Finals MCQs-July 2007

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Finals Black Bank | Finals Debrief -July 2007 | April 2007 Finals MCQs

This page provides a single place for posting all the MCQs that you can remember
from the FINALS MCQ Exam on 30 July 2007. 

* Just click on the EDIT tab and either type in the questions or paste them in from your Word processor. 
* If the MCQ is already posted, you can add any extra details you remember or correct any errors.
* Try NOT to use all CAPITALS FOR THE WHOLE QUESTION (as sometimes occurs in MCQ collections sent to me)
* Be QUICK: The sooner after the exam that you post, the more likely you are to remember

* Use the Finals Debrief -July 2007 page for general comments



FULLY CODED: 134/150

MCQs Coded into Black Bank


AA: Allergy

AA24 [Jul07]
Mast cell tryptase
A. Peak level at 1 hour
B. No increase with anaphalactoid reaction
C. 99% in mast cells
D. > 20 ng/mL is diagnostic of anaphalaxis
E. Should chck at 24 hours

AA25 [Jul07] Q148
In regards to anaphalaxis what is INCORRECT,
A. 8% risk cross-reactivity of cephalosporins with penicillin
B. Colloid use in anaphalaxis often makes situation worse (not exact phrasing...)
C. Tryptase elevated post anaphylactic but not anaphylactoid reaction
D. Repeat tryptase at 24 hours

AB: Blood & Blood Products

AB39 [Aug99] [Mar00] [Jul00] [2002-Mar] Q23 [2004-Apr] Q51, [2005-Apr] Q69, [Jul05] [Jul07]
Post-transfusion hepatitis in Australia is associated with
A. jaundice in over 50% of patients
B. development of chronic disease in less than 10% of patients
C. hepatitis B in the majority of patients
D. the presence of antigen or antibody to hepatitis C
E. elevation of serum alkaline phosphatase

AB48 [2005-Apr] Q136, [Jul07]
Which of the following statements is INCORRECT? Recombinant Factor VIIa
A. directly activates Factors IX and X on the surface of activated platelets, leading to thrombin formation
B. has a half-life of three and a half hours
C. has been used "off-label" for bleeding in trauma patients
D. is best monitored by the prothrombin time, which is shortened in a dose-dependent manner at therapeutic doses
E. was developed for patients with haemophilia A and B who have inhibitors to Factors VIII and IX respectively

AB56 [Apr07] [Jul07]
Most commonly reported cause of death from blood transfusion (didn't specify country)
C. Incompatibility
D. Anaphylaxis
E. Bacterial

AB57 [Apr07] Q140, [Jul07]
In a patient requiring FFP where the patient’s blood group is unknown, it is ideal to give FFP of group
A. A
B. B
D. O
E. Blood group of FFP in this situation does not matter

AB58 [Jul07]
Patient with von Willebrand’s disease. Jehovah’s Witness. Plan is to give DDAVP. What is NOT correct:
A. Jehovah’s Witness will accept DDAVP as it is synthetic product
B. Dose in 0.3 mcg/kg
C. Effect of DDAVP will last 5 days
D. will prevent major haemorrhage in this patient

AB59 [Jul07]
Patient having platelet transfusion. Develops fever, tachycardia, and ?. Most likely cause:
A. ABO incompatibility
B. Bacterial infection in platelets
C. Anaphylaxis
D. leucocyte mediated transfusion reaction

AC: Complications

AC01a [2004-Aug] Q138, [2005-Apr] Q81, [Mar06] [Jul06] [Jul07]
Features of the transurethral resection of the prostate (TURP) syndrome include all of the following EXCEPT
A. agitation
B. angina
C. bradycardia
D. nausea
E. tinnitus

AC68b [2003-Aug] Q117, [2004-Apr] Q55, [Jul06] [Jul07]
The estimated risk of infection following percutaneous exposure (needlestick injury) to HIV is approximately
A. 1 in 30
B. 1 in 300
C. 1 in 3,000
D. 1 in 30,000
E. 1 in 300,000

AC93 [Apr99] [Jul00] [2001-Apr] Q8, [2002-Aug] Q10, [2003-Aug] Q55, [2004-Apr] Q59, [Apr07] Q55, [Jul07]
The most important factor in reducing peri-operative morbidity in diabetic patients undergoing peripheral vascular surgery is
A. tight control of blood sugar level in the peri-operative period
B. frequent blood sugar level estimations
C. use of regional rather than general anaesthesia
D. stabilisation of co-existing disease
E. the use of an insulin infusion rather than a subcutaneous sliding scale regimen

AC96a [Mar00] [2002-Aug] Q76, [2004-Apr] Q112 , [Jul07]
The observed fall in cardiac output induced by carbon dioxide pneumoperitoneum during laparoscopic cholecystectomy is primarily a result of
A. a fall in venous return to the heart
B. reflex bradycardia
C. an increase in systemic vascular resistance
D. head-up tilt of patient
E. increased pulmonary vascular resistance

AC105b [2005-Apr] Q142, [Jul05] [Jul07]
Post-operative delirium in the elderly is associated with all of the following factors EXCEPT
A. pre-existing cognitive deficit
B. pre-existing hearing impairment
C. pre-existing visual impairment
D. post-operative urinary tract infection
E. use of general anaesthesia rather than regional anaesthesia

AC152 [Apr07] [Jul07]
Regarding Epidural Abcess - which is INCORRECT:
A. Diagnosis is dependent on triad of back pain, fever, and paralysis
B. Occurs at a rate of 1:1000-5000
C. Worse outcomes if advanced age
D. Usually gram positive cocci
E. Expectant management may be appropriate

AC156 [Jul07]
Causes of Ischaemic Optic Neuropathy do NOT include:
A. Atherosclerotic plaque in ‘eye artery’
B. Decrease in number of ciliary arteries
C. Isovolemia haemodilution

AM: Muscle Disorders

AM41 [2004-Aug] Q15, [Jul07]
The most frequently reported clinical sign in malignant hyperpyrexia is
A. arrhythmia
B. cyanosis
C. sweating
D. tachycardia
E. rigidity

AM43 [2004-Aug] Q119, [2005-Apr] Q82, [Jul07]
A 13-year-old boy with Duchenne's muscular dystrophy
A. is at increased risk of malignant hyperthermia
B. is likely to have significant scoliosis
C. is more likely to be cachectic than obese
D. is unlikely to have cardiac involvement
E. may develop rhabdomyolysis when non-depolarising muscle relaxants are used

AM48 [Jul07] Shown a family tree...
6 year old boy coming for routine operation. Maternal Great Grandfather has had a malignant hyperthermia reaction under GA. Which of the following is most likely to rule out that the 8 year old will NOT suffer a MH reaction
A. 8 year old has negative resting CK level
B. 8 year old has had a previous operation before with no problems
C. mother has had negative genetic testing
D. grandfather has had negative muscles testing
E. father has had an operation before with no problems

AP: Pain Medicine

AP18b [Jul05] [Apr07] [Jul07]
Which of the following is ineffective for acute herpes zoster pain:
A. Amitriptyline
B. Aciclovir
C. Carbamazepine
D. Corticosteroids
E. Topical aspirin

AP39 [Apr07] [Jul07]
Which of the following reduces the incidence of severe phantom limb pain following amputation
A. Use spinal anaesthesia
B. Use of PCA in post-op period
C. Use of NSAID’s pre-op
D. Use of nerve sheath catheter post-op
E. Use of ketamine intraoperatively

AP40 [Apr07] [Jul07]
Compared to IM or SC injection, opioid via PCA provides:
A. Equal favour by patients
B. Better analgesia
C. Reduced opioid side effects
D. Reduced length of stay
E. Reduced opioid requirements

AP42 [Jul07]
Epidural anaesthesia adjuncts. What is NOT true?
A. Adrenaline will improve the thoracic analgesia
B. Clonidine will prolong sensory block
C. Ketamine will improve analgesia
D. Clonidine will improve block
E. Neostigmine reduces the amount of opioid needed (or prolongs sensory and motor block)

AT: Cardiothoracic

AT20c [Jul07]
All of the following are major complications of mediastinoscopy EXCEPT:
A. Cardiac laceration
B. Air embolism
C. Pneumothorax
D. Major haemorrhage
E. recurrent laryngeal nerve damage
There was definately an option of tracheal compression as well.

AZ: Miscellaneous

AZ02 [Jul07]
Fit and healthy young female for lap. gyne operation, which of the following doesn't require continuous monitoring (See PS 18):
B. Saturation probe
C. Disconnect alarm
D. Oxygen analyzer
E. Capnography

AZ03 [Jul07]
The BEST indication of a difficult intubation in morbid obesity:
A. Mallampatti Score
B. Neck circumference
C. Limited neck movement
E. Body weight

AZ04 [Jul07]
What is NOT an appropriate action for infection control:
A. Washing hands and may use gloves to place IVL
B. Sterile procedure, including gown, to place CVL
C. Sterile procedure, including gown, to place epidural
D. Preservation of sterility of any airway device which will come into contact with blood interface
E. ? wiping vials with alcowipe for spinal
F. HME filter changed between cases, can use same circuit with subsequent patients.

AZ69b [2003-Aug] Q129, [2004-Apr] Q77, [Apr07] Q129, [Jul07]
During elective major vascular surgery the best way to reduce the risk of acute renal failure is to maintain a normal:
A. Central venous pressure
B. Mean arterial blood pressure
C. Renal blood flow
D. Systemic vascular resistance
E. Urine output

AZ74 [2004-Apr] Q123, [2004-Aug] Q63, [Mar06] [Jul07]
Intubation of patients with acute C5 spinal cord injury
A. can only be safely performed using awake fibreoptic intubation
B. is necessary in most patients for secretion clearance
C. is necessary in most patients to avoid atelectasis
D. is associated with a low risk of aspiration
E. may be safely facilitated by the use of suxamethonium

AZ78 [Mar06] [Jul07]
A healthy 25 year male (80kg) has ECT and the psychiatrist thinks the seizure duration was inadequate. You used thiopentone 350mg and suxamethonium 50mg. To prolong it next time you should:
A. Use remifentanil so that the dose of thio can be reduced
B. Give IV lignocaine
C. Hypoventilate (definitely hypo not hyper)
D. Use propofol instead of thio
E ?

AZ80 [Jul05] [Jul07]
Which of the following is not an absolute contra-indication for MRI?
A. cochlear implant
B. heart valve prosthesis
D. pacemaker
E. intracranial clips


EC: Clinical Measurement

EC17 [Apr07] Q139, [Jul07]
You have anaesthetised a patient with a partially obstructing right main bronchus tumour. You are using Heliox (28% O2:72% He) and sevoflurane. You secure the airway with an endotracheal tube and continue with the same gas mixture. After 20 minutes the ETCO2 is 28mmHg. The capnogram waveform is normal. This probably means the patient is
A. Appropriately ventilated with a low cardiac output
B. Appropriately ventilated with a normal cardiac output
C. Hypothermic (34C)
D. Hyperventilating
E. Hypoventilating

EM: Monitoring

EV: Vaporisers

EV02b [Aug99] [Mar00] [Jul07] (type A)
Isoflurane vaporiser at 3 atmospheres absolute:
A. 3 times % on the dial
B. Same % as on the dial
C. 3 times SVP
D. Same SVP
E. None of the above

EZ: Miscellaneous

EZ85 [Apr07] [Jul07]
In a bobbin rotameter system:
A. Bobbin spins inside a tube that has parallel sides
B. Flow is laminar at high flow rates
C. Height of the bobbin is proportional to the pressure drop across the bobbin
D. Pressure drop across the bobbin is constant at varying flows
E. Resistance increases with increasing gas flow

EZ86 [Apr07] Q136, [Jul07]
Adult male who is intubated and ventilated, with CVL in situ. Just before surgeon starts the Line Isolation Monitor alarms about a leak at 5mA. What do you do?
A. stop procedure and move to a safe location
B. sequentially remove non essential monitors from the circuit until fault is identified
C. unplug the CVL to electrically isolate it until fault is identified
D. ensure the patient is earthed
E. Check the diathermy pad


MC: Cardiology

MC59 [Aug94] [Aug95] [Apr96] [Aug96] [Mar00] [Jul00] [2001-Apr] Q43 [Jul07]
The treatment LEAST likely to be useful for torsades de pointes is
A. defibrillation
B. procainamide
C. magnesium
D. electrical pacing
E. isoprenaline

MC65 [Apr96] [Apr97] [Jul97] [2002-Mar] Q53, [2002-Aug] Q63, [2004-Apr] Q58, [2004-Aug] Q84, [Jul05] [Mar06] [Jul07]
Characteristic cardio-pulmonary effects of pulmonary thromboembolism include:
A. hypoxaemia due to excess perfusion of lung units with a low V/Q ratio
B. hypercarbia due to an increase in physiological dead-space
C. reverse splitting of the second heart sound
D. an increase in compliance of the left ventricle
E. an increase in coronary blood flow to the right ventricle during systole

MC100 [Jul00] [2001-Apr] Q41 [Jul07]
A 24 year old female with mitral valve prolapse develops atrial flutter during a diagnostic laparoscopy. The drug most likely to revert this arrhythmia is
A. digoxin
B. amiodarone
C. verapamil
D. esmolol
E. adenosine

MC143 [2003-Aug] Q138, [2004-Apr] Q37, [Jul05] [Jul07]
This ECG (Lead V5) most likely represents
A. Wolff-Parkinson-White (WPW) syndrome
B. atrial fibrillation
C. complete heart block
D. atrio-ventricular junctional rhythm
E. sinoatrial block

MC149 [Apr07] [Jul07]
Reverse splitting of the second heart sound occurs with:
B. Pulmonary hypertension
C. Acute pulmonary embolus
E. Severe MR

MC152 [Jul07]
60 y.o with acute aortic regurgitation. In pulmonary oedema. BP 160/90. HR was about 90. What is the best treatment pre-op:
A. Intra aortic balloon pump
B. Dobutamine infusion
C. Sodium nitroprusside infusion
D. Beta blocker
E. Dopamine infusion

MC153 [Jul07]
When viewing the central venous pressure trace:
A. an accentuated "a" wave supports the diagnosis of atrial fibrillation
B. a steeper than normal "x" descent supports the diagnosis of tricuspid regurgitation
C. blunted "a" and "v" waves are associated with extensive right ventricular infarction
D. flattened "x" and "y" descents are associated with pericardial constriction
E. a monophasic pattern with obliteration of the "y" descent supports the diagnosis of pericardial tamponade

MC154 [Jul07]
Regarding cardiac tamponade which is false?
A. Can get ST changes
B. Soft muffled heart sounds
C. Increase CVP and CO with filling
D. Diastolic pressure is the same in all chambers
B. Patient prefers to sit up and lean forward

MC155 [Jul07]
Worst position for tip of Lt internal jugular vein CVL:
A. In mid Lt brachiocephalic trunk
B. At junction brachiocephalic trunk and SVC
C. At level carina
D. Touching wall at junction SVC and atria
E. In Rt atrium

MC156 [Jul07]
Atrial fibrillation:
A. Cardioversion results in longer life expectency than rate control
B. Need to stay on warfarin following cardioversion
C. Pt with HR <80 generally do not require anticoagulation

ME: Endocrinology

ME43 [Apr07] [Jul07]
In regards to Addison's Disease, which lab features are NOT correct:
A. Ca 2.50 mmol/L
B. BSL 12.0 mmol/L
C. Na 128 mmol/L
D. K 6.1 mmol/L
E. Urea 15mmol/L

MG: Gastroenterology

MG05 [1986] [Aug94] [Mar95] [Aug95] [Apr96] [Aug96] [Jul97] [Apr99] [2003-Aug] Q4, [2004-Aug] Q79, [2005-Apr] Q47, [Mar06] [Jul06] [Jul07]
All of the following may be associated with ulcerative colitis EXCEPT
A. cirrhosis
B. iritis
C. psoriasis
D. arthritis
E. sclerosing cholangitis

MH: Haematology

MH09b [Mar91] [Mar94] [Aug94] [Aug95] [Apr98] [2002-Aug] Q41, [2005-Apr] Q83, [Jul05] [Jul07]
Anaemia in CRF is characteristically
A due to haemolysis in the renal vascular bed
B normochromic macrocytic
C Due to defective Hb synthesis
D Responsive to Fe and folate Rx
E associated with increased 2,3DPG levels in rbc

MH40 [Jul00] [Apr07] [Jul07]
In a patient who is HIV antibody positive:
A. CD4 count commonly 200-400 is usual
B. Cardiomyopathy is a recognised feature
C. Toxoplasmosis infection is a common initial presentation
D. Contraindication to epidural blood patch
E. Regional anaesthesia should not be used

MH43 [2002-Mar] Q92, [2003-Apr] Q61, [2003-Aug] Q9, [2005-Apr] Q15, [Jul07]
The thromboelastogram pattern typical of that seen in haemophilia is labelled

MH58 Heparin Induced Thrombocytopenia (HITS)
A. is associated with antibodies to complexes of anti-thrombin 3 (ATIII) and heparin
B. is associated with a more rapid drop in platelet count if the patient has been exposed to heparin within the last 3 months
C. is not associated with the use of low molecular weight heparins
D. results in the maintenance of heparin-dependent antibodies indefintely after their development
E. results in thrombotic complications in most patients

MN: Neurology

MN38 [2004-Apr] Q124, [2005-Apr] Q100, [Jul05] [Jul07]
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

MN40 [2002-Mar] Q91, [Jul07]
An INCORRECT statement regarding the autonomic nervous system is that
A. autonomic dysfunction is a predictor for worse long term survival after myocardial infarction
B. heart rate responses are primarily mediated through the sympathetic nervous system
C. inhalation anaesthetics all impair autonomic reflex responses
D. autonomic dysfunction is a predictor for haemodynamic instability following anaesthetic induction
E. low heart rate variability is associated with worse cardiac outcomes following non-cardiac surgery

MN45 [Jul07]
T4 paraplegic. Develops hypertension during bladder operation under GA. Reflex Sympathetic Dystrophy blamed by surgeon. What is TRUE:
A. T4 injury will not casue RSD
B. Spinal anaesthesia would have prevented this situation
C. RSD will stop once surgical stimulation stops
D. treat with beta blockers
E. treat with opioids

MR: Respiratory

MR45 [2003-Aug] Q99, [Jul05] [Apr07] Q99, [Jul07]
In chronic obstructive pulmonary disease (COPD), the variable most closely associated with prognosis is:
A. Arterial carbon dioxide partial pressure (PaC02)
B. Arterial oxygen partial pressure (Pa02 )
C. Forced expiratory volume in one second (FEV1)
D. Forced vital capacity (FVC)
E. Response to bronchodilators

MZ: Miscellaneous

MZ48 [Apr97] [Jul97] [Apr98] [Aug99] [2004-Aug] Q127, [2005-Apr] Q71, [Jul05] [Apr07] [Jul07]
Patho-physiological features of patients with morbid obesity include:
A. A blood volume:body weight ratio which is similar to that of patients with normal body weight
B. An increased blood pressure and systemic vascular resistance compared to that of patients with normal body weight
C. Decreased gastric motility due to increased gastrin secretion
D. Cardiac pathology resulting from excess body mass and increased metabolic demand
E. Cardiac pathology resulting mainly from fatty infiltration or fatty change of the heart

MZ62 [2001-Apr] Q72, [2001-Aug] Q37, [2002-Aug] Q48, [2003-Apr] Q59, [2004-Aug] Q77, [2005-Apr] Q33, [Apr07] [Jul07]
Which of the following statements regarding the management of hypocalcaemia is INCORRECT?
A. Correcting a respiratory or metabolic alkalosis increases the level of ionised calcium
B. Calcium should be administered via a central vein as it is irritant to peripheral veins
C. Acidosis will decrease calcium binding to albumin and therefore increase ionised calcium
D. When calcium alone is NOT sufficient for control of hypocalcaemia, Vitamin D metabolites can be added
E. Calcium chloride has been shown to be superior to calcium gluconate

MZ76 [Mar06] [Apr07] [Jul07]
Changes associated with chronic renal failure include:
A. increased Ca absorption
B. increased PO4 absorption
C. increased vit D3 production
D. increased osteoclastic activity
E. decreased osteoblastic activity

MZ78 [Jul07]
What is NOT a feature in ankylosing spondylosis :
A. Sacroillitus is an early presenting sign
B. Normochromic normocytic anaeamia in 85%
C. Uvietis is most common extra articular condition assoc with AS
D. Sarcoidosis of kidney is rare
E. Cardiac disease in 10%

MZ79 [Jul07]
In Marfan’s Syndrome which is NOT related:
A. If develop aortic disease most likely to be aortic stenosis
B. At risk illiac aneurysm
C. development of mitral valve prolapse is more likely than in general population
D. Cardiac myopathy due to medial cystic necrosis/atrophy/ degeneration
E. Intracranial aneurysm


SC: Cardiac Surgery

SC22 ANZCA version [2003-Aug] Q139, [2005-Apr] Q96, [Jul05]
With respect to intra-arterial cannulation and monitoring
A. following cardiopulmonary bypass, a cannula in the brachial artery will tend to give a more accurate blood pressure reading than in the radial artery
B. radial artery cannulation is not contra-indicated in Raynaud's Disease
C. the Allen's test is a reliable predictor of the adequacy of collateral flow
D. The axillary artery is not suitable for use in cardiac surgery
E. the infective rate of all cannulation sites is approximately 5%

plus this option: F. If use femoral must replace within 24 hours (replace, not resite) because of infection

SC27 [Apr07] [Jul07]
Placement of lumbar intrathecal catheter in Marfan's patient having thoracoabdominal aortic aneurysm repair for chronic dissection is for:
A. Drainage of CSF
B. To allow cooling spinal cord
C. Administration of neuroprotective drugs
D. Monitoring purposes
E. Administration of substrates.

SC30 [Apr07] [Jul07]
For a patient positioned in a left lateral position to allow a posterolateral incision for thoracotomy:
A. Right brachial plexus is at risk if shoulder flexed > 90 degrees
B. Radial nerve is most common injury
C. Flex the non-dependant leg, and straighten the dependant leg
D. Place axillary roll under chest to improve surgical exposure

SF: Obstetric & Gynaecology

SF53 [2001-Apr] Q6, [2001-Aug] Q4, [2003-Aug] Q66, [2004-Apr] Q55, [Jul07]
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

SF55 [1988] [2002-Aug] Q105, [2003-Apr] Q69, [2004-Aug] Q88, [Jul05] [Apr07] Q141, [Jul07]
In relation to obstetric haemorrhage
A. amniotic fluid embolism is unlikely to present as unexplained haemorrhage
B. coagulopathy is uncommon, when severe abruption leads to maternal shock and fetal death
C. the risk of placenta accreta, but NOT placenta praevia, increases with an increasing number of caesarean sections
D. treatment of uterine atony with prostaglandins is rarely associated with adverse maternal effects
E. intravenous magnesium may facilitate replacement of an inverted uterus

SF62 [2004-Aug] Q125, [2005-Apr] Q18, [Jul07]
Amniotic fluid embolism
A. can be associated with a mortality rate of 80%
B. has an incidence of 1 in 2000 pregnancies
C. is an uncommon cause of peripartum death
D. is associated with a small chance of complications in survivors
E. only presents during labour or caesarean section

SF71 [Jul05] [Apr07] [Jul07]
Best evidence in obstetric anaesthesia supports each of the following assertions EXCEPT

A. colloid effectively prevents hypotension from regional anaesthesia, but crystalloid does not
B. fentanyl added to spinal bupivacaine for caesarean section has no influence on the incidence of intraoperative nausea
C. high doses of ephedrine (>15 mg) are more likely to cause hypertension than prevent hypotension
D. in labour, combined spinal-epidural analgesia is associated with faster onset and greater maternal satisfaction than epidural analgesia
E. in nulliparous women, epidural analgesia in labour, compared with intravenous opioid analgesia, does not increase caesarean section rate

SF85 [Jul07]
Laparoscopic surgery during the second trimester of pregnancy
A. pneumoperitoneum with CO2 leads to fetal acidosis
B. intraabdominal pressures over 12 mmHg causes fetal bradycardia
C. ventilate mother to PaCO2 of 40mmHg (or 45)
D. Increased rate of miscarriage
E. decrease uteroplacental blood flow?

SG: General Surgery

SG13 [2003-Aug] Q59, [Jul05] [Jul07]
A 46 year old brewery worker has cirrhosis of the liver with oesophageal varices and has bled from these varices on one occasion. A portacaval shunt is being considered as definitive treatment for his portal hypertension. The operation would be contraindicated if he had
A. a serum bilirubin greater than 50 micromol.litre-1
B. a serum albumin less than 30 gram.litre-1
C. ascites
D. all of the above are true
E. none of the above are true

SG33d [Jul98] [2002-Mar] Q47, [2005-Apr] Q95, [Jul07] (A-type with only 4 options)
The LEAST effective means of preventing post-operative deep venous thrombosis (DVT) in elderly patients undergoing surgery for a fractured neck of femur is
A. low molecular weight heparin (LMWH) with no haematologic monitoring
B. unfractionated heparin adjusted to upper range normal aPTT
C. warfarin adjusted to an INR of 1.5 times normal
D. spinal anaesthesia

SG51 [Apr07] [Jul07]
In regards to laparotomy and hemicolectomy, what is the least effective way to minimize post-op surgical infection:
A. Aggressive peri operative fluid management
B. Timely administration of prophylactic antibiotics
C. Perioperative ‘hyperoxia’
D. Avoidance of hypothermia
E. Avoidance of blood transfusion

SG60 [Jul07]
What is NOT a feature of pneumoperitoneum with an intraabdominal pressure of 12mmHg
A. Increased inotropy
B. Increased BP
C. Decreased venous return
D. Increased SVR
E. Increased vasopressin secretion

SG61 [Jul07]
45 y.o for elective laproscoptic choecystectomy. No recent hx cholelithiasis. Drinks 40g of alcohol per week and smokes 40/day. URTI 1/52 ago. Finishing course of augmentin. No respiratory symptoms now. LFTS done – ALP 300, GGT 300, ALT normal, AST normal, albumin normal. What is next step?
A. LFTS changes likely due to recent illness. Proceed with case
B. Defer case until liver USS done
C. Cancel case as patient has early cirrhosis
D. Perform hepatitis screen pre-operation
E. likely secondary to drugs, so just continue

SG62 [Jul07]
Patient presents with carcinoid syndrome and developes hypotension intraoperatively. Best drug to treat it is:
A. Noradrenaline
B. Adrenaline
C. Metaraminol
D. Octreotide
E. Ephedrine

SN: Neurosurgery

SN15 [Apr07] [Jul07]
With regards vasospasm in SAH, which is FALSE:
A. Vasospasm proven on angiogram will be decreased 30-40% with nimodipine
B. HHH therapy is mainstay for treatment and prophylaxis
C. Transcranial doppler can be used serially to predict (not detect) vasospasm
D. Vasospasm peaks at day 7 - 10
E. ?

SN16 [Apr07] [Jul07]
A 50 y.o woman has a Grade 2 SAH (HUNT & HESS GRADE) and has had an endoluminal coiling. Post-op management to prevent vasospasm includes:
A. Giving 3L of normal saline per 24 hours
B. IV or oral magnesium supplememtation
C. Maintain systolic greater than 160mmHg
D. Keep intubated and ventilate for 24 hours before desedating
E. Cool to 33 degrees

SO: Orthopaedic Surgery

SO17 [Jul05] [Jul07]
Scoliosis surgery. what is incorrect
A. one third of the blood loss occurs postoperatively
B. major blood loss is frequently accompanied by a consumptive coagulopathy
C. surgery will halt progression of the restrictive lung deficit
D. the major neurological deficits that occur are usually due to damage to the posterior columns of the spinal cord
E. the use of aprotinin reduces blood loss

SZ: Miscellaenous Surgery

SZ10 [2002-Aug] Q84, [2003-Apr] Q47, [Jul05] [Apr07] Q11, [Jul07]
The absorption of fluid into the circulation during transurethral prostatectomy (TURP) is NOT related to
A. prostate size
B. height of the irrigation fluid bag
C. duration of surgery
D. surgical technique
E. type of irrigation fluid

SZ11 [2003-Aug] Q111, [Mar06] [Jul06] [Jul07]
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

SZ14b [2004-Aug] Q130, [Jul07]
Following a cadaveric renal transplant under general anaesthesia, your patient's plasma K+ increases to 6.0 mmol.l-1 in recovery after being 5.0 mmol.l-1 pre and intra-operatively. This patient requires
A. an intravenous infusion of CaCl2 (10 mls over 20 minutes)
B. arterial blood gases to ascertain the acid/base status
C. potassium exchange resins rectally
D. sodium bicarbonate infusion (50- 100 mEq over 5- 10 minutes)
E. urgent haemodialysis


PP31 [Aug93] [Apr96] [Aug96] [Apr97] [Jul97] [2005-Apr] Q77, [Jul05] [Jul07]
In congenital diaphragmatic hernia
A. there is hyperplasia of pulmonary arterioles in the hypoplastic lung
B. right-sided lesions are more pathologically significant
C. vasodilator drugs are contraindicated
D. right-sided lesions through the foramen of Bochdalek are the most common
E. intrapulmonary shunts are the major cause of cyanosis

PP55 [2001-Apr] Q91, [2002-Mar] Q83, [2002-Aug] Q69, [2005-Apr] Q89, [Jul05] [Jul07]
A 4-year-old child with obstructive sleep disorder presenting for tonsillectomy:
A. is likely to suffer from daytime somnolence
B. is unlikely to have a history of snoring
C. is suitable for day-case surgery
D. has a 40% chance of postoperative vomiting without antiemetic treatment
E. is likely to lose 5% of their blood volume during surgery

PP58b [2003-Aug] Q114, [2004-Apr] Q32, [2005-Apr] Q24, [Jul05] [Jul07]
Spinal anaesthesia in infants
A. eliminates the risk of postoperative apnoea
B. has a lower failure rate than in adults
C. lasts for a shorter time than in adults
D. may be performed at a higher spinal level than in adults
E. often causes hypotension if the infant is awake

PP61b [2003-Aug] Q124, [Apr07] Q124, [Jul07]
The peak effect of oral midazolam as a premedication in children occurs after:
A. 10 - 15 minutes
B. 20 - 30 minutes
C. 35 - 45 minutes
D. 50 - 60 minutes
E. 65 - 75 minutes

PP74 [2004-Apr] Q148, [2004-Aug] Q62, [Mar06] [Jul06] [Jul07]
A 20 kilogram child has a haemoglobin of 60 g.l-1. The child is normovolaemic and there is no on-going blood loss. The volume of packed cells required to increase the haemoglobin level to 100 g.l-1 is
A. 80 ml
B. 160 ml
C. 320 ml
D. 500 ml
E. 750 ml

PP79 [2004-Aug] Q103, [Jul05] [Jul07]
Pneumonia in children
A. if bacterial is commonly associated with a pleural effusion
B. is often caused by Mycoplasma Pneumoniae in infants
C. is rarely caused by Chlamydia Trachomatis in neonates
D. is rarely fatal in developed countries
E. often presents as lethargy without fever or cough

PP83 [Mar06] [Jul06] [Jul07]
Neonate and intubation:
A. use 2.5mm internal diameter ETT
B. uncuffed tube has no Murphys eye
C. external diameter of a reinforced ETT is the same as a normal ETT
D. use same size for oral and nasal
E. Something about a 4.0 ETT has an external diameter of 4mm
F. Age/4 + 4 is formula for external diameter

PP88 [Jul06] [Jul07]
Age at which GRF = adult GFR(ml/min/m2):
A. 1 month
B. 6 month
C. 2 years
D. 4 years
E. 6 years

PP95 [Jul07]
1 y.o arrest with VT. Has had 2x DC shocks, and 100 mcg adrenaline. Further 1x DC shock given. What is next step:
A. 20 J DC shock
B. 40 J DC shock
C. 50 mg amiodarone
D. 100 mcg adrenaline
E. 1000 mcg adrenaline

PP96 [Jul07]
Newborn with diaphragmatic hernia. Initially sats 95% on RA. Now beginning to develop respiratory distress. Next appropriate step:
A. Awake intubation
B. Trial NO prior to intubation and ventilation
C. Rapid sequence induction
D. Mask ventilation throughout case with CPAP
E. Gas down with CPAP

PP97 [Jul07]
8 y.o with anterior mediastinal mass. CT shows compression below trachea involving the carina. Gas induction with sevoflurane. Sats drop to 75%. What should be done:
A. Provide CPAP via mask
B. Organise median sternotomy
C. Place ETT and allow to spontaneously breath
D. Place prone
E. Place ETT and IPPV

PP98 [Jul07]
In regards to (?paediatric) aspiration: Which is TRUE?
A. unlimited clear oral fluids until 2 hr preop leads to no change in residual gastric volume but does change pH
B. Paediatric aspiration more common than in adults
C. Casein based formulas are more slowly absorbed than whey based formulas (OR..casein based products empty faster than whey)
D. fluids follow first order and solids first order kinetics
E. fluids follow zero order kinetics and solids first order kinetics


NH14 [1985] [Mar93] [Mar94] [Aug96] [Apr99] [2004-Aug] Q24, [2005-Apr] Q48, [Jul06] [Apr07] [Jul07]
Sensation from the lobule of the external ear is mediated mostly by
A. the auriculo-temporal nerve
B. the great auricular nerve
C. the lesser occipital nerve
D. the greater occipital nerve
E. none of the above

NN13 [1986] [2004-Aug] Q29, [2005-Apr] Q75, [Apr07] [Jul07]
The innervation of the human larynx is such that
A. the internal laryngeal branch of the superior laryngeal branch of the vagus supplies the lingual surface of the epiglottis
B. in the cadaveric position the cords are fully abducted
C. the recurrent laryngeal nerve supplies all the intrinsic muscles of the larynx
D. the glossopharyngeal nerves are sensory to the laryngeal mucous membrane above the level of the vocal cords
E. cord paralysis can be produced by a distended endotracheal cuff in the larynx compressing a branch of the recurrent laryngeal nerve against the thyroid cartilage

NN14 [Mar93] [Aug93] [Aug96] [Jul98] [Apr99] [2004-Aug] Q28, [2005-Apr] Q34, [Jul05] [Jul07] (A-type with only 4 options)
The muscles of the larynx which separate the vocal cords are the
A. thyro-arytenoids
B. lateral crico-arytenoids
C. oblique arytenoids
D. posterior crico-arytenoids

NN32 [Apr07] [Jul07]
Stellate ganglion is located:
A. At the level of the body of C6 (spine of C6)
B. Posterior to the brachial plexus sheath
C. Anterior to the dome of the pleura
D. Anterior to the thoracic duct
E. Anterior to scalenius anterior

NN33 [Apr07] [Jul07]
Picture of a view of laryngoscopy showing epiglottis, arytenoids and about 1/3 of the black hole of the trachea, asking for which Cormack-Lehane grade:
A. 1
B. 2
C. 3
D. 4
E. 5

NS22 [Jul07]
Spinal Arterial Supply:
A. Supplied via posterior inferior cerebellar arteries
B. Main anterior arterial supply is from lumbar level
C. 50% supplied by anterior artery, 25% supplied by each posterior artery
D. In neck, supplied mainly off vertebral arteries
E. ?

NV36d [2003-Aug] Q78, [2004-Apr] Q99, [2004-Aug] Q70, [Apr07] Q78, [Jul07]
The best predictor of poor outcome for a peri-operative ulnar nerve injury is
A. a delay in symptom onset to more than 48 hours postoperatively
B. association with anaesthesia lasting more than 2 hours
C. association with a brachial plexus block
D. presence of bilateral injury
E. presence of mixed sensory and motor deficit

NV42 [Apr07] [Jul07]
C6/7 motor function causes:
A. Flexion/extension of fingers
B. Flexion /extension of wrist
C. Flexion of elbow
D. Elbow pronation/supination
E. Shoulder external rotation/abduction

NV44 [Jul07]
Post cervical spine surgery, patient has some neurology hand. Surgeon thinks this is due to an ulnar nerve palsy from poor positioning. Which sign will differentiate between a C8/T1 nerve root lesion and an ulnar nerve lesion?
A. Parasthesia in little finger
B. Parasthesia in index finger
C. Weakness in lateral interosseus
D. Weakness in Abductor pollicus brevis
E. Weakness of adductor digiti minimi

Regional Anaesthesia

RB42d [Jul07]
Transient Neurologic Symptoms. What is NOT TRUE:
A. Less likely with lignocaine
B. may progress into cauda equina syndrome
C. Unlikely due to neurotoxicity
D. ?
E. ?

RB60 [Jul07]
80 y.o for injuinal hernia repair. Inguinal field block planned. Nerves necessary to block:
A. Ipsilateral illioinguinal nerve
B. Ipsilateral illiohypogastric nerve
C. Contralateral illioinguinal nerve
D. Femoral nerve
E. Subcostal nerve

RB61 [Jul07]
Block Height required for orchidectomy:
A. xiphisternum
B. nipple
C. umbilicus
D. midway between pubis and umbilicus
E. pubis

RH26b [2004-Apr] Q126, [Jul07]
To achieve maximum anaesthesia with minimal risk of trauma to veins, the tip of a needle used for a medial peribulbar injection should be advanced no further past the equator of the globe than
A. 5 mm
B. 10 mm
C. 15 mm
D. 20 mm
E. 25 mm

RH28 [2004-Aug] Q104, [Jul07]
Following a retrobulbar block of the eye which of the following features would suggest brainstem spread of the local anaesthetic?
A. an atonic pupil
B. blindness in the blocked eye
C. blindness in the contralateral eye
D. difficulty in swallowing
E. diplopia


IC77 [Jul05] [Apr07] [Jul07]
What sign would you expect to see in Sarin/ nerve gas poisoning?
A. dry skin
B. tetany
C. fasciculations
D. dilated pupils
E. sweating

IC84 [Jul06] [Jul07]
32 year old with early acute liver failure (not paracetamol related). Management includes
A. prophylactic antibiotics
B. N-acetyl cysteine as general liver protection
C. avoid early intubation so can assess for encephalopathy
D. INR> 3 means should be considered for transplant??
E. avoid saline as resuscitation fluid

IC86 [Apr07] [Jul07]
A young boy sustains a head injury and CT scan shows diffuse axonal injury. He is intubated and ventilated in the ICU and is going to theatre due to rising ICP’s (20 to 30) despite mannitol and cooling. The best anaesthetic to give is:
A. propofol and fentanyl
B. sevoflurane and remifentanil
C. isoflurane and remifentanil
D. option including nitrous oxide
E. propofol and remifentanil

IC87 [Apr07] [Jul07]
Following a motor vehicle accident, a young man is hypotensive (BP 70/50), tachycardic (130/mim), has a strongly positive FAST scan, and a widened mediastinum on chest xray. The MOST appropriate investigation of the widened mediastinum is:
A. Aortography
B. CT with contrast
C. Intraoperative TOE
D. Repeat CXR
E. Transthoracic ECHO

IC88 [Jul07]
50 y.o with diagnosed SIRS. BP 70/50. Think CVP was 12. Best Treatment:
A. Dopamine
B. Dobutamine
C. Adrenaline
D. Noradrenaline
E. Vasopressin
NB: IVF was NOT an option

IC89 [Jul07]
What is possible cause for INCREASED pVO2:
A. Pulmonary Embolism
B. Myocardial Infarction
C. Sepsis
D. Liver Failure
E. Tamponade

IC90 [Jul07]
What is the best indicator of adequate fluid resus (?post trauma)
A. Normal BP
B. pH
C. Urine output
D. Lactate
E.<heart rate

IC91 [Jul07]
Goal directed therapy in trauma or sepsis patient. Which is LEAST useful in management
A. sample of blood taken from tip of CVL in right atrium
B. sample of blood taken from tip of PAC
C. stroke volume variability
D. Blood presuure (and it didnt say MABP, just BP)


PC: Cardiovascular drugs

PC43 [2004-Apr] Q122, [2004-Aug] Q67, [Jul07]
The peri-operative use of beta-adrenergic antagonists
A. exerts a cardioprotective effect entirely by reduction of heart rates
B. is best started intra-operatively
C. is contraindicated in patients with chronic airways limitation
D. is contraindicated in patients receiving angiotensin converting enzyme inhibiting drugs (ACE inhibitors)
E. is safe in patients with moderately impaired ventricular function

PI: Inhalational agents

PI66 [2002-Aug] Q96, [2003-Apr] Q57, [Apr07] Q57, [Jul07]
The correct ranking of fat/blood partition co-efficients, in order of increasing solubility in fat, for sevoflurane (S), isoflurane (I), desflurane (D) and nitrous oxide (N2O) is
A. N2O < D < S approximately = I
B. N2O approximately = D < S < I
C. N2O < S < D < I
D. D < N2O < S < I
E. D < N2O approximately = S < I

PI80 [Jul05] [Jul07]
MAC (minimal alveolar concentration) of volatile anaesthetics is DECREASED by:
A. Hypercarbia
B. Hypernatraemia
C. Hyperthermia
D. Lithium
E. Tricyclic antidepressants

PI68 [2001-Apr] Q44, [Jul07]
Effects of volatile anaesthetic agents on the brain include
A. maintenance of cerebral blood flow when used with hypocapnia
B. uncoupling of autoregulation, with a consequent rise in intracranial pressure
C. reduction of cardiac output and cerebral blood volume when used at concentrations of 1.3 MAC
D. maintenance of cerebral metabolic rate, but reduction of cerebral electrical activity
E. equal depression of all neurons of the brain at 1.3 MAC concentration

PL: Local anaesthetics

PN: Narcotics

PN22 [Apr99] [Aug99] [Apr07] Q34, [Jul07]
Norpethidine toxicity:
A. Is only seen if renal function is abnormal
B. Develops because the half life of norpethidine is 2x that of pethidine
C. Is not seen unless treatment is prolonged
D. Only seen if doses of pethidine in excess of 1.2g/day
E. May manifest early as anxiety and mood changes

PN41 [Apr07] [Jul07]
The elimination of drug metabolites unaffected by renal failure is:
A. Aspirin
B. Buprenorphine
C. Pethidine
D. Morphine
E. Oxycodone

PN44 [Jul07]
A. given as a single usual dose antagonises the effects of opioids for approximately 8 hours
B. mainly renally metabolised
C. no hepatic side effects even at high doses
D. is mixed opioid agonist-antagonist
E. used for alcohol abuse

PN45 [Jul07]
What is NOT true about tramadol?
A. Has active metabolite
B. Works via NA and serotonergic receptors
C. Causes less resp depression than other opiates
D. Metabolized in liver and excreted in the kidney
E. Structurally resemble codeine

PR: Muscle relaxants

PR48 [Apr98] [Jul98] [Apr99] [Jul07]
With regard to non-depolarising muscle relaxants:
A. NDMR actions are increased with hyperkalemia
B. Vecuronium exclusively (or primarily) undergoes renal elimination
C. Mivacurium half-life 10 minutes
D. Cisatracurium is metabolised to laudanosine by the liver
E. May require larger doses if treated with phenytoin and theophylline

PV: IV anaesthetics

PV13 [Mar93] [Aug96] [Aug99] [Mar00] [Jul00] [Apr07] [Jul07]
A ‘sleep dose’ of thiopentone in a healthy adult is likely to result in:
A. A fall in peripheral resistance followed by a rise in cardiac output
B. A fall in cardiac output followed by a rise in peripheral resistance
C. A fall in peripheral vascular resistance followed by a fall in cardiac output
D. A rise in peripheral vascular resistance followed by a fall in cardiac output
E. A fall in cardiac output followed by a fall in peripheral vascular resistance

PZ: Miscellaneous drugs

PZ81 [Apr99] [Aug99] [2001-Apr] Q48, [2004-Aug] Q71, [2005-Apr] Q32, [Jul05] [Jul07]
Expected adverse drug effects in a geriatric population receiving a high dose of a selective serotonin reuptake inhibitor for depression would include all of the following EXCEPT
A. hyponatraemia caused by inappropriate secretion of ADH
B. impairment of platelet aggregation caused by depletion of 5HT (serotonin) stores
C. withdrawal symptoms characterised by anxiety, agitation and increased sweating
D. sedation, dry mouth, orthostatic hypotension and cardiac conduction defects
E. gastro-intestinal effects (nausea, vomiting, diarrhoea)

PZ118 [Jul05] [Mar06] [Apr07] Q80, [Jul07]
In renal failure, a prolonged duration of effect due to active metabolites occurs with all except:
A. codeine
B. buprenorphine
C. pethidine
D. tramadol
E. aspirin

PZ119 [Mar06] [Apr07] [Jul07]
A. activates platelet
B. cross reacts with sera from patients with heparin induced thrombocytopaenia
C. has a mechanism of action that is antithrombin (ATIII) dependent
D. is associated with thrombocytopaenia
E. can be safely used in patients with severe renal failure

PZ123 [Jul07]
In regards to chemothereputic drugs:
A. Bleomycin does NOT have dose-dependent idiopathic lung fibrosis
B. Doxyrubicin is associated with dose related effects on cardiac function
C. Methotrexate and NSAIDS worsen renal function when used together
D. Azothioprine is a cholinesterase inhibitor
E. cyclophosphamide has NO reports of interactions with muscle relaxants

PZ124 [Jul07]
Which of the following is NOT associated with serotonin syndrome
A. phenelzine
B. pethidine
C. ondansetron
D. chlorpromazine
E. sumatriptan

PZ125 [Jul07]
Anaesetising patient with history of regular use CNS stimulants. Will need
A. Increased induction agent and increased opioid agent
B. Increased induction agent and normal opioid agent
C. Decreased induction agent and increased opioid agent
D. Increased induction agent and decreased opioid agent
E. Decreased induction agent and decreased opioid agent

PZ128 [Jul07]
The plasma half-life of low molecular weight heparin is
A. Increased in conditions with raised plasma proteins
B. 2 to 4 times that of unfractionated heparin
C. Much less predictable than that of unfractionated heparin
D. Dependent upon a saturatable mechanism for clearance
E. Loger than unfractionated heparin because of a higher affinity for plasma proteins


PH60 [Apr07] [Jul07]
What raises intra-ocular pressure (IOP)?
A. metabolic acidosis
B. respiratory acidosis
C. miosis
D. reverse trendelenberg (head up)
E. trendelenberg

PH61 [Jul07]
In a 140kg obese patient, compared to a 70 kg person
A. cardiac output >20% lower
B. cardiac output 10% lower
C. cardiac output no different
D. cardiac output 10% higher
E. cardiac output >20% higher


ST07b [2001-Apr] Q30, [2002-Mar] Q9, [2004-Aug] Q45, [2005-Apr] Q46, [Jul07]
In a clinical trial, 3 out of 10 patients develop a complication in the control group, and 1 of 10 patients develops the complication in the treated group. To assess whether this is a statistically significant difference the most appropriate statistical test to use would be the
A. Chi-square Test
B. Chi-square Test with Yates correction
C. Student's t-test
D. Fisher’s Exact Test
E. Mann-Whitney Test

ST20 [2001-Aug] Q83, [2002-Aug] Q78, [Apr07] [Jul07]
In a trial, 75 patients with an uncommon, newly described complication and 50 matched patients without this complication are selected for comparison of their exposure to a new drug. The results show

                                       Complication present      Complication absent 
Exposed to new drug 50 25
NOT exposed 25 25

From this data:
A. The relative risk of this complication with drug exposure CANNOT be determined
B. The odds ratio of this complication with drug exposure CANNOT be determined
C. The relative risk of this complication with drug exposure is 2
D. The odds ratio of this complication with drug exposure is 1.33 (recurring)
E. None of the above

ST21 [2002-Aug] Q122, [2003-Aug] Q87, [2004-Apr] Q67, [Apr07] Q87, [Jul07]
Forty patients are randomly dived into two groups - one to receive induction agent A and another to receive induction agent B. The next day they are asked to rate their anaesthetic experience on a scale of 1 (very bad) to 5 (very good). The most appropriate test to compare the anaesthetic experience of the two groups is the
A. Chi squared test
B. Unpaired Student t test
C. Paired Student t test
D. Mann Whitney test
E. Kruskal Wallis test

ST36 [Jul07]
Publication bias is:
A. Publication of papers by more known authors
B. Publication of papers with negative results
C. Publication of papers with positive results
D. Publication of papers because the study was published by a prestige journal
E. The publisher decides what to print

Add any other questions you remember here

Any comments you would like to add

in general a lot of question which asked you to pick the false answer, which i found meant you had to have done quite a bit of background reading to know 4 true facts. also quite a few questions on goal directed resus, end points of resusitation.--Suzi 22:04, 31 Jul 2007 (EDT)

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