Finals MCQs-Aug 2010

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Finals Black Bank | Aug16 | Apr09 | Aug09 | Mar10 | Mar11

MCQs from the FINALS Exam 27th August 2010 - 119 MCQs coded so far
In an attempt to overcome the delays in coding MCQs after each exam, I have added in temporary codes (eg TMP-Jul10-001, TMP-100)
for some MCQs.
The MCQ will then have a page where comments can be added and then, once the MCQ is coded, there will be a re-direction added
so you can always get to the individual MCQ page. (NB: A mistake - The MCQ code should be Aug10 not Jul10) SysopKB

New Questions

Each paper has 50 new MCQs, 50 repeats from the previous MCQ paper, and 50 old repeat MCQs.  
The 'extra' new MCQs recalled here are probably just older ones that hadn't made it to the "Black Bank"

TMP-Jul10-001 Pre-eclamptic woman, BP 170/110, headache, proteinuria 1.2g. Which of the following NOT to use for control of her hypertension:

A. Magnesium
D. Hydralazine
E. Metoprolol

TMP-Jul10-002 Male with a Haemoglobin of 8G% and reticulocyte count 10%. Possible diagnosis:

A. Untreated pernicious anaemia
B. Aplastic anaemia
C. Acute leukaemia
D. Anaemia of chronic disease
E. Hereditary spherocytosis

TMP-Jul10-003 Commonest organism causing meningitis post spinal:

A. Staph epidermidis
B. Staph salivarius
C. Staph aureus
D. Strep pneumoniae
E.  ?

TMP-Jul10-004 Exponential decline / definition of time constant (with various options)

A. time for exponential process to reach log(e) of its initial value
B. Time until exponential process reaches zero
C. Time to reach 37% of initial value
D. Time to reach half if its initial value
E. 69% of half life

TMP-Jul10-005 (This is a very old repeat) Relative humidity – air fully saturated at 20 %. What is the relative humidity at 37 degrees ?

A. 20
B. 30
C. 40
D. 50
E. 60%

TMP-Jul10-006 A 50 year old man with multiple fractures. The BEST parameter to monitor volume resuscitation is:

A. Heart rate
E. Changes in R atrial pressure during inspiration

TMP-Jul10-007 Anaphylaxis to rocuronium. Which is most likely to cause coss-reactivity ?

A. Vecuronium
B. Pancuronium
C. Atracurium
D. Cisatracurium
E. None of the above -cross reactivity too variable to predict

TMP-Jul10-008 Hypotension post propofol induction in elderly patient. More pronounced / profound than in younger patient. Reason ?

A. Concentric LVH associated with ageing and therefore preload dependent
B. Because of increased lean body mass
C. Decreased cardiac output with ageing
D. Increased sensiticity to all anaesthetic agents, thus relative overdose is common
E. Decreased liver blood flow with ageing, decrease drug clearance and increased drug concentration

TMP-Jul10-009 Predictive factors for mortality in elderly patient (except):

A. Aortic stenosis
B. Diabetes mellitus
C. Elevated Creatinine
D. Cognitive dysfunction
E. Type of surgery

TMP-Jul10-010 The best clinical indicator of SEVERE AS

A. Presence of thrill
B. Mean Gradient 30mmHg
C. Area 1.2 cm2
D. Slow rising pulse and ESM radiating to carotids
E. Shortness of breath

TMP-Jul10-011 Elderly patient. Indications for pre Femoro-Popliteal Bypass angiogram include all EXCEPT:

A. Severe heart failure
B. Suspicion of L main disease
C. Symptomatic tachyarrhythmia
D. Unstable angina
E. Stable angina with positive thallium

TMP-Jul10-012 How do you minimise risk of intravenous cannulation with epidural insertion ?

A. Injection saline through epidural needle before catheter insertion
B. Lie patient lateral
D. Thread catheter slowly

TMP-Jul10-013 Timing of peak respiratory depression post intrathecal 300 mcg morphine:

A. < 3.5 hours (think it was one hour)
B. 3.5 – 7.5 hours (then three hours)
C. 7 - 12.5 hours (then 7.5 - 12.5 hrs)
D. 12.5 -18 hours
E. > 18 hours

TMP-Jul10-014 Patient with aortic dissection. Blood pressure 150/90. Best drug to control BP:

A. Captopril
B. Esmolol
D. Hydralazine

TMP-Jul10-015 Type of dissection – which is classically for NON-operative management:

A. DeBakey Type I
B. DeBakey Type II
C. Stanford A
D. Stanford B
E. Stanford C

TMP-Jul10-016 TURP – patient under spinal. Confused. ABG: Na+ 117 / normal gas exchange. Treatment ?

A. 10 ml 20% Saline as fast push IV
B. 3% NS 100 ml/h
C. Normal saline 200 ml/h
D. Frusemide 40 mg IV
E. Fluid restrict 500 ml/day

TMP-Jul10-017 Male undergoing trans-sphenoidal surgery. Now Na+ 155mmol/l and thirsty with polydypsia. Treatment:

A. Desmopressin (DDAVP)
B. Fluid restrict
C. Aldosterone

TMP-Jul10-018 The STRONGEST stimulus for ADH secretion:

A. High serum osmolality
B. Low serum osmolality
C. Hypovolaemia
D. High serum Na

TMP-Jul10-019 Stellate ganglion block. Needle entry next to SCM muscle at C6. Which direction to advance needle ?

A. C3
B. C4
C. C5
D. C6
E. C7

TMP-Jul10-020 20. Thermoneutral zone in 1 month old infant ?

A. 26 – 28 degrees Celcius
B. 28 – 30 degrees Celcius
C. 30 – 32 degrees Celcius
D. 32 – 34 degrees Celcius
E. 34-46 degrees celcius

TMP-Jul10-021 A 60 year old man describes orthopnoea. On examination: pansystolic murmur (at LSE)/ displaced apex beat. Likely diagnosis ?

A. Mitral regurgitation
B. ?

TMP-Jul10-022 A 4 year old child with VSD (repaired when 2 years old) for dental surgery. What antibiotic prophylaxis do the guidelines recommend?

A. Amoxycillyn orally
B. Amoxycillin IV
C. Cephazolin IV
D. Amoxycillin / gentamicin
E. No antibiotics required

TMP-Jul10-023 A 4 year old child with Arthrogrophysis multiplex congenita for dental surgery. Jaw rigidity post induction. Likely cause ?

A. Temporomandibular joint involvement/ TMJ rigidity
B. Inadequate depth of anaesthesia
C. Inadequate muscle relaxation/ inadequate sux
D. Masseter spasm
E. ?

TMP-Jul10-024 A 78 year old man with past difficult intubation for arm surgery. Supraclavicular block with 25 mls 0.5% bupivacaine. Shortly after begins convulsing. INITIAL management?

A. Midazolam 5mg
B. Intralipid 20% 1.5 ml/kg
C. Thiopentone 150mg
D. Suxamethonium 50mg
E. Propofol 50mg

TMP-Jul10-025 Advantages of bronchial blockers over double lumen tubes:

A. Able to achieve lobar isolation
B. Lower cuff pressure
C. Quicker deflation of isolated lung
D. Pneumonectomy
E. Lower incidence of malposition

TMP-Jul10-026 Patient for pneumonectomy. Pre op FEV1 2.4. (Predicted 4.5L) FVC given as well. For R lower lobectomy. Postoperative predicted FEV1 ?

A. 1.3
B. 1.5
C. 1.7
D. 1.9
E. 2.2

TMP-Jul10-027 Post accidental dural puncture with epidural needle. Headache. Which does NOT fit ?

A. Epidural blood patch 30-50% effective
B. Unlikely to be related to epidural if purely occipital headache
C. Caffeine mildly effective in reducing headache
D. Subdural haematoma can rarely occur with PDPH
E. (?something about photophobia)

TMP-Jul10-028 Cell saver. Which does NOT get filtered ?

A. Foetal cells
B. Free Hb
C. Platelets
D. Clotting factors
E. Microaggregates of leukocytes

TMP-Jul10-029 You are on a humanitarian aid mission in the developing world. Drawover vaporiser apparatus described being used. Given 400 mm tubing, OMV or diamedica vaporiser, 200mm tubing attached to self-inflating bag. Which other ONE piece of equipment is ESSENTIAL to make this system functional?

A. Halothane
B. In-line Waters' Cannister [1]
C. Non-rebreathing valve
D. Oxygen source
E. Ventilator

TMP-Jul10-030 Regarding post craniotomy pain:

A. Local infiltration proven to reduce long-term pain
B. Local more painful than discrete nerve blocks
C. Local infiltration more efficacious than discrete nerve blocks
D. Local infiltration more efficacious than opioid analgesia
E. Local infiltration more efficacious with clonidine included

TMP-Jul10-031 A 60 year old female is undergoing hysterectomy. Gabapentin reduces postoperative:

A. Nausea
B. Vomiting
C. Sedation
D. Pruritus
E. Constipation

TMP-Jul10-032 Burns dressings. The following is proven to be of analgesic benefit:

A. Morphine gel
B. Biosynthetic dressings (the answer per pain book)
C. Dexmedetomidine IV
D. Lignocaine IV
E. Cognitive/Distraction technique

TMP-Jul10-033 Subtenon’s block. What is the worst position to insert block?

A. Inferonasal
B. Inferotemporal
C. Superonasal
D. Supertemporal
E. Medial / canthal

TMP-Jul10-034 Liposuction. Infiltration of lignocaine with 1:200,000 adrenaline. Peak plasma concentration of lignocaine occurs at:

A. 1 hour
B. 3 hours
C. 18 hours
D. 24 hours
E. 30 mins

TMP-Jul10-035 Child-Pugh score. Components ?

A. Bilirubin / albumen / INR (yes INR, not PT), ascites, encephalopathy
B. Various other options including AST/ALT, GGT, PT
C. ?
D. ?
E. ?

TMP-Jul10-036 Which is NOT a disadvantage of drawover vaporiser versus plenum vaporiser:

A. Temperature compensation
B. Cannot use sevoflurane
C. Small volume reservoir
D. Flow compensation

TMP-Jul10-037 Acute renal failure. Which is not an indication for dialysis ?

A. Hyperkalaemia
B. Metabolic alkalosis
C. Hypernatraemia
D. Uraemic pericarditis

TMP-Jul10-038 Chronic alcohol use. Which is not an associated complication ?

B. hypertriglyceridemia
C. Macrocytosis
D. Nephrotic syndrome
E. Pancreatic Ca

TMP-Jul10-039 Chest xray shown of patient post Left pneumonectomy with heart swung to left side. Management:

A. Increase PEEP
B. Roll onto right side
C. Turn on suction to left pleural catheter
D. Lung biopsy

TMP-Jul10-040 Salicylate poisoning:

A. Respiratory acidosis
B. Metabolic acidosis (/ don’t think this was an option - ak )(yep i think it was- mm)
C. Increased CO2 (production)
D. High output renal failure
E. Hyperthermia (/ pretty sure this option was HYPOthermia - too late)

TMP-Jul10-041 New onset atrial fibrillation in a 10 week pregnant lady. BP 150/90, HR 160, SaO2 92%. Moderate mitral stenosis on TTE, no thrombus seen. Emergency doctor gave her anticoagulant (not specified what). Most appropriate management:

A. Verapamil
B. Labetalol 20mg iv to 300mg
C. Amiodarone 300mg IV
D. Synchronised biphasic cardioversion with 70-100 Joule
E. Oral digoxin -1000mcg then 500mcg 6 hrs later

TMP-Jul10-042 Patient post anterior cervical fusion. Patient in recovery. Confused and combative. Nurse concerned about haematoma Taken to theatre: Most appropriate way of securing airway:

A. Gas induction / laryngoscopy / intubate
B. Awake tracheostomy
C. Awake fibreoptic intubation using minimal sedation
D. Thiopentone, suxamethonium, direct laryngoscopy and intubation
E. retrograde intubation

TMP-Jul10-043 Young asthmatic male in emergency department. RR 26, pCO2 27, SAO2 92%, struggling talking in sentences. Given nebulised salbutamol, and ipratropium, 200mg IV hydrocortisone. After 30 minutes - no improvement. Further management:

A. IV salbutamol
B. IV aminophylline
C. IV magnesium
D. Intubate and ventilate
E. ?

TMP-Jul10-044 Called to emergency department to review a 20 y/o male punched in throat at a party. Some haemoptysis / hoarse / soft voice. Next step in management:

A. CT to rule out thyroid cartilage fracture
B. XR to rule out fractured hyoid
C. Rapid sequence induction / laryngoscopy / intubation
D. Awake fibreoptic intubation
E. Nasendoscopy by ENT in emergency department

TMP-Jul10-045 How quickly does the CO2 rise in the apnoeic patient ?

A. 1 mmHg per min
B. 2 mmHg per min
C. 3 mmHg per min
D. 4 mmHg per min
E. 5 or ?8 mmHg per min

TMP-Jul10-046 Long-standing T6 paraplegia. All present EXCEPT ?

A. Flaccid paralysis
B. Poikilothermia
C. Autonomic hypereflexia
D. Labile BP
E. Hyperkalaemia with suxamethonium

TMP-Jul10-047 Young female patient for tonsillectomy with history of bleeding tendency. Which is the most likely cause?

A. Factor V Leiden
B. Protein C deficiency
C. Haemophilia B (Christmas disease)
D. Antithrombin III deficiency
E. Lupus anticoagulant

TMP-Jul10-048 Amniotic fluid embolism. Cause of death in first half hour ?

A. Pulmonary hypertension
B. Malignant arrhythmia
C. Pulmonary oedema
D. Hypovolaemic shock

TMP-Jul10-049 Hypocalcaemia – earliest sign:

A. Tingling of face and hands
B. Chvostek’s sign
C. Carpopedal spasm

TMP-Jul10-050 Elderly COAD patient. On home oxygen. 24 hours of worsening condition. Various blood gases given:

A. paO2 > 50, paCO2 70 HCO3 30 etc…

TMP-Jul10-051 Visual loss with pupillary reflexes retained. Likely cause ?

A. Retinal detachment
B. Occipital mass
C. Frontal mass
D. Chiasmal mass
E. Optic neuritis

TMP-Jul10-052 Nerve block for anaesthesia over anterior 2/3 of ear?

A. C2
B. Mandibular nerve
C. Maxillary nerve
D. Ophthalmic nerve
E. Vagus

TMP-Jul10-053 Complex regional pain syndrome. What proportion of patients have motor involvement ?

A. 0 %
B. 25 %
C. 50 %
D. 75 %
E. 95 %

TMP-Jul10-054 Malignant hyperthermia. The number of people in the community at any given time with a predisposition is called the:

A. Prevalence
B. Incidence

TMP-Jul10-055 Patient with Hx COAD and suspected pneumonia – clinical findings supporting R pneumonia on examination:

A. R Dull percussion note & increased vocal resonance
B. R Dull percussion note & decreased vocal resonance
C. R Decreased air entry
D. Tracheal deviation to left
E. Tracheal deviation to right

TMP-Jul10-056 Thallium scan:

A. High negative predictive value
B. High positive predictive value
C. Not as good as a dobutamine stress echocardiography

TMP-Jul10-057 A 50 y/o male diabetic admitted to intensive care with pneumonia. Intubated and ventilated. Extensive results given. BP 80/-, HR 120, CVP 4, PCWP 6, SvO2 69% PaO2 80, BE -4 pH 7.2. Management:

A. Blood transfusion
B. Bicarbonate infusion
C. Fluid resuscitation
D. Adrenaline infusion
E. Insulin infusion

TMP-Jul10-058 Young female having cholecystectomy. Venous air embolus:

A. Mechanical ventilation and PEEP is part of treatment strategy
B. Most likley to occur at initial gas insufflation, but can occur at any time
C. Inert gas (argon, xenon) is safer

TMP-Jul10-059 LUSCS for failure to progress. Spinal is inserted uneventfully. Next day the patient has foot drop. The most likely cause is?

A. epidural haematoma
B. lumbosacral palsy
C. sciatic nerve palsy
D. common peroneal palsy

TMP-Jul10-061 Severe pre-eclampsia. WORST treatment option:

A. Magnesium
B. Nifedipine
C. Metoprolol

TMP-Jul10-062 In pregnancy the dural sac ends at:

A. T12
B. L2
C. L4
D. S2
E. S4

TMP-Jul10-063 Septic elderly man. Given lots of obs but essentially mixed venous oxygen sat 65%, lactate 4, MAP low. Mx.

A transfuse
B fluid bolus
C Noradrenaline

TMP-Jul10-064 Another pregnant woman with ?MS. Develops SVT. Try vagal manouveres without success.

A. Adenosine
B. ?
C. ?

TMP-Jul10-064 Pregnant woman presents with narrow complex tachycardia HR 190, stable BP 100/60. No response to vagal manoevures. Management?

A. Adenosine 6mg
C. Amiodarone
D. Atenolol
E. ?

TMP-Jul10-065 Which gives the BEST seal?

A LMA classic
B Proseal
C Intubating LMA
D. ?
E. ?

TMP-Jul10-067 Peak plasma lignocaine level after epidural lignocaine. (again various times similar to the tumesent lignocaine one)

TMP-Jul10-068 ?possible repeat Lady on citalopram. Which drug is relatively contraindicated?

A Tramadol
B. ?

Repeat Questions

AC158 A 30yo Male. 5 hour operation. Arms abducted to 60 degrees. Head turned slightly to left side. Post op numb palm/thumb/index finger/middle finger and lateral half of ring finger. Numb ventral forearm. Weak finger grip. Weak elbow flexion. Most likely nerve injured?

A. median nerve
B. musculocutanous nerve
C. upper trunk of brachial plexus
D. ?brachial plexus stretch

MC77 [Aug10] Repeat Q Diastolic dysfunction is NOT caused by:

A Adrenaline
B Aortic stenosis
C Hypertension
D myocardial fibrosis
E ?

MC157 An 18 yo with Fontan circulation undergoing exploratory laparotomy. On ICU vent, sats 70%. Which ventilator parameter would you INCREASE to improve his sats?

A. Bilevel pressure
B. Expiratory time
C. Inspiratory time
D. Peak inspiratory pressure

SC33 A 7 kg Infant with tetralogy of fallot, post BT-shunt. Definitive repair at later date. Paralysed and ventilated. Sats 85% baseline, now 70%, best treatment:

A. Increase FiO2 from 50 - 100%
B. Esmolol 70 mcg
C. Phenylephrine 35 mcg
D. Morphine 1 mg
E. 1/2 NS with 2.5% dex 70 mls

MN41 Von Hippel-Lindau disease is associated with:

A. increased risk of malignant hyperthermia
B. meningiomas
C. peripheral neuropathy
D. pheochromocytomas
E. poor dentition

MH59 70 year old post TKJR. On sub-cut heparin. Develops clinical DVT and platelets 40 (sounds like HITS type-II). Management

A. Enoxaparin
B. Fondoparinux
C. Heparin by infusion
D. Lepirudin
E. Warfarin

MC161 Drug eluting stent 6 months old. On aspirin and prasugrel 10mg. Elective lap cholecystectomy for biliary colic.

A. Do case while taking both.
B. Do case while stopping both.
C. Stop Prasugrel for 7 days, keep taking aspirin.
D. Stop Prasugrel for some other different time
E. Post-pone for 6 months

MZ80 Arterial blood gases (ABGs): pH 7.12, PO2 100, PCO2 65, HCO3 20.3, BE -10. Consistent with?

A. Chronic renal failure
B. Malignant hyperthermia
C. Diabetic ketoacidosis
D. End-stage respiratory failure
E. Ethylene glycol toxicity

TMP-100 Compared to lignocaine, bupivacaine is

A. Twice as potent
B. Three times as potent
C. Four times as potent
D. Five times as potent
E. Same potency

TMP-101 Aneurysm sugery. Propofol/remifentanil/NMDR. DOA monitoring (Entropy). MAP 70 , HR 70/min, State entropy 50, Response entropy 70. What do you do?

A. ?
B. Metaraminol
C. Check TOF
D. Nothing
E. Increase TCI.

TMP-102 Interscalene block, patient hiccups...where do you redirect your needle?

A. Anterior
B. Posterior
C. Caudal
D. Cranial
E. Superficial

TMP-103 What is the SVR in a patient with MAP 100mmHg, CVP 5, PCWP 15, CO 5L/min?

A. ?0.8
B. ?3
C. 520
D. 1280
E. 1520 dynes.sec/cm-5

TMP-104 Stellate ganglion

A. Anterior to scalenius anterior
B. ?
C. ?
D. ?
E. ?

TMP-105 The median nerve

A. can be blocked at the elbow immediately medial to the brachial artery
B. can be blocked at the wrist between palmaris longus and flexor carpi ulnaris
C. can be blocked at the wrist medial to flexor carpi ulnaris
D. is formed from the lateral, medial, and posterior cords of the brachial plexus
E. provides sensation to the ulnar half of the palm

TMP-106 A 75yo male with moderate aortic stenosis (valve area 1.1cm2).. Gets mild dyspnoea on exertion but otherwise asymptomatic. Needs hip replacement.

A. Continue with surgery
B. Beta block then continue
C. Get myocardial perfusion scan
D. Postpone surgery awaiting AVR
E. Postpone surgery awaiting balloon valvotomy

TMP-107 Baby with Tracheo-oesophageal fistula found by bubbling saliva and nasogastric tube coiling on Xray. Best immediate management?

A. Bag and mask ventilate
B. Intubate and ventilate
C. position head up, insert suction catheter in oesophagus (or to stomach?)
D. Place prone, head down to allow contents to drain
E. Insert gastrostomy

TMP-108 A 60yo man with anterior mediastinal mass, during induction for mediastinoscopy....lose cardiac output, decreased saturations, drop in ETCO2. Management:

A. Adrenaline
D. Place prone

TMP-109 The MAIN indication for biventricular pacing is

A. complete heart block
B. congestive cardiac failure

EM66 What's the most appropriate mode for neuromuscular monitoring during aneurysm clipping?

A. TOF count
B. TOF ratio
C. Post tetanic count
D. ?
E. ?

TMP-118 What's the area burnt in the following man? Half of left upper arm, all of left leg and anterior abdomen.

A. 27%
B. 32%
C. 42%

MC59b Torsades, what's not useful?

A. Amiodarone
B. Isoprenaline
C. ?

RU19 The intercostobrachial nerve:

A. Arises from T2 trunk
B. Is usually blocked in brachial plexus block
C. Supplies antecubital fossa
D. can be damaged by torniquet
E. Arises from inferior trunk

SF87 Labour epidurals increase maternal and foetal temperature. This results in neonatal

A. Increased sepsis
B. Increased investigations for sepsis
C. increased non shivering thermogenesis
D. Increased need for resuscitation
E. Cerebral palsy

SF88 Maternal cardiac arrest. In making the diagnosis of amniotic fluid embolism, large amount of PMNs surrounding foetal squamous cells are

A. Pathognomonic
B. Supportive
C. Only found at postmortem
D. Irrelevant
E. Incidental

PC50 Half life of tirofiban:

A. 2hrs
B. 8hrs
C. 12hrs
D. 24hrs
E. 15 minutes

PN48 Why is codeine not used in paediatrics?

A. Poor taste
B. High inter-individual pharmacokinetic variability
C. Not licensed for <10 year old
D. not as effective as adult when given in ?weight adjusted dose?
E. ?

TMP-113 Best agent to decrease gastric volume AND increase gastric pH before semi-urgent procedure

A. Omeprazole
B. Cimetidine
C. Ranitidine
D. Sodium citrate

AM28c Myaesthenia gravis - features predicting need for post op ventilation EXCEPT

A. Prolonged disease
B. High dose Rx
C. Previous respiratory crisis
D. Increased sensitivity to NMB's
E. bulbar dysfunction

NN13b Innervation of larynx

A. The internal branch of the superior laryngeal nerve ...
B. ?
E. Cuff compression of recurrent laryngeal nerve against thryoid can cause palsy

NA15 The nerve supplying area of skin between greater trochanter and iliac crest:

A. subcostal nerve
B. ilioinguinal nerve
C. genitofemoral nerve
D. femoral nerve
E. lat cutaneous femoral nerve.

PZ103 IV paracetamol:

A. late plasma levels around the same as oral
B. highly protein bound
C. ?30%? renally excreted
D. VD 10L/kg

MC77 Patient with diastolic dysfunction. Is it caused by:

A. Restrictive cardiomyopathy
B. Dilated cardiomyopathy

AC90 Most likely to result in myocardial infarction:

A. intraop myocardial ischaemia
B. post op myocardial ischaemia.

TMP-128 Indication for percutaneous closure of ASD

A. Primun < 3cm
B. Primun > 3cm
C. Secundum < 3 cm
D. Secundum > 3cm
E. sinus venosus ASD

MN38 Respiratory function in quadriplegics is improved by

A. abdominal distension
B. an increase in chest wall spasticity
C. interscalene nerve block
D. the upright position
E. unilateral compliance reduction

SF53 Carbon dioxide is the most common gas used for insufflation for laparoscopy because it

A. is cheap and readily available
B. is slow to be absorbed from the peritoneum and thus safer
C. is not as dangerous as some other gases if inadvertently given intravenously
D. provides the best surgical conditions for vision and diathermy
E. will not produce any problems with gas emboli as it dissolves rapidly in blood

AA04 Histamine release in anaphylaxis does NOT cause:

A. Tachycardia
B. Myocardial depression
C. Coronary artery vasodilatation
D. Prolonged PR interval
E. Decreased impulse conduction

EZ88 [Aug10] A device that detects a 10mA difference in active and neutral leads and causes turning off of the circuit within 40 ms. This is a:

A. Class 1 device
B. Equipotential earthing
C. Line isolation monitor
D. Residual Current Device
E. Fuse

AZ80 Which of the following is NOT an absolute contra-indication for MRI?

A. cochlear implant
B. heart valve prosthesis
D. pacemaker
E. intracranial clips

AT08c [Aug10] One lung ventilation and hypoxaemia. After 100% O2 and FOB next step is:

A. CPAP 5cm top lung
B. CPAP 10cm top lung
C. PEEP 5cm bottom lung
D. CPAP 5cm top + PEEP 5cm bottom
E. ?

AC158 [Aug09] [Aug10] Long duration of surgery, arms stretched out, head turned 30 degrees to right. On waking patient has a neurological deficit. Sensory loss over ventral lateral palm and 3 fingers, some weakness of the hand, weakness of the wrist, some paraesthesia of the forearm and weak elbow flexions. Most likely injury is

A. Median nerve
B. Ulnar nerve
C. C5 nerve root
D. Upper cervical trunk
E. Musculocutaneous

ME23 Plasma glucose level compared to blood glucose level

A. 32% higher
B. 14% higher
C. Same
D. 14%lower
E. 32% lower

MZ71 With regards to obstructive sleep apnoea (OSA), which of the following statements is INCORRECT?

A. hypoxaemia is the main stimulus to arousal
B. the main method of treating this syndrome is with Continuous Positive Airway Pressure (CPAP)
C. this syndrome is the most likely diagnosis in patients presenting with excessive daytime sleepiness
D. this syndrome occurs in up to 5% of adults
E. this syndrome rarely has an obstructive component

SZ14b Management of rhabdomyolysis – best option?

A. Haemodialysis
B. Bicarbonate
C. Frusemide
D. IV fluids

EZ76 Residual current devices:

A. Compare current between active and neutral lines
D. Must be fitted in cardiac protected areas
E. Must be fitted in operating theatres

PZ86d Serotonin syndrome has been reported following SSRI coadministration with:

A. Gingko
B. Garlic
C. Ginger
D. St John’s wort
E. Vallerian

[NB: PZ86 seems to be the same Q as it has same options, but is about bleeding not serotonin syndrome. Remembered wrongly here??]

PP86 Child with ?pyloric stenosis and 3 days of vomiting. Which bloods would you expect? [Not given pH]

A. Na 130 K 4.5 Cl 90 Bic 17
B. Na 130 K 2.5 Cl 87 Bic 24

EZ91 Which LMA has highest seal pressure?

A. Classic
B. Disposable supreme
C. Flexible
D. Intubating
E. Proseal

MZ51 Why is tachycardia bad in mitral stenosis?

B. Increases transvalvular pressure gradient

AT28 You intubate a young male patient for a left thoracotomy with a 39FG Robertshaw tube. When you inflate both cuffs and ventilate the bronchial lumen you get left sided ventilation. When you attempt to ventilate the tracheal lumen the pressures are very high and you get no air entry. Yet when you deflate BRONCHIAL cuff you can ventilate BOTH left and right lungs through the tracheal lumen. The most appropriate step to take next is:

A. Change to a 41FG tube
B. Change to a 37FG tube
C. Deflate both cuffs and insert further cm and recheck
D. Deflate both cuffs and withdraw a few cm and recheck
E. Pull ETT out and start again.

PP46b ANZCA version [2001-Apr] Q17, [2003-Apr] Q104, [2003-Aug] Q57, [Mar06], [Aug10]
The average expected depth of insertion of an oral endotracheal tube, from the lip, in a normal newborn infant is

A. 7.5 cm
B. 8.5 cm
C. 9.5 cm
D. 10.5 cm
E. 11.5 cm

RB58 What is NOT a feature of high spinal block?

A. Hypotension
C. Hard to speak
D. Numb hands
E. Tachycardia

ST37 Positive predictive value is:

A. The proportion of people without disease who are correctly identified as not having the disease.
B. The proportion of people with disease who are correctly identified as having the disease.
C. The proportion of people with disease who have a positive test result
D. The proportion of people without disease who have a positive test result
E. etc

RN18 Stellate ganglion block is associated with all EXCEPT:

A. Ptosis
B. Miosis
C. Sweating
D. Facial flushing
E. Nasal stuffiness

AM16 Recognised clinical associations with dystrophia myotonica include

A. development of diabetes mellitus
B. abnormal intestinal motility
C. cardiomyopathy
D. ovarian dysfunction
E. all of the above

MC110 Left bundle branch block (LBBB) is associated with:

D. Relative contraindication to CVL insertion

RB63 When hearing loss occurs following spinal anaesthesia it is usually in which of the following frequency ranges:

A. 125 - 1000 Hz
B. 1500 - 3000 Hz
C. 3500 - 5500 Hz
D. 6000 - 10000Hz
E. > 11000Hz

116. Anaemia in chronic renal failure is characteristically

A. due to haemolysis in the renal vascular bed
B. normochromic and microcytic
C. due to defective haemoglobin synthesis
D. responsive to ion and folate therapy
E. associated with increased 2,3-DPG levels in blood cells

117. A 12 year old child with hip dislocation at 4pm. Ate something 1 hour after injury. Now 11 pm. Best anaesthetic:

A. RSI with ETT
B. delay until next day then treat elective
C. inhalational induction and continue with face mask
D. Reduce immediately with iv sedation
E. inhalational induction and continue with face mask

118. Central anticholinergic syndrome, which is NOT true:

A. Will improve with neostigmine
B. Peripheral anticholinergic symptoms
C. Caused by anti-Parkinson drugs
D. CNS depression
E. Associated with agitation, delirium, and ???

119. Carcinoid syndrome - finding on examining heart:

A. Fine inspiratory crepitations
B. Systolic murmur at apex
C. Systolic murmur at left sternal edge
D. Murmur at apex with opening snap
E. Pericardial rub

SZ11 Lowering intra-ocular pressure by applying pressure to the globe (e.g. Honan balloon) is typically contraindicated in a patient having

A. a revision corneal graft
B. a revision trabeculectomy
C. an extra-capsular lens extraction
D. a redo vitrectomy
E. repeat retinal cryotherapy

121. Troponin is elevated post-infarct

A. 1-2 days
B. 2-5 days
C. 5-14 days
D. 7-21 days

122. Myotome of C6-7

A. Shoulder flexion
B. Shoulder extension
C. Elbow flexion
D. Wrist flexion and extension
E. Finger flexion and extension

123. Head Trauma patient with unilateral dialated pupil, whats the diagnosis ?

A.Global injury
B.Optic nerve injury
C.Horners syndrome
D.Transtentorial herniation

124. The PREDOMINANT pathophysiological effect of restrictive cardiomyopathy is:

B. Diastolic dysfunction

PZ65b When does effect of diclofenac on platelets wear off?

B. 12 hours

126. What does C6/7 do?

E. wrist flexion/extension

NL04 Muscle NOT supplied by sciatic nerve:

B. gluteus maximus

ST37 [Aug10] Negative predictive value is best described as

B. Chance of a negative test in people without a disease.

PL31 Aug10 Time to reach peak plasma concentration after injection of 2% lignocaine with adrenaline into epidural space

A. 20 min
B. 30 min
C. 40 min
D. 50 min
E. 60 min
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