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Anaesthesiology Final MCQs- 5th Year PMU

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Anaesthesiology MCQs 1- 5th Year PMU

Pregunta 1 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Mouth opening of only 3 fingerbreadths

  • Short, thick neck with limited mobility

  • Mallampati Class IV

  • Thyromental distance of 2 fingerbreadths

Explicación

Pregunta 2 de 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

Selecciona una de las siguientes respuestas posibles:

  • Surgery is a lumbar laminectomy

  • Surgery is removal of a lymph node of the neck

  • Surgery is appendectomy

  • Surgery is tonsillectomy

Explicación

Pregunta 3 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Vallecula

  • Cricoid cartilage

  • Epiglottis

  • Arytenoid cartilage

Explicación

Pregunta 4 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Circuit disconnection

  • Cardiac arrest

  • Endobronchial intubation

  • Complete airway obstruction

  • Esophageal intubation

Explicación

Pregunta 5 de 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?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 6 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 7 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 8 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 100 g/L

  • 80g/L

  • 60g/L

  • Individualized to every patient

Explicación

Pregunta 9 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Tachycardia

  • Decreased pulse pressure

  • Decreased urine output

  • Lactic acidosis

Explicación

Pregunta 10 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 100 cc/hr

  • 120 cc/hr

  • 150 cc/hr

  • 170 cc/hr

Explicación

Pregunta 11 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Packed red blood cells

  • Albumin (5%)

  • Pentaspan

  • Ringers Lactate

Explicación

Pregunta 12 de 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?

Selecciona una de las siguientes respuestas posibles:

  • Pentaspan 1500 mL

  • DSW 500 mL

  • Ringers Lactate 500 mL

  • Normal Saline 1500 mL

Explicación

Pregunta 13 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 14 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Hyperkalemia, hypercalcemia

  • Hypokalemia, hypocalcemia

  • Hyperkalemia, hypocalcemia

  • Hypokalemia, hypercalcemia

Explicación

Pregunta 15 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Open reduction, internal fixation of the pelvis

  • Whipple resection of the pancreas

  • Resection of large frontal brain tumour

  • Caesarian section

Explicación

Pregunta 16 de 99

1

Routine preoperative hemoglobin is NOT required for

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 17 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Patient’s underlying health

  • Length of surgery

  • Duration of surgery

  • Emergency surgery

Explicación

Pregunta 18 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 19 de 99

1

The following medication should be discontinued prior to surgery and anesthesia

Selecciona una de las siguientes respuestas posibles:

  • Anticonvulsants

  • Thyroid replacement

  • Monoamine-oxidase inhibitors

  • Antihypertensives

Explicación

Pregunta 20 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Uncorrected Tetralogy of Fallot

  • Aortic stenosis

  • Uncomplicated heart transplant

  • Prophylaxis is not required for tonsillectomy

Explicación

Pregunta 21 de 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?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 22 de 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.

Selecciona una de las siguientes respuestas posibles:

  • ASA 1

  • ASA 2

  • ASA 3

  • ASA 4

Explicación

Pregunta 23 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 24 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 25 de 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?

Selecciona una de las siguientes respuestas posibles:

  • Temperature probe

  • Agent-specific gas monitor

  • Peripheral nerve stimulator

  • Spirometer

Explicación

Pregunta 26 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Nail polish

  • Peripheral vasoconstriction due to hypothermia

  • Severe anemia (Hg 60 g/L)

  • Methemoglobinemia

  • Carbon monoxide

Explicación

Pregunta 27 de 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

Selecciona una de las siguientes respuestas posibles:

  • Pulmonary embolus

  • Exhausted CO2 absorber soda lime

  • Cardiac arrest

  • Severe bronchospasm

Explicación

Pregunta 28 de 99

1

The abbreviation “MAC” stands for

Selecciona una de las siguientes respuestas posibles:

  • Minimal arterial concentration

  • Minimal alveolar concentration

  • Maximal arterial concentration

  • Maximal alveolar concentration

Explicación

Pregunta 29 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 30 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • The ability of the patient to protect their airway

  • Stable cardiovascular status

  • Normal mental status examination

  • Effective analgesia

Explicación

Pregunta 31 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 32 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Post operative hypoxemia

  • Decreased platelet function

  • Myocardial ischemia

  • Increased analgesic requirements

Explicación

Pregunta 33 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Strong hand grip

  • The return of the eyelash reflex

  • Train of four shows 4 twitches with no fade

  • 5 second head lift

Explicación

Pregunta 34 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Open cholecystectomy

  • Laparoscopic cholecystectomy

  • Excision of lymph node from the neck

  • Tonsillectomy

Explicación

Pregunta 35 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 36 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 37 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Tinnitus

  • Perioral numbness

  • Dizziness

  • Hypertension

Explicación

Pregunta 38 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Myocardial ischemia

  • Increased oxygen consumption

  • Decreased carbon dioxide production

  • Interference with monitor signal interpretation

Explicación

Pregunta 39 de 99

1

Which ONE of the following statements about shivering is correct?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 40 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Prochlorperazine

  • Ranitidine

  • Dimenhydrinate

  • Dexamethasone

Explicación

Pregunta 41 de 99

1

Which of the following is a risk factor for PONV?

Selecciona una de las siguientes respuestas posibles:

  • History of gastroesophageal reflux

  • Smoking

  • Diabetes mellitus

  • Female gender

Explicación

Pregunta 42 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 43 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Pain

  • Airway obstruction

  • Prolonged spinal blockade

  • Full bladder

Explicación

Pregunta 44 de 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?

Selecciona una de las siguientes respuestas posibles:

  • Normal cognitive function

  • Adequate pain control

  • Ability to hold down food

  • Ability to weight-bear

Explicación

Pregunta 45 de 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

Selecciona una de las siguientes respuestas posibles:

  • Reduced adrenal activation

  • Hypertension

  • Improved respiratory function

  • Excellent post-operative pain control

Explicación

Pregunta 46 de 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

Selecciona una de las siguientes respuestas posibles:

  • 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”

Explicación

Pregunta 47 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Multiple sclerosis

  • Lumbar disc disease

  • Hypertrophic obstructive cardiomyopathy

  • Myasthenia gravis

Explicación

Pregunta 48 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 49 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Hyperthermia

  • Hypercarbia

  • Tachycardia

  • Ventricular arrhythmias

Explicación

Pregunta 50 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Turning off the volatile anesthetic

  • Active cooling measures

  • Dantrolene

  • Beta blockers

Explicación

Pregunta 51 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Decreased blood volume

  • Decreased peripheral vascular resistance

  • Decreased hematocrit

  • Compression of the vena cava

Explicación

Pregunta 52 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Decreased cardiac output

  • Delayed gastric emptying

  • Increased blood volume

  • Decreased anesthetic requirements

Explicación

Pregunta 53 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 54 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 55 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Glottis

  • Cricoid

  • Trachea

  • Pharynx

Explicación

Pregunta 56 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 4.0

  • 4.5

  • 5.0

  • 6.0

Explicación

Pregunta 57 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 58 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Increased functional residual capacity (FRC)

  • Increased oxygen consumption

  • Increased minute ventilation

  • Obligate nasal breathing

Explicación

Pregunta 59 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Larynx situated higher

  • Larynx situated more anteriorly

  • Epiglottis shorter and less mobile

  • Narrowest part of the airway at the cricoid

Explicación

Pregunta 60 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Prolonged second stage

  • Increased risk of operative delivery

  • Neonatal depression

  • Maternal sedation

Explicación

Pregunta 61 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Increased risk of aspiration in the pregnant patient

  • Increased anesthetic requirements

  • Exacerbation of uterine atony

  • Increased risk of awareness under anesthesia

Explicación

Pregunta 62 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 63 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 64 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Opioid analgesic agents

  • Induction agents

  • Muscle relaxants

  • Volatile anesthetic agents

Explicación

Pregunta 65 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Cardiac depression

  • Sedation

  • Nausea and vomiting

  • Respiratory depression

Explicación

Pregunta 66 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 67 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Ester hydrolysis

  • Liver metabolism

  • Redistribution

  • Renal excretion

Explicación

Pregunta 68 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Hyperkalemia

  • Hypothermia

  • Gentamycin administration

  • Myasthenia gravis

Explicación

Pregunta 69 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Cervical spinal cord injury (1 week ago)

  • Monoamine oxidase administration

  • Malignant hyperthermia susceptibility

  • Burn injury (24 hours ago)

Explicación

Pregunta 70 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 1 mg/kg

  • 2 mg/kg

  • 5 mg/kg

  • 7 mg/kg

Explicación

Pregunta 71 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 72 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Muscle rigidity

  • Biliary spasm

  • Myocardial depression

  • Bradycardia

Explicación

Pregunta 73 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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%

Explicación

Pregunta 74 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Morphine and sufentanil

  • Fentanyl and sufentanil

  • Morphine and fentanyl

  • Fentanyl and remifentanil

Explicación

Pregunta 75 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • GABA

  • Histamine

  • Serotonin

  • Dopamine

Explicación

Pregunta 76 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Bradycardia and bronchospasm

  • Mydriasis and confusion

  • Urinary retention and constipation

  • Dry mouth and dry eyes

Explicación

Pregunta 77 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 78 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Faster onset of action

  • Does not cross the blood brain barrier

  • More effective anticholinergic activity

  • Safe in patients with narrow angle glaucoma

Explicación

Pregunta 79 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 80 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Tissue hypoxia with hyperlactatemia

  • Kidney failure

  • Methanol intoxication

  • Diarrhea

Explicación

Pregunta 81 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 82 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Methylprednisolone i.v.

  • Adrenaline i.m.

  • Diphenhydramine i.m.

  • Atropine i.v.

Explicación

Pregunta 83 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Bilirubin, creatinine and urine output

  • Blood pressure and PaO2/FiO2 ratio

  • Platelets and GCS

  • Body temperature and WBCs

Explicación

Pregunta 84 de 99

1

Which of the statements about FAST is NOT correct?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 85 de 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?

Selecciona una de las siguientes respuestas posibles:

  • EEG

  • ETCO2 measurement

  • CVP measurement

  • Invasive arterial blood pressure measurement

Explicación

Pregunta 86 de 99

1

Generally accepted definition of coma includes a GCS score of

Selecciona una de las siguientes respuestas posibles:

  • < 6

  • < 8

  • < 10

  • < 12

Explicación

Pregunta 87 de 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?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 88 de 99

1

Rellena los espacios en blanco para completar el texto.

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



Explicación

Pregunta 89 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Pathological process affecting the brain

  • Decreased extracellular fluid volume (hypovolemia)

  • Increased Na+ loss with urine

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

Explicación

Pregunta 90 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 91 de 99

1

Rellena los espacios en blanco para completar el texto.

List Pulmonary causes of ARDS

Severe
Inhalation

Explicación

Pregunta 92 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • Heart failure → Stagnant hypoxia

  • Acute hemolysis → Anemic hypoxia

  • Anaphylaxis → Cytopathic hypoxia

  • High altitude → Hypoxic hypoxia

Explicación

Pregunta 93 de 99

1

Microblologic analysis of blood cultures is

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 94 de 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)

Selecciona una de las siguientes respuestas posibles:

  • Fluid redistribution to the vascular space

  • Decreased venous capacitance

  • Increased heart rate

  • Decreased renal losses of fluid

Explicación

Pregunta 95 de 99

1

Possible disastrous complication from overly rapid correction of hyponatremia is

Selecciona una de las siguientes respuestas posibles:

  • Cerebral edema and brain herniation

  • Insipid diabetes

  • Ischaemic Stroke

  • Central pontine myelinolysis

Explicación

Pregunta 96 de 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?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 97 de 99

1

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

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 98 de 99

1

Which of the following statements about cyanosis is correct?

Selecciona una de las siguientes respuestas posibles:

  • 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

Explicación

Pregunta 99 de 99

1

Rellena los espacios en blanco para completar el texto.

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

Explicación

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