Quiz
Anaesthesiology MCQs 1- 5th Year PMU
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1All but ONE of the following are predictors of a difficult intubation. Indicate the exception
- AMouth opening of only 3 fingerbreadths
- BShort, thick neck with limited mobility
- CMallampati Class IV
- DThyromental distance of 2 fingerbreadths
2ALL BUT ONE of the following factors represent an indication for intubation in a patient who is about to undergo surgery. Indicate the exception
- ASurgery is a lumbar laminectomy
- BSurgery is removal of a lymph node of the neck
- CSurgery is appendectomy
- DSurgery is tonsillectomy
3Which ONE of the following structures is not encountered during direct laryngoscopy?
- AVallecula
- BCricoid cartilage
- CEpiglottis
- DArytenoid cartilage
4The COMPLETE absence of a capnographic waveform immediately following endotracheal intubation may indicate ALL BUT ONE of the following. Indicate the exception
- ACircuit disconnection
- BCardiac arrest
- CEndobronchial intubation
- DComplete airway obstruction
- EEsophageal intubation
5After induction of anesthesia, the anesthesiologist is unable to intubate the patient.
Which ONE of the following is the most important management priority?- AEnsuring that intubation is achieved as soon as possible
- BInserting a laryngeal mask
- CEnsuring that bag-mask ventilation is achievable
- DEnsuring that the patient does not awaken until intubation is successfully achieved
6Advantages of a Laryngeal mask airway include ALL BUT ONE of the following. Indicate the exception
- AIt frees up the anesthesiologist’s hands
- BIt protects against aspiration
- CIt can allow mechanical ventilation
- DIt can be readily inserted without the use of muscle relaxants
7ALL BUT ONE of the following are ways to confirm endotracheal intubation. Indicate the exception
- AAuscultation of both lung fields and over the stomach
- BVisualization of the endotracheal tube through the vocal cords
- CEasy advancement of the endotracheal tube without resistance
- DPresence of a stable CO2 trace on the end-tidal capnography
8The “transfusion trigger” (the lowest allowable hemoglobin level) intra-operatively is
- A100 g/L
- B80g/L
- C60g/L
- DIndividualized to every patient
9ALL BUT ONE of the following are early indicators of hypovolemia. Indicate the exception
- ATachycardia
- BDecreased pulse pressure
- CDecreased urine output
- DLactic acidosis
10The maintenance fluid requirement for an 80 kg man using the 4-2-1 rule is
- A100 cc/hr
- B120 cc/hr
- C150 cc/hr
- D170 cc/hr
11Milllilitre for millilitre, which of the following provides the most intravascular volume expansion?
- APacked red blood cells
- BAlbumin (5%)
- CPentaspan
- DRingers Lactate
12A patient has lost 500ml of blood during a low anterior bowel resection. His hemoglobin is 115 g/L.
What is the most appropriate volume replacement?- APentaspan 1500 mL
- BDSW 500 mL
- CRingers Lactate 500 mL
- DNormal Saline 1500 mL
13Regarding vascular access and fluid resuscitation, which ONE of the following statements is TRUE?
- AAn intravenous is required for procedures under local anesthesia such as carpal tunnel release or cystoscopy
- BCannulation of a lower limb vein is inappropriate for use in the operating room
- CCannulation of the jugular vein for central venous pressure monitoring is recommended in lengthy cases with the potential for significant fluid shifts.
- DA 14 gauge central line will allow more rapid fluid resuscitation than a 14 gauge peripheral canula
14A patient receives 10 units of packed red blood cells. Which ONE of the following chemistry profiles is most likely?
- AHyperkalemia, hypercalcemia
- BHypokalemia, hypocalcemia
- CHyperkalemia, hypocalcemia
- DHypokalemia, hypercalcemia
15Which ONE of the following procedures would be associated with the most “third space" loss of fluid?
- AOpen reduction, internal fixation of the pelvis
- BWhipple resection of the pancreas
- CResection of large frontal brain tumour
- DCaesarian section
16Routine preoperative hemoglobin is NOT required for
- AA healthy female over 50 years of age
- BA patient who has been crossmatched for surgery
- CA patient on anticoagulant medication
- DA young female patient with menorrhagia
17Which ONE of the following is the most important determinant of peri-operative risk?
- APatient’s underlying health
- BLength of surgery
- CDuration of surgery
- DEmergency surgery
18Which of these patients is NOT at increased risk of aspiration?
- AA pregnant patient (32 weeks gestation) who has been NPO (nil per os) for 10 hours
- BA patient with fractured femur who has been NPO since the accident 12 hours ago
- CA healthy patient with appendicitis
- DA healthy patient who had 8 ounces of clear tea 4 hours pre-operatively
19The following medication should be discontinued prior to surgery and anesthesia
- AAnticonvulsants
- BThyroid replacement
- CMonoamine-oxidase inhibitors
- DAntihypertensives
20A patient with which ONE of the following conditions requires antibiotic prophylaxis prior to tonsillectomy?
- AUncorrected Tetralogy of Fallot
- BAortic stenosis
- CUncomplicated heart transplant
- DProphylaxis is not required for tonsillectomy
21A patient is on prednisone 30 mg daily for rheumatoid arthritis and presents for coronary bypass surgery. Which of the following best describes their peri-operative steroid requirements?
- A30mg prednisone orally on day of surgery
- B25 mg hydrocortisone IV on day of surgery
- C25 hydrocortisone IV for 72 hours
- D100 mg hydrocortisone IV for 72 hours
22A 60-year old man for minor surgery has a BP of 170/100 mmHg in the pre-operative clinic. In retrospect, he admits that his blood pressure has been consistently high when he checks it at the drugstore. Assign an ASA class.
- AASA 1
- BASA 2
- CASA 3
- DASA 4
23ALL BUT ONE of the following describes the CO2 absorber.
Indicate the exception- AChanges colour as the soda lime becomes exhausted
- BIs required if a circle circuit is being used
- CAllows for economical use of anaesthetic gases
- DProvides a waveform of exhaled carbon dioxide
24Which ONE of the following statements regarding the peripheral nerve stimulator is true?
- ADelivers four successive impulses at a rate of 2 per second
- BIs a sensitive indicator of neuromuscular blockade
- CMust be used on the awake patient to achieve a baseline
- DIs commonly applied to the radial nerve
25A patient is receiving a balanced anesthetic with volatile anesthetic gases, opioids and muscle relaxants. Which ONE of the following monitors is required to be in continuous use during the care of this patient?
- ATemperature probe
- BAgent-specific gas monitor
- CPeripheral nerve stimulator
- DSpirometer
26ALL BUT ONE of the following interfere with accurate pulse oximetry measurements.
Indicate the exception:- ANail polish
- BPeripheral vasoconstriction due to hypothermia
- CSevere anemia (Hg 60 g/L)
- DMethemoglobinemia
- ECarbon monoxide
27ALL 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- APulmonary embolus
- BExhausted CO2 absorber soda lime
- CCardiac arrest
- DSevere bronchospasm
28The abbreviation “MAC” stands for
- AMinimal arterial concentration
- BMinimal alveolar concentration
- CMaximal arterial concentration
- DMaximal alveolar concentration
29Regarding awareness, ALL BUT ONE of the following statements are correct.
Indicate the exception- AThere is no "gold" standard for measuring level of consciousness
- BVolatile agents are effective amnestic agents
- CChanges in heart rate and blood pressure can be used as surrogate indicators of level of consciousness
- DOpioids (in high doses) provide effective hypnosis
30The immediate goals of emergence include ALL BUT ONE of the following.
Indicate the exception- AThe ability of the patient to protect their airway
- BStable cardiovascular status
- CNormal mental status examination
- DEffective analgesia
31The advantages of regional anesthesia include ALL BUT ONE of the following.
Indicate the exception- AImproved outcomes for certain procedures (e.g. thoracic surgery, Caesarean section
- BAbility to continue technique postoperatively to provide pain relief
- CA reliable option for patients not well enough to undergo general anesthesia
- DAvoidance of systemic administration of drugs and consequent side effects
32Hypothermia is associated with ALL BUT ONE of the following.
Indicate the exception- APost operative hypoxemia
- BDecreased platelet function
- CMyocardial ischemia
- DIncreased analgesic requirements
33Adequacy of reversal of muscle relaxation can be assessed by ALL BUT ONE of the following.
Indicate the exception- AStrong hand grip
- BThe return of the eyelash reflex
- CTrain of four shows 4 twitches with no fade
- D5 second head lift
34Tracheal intubation would be required in ALL BUT ONE of the following procedures. Indicate the exception:
- AOpen cholecystectomy
- BLaparoscopic cholecystectomy
- CExcision of lymph node from the neck
- DTonsillectomy
35Known complications related to positioning include ALL BUT ONE of the following. Indicate the exception
- ABrachial plexus injury with arm abduction of 60°
- BHypoxemia in the Trendelenburg position
- CCommon peroneal nerve injury in the lithotomy position
- DRetinal ischemia in the prone position
- EVenous air embolus with the sitting position
36Regarding the comparative considerations of epidural and spinal anesthesia, which ONE of the following is CORRECT?
- AThe lumbar puncture for a spinal anesthetic should be performed above L1 to avoid trauma to the cauda equina
- BThe epidural space is identified by puncture of the dura and free flow of cerebral spinal fluid
- CA postdural puncture headache is a potential complication that occurs with both spinal and epidural techniques
- DEpidural anesthesia is usually faster in onset than spinal anesthesia
37Early signs and symptoms of local anesthetic toxicity include ALL BUT ONE of the following. Indicate the exception
- ATinnitus
- BPerioral numbness
- CDizziness
- DHypertension
38Shivering can lead to ALL BUT ONE of the following. Indicate the exception:
- AMyocardial ischemia
- BIncreased oxygen consumption
- CDecreased carbon dioxide production
- DInterference with monitor signal interpretation
39Which ONE of the following statements about shivering is correct?
- AShivering is a response controlled by the brainstem
- BShivering can occur in the absence of hypothermia
- CShivering is effectively treated with small doses of naloxone
- DShivering is an uncomfortable, though harmless, effect of anesthesia
40ALL BUT ONE of the following are used as intravenous antiemetics. Indicate the exception
- AProchlorperazine
- BRanitidine
- CDimenhydrinate
- DDexamethasone
41Which of the following is a risk factor for PONV?
- AHistory of gastroesophageal reflux
- BSmoking
- CDiabetes mellitus
- DFemale gender
42Which ONE of the following is part of a rational approach to post-operative nausea and vomiting?
- AAll patients should receive pharmacologic prophylaxis
- BAvoidance of anti-emetic anesthetic agents is an effective management strategy
- CProphylaxis must be given prior to induction of anesthesia for maximal effectiveness
- DDimenhydrinate remains the mainstay of PONV prevention and treatment
43Which ONE of the following is least likely to be the cause of hypertension in the PACU?
- APain
- BAirway obstruction
- CProlonged spinal blockade
- DFull bladder
44Which ONE of the following is a criteria that the patient must meet prior to transfer from the post-anesthetic care unit (PACU) to the ward?
- ANormal cognitive function
- BAdequate pain control
- CAbility to hold down food
- DAbility to weight-bear
45You see a patient in the preoperative assessment clinic prior to her laparotomy 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- AReduced adrenal activation
- BHypertension
- CImproved respiratory function
- DExcellent post-operative pain control
46Your patient's most recent surgery was thirty years ago after which she received "conventional" nurse-administered opioid analgesia. For her upcoming lumbar spinal decompression and instrumentation, she will be receiving PCA (patient-
controlled analgesia). The comparative advantages of PCA morphine include ALL BUT ONE of the following.
Indicate the exception- ALess labor intensive for nurses
- BMore opioid delivered to the patient
- CImproved patient satisfaction
- DSmall doses at frequent intervals minimizing the pharmacokinetic "peaks" and “valleys”
47ALL BUT ONE of the following is a relative contraindication to post-operative epidural analgesia.
Indicate the exception- AMultiple sclerosis
- BLumbar disc disease
- CHypertrophic obstructive cardiomyopathy
- DMyasthenia gravis
48All BUT ONE of the following are true regarding malignant hyperthermia (MH). Indicate the exception
- ANewer volatile anesthetics such as desflurane are not believed to trigger MH
- BNitrous oxide is safe
- CDantrolene is the only therapeutic drug treatment
- DMortality is as high as 10% even with prompt treatment
49Which of the following is the first sign of a malignant hyperthemic reaction?
- AHyperthermia
- BHypercarbia
- CTachycardia
- DVentricular arrhythmias
50Treatment of a malignant hyperthermia crisis includes ALL BUT ONE of the following.
Indicate the exception- ATurning off the volatile anesthetic
- BActive cooling measures
- CDantrolene
- DBeta blockers
51Maternal hypotension in the supine position during pregnancy is most often due to
- ADecreased blood volume
- BDecreased peripheral vascular resistance
- CDecreased hematocrit
- DCompression of the vena cava
52ALL BUT ONE of the following represent relevant physiologic changes of pregnancy in the 40 week gestation parturient.
Indicate the exception- ADecreased cardiac output
- BDelayed gastric emptying
- CIncreased blood volume
- DDecreased anesthetic requirements
53In the obstetrical patient in her third trimester, the supine position
- AShould be avoided by placing a pillow under her knees
- BIs detrimental due to the risk of causing excessive venous return to the right heart
- CIs harmful to the mother, but is harmless to the fetus
- DIs safe at 20 weeks of pregnancy
54ALL BUT ONE of the following are part of rational fasting guidelines for pediatric patients. Indicate the exception
- ASolids up to 8 hours pre-op
- BClear fluids up to 3 hours pre-op
- CBreast milk up to 4 hours pre-op
- DFormula up to 2 hours pre-op
55The narrowest portion of the neonate's airway is at the level of the
- AGlottis
- BCricoid
- CTrachea
- DPharynx
56The appropriate size endotracheal tube for a 4 year old child is
- A4.0
- B4.5
- C5.0
- D6.0
57ALL BUT ONE of the following represents attributes of the pediatric cardiovascular system. Indicate the exception
- ACardiac output is heart-rate dependent
- BHypoxemia is an important cause of bradycardia
- CBlood volume is greater, relative to size
- DVagal responsiveness is under-developed
58Which ONE of the following is an explanation for rapid desaturation during apnea that is seen in the pediatric patient?
- AIncreased functional residual capacity (FRC)
- BIncreased oxygen consumption
- CIncreased minute ventilation
- DObligate nasal breathing
59ALL BUT ONE are features of the pediatric airway compared to the adult. Indicate the exception
- ALarynx situated higher
- BLarynx situated more anteriorly
- CEpiglottis shorter and less mobile
- DNarrowest part of the airway at the cricoid
60The use of epidural analgesia for labour is likely to result in which ONE of the following
- AProlonged second stage
- BIncreased risk of operative delivery
- CNeonatal depression
- DMaternal sedation
61ALL BUT ONE of the following is a disadvantage of general anesthesia for Caesarian section. Indicate the exception
- AIncreased risk of aspiration in the pregnant patient
- BIncreased anesthetic requirements
- CExacerbation of uterine atony
- DIncreased risk of awareness under anesthesia
62Which ONE of the following is an accurate statement regarding the use of spinal anesthesia for Caesarian section?
- AQuick and easy in the setting of emergency Caesarian section
- BAssociated with decreased maternal morbidity
- CAssociated with increased neonatal depression
- DPresents less of a risk of maternal hypotension compared with general anesthesia
63Nitrous oxide is contraindicated in ALL BUT ONE of the following settings. Indicate the exception
- ATotal hip arthroplasty in the lateral position
- BLaparotomy for bowel obstruction
- CMultiple trauma with pneumothorax
- DPatient with history of severe post operative nausea and vomiting
64Which class of drugs is most commonly responsible for intraoperative anaphylactic (or anaphylactoid) reactions?
- AOpioid analgesic agents
- BInduction agents
- CMuscle relaxants
- DVolatile anesthetic agents
65Other than analgesia, what is the most important clinical effect of the opioid analgesics?
- ACardiac depression
- BSedation
- CNausea and vomiting
- DRespiratory depression
66Which ONE of the following describes an advantage of sevoflurane over desflurane?
- ALower lipid solubility therefore quicker onset and offset of effect
- BLess pungent therefore more practical for mask induction
- CCan be used with lower flows therefore more economical
- DMild sympathomimetic effect minimizes hypotension
67Which ONE of the following best describes the reason for the rapid OFFSET of effect of the induction agents
- AEster hydrolysis
- BLiver metabolism
- CRedistribution
- DRenal excretion
68ALL BUT ONE of the following conditions predisposes the patient to prolonged effect of non-depolarizing muscle relaxants. Indicate the exception
- AHyperkalemia
- BHypothermia
- CGentamycin administration
- DMyasthenia gravis
69ALL BUT ONE of the following are contraindications to succinylcholine. Indicate the exception
- ACervical spinal cord injury (1 week ago)
- BMonoamine oxidase administration
- CMalignant hyperthermia susceptibility
- DBurn injury (24 hours ago)
70Which of the following is the correct MAXIMUM safe dose of bupivacaine (plain)
- A1 mg/kg
- B2 mg/kg
- C5 mg/kg
- D7 mg/kg
71ALL BUT ONE of the following describes a feature of phenylephrine. INDICATE THE EXCEPTION
- APhenylephrine causes (reflex) bradycardia
- BPhenylephrine can be safely used in patients with cocaine intoxication
- CPhenylephrine acts directly at the alpha adrenergic receptor
- DPhenylephrine improves cardiac performance in cardiogenic shock
72ALL BUT ONE of the following are effects of the synthetic opioids (fentanyl, sufentanil and remifentanil). Indicate the exception
- AMuscle rigidity
- BBiliary spasm
- CMyocardial depression
- DBradycardia
73Which ONE of the following most closely describes the MAC of three commonly-used volatile anesthetic agents?
- ADesflurane 6%; Sevoflurane 1%; Isoflurane 2%
- BDesflurane 2%; Sevoflurane 6%; Isoflurane 1%
- CDesflurane 1%; Sevoflurane 2%; Isoflurane 6%
- DDesflurane 6%; Sevoflurane 2%; Isoflurane 1%
- EDesflurane 2%; Sevoflurane 1%; Isoflurane 6%
- FDesflurane 1%; Sevoflurane 6%; Isoflurane 2%
74Which of the following opioids are most commonly administered into the intrathecal (spinal) space?
- AMorphine and sufentanil
- BFentanyl and sufentanil
- CMorphine and fentanyl
- DFentanyl and remifentanil
75Which ONE of the following receptors is NOT targeted in the treatment or prevention of post-operative nausea and vomiting?
- AGABA
- BHistamine
- CSerotonin
- DDopamine
76Which ONE of the following sets correctly describes the cholinergic effects of neostigmine?
- ABradycardia and bronchospasm
- BMydriasis and confusion
- CUrinary retention and constipation
- DDry mouth and dry eyes
77Which of the following correctly describes an important principle in the use of ketorolac as an adjunct for post-operative pain?
- AIV therapy should be minimized to less than 5 days
- BKetorolac must not be given to patients with renal insuffciency
- CPotentiation of opioid effect is a risk
- DGastrointestinal bleeding is not a concern with the Cox 1 inhibitors such as ketorolac
78What is the main advantage of the use of glycopyrrolate compared to atropine to counteract the cholinergic effects of anticholinesterase administration?
- AFaster onset of action
- BDoes not cross the blood brain barrier
- CMore effective anticholinergic activity
- DSafe in patients with narrow angle glaucoma
79Which statement about the distribution of water in the body Is true?
- AMost of the body water content is located within the extracellular compartment
- BWater content in a newborn child is 30-60% of its body weight
- CPlasma water content is only 5% of the body weight
- DTotal body water content in adult females is 60% of their body weight
80Which of the following is not associated with high anion-gap metabolic acidosis
- ATissue hypoxia with hyperlactatemia
- BKidney failure
- CMethanol intoxication
- DDiarrhea
81Which of the following statements about ARDS in adults is NOT correct
- ABilateral opacities consistent with pulmonary edema on chest radiography or computed tomography (CT) scan that are not fully explained by pleural effusions, lobar/lung collapse, pulmonary nodules or heart failure are required for the diagnosis
- BSeveral conditions’can lead to the development of ARDS, including aspiration of gastric contents, pneumonia, sepsis (most common cause), trauma, transfusion of blood products (particularly plasma-rich products), pancreatitis, fat emboli, and drowning
- CMost patients with ARDS require intubation and mechanical ventilation with low tidal volumes (6 mL/kg predicted weight) and targeted plateau pressures of equal to or less than 30 cm H2O
- DModerate to severe impairment of oxygenation ts defined by the ratio of arterial oxygen tension to fraction of inspired oxygen (PaO2/FiO2). In Severe ARDS (PaO2/FiO2) ts between 200 and 300 mmHg on PEEP >5 cm H2O
82Which of the following drugs is of first therapeutic choice in managing anaphylactic shock?
- AMethylprednisolone i.v.
- BAdrenaline i.m.
- CDiphenhydramine i.m.
- DAtropine i.v.
83Which of the following suggested clinical and laboratory parameters are Not part of the SOFA score for sepsis?
- ABilirubin, creatinine and urine output
- BBlood pressure and PaO2/FiO2 ratio
- CPlatelets and GCS
- DBody temperature and WBCs
84Which of the statements about FAST is NOT correct?
- AIt is a rapid and noninvasive No to evaluate the abdomen for presence of pathological fluid collection in peritoneal and pericardial cavity
- BIt is comparable to diagnostic peritoneal lavage (DPL) as a method for detecting peritoneal fluid
- CAbdominal areas to examine are three: right upper quadrant, left upper quadrant and subxyphoid
- DExtended FAST (E-FAST) examination includes views of the bilateral hemithoraces and the upper anterior chest wall
8520 year old male cyclist is hit by a car. On the primary evaluation the GCS was 9 points and quickly deteriorated to a maximum of 6, but the breathing and hemodynamic status were initially stable. The patient was intubated, mechanically ventilated and mannitol infusion was started during the transport. On emergent CT scan of the head only diffuse brain oedema is found with no focal lesions of the brain parenchyma or intracranial hematomas. CT scan of the neck, chest and abdomen shows clear spine, fractures of fourth and fifth ribs on the right, no pleural fluid or air collections, intact heart and great vessels, no injuries to the abdominal organs or free fluid in the abdominal cavity. The patient is admitted in the ICU. Which of the suggested monitoring is not part of the initial management of that patient?
- AEEG
- BETCO2 measurement
- CCVP measurement
- DInvasive arterial blood pressure measurement
86Generally accepted definition of coma includes a GCS score of
- A< 6
- B< 8
- C< 10
- D< 12
87Augmenting O2, delivery to the tissues is undoubtedly one of the first and foremost priorities in the management of circulatory shock. Which of the following suggested measures cannot help for for that purpose?
- AAdministration of vasopressor drugs if no response to fluid therapy is achieved
- BHCO3 administration for correction of acidosis
- CBlood transfusion in case of hemorrhagic shock
- DSupplementary O2 administration
88Which drugs can be administered endotracheally during CPR if I.V. or I.0. access cannot be established?
[blank_start]Adrenaline[blank_end]
[blank_start]Naloxone[blank_end]
[blank_start]Lidocaine[blank_end]
[blank_start]Vasopressin[blank_end]- AAdrenaline
- BNaloxone
- CLidocaine
- DVasopressin
89A characteristic feature of cerebral salt wasting syndrome (CSWS) that distinguishes it from the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is
- APathological process affecting the brain
- BDecreased extracellular fluid volume (hypovolemia)
- CIncreased Na+ loss with urine
- DHyponatremia (serum (Na‘] <135 mmol/l)
90Which of the following statements about the acid-base disorders is false?
- AMetabolic alkalosis is the most common acid-base disturbance in hospitalised patients
- BSuccessful treatment of all acid-base disorders depends on the identification and elimination of the cause
- CMost cases of respiratory acidosis are due to increased production of CO2
- DAs a rule acid-base disorders of metabolic origin involve a respiratory compensatory response and vice versa
91List Pulmonary causes of ARDS
[blank_start]Aspiration[blank_end]
Severe [blank_start]Pneumonia[blank_end]
[blank_start]Smoke[blank_end] Inhalation
[blank_start]Trauma[blank_end]- AAspiration
- BPneumonia
- CSmoke
- DTrauma
92Which of the following pairs of different types of hypoxia and possible causes does not match?
- AHeart failure → Stagnant hypoxia
- BAcute hemolysis → Anemic hypoxia
- CAnaphylaxis → Cytopathic hypoxia
- DHigh altitude → Hypoxic hypoxia
93Microblologic analysis of blood cultures is
- ARequired for diagnosis of sepsis
- BRequired before starting antimicrobial therapy for sepsis
- CRequired for narrowing of the empiric antimicrobial therapy
- DRequired for selection of the optimal route for antimicrobials administration
94Which of the following suggested compensatory responses to shock state does not increase the Frank-Starling mechanism in the heart (increased preload=increased cardiac output)
- AFluid redistribution to the vascular space
- BDecreased venous capacitance
- CIncreased heart rate
- DDecreased renal losses of fluid
95Possible disastrous complication from overly rapid correction of hyponatremia is
- ACerebral edema and brain herniation
- BInsipid diabetes
- CIschaemic Stroke
- DCentral pontine myelinolysis
96A 12-year old boy with unremarkable previous medical history regularly vaccinated, was hospitalised two days ago with flu-like symptoms, abdominal pain and vomiting. His condition was gradually worsening with changes in, mentation (GCS initialty was 15 now is 12), rapid and noisy breathing arterial hypotension (BP 95/50 MmHg), oliguria (after initial polyuria), hyperthermia, with 38.8°C despite the antiviral (Oseltamivir) and the symptomatic therapy that were started initially. You run a blood and urine analysis and receive the following results: arterial blood pH 7.0, PaCO2 20 mmHg. BE (-16), [HCO3-] 10 mmol/L, blood glucose 2 mmol/L, [K+] 3.4 mmol/l, [Na+] 132 mmol/L, [Cl-] 90 mmol/L, and serum creatinine 60 μmol/l, urea 3 μmol/l, 4(+) glucose and 3(+) ketones in urine
What are the first therapeutic intervention you would start with in this case?- AImmediate administration of sodium bicarbonate to correct the acidosis
- BAggressive restoration of extracellular fluid volume with balanced cystalloid solutions
- CSubcutaneous administration of insulin
- DEndotracheal intubation and Mechanical Ventilation
97All of the following are part of the therapeutic strategy for ARDS in adults, except
- AVentilation with low tidal volumes (6 ml/kg) and PEEP
- BPeriodically switching to ventilation in prone position
- CAvoiding positive fluid balance
- DAdministration of Surfactant and inhaled Nitric Oxide
98Which of the following statements about cyanosis is correct?
- AIt is a late sign of respiratory failure
- BIt is characteristic for type 1 (hypoxemic) respiratory failure
- CIt is caused by increased amount of reduced Hb (>50-60 g/l)
- DPatients with anaemia manifest cyanosis at higher SaO2 values (earlier) than patients with normal Hb values
99Name four major categories of circulatory shock and give examples for every type
[blank_start]Hypovolemic[blank_end] Shock- [blank_start]Hemorrhage[blank_end]
[blank_start]Cardiogenic[blank_end] Shock- [blank_start]Heart[blank_end] failure
[blank_start]Obstructive[blank_end] shock- [blank_start]Blockage[blank_end] of the aorta
[blank_start]Distributive[blank_end] shock- [blank_start]Anaphylaxis[blank_end]- AHypovolemic
- BCardiogenic
- CObstructive
- DDistributive
- EHemorrhage
- FHeart
- GBlockage
- HAnaphylaxis
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- Anaesthesiology Final MCQs- 5th Year PMU
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