Testy anestezjo

The following conditions cause a collapsing pulse EXCEPT A. AV malformation B. Thyrotoxicosis C. Paget's disease D. Aortic Regurgitation E. Aortic Stenosis
With which cardiac condition are the Femoral Pulses referred to as analagous to Pistol Shots.. A. Aortic Stenosis B. Tricuspid regurgitation C. Aortic Regurgitation D. Mitral Stenosis E. Mitral Regurgitation Concerning the preoperative management of a patient with Cor Pulmonale due to Chronic Lung Disease the following Statements are True EXCEPT A. Treating the Lung infection B. Reversing Bronchospasm C. Chest Physiotherapy - ie Clearing Secretions + incentive spirometry to expand collapsed or poorly ventilated alveoli D. Correcting Electrolyte imbalance E. keeping the patient dry.. ie hydration not necessary With respect to Systolic & Diastolic Heart Failure the Following Statements are True EXCEPT A. Systolic Heart Failure is more common among Elderly Women B. Systolic Heart Failure is more common among Middle Aged Men C. A Decreased Ejection Fraction is the Hallmark seen on Echo in patients with Chronic Left Ventricular Systolic D. Left Ventricular Ejection fraction is usually preserved in patients with Diastolic Heart Failure. E. Systolic Heart Failure is more likely to occur in patients that had a previous myocardial infarction. [ The answer to the above question are in this book ->http://store.elsevier.com/Stoeltings-Anesthesia-and-Co-Existing-Disease/Roberta-Hines/isbn-9781455700820/ ] The commonest cause of Right Heart Failure is A. Pulmonary Hypertension B. Pulmonary Embolus C. Left Heart Failure D. Right Ventricular Myocardial Infarction. E. Ventricular Septal defekt Potential, problems of a Caudal Anesthetic include the following except A. Urinary Incontinence B. Hypotension C. Dural Tap D. Motor Weakness (this needs overnight stay in hospital) E. Inadvertent vascular injection [The problem is Urinary Retention and not incontinence] The following Statements are True concerning aspiration Pneumonitis EXCEPT A. Aspiration Pneumonitis occurs in 1 in 3000 anesthetics and accounts for 10-30% of Anesthetic deaths B. The general consensus is that the aspirate must have a pH lower than 2.5 and a volume in excess of 0.4ml/kg ie 25ml C. In the first phase bronchospasm & pulmonary edema occur as a consequence of direct tissue damage caused by the gastric acid. D. The second phase peaks in 48 hours and is marked by the inflammatory process. E. Secondary infection & progression to ARDS may occur. [Volume required is 0.4ml/kg ; it is suppose to be 25 ml and not 25ml/kg] What is the difference between Systolic & Diastolic Heart Failure? How is Heart Failure Graded? [???Asympatametic,mild,moderate severe ???] The following statements concerning Amniotic Fluid Embolus are True EXCEPT A. It is a Rare (1:20 000) complication of Labour or early puerperium. B. Patients present with Dyspnoea, Cyanosis & Sudden Cardiovascular Collapse. C. Most Survivors suffer No Neurological injury. D. The Pathophysiology is more in keeping with an Anaphylactoid reaction. E. Women who survive the first event may enter a second hemorrhagic phase characterized by Uterine Atony and Excessive Hemorrhage Contraindications to performing an awake fibreoptic intubation include the following EXCEPT A. Patient Refusal B. Patient Unable to Cooperate C. Bleeding Upper Airway D. Upper Airway Tumour with stridor E. A submandibular tumour with no stridor [The answer is E as the scope can cause complete obstruction from a partial obstruction of the trachea lumen. Fiber optic intubation needs time and stridor is an urgent condition] With Respect to Assessment of Difficult Airway the following statements are true EXCEPT A. Thyromental distance, is the distance from the chin to the notch of the thyroid cartilage with the head in full extension. A distance of less than 6 cm is associated with a difficult intubation B. If the distance between the chin and the sternal notch is greater than 12cm, it may be associated with a difficult intubation C. Prayer Sign - inability to place both palms flat in diabetics has been associated with difficult intubation D. An obese patient with a short thick neck would be difficult to intubate. E. Mallampati Grading was up to 3. It was only in 1987 when Samsoong & Young added the Mallampati 4 grade. According to the ASA the DEFINITION of a difficult intubation is when placement of the endotracheal tube requires. A. 2 attempts and/or more than 3 minutes B. 3 attempts and/or more than 10 minutes C. 1 attempt and/or more than 2 minutes D. 5 attempts and/or more than 10 minutes E. 3 attempts and/or more than 15minutes Please Note : This is for elective intubation and not Rapid Sequence Induction. Thus the attempts are interrupted by effective bag mask ventilation to sustain oxygenation. The Sudden Collapse of a women in labour can be one of the following EXCEPT A. Amniotic Fluid Embolus B. Abruptio Placenta C. Hepatic Rupture in a patient with fulminating Pre-ecclampsia D. Intra cerebral Bleed E. Failed Vacuum Extraction The following are commonest causes of Atrial Flutter EXCEPT A. Thyroid Disease B. Anemia C. Rheumatic Valvular Heart Disease D. Carcinoma of the bronchus E. Alcohol Abuse There is only one way to treat Brugada Syndrome... What is it? A. Implanted automated Internal Defibrillator B. Digoxin C. Amiodarone D. Flecanide E. Propafenone The Rule of 9's that is used to estimate burn area proportion to body surface area was developed by which of the following; A. Parkland B. Lund & Browder C. Wallace D. Muir & Barclay E. Brook What anesthetic induction method would you use to intubate a patient with a Broncho Pleural Fistula? Intravenous induction Gas induction There is a communication between the bronchus and the pleura and therefore no attempt should be made to ventilate the patient prior to lung isolation with a double lumen tube. Positive pressure ventilation will cause gas to enter the pleural cavity. The gas can expand the pleural space and tanponade the lungs and cause a tension pneumothorax. So traditionally the aim was gas induction to maintain spontaneous breathing. The mechanics of spontaneous breathing will not cause blowing up of the pleural space as would occur with positive pressure ventilation. Therefore positive pressure ventilation should only occur once lung isolation is established. However there may be a niche for IV induction if the intubator is swift and has skill in inserting the double tube lumen quickly, confirm placement with Fibreoptic scope and isolate the lungs... After how long must an intubated patient in ICU have a tracheostomy? I go for 2 weeks... The study below shows that ETT should not be kept for more than 21 days... http://ccforum.com/content/9/1/R46 The Seldinger Technique can also be used for Tracheostomy. True or False? - True. Yes.Ciaglia et al first used this concept in 1985 for percutaneous tracheostomy.Further advancements were Rapitrach( Schachner et al,in 1989),Griggs method(1990) and in 2000 the BlueRhino. From a historical perspective during which War Time Effort did the hypotensive effects of Sodium Thiopentone become apparent whilst treating the casualties A. Stalingrad World War 2 B. Pearl Harbour World War 2 C. Battle for Saigon. Vietnam War D. Operation Sea Lion, Battle for Britain World War 2 E. Spanish Civil War Which is the Best Agent to Prevent Post Operative Nausea & Vomiting A. Ondansetaron B. Droperidol C. Prochloperazine D. Metochlorpramide E. Dexametasone The commonest cause of nausea & vomiting post spinal anesthetic for a C-Section A. Hypotension B. Traction of the sheath C. Allergy to antibiotic (after delivery) D. Pain E. Traction of the Uterus(after delivery) What Anesthetic technique would you use IN EPIGASTRIC HERNIA? A. General Anesthesia with Endotracheal Intubation B. General Anesthesia with Laryngeal Mask C. General Anesthesia with Endotracheal Intubation with Bailey Manouvre for change to LMA at the end of procedure and thus prevent coughing. D. Spinal E. Epidural What Anesthetic technique would you use IN INCISIONAL OR INGUINAL HERNIA? A. General Anesthesia with Endotracheal Intubation B. General Anesthesia with Laryngeal Mask C. General Anesthesia with Endotracheal Intubation with Bailey Manouvre for change to LMA at the end of procedure and thus prevent coughing. D. Spinal E. Epidural The Following Definitions Are TRUE Except A. Allodynia - Pain caused by a stimulus that normally does not provoke pain B. Hyperalgesia- An increased response to stimuli that is normally painful. C. Dyesthesia - An abnormal sensation that is unpleasant to the patient D. Hyperpathia - Severe Pain in an area of numbness E. Nociception - Sensation of Noxious Stimuli This has both the sensory element of pain combined with the emotionally unpleasant feeling associated with it. Which Calcium Channel Blocker can be used in the management of Subarachnoid hemorrhage A. Diltiazem B. Amlodipine C. Nimodipine D. Verapramil E. Dantrolene Which condition is often seen to occur together with the presence of Berry Aneurysms. A. Arterio- Venous Malformations (AVM) B. Posterior Cranial Fossa Tumours C. Meningiomas D. Polycystic Ovaries E. Polycystic Kidneys Succinylcholine and ICP: A. May increase ICP B. Not recommended for elective neurosurgery C. Both D. Neither Which muscle relaxant crosses the placenta: A. Suxamethonium B. Galamine C. Alcuronium D. Rocuronium E. Vecuronium Which agent is responsible for causing emergence delirium (excitation) in children during recovery period A. Halothane B. Isoflurane C. Sevoflurane D. Desflurane E. Nitrous Oxide Patient at high risk for aspiration pneumonitis include those: A. Pt in acute pain requiring emergency surgery with full stomach B. Pt with hiatus hernia C. Pt with esophageal reflux D. A+C E. A+B+C Opioids as preanesthetic medication: A. To provide sedation B. To reduce the amont of general anesthesia required C. Both D. Neither Characteristic(s) of neuromuscular blocking drugs: A. CNS depression B. Analgesia C. Both D. Neither Resistance to succinylcholine: A. Obesity B. Myasthenia gravis C. Both D. Neither Routes of Opioid agonist administration: A. Transdermal B. Patient controlled analgesia PCA C. Intra nasal D. A+B E. A+B+C Main tissue reservoir for opioids: A. Fat B . Skeletal muscle C. Spleen D. Liver E. Lungs [ No, not FAT. Answer is B - beacuse of greater bulk of skeletal muscle ] Benzodiazepine effects if used as preanesthetic medication: A - BP reduction B - increased heart rate C - both D – neither Most important factor influencing drug absorption rate following intramuscular injection: A- needle diameter B- rate of administration C- injection site blood flow D- injection Volume Which of the following situations is best for administering reversal from neuromuscular blockage. A. 3 twitches on train of 4 (TOF) B. 4 twitches on train of 4 (TOF) C. 7 twitches per post tetanic twitch count D. 11 twitches per post tetanic twotch count E. 2 twitches on train of 4 (TOF) Which of the following conditiond has complications of Intra uterine death; a woody hard uterus and DIC. A. Placenta previa B. Abruptio Placenta C. Amniotic Embolus D. Cervical Incompetence E. Molar pregnancy Carbon dioxide and Nitrous Oxide have the same Atomic Wieght. True or False? - False. Both are muscarinic cholinergic antagonists, which one does not cross the Blood Brain Barrier A. Atropine B. Glycopyrollate Bence Jones proteins are found in the urine of patient with which condition? A. Diabetic Nephropathy B. Minimal Change glomerulonephritis C. Membranous glomerulonephritis D. Multiple Myeloma E. Hodgekins Lymphoma Which local anesthetic has vasoconstrictive properties A. Lidocaine B. Amethocaine C. Benzocaine D. Cocaine E. Bupivicaine What is methemoglobinemia? With the management of met hemoglobinemia Blue blood + Blue liquid = Red blood. Blue liquid is Methyl Blue. True or False? - True. Which local anesthetic is implicated in causing methemoglobinemia? A. Lidocaine B. Prilocaine C. Bupivicaine D. Ropivicaine E. Etidovaine This drug can cause methemoglobinemia. It is also implicated with cyanide toxicity. What is it? - Sodium nitro prusside Anesthesia decreases immune function. True Or False? - True. The following local anesthetic agents are amides except: A. Lidocaine (lignocaine) B. Ropivicaine C. Bupivicaine D. Prilocaine E. Cocaine Local anesthetic blocks Sodium Channel. True or False? - True Local anesthetic blocks the Sodium Channel from: A. Inside the cell ie from the cytosol B. Outside the cell ie the interstitial side Answer: A - local anesthesia work from inside the cell on the the cell membrane from the cytosol Effectiveness of local anesthetics when injected into infected tissue: A. Greater effect (greater anesthesia) B. Reduced effect (reduced anesthesia) C. No difference Local anesthetics types: shorter duration of action: A. Amide types agents B. Ester types agents C. No difference Type of local anesthtics with wider distribution: A. Amide agents B. Estet agents C. No difference India ink is used on a CSF specimen to diagnose: A. TB meningitis B. Meningogoccus C. Heamophylus D. Cryptococcal Meningitis E. Pneomococcus. Folic Acid defeciency in pregnancy can lead to Neural Tube defects in the baby . True or False - True. Sunset Eyes are pathognomonic of A. Graves Disease B. Burkitts lymphoma C. Phacomelacia D. Hydrocephalus E. Orbital Osteoma Which nerve supplies tactile sensation to the anterior 2/3 of the tongue? A. Mandibular Nerve B. Facial Nerve C. Glossopharyngeal D. Superior laryngeal nerve E. Hypoglossal nerve Postganglionic Sympathetic nerve fibres are unmyelinated. True or False? - True The Olfactory Nerve passes through the Cribriform Plate . True or False? - True The Chorda Tympani which supplies the sensation of taste to the anterior 2/3 of the tongue is a branch of A. Trigeminal nerve B. Glossopharyngeal nerve C. Facial nerve D. Vagus Nerve E. Accessory nerve Name the passage that connects the 3rd ventricle to the 4th ventricle A. Foramen of Munroe B. Foramen Magendie C. Foramen Luschka D. Fotamen Bochdelak E. Aqueduct of Sylvius The sitting position can be used for surgery of which intercranial tumour. - Posterior fossa tumour This tumour can cause bitemporal hemianopia and is removed via a transphenoidal approach. Where is it ? A. Posterior Cranial fossa B. Third ventricle C. Pituitary Fossa D. Falx Cerebri E. In the Ethmoidal Sinuses. What is the Munroe Kelly Doctrine? - Which make theory for post dural puncture headache of vascular nature. There' s a relation between icp, csf , blood volumes and cpp. The intracranial contents are non compressible , when there' rise of ICP there's buffering mainly by reduction of csf volume and to lesser extent from blood volume The following drugs are examples of antiplatelet drugs except A. Abciximab B. Ticlopidine C. Unfractionated Heparin D. Aspirin E. Clopidogrel Which Starch based Colloid solution is derived from POTATO? Voluven Venofundin Gelofusine Hemacel Dextran Whose Mother is a Nurse Anesthetist A. Hugo Chavez B. Josef Stalin C. Hosni Mubarak D. Bill Clinton E. Nikolas Sarkozy The opposite of Elastance is A. Resistance B. Pressure C. Contractility D. Compliance E. Flow The word that generally embodies the quest to become something - in Medicine denotes spillage of material. What is that Word: 1. Elastance 2. Aspiration 3. Efficacy Laminar Flow is dependant on the Viscosity of the fluid whereas Turbulent flow is dependant on ________ A. Temperature B. Critcal Pressure C. Density D. Volatility E. Gravity The Following Statements are TRUE concerning effective weaning of a patient from the ventilator EXCEPT A. The patient must be well oxygenated and able to ventilate at FiO2 < 50%, PaO2 >10kPa, PCO2 <6.6kPa B. The patient must be able to generate a negative intrathoracic pressure of at least -25cmH2O C. Needs A minute volume of 10 L/min D. Needs A Vital Capacity of > 5ml/kg E. Needs A Rapid shallow breathing index of < 100 What is the Anesthetic Induction Technique for Pyloric Stenosis ? A. Rapid Sequence Induction B. Inhalation Induction. Peri operative electrical pacing can be achieved through use of the following strategies EXCEPT A. Percutaneous Transthoracic Non Invasive B. Epicardial C. Transvenous D. Transesophageal E. Isoprenaline Suggested Indications for possible preoperative pacing include the following Except A. Trifasicular Block B. Acute MI with Mobitz type II C. Acute MI with 3rd degree block D. Wolf Parkinson White Syndrome E. Symptomatic Bradyarrythmia The following statements are TRUE of Alfentanil Except A. Alfentanil is a phenylpiperidine structural analogue of fentanyl B. Alfentanil has a pKa of of 6.5, it is thus 89 % in non ionized lipid soluble form in plasma C. Fentanyl has a pKa of 8.4, it is thus 9 % in non ionized lipid soluble form in plasma D. Alfentanil works within 2 mins of injection, fentanyl takes up to 5 minutes to work E. Alfentanil is a more potent opiate than fentanyl and is the opiate of choice in cardiac anesthesia In which condition are the Dibucaine Number and Flouride Score tests used to confirm the diagnosis A. Myesthenia Gravis B. Scoline Apnoea C. Malignant Hyperthermia D. Eaton Lambert Syndrome E. Carcinoid Syndrome In scoline apnoea as it detects the atypical cholinesterase Which of the following statements does not comply to the 10% Rule concerning Phaeochromocytoma ? A. 10% are Malignant B. 10% are bilateral C. 10% are in Children D. 10% are extra adrenal E. 10% are Symptomatic Thr Crash 2 Trial entailed usage of which drug A. Novoseven B. Tranaxamic Acid C. Aprotinin D. Captopril E. Protamine The Following Fluids are Colloids Except A. Voluven B. Venofundin C. Hemacel D. Gelofusine E. Ringers Lactate Which drug acts by stimulating endothelial cells and is used in patients with renal failure A. Aspirin B. Warfarin C. Desmopressin D. Tranexamic Acid  E. Aprotinin Protamine Disables Heparin through A. Ionic neutralization as heparin is an Acid and Protamine is a base B. Competitive inhibition C. Non Competitive Inhibition D. Reducing Synthesis of Anti Thrombin III E. Destroying Basophils and Mast Cells Night terror(pavour noctorns) is seen in- a.Non REM disorder b.REM dis order At a temperature of 25 degrees celsius what is Carbon Dioxide A. GAS B. VAPOUR The Critical Temperature for Carbon Dioxide is 31degrees celsius.. remember that a gas obeys the gas laws, a vapour does not, and for a vapour to become a gas it must be above its critical temperature The following are examples of organic molecules EXCEPT A. Ether B. Cyclopropane C. Benzene D. Ethanoic Acid E. Nitrous oxide Which of the following agents is a gas that is coded French Blue, promotes the 2nd Gas Effect, Concentration effect and Expands closed Air Spaces. A. Desflurane B. Nitrous Oxide C. Isoflurane D. Enflurane E. Cyclopropane Shame poor Neostigmine. Soon something sweet is coming to replace it. Yes.. a reversal to Rocuronium with comparably no hemodynamic effects. Sweeter as it has 10 sugar molecules and guess what? it is shaped like a doughnut. What is it? A. Doxacurium B. Edrophonium C. Physostigmine D. Sugammadex E. Pralidoxime 2 Acetylcholine Molecules combined gives A. Decamethonium B. Mivacurium C. Suxamethonium D. Vecuronium E. Alcuronium Which Volatile agent does not contain Chlorine A. Chloroform B. Desflurane C. Halothane D. Enflurane E. Isoflurane The following Volatile Anesthetic Agents are Ether -0- based EXCEPT A. Isoflurane B. Enflurane C. Sevoflurane D. Desflurane E. Halothane The following volatile anesthetic agents have an Acyl Halide -CF3 group EXCEPT A. Halothane B. Enflurane C. Isoflurane D. Desflurane E. Sevoflurane Which of the following Volatile Agents contain Bromine A. Halothane B. Enflurane C. Isoflurane D. Desflurane E. Sevoflurane Which one has the lowest Blood Solubility ??????????? A. Ether B. Halothane C. Desflurane D. Nitrous Oxide E. Isoflurane some sources( D )others( C) N2O 0,47 desf 0.42 WhIch Volatile Agent Can React With Dry Soda Lime to Produce Carbon Monoxide A. Sevoflurane B. Desflurane C. Isoflurane D. Halothane E. Enflurane Which Volatile Agent only has Flourine as its halogen, has a saturated vapour pressure SVP of 88.5kPa and a boiling point of 23 degrees Celsius. A. Halothane B. Enflurane C. Isoflurane D. Desflurane E. Sevoflurane Which Volatile Anesthetic Agent has been implicated in Emergence Delirium? A. Halothane B. Enflurane C. Isoflurane D. Desflurane E. Sevoflurane Of the following Inhalational Anesthetic Agents, Which is the Most Soluble in Blood ? A. Desflurane B. Halothane C. Enflurane D. Isoflurane E. Sevoflurane Which Element has a Valency of 2; the Same as Oxygen A. Bromine B. Iodine C. Sulphur D. Phosphorus E. Alluminium Which of the following Volatile Agents can produce Phosgene when exposed to Soda Lime A. Cyclopropane B. Trichloroethylene C. Methoxyflurane D. Chloroform E. Diethyl Ether Of the following Anesthetic Volatile Agents, Which is less likely to accumulate in Adipose Tissue therefore resulting in a quick recovery when used in Obese Patients. A. Halothane B. Isoflurane C. Sevoflurane D. Desflurane E. Enflurane Of the following which has the LOWEST Solubility in blood? A. Halothane B. Isoflurane C. Desflurane D. Sevoflurane E. Nitrous Oxide Którą z metod stymulacji nerwów stosuje się w monitorowaniu zwiotczenia wywołanego podaniem skoliny? drażnienie bodżcem pojedyńczym (TW – Twitch) seria 4 bodżców z częstotliwością 2 Hz (TOF – Train of four) podwójną salwą bodżców (DBS – Double Burst Stimulation) – dwie serie pobudzeń z których każda obejmuje 3 krótkie pobudzenia w odstepie 0,75 sek. bodziec tężcowy (TFT – pobudzenie tężcowe) – stymulacja o częstotliwości 50 Hz przez 5 sekund It starts with the letter L and ends with N. It was given colour and a fragrance to disguise Ether. Yes it was the name William T.G.Morton used for Ether on the Iconic Event on 16 October 1846. What was this name? - LETHEON Which Muscle Relaxant causes release of the most histamine A. Alcuronium B. Rocuronium C. Atracurium D. Tubocurare E. Vecuronium LAUDANOSINE or N-methyltetrahydropapaverine decreases the seizure threshold, and can induce seizures if present at sufficient threshold concentrations. It is a recognized metabolite of which of the following drugs A. Rocuronium B. Vecuronium C. Atracurium D. Pancuronium E. Alcuronium Which is the best anesthetic agent to use for Electroconvulsivd therapy (ECT) A. Propofol B. Etomidate C. Ketamine D. Sodium Thiopentone E. Methohexitone Which of the following Anesthetic Induction Agents block NMDA receptors A. Propofol B. Etomidate C. Ketamine D. Sodium Thiopentone E. Methohexitone Which of the following Induction Agents Exhibits the phenomenon of Tachyphylaxis A. Propofol B. Ketamine C. Sodium Thiopentone D. Methohexitone E. Etomidate This phenomenon is seen especially when the drug is used frequently in burns victims that need numerous anesthetics for dressing changes, debridements release of contractures, skin grafts etc.. Which of the following drugs works indirectly by promoting catecholamine release from the presynaptic membrane of the neuro effector junction A. Milrinone B. Phenylephrine C. Dobutamine D. Dopexamine E. Ephedrine What is the effect of High Altitude on General Anesthesia? A. High Altitude DECREASES Anesthetic Requirements B. High Altitude INCREASES Anesthetic Requirements C. High Altituds has NO effect on Anesthetic requirements. high altitude-deacrease atmosphere temperature-decrease total body metabolism and requirements-decrease need for anathestics The Isolated Forearm Technique is used for monitoring which parameter in Anesthesia ? A. Pain B. Anxiety C. Muscle Paralysis D. Awareness E. Regional Blood Flow because other parts of body paralysed only isolated limb, so give indication of awareness Which type of Awareness in Anesthesia is more common A. Explicit Awareness B. Implicit Awareness NA JAKI OPIOD NIE DZIAŁA NALOKSON? W przypadku norpetydyny nalokson nie może być stosowany jako odtrutka, wręcz może zwiększać ryzyko drgawek przez hamowanie przekaźnictwa GABA-ergicznego i obniżenie poziomu drgawkowego (w dawkach rzędu kilku mg). W przypadku podejrzenia zatrucia norpetydyną należy podać leki przeciwdrgawkowe i wspomóc wentylację. Which of the following are not treated with opoid analgesics like (dextromethorphan and methadone)? A. Pulmonary Edema B. Cough suppression C. Sedation D. Pain Which of the following is the antidote for the toxin Heparin? A. Protamine B. Methylene blue C. N-acetylcysteine D. Glucagon Which of the following are not treated with Barbiturates? A. Seizures B. Hypotension C. Insomnia D. Anxiety Which of the following statements concerning monitoring techniques in the intensive care unit are true? A. Pulmonary artery and pulmonary capillary wedle pressure readings should be made at end inspiration, to minimize ventilatory artifacts. B. Continuous SvO 2 monitoring based on the technique of reflectance spectrophotometry has been shown to be accurate and reliable. C. Direct measurement of gastric intramucosal pH can be provided by gastrointestinal tonometry. D. Hyperlactatemia may be seen in a number of clinical conditions not associated with tissue hypoxia, including liver disease and hypermetabolic states Which of the following statements about continuous cardiac output monitoring are true? A. Continuous cardiac output monitoring may unmask events not detected by intermittent cardiac output measurements. B. Continuous cardiac output monitoring by the thermodilution metod requires continuous infusion of fluid injectate at a constant rate and temperature. C. The major advantage of the Fick method over the thermodilution method of calculating cardiac output is that it is noninvasive, requiring only the determination of oxygen consumption by respiratory gas analysis. D. The technique of thoracic electrical bioimpedance utilizes sensors to determine stroke volume by detecting changes in resistance to a small, applied alternating current. choose TWO OPTIONS Answer: ADDISCUSSION: Varioustechniques are available tomeasure cardiac outputcontinuously. The advantagesof continuous cardiac outputmonitoring, as compared withintermittent methods, are (1)previously undetected eventsmay be unmasked; (2) moreprompt recognition of adverseevents may be achieved; and(3) earlier therapeuticintervention may be possible.Continuous cardiac outputmonitoring using thethermodilution methodappears to be as accurate asthe “standard” intermittentbolus method, but it does notrequire fluid injectates. In thismethod, a modifiedpulmonary artery catheterincorporating a thermalfilament heats blood in theright ventricle at pulsedintervals, and a distalthermistor detects thetemperature change, whichcan be related mathematicallyto cardiac output. The Fickmethod combines respiratorygas analysis with oximetery todetermine oxygenconsumption (V(overdot)O 2)and to estimate mixed venousand arterial oxygen contentdifferences, respectively.Cardiac output (CO) is thendetermined from the formula:CO = V(overdot)O 2/ {C(a-v)O2 × 10} @ V(overdot)O 2/{SaO 2 - SvO 2) × (Hb) ×(1.39) × 10}. Thoracicelectrical bioimpedance is atechnique by which theresistance to a small-amplitude alternating current(i.e., the impedance) ismeasured using variouselectrodes. The impedancechange induced by eachcardiac ejection is a functionof the stroke volume, whichthen can be used to calculatethe cardiac output. All of the following are true about neurogenic shock except: A. There is a decrease in systemic vascular resistance and an increase in venous capacitance. B. Tachycardia or bradykardia may be observed, along with hypotension. C. The use of an alpha agonist such as phenylephrine is the mainstay of treatment. D. Severe head injury, spinal cord injury, and high spinal anesthesia may all causa neurogenic shock. Tachycardia means that the nervous system is responding and working in a good way Which drug is derived from extract of the plant Foxglove A. Dobutamine B. Theophylline C. Digitalis D. Levosimendin E. Dopexamine Which Method is best for Carotod Endarterectomy. A. Cervical Plexus Block B. General Anesthesia If the Circle Of Willis is intact I would opt for a General Anesthetic with monitoring of cerebral function and stump pressures. I find the cervical plexus also a good option though it may be intense as it entails frequent neurological assessments. However with the Cervical block when ipsilateral blood flow is compromised, Inserting the shunt or the conversion into a general anesthetic can be quite cumbersome Complications of Thyroid Surgery include the Following Except A. Wound hematoma B. Tracheomalacia C. Recurrent Laryngeal Nerve Injury D. Hypercalcemia E. Hypocalcemia What is the Name of This Breathing Circuit A. BAIN Coaxial Mapleson D B. LACK Coaxial Mapleson A C. MAGILL Mapleson A D. Waters To and Fro System E. CIRCLE System The earliest manifestation of increased intracranial pressure following head injury is: A. Ipsilateral pupillary dilatation B. Contralateral pupillary dilatation C. Altered mental status D. Hemiparesis According to the Glasgow Coma Scale (GCS), a verbal score of 1 indicates: A. No response B. Inappropriate words C. Incomprehensible sounds D. Disoriented response Which of the following catheter materials is most suited for long-term use? A. Latex B. Silicone C. Rubber D. Polyurethane The Following Statements concerning Airway Pressures are Are True EXCEPT A. Airway pressures are regulated to prevent barotrauma B. With bag mask ventilation an airway pressure above 20cmH2O can open the esophagus and insufflate the stomach C. The APL valve can be used to adjust airway pressures D. Peak airway pressures are used to measure dynamic compliance E. Plateau Airway Pressures are a measure of airway resistance Whichapproach has a better outcome for managing Cardiac Injuries A. Sternotomy B. Left Sided Thoracotomy C. Clamshell D. Subxiphoid The Answer is A Sternotomy.. it gives better exposure.. prior to sawing remember to temporarily disconnect the ventilator to prevent the buldging ventilated lung from being torn by the sternotomy saw. Whats antidote for Warfarin poisoning ? A. Oxygen B. Glucagon C. Vitamin K D. Atropin The following drugs are hemostatic agents except A. Epsilon Amino Caproic Acid B. Demopressin C. Aprotinin D. Tirofiban E. Recombinant Human Factor VIIa What is Cryoprecipitate? Cryoprecipitated Antihaemophilic Factor", "Cryoprecipitated AHF", and "cryo" for short, is a frozen blood product prepared from plasma. It is often transfused as a four to six unit pool instead of as a single product. Many uses of the product have been replaced by factor concentrates, but it is still routinely stocked by many hospital blood banks. factor8, vonwillbrand & fibrinogen, not used now a days coz cof risk of viral born infections... What is Cut Off Platelet Count For Spinal/Epidural? - 50’000 – 80’000 Cutting Edge: Concerning Propofol. What is MCT, LCT? earlier propofol LCT has this prob of pain on injection...LCT is long chain triglyceride...recently propofol MCT/LCT emulsion has proved to dec pain....MCT is medium chain fatty acid MCT stands for Medium chain triglyceride SPINAL HEMATOMA - Incidence Epidurals - 1:150 000 Spinal (Subarachnoid block) - 1:220 000 Facultative hypermetropia occur commonly in : (1) childhood (2) old age (3) middle age (4) post menopausal females Which Muscle Relaxant Crosses The Placenta? A. Vecuronium B. Cisatracurium C. Gallamine D. Rocuronium E. Pancuronium The ENIGMA Trial investigated which agent. A. Halothane B. Isoflurane C. Desflurane D. Desflurane E. Nitrous Oxide Which Is The Predominant Extracellular Cation? A. Zinc (Zn++) B. Magnesium (Mg ++) C. Calcium Ca (++) D. Potassium (K+) E. Sodium (Na+) In An Infant With Persistant Vomiting Due To Pyloric Stenosis Which Acid/Base Disturbance Is likely To Occur? A. Respiratory Acidosis B. Respiratory Alkalosis C. Metabolic Acidosis D. Metabolic Alkalosis Concerning Red Cell Physiology,, What is Hamburger's phenomenon? - movement of chloride from plasma to erythrocyte interior, or vice versa?????? Which Induction Agent Is Preferable To Use In A Rapid Sequence Induction (RSI). A. Sodium Thiopentone B. Methohexitone C. Propofol D. Ketamine E. Etomidate Rapid Sequence Induction entails SIMULTANEOUS airway procurement with induction of Anesthesia. Giving the induction agent slowly can be counter intuitive as the patient may regurgitate prior to being fully anesthetized. You can use all of the ABOVE and I know many that use Propofol. However I would use SODIUM THIOPENTONE as the induction Agent needs to be administered quickly to prevent the patient retching prior to falling asleep. There is a lag phase with propofol and if it is given quickly it can cause a 40% reduction in the Mean Arterial Pressure. With STP the dose can be tailored ie calculated 3-5mg/kg and given with respect to the patient's profile, coexisting intercurrent ailment or blood volume status.. Dr Roc "MY' Answer; is A - SODIUM THIOPENTONE Of The Following Anesthetic Induction Agents Which One Is Implicated for Causing Excitatory Or Emergence Phenomena A. Sodium Thiopentone B. Methohexitone C. Propofol D. ketamine E. Etomidate The following Statements about Ketamine is True Except A. It blocks NMDA Receptors B. It has a Sympathomimetic Effect C. It has Analgesic Properties D. It blocks Sodium Channels E. It causes Bronchodilation Which is Structurally Similar To Atropine A. Morphine B. Pethidine C. Fentanyl D. Alfentanil E. Remifentanil Which of the following get metabolized by ester hydrolysis to compounds with minimal biological activity. A. Morphine B. Fentanyl C. Sufentanil D. Alfentanil E. Remifentanil Which is not an Aminosteroid Compound A. Vecuronium B. Rocuronium C. Pancuronium D. Cisatracurium E. Alcuronium
	Który z poniższych ma budowę chemiczną podobną do LSD? A. Midazolam B. Ketamina C. Etomidat D. Tiopental E. Propofol
	Który z poniższych ma działanie p/wymiotne? A. Midazolam B. Ketamina C. Etomidat D. Tiopental E. Propofol
Which of the following Agents exhibits Tachyphylaxis A. Milrinone B. Ephedrine C. Phenylephrine D. Dopexamine E. Dobutamine
Refeeding Syndrome is associated with the Depletion of Which Anion A. Chloride B. Sulphate C. Phosphate D. Acetate E. Carbonate
With Which of the following drugs is Methemoglobinemia a recognized complication A. Lidocaine B. Bupivicaine C. Prilocaine D. Ropivicaine E. Amethocaine
Which of the following drugs is a Phosphodiesterase Inhibitor? A. Dobutamine B. Dopexamine C. Isoprenaline D. Salmeterol E. Milrinone
Which of the following induction agents works by blocking NMDA receptors? A. Sodium Thiopentone B. Methohexitone C. Propofol D. Ketamine E. Etomidate
Methylene Blue Is Used To Treat Which Of The Following A. Methemoglobinemia B. Cyanide Toxicity C. Porphyria Crisis D. Lactic Acidosis E. Metabolic Alkalosis Note: Methylene blue may be dangerous in patients who have or may be at risk for a blood disease called G6PD deficiency, and should not be used in patients with G6PD defeciency.
Which of the following local anesthetics causes vasoconstriction? A. Lidocaine B. Cocaine C. Bupivicaine D. Prilicaine E. Amethocaine A albo B Cocaine is not a vasoconstrictor,cocaine has the opposide effect,it opens up all of your vases..thats why it makes your penis become so hard,instead lidocaine is a vasocostrictor,so it makes your dick unable to eyaculate,take both at the same time for a great party!.
Which Airway Device Is This? A. The SLIPA Supraglottic Airway Device B. The iGEL Supraglottic Airway Device C. The Ring, Elwyn & Adair Tube D. The Laryngeal Tube E. The Cobra Supraglottic Airway Device
Which Airway Device Is This? A. The SLIPA Supraglottic Airway Device B. The iGEL Supraglottic Airway Device C. The Ring, Elwyn & Adair Tube D. The King Laryngeal Tube E. The Cobra Supraglottic Airway Device
Which Airway Device Is This? A. The SLIPA Supraglottic Airway Device B. The iGEL Supraglottic Airway Device C. The Ring, Elwyn & Adair Tube D. The Laryngeal Tube E. The Cobra Supraglottic Airway Device
Which Airway Device Is This? A. The SLIPA Supraglottic Airway Device B. The iGEL Supraglottic Airway Device C. The Ring, Elwyn & Adair Tube D. The Laryngeal Tube E. The Cobra Supraglottic Airway Device
Which Of The Following Is A FLEXIBLE INDIRECT Laryngoscope A. BULLARD Laryngoscope B. GLIDESCOPE C. BONFILS Optical Stylet D. PENTAX AWS E. McCOY Laryngoscope http://www.aimedicaldevices.com/i/scope2.jpg
Which Antibiotic in the list below Can Prolong The Action Of Non Depolarizing Neuromuscular Relaxants A. Cloxacillin B. Metronidazole C. Ciprofloxacin D. Gentamycin E. Tetracycline
Carbon Dioxide Measurement with Capnography Is Measured with use of A. Absorbance Of Ultra Violet Light B. Absorbance Of Infra Red Light C. Changes In Resistance In The Wheatsone Bridge D. Use Of Mass Spectrometry E. The Use Of Clarkes Electrode
Which Of The following Contributes To The Greatest Amount Of Heat Loss From The Body A. Conduction B. Convection C. Radiation D. Evaporation
Which of the following compounds has the same molecular weight as Carbon Dioxide (44) A. Methane B. Ammonia C. Nitrous Oxide D Chloroform E. Nitric Acid
Which Of the Following Induction Agents Can Raise The Blood Pressure A. Thiopentone B. Propofol C. Ketamine D. Methohexitone E. Etomidate
Of the following Opiates, Which is Structurally Similar To Atropine? A. Morphine B. Pethidine C. Fentanyl D. Alfentanil E. Sufentanil
The major venous return system of the heart, the coronary sinus, empties into which of the following? A. Inferior vena cava B. Left atrium C. Right atrium D. Right ventricle E. Superior vena cava The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium ). It delivers deoxygenated blood to the right atrium , as do the superior and inferior vena cava. It is present in all mammals, including humans.	Główny system powrotu żylnego serca, zatoka wieńcowa, opróżnia się do którego z poniższych? A. Żyła główna dolna B. Lewy przedsionek C. Prawy przedsionek D. Prawa komora E. Żyła główna górna Zatoka wieńcowa to zbiór żył połączonych razem aby utworzyć większe naczynie, które odbiera krew od mięśnia sercowego (myco radium). Dostarcza odtlenowaną krew do prawego przedsionka, podobnie jak robi to żyła główna górna i dolna. Jest ona obecna u wszystkich ssaków, w tym ludzi.
Which of the following is a Gas that is used as a preservative for IV Paracetamol preparations is A. Helium B. Xenon C. Argon D. Nitrous Oxide E. Carbon Dioxide The Answer is Argon, a noble gas of which there is a finite amount within our atmosphere hence it must get vented out on delivery of the drug.
Which of the following are the physiological changes that are well known to occur during pregnancy? A. Increased cardiac output by 30%. B. Increase in blood volume by 30%. C. Slight drop in haemoglobin. D. Decreased oesophageal sphincter pressure resulting in heartburn. E. Increased venous pressure in the pelvis. All of the answers are true but with different Percentages. Still - best answer is D PS. i get this Question < single choice > From one of postgraduate Exams ... So simply if u r MBBS / med student >> All answers r True ... But for Postgraduates and Master students >> best answer is D
Below what PaO2 is a Patient stated to be in Respiratory Failure? A. 50mmHg B. 60mmHg C. 75mmHg D. 40mmHg E. 45mmHg	Poniżej jakiej wartości PaO2 u pacjenta mówi się o niewydolności oddechowej? A. 50mmHg B. 60mmHg C. 75mmHg D. 40mmHg E. 45mmHg
Succinylcholine is normally metabolized by pseudocholinesterase (also known as butyrylcholinesterase). The following Statements are TRUE concerning Pseudocholinesterase EXCEPT Butyrylcholinesterase is synthesized in the liver and is mostly found in the Neuromuscular Junction. (NMJ) It hydrolyzes succinylcholine to succinylmonocholine and choline. In patients with normal pseudocholinesterase levels, The metabolism of administered succinylcholine in the plasma, results in 10% of the original dose reaching the NMJ. Approximately 1 in 50 individuals have one abnormal variant of the gene, leading to a slightly prolonged block when succinylcholine is given. This is usually not clinically significant. 1 in 2000 patients have homozygous abnormal variants, and in these patients, the duration of succinylcholine is between 3 to 6 hours. A - cause it found in plasma A - the greater quantity is found in liver and blood, not in the NMJ
Which drug is most often associated with hypotension caused by histamine release? A. Diazepam B. Pancuronium C. Tizanidine D. Tubocurarine E. Vecuronium	Który lek najczęściej powoduje nadciśnienie spowodowane wyrzutem histaminy? A. Diazepam B. Pancuronium C. Tizanidyna D. Tubokuraryna E. Vecuronium
What Are These? A. Indirect Rigid Laryngoscopes Or B. Direct Rigid Laryngoscopes
The Following Statemets are TRUE About The Caudal Epidural Technique EXCEPT: A. The Caudal epidural technique is a relatively simple regional approach that helps in avoiding or reducing the systemic administration of opioids thus enabling a swift recovery with stable hemodynamics and no issues of respiratory depression. B. The caudal space is identified by feeling a groove above the coccyx between two sacral cornua. C. It is much easier performing the block in adults than in the pediatric population. D. Its main indications are for procedures at or below periumbilical area. which include urogenital, inguinal, and lower extremity surgery. E. It can also be used in chronic pain patients and in patients with shingles below the umbilicus.
What is the total volume of an adult CSF? A.500 ml B.250 ml C.150 ml D.1500 ml E.750 ml
	Wszystkie poniższe związki zmniejszają produkcję CSF (płynu mózgowo rdzeniowego) oprócz: A. Acetozolamid B. Furosemid C. Spironolakton D. Desfluran E. Isofluran Desflurane increases CSF production(Morgan anesthesia,page 579 & 581)
Which of the following muscle relaxants is an aminosteroid ? A. Atracurium B. Baclofen C. Cisatracurium D. Dantrolene E. Rocuronium	Który z moniższych miorelaksantów jest aminosteroidem? A. Atracurium B. Baclofen C. Cisatracurium D. Dantrolen E. Rocuronium
Which of the following muscle relaxants is most likely to cause a tachycardia? A. Alcuronium B. Vecuronium C. Cisatracurium D. Pancuronium E. Rocuronium	Który z poniższych miorelaksantów najczęściej może powodować tachykardię? A. Alcuronium B. Vecuronium C. Cisatracurium D. Pancuronium E. Rocuronium
Which of the following tranquilizers is the most potent & long acting A. Alprazolam B. Lorazepam C. Midazolam D. Diazepam E. Temazepam [http://www.drugs.com/pro/ativan.html] [http://www.ncbi.nlm.nih.gov/m/pubmed/6131586/]	Który z poniższych środków uspokajających ma największą siłę działania i najdłuższy czas działania? A. Alprazolam B. Lorazepam C. Midazolam D. Diazepam E. Temazepam [http://www.drugs.com/pro/ativan.html] [http://www.ncbi.nlm.nih.gov/m/pubmed/6131586/]
The infusion of which of the following is implicated in causing the green discoloration of urine? A. Midazolam B. Propofol C. Ketamine D. Diazepam E. Thipentone	Który z poniższych leków może powodować zielone zabarwienie moczu? A. Midazolam B. Propofol C. Ketamina D. Diazepam E. Thipentone
Which of the following drugs has no active metabolites? A.Succinylcholine B.Ketamine C.Codeine D.Propranolol E.Phenobarbitone	Który z poniższych leków nie ma aktywnych metabolitów? A. Sukcynylocholina B. Ketamina C. Kodeina D. Propranolol E. Phenobarbital
All of the following are characteristic of (pris) propofol infusion syndrome except. A. Hepatomegaly B. Rhabdomyolyisis C. Hyperkalemia D. Metabolic Alkalosis E. Refractory Bradycardia It is Metabolic Acidosis & Not Metabolic Alkalosis	Wszystkie z poniższych są charakterystyczne dla PRIS (PRopofol Infusion Syndrome), oprócz: Hepatomegalia Rabdomioliza Hiperkalemia Zasadowica metaboliczna Oporna bradykardia Bo metaboliczna KWASICA a nie zasadowica!
The Name Of The Laryngoscope Labelled G is: A. Macintosh B. Polio C. McCoy D. Miller E. Bullard Answer is B - It is a Polio Laryngoscope. This obtuse angled disposition of handle and blade facilitates entry of the blade into the mouth in patients with large breasts. I used this once must say it can be a bit tricky, This especially so if it is a Grade 3+ Laryngoscopy and the tongue /epiglottis need hoisting to expose the laryngeal Inlet as the handle cannot provide leverage. Here using cricoid pressure particularly the BURP Manouvre is of paramount significance.. Yes indeed we are fortunate to have an array of Videolaryngoscopes, optical stylets etc to circumvent usage of such instruments. However despite having all this armementarium, one should be comfortable with their usage in non difficult airway patients first and then pride these skills on the challenging cases. Their use require training of hand eye skills as we are looking indirectly through a visual display unit. and thus practice is essential. It is only when we are proficient with usage of these, not forgetting Cricothyroidotomy etc, can we be ready to deal with any eventuality as far as airway matters are concerned..	Nazwa laryngoskopu podpisanego jako G to: A. Macintosh B. Polio C. McCoy D. Miller E. Bullard Odpowiedź to B - Laryngoskop Polio. Jego wygięty kształt łyżki i rękojeści umożliwia wejście do dróg oddechowych pacjenta z dużymi piersiami. Używałem go raz i muszę przyznać że bywa trochę trudny w obyciu. Zwłaszcza w przypadku laryngoskopii stopnia 3+ i gdy język lub nagłośnia wymaga podźwignięcia aby wejściu do krtani a rękojeść nie może zapewnić dźwigni (punktu oparcia). W tej sytuacji stosując ucisk na chrząstkę pierścieniowatą (manewr Sellicka). Here using cricoid pressure particularly the BURP Manouvre is of paramount significance.. Yes indeed we are fortunate to have an array of Videolaryngoscopes, optical stylets etc to circumvent usage of such instruments. However despite having all this armementarium, one should be comfortable with their usage in non difficult airway patients first and then pride these skills on the challenging cases. Their use require training of hand eye skills as we are looking indirectly through a visual display unit. and thus practice is essential. It is only when we are proficient with usage of these, not forgetting Cricothyroidotomy etc, can we be ready to deal with any eventuality as far as airway matters are concerned..
THE STIMULANT EFFECTS OF CAFFEINE ARE DUE TO WHICH ACTION? A. Histaminergic Effects B. Rising Catecholamine Levels C. Antagonizing Adenosine In The Brain D. Potentiating The Effects Of Thyroxine E. Anticholinergic Effects (+ zdjęcie kawy)	Działanie pobudzające kofeiny zawdzięczamy: A. Działaniu histaminergicznemu B. Podniesieniu poziomu katecholamin C. Działaniu antagonizującemu adenozynę w mózgu D. Zwiększaniu efektu działania tyroksyny E. Działaniu antycholinergicznemu (+ zdjęcie kawy)
What is Sellick manouver? Crickoid pressure	Czym jest manewr Sellicka? Rękoczyn Sellicka (manewr Sellicka, ang. Sellick's maneuver) – technika zapobiegająca wymiotom w czasie intubacji dotchawiczej i pomagająca w jej przeprowadzeniu. Manewr polega na ucisku na chrząstkę pierścieniowatą; powoduje to zaciśnięcie przełyku, a także obniżenie głośni i jej lepsze uwidocznienie. Zbyt mocny ucisk może utrudnić wentylację i intubację pacjenta

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