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143 Cards in this Set
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2014-2Q1A. transdermal fentanyl patch is often used for management of cancer pain. After application, the time to reach peak plasma levels is:A. 1hrB. 2hrsC. 4hrsD. 12hrsE. 24hrs
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E
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2014-2Q2: Pharmacological studies are undertaken in several phases. A. phase 3 study involves:A. Animal studiesB. Testing of drug on healthy volunteersC. Observational studies on patients with diseaseD. Post marketing surveillanceE. Randomised controlled trials on target population
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E
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2014-2Q3: A pregnant patient 28/40 gestation is involved in a high-speed MVA. On admission to the DEM she complains of sudden onset severe chest pain. Her vital signs show HR 120, BP 160/100, SpO2 95% RA. and her ECG shows ST depression. Most likely diagnosis is:A. Cardiac contusionB. Tension pneumothoraxC. Aortic dissectionD. Sternal fractureE. Myocardial infarction
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C
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2014-2Q4: A. 5 year-old child with recently diagnosed Duchenne muscular dystrophy has an inhalation induction with sevoflurane for closed reduction of a distal forearm fracturE. No other drugs have been given. 10 minutes later the child suffers a cardiac arrest. After a further 5 minutes a venous blood sample shows a potassium level of 8.5mmol/L. The most likely mechanism for the hyperkalaemia is:A. MHB. ARFC. CardiomyopathyD. RhambdomyolysisE. Crush injury
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D
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2014-2Q52: A. 30yr old pregnant patient develops contractions at 30/40 gestation. Which of the following can not be used for tocolysis? (Question does NOT ask about 34/40)A. ClonidineB. IndomethacinC. MagnesiumD. SalbutamolE. Nifedipine
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A
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2014-2Q53: In a patient with intraorbital haemorrhage, following local anaesthetic injection, the adequacy of occular perfusion is best assessed by:A. AngiographyB. Indirect ophthalmoscopyC. Direct ophthalmoscopyD. Intra-occular pressure tonometryE. Palpation of the globe by an experienced physician
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B
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2014-2Q54:What is the appropriate post-operative ibuprofen dosage for a one year old child tds?A. 5mg/kgB. 7.5mg/kgC. 10mg/kgD. 15mg/kgE. 20mg/kg
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C
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2014-2Q55:You are inducing a 4yr old child with Arthrogrophysis multiplex congenitA. After you administer the induction agents, you find it difficult to place the laryngoscopE. What is the likely complication?A. Malignant hyperthermiaB. Neuroleptic malignant syndromeC. TMJ rigidityD. Opioid-induced rigidityE. Inadequate depth of anaesthesia
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C
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2014-2Q56: What is the best measure of the anticoagulant effect of Dabigatran?A. APTTB. Dilute thrombin timeC. Prothrombin timeD. Bleeding timeE. TEG
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B
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2014-2Q57: What is the ratio of compression to breaths for neonatal resuscitation?A. 3:1B. 15:1C. 30:1D. 15:2E. 30:2
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A
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2014-2 Q60: In patients with refractory elevated ICP, bilateral decompressive craniectomy is associated with reduction in ICP and also results in:A. Reduced duration of ventilationB. Reduced duration of hospitalisationC. Improved overall mortalityD. Worse long-term neurological outcomeE. Unchanged long-term neurological outcome
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D, E by association
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2014-2Q61:Tumour lysis syndrome causes all of the following biochemical abnormalities EXCEPT:A. HyperkalaemiaB. HypernatraemiaC. HyperphosphataemiaD. HyperuricaemiaE. Hypocalcaemia
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B
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2014-2 Q66 You are performing an interscalene nerve block using a nerve stimulator when your patient begins to hiccough. You should aim to position the tip of your needle moreA. AnteriorB. PosteriorC. CephaladD. CaudalE. Superficial
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B
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2014-2Q67 The characteristic respiratory pattern in a patient with an acute C5 spinal cord injury isA. Rapid respiratory rateB. Arterial hypoxaemiaC. Chest wall immobilityD. Preserved coughE. Preserved inspiratory force
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A
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2014-2Q68 Tavi vs Max medical therapy nonoperable aortic stenosis reduction in risk at 30 days ofA. AMIB. AKIC. DeathD. Atrial fibrillationE. Stroke
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B, D
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2014-2Q69 Medial peribulbar block tip max distance past equator for minimal vein injuryA. 5B. 10C. 15D. 20E. 25
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A
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2014-2Q76: A. patient has suffered flash burns to half of the left upper limb, all of the left lower limb and the anterior surface of the abdomen. The approximate percentage of the body surface which has been burnt is:A. 18%B. 23%C. 32%D. 41%E. 48%
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C
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2014-2Q77: You are anaesthetising an ASA. 1 woman for a laparoscopic gynaecological procedurE. How long does it take for the PaCO2 to peak?A. <15minB. 15-30minC. 30-60minD. 60-90minE. >90min
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B
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2014-2Q82: Anaemia post partial gastrectomy is most likely due to:A. folate deficiency secondary to steatorrheaB. ongoing haemorrhage from stomal ulcer '(yes Stomal not stomach)'C. malabsorption of ironD. Vit B12 deficiency due to loss of intrinsic factorE. folate deficiency due to lack of appetite
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C
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2014-2Q83: 65year old for video assisted thoracoscopic lower lobe wedge resection. Surgeon requests lung isolation and one lung ventilation.Predictors of intraoperative hypoxia are:A. central rather than peripheral lesionB. left sided lesionC. high Aa Oxygen gradient when ventilating both lungsD. right sided lesionE. supine rather than lateral position
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B
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2014-2Q94: Small air bubbles in the arterial line system will reduceA. Dampening coefficientB. ?Extrinsic CoefficientC. Measured systolic pressureD. Measured MAPE. Resonant frequency
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E
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2014-2Q95: RPT. Capnograph trace form a patient that is intubated and ventilateD. What does it indicateSee previous paper for a picture, it was the sameA. Endotracheal intubationB. Gas sample line leakC. ETT cuff leakD. Obstructive diseaseE. Spontaneous breaths
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B
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2014-2Q98' You extubate a young woman after a dental procedure under GA. She has a history of hereditary angioedema and in recovery she develops airway oedemA. Best treatmentA. FFPB. IV AdrenalineC. IV corticosteroidsD. IV promethazineE. Nebulized adrenaline
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A
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2014-2Q99 A. previously well 65 year old female develops acute shortness of breath 3 days post hip replacement. The most appropriate investigations to confirm PE. isA. CTPAB. D-dimerC. EchoD. EcgE. V/Q scan
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A
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2014-2Q100 20 year old female with 25% burns to her body. She weighs 80 kg. How much replacement fluid should she be given over the next 8 hours?A. 4LB. 4.8LC. 5LD. 6LE. 8L
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A
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2014-2Q101 50 y.o female with a history of mennohhragia is having a hysterectomy. Her pre-operative Hb is 95. What serum ferritin would confirm iron deficiency anaemia?A. 30 mcg/LB. 3 mg/LC. 3 mcg/LD. 0.3 mg/LE. 3000 mcg/L
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A
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2014-2Q102 An Adult Jehovah's Witness requires a redo hip replacement for a peritrochanteric fracturE. They request that no blood products are given. The anaesthetists decision to PROCEED. is best given by:A. AutonomyB. BeneficenceC. JusticeD. NonmaleficenceE. Paternalism
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A
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2014-2Q103 100% Saturated air @ 20 degrees is what relative humidity @ 37 degreesA. 20%B. 30%C. 40%D. 50%E. 60%
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C
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2014-2Q104 Maximum cumulative dose of intralipid (ml/kg)A. 10B. 12C. 15D. 20
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B
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2014-2Q105 60yo alcoholic with HTN, has abdominal pain. No findings at laparotomy. 12 hrs later: Na140 k5 cl115 HCO3 18. What is the most likely diagnosis?A. ARFB. Diabetic ketosisC. Lactic acidosisD. MethanolE. NaCl infusion
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E
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2014-2Q106 Diagram of a CTG (showing late decelerations). Causes:Uteroplacental Foetal head compressionFoetal asphyxiaUmbilical cord compressionGeneral anaesthesia
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A
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2014-2Q107 In a clinical trial, researchers looked at 2 groups - smokers vs. non-smokers and followed then up for a period of timE. This type of study is aA. CohortB. Case studyC. ObservationalD. RCTE. ?
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A, C
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2014-2Q110 Prothrombinex VF is useful in the perioperative period to correct the coagulopathic defect of all of the following exceptA. Isolated factor II deficiencyB. Isolated factor VII deficiencyC. Isolated factor IX deficiencyD. Isolated factor X deficiencyE. Warfarin
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B
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2014-2Q111 A. 65 year old man otherwise fit and healthy is having a TKR under GA. (O2, N2O, sevoflurane and fentanyl). His blood pressure has been stable throughout the case at 130/80. Before the orthopaedic surgeons start reaming and bone cemetation you shouldA. Give heparin 5000 iuB. Give a corticosteroidC. Cease N2OD. Induce hypotensionE. Give a vasopressor to increase blood pressure
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C
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2014-2Un-numbered Questions(Photograph and Ultrasound picture of regional block. probe held transverse against posterolateral aspect of distal humerus over triceps. shows triangular nerve in close proximity to humerus) after infitraion of 5mls of 0.75% ropivacine Numbess in:A. lateral aspect of forearmB. ring dorsum??C. medial??D. palmar aspect and distal dorsal aspect of little finger and medial half of ring fingerE. palmar aspect and distal dorsal aspect of thumb, index and medial fingers and lateral half od ring finger
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Radial
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2014-2Lateral CXR given. Can see lower half of thorax and vertebrae but upper half is all black with clear demarcationA. Loculated effusionB. Artifact caused by patient's armC. Left lower lobe consolidationD. Right middle lobe consolidationE. Right lower lobe consolidation
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C
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2014-212 year-old with idiopathic scoliosis, most likely have associatedA. PhaemochromocytomaB. Renal artery stenosisC. Mitral valve prolapseD. Diabetes insipidusE. ? abnormality with the larynx
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C
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2014-2Term neonate, noted to have intermittent stridor few days after birth, then parents also notice stridor during feeding and sleep. Otherwise normal and healthy. Most likely condition isA. Cri-du-chat syndromeB. LaryngomalaciaC. TracheomalaciaD. LaryngocoeleE ? something to do with cord paralysis
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B
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2014-2A. picture of an echo 4 chambers viewA. Anterior mitral valve leafletB. Posterior mitral valve leafletC ? Aortic non-coronaryD ? TricuspidE
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?
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2014-2Cryoprecipate, once thawed must use withinA. 30 minutesB. 2 hoursC. 4 hoursD. 6 hoursE. 12 hours
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Pooled 4hrs, single 6hrs
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2014-2Glycine 1.5% used for TURP, osmolality isA. 200BCD. 300E. 320
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A
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2014-2Sick ICU patients seem to have moderate - severe ARDS PaO2/FIO2 ratio of 200, C.I. 1.7 (cardiac function seems okay). Decided to have ECMO, best mode isA. AVB. VAC. VVD ? arterior-arterialE ? atrio-aortic (yes that's how they spelt it)
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B
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2014-2Middle age women c/o pain in hands when hanging out washing. Also found to have muscle wasting on one of the hand associated with weaker radial pulse.A. CRPSB. Lateral medullary syndromeC. Thoracic outlet syndromeD. Paraneoplastic syndromeE
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C
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2014-2Same radial nerve question with photos of a probe over postero-lateral upper arm and ultrasound image that show a triangular shape nerve, most likely the radial nervE. Injecting 5 ml of 0.75% [[ropivacaine] will produce sensory block overA. Medial forearmB. Lateral forearmC. Dorsum part of handD. Plantar surface of ring and little fingerE. Plantar surface of middle and ring finger
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C
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2014-2Blue urticaria is a complication ofAB. Methylene blueC. Patent blue somethingDE
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C
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2014-2Intraosseous sampling - least accurate onA. AlbuminB. UreaC. Na, KD. ChlorideE.
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C
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2014-2Subtenon's block - muscle most likely to have inadequate blockA. Medial rectusB. LateralC. SuperiorD. Superior obliqueE. Inferior
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D
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2014-2EVAR, best method to reduce risk of renal impairmentA. Sodium bicarbonateB. N-acetylcysteineC. Normal salineDE
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C
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2014-2EVAR is preferred over open AAA. repair becauseA. Lower costB. Lower mortalityC. Less follow upD. Less re-interventionE. Less need for critical care
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E
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2014-2Laser flex tube with double cuffs - how to inflate cuff(s)?A. Inflate proximal then distalB. Inflate distal then proximalCD. Inflate distal onlyE. Inflate proximal only
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B
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2014-2Forceps delivery. Loss of sensation medial thigh with loss of adduction at hip joint - resulted from injury toA. Sciatic nerveB. lumbosacral plexusC. Lateral cutaneous nerve of thighD. Obturator nerveE
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D
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2014-2Called to cath lab because patient became agitated. Unstable angina having PCI,difficult right coronary stenting. Patient was hypotensive 80/40, HR 80/min in SR. What is the next best management step?A. Transfer to operating theater immediatelyB. Sedate and intubateC ?crack onD. Transthoracic echocardiography
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D
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2014-2A. printout of 12-lead ECGA. Atrial fibrillation with BBBB. Sinus tachycardia with BBBC. Torsades de pointesD. VTE. VF
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?
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2014-2(Repeat) Diagram about 3-bottle underwater seal drain, with the height of the fluid level in the suction bottle indicatesA. Maximal suction applied to the systemB.C.D.E.
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A
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2014-2Photo of a patient with tongue deviation post cervical spinal fusion. Which nerve is damaged?A. Glossopharyngeal nerveB. Vagus nerveC. Hypoglossal nerveD. Accessory nerveE
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C
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2014-2Post cardiac surgery. Rhythm strip to assess pacing on AOO. What is the diagnosis?A. Pacing spikes with loss of captureBCDE
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A
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2014-2Young male with MVA. + femur fracture on traction. Initial CXR normal. More than 24 hours. Became confused and drowsy, BP normal, crackles both lung fields with worsening O2 saturation to 85% on ward 12 hours later despite increasing oxygen flow. He has had 40mg morphine and a femoral nerve block. Diagnosis?A. Fat embolismB. Compartment syndromeC. Pulmonary embolismD ? PneumothoraxE ? Lung contusion(other remembered options: LA. toxicity, aspiration)
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A
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2014-2G5P5 in third stage labour. Found to be unresponsive, cyanosed, faint pulsE. On oxytocin induction and epidural infusion 10ml/hour. Also oozing from previous IV or blood sampling sites. Diagnosis?A. High spinalB. AFEC. PEDE. Massive haemorrhage
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B
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2014-2In iron deficiency anaemia, one will expect a serum ferritin level to be less thanA. 300mg/LB. 30mg/LC. 30mcg/LD. 300mcg/LE
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C
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2014-2Treatment for patients with congenital long QT syndromeA. Pacemaker/defibrillatorB. Accessory pathway abalationC. Beta blockerD. Calcium channel blockerE
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C
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2014-2An 18 month old child with VF arrest, shock withA. 10JB. 30JC. 50JD. 100JE
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C
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2014-2Endovascular coiling of cerebral aneurysm under GA, patient suddenly develop hypertension. What is the most likely cause?A. Acute hydrocephalusB. Rupture of aneurysmC. Contrast reactionD. Cerebral embolismE
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B
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2014-2A. patient on citalopram. Post-op in PACU given tramadol. Developed fever, tremor, restlessness, confusion, hyperreflexiA. Diagnosis isA. Neuroleptic malignant syndromeB. MHC. Serotonin syndromeDE
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C
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2014-2Best drug to reduce both gastric acidity and volumeA. RanitidineB. PPIC. Sodium citrateDE
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A
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2014-2Patient on moclobemide came in for surgery. In view of the use of vasopressor to treat hypotension one will give judicious amount ofA. ?B. MetaraminolC. AdrenalineD. NoradrenalineE. Phenylephrine
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E
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2014-2Patient with hyperthyroidism - proceed with elective surgery only if normal level of these hormones is seenA. TSHB. T4C. T3D. T3 & T4E
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B
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2014-2In pregnant women the durac sac ends atAB. L3C. L5D. S1E. S3
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S2
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2014-2Full size oxygen cylinder providing 10L/min of oxygen flow to a patient during transport. How long will this cylinder last?ABC. 45 minutesDE
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C
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2014-2Something to do with Echinacea and renal transplant - I think the answer is regarding immune system, other options were bleeding risk, nephrotoxicity
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Hepatotoxicity, immune stimulation
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2014-2Jehovah's witness having a TKR. You agree to proceed with surgery. Which ethical principle are you honouring?A. AutonomyB. Non-maleficenceC. BeneficenceD. JusticeE. Fidelity
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A
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2014-2Red-man syndrome secondary to vancomycin is due toA. Type II hypersensitivity reactionB. VasodilationC. Mast cell degranulationD. IgE. immediated responseE. Serotonin release
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C
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2014-2A. 40 y.o. female newly diagnosed ITP. Retinal detachment for surgery in 2 days. Platelets 40 and blood group A+. Management of her ITP:A. Administer Anti-D. antibodies 6 hrs pre opB. Admister desmopressin one hour pre opC. Administer methylpred and IVIg 2 days pre opD. Recheck platelet count morning of surgery and if not dropped continueE. Platelet transfusion morning of surgery
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C
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2014-2Absolute contraindication to ECTA. Cochlear implantsB. EpilepsyC. PregnancyD. Raised intracranial pressureE. Myocardial infarction
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A
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2014-2Repeat Stellate ganglion block. Needle entry next to SCM muscle at C6. Which direction to advance needle ?A. C3B. C4C. C5D. C6E. C7
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D
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2014-2Repeat CTG with early decelerationsA. GAB. Fetal head compressionC. Uteroplacental insufficiencyD. Acute asphyxiaE. Umbilical cord compression.
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B
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2014-2Repeat Endocarditis prophylaxisA. Bicuspid valveB. Congenital repair > 12 months agoC. Rheumatic heart valveD. Uncorrected cyanotic heart diseaseE. MVP
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D
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2014-2Repeat CVL relatively contraindicated in:A. LBBB
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A
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2014-2Repeat Maximum dose (with low risk of toxicity) of lignocaine (with adrenaline 1:100000) for liposuction with tumescence techniqueA. 3 mg/kgB. 7 mg/kgC. 15 mg/kgD. 25 mg/kgE. 35 mg/kg
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E
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2014-2Repeat You’re anaesthetizing an otherwise well 40 yo male for a craniotomy. Propofol and remifentanil TIVA. Using entropy. The MAP is 70 mmHg, heart rate is 70 bpm, Sats are 98%, state entropy is 50 and the response entropy 70. Most appropriate next step isA. give 0.5 mg metaraminol ivB. use NMT to assess train of four ratioC. change to volatile anaestheticD. do nothingE. increase propofol TCI concentration by 0.5
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B
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2014-2Repeat What proportion of the population are heterozygous for pseudocholinesterase deficiency, i.E. have a dibucaine number 30-70?A. 0.04%B. 0.4%C. 4%D. 14%E. 40%
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C
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2014-2Repeat CO2 penetrates surface tissue so well with little damage to underlying tissue becauseA. Well absorbed by HbB. Poorly absorbed by H20C. Widely disseminated in tissueD. Long infrared wavelengthE. Short infrared wavelength
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D
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2014-2Repeat With regards to ROTEM: maximal clot firmness (Increased MA. maximal amplitude on TEG) correlates best with needing to give:A. FFPB. CryoprecipitateC. PlateletsD. ProthrombinexE. Tranexamimic acid
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B, C
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2014-2Repeat The MELD. score is calculated using INR, Bilirubin & what?A. CreatinineB. AlbuminC. UreaD. ASTE. Ammonia
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A
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2014-2- Repeat: Reduction of fraud in research - what's the MOST LIKELY to help? Backup of a well-known research institute, sole author (HOD), similar to published data...etc.
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Multiple authors
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2014-2Repeat An 80 year old man undergoes a unilateral lumbar sympathectic blockadE. The most likely side effect that he experiences is:A. Genitofemoral neuralgiaB. HaematuriaC. Postural hypotensionD. Lumbar radiculopathyE. Psoas haematoma
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A
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2014-2Repeat The most important effect of Lugol's iodine administration before thyroid surgery isA. reduce incidence of thyroid stormB. reduce incidence of vocal cord palsyC. increase likelihood to identify and preserve parathyroid glandsD. pigmentation of thyroid gland to help identify thyroid glandE. reduce vascularity of thyroid gland
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E
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2014-2To exclude RICP in an awake patient the most reliable finding is what ?A. No headacheB. No diplopiaC. No vomitingD. Pulsatile retinal veinE. No papilloedema
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D
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2014-2- Repeat: % of those with raised troponin post SAH: 15-30%
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15-30%
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2014-2- Repeat: Best determinant of a neonate's heart rate: Auscultate the chest.
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Auscultate
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2014-2- Repeat: Optimal fluid management during laparotomy: Pulse pressure variation, EF on a TOE, CVP, BP and HR
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PPV
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2014-2- Repeat: Just gone onto CPB, MAP 25, CVP 1, sVO2 80% - Give metaraminol.
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Metaraminol
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2014-2- Repeat: Maximum recommended time for an adult tourniquet: 90 min? 120 min?
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120min
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2014-2- Repeat: Best way to achieve cerebral perfusion during aortic arch repair: Anterograde via carotids
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Anterograde
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2014-2- Hypotensive in cath-lab for a difficult PCI to RCA. Sweaty, increased hypotension with inspiration, raised CVP. What do you do? Take to OR immediately? Perform an ECHO? Some other options.
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Perform an echo
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2014-2- Repeat: Post (R) pneumonectomy on the ward becomes acutely unwell, hypotensive, raised CVP. What do you do? Turn left lateral.
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L lateral
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2014-2- Repeat: Venous air embolism. How to position the patient? Head up + R) up, Head up + L) up, Head down + R) up or Head down + L) up. [Head down and (R) side up]
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Head down cranio, head up hepatic, R side up
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2014-2- Repeat: Diagram with 3-chamber chest drain system - X marks what? Maximum suction that can be achieveD. Sorry, can't remember the other options.
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Maximum suction
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2014-2- Repeat: Hours for tryptase to peak?
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1hr
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2014-2- Blue urthicaria - caused by what? [Cyanotic patient]
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Patent blue V
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2014-2- Repeat: TBI - What fluid NOT to give? Synthetic colloids, saline, albumin etc
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Albumin
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2014-2Which population is more liable to CNS damage from Hyponatraemia?A. ChildrenB. Young malesC. Young femalesD. Old malesE. Old females
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Young females
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2014-2You are anaesthetising an ASA. 1 woman for a laparoscopic gynaecological procedurE. How long does it take for the PaCO2 to peak?A. <15minB. 15-30minC. 30-60minD. 60-90minE. >90min
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B
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2014-2- Lat cxr of consolidation at the basE. Which lobe and which side? [Can still see diaphragm and can still see spines. Ends abruptly obliquely.]
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RML
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2014-2- Hb 86 post TKJR in an asymptomatic patient with stable angina. Transfuse to 120, transfuse to 100, observe overnight and repeat mane.
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Repeat mane
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2014-2- USS over the radial nervE. Previously the question was asked as what muscle action will be lost (wrist flexion/extension). This time the question was the pattern of sensory loss.
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Dorsum hand
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2014-2Health care worker. HBV exposurE. Known to have immunisation titres. What do you do?A. Booster dose of his immunisationB. HBV immunoglobulinsC. Pegylated InterferonD. Aciclovir
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Nothing
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2014-2- HIV seroconversion post needlestick injury: 0.3%, 3%, 30%...etc
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0.3%
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2014-2- Repeat: Craniotomy, MAP 80, transducer 13cm below, CVP given, what's the CPP
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70mmHgmmHg
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2014-2- Repeat: Unremakable finding on a laparotomy. Has been given 3L cystalloid and minimal EBL. Physiological response to such haemodilution includes ALL EXCEPT: Increased myocardial O2 extraction. Increased tissue O2 extraction. Increased tissue flow due to decrease viscosity. Increased tissue flow due to vasodilatation.
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Increased tissue extraction
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2014-2- Ideopathic scoliosis in a young female. Likely associated pathology: MV prolapse, renal artery stenosis, abnormality with the larynx...etc
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MV prolapse
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2014-2- Repeat: ABG as you diagnose intraoperative MH: Acidosis/alkalosis, high pCO2, Zero BE. vs. -9 BE.Repeat 20 year old male 80kg presents post house fire with 30% burns. Using the Parkland formula how much fluid should he have replaced in the first 8 hours.A. 2.6L N/salineB. 3.6L N/salineC. 3.6L CSLD. 4.8L N/salineE. 4.8L CSL
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E
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2014-2Repeat A. 50 year old male in recovery after an anterior cervical spinal fusion, developing increasing respiratory distress, bulge under original incision, combative, repeatedly removing oxygen mask, spO2 96%. What is the most appropriate management ?A. Direct laryngoscopy and intubation after inhalational induction with sevofluraneB. Awake tracheostomy by surgeonsC. Awake fibreoptic intubation using minimal sedationD. Direct laryngoscopy and intubation with propofol and suxE. Retrograde intubation
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A
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2014-2Asthmatic paediatric patient, tonsillectomy. Desaturates and stiff to bag. First thing to do?A. SalbutamolB. SuctionC. Ask surgeon to release gagD. ParalysisE. ? reintubate
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C
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2014-2Balloon pump trace 2:1A. Early inflationB. Late inflationC. Early deflationD. Late deflationE. ? No problem
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?
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2014-2Repeat A. 40 yo woman for laparotomy to remove phaeochromocytoma under combined epidural and general anaesthesiA. Pre-operatively treated with phenoxybenzamine and metoprolol. Intra-operatively, blood pressure is 250/130 despite high dose phentolamine and SNP. HR is 70/min and SaO2 are 98%. The next most appropriate treatment is:A. Epidural LignocaineB. IV EsmololC. IV HydralazineD. IV MagnesiumE. IV Propofol
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D
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2014-2- Fasting times for a 6week old (Repeat)
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<6/52 clear fluids 2hrs, breast milk 4hrs, formula 4hrs
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2014-2- Unremarkable/negative laparotomy. 3L saline given. ABG results (Hyperchloraemic acidosis - Repeat)
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Hyperchloraemic acidosis
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2014-2- How many hours/ minutes will the O2 cylinder last for (150 L at 10L/min => 15min is the answer to choosE. Re-worded from a similar prev question)
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5000kPa, 15min
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2014-2- AAI paced ECG: 1) Failure to capture 2) CHB, 3) 2nd degree HB, 4) AF [I think it looked like progressive prolongation of PR interval after the spikes, hence 2nd degree HB]
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2nd degree HB
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2014-2- Hyperkalaemia of 7 or 8. Most appropriate immediate (or was it most "effective") therapy: Insulin + Glucose vs Bicarb vs Salbutamol vs resin vs something else.
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Insulin/glucose
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2014-2Correct INR range for a patient with a mechanical valveABCDE
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Older gen AV 2.5-3.5, MVR 2.5-3.5, current gen AV 2-3
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2014-2Flow volume loop diagramA. Variable intra-thoracic obstructionB. Variable extra-thoracic obstructionC. Restrictive patternD. Obstructive patternE. Fixed obstruction
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?
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2014-24 METS is how many ml O2 / min
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14ml/02/min
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2014-2A. 30 year old multi trauma patient one week post injury has severe ARDS. He is currently ventilated at 6ml/kg tidal volume, PEEP of 15cm H20 and pa02/Fi02 is less than 150. The next step to improve oxygenation is:A. increase PEEP to 20cmH20B. increase tidal volume to 10mls/kgC. initiate nitrous oxide therapyD. commence high flow oscillatory ventilationE. ventilate in the prone position
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E
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2014-2Repeat When topping up a labour ward epidural to an epidural for lower segment caesarean section, the optimum level of block when assessed for light touch is to:A. T2B. T4C. T6D. T8E. T11
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B
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2014-2Repeat You are involved in research and as part of data collection you collect ASA. scores. This type of data is:A. CategoricalB. NominalC. Non-parametricD. NumericalE. Ordinal
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E
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2014-2Repeat During a pneumoperitoneum, at what level of intra-abdominal does cardiac output fall?A. 10 mmHgB. 20 mmHgC. 30 mmHgD. 40 mmHgE. 50 mmHg
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B
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2014-2Repeat Best option to reduce risk of ventilator induced pneumonia?A. Nurse in supine positionB. Early spontaneous ventilation through ETTC. Oral hygieneD. Use antacidsE. Regularly change breathing circle
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C
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2014-2Repeat Which drug should be avoided both intra- and post operatively in a woman having surgery who is breast feeding a 6 week old baby?A. codeineB. morphineC. paracetamolD. parecoxibE. tramadol
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A
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2014-2Repeat A. patient is in Class 4 haemorrhagic shock, secondary to a gunshot wound to the abdomen. He is clinically coagulopathic 30 minutes later. He has received intravenous Hartmann's 1L. The coagulopathy is likely related to:A. acidosisB. dilution of clotting factorsC. hypothermiaD. systemic release of tissue factorE. tissue hypoperfusion
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D
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2014-2Repeat The normal physiological response following ECT isA. transient tachycardia followed by bradycardia and hypotensionB. transient bradycardia followed by tachycardia and hypertensionC. unpredictableD. transient tachycardia followed by bradycardia and hypertensionE. tachycardia and hypotension
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B
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2014-2Repeat In preadmission clinic with patient with a tracheostomy. To enable patient to talk you would-A. Deflate tracheostomy cuff, insert one-way valve, insert fenestrated pieceB. Deflate tracheostomy cuff, remove one-way valve, insert fenestrated pieceC. Inflate tracheostomy cuff, remove one-way valve, insert fenestrated pieceD. Inflate tracheostomy cuff, insert one-way valve, insert fenestrated pieceE. ?
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A
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2014-2Repeat What is NOT a contraindication to MRI?A. Pulmonary artery catheterB. Arterial lineC. ScissorsD. Coiled ECG cableE. Laryngoscope
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B
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2014-2Repeat What is the mechanism of central sensitisation?A. Increased intracellular magnesiumB. Antagonism of the NMDA. receptorC. Glycine is the major neurotransmitter involvedD. Recurrent a-delta fibre activationE. Alteration in gene expression
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E
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2014-2Repeat Which volatile contributes most to greenhouse gases / environmental pollutant ?A. DesfluraneB. N2OC. SevofluraneD. IsofluraneE. Halothane
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B
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2014-2Repeat The clinical sign that a lay person should use to decide whether to start CPR is:A. Absent central pulseB. Absent peripheral pulseC. Loss of consciousnessD. Obvious airway obstructionE. Absence of breathing
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E
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2014-2Repeat A. patient's competence to give informed consent is determined by all the following except:A. Ability to communicate a choiceB. Ability to apply reasoningC. Ability to understand consequencesD. The provision of significant informationE. ?
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D
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2014-2?? First line treatment for acute attack of hereditary angioedemaA. FFPB. AdrenalineC. SteroidsD. C1 inhibitor concentrateE. anti-histamine
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D
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2014-2Repeat Adult male who is intubated and ventilated, with CVL in situ. Just before surgeon starts the Line Isolation Monitor alarms about a leak at 5mA. What do you do?A. stop procedure and move to a safe locationB. sequentially remove non essential monitors from the circuit until fault is identifiedC. unplug the CVL to electrically isolate it until fault is identifiedD. ensure the patient is earthedE. Check the diathermy pad
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C
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2014-2Repeat Patient with Haemophilia A. with known high titres of inhibitors to factor 8. What would you give to prevent bleeding in the patient for OTA. FVIIaB. High dose FVIII concentrateC. FFPD. CryoE. Platelets
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A
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2014-2Mec stained liquor post LSCS Did not state if infant flat or vigorousA. SuctionB. Routine care
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Suction if flat, routine if vigorous
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2014-255 year old subarachnoid haemorrhage secondary to aneurysm. Patient is confused with a oculomotor (3rd cranial nervE. palsy, complains of a severe headachE. This patient is in Hunt and Hess class:A. 0B. 1C. 2D. 3E. 4
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D
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2014-2Repeat In a 140kg obese patient, compared to a 70 kg personA. cardiac output >20% lowerB. cardiac output 10% lowerC. cardiac output no differentD. cardiac output 10% higherE. cardiac output >20% higher
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E
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