Download Each of the questions or incomplete statements in this section is

Each of the questions or incomplete statements in this section is followed by answer or
by completions of the statement, respectively. Select the ONE BEST answer or
completion for each item.
1.
Which of the following would be the most likely cause of oozing in a patient
transfused with 10 units of packed red blood cells (RBCs)?
A.
B.
C.
D.
E.
2.
The blood volume of a 10-kg, 1-year-old infant is
A.
B.
C.
D.
E.
3.
650 mL
800 mL
1100 mL
1300 mL
1500 mL
A 20-kg, 5-year-old child with a hematocrit of 40% could lose how much blood
and still maintain a hematocrit of 30%?
A.
B.
C.
D.
E.
4.
Citrate toxicity
Low factor V
Low fibrinogen
Dilutional thrombocytopenia
Low factor VIII
140 mL
250 mL
350 mL
450 mL
550 mL
A 100-kg male patient has a measured serum sodium concentration of 105
mEq/L. How much sodium would be needed to bring the serum sodium to 120
mEq/L?
A.
B.
C.
D.
E.
600 mEq
900 mEq
1200 mEq
2400 mEq
3600 mEq
5.
Which of the following peripheral nerves is most likely to become injured in
patients who are under general anaesthesia?
A.
B.
C.
D.
E.
6.
Renal failure associated with fluoride toxicity anaesthesia most closely resembles
A.
B.
C.
D.
E.
7.
Ulnar nerve
Median nerve
Radial nerve
Common peroneal nerve
Sciatic and peroneal nerve
Papillary necrosis
Acute tubule necrosis
Hepatorenal syndrome
Central diabetes insipidus
Nephrogenic diabetes insipidus
Naltrexone is
A.
B.
C.
D.
A narcotic with local anaesthetic properties
An opioid agonist-antagonist similar to nalbuphine
A pure opioid antagonist with a shorter duration of action than Naloxone
An opioid anatagonist used for treatment of previously detoxified heroin
addicts
E. A synthetic opioid derived from oxymorphone
8.
Which of the following mechanisms is most frequently responsible for hypoxia in
the recovery room?
A.
B.
C.
D.
E.
9.
Ventilation/perfusion mismatch
Hypoventilation
Hypoxic gas mixture
Intracardiac shunt
Abnormal gas diffusion
Pheochromocytoma would be most likely to coexist with which of the following?
A.
B.
C.
D.
E.
Insulinoma
Pituitary adenoma
Primary hyperaldosteronism (Conn’s syndrome)
Medullary carcinoma of the thyroid
Carcinoid tumor
10.
A 3-year-old child is scheduled for tonsillectomy. Clear liquids may be consumed
up to how many hours preoperatively.
A.
B.
C.
D.
E.
11.
Each of the following postoperative complications of thyroid surgery can result in
upper airway obstruction EXCEPT
A.
B.
C.
D.
E.
12.
Tachycardia
Hypertension
Fever
Hypoxia
Increased end-expiratory CO2 tension (PECO2)
Which of the following is NOT a component of the Post-Anaesthetic Discharge
Scoring System (PADSS) used to evaluate the suitability of a patient to be
discharged from an ambulatory surgical facility?
A.
B.
C.
D.
E.
14.
Tracheomalacia
Tetany
Cervical hematoma
Bilateral recurrent laryngeal nerve injury
Bilateral superior laryngeal nerve injury
The most sensitive early sign of malignant hyperthermia during general
anaesthesia is
A.
B.
C.
D.
E.
13.
2
4
6
8
Anytime before induction
Drinking
Ambulation
Nausea and vomiting
Pain
Surgical bleeding
Which of the following drugs is useful in the treatment of asthma by specifically
interfering with the leukotriene pathway?
A.
B.
C.
D.
E.
Fluticasone (Flovent)
Ipratropium bromide (Atrovent)
Triamcinolone (Azmacort)
Montelukast (Singulair)
Salmeterol
15.
Which of the following would not result in an increase in intraocular pressure?
A.
B.
C.
D.
E.
16.
Remifentanil is metabolized primarily by
A.
B.
C.
D.
E.
17.
Venous air embolism
Pneumothorax
Peripheral neuropathies
Postdural puncture headache
Hypotension with regional anaesthesia
Each of the following may increase MAC for volatile anaesthetics EXCEPT
A.
B.
C.
D.
E.
19.
Kidneys
Liver
Hoffman elimination
Pseudocholinesterase
Nonspecific esterases
Patients who undergo extracorporeal shock wave lithotripsy are at increased risk
for
A.
B.
C.
D.
E.
18.
Increase in Paco2 from 35 to 40 mm Hg
100 mg IV succinylcholine after pretreatment with 1 mg Vecuronium
100 mg IM succinylcholine
Acute rise in venous pressure from coughing
100 mg IV succinylcholine in patient in whom eye muscles have been
detached from the globe
Cocaine
Hyperthyroidism
Monoamine oxidase inhibitor therapy
Tricyclic antidepressants
Hypernatremia
Hypoglycemia is more likely to occur in the diabetic surgical patient with which
of the following diseases?
A. Renal disease
B. Rheumatoid arthritis requiring high-dosage prednisone
C. Chronic obstructive lung disease treated with a terbutaline inhaler and
Aminophylline
D. Manic-depressive disorder treated with lithium
E. Congestive heart failure
20.
The most sensitive test for detecting primary hypothyroidism in the preoperative
evaluation of a patient in whom hypothyroidism is suspected is
A.
B.
C.
D.
E.
21.
In the newborn the cricoid cartilage is at which level relative to the cervical spine?
A.
B.
C.
D.
E.
22.
TSH level
Total plasma T3 level
Total plasma T4 level
Resin T3 uptake
Antithyroid antibodies
C3
C4
C5
C6
C7
The most common cause of neonatal bradycardia (heart rate less than 100/min) is
A. Congenital heart disease
B. Maternal drug intoxication (narcotics, alcohol, magnesium, barbiturates,
digitoxin)
C. Fever
D. Postpartum cold stress
E. Hypoxemia
23.
Each of the following statements concerning side effects of succinylcholine when
used to paralyze neonates is true EXCEPT
A.
B.
C.
D.
E.
24.
It seldom causes muscle fasciculation
It can cause bradycardia
Dysrhythmias frequently occur following intramuscular injections
It can cause myoglobinuria
It can cause hyperkalemia
Magnesium sulfate (MgSO4) is used as an anticonvulsant in patients with
preeclampsia and may produce any of the following effects EXCEPT
A.
B.
C.
D.
E.
Sedation
Analgesia
Hypotension
Respiratory paralysis
Tocolysis.
25.
Normal fetal heart rate (FHR) is
A.
B.
C.
D.
E.
26.
Toxic side effects of MgSO4 when used to treat preeclampsia include all the
following EXCEPT
A.
B.
C.
D.
E.
27.
Dyspnea
Hypertension
Bleeding (disseminated intravascular coagulation)
Hypoxemia
Seizures
Which of the following respiratory parameters is not increased in the parturient?
A.
B.
C.
D.
E.
29.
Cardiac arrest
Neonatal hypotonia
Potentiation of neuromuscular blockade with Vecuronium
Renal failure
Hypoventilation
Which of the following signs and symptoms is NOT associated with amniotic
fluid embolism?
A.
B.
C.
D.
E.
28.
60 to 100 beats/min
100 to 140 beats/min
120 to 160 beats/min
150 to 200 beats/min
None of the above
Minute ventilation
Tidal volume
Arterial PaO2
Oxygen consumption
Serum bicarbonate
A patient having which of the following conditions is LEAST likely to develop
disseminated intravascular coagulation?
A.
B.
C.
D.
E.
Pregnancy-induced hypertension
Placenta abruption
Placenta previa (bleeding)
Amniotic fluid embolism
Dead fetus syndrome
30.
Morphine is not used routinely for labor epidurals because it
A.
B.
C.
D.
E.
31.
Which of the following lung volumes or capacities change the LEAST during
pregnancy?
A.
B.
C.
D.
E.
32.
5 mm Hg
15 mm Hg
25 mm Hg
40 mm Hg
None of the above
Which of the following intravenous anaesthetics is contraindicated in patients
with intracranial hypertension?
A.
B.
C.
D.
E.
34.
Tidal volume
Functional residual capacity
Expiratory reserve volume
Residual volume
Vital capacity
Intracranial hypertension is defined as a sustained increase in intracranial pressure
(ICP) above
A.
B.
C.
D.
E.
33.
Increases uterine tone
Causes excessive neonatal respiratory depression
Has a slow onset
Decreases uterine blood flow
Adversely affects FHR variability
Diazepam
Fentanyl
Thiopental
Midazolam
Ketamine
Normal global CBF is
A.
B.
C.
D.
E.
25 mL/100 g/min
50 mL/100 g/min
75 mL/100 g/min
100 mL/100 g/min
150 mL/100 g/min
35.
Which of the following is the most sensitive means of detecting venous air
embolism (VAE)?
A.
B.
C.
D.
E.
36.
Which of the following is the earliest sign of lidocaine toxicity?
A.
B.
C.
D.
E.
37.
Bupivacaine, lidocaine, ropivacaine
Bupivacaince, ropivacaine, lidocaine
Lidocaine, bupivacaine, ropivacaine
Ropivacaine, bupivacaine, lidocaine
Lidocaine, ropivacaine, bupivacaine
The primary determinant of local anaesthetic potency is
A.
B.
C.
D.
E.
39.
Shivering
Nystagmus
Lightheadedness and dizziness
Tonic-clonic seizures
Nausea and vomiting
The correct arrangement of local anaesthetics in order of their ability to produce
cardiotoxicity from most to least is
A.
B.
C.
D.
E.
38.
Electroencephalography (EEG)
Pulmonary artery catheter
Transesophageal echocardiography
Mass spectrometry
Right atrial catheterization
pKa
Molecular weight
Lipid solubility
Concentration
Protein binding
Severe hypotension associated with high spinal anaesthesia is caused primarily by
A.
B.
C.
D.
E.
Decreased cardiac output secondary to decreased preload
Decreased systemic vascular resistance
Decreased cardiac output secondary to bradycardia
Decreased cardiac output secondary to decreased myocardial contractility
Increased shunting through metarterioles
40.
Select the FALSE statement regarding spinal anatomy and spinal anaesthesia
A.
B.
C.
D.
E.
41.
A retrobulbar block anaesthetizes each of the following nerves EXCEPT
A.
B.
C.
D.
E.
42.
Common carotid artery
Internal carotid artery
Vertebral artery
Axillary artery
Aorta
If the recurrent laryngeal nerve were transected bilaterally, the vocal cords would
A.
B.
C.
D.
E.
44.
Ciliary nerves
Cranial nerve IV (trochlear nerve)
Cranial nerve III (oculomotor nerve)
Cranial nerve VI (abducens nerve)
Maxillary branch of the trigeminal nerve
The stellate ganglion lies in closest proximity to which of the following vascular
structures?
A.
B.
C.
D.
E.
43.
The addition of phenylephrine to lidocaine will prolong spinal anaesthesia
A high thoracic sensory block will result in total sympathetic blockade
The largest vertebral interspace is L5-S1
The dural sac extends to the S3-4 interspace
Tetracaine provides longer anaesthesia than does procaine
Be paralyzed in the open position
Be paralyzed in the closed position
Be paralyzed in the intermediate position
Not be affected unless the superior laryngeal nerve were also injured
Appear exactly the same as if an intubating dose of succinylcholine were
given
The most common complication associated with a supraclavicular brachial plexus
block is
A.
B.
C.
D.
E.
Blockade of the phrenic nerve
Intravascular injection into the vertebral artery
Spinal blockade
Blockade of the recurrent laryngeal nerve
Pheumothorax
45.
Epidural use of which of the following opioids would result in the greatest
incidence of delayed respiratory depression?
A.
B.
C.
D.
E.
46.
Which of the following is the most sensitive indicator of left ventricular
myocardial ischemia?
A.
B.
C.
D.
E.
47.
Wall-motion abnormalities on the echocardiogram
ST-segment changes in lead V5 of the electrocardiogram (ECG)
Appearance of V waves on the pulmonary capillary wedge pressure tracing
Elevation of the pulmonary capillary wedge pressure
Decrease in cardiac output as measured by the thermodilution technique
Afterload reduction is beneficial during anaesthesia for noncardiac surgery in
patients with each of the following conditions EXCEPT
A.
B.
C.
D.
E.
48.
Sufentanil
Fentanyl
Morphine sulfate
Hydromorphone
Meperidine
Aortic insufficiency
Mitral regurgitation
Tetralogy of Fallot
Congestive heart failure
Patent ductus arteriosus
Which of the following drugs should NOT be administered via an endotracheal
tube?
A.
B.
C.
D.
E.
Lidocaine
HCO3
Atropine
Naloxone
Epinephrine