Finals MCQs-Mar 2016

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 PLEASE record questions you have recalled but don't recall the Q number, as X then a number (e.g. X1, X2, ... ) which 
 can then be sorted in a way which makes it easier for people to use the black bank to compare answers!

MCQs

Q41. (new) 17 y.o F with Fontan's circulation for open appendectomy. Recent TTE showing good LV function. On b blocker and ACEi, Just after induction develops rapid AF with HR of 150bpm, BP 60/30 and starts to desaturate. Immediate management should be?

a. Adrenaline
b. Adenosine
c. Amiodarone
d. Cardioversion
e. Phenylephrine


Q42. (rpt) 32 year old male with recent respiratory tract illness presents with weakness in his legs and arms. Diagnosis?

a. Guillian barre
b. MS
c. Myasthenia gravis
2 others that were wrong


Q43. (new) A set of blood results. Hb 86, MCV 72, Fe levels were very low, transferrin was very low, ferriting was normal (190). What is the most likely diagnosis?

a. Fe Deficiency
b. Latent Fe Deficiency
c. Acute phase response
d. Thallasemia
e. ?

Q44 was a rpt, cant remember which.

59. You are about to anaesthetise a patient with know MH susceptibility. The machine has been prepared according to the guidelines, however you don't have any charcoal filters. You proceed with the case and the minimum flows for the case should be:

A. 0.5 l/min
B. 2 l/min
C. 3 l/min
D. 5l/min
E. 10 l/min

60. You have just conducted a LUCS under spinal anaesthesia and the baby is out. You accidentally administer IV suxamethonium instead of syntocinon. This can BEST best be described as a:

A. Misjudgement
B. Lapse
C. Mistake
D. ?
E. ?

Alternate remembered options:

A. Slip
B. Mistake
C. Violation
D. Diversion
E. ?


143. New

A 2 year old with leukaemia for intrathecal chemotherapy. Previous history of post procedure nausea and vomiting. Which prophylaxis to use?

A. Haloperidol
B. Dexamethasone
C. Ondansetron
D. Promethazine
E. Metaclopramide

144. New:

Anaphylaxis to rocuronium, confirmed on skin testing. Negative skin test to atracurium, six and veg. Which to use?

A. Atracurium
B. Vecuronium
C. Pancuronium
D. Sux
E. ?

NEW: Urosurgery. Surgeon wants to give methylene blue. This is contraindicated if patient is taking:

A Fluoxetine
B Droperidol
C Risperidone
D Oxybutinin
E Prazosin

NEW 6 year old normal size child. Current Hb 70. What volume packed red cells do you need to give to increase Hb to 80?

A 80mL
B 120mL
C 160mL
D 200 mL
E 240mL

Most common organism in septic arthritis is:

A Strep progenies
B Staph aureus
C Neisseria
D
E

Low pressure leak test. Cant remember question- something about bulb syringe to common gas outlet and where fault is:

A Check valve incorrectly seated
B Oxygen cylinder
C Pipeline gas supply
D Vaporiser incorrectly seated


“Leaks in the machine low-pressure system can occur as a result of cracked rotameter flow tubes, incorrectly mounted vaporizers, vaporizer leak around agent filling device, or fracture in the gas piping. Leaks in the high-pressure and intermediate pressure systems usually result from defective valves, connectors, and hanger yokes.”

Excerpt From: Fun-Sun F. Yao. “Yao & Artusio's Anesthesiology: Problem-Oriented Patient Management.” LWW, 2016-03-02T13:00:00+00:00. iBooks. This material may be protected by copyright.

“Some anesthesia machines (e.g., GE Excel) have a one-way outlet check valve just upstream of the common gas outlet. Other models have no outlet check valve. The presence of an outlet check valve precludes the application of a positive pressure leak check. If such a valve is present, a negative pressure leak test can be used to check the low-pressure system. In this test, a suction bulb (negative pressure leak-check device) is connected to the common gas outlet. With all gas flows turned off and vaporizers off, the bulb is squeezed empty (to create a negative pressure of −65 mm Hg) and then connected to the common gas outlet of the workstation. Reexpansion of the bulb should not occur in less than 30 seconds. The test is repeated with each vaporizer turned on in turn to check for leaks in the vaporizers.”

Excerpt From: Fun-Sun F. Yao. “Yao & Artusio's Anesthesiology: Problem-Oriented Patient Management.” LWW, 2016-03-02T13:00:00+00:00. iBooks. This material may be protected by copyright.


Obese patient. Given 100mg rocuronium at start of case. Now post titanic count= 2. Lean body weight 60, total body weight 110kg. What is the correct dose of sugammadex?

A 120mg
B 220mg
C 240mg
D 360mg
E 440mg

Peribulbar block, get numbness of ipsilateral upper lip. Which nerve responsible

A. Infraorbital
B Trochlear
C Facial
D
E

Q1) Post partum woman has sensory loss on anterior lateral part of her thigh. There is no motor deficit. She had an epidural and vaginal delivery with forceps. Where is the most likely location of the lesion?

Femoral nerve
Lateral femoral cutaneous nerve
Obturator nerve
Sciatic nerve
Lumbosacral plexus

Q2) Neonatal resuscitation. What is the most reliable way of determining a neonates heart rate?

A) auscultate the praecordium
B) palpate umbilical stump
C) palpate carotid pulse
D) palpate femoral puse
E) pulse oximetry


Q150

According to current Australia Red cross screening procedures, which virus has the the highest rate of being present within Packed red blood cells?
A) Hep A
B)Hep B
C) Hep C
D) HIV1
E) HIV2


Q20. obese patient for lap sleeve gastrectomy?  you used 100mg rocuronium for induction. his ideal body weight is 60kg, actual body weight is 110kg. At end of case, post-tetanic count of 2. You want to use sugammadex to reverse him. According to the manufacturer’s product information guidelines, how much would you use to reverse?  :- 120mg  :- 220mg  :- 240mg  :- 360mg  :- 440mg


Q17. 64 year old male in preop clinic. HR 60. Free T4 is normal. TSH <0.05. This is consistent with  :- clinical hypothyroidism  :- autoimmune thyroiditis

 - sick euthyroid
 - previous hypophysectomy

 :- subclinical hyperthyroidism


Q18. 12kg child for orchidopexy. How much of 0.2% ropivacaine would you used to do a caudal.

 - 3ml
 - 6ml
 - 12ml
 - 18ml
 - 24ml

Q19. which would give you paradoxical increase in BIS number  :- ketamine

 - nitrous oxide
 - propofol
 - thio
 - remi

Q33. 80yo female, for a repair of NOF #, systolic murmur. ECHO shows calcified aortic valve with peak flow velocity 4m/s. Using Bernoulli equation, what is the peak pressure?

a 16 mmHg
b 32 mmHg
c 48 mmHg
d 64 mmHg
e 80 mmHg

Q34. Patient is being treated for malignant hyperthermia. Active cooling should cease at what temperature?

a 34
b 35
c 36
d 37
e 38


Q115 along the lines of you are setting up a endoscopy suite the minimum number required for propofol sedation for endoscopy is

A 3 personnel With medical practitioner / dentist  giving sedation
B 3 personnel With proceduralist giving sedation
C 2 personnel with anaesthetist giving sedation
D 3 personnel With Anaesthetist giving sedation
E 4 personnel With Anaesthetist giving sedation

Q116 Something like: What volatile agent has the longest time to environmental degradation 

A Desflurane
B Sevoflurane
C Isoflurane
D Enflurane
E Halothane

Q103 - single most effective way to reduce risk of bacterial infection with Peripheral IV insertion

A. alcohol swipe the skin
B. chlorhex hand wash
C. sterile gloves
D. change cannula every 3 days
E.

Q104 - Patient 27/40 gestation, new hypertension 169/, best medication to start

A. Atenolol
B. Hydrochlothoazide
C. Labetolol
D. Prazocin 
E. E was def not Methydopa or Nifedipine

Q77. What is the osmolality of Glycine1.5% used for a TURP

150
200
250
300
350

Q78. What is the oxygen consumption equivalent to 4METS in a 40yo 

4-8ml/kg/min
8-12
12-16
16-20
20-24

Q59. To prevent transmission of CJD? Airway-contaminated equipment should be:

A. autoclaved
B. protected plastic covers
C. sterilise in ethylene oxide
D. 134degreesC for 3 min
E. thrown away

Q60. A patient is post op in PACU and complains of visual loss in the left temporal and the right nasal visual fields. Where is the lesion?

A. Optic chiasm
B. Rt optic tract
C. Rt optic nerve
D. Lt optic tract
E. Lt optic nerve

Q61. Repeat (verbatim) Co-phenylcaine spray accidentally gets in patient's eye. What will happen? Answer - mydriasis

Q62. You are anaesthetising a well patient for a LUSCS under spinal. After the baby is delivered, instead of giving syntocin, you give suxamethonium. What is the best term to describe this type of error?

A. Deviation
B. Slip
C. Mistake
D. Transgression
E. ?

Q63. A morbidly obese pt (BMI 50) is undergoing a NOF. You place a fascia illiaca block with 15mls of 0.75% ropivacaine, induce him, relaxant GA, ETT. When the patient is turned on his side, he desaturates, becomes bradycardic, hypotensive (~BP 80/50?) ETCO2 40s. What is the most likely diagnosis?

A. LA toxicity
B. Myocardial ischaemia (definitely said ischaemia and NOT infarction)
C. Anaphylaxis
D. Tension pneumothorax
E. Fat embolism

The above stem has been repeated many times, but this year they added the modifier of the patient being morbidly obese.


Q64. The nerve most commonly injured during a total knee joint replacement is:

A. Common peroneal
B. Tibial
C. Sciatic
D. Patellar branch of the saphenous
E. Lat cutaneous nerve of the thigh


Q75: Which ocular muscle is most often not paralysed with a peribulbar block

a: Superior orbital
b: medial rectus
c: lateral rectus
d: Inferior rectus
e: superior rectus


Q76: Very long stem on this one…. this is what I can remember: A 25 yo male presents to ED following a MVA with a fractured femur. He is haemodynamically stable on arrival and saturating well. He is given a total of 40mg of IV morphine for analgesia.  On subsequent review his oxygen saturations are now 90%, he is very drowsy and confused, and BP is 120/80. His initial CXR on arrival was normal. What is most likely to be the cause of his desaturation 

a: Opioid overdose
b: Pulmonary contusion 
c: Fat embolism syndrome
d: Pneumonia
e: Pneumothorax

Q9.   65 yr old male , with HT, Renal failure and Atrial Fibrillation, what is his CHADS2 Score?

 :      a)   0   :     b)    1    :    c)    2  :      d)    3    :     e)     4

Q10.    20 yr old male 80 kg  in a house fire sustained 25% burns. What is his fluid resuscitation using Parkland formula for the first 8 hours?

      a)    3 litres of 0.9% Saline

 :      b)   3 litres of colloid  :      c)   3 litres of Hartmans solution  :      d)    4 litres of 0.9% Saline

       e)    4 litres of Hartmans solution


Q11.     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


Q12.   (Cant remember the whole stem... )   But it was about the Lateral aspect of forearm being missed after an axillary nerve block       :        a ) Inferior trunk  :        b)   Radial 

         c)   Ulnar
         d)   Musculocutaneous
         e) Median n

Q142.   Normal cuff pressure in an ETT to avoid damage / schema  :        a)  20 cm H2O

         b )  30 cm H2O

 :         c)   40 cm H2O  :         d)   50 cm H2O

e) 50cmH2O

Q149. In Paediatric in-hospital arrest, defib energy for a 10 kg child is 

       a)  10 J

 :      b) 20 J   :     c) 40 J

      d)  100 J

 :       e) 200 J


Q46)  Cannot recal full question.  PFTs in a long term smoker who I think had a diagnosis of COPD but had restricitive/fibrotic tests (FEV1/FVC was 88%, FEV1 90% with reduced TLC and DLCO).

I think the answer was fibrosis

Q47) (repeat) How long does the PaCO2 take to reach a plateau following initiation of pneumoperitineum?:

A) <15mins
B) 15-30
C) 30-60
D) 60-90
E) >90

Q48) Best anaesthetic for patient with pulmonary hypertension is use of an ETT with PPV and

A) High dose opioids and O2 and N2)
B) Isoflurane and O2
C) Isoflurane and N20
D) Propofol and O2
E) Ketamine and O2

Q50) (repeat) Cannot recall full stem but Patient post THR who has had a PE.  On maximal medical therapy (aside frrom anti-coagulation) with escalating O2 requirements and poor sats.  Next treatment

A) Radiological pulmonary embolectomy
B) Thrombolitic
C) Anti-coagulation


Q51. Repeat question about trauma with suspected aorta rupture, it was clear the patient was stable, and what investigation to do, options were CT chest, TOE, aortogram


Q52. I think was new, ECG in a man who has taken a B-blocker overdose, looked like ?complete heart block rate around 30, patient was conscious and talking but felt dizzy?. Options were atropine, adrenaline, glucagon 5mg IV, isoprenaline or transcutaneous pacing.


Q41)   17 y.o girl with fontan for appendicectomy. Good LV function last week on echo. Takes aspirin and lisinopril. Post induction goes into AF at 150 and BP 60/30. Immediate management?

A) Adrenaline
B) Amiodarone
C) Adenosine
D) Phenylephrine
E) Defibrilation


Q42)   22 y.o male 4 weeks post complete spinal cord injury at T1. Least consistent with acute hyperreflexia?

A) Profound hypotension
B) AF
C) APO
D) Piloerection below T1

Q109.  65 yo, VATS for lower lobectomy. Needs one lung ventilation. Major risk factor for hypoxaemia:

A large central vs smaller peripheral lesion
B right sided surgery
C left sided surgery
D small alveolar-arterial oxygen gradient on two lung ventilation
E lateral vs supine positioning


Q110. Complications of oral bowel preparation (all except):

A. Acute kidney injury
B hepatic failure
C hyponatraemia
D myocardial ischemia
E seizures


Q84. Characteristics of flow meters is such that gas flow:

A) cannot be stopped by closing the knob if glass top chamber is broken
B) is measured accurately even when the flowmeter is tilted
C) Overestimates flow rate if connected to a high resistance device such as a nebuliser
D) The ball is lifted within the parallel sided tube in the flowmeter
E) Rate should be measured at the bottom of the ball


Q85. (Rpt) Staff suffers needlestick injury from a patient with known chronic hepatitis B.  Positive antibody titres. What should they receive?

A) Aciclovir
B) Hepatitis B vaccine boosters
C) Immunoglobulins
D) No treatment
E) Pegylated interferon

Q95. What are the clinical features associated with Horner's Syndrome

a) proptosis, miosis,  anhidrosis
b) proptosis, mydriasis, anhidrosis
c) ptosis, miosis, anhidrosis
d) ptosis, mydriasis, anhidrosis
e) ptosis, miosis, hyperhidrosis

Q96. Severe traumatic brain injury in infant in ICU. Minimum CPP aim should be:

a) 30
b) 40
c) 50
d) 60
e) 70


Q105: Propofol infusion syndrome includes all of the following EXCEPT

A: Hyperkalaemia
B: Hypertriglyeridaemia
C: Metabolic Alkalosis
D: Rhabdomyolysis
E: Arrthymias


Q106:  In patients with refractory elevated ICP, bilateral decompressive craniotomy is associated with reduction in ICP and also results in:

A: Shortened hospital stay
B: Shortened period of mechanical ventilation
C: No change in neurological outcome
D: Improvement in neurological outcomes
E: Improved overall mortality


Q108:  In preadmission clinic with a patient with a tracheostomy. To enable patient to talk you would

A: Deflate tracheostomy cuff, insert one way valve, insert penetrated piece
B: Deflate tracheostomy cuff, remove one way valve, insert fenestrated piece
C: Inflate tracheostomy cuff, remove one way valve, insert fenestrated piece
D: Inflate tracheostomy cuff, insert one way valve, insert fenestrated piece

Q57. Statistics question - NNT for a drug ('Nonimoto') for treatment of PONV? Rate of PONV with placebo is 36% and rate of PONV with drug is 12%.

4, 8, 12, 25, 36


Q42. (rpt) 32 year old male with recent respiratory tract illness presents with weakness in his legs and arms. Diagnosis?

a. Guillian barre
b. MS
c. Myasthenia gravis
2 others that were wrong


Q43. (new) A set of blood results. Hb 86, MCV 72, Fe levels were very low, transferrin was very low, ferriting was normal (190). What is the most likely diagnosis?

a. Fe Deficiency
b. Latent Fe Deficiency 
c. Acute phase response
d. Thallasemia 
e. ?


Q21. Hyperkalaemic patient with QRS beginning to widen.  What is the best initial therapy?  

a.    calcium gluconate
b.    frusemide
c.     salbutamol
d.    insulin
e.    resonium

  Q22. Female singer underwent GA with LMA.  Next day complains of voice/singing impairment.  What nerve is affected?  

a.    lingual
b.    hypoglossal
c.     glossopharyngeal
d.    recurrent laryngeal
e.    superior laryngeal

 

Q23. Patient with SAH. Opens eyes spontaneously, obeys commands but is confused.  Cannot move left limbs.  What WFNS grade is she?  

a.    1
b.    2
c.     3
d.    4
e.    5

 

Q24. Endocarditis prophylaxis for dental extraction needed for what history?  

a.    bileaflet aortic valve
b.    mitral valve prolapse
c.     mitral annuloplasty
d.    aortic valvuloplasty
e.    patch of VSD in childhood

 

Q110. Shelf life of platelets:

A.  5 days at 20-24 deg C
B. 14 days at 20-24 deg C
C. 35 days at 2-6 deg C
D. 42 days at 2-6 deg C
E. 12 months at…?


Q57. You perform an interscalene block for an adult patient. After injecting 2ml of 0.75% ropivacaine, the patient has a seizure. The most likely cause of this is inadvertent injection of local anaesthetic into the:

A. dural cuff
B. external jugular vein
C. internal carotid artery
D. internal jugular vein
E. vertebral artery


Q58. A new blood test has been developed to test for anaesthetic anaphylaxis. 100 volunteers are tested, and also have skin prick tests done, which are assumed to be the gold standard. The results are below.                                            Skin prick positive         Skin prick negative Blood test positive                        35                                   5 Blood test negative                      15                                    45 

What is the sensitivity of the blood test?

A. 66%
B. 70%
C. 75%
D. 87.5%
E. 90%


Q24 repeat NMS vs serotonin syndrome schizophrenic pt post op. Which supports serotonin syndrome..

A) confusion
B) elevated CK
C) elevated WCC
D) hypertonia 
E) myoclonus

Q125 repeat  Laser tube

A) both in any orde
B) both distal then proximal
C) both proximal then distal
D) proximal only and leave distal for backup
E) distal only and leave proximal for backup

Q126 repeat NAP4 showed in ICU biggest cause of airway problem

A) barotrauma
B) ETT blocked
C) tracheostomy dislodged
D) bleeding post-trache insertion
E) aspiration

Q127- (new) New expensive drug. Hospital restricts use to particular clinical situations due to the expense. The hospital states that free use of this drug would mean that other drugs will not be able to be used. This is an example of:

Autonomy
Beneficence
Fiselity
Non-malificence
Utility

:No numbers:

rpt: What is best position to place patient with VAE?

new: What size cannula comes with the EZ-IO gun?

a. 14g
b. 15g
c. 16g
d. 17g
e. 18g

rpt: ECG with irregular rhythm and broad complexes followed by t waves. No visible p waves. Looked like a LBBB pattern in V1. Dx?

a. AF with BBB
b. Sinus tachy with BBB
c. VF
d. VT
e. Torsades de Pointes

rpt: Terrible quality lateral CXR. Could see the left diaphragm + gas bubble but not the right diaphragm. Maybe something just above it. The top half was all black with a clear demarkation line and nothing visible at all.

a. Right lower lobe consolidation
b. Right middle lobe consolidation
c. Left lower lobe consolidation
d. Artifact from pts arm
e. Pleural effusion

new: The QT interval is measured from where to where? (had a picture of an ECG with markings on start of QRS, start of R wave, start of p wave, end of T wave. Had to choose the answer that corresponded)

new: What is the sensitivity of the following test? (Gave you a 2x2 table with values in each one. Was very easy to work out)

rpt: Laserflex tube. How should you inflate the cuffs?

a. Proximal only. Distal left deflated in case proximal ruptured
b. Distal only. Proximal left deflated in case distal ruptured
c. Any order
d. Proximal then distal
e. Distal then proximal

rpt: Question on man getting punched in the throat. Sore throat, quiet voice, some dyspnoea. Able to lie flat. What is your next management?

a. Soft tissue xray of neck to exclude thyroid cartilage and hyoid fractures
b. Nasendoscopy by ENT
c. CT scan
d. Direct laryngoscopy and intubation after gas induction
e. Awake trache

new: 20 year old previously well lady in a motor vehicle accident arrives to trauma ED. What is the most appropriate test to diagnose ruptured thoracic aorta?

a. Chest xray
b. CT angiogram
c. Angiogram of aorta
d. MRI
e. TOE

New: Glenn shunt inserts from where to where? (can't recall the options)

New: what is the nerve that is injured the most following primary total knee replacement?

a. Common peroneal
b. Sciatic
c. Infrapatellar branch of saphenous
d. Lateral cutaneous nerve of thigh
e. ? (something else wrong)

New: What gives the highest risk of TRALI post transfusion of FFP?

a. Male donors
b. Female donors of child bearing age
c. ?
d. ?
e. ?

Rpt but with new options: What is not present with propofol infusion syndrome?

a. metabolic alkalosis
b. hyperlipidaemia
c. Enlarged liver
d. rhabdomyolysis
e. hyperkalaemia

New: 80 year old man with accidental overdose of metoprolol. Gave you a whole lot of other information on the stem that was irrelevant then showed an ECG with a HR of 30bpm and narrow complexes. P waves were VERY hrad to see (poor quality + smallish ECG) but I'm pretty sure where there with a 1st degree HB. What is the next best treatment?

a. Atropine 600mcg
b. Transvenous pacing
c. Transcutaneous pacing
d. Isoprenaline
e. Adrenaline 10mcg bolus

Rpt: Picture of axillary nerve block. Musculocutaneous labelled 1, Radial labelled 2, Ulnar labelled 3, Median labelled 4. What combination is needed for operation on lacerated index finger?

a. 1 and 2
b. 1 and 3
c. 2 and 3
d. 3 and 4
e. 1 and 4

Gillick case legally refers to what in the context of consent?

A. Minors having enough understanding and competency to provide consent
B. Capacity to consent in dementia patients
C.?

Tracheal narrowing % before UAO picture manifests on spirometry?

A. 20%
B. 35%
C. 50%
D. 60%
E. 80%

Use of powerboards and extension cords renders what safety feature innefective?

A. Equipotential earthing
B. RCDs
C. Isolated line supply
D. Line isolation monitors
E. Something else clearly wrong

Machine check passed so far, now performing bulb test on CGO, bulb fails to stay collapsed the required 10s. What is most likely cause?

A. Oxygen cylinder connection leak
B. Broken flow meter
C. Vaporiser not correctly seated on backbar
D. Inspiratory valve broken
E. Something about the breathing circuit

Dual chamber PPM. What mode would you expect with magnet application ?

A. AOO
B. VOO
C. DOO
D. VVI
E. AAI


A patient has anaphylaxis and has positive skin prick test to Rocuronium. She has a negative skin prick test to Atracurium, Vecuronium and Suxamethonium. Which agent is she least likely to react to on subsequent anaesthetics?

Mivacurium
Atracutiurm
Suxamethonium
Vecuronium
Pancuronium


Which compound in cough medicine is most likely to cause anaphylaxis to subsequent aminosteroidal neuromuscular blockers?

A) Pholcodine


New: 80 year old man with accidental overdose of metoprolol. Gave you a whole lot of other information on the stem that was irrelevant then showed an ECG with a HR of 30bpm and narrow complexes. P waves were VERY hrad to see (poor quality + smallish ECG) but I'm pretty sure where there with a 1st degree HB. What is the next best treatment?

a. Atropine 600mcg
b. Transvenous pacing
c. Transcutaneous pacing
d. Isoprenaline
e. Adrenaline 10mcg bolus


Patient receives packed red blood cells. 1 hour later becomes hypoxic, febrile, higher airway pressure and copious frothy sputum.

ABO incompatibility
Sepsis
Transfusion related overload
Transfusion related acute lung injury
Transfusion related ?sepsis



Which electrical safety device in theatre is rendered useless by the use of power extension cord and power boards?

A)Equipotential earthing
B) Residual current devices
C) Line isolation monitor
D) Isolated circuit
E) circuit breaker


Antiphospholipid syndrome and pregnancy, which condition isn’t associated with APS?

Hyperthyroidism
Recurrent early miscarriage
Valvular heart disease
Pregnancy induced hypertension
Venous thromboembolism


Lateral XR with white opacity in lower lobe, clearly delineated by oblique fissure, what is it?

Loculated effusion
artefact from patients arm
Right middle lobe consolidation
Right lower lobe consolidation
Left lower lobe consolidation


How long do you have to sort Ticagrelor prior to neuraxial anaesthesia

A)1-2days
B) 2-4 days
C) 5-7 days
D)


Pregnant patient arrested. According to American heart association guidelines, what is the longest time that resuscitation should proceed for until you should perform a perimortem caesarean delivery?

4mins
5mins
6 mins
7 mins

Why shouldn’t you give a COX inhibitor in a 30/40 pregnant patient

ARF
APH
Closure of foetal ductus arteriosus
pre-eclapmsia
pre-term

Picture of a CTG with late decelerations (not labeled as such but had to interpret). Cause:

head compresion
cord compression
uteroplacental insufficiency


For a shockable rhythm what is the recommended joules for a 10kg child? 

A. 10J
B. 20J
C. 40J
D. 60J
E. 80J



You give suxamethonium when you were meaning to give syntocinon after delivery of baby a c section. What kind of error is this? 

A violation
B lapse
C mistake
D slip
E diversion

A patient has come in with TCA overdose. Wide QRS on ecg. How do you treat them? 

A calcium glauconite
B bicarbonate 
C lignocaine 
Can't remember the other options

With a blood transfusion which is the highest risk 

A hep a
B hep b
C hep c
D hiv 1
E hiv 2

Baby delivery after c section. Blue and HR dropped from 140 to 90. No sats given.  What do you do? 

A intubate
B positive pressure mask ventilate
C nothing
D dry and stimulate 


You see a patient in the pre-op clinic. He is on propranolol for treatment of long QT syndrome. Which of the following will give the best reassurance that his treatment is effective?

a. normal QT interval on resting ECG
b. no change in QT interval with valsalva
c. HR less than 60
d. no arrhythmias on 24h holter monitor

Acute intermittent porphyria, signs except: 

abdominal pain 
hypotension 
confusion 
tachycardia 
peripheral neuropathy


What symptoms are consistent with post op cognitive decline:

- decreased short term memory
- decreased Executive function
- delirium
- high sedation scores

Gillick case legally refers to what in the context of consent?

A) Minors having adequate understanding of the nature and consequences of a treatment enabling them capacity to give consent 
B) You cannot give pre-medications prior to signing a consent
C) Anaesthetist should be the person obtaining an anaesthetic consent
D) Elderly patient must not be delirious when giving consent
E) Appropriate consent for a labour epidural

Tracheal narrowing % before UAO picture manifests on spirometry?

A. 20%
B. 35%
C. 50%
D. 60%
E. 80%

Use of powerboards and extension cords renders what safety feature innefective?

A. Equipotential earthing
B. RCDs
C. Isolated line supply
D. Line isolation monitors
E. Something else clearly wrong


Machine check passed so far, now performing bulb test on CGO, bulb fails to stay collapsed the required 10s. What is most likely cause?

A. Oxygen cylinder connection leak
B. Broken flow meter
C. Vaporiser not correctly seated on backbar
D. Inspiratory valve broken
E. Something about the breathing circuit


Dual chamber PPM. What mode would you expect with magnet application ?

A. AOO
B. VOO
C. DOO
D. VVI
E. AAI


NAP5 found that the risk factors of awareness included all except:   :- Age  : Emergency surgery  :- ASA score  :- use of muscle relaxants  :- Obesity


A patient requires index finger surgery. Which of the labelled structures (1-4) is required to be blocked for anaesthesia? Shown below is an US of the axillary with labels for triceps and crocobrachialis and bicep shown. The structures 1-4 correspond to the the nerve branches: musculocutaneous - 1, ulnar - 4, median -2  and radial - 3.    options were a combination of two nerves



A patient comes to ED with amitriptyline poisoning. The ECG shows QRS widening. What is the best drug to treat this?

 - Atropine

 :- adrenaline 

 - amiodarone
 - Ca Gluconate
 - Sodium bicarbonate

A child is being treated with chemotherapy for leukaemia. Comes for surgery and required PONV prophlaxis. What is the best agent?

 - Dexamethasone
 - ondansetron
 - droperidol
 - metoclopramide


What happens to the BIS in the first 5 minutes when suxamethonium is given to an AWAKE person? 

 - decrease
 - increase 
 - decrease then increase
 - increase then decrease
 - nothing


Q56. What protective mask to wear in laparoscopy for patient with desseminated TB

N95
P99
R95
None
Surgical mask


Others:

1. (Repeat) Patient has numbness over anterolateral aspect of thigh after delivery with neuraxial block. No motor involvement. What is most likely injured?
A) Femoral
B) Lateral cutaneous nerve of thigh


Methylene Blue reacts with

A: Oxybutynin
B: Fluoxetine 
C: Prazosin
D: Droperidol
E: Risperidone


new: What size cannula comes with the EZ-IO gun?

a. 14g
b. 15g
c. 16g
d. 17g
e. 18g


rpt: ECG with irregular rhythm and broad complexes followed by t waves. No visible p waves. Looked like a LBBB pattern in V1. Dx?

a. AF with BBB
b. Sinus tachy with BBB
c. VF
d. VT
e. Torsades de Pointes


rpt: Terrible quality lateral CXR. Could see the left diaphragm + gas bubble but not the right diaphragm. Maybe something just above it. The top half was all black with a clear demarkation line and nothing visible at all. 

a. Right lower lobe consolidation
b. Right middle lobe consolidation
c. Left lower lobe consolidation
d. Artifact from pts arm
e. Pleural effusion


new: The QT interval is measured from where to where?  (had a picture of an ECG with markings on start of QRS, start of R wave, start of p wave, end of T wave. Had to choose the answer that corresponded)


new: What is the sensitivity of the following test? (Gave you a 2x2 table with values in each one. Was very easy to work out)


rpt: Laserflex tube. How should you inflate the cuffs?

a. Proximal only. Distal left deflated in case proximal ruptured
b. Distal only. Proximal left deflated in case distal ruptured
c. Any order
d. Proximal then distal
e. Distal then proximal


rpt: Question on man getting punched in the throat. Sore throat, quiet voice, some dyspnoea. Able to lie flat. What is your next management?

a. Soft tissue xray of neck to exclude thyroid cartilage and hyoid fractures
b. Nasendoscopy by ENT
c. CT scan
d. Direct laryngoscopy and intubation after gas induction
e. Awake trache


New: Glenn shunt inserts from where to where? (can't recall the options)


New: what is the nerve that is injured the most following primary total knee replacement?

a. Common peroneal
b. Sciatic
c. Infrapatellar branch of saphenous
d. Lateral cutaneous nerve of thigh
e. ? (something else wrong)


New: What gives the highest risk of TRALI post transfusion of FFP?

a. Male donors
b. Female donors of child bearing age
c. ?
d. ?
e. ?
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