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L3 (1ST BMEX) > SURG1 > Flashcards

SURG1 Flashcards

1
Q

Which of the following is characteristic of Malignant Hyperthermia?

A. It is a life-threatening hypermetabolic disorder.
B. Triggering agents include all volatile anesthetics and all non-depolarizing neuromuscular blockers.
C. It is an autosomal recessive disorder.
D. It causes metabolic alkalosis.

A

A. It is a life-threatening hypermetabolic disorder.

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2
Q

The trauma patient in the emergency room needs to be intubated as soon as possible. Being the emergency room physician, you decided to do a Rapid Sequence Intubation.

His vital signs are the following:
BP: 50/30, HR: 54 bpm, RR: 28 cpm, Temp: 36.5 Celsius, O2 sat: 85%. Which sedating drug would be ideal in this situation?

A. Etomidate
B. Propofol
C. Ketamine
D. Midazolam

A

C. Ketamine (HARAYA)
A. Etomidate (INARA)

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3
Q

The addition of Epinephrine to local anesthetics could result to:

A. Flushing and hypotension
B. A shorter duration of action
C. A faster onset of action
D. A reduction in toxicity threshold

A

C. A faster onset of action

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4
Q

Which of the following local anesthetic can cause allergic reaction secondary to metabolism by plasma cholinesterase?

A. Lidocaine
B. Tetracaine
C. Ropivacaine
D. Bupivacaine

A

B. Tetracaine

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5
Q

Which of the following cannot help the patient in relieving pain?

A. Diazepam
B. Nitrous oxide
C. Ketamine
D. Dexmedetomidine

A

A. Diazepam

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6
Q

What volatile anesthetic could attribute to tension pneumothorax to trauma patients, or increased bowel air in cases of complete intestinal obstruction?

A. Sevoflurane
B. Nitric Oxide
C. Desflurane
D. Nitrous Oxide

A

D. Nitrous Oxide

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7
Q

Which of the following is not included in the American Society of Anesthesiologist standards for basic intraoperative monitoring?

A. Pulse oximetry is essential in monitoring the oxygenation of the patient.
B. End-tidal carbon dioxide monitoring is required in all cases of general anesthesia.
C. Heart rate and blood pressure should be recorded at least every 5 minutes.
D. A qualified anesthesia personnel shall be present in the room throughout the conduct of all general anesthetics and regional and monitored anesthesia care.

A

B. End-tidal carbon dioxide monitoring is required in all cases of general anesthesia.

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8
Q

Which step differentiates rapid sequence intubation/induction (RSI) to Routine Induction of General Anesthesia?

A. Cricothyroid pressure for RSI
B. Using Sevoflurane for rapid sequence intubation
C. Using a smaller laryngoscope blade for Routine Induction of GA
D. The preference of using a videolaryngoscopy during RSI

A

A. Cricothyroid pressure for RSI

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9
Q

A 56-year-old male came in the emergency room after one episode of vomiting of gross blood. Per medical history, he slipped in their comfort room 2 weeks ago and has assumingly sprained his ankle. He has been taking unrecalled medications that helped him relieve his pain. Which of the following pain medications could be pertinent in extracting in the history that could be essential in his further management?

A. Ibuprofen
B. Morphine Opioid
C. Celecoxib Selective COX-2 inhibitor
D. Paracetamol

A

A. Ibuprofen

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10
Q

Which of the following is an adverse effect of Neostigmine?

A. Increased blood pressure
B. Increased heart rate
C. Pupillary dilatation
D. Bronchial constriction

A

D. Bronchial constriction

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11
Q

A three-year-old male, 14 kg, preterm underwent herniotomy under general anesthesia using Fentanyl and Propofol. Past medical and family history were unremarkable. What is the best postoperative vomiting prophylaxis for this patient?

A. Dexamethasone 1.5mg IV plus Metoclopramide 2.5 mg IV
B. Dexamethasone 1.5 mg IV plus Promethazine 5 mg IV
C. Dexamethasone 1.5 mg IV
D. Dexamethasone 1.5 mg IV plus Ondansetron 1.5 mg

A

D. Dexamethasone 1.5 mg IV plus Ondansetron 1.5 mg

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12
Q

AH is a 5-year-old male who is inducted for general anesthesia for a circumcision. A few minutes later after induction, he developed masseter rigidity, tachycardia, hypertension, and increased body temperature. Which of the following could have caused this effect?

A. Succinylcholine
B. Atracurium
C. Propofol
D. Fentanyl

A

A. Succinylcholine

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13
Q

A 45-year-old, 60-kg male was scheduled for elective total thyroidectomy. In the operating room the baseline vital signs are BP 160/90 mm Hg, Heart rate of 110 bpm, SP02 99% and RR 15 cpm. Which of the following anesthetics should be avoided?

A. Midazolam
B. Fentanyl
C. Propofol
D. Ketamine

A

D. Ketamine

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14
Q

Which of the following is not a characteristic of its paired volatile anesthetic?

A. Isoflurane - inexpensive
B. Desflurane - requires electric/heated vaporizer
C. Sevoflurane - breakdowns to compound A in the circuit
D. Nitrous Oxide - pungent

A

D. Nitrous Oxide - pungent

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15
Q

Which of the following post-operative findings is a clinical criterion for discharge of a patient in an outpatient surgery from the Recovery Room immediately to the Household setting?

A. No written or verbal orders are required in discharging these types of patients.
B. A pain score of 4/10
C. The patient is both actively nauseous with 2 episodes of vomiting.
D. Inability to urinate after doing inguinal hernia repair after spinal anesthesia

A

B. A pain score of 4/10

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16
Q

What is the patient’s PACU score 2 hours into the recovery room after TURP under spinal anesthesia?

Preoperative Vital Signs: BP: 120/80, HR: 65 bpm, RR: 10 cpm, O2 sat: 97% nasal cannula
Postoperative findings: BP: 110/80, HR: 75 cpm, RR: 10 cpm, O2 sat: 98% room air, able to move all extremities and fully awake

A. 14
B. 8
C. 12
D. 10

A

C. 12

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16
Q

Mr. Smith is a 23-year-old male who came in unresponsive in the ER with stable vital signs after a 2-wheel vehicular accident. Upon checking his personal items, it was discovered that he opted to give his vital organs for donation in the case that he was considered braindead. He was scheduled for organ donation surgery. What is Mr. Smith’s ASA physical status classification?

A. ASA IIE
B. ASA IV
C. ASA VI
D. ASA V

A

C. ASA VI

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17
Q

The surgery resident while doing rounds on the PACU had to report on her senior resident on the status of their post-op exploratory laparotomy patient that has been operated on. The patient was still sedated and attached to the mechanical ventilator. The anesthesia resident only endorsed to her that her last dose of paralyzing agent was given to her 6 hours ago thus her paralyzed state. Which drug could have been used during the surgical procedure?

A. Rocuronium
B. Atracurium
C. Pancuronium
D. Cis-atracurium

A

C. Pancuronium

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18
Q

DA is a 7-year-old child whose elective surgical procedure will be delayed by at least 2 hours due to delayed flight of the attending surgeon. She has been crying and complaining of hunger since early morning. What can you give DA to relieve her of her hunger and still prepare her for her surgery 2 hours later?

A. Mango shake Mango shake contains milk.
B. Sugared Water
C. Orange Juice with pulp
D. Infant Formula

A

B. Sugared Water

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19
Q

GH is a 21-year-old female with Hodgkin’s Lymphoma. Multiple lymph nodes enlarged around her neck as her condition progressed. She was admitted to the emergency room for inability to eat for 24 hours and was scheduled for emergency surgery. What is the ideal management in securing her airway during the said procedure?

A. Bullard’s Intubating Laryngoscope
B. Laryngeal Mask Airway
C. Fiberoptic Guided Intubation
D. Awake nasal intubation

A

C. Fiberoptic Guided Intubation

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20
Q

DI is a 38-year-old female with tongue mass that quickly developed in 3 months’ time, and completely encroaching the oral cavity. She has been unable to eat for the past 3 days, and she was scheduled for a tube gastrectomy for feeding. What is the ideal management in securing her airway during the said procedure?

A. Awake nasal intubation
B. Laryngeal Mask Airway
C. Fiberoptic Guided Intubation
D. Bullard’s Intubating Laryngoscope

A

C. Fiberoptic Guided Intubation

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21
Q

An 18-year-old female was scheduled for elective excision of her thyroglossal duct cyst under general anesthesia. Patient is a known asthmatic with documented exacerbation two (2) weeks prior the surgery. Family history is unremarkable. Baseline vital signs are 110/70 mm Hg, HR 70 bpm, RR 12 cpm, SPO2 99%. She was induced with Fentanyl, Propofol and Cis-Atracurium. Anesthesia was maintained with Sevoflurane and boluses of fentanyl and cis-atracurium as needed. Which of the following is correct?

A. Vomiting prophylaxis is not needed.
B. Total intravenous anesthesia is contraindicated in this case.
C. Neuromuscular reversal is best achieved with Sugammadex.
D. Vomiting prophylaxis - Dexamethasone during induction, Ondansetron 30 minutes prior the end of surgery

A

D. Vomiting prophylaxis - Dexamethasone during induction, Ondansetron 30 minutes prior the end of surgery

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22
Q

Mr. Guadalupe was coming in for his scheduled hernia surgery. History shows that the patient had his full breakfast at 7am just before he came in the hospital. What could be the earliest time he could be scheduled for an elective hernia surgery?

A. 11 AM
B. 9 AM
C. 1 PM
D. 3 PM

A

D. 3 PM

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23
Q

Which of the following binds to acetylcholine receptors on the postjunctional membrane in the
neuromuscular junction and causes depolarization of muscle fibers?

A. Rocuronium
B. Atracurium
C. Succinylcholine
D. Pancuronium

A

C. Succinylcholine

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24
Q

GB is a 43-year-old female scheduled for elective laparoscopic cholecystectomy. Which of the following preoperative plans would help her prepare for surgery?

A. One dose of Ondansetron prior to being wheeled into the operating room
B. Letting the patient have consent for an awake intubation
C. Inserting the Foley Bag catheter the night before surgery
D. Nothing per Orem (NPO) for 4 hours

A

A. One dose of Ondansetron prior to being wheeled into the operating room

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25
Q

During history taking of the anesthetic history of the surgical patient, she narrated that she was put into a side lying position and felt a sharp pain in her lower back. A few minutes later, she was unable to feel both her lower extremities and was also unable to move them. What type of anesthesia technique could have been done?

A. Epidural Anesthesia
B. Caudal Block
C. Spinal Anesthesia
D. lliac Block

A

C. Spinal Anesthesia

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26
Q

Which of the following should be given to reduce the dissociative anesthetic effect of Ketamine?

A. Ketamine
B. Propofol
C. Thiopental
D. Midazolam

A

D. Midazolam

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27
Q

The patient is to be given Propofol as an amnesic effect during the induction of anesthesia, what clinical complains should be addressed during induction?

A. Nausea
B. Vomiting
C. Pain upon injection
D. Nystagmus

A

C. Pain upon injection

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28
Q

Which of the following intraoperative monitor is correctly paired with its function?

A. Pulse oximetry - arterial oxygen saturation
B. Bispectral Index - core temperature
C. Transesophageal echocardiogram - blood pressure
D. Capnography - acid/base status

A

A. Pulse oximetry - arterial oxygen saturation

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29
Q

AH is a 43-year-old female, ASA 1, who underwent laparoscopic cholecystectomy. Her surgery was unremarkable, however, she had shallow breathing as the surgery was ending. The anesthesiologist decided to reverse the effect of rocuronium during the procedure. What drug could she use?

A. Dexmedetomidine
B. Sugammadex
C. Atropine
D. Vecuronium

A

B. Sugammadex

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29
Q

Which of the following is done in preparing the surgical patient?

A. Determining their initial Hemoglobin and Complete Blood Count prior to OR and preparing blood products for cases that may cause massive blood loss
B. Putting them in NPO status for at least 9 hours
C. Pulmonary Function test for all males who have a history of smoking
D. A routine ECG, 2D echo, and Chest X-ray for patients 35 years old and below

A

A. Determining their initial Hemoglobin and Complete Blood Count prior to OR and preparing blood products for cases that may cause massive blood loss

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30
Q

Which of the following can cause chronic pain?

A. Surgery
B. Cancer
C. Childbirth
D. Labor

A

B. Cancer

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31
Q

After giving a local infiltration of local anesthetic, the patient manifested with rashes and swelling of the lips and eyelids. Which local anesthetic could likely be the cause?

A. Lidocaine
B. Tetracaine
C. Bupivacaine
D. Ropivacaine

A

B. Tetracaine

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32
Q

Which of the following drug has no has no analgesic property?

A. Dexmedetomidine
B. Ketamine
C. Midazolam
D. Nitrous oxide

A

C. Midazolam

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33
Q

Which of the following intraoperative monitor is necessary in presenting the graphical representation of the patient’s breathing via monitoring the patient’s expiratory end tidal carbon dioxide level?

A. Pulse Oximetry
B. Pulse Plethysmography
C. Capnography
D. Capnometry

A

C. Capnography

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33
Q

A 23-year-old female was undergoing labor analgesia using an epidural block, what is expected to happen if the patient undergoes CNS toxicity secondary to Local Anesthetics?

A. Tinnitus → restlessness → slurred speech → seizure
B. Slurred speech → tinnitus → restlessness → seizure → coma
C. Restlessness → tinnitus → slurred speech → seizure → coma
D. Restlessness → tinnitus → slurred speech → coma → seizures

A

C. Restlessness → tinnitus → slurred speech → seizure → coma

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33
Q

TR is a 23-year-old male who came in for several gunshot wounds. His vital signs were the following: BP: 50/30, HR: 140 bpm, RR: 24 cpm, O2 sat: 70%. Rapid Sequence Intubation should be initiated with:

A. Etomidate
B. Propofol
C. Midazolam
D. Ketamine

A

A. Etomidate

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33
Q

Mr. DH, the 45-year-old male, is undergoing emergency exploratory laparotomy for acute abdomen secondary to vehicular accident. While doing surgery, the patient went into cardio-pulmonary arrest. Autopsy showed he died secondary to tension pneumothorax. Which of the following drugs could have caused the said complication?

A. Nitrous Oxide
B. Desflurane
C. Nitric Oxide
D. Sevoflurane

A

A. Nitrous Oxide

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34
Q

In the Difficult Airway Algorithm, in which situation should a supraglottic airway be attempted?

A. A failed awake intubation
B. Multiple failed intubation attempts even if face mask ventilation was adequate
C. An initial attempt in intubation was unsuccessful and face mask ventilation was not adequate.
D. A failed invasive airway access attempt

A

C. An initial attempt in intubation was unsuccessful and face mask ventilation was not adequate.

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34
Q

The patient narrated that she was given a type of anesthesia during her cesarean section that had been used even after surgery and required an anesthesiologist to remove a long piece of tube from her back. What type of anesthesia could have she been subjected to?

A. Epidural Anesthesia
B. Caudal Block
C. Iliac Block
D. Spinal Anesthesia

A

A. Epidural Anesthesia

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35
Q

Which of the following is incorrect regarding the MAC of volatile/inhaled anesthetics?

A. It is a measure of anesthetic potency.
B. It is the dose required to prevent movement in response to skin incisions in 50% of patients.
C. It is short for Minimum Alveolar Concentration.
D. The higher the MAC, the more potent the agent is.

A

D. The higher the MAC, the more potent the agent is.

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35
Q

A dose of Neostigmine given to a surgical patient prior to extubation post operatively, what is its most common side effect?

A. Bradycardia
B. Bradypnea
C. Hypotension
D. Hyperthermia

A

A. Bradycardia

36
Q

A 53-year-old diabetic patient constantly complains of tingling, shooting pain on both lower extremities. Which drug would greatly relieve him of this complication?

A. Fentanyl
B. Morphine
C. Pregabalin
D. Codeine

A

C. Pregabalin

37
Q

An 18-year-old male is to undergo open brain surgery for a chronic subdural hematoma. Which of the following is the ideal induction agent?

A. Propofol
B. Etomidate
C. Ketamine
D. Thiopental

A

D. Thiopental

37
Q

Which patient has the highest risk for gastric aspiration during the induction of general anesthesia?

A. An 18-year-old female for elective fistula in ano repair in a lithotomy position
B. A 23-year-old pregnant female for elective Cesarean Section
C. A 39-year-old female with history of GERD for emergency appendectomy
D. A 70-year-old male who will undergo laparoscopic cholecystectomy

A

D. A 70-year-old male who will undergo laparoscopic cholecystectomy (INARA)
C. A 39-year-old female with history of GERD for emergency appendectomy (HARAYA)

37
Q

Which of the following is correct regarding neuromuscular blockade in anesthesia?

A. Edrophonium is one of the most common agents for muscle block reversal in clinical practice.
B. Succinylcholine is useful in RSI and maintenance of muscle relaxation for the excision of an intracranial mass.
C. Acetylcholinesterase inhibitors reverse the neuromuscular block.
D. Nondepolarizing neuromuscular agents act directly at the synaptic cleft to hydrolyze acetylcholine.

A

C. Acetylcholinesterase inhibitors reverse the neuromuscular block.

38
Q

What is the confirmatory laboratory test of malignant hyperthermia?
A. Creatinine Kinase Level
B. Caffeine-contracture halothane test of the muscle sample
C. Serum calcium determination
D. Rapid test of antibody

A

B. Caffeine-contracture halothane test of the muscle sample

38
Q

A 33-year-old male will undergo open brain surgery to relieve him of bleeding secondary to a hemorrhagic stroke. Which of the following inducting or sedating agent would be beneficial to him the most?

A. Propofol
B. Thiopental
C. Etomidate
D. Dexmedetomidine

A

B. Thiopental

39
Q

What is the minimum allowable score for the patient to be discharged from the Post-Anesthesia Case Unit?

A.9/10
B.8/10
C.10/10
D.10/12

A

A.9/10

40
Q

When giving non-depolarizing paralyzing agents during the maintenance of anesthesia, which of the following monitoring devices is needed to measure its level of effectivity?

A. Invasive Blood Pressure Monitor
B. Nerve Stimulator
C.ECG
D.EEG (electroencephalogram)

A

B. Nerve Stimulator

40
Q

A patient with no prior medical history would undergo an emergency appendectomy, what is his ASA status?

A. ASA IIE
B. ASA II
C. ASA IE
D. ASA I

A

C. ASA IE

41
Q

The following factors causes respiratory depression following anesthesia, EXCEPT:

A. Anemia
B. Residual Inhaled Anesthetic
C. Opioid
D. Residual Neuromuscular blockade

A

A. Anemia

42
Q

Which among the following is/are an intermediate-acting steroid-based neuromuscular blocking agent?

A. Rocuronium and Vecuronium
B. Atracurium and Cisatracurium
C. Pancuronium
D. Succinylcholine

A

A. Rocuronium and Vecuronium

43
Q

The addition of Epinephrine to local anesthetics could result to:

A. A faster onset of action
B. Reduction in toxicity threshold
C. A shorter duration of action
D.F lushing and hypotension

A

B. Reduction in toxicity threshold

44
Q

Physical Examination of patient undergoing anesthesia should be focused on the:

A. Abdominal Status
B. Lower extremity strength
C. Vision
D. Airway

A

D. Airway

45
Q

Succinylcholine is contraindicated in patients with severe burns as this could cause:

A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hyponatremia

A

B. Hyperkalemia

45
Q

A 66-year-old male who just underwent spine surgery under General Anesthesia gradually developed bradycardia during a post-operative multimodal approach to pain control. Which of the following could have attributed to his bradycardia?

A. Increased amount of dexmedetomidine
B. Improper timing of his NSAIDs
C. Side effect of using ondansetron
D. Low dose fentanyl infusion

A

A. Increased amount of dexmedetomidine

46
Q

Which of the following could be a predictor of a difficult intubation?

A. Thyromental distance of more than 6cm
B. Inability to shift the upper incisors in front of the lower incisors
C. Mallampati Class 4
D. Small overbite

A

C. Mallampati Class 4

47
Q

The liberal use of opiates in the management of pain in the post-operative period has caused this surge of this problem in the population.

A. Infertility in females
B. Increased incidence of suicide
C. Opioid Abuse
D. Early onset dementia in the elderly

A

C. Opioid Abuse

48
Q

Which of the following is not a component of the basic intraoperative monitoring of an anesthesized patient?

A. Intermittent electrocardiogram display
B. Blood pressure monitoring with non-invasive blood pressure monitor
C. Pulse oximetry
D. Observation of the reservoir bag

A

A. Intermittent electrocardiogram display

49
Q

Which of the following is an invasive mode of monitoring?

A. Electroencephalogram
B. Pulse oximetry
C. Central venous pressure monitor
D. Capnography

A

C. Central venous pressure monitor

50
Q

Which of the following is an analgesic?

A. Isoflurane
B. Diazepam
C. Fentanyl
D. Naloxone

A

C. Fentanyl

51
Q

Which of the following is not a part of regional anesthesia?

A. Truncal anesthesia
B. Monitored anesthesia care
C. Neuraxial anesthesia
D. Peripheral nerve blockade

A

B. Monitored anesthesia care

52
Q

Which of the following is a cuffed supraglottic oral airway that can be used in airway management

A. Endotracheal tube
B. Nasal cannula
C. Face mask
D. Laryngeal mask airway

A

D. Laryngeal mask airway

53
Q

Which of the following is not a component in the anesthetic management of a surgical patient?

A. Amnesia
B. Sedation
C. Muscle relaxation
D. Analgesia

A

B. Sedation

54
Q

The following should be monitored in patients with hepatic dysfunction:

A. Anemia
B. Sleeping time
C. Bleeding and coagulation parameters
D. Color of the skin

A

C. Bleeding and coagulation parameters

55
Q

A patient with obstructive sleep apnea should be informed, at the preoperative visit, of the possibility of this situation occurring post-operatively:

A. Pain on surgical site
B. Inability to urinate for two days
C. Blurring of vision for 30 minutes
D. Delayed extubation until he is fully awake

A

D. Delayed extubation until he is fully awake

56
Q

Which drug causes dissociative anesthesia?

A. Ketorolac
B. Rocuronium
C. Propofol
D. Ketamine

A

D. Ketamine

57
Q

Local anesthetics act on which channels on the cell membrane to prevent neural impulses?

A. Sodium channels
B. Calcium channels
C. GABA channels
D. Potassium channels

A

A. Sodium channels

58
Q

A patient suddenly has hypotension, ventricular arrhythmias, and a sudden cardiac arrest during induction of an axillary peripheral nerve block. Which local anesthetic could have caused such toxicity?

A. Lidocaine
B. Rocuronium
C. Levobupivacaine
D. Bupivacaine

A

D. Bupivacaine

59
Q

Which of the following is a Neuraxial block?

A. Local infiltration
B. Epidural block
C.Truncal block
D. Peripheral nerve block

A

B. Epidural block

60
Q

What is the most common complication of a nerve block?

A. Amnesia
B.Permanent muscle paralysis
C.Nerve damage
D.Local anesthetic toxicity

A

D.Local anesthetic toxicity

61
Q

What is the ideal needle gauge to be used in doing spinal anesthesia?

A. 26-gauge
B. 32-gauge
C. 25-gauge
D. 30-gauge

A

C. 25-gauge

62
Q

Which of the following does not affect the level of the block during spinal anesthesia?

A. Type of local anesthetic
B. Baricity of the solution
C. Dose of local anesthetic
D. Temperature of the local anesthetic

A

D. Temperature of the local anesthetic

63
Q

What is the most life threatening complication of opioid toxicity?

A. Respiratory depression
B.Constipation
C.Bradycardia
D.Sweating

A

A. Respiratory depression

64
Q

Which drug reverses opioid toxicity?

A. Propofol
B. Naloxone
C.Diazepam
D.Remifentanyl

A

B. Naloxone

65
Q

What drug is used as a reversal agent for Benzodiazepine overdosage?

A. Propofol
B. Flumazenil
C. Ketorolac
D. Ketamine

A

B. Flumazenil

66
Q

A defect in this receptor causes a surge of calcium release from sarcoplasmic reticulum seen in malignant hyperthermia.

A. Ryanodine receptor 1
B. ATP receptor
C. Conjugase 3 receptor
D. Elastomeric 1 chloride receptor

A

A. Ryanodine receptor 1

67
Q

Which of the following is an early sign of malignant hyperthermia?

A. Increased endotracheal carbon dioxide (ETCO2)
B. Metabolic acidosis
C. Hyperkalemia
D. Elevated creatine kinase level

A

A. Increased endotracheal carbon dioxide (ETCO2)

68
Q

What is the initial dose of Dantrole during malignant hyperthermia?

A. 2.5 mg/kg
B. 10 mg/kg
C. 1.5 mg/kg
D. 1.0-2.0 mg/kg

A

A. 2.5 mg/kg

69
Q

What is the first thing to do when you suspect a malignant hyperthermia immediately following induction of general anesthesia?

A. Decrease dose of anesthetic drugs and proceed with surgery
B. Cooling the groin, axilla and neck
C. Dantrolene initial dose
D. Call for help

A

D. Call for help

70
Q

Which of the following scales is not useful in identifying and evaluating pain in the Clinical Setting?

A. Digital analog scale
B. Verbal pain intensity scale
C. Numeric pain intensity scale
D. Faces scale

A

A. Digital analog scale

71
Q

The 1st line of Management for surgical procedures with low risk pain complication is:

A. Oxycodone
B. Tramadol
C. Gabapentin
D. Acetaminophen or paracetamol

A

D. Acetaminophen or paracetamol

72
Q

Which of the following is an adjuvant in chronic pain management?

A. Gabapentin
B. Morphine
C. Aspirin
D. NSAIDS

A

A. Gabapentin

73
Q

What do you call a standby analgesic that can be used for cases of unanticipated surges of pain intensity in patients with chronic pain?

A. Long-acting sedatives
B. Breakthrough pain analgesics
C. Slow acting opioids
D. Adjuvants

A

B. Breakthrough pain analgesics

74
Q

What is the patient’s Mallampati score when only the soft palate and the base of the uvula are visualized?

A. Mallampati 3
B. Mallampati 2
C. Mallampati 4
D. Mallampati 1

A

A. Mallampati 3

75
Q

Which of the following predisposing factors and risk for aspiration on general anesthesia fall under increase in gastric content?

A. Morbid obesity
B. Intestinal obstruction
C. Pregnancy
D. Gastroesophageal reflux

A

B. Intestinal obstruction

76
Q

Which of the following cannot be given at least 2 hours prior to an elective procedure?

A. Water
B. Orange juice
C. Vodka
D. Clear tea

A

C. Vodka

77
Q

he following are seen in patients with Mallampati class III

A. Soft palate, fauces, pillars of uvula
B. Soft palate, base of uvula
C. Soft palate, fauces, pillars
D. Soft palate, fauces, uvula, pillars

A

B. Soft palate, base of uvula

78
Q

In evaluating a preoperative patient, which of the following laboratories is warranted?

A. Pulmonary function test in COPD
B. Routine ECG for men more than 35 years old
C. Coagulation tests for pediatric male patients
D. Chest radiograph for all surgery candidates

A

A. Pulmonary function test in COPD

79
Q

The following is not necessary in the preoperative evaluation of a surgical patient

A. Auscultation of the lungs
B. History of allergies
C. Auscultation of the heart for murmurs and rhythm
D. Hygiene and bedtime habits

A

D. Hygiene and bedtime habits

80
Q

Which of the following opioid is a partial agonist?

A. Morphine
B. Oxycodone
C. Fentanyl
D. Nalbuphine

A

D. Nalbuphine

81
Q

A patient in PACU complained of postoperative pain with a pain score of 8/10. Which pain medication would be highly effective in managing his pain?

A. Morphine
B. Paracetamol
C. Ketorolac
D. Mefenamic acid

A

A. Morphine

82
Q

An 18-year-old female was admitted for an acute abdomen secondary to stab wound. She has no pertinent medical history and her vital signs are BP 120/80 mmHg, HR 90 bpm, RR 18 cpm, O2 saturation 99%. According to ASA Risk Stratification, she is classified as

A. ASA I
B. ASA II
C. ASA IE
D. ASA IIE

A

B. ASA II

83
Q

Low dose of this anesthetic agent reduce nausea, vomiting and opioid use after surgery

A.Nitrous oxide
B. Ketamine
C. Propofol
D. Fentanyl

A

B. Ketamine

84
Q

Some effects of the cholinergic crisis from cholinesterase inhibitor can be masked by giving

A. Atropine
B. Glycopyrolate
C. None of the above
D. All of the above

A

D. All of the above

85
Q

Acetylcholinesterase inhibitors can stimulate ________ receptor to cause cholinergic crisis such as bronchospasm and increased peristalsis.

A. Nicotinic
B. Muscarinic
C. Adrenergic
D. Sympathetic

A

B. Muscarinic

86
Q

Mallampati score us a poor predictor for:

A. Difficult bag mask ventilation
B. Difficult laryngoscopy
C. Difficult intubation
D. All of the above

A

A. Difficult bag mask ventilation

87
Q

Toxic dose of lidocaine with epinephrine

A. 4 mg/kg
B. 7 mg/kg
C. 5 mg/kg
D. 6 mg/kg

A

B. 7 mg/kg

88
Q

toxic dose of bupivacaine:

A. 2.5 mg/kg
B. 3.5 mg/kg
C. 4.5 mg/kg
D. 5.5 mg/kg

A

A. 2.5 mg/kg

89
Q

A 5 year old boy was scheduled for herniotomy tomorrow at 8am. He was placed at NPO at 12 midnight, Upon arriving at the operating room the mother informed the nurse that the child drank water at 6am. What is the best thing to do?

A. Reschedule the operation on ff day
B. Delay until 12nn
C. Proceed with the scheduled time
D. Delay until 10am

A

C. Proceed with the scheduled time

90
Q

Antidote of fentanyl?

A. Flumazenil
B. Naloxone
C. Neostigmine
D. Sugammadex

A

B. Naloxone

91
Q

The following intravenous agents exerts their effect on the GABA receptors except:

A.Ketamine
B. Benzodiazepine
C.Propofol
D.Etomidate

A

A.Ketamine

92
Q

The ff is true of neuromuscular blockade.

A. Reversal requires presence of pain
B. Nausea and vomiting are common side effects
C. It cannot be reversed
D. It can be reversed with anticholinesterase agent

A

D. It can be reversed with anticholinesterase agent

L3 (1ST BMEX) (18 decks)

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