Finals MCQs-Mar 2012

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Finals Black Bank | Apr09 | Aug09 | Mar10 | Aug10 | Mar11

MCQs from the Final Exam March 2012
Each paper has 50 new MCQs, 50 repeats from the previous MCQ paper, and 50 old repeat MCQs. 
If you can, please indicate whether you think each MCQ is a new one or a repeat one.

50 new questions MCQ March 2012

1. A patient undergoing liver surgery has a venous air embolism, what is the most appropriate position to place them in:

a. Reverse trendelenburg, right side up
b. Reverse trendelenburg left side up
c. Reverse trendelenburg, neutral
d. Trendelenburg right side up
e. Trendeleburg left side up


2. Which of the following is NOT a side effect of cyclosporine

a. Alopecia
b. Hypertension
c. Renal impairment
d. Gum hyperplasia


3. What is the half life of clopidogrel?

a. 6 hours
b. 14 hours
c. 24 hours
d. 7 days


4. When administering adrenaline and atropine via ETT dose compared with IV should be

a. Same dose
b. Double
c. Quadruple
d. Six times


EV14 What splitting ratio gives a 3% concentration of isoflurane?

a. 1/5
b. 1/9
c. 1/?
d. 1/20
e. 1/23


6. What transfusion related complication is the commonest cause of mortality

a. Bacterial infection
b. TRALI
c. ABO incompatibility
d. ?
e.


7. Which of the following is not included in the DHATS2 AF thromboembolic risk scoring system

a. Age
b. Gender
c. Diabetes
d. Heart failure
e. Previous TIA


8. What is the ratio of breaths to compressions in neonatal resuscitation

a. 1:3
b. 1:5
c. 2:15
d. 2:30


9. What is the innervation of the hard palate

a. Greater palatine and nasopalatine


10. Which of the following is suggesting of an inhaled foreign body in a child on chest x ray

a. Foreign body visible in front of airway

b. Hyper-expanded hemithorax

c. Collapse


11. What is the distance from the lips to the carina in an 70kg adult male in cm

a. 21

b. 23

c. 25

d. 27

e. 29


12. What colour is the label for subcutaneously administered drugs

a. Pink

b. Yellow

c. Brown

d. Red

e. Blue


I thought the question was about ketamine, hence yellow?


13. How much air is the maximum to that should be used to inflate a 5 LMA classic cuff

a. 15

b. 20

c. 25

d. 40

e. 45


14. Where should the tip of an IABP lie

a. 2cm distal to the left subclavian

b. 2 cm proximal to the left subclavian

c. 2cm proximal to the renal artery

d. 2 cm distal to the renal artery


15. A 60kg female is given 50 mg of rocuronium, she is unable to be intubated, what dose of sugamadex is required to reverse the rocuronium

a. 240

b. 800

c. 960


IC67 In a penetrating chest injury what part of the heart is most likely to be injured

a. Left ventricle

b. Right ventricle

c. Right coronary artery

d. Right atrium

e. Sinus node


17. What is the maximum recommended dose of Intralipid in local anesthetic toxicity (ml/kg)

a. 6
b. 8
c. 10
d. 12
e. 14


18. What is a contraindication to an IABP?

A. Aortic regurgitation
B. Aortic stenosis


19. An infant is born with meconium stained liquor and is apnoeic and floppy… your first step should be

a. Stimulate and dry
b. Positive pressure ventilation
c. Suction the trachea

20. Central sensitization occurs due to

a. Primary events mediated by the NMDA receptor
b. Alterations in gene expression
c. Increased magnesium

21. What volume of FFP is required to increase fibrinogen level by 1g/L (I think it was FFP or did it say cryoprecipitate?)

a. 10-15ml/kg
b. 30ml/kg

It was FFP....i would use cryo if the fibrinogen was less than 1 anyways, so seriously?


22. An epidural in a healthy individual causes all EXCEPT

a. Raised Co2
b. Bradycardia
c. Vasodilation
d. Dyspnea

23. In the Revised Trauma Score includes GCS, Blood pressure and what other parameter?

a. HR
b. Saturation
c. Respiratory rate
d. Urine output

24. Autologous transfusion results in less

a. Cost
b. Blood waste
c. Incompatible transfusion
d. Unrequired transfusion

25. After an infusion of normal saline causing isovolumetric haemodilution what occurs?

a. Increased cardiac output
b. Increase oxygen extraction
c. Capillary vasodilatation

IC97 Bleeding in trauma has been shown to be reduced by

A. Tranexamic acid
B. Recombinant factor VIIa
C. DDAVP
D. Prothrombinex

IC97 Which drug has the best evidence for reducing blood loss in trauma?

A. Aminocaproic acid
B. Novo 7
C. Prothrombinex
D. Tranexamic acid
E. Aprotinin


27. The time constant of the lung is calculated by

a. Compliance x resistance
b. Compliance plus resistance
c. Compliance /resistance
d. Resistance/compliance

28. The commonest post operative complication in a patient with a # NOF is

a. UTI
b. Pneumonia
c. Delirium
d. Myocardial infarction

29. In an infant, the intercristine line is at the level of

a. L1-L2
b. L2-L3
c. L3-L4
d. L4-L5
e. L5-S1

30. Which of the following is a contra-indication to a left DLT

a. Left pneumonectomy
b. Tumour in the left main stem bronchus

31. What is the commonest symptomatic cardiac condition in pregnancy

a. Mitral stenosis
b. Aortic stenosis
c. Eisenmengers
d. Tetralogy of fallot
e. ?

32. What is the ratio of MAC awake:MAC of sevoflurance

a. 0.2
b. 0.34
c. 0.5

33. A man presents to ED after a fight with his son in law in which he is punched in the head- calculate the GCS.


34. Pain from the uterus during labour is transmitted via

a. From the anterior roots of T10-L1
b. Parasympathetic fibres
c. The inferior hypogastric plexus
d. Via grey rami communicantes


NEW: The features of Pierre Robin sequence include cleft palate, micrognathia and:

A. Glossoptosis
B. Craniosynostosis
C. Macroglossia
D. Microstomia
  • Glossoptosis (Rasch, Canadian Journal ... , 33 , 1986) --Methoxyflurane 06:45, 21 April 2012 (CDT)


36. A size C oxygen cylinder that reads 5000kpa contains approximately how many litres of oxygen

a. 100
b. 150
c. 200
d. 350
e. 600

37. A patient having a craniotomy has the CVP/arterial transducers at the level of the right atrium. The head is 13cm above the level of the heart. If the MAP is 80mmHg and the CVP is 5mmHg what is the cerebral perfusion pressure in mmHg

a. 60
b. 62
c. 65
d. 70
e. 75

38. After a procedure with an LMA in situ a patient complains of loss of sensation to the anterior part of the tongue. What nerve is likely damaged?

a. Facial
b. Lingual
c. Greater palatine
d. Glossopharyngeal

39. What statistical test would be best to evaluate the effects of ? 2 drugs in patients at ? 3 different points in time

a. ANOVA
b. Mantel Hantzel
c. Crusckall Wallis
d. Students t test

40. A man is working with electrical appliances at home with a residual current device. If he touches the active and the neutral (was it neutral or earth) wire he will suffer

a. A microshock
b. A macroshock
c. Nothing happens because the fuse blows
d. The RCD will protect him from macroshock

41. An infant with failure to thrive is noted to have an apical systolic murmur weak pulses, with the femoral felt most easily. They most likely have

a. Patent ductus arteriosis
b. Ventriculoseptal defect

42. Which radiological finding is most consistent with atlantoaxial instability in a patient with rheumatoid arthritis

a. A 9mm gap between the anterior arch of C1 and the odontoid peg

43. What is the most accurate method of determining fetal heart rate in a neonate

a. Palpation of an umbilical vein pulse
b. Auscultation with a stethoscope
c. Palpation of femoral pulse
d. Pulse oximetry

44. In acute liver injury what causes the highest risk of bleeding

a. Thrombocytopenia
b. Coagulopathy
c. Portal hypertension
d. Platelet dysfunction
e.

45. A patient in recovery post op total hip replacement develops crushing central chest pain, ECG shows ST segment elevation (NB- no BP etc given, beta blockade was not an option). The most appropriate action is to give

a. Aspirin
b. IV GTN
c. IV heparin
d. Calcium channel blocker
e. T/L

46. Stellate ganglion blockade causes

a. Conjunctival injection
b. Dry eyes
c. Decreased axillary sweating

47. Features of ventricular tachycardia DO NOT include

a. Absence of p waves
b. Monophasic waves
c. Prominent R wave in V1
d. A-V dissociation

48. An inpatient becomes hyponatraemic 48 hours post op and has a seizure. The most appropriate treatment is

a. Fluid restriction
b. Normal saline ?ml/hr
c. Hypertonic saline
d. Salt tables

49. A patient has a laparotomy for an acute abdomen, nothing in found intra-operatively. ABG reveals

50. A child with 10% dehydration is likely to have

a. Bradycardia
b. Rapid deep breathing


Ones I cant recall much at all

  • Something about an arterial line- was it damping? Air bubbles was an option.
  • I've written down CO desflurane but don’t know what that means


1. REPEAT Sep 11 When stimulating the ulnar nerve with a nerve stimulator, which muscle do you see twitch?

A. opponens abducens
B. abductor pollicis brevis
C. adductor pollicis brevis
D. extensor pollicis
E. flexor pollicis brevis


ST39 When analyising a study containing a control and two test groups, the best statistical method to use is....

A. Analysis of variance
B. Chi squared with Bonnferoni correction
C. ?
D.
E.


3. REPEAT Sep 2011 20. Really poor copy of a CXR. Looked to me like a haemopneumothorax (you could very faintly see a collapsed lung outline, there was no 'meniscus' to the fluid shadow) but other people thought it was an artefact. It did indeed look like a pneumothorax and then someone had put a piece of metal up to simulate a haemothorax, because on the lateral you couldn't see past the ribs (ie the film was cut off at the rib borders). It was terrible quality (too black, and hard to discern tissue from air), and an inadequate film (cut off apices, and poor lateral view as before)

A: Pneumothorax
B: Haemopneumothorax
C:
D:
E: Artefact.


4. REPEAT ME46 Acromegaly due to excess of growth hormone. Why is it difficult to do a direct laryngoscopy?

A: Distorted facial anatomy
B: Macroglossia
C: Glottic stenosis
D: Prognathe mandible
E: Arthritis of the neck


AC159 REPEAT Mar 2011 Post CEA on ward, patient seizes. BP has been hard to control. What to do to prevent further seizures?

A: Add another antihypertensive
B: Start antiplatelet drugs
C: Start anticonvulsants
D: Do angio and stent
E: Nimodipine


6. Repeat Sep 2011 - Main heat loss in anaesthetic for neonate

A. vasodilatation
B. radiation
C. convection
D. conduction
E. evaporative


7. REPEAT - Sep 2011 Patient with aortic stenosis, the signs indicate poor prognosis

A. Palpitation
B. Radiation to carotid arteries
C. Paroxysmal nocturnal dyspnoea
D. Angina
E. Syncope


8. REPEAT Sep 2011 - EM16 ANZCA version [2002-Mar] Q68, [2002-Aug] Q64, [2005-Apr] Q94, [2005-Sep] Q75 Circuit disconnection during spontaneous breathing anaesthesia

A. will be reliably detected by a fall in end-tidal carbon dioxide concentration
B. will be detected early by the low inspired oxygen alarm
C. will be most reliably detected by spirometry with minute volume alarms
D. may be detected by an unexpected drop in end-tidal volatile anaesthetic agent concentration
E. can be prevented by using new, single-use tubing


9. REPEAT PZ130 Which drugs below does not need dose adjustment in renal failure patient

A. Buprenorphine
B. Morphine
C. Tramadol
D. ?
E. ?


10. Repeat- Fat: blood coefficient- N2O, Desflurane, Sevoflurane, Isoflurane

A. N2O ~ D > S > I
B. N2O > D > S > I
C. D > N2O > S > I
D. N2O > D > S ~ I
E . D > N2O > I > S


11. REPEAT PP46 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


NEW: What is the average distance from the lips to carina in an average 70kg adult male?

21 cm
23
25
27
29


NEW: Q51 Patient with severe Rheumatoid arthritis. Has C1/C2 instability. Most likely C-spine Xr finding would be

A. Anterior Atlantoodental interval >9
B. Increased sagittal diameter
C. Posterior atlantodental interval >14
D. Midpart of C1 over C2
E. Tear drop sign of C2


NEW NH32 (Similar to NH11): Which nerves need to blocked to anaesthetise the hard palate:

A. Superior labial nerve and greater palatine nerve
B. Greater palatine nerve and nasopalatine nerve
C. Inferior orbital nerve and nasopalatine nerve
D. Glossopharyngeal nerve and…
E. Anterior ethmoidal nerve and…


NEW: Patient complains of numbness of the anterior third of his tongue following GA with LMA. Which nerve is involved?

A. Glossopharyngeal
B. Facial nerve
C. Superior vagus
D Mandibular n.


NEW: CHADS2 score. Which is not a feature?

A. Age
B. Gender
C. Diabetes mellitus
D. Stroke
E. CCF


NEW: Increased risk of post-partum haemorrhage in:

A. Nulliparous patient
B. Patient < 20 years old
C. Factor V Leiden deficiency
D. Oligohydramnios
E. Prolonged labour


NEW: Chest Xray findings in a child who has inhaled a foreign body:

A. Opaque mass overlying the airway
B. Hyper-expanded lung fields
C. Unilateral pulmonary oedema
D. Collapsed lung base
E. Mediastinal shift


ME47 Which of the following are feature of Conn’s syndrome?

A. Normoglycaemia, hypernatremia , hypokalemia
B. Hypoglycaemia, hypernatremia, hypokalemia
C. Hyperglycaemia, hyponatremia, hyperkalemia
D. Normoglycaemia, hyponatremia, hyperkalemia
E. Hypoglycaemia, hyponatremia, hyperkalemia


REPEAT: MR47 Unequal consolidation on CXR can be caused by all except:

A. Pleural effusion
B. Pulmonary infarction
C. Pulmonary haemorrhage
D. APO
E. Pneumonia


NEW: 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


NEW: What is the resus dose of atropine and adrenaline when given via ETT compared to IV

A. x 0.5
B. No change
C. x 2
D. x 4
E. x 6


NEW: EZ94 A home handyman leaves his electricity turned on whilst fiddling with wires [repairing a power outlet]. He has a RCD. What happens if he touches the neutral and ground wires?

A. Nothing will happen
B. Receives macroshock
C. Protected from macroshock by RCD
D. Protected from microshock by domestic fuse
E Receives microshock


REPEAT: RU12 If a patient experiences parasthesia in the little finger during supraclavicular brachial plexus block, the needle is in proximity to the

A. posterior cord
B. middle trunk
C. Ulnar nerve
D. lower trunk
E. medial cord


NEW: What is the best predictor of severe bleeding in cirrhosis?

Thrombocytopaemia
Hypofibrinogenaemia
Prolonged PT
Hypoalbuminaemia
Pulmonary hypertension


NEW: What is the dose of FFP required to increase fibrinogen levels by 1 g/L

A. 2 ml/kg
B. 5
C. 10
D. 20
E. 30


REPEAT FFP dose to increase fibrinogen by 1 mg/l

a. 10 mls/kg
b. 20 mls/kg
c. 30 mls/lg
d. 40 mls/kg


EZ95 What is the oxygen concentration in a standard bottle of heliox?

21%
25%
30%
33%

28% was NOT an option


NEW: EZ96 A C size oxygen cylinder (A size in New Zealand) reads 5000kPa. How much oxygen remains?

A. 50 Litres
B. 150 litres
C. 500
D. 750
E. 1500


NEW: Patient undergoing partial hepatic resection develops Venous Air Embolism. Best position should be

A. Head down left side up
B. Head down right side up
C. Head up right side up
D. Head up left side up


NEW: What is the ratio of compressions to breaths in neonatal resus?

A. 3:1
B. ?


REPEAT: SF27 The pain of the first stage of labour is transmitted by:


A. Grey rami communicantes

B. T10-L1 anterior roots
C. The hypogastric plexus

D. Inhibitory nerves to the internal vesical sphincter

E. Parasympathetic nerves


NEW: You are asked by an Obstetrician to help relax a uterus in labour and deliver for manual removal of placenta. What is a safe and effective dose of IV GTN to be delivered?

A. 5 mcg
B. 50 mcg
C. 250 mcg
D. 400 mcg
E. 500 mcg

NEW Dose of GTN IV to relax uterus?

A. 25 mcg
B. 50 mcg
C. 250 mcg
D. 500 mcg
E. 750 mcg
  • ANZJOG Volume 37, Issue 1, pages 20–24, February 1997 : 50 - 200 mcg , 200mcg is mentioned a few places. I will check the O&G textbooks for a proper reference. --Methoxyflurane 06:45, 21 April 2012 (CDT)


NEW:Middle-aged male with severe MS having general anaesthesia for repair of fractured ulna / radius. 10 minutes into the case you notice a tachyarrythmia with his HR 130 and BP 70. He is normally in sinus. What do you do?

A. Adenosine
B.Amiodarone
C. Shock
D. :Volume
E. Metaraminol
  • Someone help - Why can we not give metaraminol in MS ? --Methoxyflurane 06:45, 21 April 2012 (CDT)


NEW: The ratio of MAC to MAC Awake for sevoflurane is:

0.22
0.33


NEW: A lady with a Fontan’s circulation for tricuspid atresia presents for caesarian section. What is the best way of maintaining her cardiac output? Trendelenburg

Epidural contraindicated
Allow pCO2 to rise to 50 to vasodilate her
Short inspiratory time
Allow hypovolaemia


NEW:What is the cerebral perfusion pressure if MAP 80, CVP 5, both at the level of the RA with the tragus 13 cm above the RA?

62 mmHg
65
75
80


NEW: What is the best way to measure neonatal heart rate during resus?

Palpate a femoral artery
Palpate a carotid artery
Auscultate the precordium
Palpate the umbilical stump


NEW: A term primip with meconium-stained liquor has a caesarian section. On initial assessment the neonate if pale and floppy with a heart rate of 90 bpm. Initial treatment should be:

Positive pressure ventilation
Dry and stimulate
Suction the trachea
Start CPR


NEW: The Revise Trauma Score includes the first measures of GCS, BP and:

HR
RR
SpO2
Temp
CVP


NEW: The most common clinically significant valvular lesion in pregnancy is:

MS
MR
AS
AR
TR


NEW:During prolonged trendelenburg positioning there is: SG65

No change in ICP
No change in IOP
Increased pulmonary compliance
Increased myocardial work
No increased pulmonary venous pressures


NEW: How do you calculate the inspiratory time constant for lungs

resistance multiplied by compliance
resistance divided by compliance
compliance divided by resistance
resistance minus compliance
resistance plus compliance


NEW: What is the best indicator of pending respiratory depression when using a morphine PCA

Respiratory rate
Sedation score
Reduced saturations


NEW:A 60kg 17 year old female given 50 mg rocuronium for RSI. You can’t intubate or ventilate. What is the appropriate dose of sugammadex?

300mg
600mg
920mg
1300mg


NEW A 60kg patient received a modified rapid sequence with Rocuronium. Difficult intubation and requires immediate reversal. What's dose of sugammadex to reversal dose?

A. 960 mg
B.


NEW: What is the maximum dose of Intralipid during LA toxicity resus?

8ml/kg
10
12
16


NEW: What is the maximum volume of air the can be placed in a size 5 classic LMA?

35ml
40


NEW: EZ97 Classic LMA size 5, what is the suggest maximum volume

A. 30ml
B. 35ml
C. 40ml
D. 45ml
E. 50ml


NEW: What is the immediate compensation for the dilutional anaemia when 3 litres of normal saline is given at the start of a case?

Increased CO
Capillary dilatation
Increased oxygen delivery
Right shift in the oxygen dissociation curve


NEW: The following electrolytes are from an alcoholic 12 hours post laparotomy. What is the diagnosis? Na 141, K 4, Cl 114, HCO3 19

DKA
Methanol
Lactate
NaCl resus


NEW Alcoholic patient undergoes unremarkable anaesthesia for explorative laparotomy for investigation of abdominal pain. No pathology is found. However, in recovery the following electrolyte disturbances found:

Na 140
K 5.0
CL 115
HCO 18

What is the most likely cause

A. Acute renal failure
B. Lactatic acidosis
C. Methanol ingestion
D. Chloride [N/saline resuscitation]
E DKA



The plasma half-life of clopidogrel is:

A. 6 hrs
B. 14 hrs
C. 24 hrs
D. 7 days
E. 14 days


NEW: EV14 Isoflurane vaporiser giving 3%. What is the splitting ratio?

1:3
1:9
1:13
1:20
1:27


NEW: The line between the iliac crests in a neonate corresponds to:

L2/3
L3/4
L4/5
L5/S1
S1/2


REPEAT: EZ79 In a neonate the main resistance in a circle system with CO2 absorber

APL valve
Expiratory and inspiratory unidirectional valves
tubing
ETT
HME filter


NEW: Blood flow across which of the following is used to estimate pulmonary artery pressures during echocardiography?

A. Tricuspid valve
B. Pulmonary valve
C. Mitral Valve


REPEAT: AT16 Which patient do you not put a left-sided Robert-Shaw DLT into?

A. Left pneumonectomy
B. Left main bronchial lesion
C. There is a right-sided broncho-pleural fistula
D. The patient has s hunt > 10%
E. The left lung is to be collapsed


NEW: An infant born at 32 weeks gestational age comes at 6 weeks for elective bilateral inguinal hernia repair. The parents expect to take him home that day. What do you tell them?

A. He cannot have surgery until he is 3 months old
B. They can take him home that day
C. They can take him home with apnoea monitoring overnight
D. He needs to stay in hospital for apnoea monitoring


NEW: EZ98 A machine with a soda lime absorber was left on overnight with oxygen running at 6 litres per minute. In the morning a desflurane vaporiser is connected. What toxic substance may be produced?

A. Substance A
B. Carbon monoxide
C. Carbon dioxide
D. Calcium hydroxide
E. Substance B


REPEAT: {Apr09], [Mar 12] A post-op child being given 2.5%D + 1/2NS on the ward seizes, is intubated and ventilated and transferred to ICU. Sodium is 116. What do you do?

A. Give phenytoin
B. Give hypertonic saline
C. Give normal saline
D. Give frusemide
E. Give normal saline


NEW: Which two nerves are most reliably blocked in a fascia iliaca block?

Various combinations of femoral, obturator, lateral cutaneous and sciatic


NEW: Which is not a side effect of cyclosporine?

A. Alopecia
B. Gingival hyperplasia
C. Hypertension
D. Renal impairment


NEW: New national labelling standards endorsed by ANZCA. What colour should the label on a subcutaneous ketamine infusion be?

A. Red
B. Blue
C. Beige
D. Yellow
E. Pink


NEW ANZCA professional documents, ketamine labels should be

A. Pink
B. Green
C. Grey
D. Yellow
E. Black


REPEAT Q121. Poor prognosis of AS

A. PND
B. Chest pain
C. Palpitation
D. Syncope
E. Malaise


NEW Q122. Required for diagnosis of Neuroleptic Malignant Syndrome

A. Diaphoresis
B. ↑ CK
C. Rigidity
D. Hypertenion
E. ↑ HR


NEW Q143. 2 yo 15kg child following seizure on surgical ward. Admitted with appendicitis and perforation. 60ml/hr of ½ N. Saline 5%dextrose

Na+ 119
K+ 4.5
HCO3- 19
Cl- 90

Best treatment would be

A. Desmopressin
B. Frusemide
C. 3% normal saline
D. Normal Saline
E. Fluid restrict


NEW Atrial septal defect, where is the murmur heard the loadest?

A. PV
B. MV
C. ASD
D. AV
E. TV


NEW Young infant with Failure to Thrive. Born on the 20th percentile now is on the 5th percentile. Found to have a systolic murmur, tachynpnea with weak femoral pulse. The most likely diagnosis is

a. Coarctation
b. HOCM
c. PDA
d. AS

Alt: Child 5th percentile (used to be 30th). Systolic murmur, weak pulses but strongest at femoral. Most likely CHD?

A VSD
B Coarctation
C PDA


NEW Myasthenia gravis, Eaton Lambert Syndrome What happens with exercise?

a. MG better, EL worse
b. EL better, MG worse
c. Both EL and MG get worse
d. Both EL and MG get better


REPEAT Cephalothin doesn't cover:

a. Proteus
b. E coli
c. Staph
d. Strep
e. Pseudomonas


NEW:Regarding PS9 safe provision of anaesthesia for Colonoscopy:

A. Medical Practitioner to providing sedation with a skilled assistant who is not assisting the proceduralist.
B. Medical practitioner alone
C. Specialist Anaesthetist
D. Skilled nurse with airway experience
E. Skilled bogan


NEW: You see a man in his 60s in clinic 1 week prior to laparoscopic cholecystectomy. He has dilated cardiomyopathy with an ejection fraction of 30%, but does not get dyspnoeic with normal activities of daily living. What is the most appropriate management of his heart failure?

a. Frusemide
b. Amiodarone
c. ACE
d. Digoxin
e. Biventricular pacemaker


Young child with WPW undergoes general anaesthesia. Intra operatively developed tachycardia. HR 220, BP 80/40. Best drug to cardiovert

A. Adenosine
B. Amiodarone
C.


REPEAT Finding on haemophilia A patient

A. Female haemarthrosis
B. Male haemarthrosis
C. Normal PT, abnormal APTT
D. Abnormal PT, normal APTT


NEW: 32 y/o male. Weakness distal and prox muscles, infection 10 days ago, no sensory involvement, temp 37.8, facial weakness. Cause:

A. Guillian Barre
B. Myasthenia Gravis
D. Poliomyelitis
E. ?Acute encephalitis
F. ?Polymyositis


NEW: What gestation to monitor uteroplacental flow

A 20 weeks
B 24 weeks
C 28 weeks
D 32 weeks
E 36 weeks


REPEAT: Cause of hypoxia in 1 lung ventilation?

A Blood to non-ventilated lung
B V/Q mismatch in ventilated lung
C ?hypoxic pulm vasoconstriction


NEW: Endocarditis prophylaxis

A Bicuspid valve
B Congenital repair > 12 months ago
C Rheumatic heart valve
D Uncorrected cyanotic heart disease
E MVP + ?MR


REPEAT: Air bubble in arterial line. Causes decreased:

A Damping
B Resonant freq of system


REPEAT: Area burnt in adult male - upper half of upper limb, anterior abdo, whole left leg:

A 23% [changed figure compared to prev years]
B 32%


REPEAT: Pulmonary Hypertension possible except in:

A Tetralogy of Fallot


REPEAT: Contraindication to Intra-aortic Balloon pump:

A AR
B AS
C MR


NEW: Best position for tip of IABP is 1-2 cm:

A Distal to Left subclavian artery
B Proximal to Left subclavian artery


NEW: VT features:

A monophasic V6
B QRS > 0.14
C Right axis deviation


NEW: 70 y/o postop in recovery following hip surgery. Develops severe chest pain, ST elevation. Immediate mx:

A Beta blocker
B Aspirin
C GTN infusion
D Heparin infusion


Repeats

1. The following movements are supplied by C6-7


2. NH30 Motor innervation of upper eye lid


3. Crappy CXR PA and lateral with right sided hydropneumothorax


4. What proportion of the population are heterozygous for pseudocholinesterase deficiency, i.e. have a dibucaine number 30-70?: 4%


5. Fat:blood coefficent N2O, D, S, I


6. Patient with mastocyotosis, intraoperatively would most likely: hypotension


7. AP08c Complication of Caelic plexus block: paraplegia


8. MC151 All can prolong the QT interval except: Magnesium


9. SG62 Carcinoid patient develops hypotension intraop: octreotide


10. Features of longstanding paraplegia includes all except: flaccid paralysis


11. sensitivity 90%, specificity 99%- False positive 1%


12. SVRI = SVR x BSA


13. .EZ80 Repeat- A line isolation monitor protects against microshock


14. Commonest presenting features of anaphylaxis- hypotension


15. AT27 Following a left sided pneumonectomy, a left intercostal drain is placed and connected to an underwater drainage system. In the postoperative period


16. TMP-Jul10-033 Most safe side to insert subtenon block


17. Inserting ETT over bougie: turn 90 deg counter clockwise


18. Levosomendin: conformational change on troponins C


19. During scoliosis surgery with monitoring of somatosensory evoked potentials, which tract are they mainly monitoring? : Dorsal column


20. What is the major cause of death in a patient with perforation of the pharynx, oesophagus or trachea?: Sepsis


21. Post op cervical- patient complaint arm weakness. Differentiate C8, T1 versus ulnar nerve injuries- Abduction pollicis brevis


22. The below would increase A-a oxygen gradient Except: decrease FiO2


23. Stallate ganglion is located: anterior to scalenous anterior


24. EZ79 In a neonate the main resistance in a circle system with CO2 absorber


25.->AZ84 Modified Cormack and Lehane grade - You cannot see beyond the epiglottis and there is a little space between the epiglottis and the posterior pharyngeal wall (? remembered as epiglottis touching posterior pharyngeal wall): 3B


26. When stimulating the ulnar nerve with a nerve stimulator, which muscle do you see twitch? Abductor pollicis brevis


27. Iron deficiency: increased serum ferritin, decreased serum iron


28. A 62 year old man has chronic renal failure. You notice his total serum calcium is 2.05 mmol/L. This is because he has: Secondary hyperparathyroidism


29. Half life of tirofiban: 2hrs


30. Popliteal block - lateral approach


31. Coeliac plexus block - complication: paralysis


32. Addison's features except: Glucose 12 mmol/L


33. TURP syndrome - NA 119, Mx: Hypertonic saline @ 100ml/hr


34. Reversed splitting in: LBBB


35. C6/7: wrist flexion/extension


36. Congenital diaphragmmatic hernai: hyperplasia of pulm

101. What will not increase A-a gradient a. decreased cardiac output b.. Increased FiO2 c. Decreased FiO2 d. increased shunt

100. Mac awake: MAC of sevo ratio



Q115: Wolf Parkinson White Syndrome: a. PR interval lenghtened b. [Something about delta wave] c. DCR is less effective d. Central IV access may precipitate arrythmias


Q116: For adrenaline and atropine given via ETT, the ETT dose compared to the IV dose is: a. half b. same c. double d. 4 times e. 6 times

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