9. Middle aged woman complains of intermittent stabbing pain to left jaw. Normal physical examination. Most appropriate initial management. A. Aciclovir B. Carbamazepine ? C. CT brain ? D. Lamotrigine E. Prednisolone

b) carbamazepine is first line or c) CT brain. Usually need MRI to diagnose

2018.1 Flashcards by Matt Stewart

Which of the following is diagnostic of obesity hypoventilation syndrome?

a. PaCO2 >45 mmHg
b. SpO2 <90%
c. AHI > 5
d. STOPBANG>3

a. PaCO2 >45 mmHg

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A patient has an AHI of 4. What is the severity of their OSA?

a. Absent (If Adult)
b. Mild (if Paed)
c. Moderate
d. Severe
e. Life threatening

If adult = none
If paed = mild

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Scavenging connected to APL valve - what is the size of the connector?

a. 12 mm
b. 15 mm
c. 22 mm
d. 25 mm
e. 30 mm

e) 30 mm

22mm is normal tubing

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4 Which is the first factor to be depleted in surgical bleeding?

a. I
b. II
c. VII
d. X
e. XIII

a) I

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5 What is the target CPP in a 3 year old with a severe TBI?

a. 20
b. 30
c. 40
d. 50
e. 60

c) 40

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Primip with an epidural in situ 8 hours into labour. What is the most likely cause of her developing a temperature of 37.6 degrees?

a. Impaired thermoreg
b. Chorioamnionitis?
c. UTI
d. Epidural infection
e. Inflammatory response?

e) inflammatory response

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8 In the early period after a lung transplant, all the following are lost EXCEPT:

a. Impaired cough distal to anastomosis
b. Loss of HPV
c. Loss of respiratory response to elevated PaCO2
d. Impaired mucociliary function
e. Impaired lymphatic drainage

b. Loss of HPV

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Middle aged woman complains of intermittent stabbing pain to left jaw. Normal physical
examination. Most appropriate initial management.

A. Aciclovir
B. Carbamazepine ?
C. CT brain ?
D. Lamotrigine
E. Prednisolone

b) carbamazepine is first line

c) CT brain. Usually need MRI to diagnose

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10 Most common cause of bilateral blindness in spinal surgery and anaesthesia?

A retinal artery occlusion
B embolic cortical stroke
C cortical stroke
D ischaemic optic neuropathy
E bilateral acute angle glaucoma

D ischaemic optic neuropathy

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11 Recommended target MAP in septic shock in an adult:

A. 55
B. 60
C. 65
D. 70
E. 75

C. 65

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12 36yo woman sustained an injury to her left arm and presents with pain. She complains of
increased pain to pin prick on her left side compared to her right side. This is an example of:

A. Dysaesthesia
B. Allodynia
C. Hyperalgesia
D. Paraesthesia
E. Hyperaesthesia

C. Hyperalgesia

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13 On inhalation induction in a 10kg 1yo develops severe laryngospasm. Failed IV access but
intraosseous obtained. What is the dose of Suxamethonium?

a. 10
b. 20
c. 30
d. 40
e. 50

a. 10

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14 What is a relative contraindication to a peribulbar Block

a. Axial length of 24mm
b. INR 2.5 for mechanical aortic valve
c. Staphyloma
d. Scleral buckle
e. Pterygium

b. INR 2.5 for mechanical aortic valve

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15 Management of prolonged block with mivacurium.

a. Sugammadex
b. FFP
c. Keep anaesthetised and ventilated until block wears off
d. Pralidoxime
e. Neostigmine 100microg/kg

c. Keep anaesthetised and ventilated until block wears off

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16 GCS eyes open to voice, responding to questions but occasional confusion, purposeful
movement to pain. What is his GCS?

a. 11
b. 12
c. 13
d. 14
e. 15

b) 12

E3 V4 M5

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What needle is this? Sharp oblique tip

a. Pitkin
b. Quinke
c. Whitacre
d. Sprotte
e. Tuohy

b. Quinke

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18 A patient is in ICU following MVR, requires MRI Brain to assess neuro in the event of neurological deterioration. What presents the greatest safety risk to the patient?

a. Epicardial pacing leads
b. Arterial transducer
c. ETT spring
d. Sternal wires
e. Pilot balloon spring

a. Epicardial pacing leads

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19 Pt with mediastinal mass, for anterior mediastinoscopy, post induction, unable to vent, loss of SpO2 and weak carotid pulse. Immediate management:

a. Urgent CPB
b. CPR
c. Turn pt prone
d. Fluid
e. Adrenaline

c. Turn pt prone

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22 Woman post epidural catheter removal complaining of thigh weakness. How would you discriminate between peripheral nerve injury and nerve root lesion?

a. Weakness of hip flexion and adduction
b. Foot drop
c. Weakness of knee flexion and plantar flexion
d. Urinary incontinence
e. Bilateral increased reflexes LL

a. Weakness of hip flexion and adduction

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23 Sickle cell. HbS percentage that is the threshold for transfusion to prevent sickle crisis?

a. 5%
b. 10
c. 20
d. 30
e. 50

d. 30

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24 Which of the following is most likely to cause hypoglycemia if continue perioperatively?

a. Metformin
b. Pioglitozone
c. Glibenclamide
d. Acarbose
e. Sitagliptin

c. Glibenclamide

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25 Patient with septic shock in ICU remains hypotensive on noradrenaline. What should be second line vasopressor?

a. Adrenaline
b. Dopamine
c. Phenylephrine
d. Vasopressin
e. Methylene blue

d. Vasopressin

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27 ECT producing cerebral seizure activity. What is the threshold for intervention and seizure termination?

a. 30 seconds
b. 60 seconds
c. 90 seconds
d. 120 seconds
e. 150 seconds

d. 120 seconds

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28 Which is not recommended in treatment of severe coagulopathy due to AFE?

a. Platelets
b. Fibrinogen concentrate
c. Novo7
d. Prothrombinex
e. TXA

d. Prothrombinex

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32 What FFP can be given in critical bleeding prior to cross-match? a. AB b. A c. B d. O negative e. Any available

a. AB

33 Most likely cause of decreased DLCO a. Asthma b. Left to right shunt c. Pulmonary haemorrhage d. Emphysema e. Morbid obesity

d. Emphysema

34 Coming to OT for urgent thoracics case. Chest US showing liver and lung looking almost the same. What is the cause of the appearance of the lung? a. Empyema b. Pneumonia c. PTx d. Pleural Effusion e. Pulmonary oedema

b. Pneumonia

36 Lowers seizure threshold the most? a. Alfentanil b. Remifentanil c. Methadone d. Morphine e. Fentanyl

a. Alfentanil

37 Most common arrhythmia with methadone? a. Torsades de Pointes b. VT c. AF d. SVT e. CHB

a. Torsades de Pointes

38 A 15 year old male with known prolonged QT. You are called to PACU where he is noted to be in VT. GCS 15, Nil chest pain. What is your management? a. Magnesium b. Synchronised shock c. Amiodarone d. Adenosine e. Metoprolol

a. Magnesium

39 Normal PR interval range a. 80-100 b. 100-200 c. 120-200 d. 120-220

c. 120-200

40 Heparin resistance for CPB, had 500IU/kg heparin what do you give next? a. More Heparin b. FFP

a. More Heparin

41 HR 60 sinus rhythm, QT 420. What is QTc? a. 400 b. 420 c. 440 d. 450

b. 420

42 Which is the best view on TOE to monitor for ischemia? b. Mid oesophageal 2 chamber c. Transgastric SAX mid papillary

c. Transgastric SAX mid papillary

45 Pregnant 28/40 150/90, SpO2 100% on RA, inferolateral ST elevation, HR 120. Sudden onset chest pain: a. Dissection b. Cardiac contusion c. Rib fracture d. Sternal fracture e. PTx

a. Dissection

46 Pneumoperitoneum with CO2 maintained at 15mmHg. What is most likely: A. Decreased arterial Blood pressure B. Decreased Heart rate C. Increased central venous pressure D. Increased renal blood flow E. Increased systemic vascular resistance

E. Increased systemic vascular resistance

48 Renal protection AAA surgery a. Mannitol b. High urine O/P c. Maintain intravascular volume

c. Maintain intravascular volume

49 What don’t you give when radiology puts wire through vessel in coiling? a. Protamine b. Increase BP c. Thio d. Increase MV e. Manntiol

b. Increase BP

50 What doesn’t increase TCT (Thrombin time) a. Enoxaparin b. Dabigatran c. Heparin d. Warfarin e. Bivalirudin

d. Warfarin

51 Spinal corrective surgery causing hyponatremia in paediatric patient. What is the cause? a. Vasopressin b. ANP

a. Vasopressin

52 75 yo HTN, week of fatigue and tiredness. Fall and fracture. Na 113, K 3.2, Cl 72 urinary sodium <10. Normal urea, creatinine. What is the likely cause? a. SIADH b. Diuretics c. Cerebral salt wasting d. Adrenal insufficiency

b. Diuretics SIADH urine Na 20 - 40 or >40

53 40 year old female in recovery following endometrial ablation and endometrial myomectomy. Na 118, confused but rousable. Otherwise stable. What is your management? a. Fluid restrict b. Lasix 20mg c. 100ml 3% NaCl d. 0.9% NaCl 500ml

c. 100ml 3% NaCl

54 What is the rate of sore throat CMAC vs direct laryngoscopy? a. Reduction by 1/3 b. Reduce by ½ c. Same d. Increase by 2 e. Increase by 3

c. Same

55 Reduce risk of laryngospasm in URTI paeds a. ETT instead of LMA b. IV induction over inhalational c. Deep extubation d. Desflurane maintenance instead of sevoflurane e. Thiopentone instead of propofol

b. IV induction over inhalational

56 Best single method to decrease emergence delirium in a 5 year old you are anaesthetizing? a. Transition to propofol at the end of case b. Transition to isoflurane c. Parents in the room d. Awaken in a dark quiet room e. Premed with midazolam

a. Transition to propofol at the end of case

57 Which anaesthetic technique is least likely to cause hypotension in infant for orchidopexy? a. GA TIVA b. GA Sevo c. GA des d. Spinal sedation e. Spinal without sedation

e. Spinal without sedation

58 Anaesthetising a paediatric patient with newly diagnosed lymphoma. Which of the following is contraindicated for PONV prophylaxis? a. Dexamethasone b. Ondansetron c. Droperidol d. Metoclopramide e. Promethazine

a. Dexamethasone

59 How much FFP is required to raise fibrinogen by 1g/L a. 10ml/kg b. 20ml/kg c. 30ml/kg d. 40ml/kg e. 50ml/kg

c. 30ml/kg

61 Which of the following has the highest risk of Thromboembolism in pregnancy? a. Antithrombin 3 b. Prothrombin gene mutation ? homo/hetero c. Protein C deficiency d. Protein S deficiency e. Factor V Leiden heterozygous

Depends if Prothrombin gene is homo or hetero FVL homo > PTGM homo > FVL hetero > PTGM hetero > ATIII def/ Prot C def > Prot S def

62 Which subtype of vWF is a relative contraindication to DDAVP a. Type 1 b. Type 2a c. Type 2b d. Type 3 e. None, it’s indicated in all

c. Type 2b

63 When to restart Rivaroxaban after removal of an epidural catheter? a. 4 hours b. 6 hours c. 12 hours d. 18 hours e. 24 hours

b. 6 hours

64 What is the size of the largest particle that can pass through the filter for an epidural catheter? a. 0.2 micrometers b. 2 micrometers c. 10 micrometers d. 20 micrometers e. 200 micrometers

a. 0.2 micrometers

65 Measurement of which part of the stomach provides the most accurate volume measurement when performing gastric ultrasound pre-operatively? a. Antrum b. Body c. Cardia d. Pylorus e. Fundus

a. Antrum

66 Targeted preductal sats in neonatal at 5mins a. 50-60 b. 60-70 c. 70-80 d. 80-90 e. 90-100

d. 80-90

68 Suction catheter in a neonatal airway with no evidence of airway obstruction. Why don’t you suction (because it’s dumb) a. Bradycardia b. Bleeding c. Hypertension d. Mec aspiration e. Tachycardia

a. Bradycardia

69 Minimum internal diameter of ETT for going over an Aintree Catheter according to product information: a. 5.5 b. 6.0 c. 6.5 d. 7.0 e. 7.5

d. 7.0

70 Max endotracheal cuff pressure to avoid mucosal damage in an adult a. 10cmH2O b. 20cmH2O c. 30cmH2O d. 40cmH2O e. 50cmH2O

c. 30cmH2O

71 What single risk factor for pre-eclampsia would be sufficient to prescribe low-dose aspirin? a. Last child > 10 years ago b. FHx pre-ec c. Autoimmune disease d. BMI>35 e. Maternal age > 40

c. Autoimmune disease

73 How long do you continue MgSO4 infusion after a single eclamptic seizure? a. 4 hours b. 6 hours c. 12 hours d. 24 hours e. 48 hours

d. 24 hours

75 Which of the following nerves is blocked in a superficial cervical plexus block? a. Phrenic nerve b. Greater occipital c. C1 branch d. C5 branch e. Transverse cervical

e. Transverse cervical

76 Pt in awake recovery. NGT has blood coming out of it. CXR below (NGT in RLL). After removing it what do you do next? a. Bronchoscopy b. CXR in 4 hours c. Insert ICC

b. CXR in 4 hours

77 Young female for multiple varicose vein foam scelrotherapy. Following the procedure, she stands up and loses conscious with unilateral weakness. What is the mostly likely cause? a. Paradoxical air embolus b. Thromboembolic stroke c. ICH

a. Paradoxical air embolus

78 What is the most common adverse drug reaction of carboxymaltose iron infusion? A skin discolouration B fever C Anaphylaxis D cholestatic jaundice E ? hypophosphataemia

E ? hypophosphataemia

79 During a case the cerebral oximetry saturation falls. An increase in the following will not improve the cerebral saturations A increased MAP B increased minute ventilation C increased anaesthetic depth D increased Hb E x

B increased minute ventilation

80 Question about why chlorhexidine is preferred to povidone iodine for skin prep neuraxial, except? A. Faster onset of action B. Longer duration of action\persists on the skin C. Is less neurotoxic D. Has less skin reactions E. Is not inactivated by blood/organic debris

C. Is less neurotoxic

81 What is name of the process for removing contamination and inactivating biological agents? A. Asepsis B. Antisepsis C. Sterilisation D. Disinfection

D. Disinfection

82 Coiling of an intracerebral aneurysm. Radiologist notifies you of a rupture. What drug don’t you give a. Protamine b. Metaraminol c. Thiopentone d. Heparin e. Mannitol

d. Heparin

83 During a propofol infusion in intensive care – how often must the propofol line be changed? a. 12 hours b. 24 hours c. 48 hours d. 72 hours e. 6 hours

a. 12 hours

84 Woman in her 30’s after operation on her left foot complains of ongoing intermittent pain in her left foot. On examination she experiences greater pain in her left foot than her right on pinprick testing. This is: a. Dysaesthesia b. Allodynia c. Hyperalgesia d. Hyperaesthesia e. Paraesthesia

c. Hyperalgesia

85 What is not a border of the adductor canal? a. Sartorius b. Saphenous nerve c. Adductor longus d. Vastus medialis e. Gracilis

e. Gracilis

86 Which NSAID associated with the lowest risk of developing VTE? a. Naproxen b. Diclofenac c. Aspirin d. Ibuprofen e. Celecoxib

c. Aspirin

87 Severe TBI in 24year old male – what is the target systolic blood pressure? a. 90 mmHg b. 100 mmHg c. 110 mmHg d. 120 mmHg e. 130 mmHg

c. 110 mmHg

88 Patient post op THR, heparinsed for treatment of a PE. Develops hypotension, SBP < 80mmHg and tachycardia. What is the next step in management? a. Fluids and inotropes b. Refer for embolectomy c. IVC filter d. Thrombolysis e. Warfarin

a. Fluids and inotropes

89 What are the fasting requirements for an 8 month old child undergoing an elective procedure on the morning list? a. Fast from midnight b. 6 hours solids, breast milk, formula and 2 hours clear fluids c. 6 hours solid, 4 hours formula and breast milk, 2 hours clear fluids d. 6 hours solid, 3 hours formula and breast milk, 2 hours clear fluids e. 6 hours solid, 4 hours formula, 3 hours breast milk, 2 hours clear fluids

b. 6 hours solids, breast milk, formula and 2 hours clear fluids

91 Talking to a patient with a tracheostomy in-situ in the Pre-admission clinic. In order for the patient to talk to you, you must: a. Inflate the tracheostomy cuff, insert fenestrated piece, insert one-way valve b. Inflate tracheostomy cuff, insert un-fenestrated piece, insert one-way valve c. Deflate tracheostomy cuff, insert fenestrated piece, insert one-way valve d. Deflate tracheostomy cuff, insert fenestrated piece, remove one-way valve e. Deflate tracheostomy cuff, insert un-fenestrated piece, insert one-way valve

c. Deflate tracheostomy cuff, insert fenestrated piece, insert one-way valve

92 EVAR compared to open AAA repair results in a. Decreased re-intervention rate b. Less use of critical care resources c. Increased mortality d. Increased perioperative morbidity e. Poorer short term outcomes

b. Less use of critical care resources

93 Which muscle is most likely to be missed following a Sub-Tenons block? a. Inferior oblique b. Superior rectus c. Lateral rectus d. Superior oblique e. Medial rectus

d. Superior oblique

94 What is the first line treatment for a young man in ED recently diagnosed with phaechromocytoma who has presented with severe hypertension and tachycardia? He is not on any current treatment. a. Esmolol b. Phentolamine c. Phenoxybenzamine d. GTN

c. Phenoxybenzamine