2021.1 Flashcards by Matt Stewart

The optimal position, under ultrasound guidance, to place a catheter tip to provide continuous erector spinae plane block for post-thoracotomy analgesia is

A. Superficial to erector spinae
B. Tip of transverse process?
C. Midpoint of transverse process

B. Tip of transverse process?

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A structure that is NOT clamped during a Pringle manoeuvre is the

-Hepatic artery
-Portal vein
-Hepatoduodenal ligament
-Hepatic vein

Could have been any other structure than:
-Hepatic artery
-Portal vein
-Hepatoduodenal ligament

Structures not clamped:
-IVC
-Hepatic vein

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The muscle or muscle group with the greatest sensitivity to the action of non-depolarising neuromuscular blocking agents is/are the

a. Abdominal muscles
b. Adductor pollicis
c. Pharyngeal muscles
d. Diaphragm

c. Pharyngeal muscles

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The most common cause of mortality in children with diabetic ketoacidosis is

Cerebral oedema
Central pontine demyelination
Septic chock

Cerebral oedema

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The intubating dose of atracurium in a patient with post-polio syndrome should be

Reduced – unclear by what degree

Probably 50% reduction

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In the morbidly obese the induction dose of propofol should be calculated based on

Lean body weight
Total body weight
Ideal body weight
Ideal body weight + 70%

Lean body weight

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All of the following conditions are associated with acromegaly EXCEPT
Depends

Depends

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The composition of blood returned to the patient from intraoperative cell salvage shows

Cell-salvaged blood contains no platelets or coagulation factors

Bad things can also be in there – air/fat/microaggregates

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When performing a brachial plexus block at the level of the axilla, the structure indicated by the arrow is the (ultrasound image shown)

Could be any structure – no picture provided

From previous MCQs seems to be musculocutaneous nerve
Remember MUR from top to bottom around AA for individual nerves

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Severe obstructive sleep apnoea in a 6-year-old child is confirmed if during polysomnography the apnoea/hypopnea index (AHI) is greater than or equal to

AHI >5
AHI >10
AHI >15
AHI >30

AHI >10

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Predictors of successful awake extubation after volatile anaesthesia in infants include

2ml/kg tidal volume
Grimacing
Coughing
RR >20
CO2 >60

Grimacing

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Major international guidelines recommend maintaining the core body temperature between 32°C and 36°C in comatose patients after

Comatose patient post cardiac arrest

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A man presents with a fractured tibia. He has increasing pain in his leg, loss of sensation on the plantar surface of his foot and weakness of toe flexion. This is most consistent with a compartment syndrome of the leg in the

Anterior compartment
Lateral compartment
Deep posterior compartment
Superficial posterior compartment

Deep posterior compartment

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The coagulopathy that can result from intrahepatic cholestasis of pregnancy is due to

Deficiency all hepatic synthesised enzymes
Deficiency II, V, VII, IX

Deficiency II, V, VII, IX

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The best patient position to evaluate the gastric contents with ultrasound is

Right lateral decubitus position

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A 50-year-old man is seen prior to his hip revision surgery. His blood results are (FBE and Iron Studies shown). The most likely diagnosis is

?Depends on results

Given FBE and iron studies provided likely related to IDA

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Of the following, allergy based on cross reaction to penicillin sensitivity is most likely with

Depends on options provided, table to right might help (from Anaesthesia + Analgesia 2019: Misconceptions surrounding penicillin allergy: implications for anesthesiologists)

Probably something with same R1 side chain:
-Cephalexin

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In maternal cardiac arrest the most common arrhythmia is

VT
VF
Asystole
PEA
SVT

PEA

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You are performing a regional block for analgesia following knee surgery. You have an ultrasound probe scanning the anterior mid-thigh. The muscle indicated by the arrow in the ultrasound image below is the

Could be anything
Sounds like Femoral nerve/Saphenous nerve block depending on position of thigh

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The recommended antibiotic prophylaxis for insertion of an intrauterine device is

None
Cephalexin 500 mg
Doxycycline 400
Cephazolin 2g
Cephazolin 2g and metronidazole

None

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The independent predictors for severe bone cement implantation syndrome (BCIS) in cemented hemiarthroplasty for hip fracture do NOT include

Male sex
GA
Previous history of same
Diuretic use
Age

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The 12 lead ECG shown is most consistent with acute total occlusion of the

Depends on which vessel affected

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A 45-year-old man has poor oxygenation in the post-anaesthesia care unit after a low anterior resection. His chest x-ray is below. The most likely diagnosis is

Depends on CXR findings

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According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia using a non-relaxant technique with a volatile agent is

1:136,000

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The drug which has the LEAST impact on somatosensory evoked potentials (SSEPs) monitored in a 15-year-old patient undergoing scoliosis surgery is Propofol Fentanyl Desflurane Midazolam Sevoflurane

Fentanyl

Toxicity of methylene blue is likely to be seen after single bolus dose (in mg/kg) greater than 1mg/kg 3mg/kg 5mg/kg 7mg/kg

7mg/kg

A woman is having a potentially curative primary breast cancer resection. Compared with a sevoflurane and opioid technique, using a regional anaesthesia-analgesia technique with paravertebral block and a propofol infusion will result in Decreased cancer recurrence Decreased pain and recurrence Decreased incision pain at 6 months Decreased neuropathic pain at 6 months Decreased neuropathic pain at 12 months

Uncertain/ No difference ?Not remembered properly

A normal 75 kg term parturient may be expected to have a total blood volume of 5250 6000 6750 7500

7500

A patient undergoing robotic prostatectomy with controlled mandatory volume ventilation has the following measurements: (plateau pressure, PEEP, autoPEEP, peak pressure, tidal volume given) The static compliance is Plateau pressure 32 cmH2O PEEP 8 cmH2O AutoPEEP 4 cmH2O Peak pressure 38 cmH2O Tidal volume 600mL 20 ml/cmH2O 23 ml/cmH2O 25 ml/cmH2O 30 ml/cmH2O 38 ml/cmH2O

30 ml/cmH2O

A 30-year-old professional athlete who underwent a knee arthroscopy under general anaesthesia becomes tachycardic in the recovery room. His non-invasive systolic blood pressure is 90 mmHg. A 12-lead ECG is obtained. The most appropriate therapy is

Depends on ECG! ?some sort of SVT ?delta waves

A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is: 3 months 6 months 9 months 12 months

9 months

The direct physiological effects of electroconvulsive therapy include

Answer –

A man is brought into hospital after a motor vehicle accident 45 minutes ago. His chest x-ray is shown. This is most consistent with a left-sided

Answer -

A common electrolyte disturbance following the administration of ferric carboxymaltose is

Answer - Hypophosphataemia

Globe perforation during eye block is more common in myopic eyes because Higher incidence of staphyloma Globe is too short Higher rate of increased IOP Corneal is less thick

Higher incidence of staphyloma

A five-year-old child weighing 25 kg is to be strictly nil by mouth overnight following a laparotomy. The most appropriate fluid prescription is 65ml/hr N Saline 45ml/hr N Saline w 5% dextrose 45ml/hr N Saline w 2.5% dextrose 65ml/hr 0.45% Saline w 2.5% dextrose 65ml/hr 0.45% Saline w 5% dextrose

45ml/hr N Saline w 5% dextrose

A four-year-old boy with a history of waddling gait, larger than normal calves and frequent falls receives a spontaneously breathing volatile-based anaesthetic with sevoflurane. One hour into the case he develops peaked T waves and then the end-tidal CO2 begins to rise. The most appropriate immediate treatment is to Temp probe, and go from there Cool + dantrolene Stop volatile, cool + dantrolene Stop volatile, calcium Stop volatile

Stop volatile, calcium

The substance that should be avoided in a patient with history of anaphylaxis to MMR vaccine is Protamine Gelofusine Sulphonamides Penicilins

Gelofusine

A patient with a history of hereditary angiooedema requires an appendectomy for acute appendicitis. The most effective therapy for the prevention of an acute attack in the perioperative period is Danazol FFP Icatibant Hydrocort

Danazol

Sensory innervation of the cornea is by the Nasociliary nerve Optic nerve Trigeminal nerve * Frontal nerve

Nasociliary nerve

Local anaesthetic-induced myotoxicity is most likely to be associated with Bier’s block Adductor canal Sciatic nerve block

Adductor canal

The minimum microshock current required to elicit ventricular fibrillation is 10μA 100μA 10 mA 100 mA 1A 10 A

100μA

You give a dose of intravenous indocyanine green to facilitate videoangiography during cerebral aneurysm surgery. The displayed pulse oximetry (SpO2) and cerebral oxygen tissue saturation (SctO2) changes you expect to see are Increases NIRS, decreases peripheral Decreases NIRS, decreases peripheral No change NIRS, decreases peripheral Increases NIRS and peripheral Decreases NIRS, increases peripheral

Increases NIRS, decreases peripheral

Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of 6 weeks 3 months 6 months 12 months

3 months

Of the following classes of medication for diabetes mellitus, the most likely to cause hypoglycaemia in the fasted patient are the

Answer – sulfonylureas

A 25-year-old ASA I patient develops ongoing seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is Midazolam Intralipid Propofol Levetiracetam Phenytoin

Midazolam

A 50 year old man has the following pulmonary function test result. The most consistent diagnosis is

Answer -

You have been asked to anaesthetise a patient with a history of severe depression which has been well controlled on moclobemide. The most appropriate medications in combination with propofol are Sevoflurane, morphine, phenylephrine Sevoflurane, pethidine, phenylephrine Midazolam, fentanyl, ephedrine Midazolam, fentanyl, metaraminol

Sevoflurane, morphine, phenylephrine

Infection control management of patients with carbapenemase-producing Enterobacteriaceae (CPE) infection should include all of the following EXCEPT

Answer -

Blocking the sciatic nerve results in loss of function of all of the following EXCEPT

Answer – hamstring + entire lower leg anaesthetised so depends what is listed

Benztropine ameliorates the side effects of drugs that antagonize Muscarinic receptors Nicotic receptors Dopamine receptors Serotonin receptors Noradrenaline receptors

Dopamine receptors

You are anaesthetising a 35-year-old woman undergoing a laparoscopic appendectomy. She uses a levonorgestrel-releasing intrauterine device (Mirena®) for contraception and you have used sugammadex for reversal of neuromuscular blockade at the end of the procedure. Your postoperative advice to her regarding contraception should state that Barrier protection for a week Barrier protection until the next period. The mirena is sufficient OCP for a week OCP until next period

Barrier protection for a week

You are resuscitating a 60 kg man in cardiac arrest secondary to severe hyperkalaemia. You decide to give intravenous sodium bicarbonate. Australian and New Zealand resuscitation guidelines state the initial dose of 8.4% sodium bicarbonate should be 30ml 40 ml 50 ml 60 ml 70ml

60 ml

Regarding healthcare research, the SQUIRE guidelines describe

Answer – a framework for reporting new knowledge about how to improve healthcare

A 30-year-old woman is administered an anaesthetic for a laparoscopic cholecystectomy for acute cholecystitis. She is breastfeeding her six-week-old infant. During anaesthesia she receives the following drugs: propofol, fentanyl, sevoflurane, rocuronium, oxycodone, parecoxib, ondansetron, sugammadex and cefuroxime. The best advice regarding breastfeeding after anaesthesia is to

Answer – continue breastfeeding and monitor infant for signs of respiratory depression and drowsiness

The most common cause of postoperative visual loss after spinal surgery is Central retinal artery occlusion Central retinal vein occlusion Ischemic optic neuropathy Haemorrhage

Ischemic optic neuropathy

A baby is brought to the emergency department three days after a term home birth. It has not been feeding well and has had few wet nappies. The child is grey in appearance and femoral pulses are difficult to palpate. You note an enlarged liver and marked tachycardia. Pulse oximetry reveals saturations of 75% despite oxygen being administered. You suspect a duct-dependent circulation. The best initial management is

Answer -Prostaglandin E1

A patient with a history of restless leg syndrome is experiencing significant agitation in the postanaesthesia care unit. After excluding other precipitating causes, the best treatment of the agitation in this patient is Midazolam Olanzepine Haloperidol Clozapine Droperidol

Midazolam

During trauma resuscitation in adults, contraindications to blind nasogastric tube insertion include all of the following EXCEPT Answer -

Answer -

Cardiovascular effects of hyperthyroidism include Decreased diastolic relaxation Decreased SVR Decreased PVR Increased diastolic BP

Decreased SVR

Effective pharmacotherapy options to support smoking cessation in the perioperative period include all of the following EXCEPT

Answer - Effective pharmacotherapy options include nicotine replacement therapy, nicotine partial agonists such as varenicline (Champix), bupropion (Zyban), nortryptilline and clonidine. Answer probably SSRI

The main advantage of using norepinephrine (noradrenaline) over phenylephrine for the prevention of hypotension as a result of spinal anaesthesia for elective caesarean section is Better APGAR Better foetal acid/base Less nausea/vomiting Less maternal bradycardia

Less maternal bradycardia

The atmospheric lifetime of nitrous oxide (in years) is approximately

Answer: 114yrs

The risk of a perioperative respiratory adverse event in a child is least likely to be increased by

Answer – URTI > 2 weeks prior

In elderly patients without diabetes mellitus the use of aspirin in primary prevention of disease Increased risk of bleeding Reduced overall mortality Reduced CVS mortality Reduced cancer mortality

Increased risk of bleeding

You are involved in the care of a two-year-old child who has ingested a button battery in the last four hours. You would consider giving Honey Milk Water Bicarb

Honey

The most likely cause of hip adduction in a patient undergoing transurethral resection of a bladder tumour is

??obturator jerk/reflex

In critically ill patients undergoing mechanical ventilation, energy dense enteral nutrition (1.5 kcal/mL/kg) compared to routine (1 kcal/mL/kg) enteral feeding provides

Answer – No difference

Chronic recreational use of nitrous oxide may lead to Anaemia due to decreased EPO Anaemia from glutathione deficiency Neurological damage due to methionine deficit Pulmonary hypertension

Neurological damage due to methionine deficit

Risk factors for chronic postsurgical pain do NOT include Smoking Pre-existing pain High level of anxiety Young age High level of education

High level of education

A drug which is likely to slow the heart rate in a patient with a heart transplant is Adenosine Metaraminol Phenylephrine

Adenosine

The following is an image from a focussed cardiac ultrasound in a patient with dyspnoea presenting for thoracic surgery. The diagnosis is Answer -

Answer -

Once a unit of fresh packed red blood cells has been removed from controlled refrigeration the transfusion should be completed within

Answer - Once a unit of red cells has been out of temperature-controlled storage for more than 30 minutes: transfusion of the unit must be completed within 4 hours (as per Section 6.10.1)

The abnormality shown in this image is LEAST likely to be caused by an injury to the (image of a patient’s back shown) Answer -

Answer - Apparently winged scapula - serratus anterior (long thoracic nerve) or spinal accessory nerve

When commencing treatment of proximal deep vein thrombosis or pulmonary embolus, factor Xa inhibitors (apixaban, rivaroxaban) are preferred to dabigatran or warfarin because they do not require

Answer - Rivaroxaban or apixaban are generally favoured over dabigatran or warfarin as they do not require a period of parenteral anticoagulation or routine laboratory monitoring

A neonate born by emergency caesarean section is limp, pale, has a weak grimace and weak cry, and a heart rate of 60 beats per minute. The Apgar Score is

Answer – 3

Of the following, the LEAST likely cause of high anion gap metabolic acidosis is Pancreatic fistula DKA Cardiac failure Antiretroviral Methanol

Pancreatic fistula

A patient presents with a serum sodium of 110 mmol/L. A feature NOT consistent with a diagnosis of syndrome of inappropriate antiduretic hormone (SIADH) is

Answer – Dehydration/hypovolaemia (this is seen in cerebral salt wasting syndrome)

A patient with C6 tetraplegia is undergoing removal of bladder stones under general anaesthesia. The blood pressure rises to 166/88 mmHg. The appropriate response is to Clonidine Hydralazine Decompress the bladder Fentanyl Deepen your anaesthetic

Decompress the bladder

A 26-year-old man is brought into the Emergency Department four hours after an accidental chemical exposure during crop spraying. His clinical signs include bradycardia, vomiting, diarrhoea, coughing, miosis and weakness. A drug which is NOT recommended during his resuscitation and treatment is Diazepam Pralidoxime Glycopyrrolate Rocuronium Suxamethonium

Suxamethonium

A 30-year-old previously healthy woman is four days post-caesarean section. You are asked to see her to manage her abdominal pain. Over the last two days she has had increasing abdominal pain, increasing abdominal distension, tachycardia and nausea. An abdominal x-ray shows a caecal diameter of 9 cm. After excluding mechanical obstruction, an appropriate management option is

Answer – Colonic decompression ?Neostigmine

The following ECG is consistent with

Answer -

A 40-year-old man suffers a hydrofluoric acid burn to 60% of his total body surface area in an industrial accident. An expected electrolyte disturbance is Hypocalcemia Hyponatremia Hypophosphatemia Hypomagnesemia

Hypocalcemia (1st option) Hypomagnesemia (2nd option)

The lung ultrasound finding most consistent with atelectasis is three or more

Answer - ?No air bronchograms

If group A RhD negative fresh frozen plasma is not available for use in an A RhD positive patient, of the following your next best choice should be a. AB + b. A+ c. A- (why is this an option) d. O+ e. O-

A+

Perioperative overheating is most likely to cause worsening of symptoms of Duchenne Muscular dystrophy Myasthenia gravis Multiple sclerosis Myotonica dystrophia Eaton Lambert syndrome

Multiple sclerosis

A transhiatal oesophagectomy is performed via a Laparotomy left thoracotomy Laparotomy, left neck incision Left thoracotomy, left neck incision Left thoracotomy

Laparotomy, left neck incision

A 69-year-old woman has a recent onset of dyspnoea and undergoes a right heart catheterisation, with results displayed below. Her pulmonary capillary wedge pressure is 10 mmHg. The most likely diagnosis is COPD MR PE AS MS

The modified Aldrete scoring system uses all of the following EXCEPT

Answer – for paeds – DC from PACU: Activity, respiration, circulation, consciousness & O2 sats

A woman with preeclampsia presents with a blood pressure of 150/100 mmHg. An appropriate first line treatment to reduce the blood pressure is Labetalol Nifedipine Magnesium

Labetalol

The ANZCA Choosing Wisely recommendations advise avoiding all of the following EXCEPT Answer -

Answer - 1. Avoid routinely performing preoperative blood investigations, chest X-ray or spirometry prior to surgery, but instead order in response to patient factors, symptoms and signs, disease, or planned surgery 2. Avoid ordering cardiac stress testing for asymptomatic patients prior to undergoing low to intermediate risk non-cardiac surgery. 3. Avoid administering packed red blood cells (blood transfusion) to a young healthy patient with a haemoglobin of ≥70g/L who does not have on-going blood loss, unless the patient is symptomatic or haemodynamically unstable. 4. Avoid initiating anaesthesia for patients with limited life expectancy, at high risk of death or severely impaired functional recovery, without discussing expected outcomes and goals of care. 5. Avoid initiating anaesthesia for patients with significant co-morbidities without adequate, timely preoperative assessment and postoperative facilities to meet their needs.

A 55-year-old man with no past history of ischaemic heart disease is three days post-total hip replacement surgery. He has an episode of chest pain characteristic of angina which began at rest and lasted thirty minutes before resolving fully. There are no ECG changes. Six hours later there is a troponin rise above the 99th percentile upper reference limit. The diagnosis is

Answer - NSTEMI

Consideration for same-day discharge in an ex-premature infant after orchidopexy for undescended testis would be suitable at a minimum postmenstrual age of

Answer – 54 weeks

The implementation of comprehensive multidisciplinary geriatric assessments in the peri-operative period has been shown to Less duration in hospital Less in aged care More alive and at home at 12 months

More alive and at home at 12 months

The advantage of the Mapleson E circuit in paediatric anaesthesia is due to its Can use low gas flows Tactile feel of compliance Assess tidal volume Rapidly change CPAP Low resistance

Low resistance

A 30-year-old woman, gravida 2, parity 1, undergoes an elective lower segment caesarean section for breech presentation. The international consensus statement on the use of uterotonic agents recommends that the first line uterotonic management is Oxytocin 1 unit Oxytocin 3 units Oxytocin 5 units Oxytocin 10 units

Oxytocin 1 unit

An 84-year-old woman with dementia presents for surgery for a breast lump. She lives in a care facility and is accompanied by the nurse manager from the facility and her son. Neither have a written legal authority to act on her behalf. Regarding consent for her surgery Answer -

Answer -

The apical four–chamber view of a transthoracic echocardiogram below shows Answer -

Answer -

A man who had successful treatment of a germ cell tumour 10 years ago presents for laparoscopic appendectomy. Your intraoperative management should consider

Lowest FiO2 possible

A 100 kg 32-year-old male presents two hours after suffering a 30% total body surface area electrical burn. He has had no resuscitation fluids. The infusion rate of isotonic crystalloid resuscitation fluid required for this man for the next six hours is 500 ml/hr 750 ml/hr 1000 ml/hr 1200 ml/hr

1000 ml/hr

Intraoperative lung protective ventilation strategies include all of the following EXCEPT Vt 6-8ml/kg Patient titrated PEEP Recruitment manoeuvres I:E ratio 1:3

I:E ratio 1:3

An ECG abnormality which is NOT usually associated with severe anorexia nervosa is Resting tachycardia Wandering pacemaker ST depression T-wave inversion Prolonged QT

Resting tachycardia

Of the following, the lifestyle modification that is least effective in reducing essential hypertension is Stopping caffeine Low salt diet High potassium diet Exercise Stop alcohol

Stopping caffeine

A 25-year-old man suffers a 30% total body surface area burn. A cardiovascular physiological change expected within the first 24 hours is Increased CI Decreased SVR Increased PVR Increased hepatic flow Increased stroke volume

Increased PVR

Hepcidin production is inhibited in response to Anaemia Inflammation Acute leukemia Infection Excess iron stores

Anaemia

The function of the bottle labelled 'D' in the diagram below is to protect against the consequences of (diagram of chest drain bottles) Answer -

Answer -

The domains described in the Edmonton Frail Scale do NOT include Cognition Mental illness Weight Age Functional assessment

Age

Unsupported ventilation in a non-anaesthetised patient with long-standing tetraplegia is improved when Supine Standing Reverse Trendelenburg

Supine

The breast does NOT receive sensory innervation from the Supraclavicular Anterior intercostal Posterior intercostal Pectoral

Posterior intercostal

A respiratory effect of high flow nasal oxygen therapy is Reduced respiratory rate Reduced minute ventilation Increased work of breathing Increased deadspace

Reduced respiratory rate

A condition or therapy that is NOT a contraindication to hyperbaric oxygen therapy is Answer -

Answer -

In patients without other co-morbidities, bariatric weight loss surgery is indicated when the body mass index (kg/m2) is greater than 35 40 50 60

The image below shows a normal central venous pressure (CVP) trace on the left. The CVP trace shown on the right is most consistent with Tricuspid regurg Mitral stenosis Mitral regurg Pericarditis tamponade

Unclear what trace is shown

Of the following, the device that delivers the greatest flow when using 'Level 1® Fast Flow Fluid Warmer' rapid fluid infuser system is a (list of intravascular catheters) 6.5 Fr sheath 8.5 Fr MAC Multilumen line 8.5 Fr Swan Ganz Sheath 14G IVC 8.5 Fr Peripheral RICC line

8.5 Fr Peripheral RICC line

The most reliable clinical indicator of opioid-induced ventilatory impairment (OIVI) is decreased Conscious state Respiratory rate Oxygen saturations Tidal volume

Conscious state

A patient had prolonged surgery with a laryngeal mask airway in situ. The following day she reports a problem with her tongue. You examine her and see the following when she protrudes her tongue: The most likely cause of the abnormality is R hypoglossal nerve injury L hypoglossal R glossopharyngeal L glossopharyngeal

R hypoglossal nerve injury

A 10-year-old boy (weight 30 kg) has a displaced distal forearm fracture that requires manipulation and application of plaster. The volume of 0.5% lidocaine (lignocaine) that should be used for intravenous regional anaesthesia (Bier block) is 6ml 12ml 18ml 30ml 40ml

18ml

Local anaesthetic systemic toxicity does NOT manifest as Answer -

Answer -

A patient has bipolar disorder and is on long term lithium therapy. An analgesic which should be avoided is Diclofenac Tramadol Oxycodone Methadone

Diclofenac

According to the ANZCA 'Guideline on infection control in anaesthesia', skin preparation prior to central neuraxial blockade should be performed using

0.5 per cent chlorhexidine in alcohol

The following muscles of the larynx are all innervated by the recurrent laryngeal nerve, EXCEPT

Cricothyroid muscle

A patient who usually takes oral morphine 50 mg bd develops a bowel obstruction and experiences withdrawal symptoms. They may be described as having Tolerance Physical dependence Addiction Opiate dependence

Physical dependence

The most common cause of cor pulmonale is

COPD

The management of a patient who has experienced a cardiac arrest within 10 days of cardiac surgery should NOT routinely include

Adrenaline in conventional ALS doses

A third heart sound at the apex may be heard with

Physiological (young fit or 3rd trim preg) or pathological (volume loaded-LVF/RVF/MR/AR)

A patient presents for endovascular clot retrieval after experiencing a right hemisensory loss and right homonymous hemianopia. The vessel most likely occluded is the left Anterior cerebral artery Anterior inferior cerebellar artery Posterior cerebral artery Posterior inferior cerebellar artery Superior cerebral artery

Posterior cerebral artery

A 45-year-old man has the following results on his blood biochemistry testing (Liver function tests shown). The most likely diagnosis is

Answer - ? sick liver

In cardiac surgery, volatile-based anaesthesia compared to total intravenous anaesthesia Answer – Dependant on options

Answer – Dependant on options

Suxamethonium may be safely given to patients with

Answer –

A patient has numbness and weakness in her hand postoperatively. You are trying to distinguish between an ulnar nerve lesion and a C8-T1 radiculopathy. You can diagnose a C8-T1 radiculopathy if she has weakness Thumb adduction Thumb abduction Fingers adduction Fingers Abduction Little finger flexion

Thumb abduction

The recommended cleaning protocol for a laryngoscope handle which has been used but which has no visible soiling is

Detergent and water

Considering emergency front-of-neck airway access, the major blood vessel that is most likely to lie anterior to the trachea above the sternal notch is the

?Brachiocephalic artery

Of the following, the incidence of venous air embolism is considered highest for LUSCS Prostatectomy Coronary artery surgery Spinal surgery Gastric endoscopy

LUSCS

In the treatment of persistent mucosal bleeding in patients with von Willebrand disease type 3, desmopressin (DDAVP) is

Useless ?TXA ?vWF/FVIII concentrate instead

High-risk transthoracic echocardiogram findings associated with aortic dissection include all of the following EXCEPT AR RV dilatation Regional wall motion abnormality Pericardial effusion

RV dilatation

A 48 year old male is day two post-laparoscopic high anterior resection. He has used 42 mg of intravenous morphine in the past 24 hours. You wish to start him on oral tapentadol immediate release. The most appropriate equianalgesic dosage would be

42mg IV morph = 126mg PO morph (@3) = 420mg Tapentadol (@0.3)

A patient with a purely metabolic acidosis has a serum bicarbonate of 14 mmol/L and a lactate of 3.8 mmol/L. The expected PaCO2 is

Answer - 29

The part of the lung that is typically divided into superior, medial, anterior, lateral and posterior segments is the

Answer - RLL

2021.1 Flashcards

(138 cards)