Finals MCQs-Aug 2016
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PLEASE record the MCQs you have recalled. Thank you to everyonwe who has contributed.
1) A 120kg lady 34/40 is admitted to the ward with threatened pre-term labour. What dose of s/c Clexane do you prescribe her for thromboprophylaxis?
- A. 20mg D
- B. 40mg D
- C. 60mg D
- D. 100mg D
- E. 120mg D
2) What is the arrangement of 3 lead ECG:
- A. Left arm – black, right arm – white, left leg – green
- B. Left arm – red, right arm – white, left leg – black
- C. Left arm – black, right leg – white, left leg – red
- D. Left arm – black, right arm – white, left leg – red
- E. Left arm – black, right arm – white, right leg – red
3) What is your aim for systolic blood pressure in a closed head injury
- A. 80 mmHg
- B. 90 mmHg
- C. 100 mmHg
- D. 110 mmHg
- E. 120 mmHg
4) The vocal cords are lax after an LMA anaesthetic. What nerve has been injured?
- A. Superior laryngeal
- B. Inferior laryngeal
- C. Recurrent laryngeal
5) What is the 1st line treatment of a young man in ED with recently diagnosed phaeochromocytoma
- who has presented with severe hypertension and tachycardia? He is not on any current treatment.
- A. Esmolol
- B. Phentolamine
- C. Phenoxybenzamine
- D. GTN
6) What is the safest duration between ceasing Ticagrelor and performing a neuraxial block?
- A. 1 day
- B. 3 days
- C. 5 days
- D. 7 days
7) You are a consultant anaesthetist asked to help a junior registrar who is
- having difficulty siting a labour epidural. In assisting them site the epidural
- all you do is place on sterile gloves.
- This is known as a:
- A. Slip
- B. Lapse
- C. Violation
- D. Deviation
- E. Mistake
8) You are called to assist a registrar in the next theatre who is having difficulty intubating a patient.
- On arrival, the nurse tells you he has been trying for 5 minutes and you notice the sats are 70%.
- You place an LMA easily and ventilate the patient back to normal saturations.
- According to Crisis Resource Management principles, the error the registrar was displaying is…
- A. Fixation error
- B. Failure to use cognitive aids
9) What is not a feature of Horner’s Syndrome?
- A. Exophthalmos
- B. Anhydrosis etc
- C. Miosis
10) Given a series of PFT’s all approximately in the 80%s. DLCO 102%. What is the diagnosis?
- A. Asthma
- B. Emphysema
- C. Fibrosis
- D. Pulmonary hypertension
11) Unilateral lumbar sympathetic block. Most likely side effect?
- A. Genitofemoral neuralgia
- B. Hypotension
12) Troponin rise in SAH occurs in what percentage of patients?
- A. 5-15%
- B. 15-30%
- C. 30-45%
- D. 45-60%
- E. 60-75%
13) Accidental needlestick injury with a hollow bore needle. Likelihood of Hepatitis C transmission?
- A. 0.3%
- B. 2%
- C. 10%
- D. 20%
- E. 30%
14) Emergence delirium in paediatric patients occurs most commonly after what type of surgery:
- A. Adenotonsillectomy
- B. Circumcision
- C. Closed reduction of fracture
- D. Colonoscopy
- E. Inguinal hernia repair
15) The Pin Index System for nitrous oxide on a size C cylinder:
- A. 1, 5
- B. 1, 6
- C. 2, 5
- D. 3, 5
- E. 3, 6
16) 70 year old male in the emergency department with a ?small bowel obstruction.
- On candesartan, an NSAID and a diuretic. His serum potassium is 7.0mmol/L.
- What is the first/initial step for lowering his potassium
- A. Slow IV injection of 10ml calcium gluconate 10%
- B. Salbutamol 5mg nebuliser
- C. 15IU insulin in 50ml of 50% dextrose
- D. Sodium bicarbonate 50ml
- E. Calcium resonium
17) A patient has a tumour of some sort. He is hypokalaemic and has a metabolic alkalosis.
- What is the tumour most likely secreting?
- A. Adrenocorticotropic hormone
- B. Antidiuretic hormone
- C. Parathyroid-type secreting hormone
- D. Glucocorticoid
- E. Thyroid stimulating hormone
18) The nerve integrity monitor (NIM) endotracheal tube works by monitoring:
- A. Electromyography of internal laryngeal muscles
- B. Recurrent laryngeal nerve action potential
- C. Movement of the vocal cords on the endotracheal tube
- D. Pressure of the vocal cords on the endotracheal tube
- E. Recurrent laryngeal nerve action potential
19) External and internal diameter of the common gas outlet
- A. 30mm and 15mm
- B. 22mm and 15mm
- C. 30mm and 20mm
- D. 32mm and 20mm
20) Adult male is anaesthetised with a CVC in situ.
- Just before the surgeon starts the Line Isolation Monitor alarms about a leak of 5mA.
- What do you do?
- A. Check the diathermy pad
- B. Ensure the patient is earthed/grounded
- C. Unplug the CVL to isolate the patient until the fault is identified
- D. Sequentially remove non-essential monitors from the circuit until the fault is identified
- E. Stop the procedure and move the patient to a safe location
21) In a patient with rheumatoid arthritis, what is the most common direction of atlanto-occipital subluxation?
- A. Anterior
- B. Posterior
- C. Vertical
- D. Rotatory
- E. Lateral
22) An interosseus aspiration is least accurate for measuring:
- A. Albumin
- B. Creatinine
- C. Chloride
- D. Sodium
- E. Potassium
23) You are called to assist your registrar who is administering an interscalene nerve block.
- After injection of 2ml 0.75% ropivacaine the patient has a grand-mal seizure.
- The local anaesthetic has likely been injected into the:
- A. Dural cuff
- B. Internal jugular vein
- C. Internal carotid artery
- D. External jugular vein
- E. Vertebral artery
24) A patient has an above the elbow ulnar nerve palsy following a procedure. They
- A. Reduced sensation of posterior arm
- B. Arm held in persistent supination
- C. Unable to flex wrist
- D. Weakness of thumb abduction
- E. Weakness of finger adduction
25) You’ve been asked to set up an outside area recovery room.
- All of the following are essential in each bay except:
- A. ECG
- B. Sphygmanomanometer
- C. Stethoscope
- D. Pulse oximetry
- E. Thermometer
26) Praecordial thump
- A. Monitored ventricular fibrillation with no immediately available defibrillator
- B. Monitored ventricular tachycardia with no immediately available defibrillator
- C. ?
27) Patient asked to look straight ahead. Picture of eyes with lateral deviation of right eye. What is his abnormality?
- A. CN II palsy
- B. CN III palsy
- C. CN IV palsy
- D. CN V palsy
- E. CN VI palsy
28) A 63 yo lady has known chronic atrial fibrillation, hypertension, previous stroke, type 2 diabetes.
- What is her annual stroke risk if she is not on anticoagulation?
- A. 1.3%
- B. 4.0%
- C. 5.8%
29) A patient with cardiac disease gets short of breath moving around their house. What is their New York Heart Association classification?
- A. Class I
- B. Class II
- C. Class III
- D. Class IV
- E. Class V
30) Patient having resection of a lesion from the lateral border of their lower right lip.
- The surgeon does not want to perform local infiltration and the patient refuses a GA.
- Which nerve will you block?
- A. Infraorbital
- B. Mental
31) The afferent limb of the occulocardiac reflex is mediated by:
- A. Long and short ciliary nerves
- B. Facial nerve
- C. Vagus nerve
- D. Optic nerve
- E. Ophthalmic nerve
32) Patient’s core temperature drops 1 degree 20 minutes after induction of general anaesthesia. What is the most likely cause:
- A. Redistribution from core to peripheries
- B. Radiation
- C. Conduction from body to operating table/bed
- D. Evaporation
33) Well child for closed reduction of a fracture sustained 2 days ago.
- Well controlled asthma (on inhalers), current URTI. Chest sounds clear, systemically well.
- What is the best option for managing his airway?
- A. Controlled ventilation via ETT
- B. Spontaneous ventilation via ETT
- C. Spontaneous ventilation via face mask
- D. Spontaneous ventilation via Laryngeal Mask Airway
- E. Spontaneous ventilation via Proseal Laryngeal Mask Airway
34) Pressure comparison, list in order from highest to lowest:
- A-E. (different combos of 10 kPa/10 atm/10 psi/10 mmHg/10 cmH2O)
35) How much fibrinogen will it take to increase fibrinogen by 1g/L
- A. 1ml/kg
- B. 5ml/kg
- C. 10ml/kg
- D. 20ml/kg
- E. 30ml/kg
36) Time taken for plasma and brain equilibration of methadone
- A. 3 minutes
- B. 8 minutes
- C. 20 minutes
- D. 60 minutes
- E. 120 minutes
37) Septic elderly patient with multiorgan failure requiring laparotomy for suspected dead gut.
- INR 2.1, Hb 90, Platelets 105, Fib 4 (?or 1.5). What products to give?
- A. 2 units FFP, 1 unit platelets
- B. 2 units FFP, 1 unit blood
- C. 50IU/kg Prothrombinex to correct INR
- D. Platelets
- E. Fibrinogen to aim fib >2
38) BIS change when suxamethonium given to an awake patient:
- A. Decrease
- B. Increase
- C. Increase then decrease
- D. Decrease then increase
- E. Nothing
39) Drug least likely to interfere with MEP monitoring during scoliosis surgery
- A. N2O
- B. Non-depolarising neuromuscular blocker
- C. Opioids
- D. Propofol
- E. Volatile
40) According to NAP4: incidence of failed cricothyroidotomy
- A. ?
- B. ?
41) Morbidly obese lady in ICU with pneumonia, elective tracheostomy placed 8 hours ago.
- On rolling for pressure care, started desaturating and you suspect dislodgement of the tracheostomy.
- What is your immediate management?
- A. Readvance tracheostomy over gum elastic bougie
- B. Use fibreoptic bronchoscope
- C. Intubate from the mouth
- D. Insert airway exchange catheter
- E. Perform needle cricothyroidotomy
42) A 53 year old man is having major urological surgery.
- The surgeon asks you to give methylene blue to help avoid ureteric injury.
- What drug interacts with methylene blue?
- A. Droperidol
- B. Prazocin
- C. Fluoxetine
- D. Oxybutynin
- E. Risperidone
43) You review a patient 12 hours post right pneumonectomy on the ward.
- He is hypoxic, distressed with distended neck veins.
- hat is the best IMMEDIATE management?
- A. Clamp chest tube to prevent more air leak
- B. Place patient left lateral
- C. Place another chest tube on the right side
- D. Perform urgent pericardiocentesis
- E. Urgently transfuse 2 units packed red blood cells
44) What is a positive endotracheal tube cuff leak test?
- A. >110ml leak with cuff deflated
- B. >110ml leak with cuff deflated
- C. Audible leak with cuff deflated
- D. No audible leak with cuff deflated
- E. No audible leak with cuff pressure <30cm H2O
45) Horner's syndrome results from blockade of which structure?
- A. Ciliary ganglion
- B. Stellate ganglion
- C. Pterygopalatine ganglion
- D. Otic ganglion
- E. Submadibular ganglion
46) According to PS09, the minimum requirement for administering propofol for conscious sedation is
- A. Medical practitioner with a skilled assistant that is separate from the assistant to the proceduralist
- B. Medical practitioner
- C. Nurse supervised by proceduralist with recent ALS training
- D. Specialist anaesthetist
- E. Nurse with advanced airway skills
47) The characteristic respiratory pattern in a patient with an acute C5 spinal cord injury is
- A. Rapid respiratory rate
- B. Arterial hypoxaemia
- C. Chest wall immobility
- D. Preserved cough
- E. Preserved inspiratory force
48) What is the mechanism of central sensitisation?
- A. Increased intracellular magnesium
- B. Antagonism of the NMDA receptor
- C. Glycine is the major neurotransmitter involved
- D. Recurrent a-delta fibre activation
- E. Alteration in gene expression
49) What is the reason infants desaturate faster than adults on induction with rapid sequence intubation?
- A. More difficult to preoxygenate
- B. More rapid detection of hypoxia
- C. FRC decreased more than adults
- D. Drugs work more rapidly
- E. Persistent R to L shunt
50) A woman complains of paraesthesia in her hands when hanging out the washing.
- She also has muscle wasting on her hands and a weak radial pulse.
- What is the most likely diagnosis?
- A. Thoracic outlet syndrome
- B. Brachial plexus injury
- C. Paraneoplastic syndrome
- D. Lupus
- E. Coarctation of the aorta
51) A neonate is born floppy and apnoeic. They do not start breathing following stimulation. What FiO2 should you initially perform bag-mask ventilation with?
- A. 0.21
- B. 0.3
- C. 0.5
- D. 0.7:E. 1
52) Which would be consistent with deep partial thickness burns?
- A. Pain to deep pressure only, decreased capillary refill
- B. Blanches to pressure, very painful
- C. Painful to air, red and wet, blanches to pressure
- D. Not painful, does not blanch
53) Background radiation is 2.5mSv per annum. How much ionising radiation in a CTPA?
- A. 0.15mSv
- B. 0.5mSv
- C. 5mSv
- D. 15mSv
- E. 50mSv
54) You assist a junior to do spinal. Instead of gown and gloving, you put on gloves. What catergory of error is this?
- A. deviation
- B. lapse
- C. mistake
- D. slip
- E. violation
55) Difficult intubation least likely in
- A. Apert syndrome
- B. Down’s syndrome
- C. Hurler syndrome
- D. Pierre Robin syndrome
- E. Treacher Collin’s syndrome
56) The following have been found to decrease the incidence of spinal cord ischaemia EXCEPT
- A. CSF drainage
- B. high dose IV methylprednisolone
- C. maintaining MAP > 80
- D. monitoring motor evoked potentials
- E. preop identification of intercostal lumbar arteries supplying artery of Adamkiewizcs
57) The musculocutaneous nerve is difficult to block because
- A. arises from C6
- B. arises from lateral head of median nerve
- C. arises from medial head of median nerve
- D. congenitally absent in 10% of the population
- E. located outside the axillary sheath
58) 0.5mg/kg mannitol for kidney transplant
- A. increases survival of graft
- B. increases renal tubular necrosis
- C. reduces post-transplant dialysis requirements
- D. no change in urine output
59) According to the ATACAS trial, aspirin causes
- A. increased red blood cell transfusion
- B. increased platelet transfusion
- C. increased return to theatre for hemorrhage
- D. no change in myocardial infarct
- E. reduced rate of thromboembolic events
- F. ?no increase in the risk of bleeding
60) SAH, delayed ischaemia most common
- A. 24-28 hours
- B. 4-10 days
- C. 10-14 days
- D. 14-21 days
61) In RBC transfusions in Aus/NZ, the most common infection transmitted:
- A. hep A
- B. hep B
- C. hep C
- D. HIV 1
- E. HIV 2
62) [52. repeat Aug 15] You suspect your patient just had anaphylactic reaction.
- The optimal time to take blood for tryptase estimation:
- A. within 15min of onset of event
- B. 1-3 hours after event
- C. 3-6 hours after event
- D. 6-12 hours after event
- E. 24 hours after event
63) 66 year old with moderate AS (AV area 1.1cm2). You see him in preadmission clinic for elective THR.
- Aside from mild dyspnoea on exertion, he is asymptomatic.
- What is appropriate management?
- A. accept for surgery
- B. beta block and accept for surgery
- C. organise myocardial perfusion scan
- D. postpone until AV replacement
- E. postpone until percutaneous aortic valvotomy
64) Glycine irrigation is required for TURP if the resection is performed with
- A. greenlight laser
- B. helium laser
- C. monopolar laser
- D. Nd:Yag laser
- E. plasma kinetic diathermy
65) 56yo male with chronic T6 injury undergoes cystoscopy and TURBT under GA.
- In PACU, he is hypertensive, bradycardic has chest tightness and is sweating. Most likely cause:
- A. blocked catheter
- B. fluid overload
- C. myocardial ischaemia
- D. perforated bladder
- E. serotonin syndrome
66) u see your trainee self-injecting propofol while at work. What is the best immediate action?
- A. notify trainee’s next of kin
- B. notify medical board
- C. notify trainee’s supervisor of training
- D. relieve trainee of clinical duties
- E. terminate trainee’s employment
67) Man undergoing transcatheter aortic valve replacement, ECG shown with
- two broad complex beats (LBBB pattern) and clear p waves approx. Rate of 100
- but no ventricular beats.
- What is the best way of managing this
- (I think it was this ECG, but correct me please if I am wrong: complete heart block
- --> p-wave systole (aka ventricular standstill -- CPR was NOT an option)
- A. atropine
- B. external pacing
- C. adrenaline
- D. isoprenaline
- E. transvenous pacing
68) Risk of anaphylaxis recurring post-rocuronium anaphylaxis is greatest with
- A. atracurium
- B. cisatracurium
- C. pancuronium
- D. vecuronium
- E. none, as cross sensitivity is unpredictable
69) 60. elderly undergoing orthopaedic surgery for acute hip fracture requires
- thromboprophylaxis in the perioperative period.
- Best pharmacological option:
- A. LMWH or aspirin
- B. LMWH or unfractionated heparin
- C. LMWH or fondaparinux
- D. UFH or fondaparinux
- E. unfractionated heparin or warfarin
70) Spirometry can measure
- A. TLV
- B. RV
- C. FRC
- D. TLC
- E. VC
71) Pulmonary function tests:
- FEV1 82% predicted
- FVC 86% predicted
- FEV1/FVC 81% predicted
- FEV25-75 80% predicted
- TLC 81% predicted
- RV 94% predicted
- DLCO 102% predicted
- MVV 42% predicted
What is the diagnosis?
- A. asthma
- B. emphysema
- C. interstitial fibrosis
- D. myasthenia gravis
- E. pulmonary hypertension
72) 27 weeks gestation. BP 165/105. Best treatment:
- A. atenolol
- B. candesartan
- C. labetalol
- D. magnesium sulphate
- E. nifedipine
73) 40year old short of breath (flow-volume loop shown)
- A. artefact of equipment failure
- B. fixed intra and extra thoracic obstruction
- C. normal
- D. variable extrathoracic obstruction
- E. variable intrathoracic obstruction
74) Post dental surgery, resident prescribes 1L 0.9% saline + 5% dextrose.
- Registrar asks if he should amend the order?
- A. no, maintain oncotic activity
- B. no, prevent hyponatraemia
- C. only if child >2 years old
- D. yes, will cause hyperglycaemia
- E. yes, fluid is hypertonic
75) 87yo for selective neck dissection for laryngeal cancer with musculocutaneous flap repair.
- He is awake and sitting up. BP 120/70. Flap capillary refill time <1sec. What is best management?
- A. IV fluid bolus
- B. intra-arterial streptokinase
- C. IV dextran 40
- D. IV heparin
- E. Re-explore flap surgically
76) 120kg lady needs DVT prophylaxis. What dose?
- A. 40mg daily
- B. 60mg daily
- C. 80mg daily
- D. 100mg daily
- E. 120mg daily
77) 75. During CPR, What percentage of pre-arrest cardiac output is achieved by effective external cardiac compression?
- A. <20
- B. 20-30
- C. 40-50
- D. 60-70
- E. >70
78) Patient is nil by mouth. 2L Hartmann’s, 1L NS over 24 hours. How much Na in mmol did he receive?
- A. 390
- B. 410
- C. 430
- D. 440
- E. 460
79) What characteristic of local anaesthetic influences or increases duration of nerve block?
- A. lipid solubility
- B. molecular weight
- C. pKa
- D. presence of amide bond
- E. protein binding
80) Latest guidelines regarding Breast milk:
- A. Discard 12 hours post procedure
- B. discard 24 hours post procedure
- C. discard 1st feed
- D. discard first 2 feeds
- E. discarding not required
81) Stabbing injury to lateral half of spinal cord. What are the classical signs 3 segments below lesion?
- A. ipsilateral loss of light touch sensation, contralateral loss of temperature sensation
- B. ipsilateral loss of motor, contralateral loss of light touch sensation
- C. ipsilateral loss of pain sensation, contralateral loss of light touch sensation
- D. ipsilateral loss of pain sensation, contralateral loss of motor
- E. ipsilateral loss of temperature sensation, contralateral loss of pain sensation
82.Dental extraction of right lower 3rd molar (48).
- Patient complains of paraesthesia to the chin.
- This is most likely neuropraxia to
- A. glossopharyngeal n
- B. inferior alveolar n
- C. lingual n
- D. long bucchal nerve
- E. mental nerve
83) 85 yo for ORIF NOF. No medical past history. Exam normal.
- FBE, Electrolytes, ECG yesterday normal.
- Now in rapid AF with ventricular rate 110-145. BP 130/80.
- Best management:
- A. amiodarone
- B. direct current cardioversion after induction
- C. digoxin
- D. heparin
- E. metoprolol
83) Sub-Tenon block. Which muscle is most likely to be missed
- A. internal oblique
- B. lateral rectus
- C. medial rectus
- D. superior oblique
- E. superior rectus
84) Adenosine can be used to terminate an arrhythmia due to:
- A. Atrial fibrillation
- B. Atrial flutter
- C. WPW
- D. VT
- E. Torsades
85) PA CXR. What is enlarged (CXR with enlarged L:A.
- A. aorta
- B. LA
- C. LV
- D. RA
- E. RV
86) The following are consistent with acute systemic inflammatory response except
- A. hypotension
- B. hypothermia
- C. leukopenia
- D. tachycardia
- E. tachypnoea
87) A patient undergoing elective coiling of cerebral aneurysm has an abrupt rise in MAP.
- This is most likely due to
- A. acute hydrocephalus
- B. contrast reaction
- C. embolic complication
- D. vascular rupture
- E. vessel thrombosis
88) A patient with a haemopneumothorax has a chest drain in situ. The chest drain is attached
- to a 3 bottle underwater seal drain apparatus, and the system is attached to the wall suction
- at -80cmH2O.
- Omission of water from the wet suction bottle of this apparatus will cause
- A. excessive negative pressure in the water seal bottle, resulting in loss of the water seal
- B. failure of the water seal chamber to oscillate
- C. inability to apply negative pressure to the pleural cavity
- D. possible return of drain contents into the pleural space
- E. re-expansion pulmonary oedema
89) A multicentre trial reports that using N2O as part of general anaesthesia
- has a relative risk of morbidity of 0.96 (95% confidence interval 0.82-1.13).
- This means
- A. there is 95% confidence that N2O is assoc with an increased risk of morbidity
- B. the result is significant as the confidence interval range is very small
- C. the sample mean has a 95% chance of being between 0.82 to 1.13
- D. the study size was not large enough to find a difference
- E. the true relative risk has a 95% chance of being between 0.82 to 1.13
90) 125. Following donation after cardiac death, the maximum warm ischaemic time acceptable for procuring the lungs is
- A. 30min
- B. 45 min
- C. 60min
- D. 90min
- E. 120min
91) R) lower lip 10mm cancer. Surgeon doesn’t want to infiltrate the area with local anaesthetic. Patient refuses general anaesthetic. Which block do you need to do?
- A. facial n
- B. hypoglossal n
- C. infraorbital n
- D. lingual n
- E. mental n
92) 63 yo right pneumonectomy for malignancy.
- 12 hours post op, profound hypotensive and shock.
- Raised CVP. Immediately:
- A. clamp any open chest drains to minimise leak
- B. insert new chest drain on operative side
- C. perform urgent pericardiocentesis
- D. place patient in L) lateral position
- E. urgently transfuse 2 units of packed blood cells
93) Open AAA repair, best method to reduce risk of renal impairment?
- A. Sodium bicarbonate
- B. N-acetylcysteine
- C. Maintaining intravascular volume
- D. Minimise cross clamp time
- E. ?mannitol
94) You give a transfusion of 1u PRBC.
- What is the maximum duration of time in which it must it be completed?
- A. 2 hours
- B. 4 hours
- C. 6 hours
- D. 8 hours
- E. 10 hours
95) Patient with chronic liver failure. Coagulation factor least likely to be affected:
- A. I
- B. VII
- C. VIII
- D. XII
96) An 80 year old man undergoes a unilateral lumbar sympathetic blockade.
- The most likely side effect that he experiences is:
- A. Genitofemoral neuralgia
- B. Haematuria
- C. Postural hypotension
- D. Lumbar radiculopathy
- E. Psoas haematoma
97) Patient having a craniotomy, MAP 80, CVP 5. Both transducers are at the level of the heart, 13cm below the level of the tragus. What is the CPP?
- A. 60mmHg
- B. 65mmHg
- C. 70mmHg
- D. 75mmHg
- E. 80mmHg
98) Urosurgical procedure. Surgeon wants to give methylene blue. This is contraindicated if patient is taking:
- A. Fluoxetine
- B. Droperidol
- C. Risperidone
- D. Oxybutinin
- E. Prazosin
99) You are the anaesthetist at a Caesarean Section for a 36/40 gestation pregnancy.
- The baby at birth is floppy and apnoea.
- You decide that positive pressure ventilation via mask is necessary.
- The recommended FiO2 is:
- A. 0.21
- B. 0.4
- C. 0.6
- D. 0.8
- E. 1.0
100) 64 year old male in preoperative clinic. HR 60. Free T4 is normal. TSH high.
- This is consistent with:
- A. non compliance with thyroxine treatment
- B. autoimmune thyroiditis
- C. sick euthyroid
- D. previous hypophysectomy
- E. subclinical hyperthyroidism
102. Patient receives 1 unit packed red blood cells. 1 hour later becomes hypoxic,
- febrile, higher airway pressure and copious frothy sputum.
- A. ABO incompatibility
- B. Sepsis
- C. Transfusion related overload
- D. Transfusion related acute lung injury
- E. Transfusion related sepsis
103. What is the maximum Intralipid 20% dose?
- A. 6ml/kg
- B. 8ml/kg
- C. 10ml/kg
- D. 12ml/kg
- E. 14ml/kg
104. How many vials of dantrolene should be kept at a remote hospital which has general anaesthesia services?
- A. 2
- B. 6
- C. 12
- D. 24
- E. 36
105. Which volatile agent has the longest time to environmental degradation
- A. Desflurane
- B. Sevoflurane
- C. Isoflurane
- D. Enflurane
- E. Xenon
106. 20 yr old male 80 kg in a house fire sustained 25% burns.
- Using the Parkland formula, what is his fluid resuscitation requirement for the first 8 hours?
- A. 3L of 0.9% Normal Saline
- B. 3L of Hartmann’s solution
- C. 3L of colloid
- D. 4L of 0.9% Normal Saline
- E. 4L of Hartmann’s solution
107. 3 yr old child with # forearm, best way to valid pain assessment
- A. the reported severity from the child
- B. the reported severity from the parent
- C. the reported severity from the nursing staff
- D. using the FLACC scale
- E. the Wong-Baker Faces scale
108. Female singer underwent GA with LMA.
- Next day complains of voice/singing impairment.
- Nasendoscopy shows one vocal cord in the paramedian position.
- What nerve is affected?
- A. lingual
- B. hypoglossal
- C. glossopharyngeal
- D. recurrent laryngeal
- E. superior laryngeal
109. According to NAP4 what is the rate of failure for emergency cannula cricothyroidotomy?
- A. 10%
- B. 20%
- C. 40%
- D. 60%
- E. 80%
110. Blalock-Taussig shunt inserts into the right pulmonary artery, originating from the:
- A. Right subclavian artery
- B. IVC
- C. SVC
- D. Aorta
- E. Axillary artery
111. A patient has come in with TCA overdose. Wide QRS on ECG (Torsades). How do you treat them?
- A. calcium gluconate
- B. amiodarone
- C. lignocaine
- D. magnesium
- E. atropine
112. What protective mask to wear in laparoscopy for patient with disseminated TB
- A. N95
- B. P99
- C. R95
- D. None
- E. Surgical mask
113. According to the ARC, precordial thump is only indicated for:
- A. monitored pulseless VF if defibrillator not immediately available
- B. monitored pulseless VT if defibrillator not immediately available
- C. unwitnessed cardiac arrest
- D. witnessed onset of asystole caused by AV conduction disturbance
- E. unwitnessed unmonitored cardiac arrest
114. Patient with a history of smoking. patient with stridor, waking him up from sleep.
- What investigations to do next?
- A. ?
- B. CT neck
115. 4month old Term neonate, noted to have intermittent stridor a few days after birth,
- then parents also notice stridor during feeding and sleep.
- Otherwise normal and healthy.
- Most likely condition is:
- A. Cri-du-chat syndrome
- B. Laryngomalacia
- C. Tracheomalacia
- D. Laryngocoele
- E. ? something to do with cord paralysis
116. You notice a fire from the anaesthetic machine. Which is the most useful extinguisher?
- A. CO2
- B. blanket
- C. fire hose
- D. foam extinguisher
- E. wet chemical extinguisher
117. Randomised controlled trial means:
- A. Patients randomly allocated to treatment groups
- B. Patients randomly allocated to treatment or placebo
- C. Patients allocated randomly to groups before treatment arms decided
- D. Neither the patient nor the investigator knows which group the patient is in
118. Young man in the emergency department.
- Opens his eyes to voice, removes his tie when instructed to and is speaking, but confused.
- What is his GCS?
- A. 10
- B. 11
- C. 12
- D. 13
- E. 14
119. Patient with respiratory failure, low PaO2/FiO2 ratio,
- cardiac index of 1.7, PCWP of 25.
- Which mode of ECMO would be most appropriate?
- A. VA
- B. VV
- C. AV
120. What is the largest size suction catheter that can fit through a size 4.0 ETT?
- A. 6F
- B. 8F
- C. 10F
- D. 12F
121. In an infant, the intercristal line corresponds to
- A. L1-2
- B. L2-3
- C. L3-4
- D. L4-5
- E. L5-S1
122. You are trialling a new drug for hypertension in one group of patients
- and comparing it to placebo (given to another group).
- In three months time you will measure the blood pressure and want to compare
- the two groups. Knowing that the sample is non-parametric,
- Which test would be most appropriate?
- A. Chi squared
- B. Fishers exact test
- C. Student's t-test
- D. Mann-whitney U test
- E. Bland Altman test
123. What is the best indication of fluid responsiveness
- B. BP change when legs are raised
124. What is the timing of peak respiratory depression post 300 mcg morphine intrathecally?
- A. < 3.5 hours
- B. 3.5 – 7.5 hours
- C. 7 - 12.5 hours
- D. 12.5 -18 hours
- E. > 18 hours
125. Pregnant patient with BP 140/. What is indication for MgSO4?
- A. seizure prophylaxis
- B. anti-hypertensive
- C. foetal neuroprotection
126. Maximum level of serum Mg after administration of MgSO4?
- A. 1 mmol/l
- B. 2 mmol/l
- C. 3 mmol/l
- D. 4 mmol/l
- E. 5 mmol/l
127. Patient with traumatic brain injury patient.
- Cerebral angiogram shows Cerebral perfusion = 15mL/100g/min,
- cerebral oxygen consumption 3.5mL/100g/min.
- This is consistent with:
- A. Cerebral hyperperfusion
- B. Reperfusion injury
- C. Cerebral ischaemia
- D. Appropriate autoregulation
- E. Cereberal vasoconstriction
128. What is the mechanism of Trauma induced coagulopathy
- A. acidosis
- B. hypothermia
- C. endothelial damage from ischaemia
- D. dilution of coagulation factors from resuscitation fluids
129. You are inserting a right internal jugular vein CVL.
- Why is it important to avoid turning the patient's head extremely to the left?
- A. Uncomfortable for the patient
- B. Increases risk of internal carotid artery puncture
- C. Compresses internal jugular vein and makes it more difficult to puncture
- D. Distorts the anatomy, making the vein more difficult to correctly identify
- E. Increases risk of external jugular vein puncture
130. What happens with oxygen flush is pressed?
- A. oxygen 20-30L/min
- B. oxygen 50-70L/min
- C. oxygen and volatile at 20-30L/min
- D. oxygen and volatile at 50-70L/min
131. Intubation view: Little space between epiglottis and posterior pharyngeal wall. What is the modified C&L classification?
- A. 2A
- B. 2B
- C. 3A
- D. 3B
- E. 4
Rpt 2011B, 2012A, 2013A, 2013B
132. Relative contraindications to mediastinoscopy include
- A. Cervical spondylosis
- B. Emphysema
- C. Mediastinal lymphadenopathy
- D. Poor left ventricular function
- E. Superior vena cava syndrome
133. Asystolic arrest adrenaline just given, how often do you give adrenaline?
- A. 2 min
- B. 3 min
- C. after 1 loop of ACLS algorithm
- D. after 2 loops of ACLS algorithm
135. Tumour lysis syndrome causes all of the following biochemical abnormalities EXCEPT:
- A. Hyperkalaemia
- B. Hypernatraemia
- C. Hyperphosphataemia
- D. Hyperuricaemia
- E. Hypocalcaemia
135. Balloon pump trace 1:2
- A. Early inflation
- B. Late inflation
- C. Early deflation
- D. Late deflation
- E. No problem
136. Healthy mother undergoing surgery 4 months post-partum. What are current recommendations regarding when to resume breast feeding post-surgery?
- A. 12 hours after procedure
- B. 24 hours after procedure
- C. Discard first feed post procedure
- D. Discard first two feeds post procedure
- E. No need to discard
137. Complications of patient with anorexia nervosa include all except
- A. Cardiomyopathy
- B. Delayed gastric emptying
- C. Hypokalemia
- D. Hypercalcemia
- E. Prolonged QT
138. 8 year old boy under general anaesthetic, BP about 85/40.
- ECG trace given showing SVT. What is the appropriate treatment?
- A. IV Adenosine 100ug/kg
- B. IV Amiodarone 5mg/kg
- C. IV Esmolol 0.5mg/kg
- D. Sync DC Shock 1J/kg
- E. IV verapimil
139. Propofol is a Category (...) drug in pregnancy:
- (gave the full definition of each category)
- A. A
- B. B1
- C. B2
- D. B3
- E. C
140. In a patient with severe hepatic fibrosis.
An increased risk of life threatening haemorrhage is best indicated by:
- A. dysfibrinogenaemia
- B. hypoalbuminaemia
- C. portal HTN
- D. increased PT time
- E. thrombocytopaenia
141. The Swan Ganz catheter is unreliable for measurements of Pulmonary Artery SBP
- and DBP due to length and compliance of tubing.
- This affects the measuring system by:
- A. decreasing resonant frequency
- B. decreasing frequency response
- C. decreasing damping coefficient
- D. inducing zero error
- E. inducing baseline drift
Rpt Multiple 2006B
142. Woman for LUSCS. Allergic to amoxycillin. Reaction is limited to a rash.
- For surgical antibiotic prophylaxis consider: (definitely said "consider")
- A. Cefazolin
- B. Cefoxitime
- C. Clindamycin
- D. Gentamicin
- E. Vancomycin
143. ROTEM picture asking what is the problem.
- A. Hyperfibrinolysis
144. In a patient taking dabigatran prior to surgery:
- A. Stop 7 days in advance
- B. Stop 3 days in advance
- C. Stop 3 days in advance and bridge with clexane
- D. Continue until day of surgery
- E. Check INR on day of surgery
145. In patients with an opioid PCA, adding a NSAID will reduce the rate of PONV by
- A. 5%
- B. 10%
- C. 15%
- D. 20%
- E. 25%
146. Arteriolar dilatation occurs with
- A. Serotonin
- B Angiotensin I
- C Neuropeptide Y
- D Endothelin
- E. Vasointestinal Peptide
147. Which drug is best administered as a racemic mixture?
148. Regarding a graded Dose-Response curve (note: question may have used a drug as clinical context)
- A. There is linearity between 20-80% of max response
- B. There is linearity between 20-80% of max dose
- C. Characteristics of the drug can be deduced by calculating the ED50 and the Hill coefficient
- D. The addition of a synergistic drug causes a right-shift of the curve
- E. [Something I can't remember but didn't seem right]