastasis from colon cancer is scheduled for a resection of a right lobe of liver. In order to manage the risk of intra-operative haemorrhage, it is most important to maintain:
Respuesta
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High CVP in anticipation of heavy blood loss
-
Decreased MAP to reduce arterial bleeding
-
Decreased CVP to reduce venous bleeding
-
Normal MAP in anticipation of heavy blood loss
-
Normal CVP to ensure adequate filling of the heart
Pregunta 4
Pregunta
An 80 year old man is having a transuretheral bladder resection. The surgeon is using diathermy close to the lateral bladder wall which results in patient thigh adduction. The nerve involved is:
Respuesta
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Inferior gluteal
-
Obturator
-
Pudendal
-
Scaitic
-
Superior gluteal
Pregunta 5
Pregunta
In Conn's syndrome, the usual derangement is
Respuesta
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Hypoglycaemia, hypokalaemia and hypernatraemia
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Hypoglycaemia, hyperkalaemia and hyponatraemia
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Normoglycaemia, hypokalaemia and hypernatraemia
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Normoglycaemia, hyperkalaemia and hyponatraemia
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Hyperglycaemia, hyperkalaemia and hyponatraemia
Pregunta 6
Pregunta
A 60 year old woman is admitted to hospital with a subarachnoid haemorrhage. Her GCS is 11 and her blood pressure is 175/110 mmHg. She is administered oral nimodipine. The main reason for this treatment is:
Respuesta
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Control her blood pressure
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Manage acute hydrocephalus
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Prevent delayed cerebral ischaemia
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Reduce the risk of rebleeding
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Treat angiographically-proven cerebral vasospasm
Pregunta 7
Pregunta
You are the anaesthetist at a Caesarean Section for a 36/40 gestation pregnancy. The baby at birth is floppy and apnoeic. You decide that positive pressure ventilation via mask is necessary. The recommended FiO2 is:
Respuesta
-
0.21
-
0.4
-
0.6
-
0.8
-
1.0
Pregunta 8
Pregunta
You are inducing a 20-year-old female who has an IV cannula in her antecubital fossa which was inserted in the emergency department. She complains of pain after 10mL of propofol and it becomes clear that cannula is intraarterial. The best management option is:
Respuesta
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Intraarterial injection of 5mL 1% lignocaine
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Intraarterial injection of 30mL Normal Saline
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Intraarterial injection of 50mg paparverine
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Intraarterial injection of 500u heparin
-
Observation
Pregunta 9
Pregunta
When is it necessary to use glycine as irrigation fluid for TURP?
Respuesta
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For monopolar diathermy
-
For bipolar diathermy
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For Nd:Yag laser
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Greenlight laser
Pregunta 10
Pregunta
A 69 yo man is brought into ED by ambulance with a compound fracture of his forearm from an unwitnessed fall. Has a history of schizophrenia and depression with uncertain medication compliance. He is confused and agitated with generalised rigidity but no hyperreflexia. Obs - HR 120, BP 160/90, RR 18, Sats 98 Temp 38.8 Likely Dx?
Respuesta
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Heat stress from anticholinergic therapy
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Hypoxic ischaemic encephalopathy
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Neuroleptic malignant syndrome
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Serotonin syndrome
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Pain from the compound fracture
Pregunta 11
Pregunta
With surgical bleeding, the first clotting factor to reach a critical level is
Respuesta
-
I
-
II
-
VII
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X
-
XIII
Pregunta 12
Pregunta
Anaesthetic and respirable gas supplies to wall outlets in the operating theatre is at pressures of
Respuesta
-
200kPa
-
400kPa
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500kPa
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750kPa
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1200kPa
Pregunta 13
Pregunta
The most useful sign to distinguish between severe serotonin syndrome and malignant hyperthermia are
Respuesta
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Clonus
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Hyperthermia
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Metabolic acidosis
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Muscle rigidity
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Wheeze
Pregunta 14
Pregunta
A patient is having a laparotomy, who has been on prednisolone for 6 months at 10mg/day. What is the equivalent dose of dexamethasone?
Respuesta
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2mg
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4mg
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6mg
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8mg
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10mg
Pregunta 15
Pregunta
Patient having an operation of a lacerated index finger under regional anaesthesia. Which combination of nerves blocked on this axillary view will provide adequate cover?
Respuesta
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1 and 2
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1 and 3
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2 and 3
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2 and 4
-
3 and 4
Pregunta 16
Pregunta
A 20kg child has just had a caudal block but immediately has a VF arrest and is non-responsive to usual treatments. What dose of intralipid 20% would you give?
Respuesta
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10ml
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20ml
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30ml
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40ml
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50ml
Pregunta 17
Pregunta
An epidural for labour is placed. She then has a headache postpartum. Which of the following is inconsistent with a post-dural puncture headache.
Respuesta
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Headache located frontal only
-
Presents > 24 hrs post partum
-
presents immediately post partum
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associated with auditory symptoms
-
associated with neck stiffness
Pregunta 18
Pregunta
An eclamptic patient is given IV Magnesium. Which of these symptoms is often associated with magnesium administration?
Respuesta
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Bradyarrhythmia
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Cardiac arrest
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Hypotension
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Depressed respiratory effort
Pregunta 19
Pregunta
The clinical sign that a lay person should use to decide whether to start CPR is:
Respuesta
-
absence of breathing
-
loss of central pulse
-
loss of peripheral pulse
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loss of consciousness
-
obvious airway obstruction
Pregunta 20
Pregunta
What is the maintenance fluid rate for a 15kg child?
Respuesta
-
60ml/hr
-
50ml/hr
Pregunta 21
Pregunta
Patient's K+ is 7.0 what is the best initial management?
Respuesta
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Give calcium
-
Give insulin and dextrose
Pregunta 22
Pregunta
Which patients require antibiotic prophylaxis?
Respuesta
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Previous Mitral valve ring annuloplasty
-
Previous patch repair of vsd
Pregunta 23
Pregunta
A 63 yo lady has a difficult thyroidectomy for cancer. Immediately post extubation she develops stridor and respiratory distress.
Respuesta
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Hypocalcaemia
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Recurrent laryngeal nerve palsies
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Tracheomalacia
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Neck oedema and haematoma
-
Vocal cord oedema
Pregunta 24
Pregunta
A 23 yo has a traumatic brain injury. Which fluid is relatively contraindicated?
Respuesta
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Albumin
-
Normal saline
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CSL
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Colloid
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Something else
Pregunta 25
Pregunta
A 53 year old smoker presents for a laparotomy. PFT results are:
FEV1 and FVC - both reduced
FEV1/FVC 98%
TLC, RV, DLCO 8 (30% of predicted)
What is the cause?
Respuesta
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PE
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Obesity
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Bilateral phrenic nerve palsies
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Pulmonary fibrosis
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COPD
Pregunta 26
Pregunta
A Traumatic Brain Injury patient has a cerebral angiogram that shows:
Cerebral perfusion = 15mL/100g/min,
Cerebral oxygen consumption = 3.5mL/100g/min.
This is consistent with:
Respuesta
-
Cerebral hyperperfusion
-
Reperfusion injury
-
Cerebral ischaemia
-
Appropriate autoregulation
-
Cereberal vasoconstriction
Pregunta 27
Pregunta
Absolute contraindication to ECT:
Respuesta
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Cochlear implants
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Epilepsy
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Pregnancy
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Raised intracranial pressure
-
Recent myocardial infarction
Pregunta 28
Pregunta
FFP is given to a patient to treat hypofibrinogenaemia. The volume required to raise the fibrinogen by 1g/L is
Respuesta
-
1mL/kg
-
5mL/kg
-
10mL/kg
-
20mL/kg
-
30mL/kg
Pregunta 29
Pregunta
The diluted thrombin time measures the anticoagulant activity of:
Respuesta
-
apixaban
-
rivaroxaban
-
dabigatran
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warfarin
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heparin
Pregunta 30
Pregunta
In a trauma patient the main mechanism by which hypothermia exacerbates bleeding is by
Respuesta
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altered blood viscosity
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causing DIC
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inhibition of clotting factors
-
potentiation of anticoagulant effect of drugs used to treat DVT
-
decreases platelet number and function
Pregunta 31
Pregunta
A patient having a liver resection suffers a haemodynamically significant venous air embolism. During resuscitation how do you best position the patient?
Respuesta
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head up, right side down
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head up, left side down
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head up, no lateral tilt
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head down, right side down
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head down, left side down
Pregunta 32
Pregunta
In a normal adult what amount of IV potassium chloride is needed to raise the serum potassium from 2.8 to 3.8mmol/L?
Respuesta
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10mmol
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20mmol
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50mmol
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100mmol
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200mmol
Pregunta 33
Pregunta
In a haemodynamically stable 20 year old man with blunt chest trauma, the best screening test to diagnose cardiac injury requiring treatment is:
Respuesta
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CXR
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serum CK-MB
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serum troponin
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12 lead ECG
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Transthoracic Echocardiogram
Pregunta 34
Pregunta
With regards to medical ethics, the concept of fidelity involves:
Respuesta
-
equitable distribution of resources
-
following a professional code of conduct
-
promoting well being
-
wise use of resources
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witholding of futile treatments
Pregunta 35
Pregunta
What is the correct position for the tip of a PICC in a child?
Respuesta
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Carina
-
Below right tracheobronchial angle
-
Above right heart border
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Sternoclavicular junction
Pregunta 36
Respuesta
-
Atlantoaxial instability
-
Retropharyngeal haematoma (?or abscess)
-
Tear drop fracture
-
Epiglottitis
-
Unilateral facet joint dislocation
Pregunta 37
Pregunta
According to the ANZCA endorsed guidelines, what is the correct colour for the label for a subcutaneous ketamine infusion?
Respuesta
-
Pink
-
Red
-
Beige
-
Blue
-
Yellow
Pregunta 38
Pregunta
Prior to nasal intubation you spray Lignocaine/Phenylephrine preparation (CoPhenylcaine) into the nose. Some lands in the eye. What happens?
Respuesta
-
Ecchymosis
-
Miosis
-
Mydriasis
-
Proptosis
-
Nystagmus
Pregunta 39
Pregunta
You trial a new drug to prevent PONV. It is 50% more effective than the current drug. Four percent of people still experience PONV with the new drug. How many people need to receive the new drug in place of the current drug to have one person less suffering from PONV?
Respuesta
-
2
-
8
-
15
-
25
-
33
Pregunta 40
Pregunta
What does a white cylinder with a grey coloured shoulder/neck contain?
Respuesta
-
Medical air
-
Carbon Dioxide
-
Helium
-
Oxygen
-
Argon
Pregunta 41
Pregunta
The best solution to ensure asepsis prior to neuraxial anaesthesia is:
Respuesta
-
0.5% Chlorhexidine
-
0.5% Chlorhexidine with 70% alcohol
-
5% Povidine Iodine
-
5% Povidine Iodine with 70% alcohol
-
10% Povidine Iodine
Pregunta 42
Pregunta
You are anaesthetising a 25 year male for an open appendicectomy. He has a Fontans circulation on a background of tricuspid atresia. The best strategy to manage his ventilation intraoperatively would be:
Respuesta
-
Ensure adequate PEEP
-
Decrease inspiratory time
-
Alter the I:E Ratio from 1:3 to 1:1.2
-
Increase Inspiratory time but with reduced inspiratory pressures
-
Ensure adequate spontaneous ventilation
Pregunta 43
Pregunta
You are anaesthetising a 70 year old woman for a CABG with a pulmonary artery catheter in situ. After separation from bypass you notice frank, copious blood rising in the endotracheal tube. Your immediate action should be to:
Respuesta
-
Check ACT
-
Insert a double lumen tube
-
Reinstate bypass
-
Administer protamine
-
Pull back the pulmonary artery catheter several centimetres
Pregunta 44
Pregunta
Consider the following arterial blood gases. (Ref ranges in brackets)
-pH 7.28
-PaCO2 36
-Bicarbonate 18 mmol.l-1 (18-25)
-Base excess -7 mmol.l-1 (-4- +3)
-Na+ 142 mmol.l-1 (135-145)
-Cl- 112 mmol.l-1 (98-110)
These blood gases are consistent with:
Respuesta
-
acute renal failure
-
diabetic ketoacidosis
-
ethylene glycol overdose
-
intraoperative infusion of 6 litres of normal saline
-
salicylate overdose
Pregunta 45
Pregunta
A 30 year old woman is admitted to ICU after a 500mg/kg aspirin overdose. What is the most effective therapy to enhance her elimination of the aspirin?
Respuesta
-
Frusemide
-
Haemodialysis
-
Mannitol
-
0.9% sodium chloride
-
Sodium bicarbonate
Pregunta 46
Pregunta
MELD score: INR, Cr, Na, and
Respuesta
-
albumin
-
ALT
-
AST
-
bilirubin
-
fibrinogen
Pregunta 47
Pregunta
Endovascular coiling of cerebral aneurysm under GA, patient suddenly develop hypertension. What is the most likely cause?
Respuesta
-
Acute hydrocephalus
-
Rupture of aneurysm
-
Contrast reaction
-
Cerebral embolism
-
Nothing
Pregunta 48
Pregunta
A 70 year old is is intubated and ventilated post-laparotomy. He has CSL running @60ml/hr, with an NGT on suction with continuing high output. His ABG shows an appropriate pO2, pCO2 32, pH 7.66, Na 144, K 3.5, Cl 76. He has a normal creatinine and raised urea. How should you improve his acid base status? (Had a very very very long stem, with very long answers, but this was the gist, and I'm pretty confident with the answers except the first 2 fluid options).
Respuesta
-
Leave minute ventilation unchanged, (?leave fluids unchanged), commence PPI
-
Leave minute ventilation unchanged, (?leave fluids unchanged), commence acetazolamide
-
Increase minute ventilation, change IVF to normal saline, commence PPI
-
Increase minute ventilation, increase the fluid rate, commence acetazolamide
-
Increase minute ventilation, leave fluids unchanged, commence acetazolamide
Pregunta 49
Pregunta
What is the most sensitive monitor for detecting a venous air embolus during neuroanaesthesia?
Respuesta
-
transoesophageal electrocardiography (yes - it said electro)
-
precordial Doppler
-
precordial stethoscope
-
capnography
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