Archive for October 2016

CHADS2 score. Which is not a feature?

CHADS2 score. Which is not a feature?









A. Age
B. Gender
C. Diabetes mellitus
D. Stroke
E. CCF










Answer:  B

Cephalothin doesn't cover:

Cephalothin doesn't cover:









A. Proteus
B. E coli
C. Staph
D. Strep
E. Pseudomonas








Answer:  E

Best position for IABP is 1-2 cm:

Best position for IABP is 1-2 cm:









A. Distal to Left SCA
B. Proximal to Left SCA
C. Distal to artery of Adamkiewicz
D. Distal to renal artery
E. Proximal to renal artery









Answer:  A

A man is working with electrical appliances at home with a residual current device. If he touches the active and the neutral (was it neutral or earth) wire he will suffer

A man is working with electrical appliances at home with a residual current device. If he touches the active and the neutral (was it neutral or earth) wire he will suffer









a. A microshock
b. A macroshock
c. Nothing happens because the fuse blows
d. The RCD will protect him from macroshock










Answer:  D

A child with intra-operative blood loss. A cardiac arrest is most likely because of

A child with intra-operative blood loss. A cardiac arrest is most likely because of









A. A delay in delivery of blood from the blood bank
B. Inadequate intravenous access
C. Underestimated intra-operative blood loss
D. Underestimated pre-operative hypovolaemia
E. Complication of transfusion









Answer:  C

When instructing ward staff on monitoring for respiratory depression in a patient using PCA (patient controlled analgesia) you would advise that early respiratory depression is best detected by monitoring

When instructing ward staff on monitoring for respiratory depression in a patient using PCA (patient controlled analgesia) you would advise that early respiratory depression is best detected by monitoring








A. frequency of boluses on PCA machine
B. pulse oximetry
C. pupil size
D. respiratory rate
E. sedation scores









Answer:  E

Essential diagnostic criteria on ECG for LBBB

Essential diagnostic criteria on ECG for LBBB









A. Loss of septal Q's in V5 and V6
B. RSR in V1
C. Large slurred S in V6
D. T-waves opposite to direction of QRS
E. QRS duration minimum 0.2 s








Answer:  A

A diagnostic test has a sensitivity of 90% and a specificity of 99% in detecting a certain disease. From this we can conclude that

A diagnostic test has a sensitivity of 90% and a specificity of 99% in detecting a certain disease. From this we can conclude that









A. the false positive rate of this test is 1%
B. the false negative rate of this test is 1%
C. the positive predictive value of this test is 90%
D. the negative predictive value of this test is 90%
E. this test would be a useful screening test for this disease











Answer:  A

An indication for NON-operative management of blunt liver trauma in adults is

An indication for NON-operative management of blunt liver trauma in adults is








A. absence of peritoneal signs
B. a haemodynamically stable patient
C. a haemopertitoneum of LESS than 500 ml
D. a LOW grade injury on CT scan
E. severe chronic obstructive airway disease










Answer:  B

Preoperative assessment shows a Mallampati (ML) score of III and thyromental distance (TMD) of < 6cm. A grade 3 to 4 on Cormark and Lehane is predicted. Compared to the ML score, the TMD is

Preoperative assessment shows a Mallampati (ML) score of III and thyromental distance (TMD) of < 6cm. A grade 3 to 4 on Cormark and Lehane is predicted. Compared to the ML score, the TMD is









A less sensitive, less specific
B less sensitive, more specific
C more sensitive, less specific
D more sensitive, more specific
E equal sensitivity an specificity









Answer:  B

In infants with congenital pyloric stenosis

In infants with congenital pyloric stenosis








A. dehydration is associated with early hyponatremia
B. plasma chloride levels seldom fall below 85 mmol.1-I
C. renal conservation of hydrogen and potassium ions occurs
D. the urine is initially alkaline, then may become acidic
E. vomiting causes a loss of potassium ions










Answer:  D

What is NOT a contraindication to MRI?

What is NOT a contraindication to MRI?










A. Pulmonary artery catheter
B. Arterial line
C. Scissors
D. Coiled ECG cable
E. Laryngoscope









Answer:  B

During prolonged trendelenburg positioning there is:

During prolonged trendelenburg positioning there is:








A. No change in ICP
B. No change in IOP
C. Increased pulmonary compliance
D. Increased myocardial work
E. No increased pulmonary venous pressures









Answer:  D

A patient is having an electrophysiological study and ablation for atrial fibrillation. Suddenly the blood pressure drops to 76/38 mmHg, with the heart rate at 110 in sinus rhythm. What is the best investigation to confirm the cause of hypotension?

A patient is having an electrophysiological study and ablation for atrial fibrillation. Suddenly the blood pressure drops to 76/38 mmHg, with the heart rate at 110 in sinus rhythm. What is the best investigation to confirm the cause of hypotension?









A. Troponin
B. ST-segment elevation
C. Transoesophageal echocardiography
D. Coronary Angiogram
E. Electrocardiogram
F. MRI










Answer:  C

Acute visual loss after non-ocular surgery is most commonly caused by

Acute visual loss after non-ocular surgery is most commonly caused by









A. ischaemic optic neuropathy
B. prolonged direct compression of the globe
C. cortical blindness
D. retinal artery occlusion
E. electrolyte imbalance









 Answer:  A

A 29 year old female undergoes craniotomy for posterior fossa tumour. Which of the following is an absolute contraindication to the sitting position

A 29 year old female undergoes craniotomy for posterior fossa tumour. Which of the following is an absolute contraindication to the sitting position









A. Patent ventriculo-atrial shunt
B. Previous back surgery
C. Pacemaker
D. Small patent foramen ovale
E. Oesophageal stricture contraindicated for transoesophageal echocardiogram










Answer:  A

Pulsus paradoxus in constrictive pericarditis:

Pulsus paradoxus in constrictive pericarditis:









A. Decrease in BP Every second beat
B. Decrease in BP In expiration when increase is normal
C. Decrease in BP In expiration more than normal subjects
D. Decrease in BP In inspiration when increase is normal
E. Decrease in BP In inspiration more than normal subjects









Answer:  E

Inverted P waves in lead II may be caused by?

Inverted P waves in lead II may be caused by?









A. transposed lower limb leads
B. junctional rhythm
C. hypothermia
D. left axis deviation
E. inferior myocardial infarction









Answer:  B

cTnI remains elevated for up to?

cTnI remains elevated for up to?








A. 1-2 days
B. 2-5 days
C. 5-14 days
D. 1 month
E. 1 year








Answer:  C

Abnormal Q waves are NOT a feature of the ECG in

Abnormal Q waves are NOT a feature of the ECG in








A. an old myocardial infarction
B. left bundle branch block
C. recent transmural myocardial infarction
D. digitalis toxicity
E. Wolff-Parkinson-White syndrome








Answer:  E

A Full Size C oxygen cylinder has pressure downregulated from?

A Full Size C oxygen cylinder has pressure downregulated from?









A. 16,000 kPa to 400 kPa
B. 16,000 kPa to 240 kPa
C. 14,000 kPa to 400kPa
C. 11,000 kPa to 400 kPa
D. 11,000 kPa to 240 kPa









 Answer:  C

Desflurane vaporiser, heated because of

Desflurane vaporiser, heated because of










A. High SVP
B. High boiling point
C. Low SVP
D. High MAC
E. Low MAC









Answer:  A

Endocarditis prophylaxis is appropriate in?

Endocarditis prophylaxis is appropriate in?








A. All patients undergoing dental surgery
B. Aortic valve repair
C. cardiac transplant
D. Rheumatic heart diease
E. recently repaired ASD









Answer:  E

Indicator in sodalime?

Indicator in sodalime?









A. Ethyl violet
B. Potassium permangenate
C. Blue dye
D. Ethylene blue
E. Magic marker








Answer:  A

Half-life of mast cell tryptase?

Half-life of mast cell tryptase?








A. 1 hour
B. 2 hours
C. 24 hours
D. 36 hours
E. 72 hours








Answer:  B

Iron deficiency

Iron deficiency










A. decreased serum ferritin, increased serum iron
B. decreased serum ferritin, absence of bone marrow iron
C. decreased serum ferritin, normal serum iron
D. increased serum ferritin, decreased serum iron
E. increased serum ferritin, decreased total iron binding capacity










Answer:  B

Advantages of off-pump CABG over on-pump CABG

Advantages of off-pump CABG over on-pump CABG









A. decreased transfusion rate
B. decreased mortality
C. decreased cost
D. increased graft patency
E. less cognitive impairment
F. less stroke










Answer:  A

Preoperative assessment shows a malampati (ML) score of III and thyromental distance (TMD) of < 6cm. A grade 3 to 4 on Cormark and Lehanes is predicted. Compared to the ML score, the TMD is:

Preoperative assessment shows a malampati (ML) score of III and thyromental distance (TMD) of <  6cm. A grade 3 to 4 on Cormark and Lehanes is predicted. Compared to the ML score, the TMD is:










A less sensitive, less specific
B less sensitive, more specific
C more sensitive, less specific
D more sensitive, more specific
E equal sensitivity an specificity











Answer:  B

Blunt liver trauma can be treated non surgically if

Blunt liver trauma can be treated non surgically if









A. No peritoneal signs
B. Low Grade injury on CT scan
C. Severe COPD
D. Haemodynamically stable









Answer:  D

Respiratory function in quadriplegics is improved by

Respiratory function in quadriplegics is improved by









A. abdominal distension
B. an increase in chest wall spasticity
C. interscalene nerve block
D. the upright position
E. unilateral compliance reduction











 Answer:  B

A patient with severe COPD on home oxygen is having an excision of a submandibular tumour under local anaesthesia. The best way to prevent fire in the operating room is:

A patient with severe COPD on home oxygen is having an excision of a submandibular tumour under local anaesthesia. The best way to prevent fire in the operating room is:









A. seal the surgical site from the patients airway with adhesive drapes
B. use bipolar instead of monopolar diathermy
C. decr FIO2 to maintain sats 97%
D. use alcoholic chlorhex instead of iodine
E. add nitrous oxide to the inhaled gases to reduce the FiO2 and provide sedation












 Answer:  B

The carotid sinus derives its nerve supply from the

The carotid sinus derives its nerve supply from the










A. vagus nerve
B. glossopharyngeal nerve
C. ansa cervicalis (hypoglossi)
D. middle cervical ganglion
E. stellate ganglion










Answer:  B

What nerve supplies sensation to the larynx above the vocal cords:

What nerve supplies sensation to the larynx above the vocal cords:










A. internal branch of superior laryngeal nerve
B. external branch of superior laryngeal nerve
C. recurrent laryngeal nerve
D. glossopharyngeal nerve










Answer:  B

Best indicator of return function of laryngeal muscle

Best indicator of return function of laryngeal muscle









A. Sustained head lift 5 sec
B. Sustained leg lift 5 sec
C. TOF 0.9
D. DBS no fade
E. Tetanus 50Hz










Answer:  D

Indicates autonomic neuropathy except

Indicates autonomic neuropathy except









A. Sinus arrthymias
B. Gastric reflux
C. Postural hypotension
D. Priaprism
E. Constipation










Answer:  A

What do C6/7 motor function do

What do C6/7 motor function do









A. flex/extension of fingers
B. flex /extend wrist
C. shoulder ext rotation / abduction
D. elbow pronation/supination
E. flexion at elbow









Answer:  B

Suxamethonium dosage higher in neonates compare to adult because

Suxamethonium dosage higher in neonates compare to adult because








A. Increased volume of distribution
B. Increased pseudocholinesterase activity
C. More receptors
D. Higher cardiac output
E. Decreased sensitivity of nicotinic ACH receptors to suxamethonium











Answer:  A

The cause of hypoxia in one lung ventilation

The cause of hypoxia in one lung ventilation









A. Blood flow through non ventilated lung
B. Impairment of hypoxic pulmonary vasoconstriction










Answer:  A

A patient with pulmonary hypertension secondary to lung disease presents for a laparotomy. Regarding this patient's anaesthetic management

A patient with pulmonary hypertension secondary to lung disease presents for a laparotomy. Regarding this patient's anaesthetic management











A. an alpha-agonist is the inotrope of choice
B. hypothermia is protective against rises in pulmonary artery pressure
C. isoflurane will tend to decrease pulmonary artery pressure
D. ketamine is an appropriate anaesthetic agent













Answer: A

Tracheo-oesophageal Fistula (TOF)

Tracheo-oesophageal Fistula (TOF)








A. is associated with cardiac anomalies in approximately 60% of cases
B. is associated with oesophageal atresia in approximately 20% of cases
C. is more common in males than females
D. is usually left sided
E. does not usually require contrast studies for diagnosis










Answer:  E

Systemic vascular resistance index (SVRI) is calculated from

Systemic vascular resistance index (SVRI) is calculated from










A. systemic vascular resistance multiplied by body surface area
B. systemic vascular resistance divided by body surface area
C. mean aortic and central venous pressure difference divided by cardiac output
D. cardiac index divided by the mean aortic and central venous pressure difference
E. none of the above












Answer:  A

An 18 yo with Fontan circulation undergoing exploratory laparotomy. On ICU ventilation, saturation is 70%. Which ventilator parameter would you INCREASE to improve his saturation?

An 18 yo with Fontan circulation undergoing exploratory laparotomy. On ICU ventilation, saturation is 70%. Which ventilator parameter would you INCREASE to improve his saturation?










A. Bilevel pressure
B. Expiratory time
C. Inspiratory time
D. Peak inspiratory pressure
E. PEEP










Answer:  B

Levosimendan:

Levosimendan:








A. Increases contractility and myocardial oxygen consumption
B. Increases SVR
C. Binds to troponin C and induces a conformational change
D. Increases contractility by increasing calcium influx
E. Causes coronary vasodilation but NOT peripheral vasodilation











Answer:  C

A diagnostic test has a sensitivity of 90% and a specificity of 99% in detecting a certain disease. From this we can conclude that

A diagnostic test has a sensitivity of 90% and a specificity of 99% in detecting a certain disease. From this we can conclude that










A. the false positive rate of this test is 1%
B. the false negative rate of this test is 1%
C. the positive predictive value of this test is 90%
D. the negative predictive value of this test is 90%
E. this test would be a useful screening test for this disease












Answer:  A

Called to emergency department to review a 20 year old male punched in throat at a party. Some haemoptysis / hoarse / soft voice. Next step in management:

Called to emergency department to review a 20 year old male punched in throat at a party. Some haemoptysis / hoarse / soft voice. Next step in management: 










A. CT to rule out thyroid cartilage fracture
B. XR to rule out fractured hyoid
C. Rapid sequence induction / laryngoscopy / intubation
D. Awake fibreoptic intubation
E. Nasendoscopy by ENT in emergency department












Answer:  E

A young woman with type 1 von Willebrand disease presents for a dilatation and curettage. She is a Jehovah's Witness. You consider administering intravenous desmopressin in an attempt to reduce haemorrhage. Which of the following statements regarding desmopressin is FALSE?

A young woman with type 1 von Willebrand disease presents for a dilatation and curettage. She is a Jehovah's Witness. You consider administering intravenous desmopressin in an attempt to reduce haemorrhage. Which of the following statements regarding desmopressin is FALSE?










A. it is a synthetic substance and is acceptable to Jehovah's Witnesses
B. it is likely to reduce haemorrhage in this patient
C. it should be given 30 minutes prior to surgery as an infusion
D. its duration of effect is approximately 5 days
E. the intravenous dose is 0.3 mcg.kg-1












Answer:  D

ASD murmur heard at

ASD murmur heard at








A. ASD
B. Tricuspid valve
C. Pulmonary valve
D. Mitral valve
E. Aortic valve








Answer:  C

Lumbarsacral nerve does not supply:

Lumbarsacral nerve does not supply:










A. Subcostal nerve
B. Ilioinguinal n
C. Iliohypogastric n
D. Femoral n








Answer:  A

Diastolic dysfunction Not caused by

Diastolic dysfunction Not caused by









A. Adrenaline
B. Myocardial fibrosis
C. Aortic stenosis
D. Hypertension








Answer:  A

Most safe side to insert subtenon block

Most safe side to insert subtenon block










A. Inferonasal
B. Inferotemporal
C. Medial
D. Superonasal
E. Superotemporal










Answer:  A

Carbon dioxide is the most common gas used for insufflation for laparoscopy because it

Carbon dioxide is the most common gas used for insufflation for laparoscopy because it










A. is cheap and readily available
B. is slow to be absorbed from the peritoneum and thus safer
C. is not as dangerous as some other gases if inadvertently given intravenously
D. provides the best surgical conditions for vision and diathermy
E. will not produce any problems with gas emboli as it dissolves rapidly in blood












Answer:  C

Infra-renal aortic cross-clamping usually results in

Infra-renal aortic cross-clamping usually results in 










A. decreased cardiac contractility
B. decreased coronary blood flow
C. decreased renal blood flow
D. minimal change in cardiac output
E. increased heart rate










Answer:  C

Post dural punture headache

Post dural punture headache








A. 24hour bed rest
B. Prone position worst
C. Increase incidence with insertion of spinal catheter
D. Hearing loss









Answer:  D

Following a left sided pneumonectomy, a left intercostal drain is placed and connected to an underwater drainage system. In the postoperative period

Following a left sided pneumonectomy, a left intercostal drain is placed and connected to an underwater drainage system. In the postoperative period










A. A leakage of air is expected from the drain
B. The patient should be nursed in the right lateral decubitus position
C. The underwater seal drain should be left on continuous free drainage
D. The underwater seal drain should be left on continuous free drainage, and connected to wall suction for 5 minutes every hour
E. The underwater seal drain should remain clamped and be released for a short period every hour









Answer:  E

A line isolation monitor protects against microshock

A line isolation monitor protects against microshock









A. only if the warning current is set at 10mA
B. only if the warning current is set at 30mA
C. under no circumstances
D. only if the equipment used is grounded
E. only if it monitors all the equipment in the region










 Answer:  C

You see a man in his 60s in clinic 1 week prior to laparoscopic cholecystectomy. He has dilated cardiomyopathy with an ejection fraction of 30%, but does not get dyspnoeic with normal activities of daily living. What is the most appropriate management of his heart failure?

You see a man in his 60s in clinic 1 week prior to laparoscopic cholecystectomy. He has dilated cardiomyopathy with an ejection fraction of 30%, but does not get dyspnoeic with normal activities of daily living. What is the most appropriate management of his heart failure?










A. amiodarone 100mg bd
B. digoxin 250mcg daily
C. enalapril 2.5mg bd
D. metoprolol 100mg bd
E. diltiazem slow release 240 mg daily






Answer:  C

Post cervical spine op, there is bulging noted under the incision site. Patient desaturated, combative, keep pulling off the oxygen facemask. Next course of action

Post cervical spine op, there is bulging noted under the incision site. Patient desaturated, combative, keep pulling off the oxygen facemask. Next course of action









A. Rapid sequence induction
B. Gas induction
C. Needle aspiration of the bulge at the neck
D. Sedation with precidex
E. Olanzepine










Answer:  A

There is evidence to avoid BIS 40 for more than 5 minutes because

There is evidence to avoid BIS <40 5="" because="" for="" h2="" minutes="" more="" than="">







A. Safe cost
B. Increase incidence of hypotension
C. Increase post op mortality
D. Decrease volatile for poor cardiac output patient
E. Decrease the incidence of awareness








Answer:  C

Transfusion related acute lung injury (TRALI)

Transfusion related acute lung injury (TRALI)










A. can be caused by all homologous blood components, but particularly FFP (fresh frozen plasma)
B. is associated with significantly elevated pulmonary artery pressure
C. is the commonest cause of morbidity associated with blood transfusion
D. should be treated with high dose steroids
E. typically presents 24 hours following transfusion











Answer:  A

Which does NOT have abnormal Q waves:

Which does NOT have abnormal Q waves:









A: Digoxin toxicity
B: Anterior myocardial infartion
C: Previous AMI
D: LBBB
E: Wolff-Parkinson-White syndrome









Answer:  A

You are asked to see a 60 y.o. male 2 days following a cervical laminectomy because he has new new neurological symptoms in his right arm. The surgical team think these may be due to poor patient positioning. The sign that would most help differentiate c C8-T1 nerve root injury from an ulnar nerve injury is

You are asked to see a 60 y.o. male 2 days following a cervical laminectomy because he has new new neurological symptoms in his right arm. The surgical team think these may be due to poor patient positioning. The sign that would most help differentiate c C8-T1 nerve root injury from an ulnar nerve injury is








A. loss of sensation in the index finger
B. loss of sensation in the little finger
C. weakness of the abductor digiti minimi muscle
D. weakness of the abductor pollicis brevis m
E. weakness of the first dorsal interosseous m.










Answer:  D

Post epidural and LSCS, the next day patient have persistent paraesthesia anterior thigh. What other injuries would indicate more of nerve roots instead of peripheral nerve injuries

Post epidural and LSCS, the next day patient have persistent paraesthesia anterior thigh. What other injuries would indicate more of nerve roots instead of peripheral nerve injuries










A. Weakness on hip flexion and thigh adduction
B. Weakness on knee flexion and plantar flexion
C. Urinary incontinence
D. Foot drop











Answer:  D

Complication of celiac plexus block

Complication of celiac plexus block










A. Hypertension
B. Failure of erection
C. Constipation
D. Paraplegia
E. L3,4 lumbar pain









Answer:  D

An elderly lady has a closed neck of femur fracture and presents to ED. She is in chronic AF and on warfarin. INR is 2.6 and she is not bleeding. It is 9am and she is scheduled for repair the following day. According to current guidelines, how should her warfarin be reversed?

An elderly lady has a closed neck of femur fracture and presents to ED. She is in chronic AF and on warfarin. INR is 2.6 and she is not bleeding. It is 9am and she is scheduled for repair the following day. According to current guidelines, how should her warfarin be reversed?










A. Prothrombinex 25IU/kg immediately and then 2 units FFP immediately prior to surgery
B. No immediate treatment then 2 units FFP immediately prior to surgery
C. Vitamin K 1mg IV immediately
D. Vitamin K 10mg IV immediately
E. Withhold warfarin












Answer:  C

LSCS for foetal distress, meconium stained liquor. Management of baby

LSCS for foetal distress, meconium stained liquor. Management of baby










A. Intrapartum suctioning
B. Intrapartum suctioning and post partum tracheal suction
C. Post partum tracheal suctioning
D. Routine neonatal care
E. Intubate










Answer:  C

Finding on haemophilia A patient

Finding on haemophilia A patient










A. Female haemarthrosis
B. Male haemarthrosis
C. Normal PT, abnormal APTT
D. Abnormal PT, normal APTT










Answer:  C

The test to diagnose pulmonary embolism

The test to diagnose pulmonary embolism








A. CT pulmonary angiogram
B. Echocardiography
C. Electrocardiogram
D. Ventilation-perfusion scan









Answer:  A

72 year old has had hip replacement surgery and 3 days postop has a pulmonary embolus. He is fully heparinised, but still dyspnoeic, clammy, BP 80/40, pulse 120 and CVP 18. The most appropriate next step is

72 year old has had hip replacement surgery and 3 days postop has a pulmonary embolus. He is fully heparinised, but still dyspnoeic, clammy, BP 80/40, pulse 120 and CVP 18. The most appropriate next step is












A. IVC filter
B. Refer him for a pulmonary embolectomy
C. Supportive (fluids and inotropes)
D. Thrombolysis
E. Warfarin













Answer:  B

Circuit disconnection during spontaneous breathing anaesthesia

Circuit disconnection during spontaneous breathing anaesthesia










A. will be reliably detected by a fall in end-tidal carbon dioxide concentration
B. will be detected early by the low inspired oxygen alarm
C. will be most reliably detected by spirometry with minute volume alarms
D. may be detected by an unexpected drop in end-tidal volatile anaesthetic agent concentration
E. can be prevented by using new, single-use tubing










Answer:  D

Patient indicated for prophylaxis of infective endocarditis

Patient indicated for prophylaxis of infective endocarditis






A. amoxicillin orally 2 hours prior
B. amoxicillin IV 1 hourly prior
C. amoxicillin IV just before incision
D. cefazolin IV 1 hour prior









Answer:  D

Main heat loss in anaesthetic for neonate

Main heat loss in anaesthetic for neonate










A. vasodilatation
B. radiation
C. convection
D. conduction
E. evaporative










Answer:  B

Young asthmatic male in emergency department. RR 26, pCO2 27, SAO2 92%, struggling talking in sentences. Given nebulised salbutamol, and ipratropium, 200mg IV hydrocortisone. After 30 minutes - no improvement. Further management:

Young asthmatic male in emergency department. RR 26, pCO2 27, SAO2 92%, struggling talking in sentences. Given nebulised salbutamol, and ipratropium, 200mg IV hydrocortisone. After 30 minutes - no improvement. Further management:










A. IV salbutamol
B. IV aminophylline
C. IV magnesium
D. Intubate and ventilate









Answer:  C

Patient post anterior cervical fusion. Patient in recovery. Confused and combative. Nurse concerned about haematoma. Taken to theatre: Most appropriate way of securing airway:

Patient post anterior cervical fusion. Patient in recovery. Confused and combative. Nurse concerned about haematoma. Taken to theatre: Most appropriate way of securing airway:










A. Gas induction / laryngoscopy / intubate
B. Awake tracheostomy
C. Awake fibreoptic intubation using minimal sedation
D. Thiopentone, suxamethonium, direct laryngoscopy and intubation
E. Retrograde intubation












Answer:  D

The best clinical indicator of SEVERE Aortic stenosis

The best clinical indicator of SEVERE Aortic stenosis










A. Presence of thrill
B. Mean Gradient 30 mm/Hg
C. Area 1.2 cm2
D. Slow rising pulse and ESM radiating to carotids
E. Shortness of breath









Answer:  A

Exponential decline / definition of time constant

Exponential decline / definition of time constant 










A. time for exponential process to reach log(e) of its initial value
B. Time until exponential process reaches zero
C. Time to reach 37% of initial value
D. Time to reach half if its initial value
E. 69% of half life










Answer:  C

Correct statements regarding fondaparinux include each of the following EXCEPT

Correct statements regarding fondaparinux include each of the following EXCEPT









A. it has a structure unrelated to heparin
B. it is administered once daily
C. it is a synthetic, selective Factor Xa inhibitor
D. it is recommended for DVT prophylaxis in major orthopaedic surgery
E. the dosage does NOT need to be adjusted for age and sex










Answer:  A

The most appropriate method for improving oxygenation during one lung anaesthesia, after institution of an FiO2 of 1.0, is application of

The most appropriate method for improving oxygenation during one lung anaesthesia, after institution of an FiO2 of 1.0, is application of









A. 5 cm H2O CPAP to the non-dependent lung
B. 10 cm H2O CPAP to the non-dependent lung
C. 5 cm H2O PEEP to the dependent lung
D. 5 cm H2O CPAP to the non-dependent and 5cm H2O PEEP to the dependent lung
E. intermittent re-inflation to the non-dependent lung








Answer:  C

Thallium scan:

Thallium scan:







A. High negative predictive value
B. High positive predictive value
C. Not as good as a dobutamine stress echocardiography
D. Requires the patient to exercise




Answer:  A

A 78 year old man with past difficult intubation for arm surgery. Supraclavicular block with 25 mls 0.5% bupivacaine. Shortly after begins convulsing. INITIAL management?

A 78 year old man with past difficult intubation for arm surgery. Supraclavicular block with 25 mls 0.5% bupivacaine. Shortly after begins convulsing. INITIAL management?










A. Midazolam 5mg
B. Intralipid 20% 1.5 ml/kg
C. Thiopentone 150mg
D. Suxamethonium 50mg
E. Propofol 50mg










Answer:  A

Transfusion related acute lung injury (TRALI)

Transfusion related acute lung injury (TRALI)










A. can be caused by all homologous blood components, but particularly FFP (fresh frozen plasma)
B. is associated with significantly elevated pulmonary artery pressure
C. is the commonest cause of morbidity associated with blood transfusion
D. should be treated with high dose steroids
E. typically presents 24 hours following transfusion









Answer:  C

What makes tramadol less effective?

What makes tramadol less effective?







A: ondansetron
B: prochlorperazine
C: metoclopramide
D: paracetamol
E. droperidol









Answer:  A

Eisenmenger's syndrome:

Eisenmenger's syndrome:







A: decrease Hb to <180 p="" venesection="" with="">B: Give high FiO2
C: Pulmonary vasodilators will treat the pulmonary hypertension
D: terminal RV failure usually occurs in the 3rd-4th decade









Answer:  D

Popliteal block placed from the lateral approach:

Popliteal block placed from the lateral approach:









A: Passes through semimembranosus
B: Has eversion of the foot as the end point
C: Has increased failure rate compared to a posterior approach
D: Can be performed supine or prone









Answer:  D

Anaesthetising an obese patient. Acelerometer on TOF 0.9. Could dose suxamethonium on ideal body weight or total body weight. With respect to 1mg/kg IBW vs. TBW you will see:

Anaesthetising an obese patient. Acelerometer on TOF 0.9. Could dose suxamethonium on ideal body weight or total body weight. With respect to 1mg/kg IBW vs. TBW you will see:








A: shorter onset and faster twitch recovery
B: shorter onset and similar twitch recovery
C: shorter onset and slower twitch recovery
D: similar speed of onset with similar speed of twitch recovery
E: similar onset and longer recovery










 Answer:  E

Post scoliosis repair, decreased movement bilaterally in the legs with decreased pain and temperature sensation but spared joint position sense and vibration. What is at fault?

Post scoliosis repair, decreased movement bilaterally in the legs with decreased pain and temperature sensation but spared joint position sense and vibration. What is at fault?









A: Posterior spinal arteries
B: Anterior spinal arteries
C: Epidural haematoma
D: Misplaced pedicle screw
E: Lateral cord syndrome










Answer:  B

Ageing (adult) causes:

Ageing (adult) causes:









A: Decreased FRC
B: Decreased Cardiac output
C: Diastolic dysfunction
D: Increased creatinine









Answer:  C

Autonomic dysreflexia. Which ONE is true?

Autonomic dysreflexia. Which ONE is true?









A: 50% of patients with a level below T6
B: Unlikely if below T10
C: Can be prevented??
D: Can be precipitated by light touch







Answer:  B

What is NOT true for PDPH following puncture

What is NOT true for PDPH following puncture








A: Prophylactic bed rest
B: Decreased incidence when catheter is inserted intrathecally
C: Decreased incidence in elderly
D: Caffeine is not effective
E: Epidural blood patch is 80% effective









Answer:  A

Post operative left pneumonectomy. What to do with underwater seal drain?

Post operative left pneumonectomy. What to do with underwater seal drain?










A: Nurse patient in R lateral decubitus position
B: Expect to see bubbles
C: Suction every hour for 5 minutes
D: Unclamp drain once an hour for 5 minutes, leave clamp on for the rest of the time
E: Leave on free drainage









Answer:  D

Petit mal epilepsy - Which is true? (or words to that effect)

Petit mal epilepsy - Which is true? (or words to that effect)









A: Most common in child <2 nbsp="" old="" p="" years="">B: Can precipitate seizures by hyperventilating
C: Often seizures last for more than 30 seconds
D: Rarely familial
E: Isoelectric EEG during seizure (burst suppression)







 Answer:  B

Long stem about an old #NOF patient with aortic stenosis. What is a sign/ investigation/ symptom that shows the most severity? (ie Which one of these would indicate that the lesion was severe?)

Long stem about an old #NOF patient with aortic stenosis. What is a sign/ investigation/ symptom that shows the most severity? (ie Which one of these would indicate that the lesion was severe?)









A: Thrill in Aortic area
B: Murmur in lower left sternal edge
C: Murmur radiating to carotids
D: History of ischaemic heart disease or coronary artery disease
E: history of angina/ syncope










Answer:  A

ECG- which does NOT have abnormal Q waves:

ECG- which does NOT have abnormal Q waves:









A: Digoxin toxicity
B: Anterior myocardial infartion
C: Previous AMI
D: LBBB
E: Wolff-Parkinson-White syndrome










Answer:  A

Ehlers-Danlos syndrome. Most important to specifically do all EXCEPT:

Ehlers-Danlos syndrome. Most important to specifically do all EXCEPT:










A: Avoid hyperextension of the neck
B: Damage to the teeth
C: Avoid joint hypermobility
D: Gastro oesophageal reflex
E: Strict temperature regulation










Answer:  E

According to the study by OReilly and Tushman, effective ambidextrous structures had all of the following attributes except _____________.

According to the study by OReilly and Tushman, effective ambidextrous structures had all of the following attributes except _____________. 










A. a clear and compelling vision
B. managerial efforts were highly focused on revenue enhancement
C. cross-fertilization among business units
D. established units were shielded from the distractions of launching new businesses













Answer: B

Effective ambidextrous organizations have alignment, which means that _____________.

Effective ambidextrous organizations have alignment, which means that _____________. 










A. employees are rewarded according to both profit and sales growth
B. managers are focused on growth opportunities
C. there is a clear sense of how value is being created in the short-term and how activities are properly integrated and coordinated
D. divisional-level goals are consistent with overall corporate goals













Answer: C

If a firm outsources some parts of its value chain in order to reduce costs and increase quality and at the same time engages in multiple alliances to penetrate new markets, this is a example of a firm using a ______________ of organizational types.

If a firm outsources some parts of its value chain in order to reduce costs and increase quality and at the same time engages in multiple alliances to penetrate new markets, this is a example of a firm using a ______________ of organizational types. 









A. combination
B. boundaryless consortium
C. bounded consortium
D. barrier free collection










Answer: A

Coca-Cola, Ford Motor Company, H. J. Heinz, Nike, and Procter and Gamble are working together to develop plant-based plastics. Each company brings its own competency to the table. This collaboration is an example of a _____________.

Coca-Cola, Ford Motor Company, H. J. Heinz, Nike, and Procter and Gamble are working together to develop plant-based plastics. Each company brings its own competency to the table. This collaboration is an example of a _____________. 










A. virtual organization
B. modular organization
C. horizontal organization
D. vertical organization












Answer: A
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