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Anaesthesiology Final MCQs 5th Year PMU

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Anaesthesiology Final MCQs 2- 5th Year PMU

Question 1 of 49

1

A new intravenous anaesthetic is found to have a very large volume of distribution. This drug is most likely to have which of the following properties?

Select one of the following:

  • Hydrophilic with a high degree of plasma protein binding

  • Hydrophilic with a large non-ionized fraction

  • Hydrophilic with a low degree of tissue protein binding

  • Lipophilic with a high degree of tissue protein binding

Explanation

Question 2 of 49

1

Each of the following drugs causes enhanced activity of the gamma-aminobutyric acid receptor EXCEPT:

Select one of the following:

  • Etomidate

  • Midazolam

  • Ketamine

  • Propofol

Explanation

Question 3 of 49

1

What is the primary purpose of denitrogenation prior to anesthetic induction?

Select one of the following:

  • Improving matching of ventilation and perfusion

  • Increasing oxygen reserve in the functional residual capacity

  • Increasing contribution of second gas effect to rate of induction

  • Maximising arterial oxygen content

Explanation

Question 4 of 49

1

Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?

Select one of the following:

  • Patient position

  • Barbotage

  • Added epinephrine

  • Total dose of drug

Explanation

Question 5 of 49

1

Which one of the following best describes the reason for the rapid offset of effect of the induction agents?

Select one of the following:

  • Ester hydrolysis

  • Liver metabolism

  • Renal excretion

  • Redistribution

Explanation

Question 6 of 49

1

If 50% Nitrous oxide is inhaled for 3 days

Select one of the following:

  • The lymphocyte count falls

  • Vit B12 deficiency anaemia develops

  • Megaloblastic bone marrow changes occur

  • Peripheral neuropathy develops

Explanation

Question 7 of 49

1

Which one of the following structures is not encountered during direct laryngoscopy?

Select one of the following:

  • Vallecula

  • Cricoid Cartilage

  • Epiglottis

  • Arytenoid Cartilage

Explanation

Question 8 of 49

1

Regarding the comparative consideration of epidural ad spinal anaesthesia, which one of the following is CORRECT?

Select one of the following:

  • A postdural puncture headache is a potential complication that occurs with both spinal and epidural techniques

  • The epidural space is identified by puncture of the dura and free flow of cerebral spinal fluid

  • The lumbar puncture for spinal anesthesic should be performed above L1 to avoid trauma to the cauda equina

  • Epidural anaesthesia is usually faster in onset than spinal anaesthesia

Explanation

Question 9 of 49

1

The narrowest portion of the neonate's airway is at the level of the

Select one of the following:

  • Glottis

  • Pharynx

  • Trachea

  • Cricoid

Explanation

Question 10 of 49

1

All but one of the following are contraindications to succinylcholine. Indicate the exception

Select one of the following:

  • Cervical spinal cord injury (1 week ago)

  • Malignant hyperthermia susceptibility

  • Monoamine oxidase administration

  • Burn injury (24 hours ago)

Explanation

Question 11 of 49

1

A 17-year-old boy develops pulmonary edema after resolution of postoperative laryngospasm. While breathing 100% oxygen, SpO2 is 80%.
Which of the following is the most appropriate management?

Select one of the following:

  • Administration of albuterol

  • Positive-pressure ventilation

  • Infusion of nitroglycerin

  • Administration of furosemide

Explanation

Question 12 of 49

1

Which one of the following conditions is not associated with upregulation of the postjunctional acetylcholine receptors at the neuromuscular junction?

Select one of the following:

  • Myasthenia gravis

  • Burn injuries

  • Prolonged bed rest

  • Prolonged use of neuromuscular blocking agents

Explanation

Question 13 of 49

1

The right lung has

Select one of the following:

  • One fissure

  • No Sibson’s fascia

  • Seven bronchopulmonary segments

  • Two pulmonary veins

Explanation

Question 14 of 49

1

At 30°C

Select one of the following:

  • Oxygen consumption is one-third that at 37°C

  • Active rewarming should be commenced

  • Oxygen solubility is raised

  • Carbon dioxide solubility is reduced

Explanation

Question 15 of 49

1

If 50% nitrous oxide is inhaled for 3 days

Select one of the following:

  • The lymphocyte count falls

  • Peripheral neuropathy develops

  • Vit. B12 deficiency anaemia develops

  • Methionine svnthetase activity is reduced

Explanation

Question 16 of 49

1

A volatile liquid is allowed to equilibrate with a mixture of gases.
The resulting partial pressure of the vapour will depend on

Select one of the following:

  • Atmospheric pressure

  • The surface area of the liquid

  • Ambient temperature

  • The volume of liquid

Explanation

Question 17 of 49

1

A 36-year-old woman is receiveing general anesthesia for a diagnostic laparoscopy in the Trendelenburg position with carbon dioxide insufflation. During a 15-minute period after induction. her SpO2 decreases from 99% to 90% and PetCO2 increases from 38 to 43 mmHg. FiO2 is 0.3; all ventilator settings have been constant.
Which of the following is the most likely cause of the decrease in SpO2?

Select one of the following:

  • Carbon dioxide embolus

  • Decreased diaphragmatic excursion

  • Compression of the vena cava

  • Pnemnothorax

Explanation

Question 18 of 49

1

Which one of the following best explains the failure of nondepolarizing neuromuscular blocking agents to produce fasciculation?

Select one of the following:

  • Absence of acetylcholine receptor activation

  • Binding in the ion channel of the acetylcholine receptor

  • Binding to agonist and antagonist sites on the acetylcholine receptor

  • Binding to presynaptic and postsynaptic acetylcholine receptors

Explanation

Question 19 of 49

1

About Nitrous oxide we can say

Select one of the following:

  • N2O forbidden in low flow anesthesia

  • It can stabile the patient with increased intracranial pressure

  • N2O reduces the preen house effect

  • It leads to a reduction of supplementary opioids and anesthetics

Explanation

Question 20 of 49

1

Hypotension is least likely to occur following induction with which of the following anesthetic agents?

Select one of the following:

  • Midazolam

  • Methohexital

  • Etomidate

  • Propofol

Explanation

Question 21 of 49

1

The complete absence of a capnographic waveform immediately following endotracheal intubaion may indicate all but one of the following.
Indicate the exception:

Select one of the following:

  • Cardiac arrest

  • Endobronchial intubation

  • Complete airway obstruction

  • Esophageal intubation

Explanation

Question 22 of 49

1

All but one of the following conditions will cause the capnograph to give a reading that is much lower than the arterial CO2.
Indicate the exception.

Select one of the following:

  • Exhausted CO2 absorber soda lime

  • Pulmonary embolus

  • Cardiac arrest

  • Severe bronchospasm

Explanation

Question 23 of 49

1

Early signs and symptoms of local anesthetic toxicity include all but one of the following.
Indicate the exception:

Select one of the following:

  • Tinnitus

  • Perioral numbness

  • Dizziness

  • Hypertension

Explanation

Question 24 of 49

1

Which one of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?

Select one of the following:

  • Desflurane 6%: Sevoflurane !%; Isoflurane 2%

  • Desflurane 2%: Sevoflurane 6%; Isoflurane 1%

  • Desflurane 6%: Sevoflurane 2%; Isotlurane 1%

  • Desflurane 2%: Sevoflurane 1%: Isoflurane 6%

Explanation

Question 25 of 49

1

In a patient receiving pressure support ventilation, pressure support breaths are triggered by achieving which of the following preset milestones?
??

Select one of the following:

  • An increase in airway pressure

  • A decrease in airway pressure

  • An inspiratory flow rate

  • An inspired volume

Explanation

Question 26 of 49

1

In the early detection of an air embolism, the following is useful

Select one of the following:

  • PetCO2

  • ECG

  • Fall in blood pressure

  • Change in ventilatory pattern

Explanation

Question 27 of 49

1

The right lung has

Select one of the following:

  • One fissure

  • No Sibson’s fascia

  • Seven bronchopulmonary segments

  • A direct relationship to the azygos vein

Explanation

Question 28 of 49

1

Which one of the following factors exerts the greatest effect on the extent of spread of local anesthetic following subarachnoid block with hyperbaric Bupivacaine?

Select one of the following:

  • Added epinephrine

  • Barbotage

  • Total dose of drug

  • Patient position

Explanation

Question 29 of 49

1

All but one of the following describe the CO2 absorber. Indicate the exention

Select one of the following:

  • Changes colour as the soda lime becomes exhausted

  • Is required if a circle circuit is being used

  • Provides a waveform of exhaled carbon dioxide

  • Allows for economical use of anaesthetic gases

Explanation

Question 30 of 49

1

Two hours after a laparoscopic cholecystectomy, an obese 45-year-old woman is receiving intravenous patient-controlled analgesia with morphine. Her SpO2 is 92% on room air. Which ONE of the following is the most likely?

Select one of the following:

  • Absorption of carbon dioxide from the abdomen

  • Hypoventilation

  • Impaired oxygen diffusion

  • Increased dead space

Explanation

Question 31 of 49

1

About N2O we can say

Select one of the following:

  • It leads to a reduction of supplementary opioids and anesthetia

  • The use prevents vomiting!

  • N2O is forbidden in low flow anesthsia

  • N2O reduces the green house effect

Explanation

Question 32 of 49

1

Suxamethonium does not cross the placenta because of

Select one of the following:

  • Placental cholinesterase

  • High protein binding

  • It being an elongated molecule

  • Its high degree of ionization

Explanation

Question 33 of 49

1

Isoflurane

Select one of the following:

  • Has a similar boiling point to enflurane

  • Has a MAC of 0.56% in oxygen

  • Has a lower blood/gas coefficient than halothane

  • Is extensively metabolised

Explanation

Question 34 of 49

1

After induction of anesthesia, the anesthesiologist is unable to intubate the patient. Which one of the following is the most important management priority?

Select one of the following:

  • Ensuring that intubation is achieved as soon as possible

  • Ensuring that bag-mask ventilation is achievable

  • Inserting a laryngeal mask

  • Ensuring that the patient does not awaken until intubation is successfully achieved

Explanation

Question 35 of 49

1

The abbreviation “MAC” stands for

Select one of the following:

  • Minimal alveolar concentration

  • Minimal arterial concentration

  • Maximal arterial concentration

  • Maximal alveolar concentration

Explanation

Question 36 of 49

1

Shivering can lead to all but one of the following. Indicate the exception:

Select one of the following:

  • Interference with monitor signal interpretation

  • Increased oxygen consumption ,

  • Increased anesthesia requirements

  • Decreased carbon dioxide production

Explanation

Question 37 of 49

1

(Var 4 10) All but one of the following are disadvantages of general anesthesia for Caesarian section. Indicate the exception
???

Select one of the following:

  • Increased rise of inspiration in the pregnant patient

  • Increases risk of unawareness under anesthesia

  • Increased anesthesia requirements

  • Exacerbation of ?

Explanation

Question 38 of 49

1

Pressure support ventilation

Select one of the following:

  • Delivers a specified volume regardless of airway pressure

  • Can only be used in a spontaneously breathing patient

  • Can not be used in conjunction with continuous positive airway pressure

  • Increases the work of breathing

Explanation

Question 39 of 49

1

The following commonly contributes to poor oxygenation during general anaesthesia

Select one of the following:

  • Atelectasis

  • Hyperventilation

  • Hypersensitive chemoreceptors

  • Increased metabolic rate

Explanation

Question 40 of 49

1

The trachea

Select one of the following:

  • Begins at C4 and ends at T6

  • Is supplied entirely by the bronchial arteries

  • Is lined by transitional epithelium

  • Is narrowest at the level of the cricoid in a child

Explanation

Question 41 of 49

1

An adult breathing 100% oxygen at sca level may suffer from

Select one of the following:

  • Permanent visual damage

  • Convulsions

  • Retrosternal chost pain

  • Dizziness

Explanation

Question 42 of 49

1

Immediately after complete transection of the spinal cord, the following occur

Select one of the following:

  • Loss of sensation but no loss of power

  • Flaccid paralysis with loss of sensation end reflexes

  • Loss of motor function and sensation with no loss of reflexes

  • Loss of power but no loss of sensation

Explanation

Question 43 of 49

1

All but one of the following are contraindications to post-operative epidural analgesia. Indicate the exception

Select one of the following:

  • Multiple sclerosis

  • Myasthenia gravis

  • Hypertrophic obstructive cardiomyopathy

  • Lumbar disc disease

Explanation

Question 44 of 49

1

The primary toxic effect of Bupivacaine on the cardiovascular system is

Select one of the following:

  • Blockade of norepinephrine release

  • Coronary vasoconstriction

  • Delay of ventricular repolarization

  • Increased atrial excitability

Explanation

Question 45 of 49

1

Redistribution from the brain to which of the following sites is primarily responsible for emergence after a single dose of Propotol?

Select one of the following:

  • Fat

  • Skeletal muscle

  • Lung

  • Liver

Explanation

Question 46 of 49

1

About the MAC we can say
???

Select one of the following:

  • To low level (< 0,7 MAC) can lead to awareness

  • To high level (> 1,3 MAC) can lead to postoperative delirium

  • To low level (< 1,3 MAC) can lead to postoperative vomiting

  • The MAC depends on the gender and the body weight of the patient

Explanation

Question 47 of 49

1

Suxamethonium does not cross the placenta because of

Select one of the following:

  • Placental cholinesterase

  • High protein binding

  • Insufficient maternal concentration

  • Its high degree of ionization

Explanation

Question 48 of 49

1

You see a patient in the preoperative assessment clinic prior to her laparatomy for colon cancer. If the patient has an epidural inserted for post-operative pain she is likely to experience all but one of the following. Indicate the exception

Select one of the following:

  • Reduced adrenal activation

  • Improved respiratory function

  • Hypertension

  • Excellent post-operative pain control

Explanation

Question 49 of 49

1

All but one of the following are ways to confirm endotracheal intubation. Indicate the exception

Select one of the following:

  • Auscultation of both lung fields and over the stomach

  • Easy advancement of the endotracheal tube without resistance

  • Visualisation of the endotracheal tube through tube through the vocal cords

  • Presence of a stable CO2 trace on the end-tidal capnography

Explanation

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