MCQ-Complications

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Finals Black Bank | Primary Physiology Black Bank | Primary Pharmacology Black Bank

This section is now split across 2 pages:
Complications-MCQs 1-100 (here) | Complications-MCQ 101-200


AC01a ANZCA version [2004-Aug] Q138, [2005-Apr] Q81, [Mar06] [Jul06] [Jul07]
Features of the transurethral resection of the prostate (TURP) syndrome include a11 of the following EXCEPT
A. agitation
B. angina
C. bradycardia
D. nausea
E. tinnitus

AC01b
Which of the following is likely to be caused by water intoxication during transurethral resection of the prostate?
A. Hypertension
B. Nausea
C. Confusion
D. Headache
E. Convulsions


AC02 A patient having a TURP under spinal anaesthesia starts behaving strangely. Causes include:
1. Irrigation of bladder with hypotonic fluid
2. Local anaesthetic toxicity
3. ?
4.

AC02b ANZCA version [2001-Apr] Q101 (Similar question reported in [Mar00] [Jul00])
The use of large quantities of isotonic non-electrolyte solution for irrigation during prolonged transurethral resection of the prostate often results in
1. hyponatraemia
2. haemolysis
3. haemodilution
4. hyperkalaemia


AC03 [1986] [1988] [1989] [Mar90] [Mar93] [Apr96] [Aug96]
Glycine, if absorbed into the circulation in large amounts during trans-urethral prostatic surgery, may cause:

A. Hyperphosphataemia
B. Nausea and vomiting
C. Disseminated intravascular coagulation
D. Anuria
E. Temporary blindness


AC04 [1989] Patient having TURP becomes restless, dyspnoeic and hypertensive. Which test would be most useful?

A. Haematocrit
B. Arterial blood gases
C. Sodium
D. Plasma Hb

AC04b [Aug92]
The most rapid way of assessing the cause of confusion following spinal anaesthesia for TURP:
A. Serum Na+
B. Osmolality
C. Blood gases
D. Haemoglobin
E. ?


AC05 [Mar90]
A patient having a thoracotomy for carcinoma of the lung (2.5 hour procedure) is given a premed of 10 mg Morphine and 7 mg Droperidol. Anaesthesia is maintained with 45 mg Curare, N2O/O2 = 4/2. After reversal with 2.5 mg Neostigmine and 1.2 mg Atropine, he does not breathe. This could be due to:
A. Myaesthenic syndrome
B. Decreased pCO2 because of hyperventilation
C. Inadequate Neostigmine
D. Droperidol


AC06 [1985] [1986] [1987] [1988] [1989] [Mar90] [Sep90] [Mar91] [Aug91] [Mar92] [Aug93]
A 35 year old woman with a three day history of abdominal pain has a laparotomy with a gangrenous appendix being found. She received Thiopentone 300 mgs, Fentanyl 200 mcg, dTC 30 mgs, Nitrous oxide and the operation lasted one hour. Postoperatively there is inadequate reversal after Neostigmine 2.5 mgs and Atropine 1.2 mgs. The most potent likely cause of this is:
A. PaCO2 60mmHg
B. K+ 2.9 mmol/L
C. Rectal temperature of 34C
D. Overdose of d-tubocurarine
E. Perioperative urine output of 5 mls


AC07 [1986]
For the above mentioned patient, the best resuscitative measure is:
A. Thiobarbiturate
B. ?
C. Colloid +/- crystalloid
D. Magnesium
E. None of the above


AC08 [1987]
The initial treatment of oculocardiac reflex is:
A. Deepen anaesthesia
B. Retrobulbar block
C. IV lignocaine
D. Carotid sinus pressure


AC09
Immediate treatment of oculocardiac reflex is:
A. IV atropine
B. Deepen anaesthesia
C. Beta-blocker
D. Stopping muscle traction
E. Retrobulbar block


AC10 [1985] [Mar90] [Jul00] (type A)
Oculocardiac reflex:
A. Deepening anaesthesia abolishes the reflex
B. Requires intact III, IV and VI nerves
C. Can be abolished by IV Atropine (OR: Can be attenuated by IV atropine adinistration prior to surgery)
E. All of the above


AC11 [Mar94] [Aug99] (type A)
The oculocardiac reflex is:
A. More common with LA than GA
B. Caused by retrobulbar block
C. Caused by pulling on medial rectus muscle
D. Most commonly caused by pulling on lateral rectus muscle
E. Not in children


AC12
The oculocardiac reflex is enhanced by:
A. Traction on the medial rectus muscle
B. Adrenaline injected into the lacrimal sac
C. Pressure on the eyeball
D. More common over twelve years of age


AC13 [Apr97] [Aug99]
The following methods can be used to prevent postoperative hypoxia in patients having upper abdominal surgery:
A. Avoid hyperventilation and hypocarbia
B. IPPV with PEEP
C. Sit up postoperatively
D. Continuous epidural postoperatively
E. Increased inspired oxygen
F. Forced expiration exercises


AC14
Causes of postoperative hypoxaemia:
A. Diminished tidal volume
B. Posture
C. Inspired oxygen concentration
D. Hypercarbia


AC15 [Apr99]
Postoperative hypoxaemia may be reduced by:
A. Epidural analgesia
B. PEEP
C. Narcotic analgesia
D. IPPV with intermittent sighs of twice tidal volume
E. None of the above work


AC16 [Jul98]
Postoperative diffusion hypoxia is associated with:
A. Prolonged operation with N20
B. High concentrations of N20
C. Low cardiac output
D. Postoperative hypoventilation


AC17
Hypoxaemia may be relieved by assisted ventilation with:
A. Rapid early inspiratory phase
B. Steady rise in inspiratory pressure
C. Inspiratory phase of less than one second
D. PEEP


AC18a
Bronchospasm may be induced in the asthmatic patient by:
A. Suxamethonium
B. Intubation
C. Tubocurarine
D. Halothane
E. Opiate premed

AC18b ANZCA version [2002-Aug] Q68, [2004-Apr] Q85, [2004-Aug] Q98, [Jul06] [Apr07] (Similar question reported in [Jul98] [Apr99])
When providing general anaesthesia to a patient with a history of asthma
A. thiopentone should not be used as it may cause bronchospasm
B. intravenous and topical tracheal lignocaine are equally effective in preventing bronchial hyperreactivity
C. ketamine provides little benefit in a patient with active wheezing
D. induction with propofol is effective in reducing the incidence of wheezing following intubation
E. isoflurane is as effective a bronchodilator as halothane when given in MAC equivalent doses


AC19
In asthmatic patients having anaesthesia, the most significant factor in bronchospasm production is:
A. Thiopentone
B. Suxamethonium
C. Intubation
D. Opiate premedication


AC20
Cause of generalised convulsions 20 minutes postop:
A. Pre-existing Grand mal epilepsy
B. Local anaesthesia with lignocaine
C. Enflurane
D. Intraoperative use of vasoconstrictors
E. Post intracranial surgery


AC21
Effects of hypothermia include:
A. Increase in blood sugar level
B. Oxygen dissociation curve moved to the right
C. Increase in stroke volume
D. Decrease in serum potassium


AC22a Black Bank version [1989] [Mar94] [Aug94] [Mar95] [Aug95]
Effects of hypothermia at 25C:
A. Hyperglycaemia
B. Oxygen consumption is decreased by greater than 50%
C. Cerebral blood flow is decreased by 25%
D. Coronary blood flow is decreased
E. Increased coagulability of blood
F. Decreased viscosity
G. Increased BSL
H. ? Decrease in K+

AC22b Black Bank version [Aug91] [Mar92] [Aug93]
Whole body hypothermia to 29C:
A. Increase gas solubility in blood
B. ST depression
C. Decrease in stroke volume
D. Ventricular fibrillation
E. ?Decreased urine output

AC22c Black Bank version [Aug99] [Mar00] [Jul00]
What is NOT an effect of hypothermia in the elderly?
A. Hypoglycaemia
B. Increased metabolic rate
C. Increased viscosity
D. Increased coagulability
E. Hypotension
F. Increased effect of volatile agents

AC22d ANZCA version [2001-Apr] Q11, [2003-Aug] Q113, [2004-Apr] Q2
Induced hypothermia to below 30C
A. decreases blood viscosity
B. decreases the transfer of oxygen from blood to the tissues
C. decreases the solubility of oxygen in arterial blood
D. produces systemic vasodilation
E. will produce amnesia

AC22e ANZCA version [2002-Aug] Q34
Detrimental effects of hypothermia associated with general anesthesia in the elderly do NOT include
A. reduced elimination of anaesthetic agents
B. prolonged awakening
C. increased body metabolism
D. hypercoagulability
E. shivering

AC22f ANZCA version [2003-Apr] Q114
A fall in core temp from 37 to 34 degrees causes:
A. decrease arterial blood pressure
B. decrease blood glucose level
C. decrease blood viscosity
D. impair platelet adhesion
E. increase blood potassium concentration

AC22g ANZCA version [2002-Aug] Q98
Peri-operative hypothermia in the elderly is associated with
A. an increase in post-operative cardiac morbidity
B. no change in the risk of infection
C. a decrease in the circulating noradrenaline concentration
D. a decrease in hospital stay
E. a decrease in blood loss during hip replacement surgery

AC22h ANZCA version [2002-Mar] Q145
Problems of hypothermia in the post-operative patient include
1. coagulopathy
2. prolonged drug action
3. metabolic acidosis
4. hypovolaemia


AC23 [1987] [1989] [Aug93]
A 20 year old male with 50% burns presents 2 weeks later for laparotomy for sepsis:
A. Behaves as if there were an increased number of receptors
B. d-Tubocurarine 3 mg will decrease muscle fasciculation
C. ?
D. Suxamethonium will cause hyperkalaemia


AC24
A patient who sustained 40% burns 3 weeks previously, presents with peritonitis presumed to be due to a perforated appendix. He has a serum K+ of 6.0. You would:
A. Proceed immediately with anaesthesia
B. Commence a dextrose-insulin infusion
C. Dialyse the patient
D. Correct the hyperkalaemia, then proceed with a standard crash induction
E. Delay surgery until the potassium level was normalised


AC25 [1988] [Mar95]
Burns 40%, 10 days old, with acute peritonitis for emergency surgery, K+ = 6.5 mmols/L:
A. Postpone the operation till K+ is lowered
B. IV insulin and glucose
C. IV bicarbonate
D. Rectal resonium


AC26 [1988] [Sep90] [Aug93]
A 25 year old female on induction was noted to have a BP of 45mmHg systolic, so the obstetrician quickly opened the abdomen and clamped the bleeding ectopic pregnancy. The ECG showed an SVT with a heart rate of 180 bpm. Apart from rapid IV infusion, the other treatment is:
A. Neosynephrine (Metaraminol on Aug 93 paper)
B. Verapamil
C. Propanolol
D. Lignocaine
E. Dopamine


AC27 ANZCA version [Apr 2004] Q39 (Similar question reported in [Aug91] [Mar92] [Aug93])
The congenital arterial abnormality of the upper limb which is most likely to lead to accidental arterial puncture at the antecubital fossa is:
A. High bifurcation of the brachial artery
B. Superficial radial artery
C. Superficial ulnar artery
D. Ulnar recurrent artery
E. Radial recurrent artery


AC28
A patient becomes flaccid, pale, hypotensive and bradycardic in which of the following conditions:
A. In the dental chair
B. Old patient having halothane
C. Both A and B
D. Neither A nor B


AC29
During bronchoscopy to remove foreign body, a 2 year old gets bradycardia. Immediate treatment:
A. Hyperventilation
B. Atropine
C. Lighten anaesthesia
D. Deepen anaesthesia
E. Remove bronchoscope and ventilate with 100% O2


AC30
Arrhythmias on intubation are caused by:
A. Suxamethonium
B. Hypertension
C. Sympathetic activity
D. Parasympathetic reflex


AC31
On intubation the commonest finding is:
A. Tachycardia and hypertension
B. Bradycardia and hypotension
C. Tachycardia and hypotension
D. Bradycardia and hypertension


AC32 [1988] [1989] [Mar90] [Aug91] [Mar92] [Aug92] [Mar93] [Aug93]
Nerve lesions developing after abdominal & pelvic surgery. Predisposing factors:
1. High porphobilinogen levels in the urine
2. Nerves passing through areas banded by tight ligaments
3. Glucose intolerance
4. Nerves close to bony surfaces
5. Anti-Trendelenburg


AC33 ANZCA version [2003-Aug] Q100
Intraocular pressure may be increased by all of the following EXCEPT:
A. Anticholinergic agents applied directly to the eye
B. Hyperventilation
C. Hypoxia
D. Laryngoscopy
E. Peribulbar block

AC33 Black Bank version [1988] [Mar91] [Aug91] [Aug93]
Intraocular pressure is increased by:
A. Hypercarbia / ?hypoventilation
B. Hypoxia
C. Suxamethonium following pretreatment
D. Intubation following local anaesthesia of the airway
E. Ketamine

AC33b ANZCA version [2002-Aug] Q134 & [2004-Apr] Q132
The drug most likely to cause an increase in intraocular pressure is
A. Ketamine
B. Propofol
C. Thiopentone
D. Diazepam
E. Etomidate


AC34
The use of acetazolamide in open eye injury is contraindicated in the presence of:
A. Hyponatraemia
B. Acidosis
C. Allergy to Sulphonamide
D. Epilepsy


AC35
Following prolonged tracheal intubation, a granuloma of a vocal cord may develop. Its usual site is:
A. Arytenoid cartilage
B. Anterior 1/3 of the cord
C. Middle 1/3 of the cord
D. Posterior 1/3 of the cord
E. False cord


AC36
Which of the following are possible causes of postoperative oliguric renal failure?
A. Acute tubular necrosis
B. Hypokalaemia
C. Haemorrhage
D. Methoxyflurane
E. All of the above

AC36b [Aug99] (type K)
Causes of postoperative oliguric renal failure?
1. Acute tubular necrosis
2. Ketorolac
3. Papillary necrosis
4. Sevoflurane


AC37
A patient with rheumatic valvular disease is admitted for dental treatment and is allergic to penicillin. The drug of choice is:
A. Tetracycline
B. Methicillin
C. Erythromycin
D. Chloramphenicol
E. Sulphonamides


AC38 [1989] [Mar90] [Mar93]
Typical ECG changes seen during hypothermia include:
A. Atrial fibrillation
B. Prolonged QTc interval
C. Delta waves
D. Complete heart block
E. Tall T waves


AC39 [Sep90] [Mar92]
During anaesthesia, pressure on nerve can cause the following EXCEPT:
A. Wrist drop
B. Claw hand
C. Foot drop
D. Faecal incontinence
E. Diplopia


AC40 [Mar91] [Aug91] [Apr97]
A 65 year old man on induction has 3mm ST depression on ECG. BP 60/40 & heart rate 100/min. Best treatment is:
A. Metaraminol
B. GTN infusion
C. Esmolol
D. Phenylephrine
E. SNP


AC41 ANZCA version [2001-Apr] Q21 (Similar question reported in [Mar91] [Aug91])
A patient with idiopathic hypertrophic subaortic stenosis becomes hypotensive following induction of anaesthesia. An acceptable therapeutic regime would be
A. calcium chloride by bolus injection
B. isoprenaline by infusion
C. dopamine by infusion
D. nitroglycerine by infusion
E. phenylephrine by bolus injection


AC42 [Mar92]
Most common cause of delay in discharge of a patient from a Day Surgery Unit:
A. Hypotension
B. Weakness
C. Dizziness
D. ?
E. Post-operative nausea & vomiting


AC43 [Mar92] [Aug95]
The use of 1.5% glycine for bladder irrigation:
A. Glycine is excreted by the kidney
B. Glycine is metabolised to pyruvate, lactate & other amino-acids
C. Is not isotonic
D. ?

AC43b ANZCA version [2002-Mar] Q97, [2003-Apr] Q12, [2005-Sep] Q8
Glycine solution (1.5%) used for irrigation during transurethral prostatectomy (TURP) is
A. slightly hypertonic
B. associated with blindness due to neurotoxicity
C. metabolised to glucose
D. a cause of central pontine demyelination if the plasma sodium concentration falls below 120 mmol.l-1
E. a cause of significant haemolysis on absorption

AC43c ANZCA version [2002-Aug] Q107
Glycine, if absorbed into the circulation in large amounts during transurethral prostatic (TURP) surgery, may cause any of the following EXCEPT
A. an elevated serum ammonia
B. hyponatraemia
C. disseminated intravascular coagulation
D. restlessness
E. temporary blindness


AC44 [Aug92]
Response to intubation:
A. Rise in PCWP
B. Is prevented by local anaesthesia of the airway
C. ?
D. ?


AC45 [Aug92] [Mar95]
Postoperative cardiac morbidity/mortality is increased with which one of the following:
A. Hypertension
B. CCF
C. MI > 1 year previously
D. ?
E. ?


AC46 -Deleted : same question as PI08


AC47 [Mar93] [Aug93] [Mar94]
Atelectasis in healthy patients with normal lungs during general anaesthesia:
A. Incidence of approximately 50%
B. Is not usually eliminated by PEEP of 10 cms H2O
C. Is readily detected on CT scan
D. Is greater with an inspired O2 concentration of 100% compared to 40%
E. Always prevent with tidal volume of 15 mls/kg

AC47b [Jul98] [Apr99]
Best way to prevent intraoperative atelectasis:
A. 10 cm PEEP
B. Intermittent sighs (x2 tidal volume)
C. Preoperative oxygenation
D. ?
E. None of the above


AC48 [Mar93]
Recognised features of masseteric muscle spasm following administration of suxamethonium do NOT include:
A. Occurrence in normal healthy patients
B. A duration (if it occurs) of 40-60 seconds after fasciculations wear off
C. Optimal intubating conditions (following a dose of 1 mg/kg) 20-30 seconds after fasciculations wear off
D. Poor correlation between the dose of suxamethonium and the magnitude of increased jaw tone

AC48b [Mar94]
Jaw stiffness with suxamethonium:
A. Normal response to use of sux
B. Worse in adults compared to children
C. Depends on sux dose
D. Usually does not cause problems with intubation
E. ?


Previous AC49a - renumbered as AA02a


Previous AC49b - renumbered as AA02b


AC50 [Mar93] [Aug95]
The immediate management of sudden difficulty in inflating the lungs following induction of general anaesthesia and intubation of the trachea should always include:
A. Diagnostic manoeuvre(s) to distinguish a patient cause as distinct from an equipment cause
B. Establishment of a definitive cause if bronchospasm is present
C. Discontinuation of all inhalational and intravenous anaesthetic agents
D. Administration of salbutamol rather than adrenaline if bronchospasm is present


AC51 [Aug93]
Junctional rhythm occurring during anaesthesia is commonly associatedwith:
A. A fall in BP
B. Halothane used with pancuronium
C. Abolished by a small dose of beta-blocker
D. Caused by a small dose of atropine


AC52 [Aug93] [Mar94]
The characteristic early indication of oesophageal intubation is:
A. Absent breath sounds bilaterally
B. Lack of symmetrical chest movement
C. Falling oximeter saturation
D. Unable to get a good seal with the cuff
E. None of the above


AC53 [Mar94] [Aug95]
The most common nerve lesion occurring under general anaesthesia is:
A. Lateral cutaneous nerve of the thigh
B. Common peroneal nerve
C. Median nerve
D. Ulnar nerve
E. Brachial plexus


AC54 [Mar94]
Assessment of mental function post-GA is not influenced by:
A. Gender
B. Time of day
C. Prolonged bed rest
D. Familiarity with test


AC55 [Mar94]
Memory testing post-GA:
A. Picture recall
B. Flicker fusion test
C. Maddox wing test
D. P deletion test
E. ...??.... reaction time


AC56 ANZCA version [2001-Apr] Q3 (Similar question reported in [Mar94] [Mar00] [Jul00])
The Visual Analogue Scale for assessment of post-operative pain
A. is considerably less reliable if the line is less than 50mm long
B. is best used as a once-only measurement after the surgical procedure
C. gives best results if the patient is instructed to make one clear mark parallel to the line
D. should be used 60 minutes after each administration of an analgesic
E. should have indicator marks at one quarter, one half and three quarters of the scale


AC57 [Mar94] [Mar95]
The initial sign of abscess:
A. Back pain
B. Fever
C. Paralysis
D. Headache
E. Sudden onset sensory deficit


AC58 [Aug94] [Apr97]
A 65 year old man with severe COAD undergoes an urgent laparotomy. During the procedure his saturation falls from 93% to 83% and breath sounds could not be heard on the left side and there was an audible wheeze on the right. The first thing you would do:
A. Suck out the ETT
B. Readjust the ETT
C. Insert an intercostal catheter drain
D. Start a salbutamol infusion
E. ?


AC59 [Aug94] [Mar95] [Aug95]
With an air embolus occurring during neurosurgery:
A. Leave supine
B. Consider hyperbaric oxygen therapy
C. Give IV fluids rapidly
D. Give lignocaine if cardiac arrhythmias persist


AC60 -renumbered as AA03


AC61 [Aug94]
Aspiration. What has been shown to NOT be of benefit:
A. ?
B. CPAP
C. Ventilation
D. Corticosteroids
E. ?Physiotherapy


AC62a ANZCA version [2001-Aug] Q90, [Jul06] [Apr07] Q5 (Similar question reported in [Aug94] [Aug96] [Jul98] [Mar00])
The most commonly reported cause of awareness during general anaesthesia for a non-obstetric procedure is
A. inadequate intra-operative opiate analgesia
B. equipment failure
C. the use of total intravenous anaesthesia
D. faulty anaesthetic technique
E. use of a laryngeal mask airway

AC62b ANZCA version [2003-Apr] Q144, [2004-Apr] Q98 & [2004-Aug] Q44
The most commonly reported cause of awareness during general anaesthesia for a non-obstetric procedure is
A. Equipment failure
B. Human error
C. Lack of premedication
D. Recreational drug use
E. Use of total intravenous anaesthesia

AC62c [Mar95] [Aug95]
Majority of reported cases of unprompted awareness:
A. Failure to check machine
B. Equipment failure
C. Deliberate due to patient’s condition
D. Spurious claim by patient
E. Faulty anaesthetic technique

AC62d [Jul98] [Apr99]
Awareness risk greatest in:
A. ?
B. ?
C. ?
D. Air/O2 + 2% enflurane

AC62e ANZCA version [2001-Apr] Q32 (Similar question reported in [Jul00])
The clinical sign which has the highest correlation with awareness in a spontaneously breathing patient under general anaesthesia is
A. patient movement in response to a stimulus
B. an increase in blood pressure and heart rate
C. increased lacrimation and sweating
D. pupillary dilation
E. an increase in respiratory rate


AC63a [Mar95] [Apr97] [Jul98]
The commonest cause of maternal death in the CEPOD study was:
A. Gastric aspiration
B. Difficult intubation
C. Ventilator disconnect
D. Equipment malfunction
E. High spinal after epidural topups

AC63b ANZCA version [2001-Aug] Q44
In Australia the current leading cause of direct maternal mortality is
A. post-partum haemorrhage
B. pre-eclampsia and eclampsia
C. embolism
D. sepsis
E. complications of anaesthesia

AC63c ANZCA version [2001-Apr] Q79, [2003-Apr] Q93, [2003-Aug] Q2
In Australia the current leading cause of direct maternal mortality is
A. Cardiac disease
B. Complications of anaesthesia
C. Embolism
D. Pre-eclampsia and eclampsia
E. Post-partum haemorrhage


AC64 [Mar95]
Incidence of sore throat associated with ETT:
A. 80%
B. 50%
C. 30%
D. 10%
E. 5%


AC65 [Mar95] [Apr96] [Aug96] [Aug99]
A patient having a carotid endarterectomy under GA develops bradycardia & bronchospasm. The most appropriate treatment would be:
A. Deepen anaesthesia with a bolus of thiopentone
B. Isoprenaline infusion
C. Infiltrate the carotid sinus with lignocaine
D. Adrenaline 0.3 mg IM (?IV)
E. Aminophylline 5mg/kg slowly IV


AC66 [Aug95] [Mar00]
ASA Closed Claims Study. What was the most claimed injury?
A. Ulnar nerve palsy more common in males than females
B. Lumbosacral spine most common problem in females
C. Brachial plexus
D. Peroneal n.
E. Pads do not prevent ulnar nerve palsy


AC67 ANZCA version [Apr03] Q199, [Aug03] Q10 (Similar question reported in [Aug95] [Apr96] [Aug96] [Apr97] [Jul98] [Apr99] [Mar00])
The risk of seroconversion of a non-immunised anaesthetist, after a needlestick injury with a hollow needle contaminated with blood containing Hepatitis B virus, is approximately
A. 10%
B. 20%
C. 30%
D. 40%
E. 45%

AC67b ANZCA version [2001-Apr] Q24, [2004-Apr] Q14
The risk of Hepatitis B infection after a needle-stick injury from a Hepatitis B E-Antigen positive patient is
A. less than 1%
B. 10%
C. 20%
D. 35%
E. 50%


AC68a ANZCA version [2002-Aug] Q13 (Similar question reported in [Apr96] [Aug96] [Apr97] [Jul97] [Apr98])
The risk of seroconversion after a needle-stick, with a hollow needle from a HIV positive patient, is: (type A)
A. 30%
B. 15%
C. 3%
D. 0.3%
E. 0.03%

AC68b ANZCA version [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


AC69 [Apr96]
Prevention of postoperative hypoxia after abdominal surgery:
A. Give supplemental oxygen
B. ?Ensure adequate analgesia
C. Nurse in the sitting position
D. Avoid hypocarbia intraoperatively


AC70 [Apr96] [Apr97] [Jul98] [Apr99]
A fit well young man 48 hours after a laparotomy will have the following respiratory function on spirometry:
A. Obstructive lung pattern
B. Restrictive lung pattern
C. Diffusion abnormality
D. Normal pattern
E. Decreased vital capacity


AC71- renumbered as AA04


AC72 -renumbered as AA05


AC73 -renumbered as AA06


AC74 ANZCA version [2003-Aug] Q18 (Similar question reported in [Apr96] [Aug96] [Jul98] [Apr99])
Difficulty with tracheal intubation does not usually occur in the situation of
A. Quinsy
B. Mallampatti score IV airway
C. Acromegaly
D. Bilateral fractured mandible
E. Re-exploration for bleeding following carotid endarterectomy


AC75 [Aug96] [Apr97] [Jul97]
A patient is suspected of having an intraoperative myocardial infarction. The best way to diagnose this is:
A. CKMB 2 hours postop
B. CKMB 24 hours postop
C. SGOT
D. LDH ?2/?6 days after surgery
E. CKBB at 18 hours
F. CKMM at 10 hrs after surgery


AC76 ANZCA version [2002-Aug] Q128, [2003-Apr] Q32 (Similar question reported in [Apr97] [Apr99])
Post-intubation croup in paediatric anaesthesia:
A. Rarely occurs if uncuffed endotracheal tubes are used
B. Is reduced if prophylactic steroids are administered intraoperatively
C. Occurs predominately in children under the age of five years
D. Can be treated with 1 ml of aerosolysed 4% racemic adrenaline
E. Is less frequent if local anaesthetic lubrications are used


AC77 [Jul97] [Apr98] [Jul98]
The most important stimulus for mast cell histamine release under anaesthesia
A. Antibodies
B. Complement
C. Cross-linking of mast cell surface IgE by antigen
D. Increased osmolality
E. Short chain peptides


AC78 [Jul97] [Jul98]
The best treatment for a patient under GA in rapid AF with hypotension is:
A. Unsynchronised 50 J shock
B. Unsynchronised 200J shock
C. Injection 6 mg adenosine ?slowly/?quickly
D. Injection 5 mg verapamil ?slowly/?quickly
E. Amiodarone 5mg/kg load
F. Digoxin loading dose ?500mcg


AC79 [Jul97]
Cause of hypothermia post induction of GA?
A. Vasodilatation
B. Decreased heat production
C. Redistribution from core to periphery
D. ?

AC79b [Apr98]
A patient 20 minutes after induction has a fall of temperature of 1 degree Centigrade. The MOST likely cause is: (type A)
A. Redistribution from core to periphery
B. ?... radiation
C. ?
D. ?

AC79c [Jul98] [Apr99] [Aug99]
Regarding radiant heat loss in a patient in theatre?
A. Proportional to the square root of the air velocity past the patient (wind chill factor)
B. Proportional to the 4th power of the temperature difference between the wall & the patient
C. Accounts for 20% of heat loss (?in neonates)
D. Independent of the anaesthetic technique used
E. Independent of patient position
F. Dependent on temperature of equipment in contact with patient


AC80 [Jul97] [Apr99]
The best method of maintaining temperature during a colectomy is:
A. Warm the operating theatre to 22C
B. Warm the fluids to 38C
C. Humidify the inspiratory gases to 38C
D. Forced air warming blanket to 38C
E. Use a warming mattress at 38C

AC80b ANZCA version [2003-Apr] Q26, [2003-Aug] Q35
The fall in body temperature seen intra-operatively is
A. minimised by thermoregulatory vasoconstriction
B. greater in the elderly because basal metabolic rate increases with age
C. less well controlled by forced air warming than by a circulating water mattress
D. decreased by high spinal blockade
E. beneficial for patients with ischaemic heart disease


AC81 [Jul97]
Blood loss during major head & neck surgery is best minimised by:
A. Avoiding hypertension
B. Using Trendelenburg position
C. Intraoperative cell saver
D. Isovolumic haemodilution
E. Autologous pre-donation


AC82 [Apr98] [Apr99] (type K)
Which of the following may be injured in a patient in the prone position?
A. Male genitalia
B. Eye injury/pressure/retina
C. Femoral nerve
D. Lateral cutaneous nerve of the thigh
E. Ulna nerve


AC83 [Apr98] Difficult intubation is associated/anticipated with: (Type K)

1. Prader-Willi syndrome
2. Hurler’s syndrome
3. Ehlers-Danlos syndrome
4. Beckwith-Wiedmann syndrome


AC84 [Apr98] [Aug99]
Postop pulmonary oedema in recovery room may be caused by all of the following EXCEPT:
A. CCF ?LVF
B. Aspiration
C. Anaphylaxis
D. Negative pressure pulmonary oedema
E. Oxygen toxicity


AC85 [Apr98]
Using a syringe on a second patient is acceptable if the syringe has been used on the first patient to:
A. Inject into the burette
B. Inject into the bag of a fast flowing IV line
C. If used in the tail of a ....cm winged needle
D. ?
E. None of the above


AC86 [Apr98] [Aug99] [Mar00] [Jul00] (type K)
Risk of perioperative stroke (CVA):
1. 5% incidence following carotid surgery
2. Incidence of 0.2% in general population
3. incidence 2.9% with anaesthesia if previous CVA
4. Should wait at least 6 months following a CVA before GA to minimise risk of further CVA

(Jul 2000: type K with order of options: 2 3 1 4)


AC87 [Jul98]
A 35 yr old patient (?with myotonia congenita) is having a laparoscopic cholecystectomy. Following intubation, heart rate increases from 80/min to 140/min. The MOST likely cause is:
A. Malignant hyperthermia
B. Light anaesthesia
C. Anaphylaxis
D. SVT


AC88 [Jul98]
Elderly patient having surgery in the prone position:
A. Head should be turned to one side to prevent pressure on orbit
B. ?
C. Positioning may increase intraop bleeding
D. Positioning to affect heat loss


AC89 ANZCA version [2002-Aug] Q88
Negative pressure pulmonary oedema
A. does NOT typically occur in young patients
B. is manifest by clinical signs different to other causes of pulmonary oedema
C. is usually associated with cardiomegaly on chest X-ray
D. responds well to supportive therapy, avoiding intubation in the majority of cases
E. needs to be followed up by a physician

AC89 Black Bank version [Jul98] [Aug99]
Negative pressure pulmonary oedema. All true EXCEPT:
A. Caused by inspiration against closed glottis
B. Resolves in 12-24 hours
C. Rapidly responds to corrective measures usually avoiding the need for intubation
D. Intubate & ventilate
E. Should refer to physican for followup
F. Doesn’t occur in young adults
G. Commonly see cardiomegaly
H. Conservative management usually avoids intubation & IPPV

AC89b ANZCA version [2003-Aug] Q119, [2004-Apr] Q57
Negative pressure pulmonary oedema
A. is typically seen in a patient following the relief of bronchospasm
B. is usually associated with cardiac pathology
C. should be investigated with echocardiography
D. typically requires endotracheal intubation
E. usually presents suddenly


AC90 [Jul98] [Apr99] [Aug99] [Mar00] (type A)
Increased risks of postoperative myocardial infarction:
A. Intraoperative hypotension
B. Intraoperative hypertension
C. Postoperative angina
D. Prolonged silent myocardial ischaemia
E. Postop ischaemia

AC90b ANZCA version [2001-Aug] Q17, [2002-Aug] Q83
In a patient undergoing a femoro-popliteal bypass, the most predictive independent risk factor for the development of post-operative myocardial infarction would be
A. a previous history of coronary artery bypass grafts
B. diabetes mellitus
C. an episode of intra-operative myocardial ischaemia
D. hypercholesterolaemia
E. an episode of post-operative myocardial ischaemia lasting over 60 minutes

AC90c ANZCA version [2003-Apr] Q98, [2003-Aug] Q14, [2005-Apr] Q7, [2005-Sep] Q22, [Mar06]
In a patient undergoing a femoro-popliteal bypass, the most predictive independent risk factor for the development of post-operative myocardial infarction would be
A. an acute myocardial infarct 3 months ago
B. an episode of intra-operative myocardial ischaemia
C. an episode of post-operative myocardial ischaemia
D. 50% blood volume blood loss intra-operatively
E. poorly controlled diabetes mellitus


AC91 [Apr99]
With regards to the use of central venous catheters, which of the following is true?
A. Increased infection with multiple ports
B. Increased infection with transparent dressing
C. Should be changed every 7 days
D. There is a good chance of identifying an infecting organism by culturing the tip of the catheter
E. It is important to distinguish between a superficial skin infection, catheter tip infection & systemic sepsis


AC92 [Apr99]
Which of the following does NOT affect the incidence of CVA after general surgery?
A. Age
B. Hypertension
C. Type of surgery
D. Co-existing ischaemic heart disease
E. Gender


AC93 ANZCA version [2001-Apr ] Q8, [2002-Aug] Q10, [2003-Aug] Q55, [2004-Apr] Q59, [Apr07] Q55, [Jul07] (Similar question reported in [Apr99] [Jul00])
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


AC94 [2001-Aug] Q47, [2002-Aug] Q62 (Similar question reported in [Apr99] [Aug99])
Masseter muscle spasm in response to suxamethonium
A. has an incidence of 0.03-0.1%
B. is associated with a likelihood of malignant hyperpyrexia of 40-60%
C. requires immediate discontinuation of the anaesthetic if the mouth is unable to be opened
D. is associated with pseudocholinesterase deficiency
E. is NOT seen if the patient has been pre-treated with a small dose of a non-depolarising muscle relaxant


AC95 [Mar00] (type K)
Changes with GA in prone position:
1. Increased lung compliance
2. Increased FRC
3. Decreased shunt fraction
4. Increased V/Q mismatch


AC96 ANZCA version [2002-Aug] Q76, [2004-Apr] Q112 (Similar question reported in [Mar00] [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

AC96b ANZCA version [2001-Apr] Q146,[2001-Aug] Q105
Haemodynamic changes associated with carbon dioxide pneumoperitoneum, for laparoscopy, include increased
1. central venous pressure
2. stroke volume
3. mean arterial pressure
4. cardiac output

AC96c ANZCA version [2003-Apr] Q127
Haemodynamic responses to pneumoperitoneum include all the following EXCEPT:
A. decreased cardiac output
B. decreased venous vascular resistance
C. increase in pulmonary artery occlusion pressure
D. increased systemic vascular resistance
E. increased systemic blood pressure


AC97 ANZCA version [2001-Apr] Q25 (Similar question reported in [Mar00] [Jul00])
A male with stable angina treated with atenolol (a beta blocker) is scheduled for a semi-elective bowel resection. The most appropriate postoperative management of his coronary artery disease would be to
A. re-commence his oral atenolol once he is tolerating oral intake, if he has no angina before this time
B. use a parenteral form of nitroglycerin until atenolol can be re-commenced orally
C. use intravenous atenolol (at approximately 10% of the oral dose) until atenolol can be re-commenced orally
D. use intravenous atenolol (at approximately 30% of the oral dose) until atenolol can be re-commenced orally
E. monitor his ECG and re-commence his oral atenolol once he is tolerating oral intake, if he has no ST changes suggesting myocardial ischaemia before this time


AC98 ANZCA version [2001-Aug] Q129, [2002-Aug] Q150 (Similar question reported in [Mar00])
A patient is undergoing a total hip joint replacement under general anaesthesia. One hour into the case, the end-tidal CO2 falls from a stable level of 34 mmHg to 20 mmHg over a period of 30 seconds.
Possible causes include
1. air embolism from entrainment into pelvic veins

2. fat embolism
3. methyl-methacrylate monomer induced pulmonary shunting
4. a profound fall in cardiac output


AC99 – DELETED – same question as MC108


AC100 [Jul00]
A young fit 20 yr old male for appendicectomy. Given propofol, suxamethonium, vecuronium, volatile, N2O/O2 & IPPV. Ten minutes into the case, he develops VF. Most likely cause:
A. Undiagnosed heart disease
B. Hyperkalaemia
C. WPW syndrome
D. Re-entrant arrhythmias


Further MCQs in this section are: Complications-MCQ 101-200

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