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MCQ on Anesthesia
1. In a 70 kg patient, 1 unit of platelet concentrate should increase the platelet count by
(1) 2000 to 5000/mm3
(2) 5000 to 10000/mm3
(3) 15000 to 20000/mm3
(4) 20000 to 25000/mm3
2. Which of the following clotting factors has the shortest half-life ?
(1) Factor II
(2) Factor X
(3) Factor VII
(4) Factor IX
3. A 38 year old, 70 kg patient with haemophilia A is scheduled for a right total knee arthroplasty. His laboratory test results show a hematocrit of 35, a factor VIII level of 0%, and no inhibitors to factor VIII. How much factor VIII concentrate do you need to give him to bring his factor VIII level to 100% ?
(1) 1560 units
(2) 1850 units
(3) 2540 units
(4) 2960 units
4. A 45 year old male with a positive blood group was brought to the emergency room with hemorrhagic shock. He was resuscitated and transfused with 4 units of type O, Rh- negative whole blood. Which of the following is the most appropriate blood type for further intraoperative transfusions ?
(1) Type O, Rh-negative RBCs
(2) Type A, Rh-positive whole blood
(3) Type A, Rh-positive RBCs
(4) Type O, Rh-positive whole blood
5. Which of the following is not a characteristic for packed RBC that have been stored for 35 days at 4 °C in citrate phosphate dextrose adenine 1 anticoagulant preservative ?
(1) 2, 3-diphosphoglycerate (2, 3-DPG) < 1 µ M/L
(2) pH <7.0
(3) Blood glucose <100 mg/dL
6. Which is not correct for patients of G 6pd deficiency ?
(1) Common in black American male have common significant a variant.
(2) Mediterranean variants may be associated with chronic haemolytic anemia.
(3) Seen in individual of Chinese ancestry because the locus for the enzyme is on the Y chromosome abnormalities.
(4) Quinidine should be avoided because of potential cause of methemoglobinemia
7. Anticoagulation with low-molecular-weight heparin can be best monitored through which of the following laboratory tests ?
(1) Anti-factor Xa assay
(2) Prothrombin time
(3) Thrombin time
(4) Clotting time
8. Which of the following processes reduces the possibility of transmission of CMV to a susceptible recipient via red cell transfusion ?
(1) Washing erythrocytes
(2) Leukocyte reduction
(4) Storage in ADSOL
9. Which of the following option is correct for distribution of blood volume ?
(1) Arterial > Venous Pulmonary > Heart
(2) Venous > Arterial > Pulmonary > Heart
(3) Venous > Heart > Pulmonary > Arterial
(4) Arterial > Pulmonary 7 Venous > Heart
10. Which coagulation factor is not produced by the lever ?
(3) Christmas factor
(4) Antihemophilic factor
11. Which coagulation factor is decreased in disseminated intravascular coagulation ?
(1) Prothrombin time
(2) Partial thromboplastin time
(4) Thrombin time
12. Which factor does not predict cardiac risk in patients undergoing elective major noncardiac surgery ?
(1) History of Myocardial infarction
(2) Preoperative Serum Creatinine concentration < 2 mg/dl
(3) History of stroke
(4) Insulin-dependent diabetes mellitus
13. Which of the following activities correspond to 4 METS (Metabolic Equivalents) ?
(1) Take care of yourself
(2) Eat, dress and take care of yourself
(3) Walk indoor around the house
(4) Do light work around the house like dusting or washing dishes
14. In which of the following cases, cardiac patients need not undergo active cardiac evaluation and treatment prior to posting for non-cardiac surgery ?
(1) Recent Myocardial infarction
(2) Compensated heart failure (NYHA Functional Class 2)
(3) Symptomatic mitral stenosis with progressive dyspnea on exertion
(4) Symptomatic ventricular arrhythmia
15. Following is the recommended time interval to wait for elective noncardiac surgery after coronary revascularization procedure. Which statement is wrong ?
(1) No wait for elective surgery in angioplasty without stenting
(2) At least 30 days to 12 weeks preferable in bare-metal stent placement
(3) At least 6 weeks; 12 weeks preferable in coronary artery bypass grafting
(4) At least 12 months in drug-eluting stent placement
16. Which of the following is an indication of endocarditis prophylaxis in patients with valvular heart disease undergoing dental procedure ?
(1) Gingival manipulation or perforation of mucosa
(2) Removal of prosthodontic implant
(3) Shedding of deciduous teeth
(4) Routine anaesthetic injection
17. Which of the following would provide the best prophylaxis against deep vein thrombosis in a 45 year old obese male in the intensive care unit ?
(1) Pneumatic compression boots
(2) Heparin 5000 units SQ every 8 hours
(3) Early ambulation
(4) Dextran 10 mL/kg IV during surgery
18. A 57 year old male is undergoing a right hemicolectomy under general anaesthesia. Intraoperatively S mm ST segment elevation is noted on lead ii and the patient develops complete heart block. The coronary artery most likely affected is
(1) Circumflex coronary artery
(2) Right coronary artery
(3) Left main coronary artery
(4) Left anterior descending coronary artery
19. Which of the following is correct incidence for Cyanotic Congenital Heart disease ?
(1) VSD > ASD 7 PDA > Atrioventricular Septal Defect
(2) VSD > PDA 7 ASD > Atrioventricular Septal Defect
(3) PDA > VSD > ASD > Atrioventricular Septal Defect
(4) VSD > PDA > Atrioventricular Septal Defect > ASD
20. Which condition is not associated with development of ventricular premature beats?
(1) Arterial Hypoxemia
(2) Sympathetic nervous system activation
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21. Cyclic crescendo-decrescendo tidal volume patterns interrupted by apnea is which type of abnormal pattern of breathing ?
(1) Cheyne-stokes breathing
(2) Ataxic breathing
(3) Apneustic breathing
(4) Central neurogenic hyperventilation
22. Contralateral hemiparesis, hemisensory deficit, aphasia and contralateral visual field defect is seen in occlusion of which cerebrovascular artery ?
(1) Anterior cerebral artery occlusion
(2) Middle cerebral artery occlusion
(3) Posterior cerebral artery occlusion
(4) Basilar artery occlusion
23. Hypoparathyroidism secondary to the inadvertent surgical resection of the Parathyroid glands during total thyroidectomy typically results in symptoms of hypocalcaemia after how many hours postoperatively ?
(1) 1 to 2 hours
(2) 3 to 12 hours
(3) 12 to 24 hours
(4) 24 to 72 hours
24. In which of the following cases, postoperative complications of thyroid surgery do not result in upper airway obstruction ?
(2) Bilateral superior laryngeal nerve injury
(3) Cervical hematoma
(4) Bilateral recurrent laryngeal nerve injury
25. Which statement is false for malignant hyperthermia during general anaesthesia ?
(1) Succinylcholine and halogenated anaesthetic agent induced
(2) Induced masseter spasm
(3) Decreased serum creatinine kinase
(4) Increased end-expiratory CO2 tension
26. Which of the following is not a clinical sign of diabetic autonomic neuropathy ?
(1) Painless myocardial ischemia
(2) Orthostatic hypotension
(3) Neurogenic bladder
(4) Delayed satiety
27. What is the P50 of haemoglobin for an adult ?
28. Which statement is untrue regarding the action of oral hypoglycemic drugs ?
(1) Alpha Glucosidase inhibitor improve carbohydrate absorption
(2) Sulphonylurea stimulate impaired insulin secretion
(3) Biguanides reduce excessive hepatic glucose output
(4) Glitazones improve peripheral action of insulin
29. Which parameters is not a diagnostic feature of Hyperglycemic Hyperosmolar Syndrome ?
(1) Serum glucose level (Mg/dL) ≥ 600
(2) pH ≥ 27.3
(3) Serum osmolarity (Mosm/L) < 350
(4) Serum HCO, (MEq/L) ≥ 15
30. Patients with known or suspected adrenal suppression should receive their baseline steroid hydrocortisone supplementation in the perioperative period. Which option is not correct ?
(1) Superficial surgery (e.g., dental | surgery, biopsy)—12.5mgIV
(2) Minor surgery (e.g., inguinal hernia repair) 25 mg IV
(3) Moderate surgery (e.g., cholecystectomy, colon resection) 50 — 75 mg IV, taper 1-2 days
(4) Major surgery (e.g., cardiovascular surgery, Whipple procedure) 100-150 mg IV, taper 1-2 days.
31. Which statement is false for myasthenia gravis ?
(1) Extraocular, bulbar, and facial muscle weakness
(2) Exercise improves muscle strength
(3) Resistant to succinylcholine and sensitive to nondepolarizing muscle relaxants
(4) Good response to anticholinesterases
32. A 65 year old patient admitted in emergency with severe shortness of breath on examination, found that the patient has inspiratory and expiratory stridor and wheezing due to marked extrinsic compression of the mid trachea by a tumor. Patients get symptomatic relief by administration of 70% helium in O2. Choose the correct option.
(1) Helium decreases the viscosity of the gas mixture
(2) Helium decreases the friction coefficient of the gas mixture
(3) Helium decreases the density of the gas mixture
(4) Helium increases the Reynolds number of the gas mixture
33. Which of the following methods can be used to detect all leaks in the low-pressure circuit of any contemporary anesthesia machine ?
(1) Oxygen flush test
(2) Common gas outlet occlusion test
(3) Traditional positive-pressure leak test
(4) Negative-pressure leak test
34. Which of the following valves prevents transfilling between compressed gas cylinders ?
(1) Fail-safe valve
(2) Pop-off valve
(3) Check valve
(4) Pressure-sensor shutoff valve
35. The pressure gauge on a size “E” compressed-gas cylinder containing O2 reads 1600 psi. How long can the O2 be delivered from this cylinder at a rate of 5 L/min ?
(1) 50 minutes
(2) 100 minutes
(3) 150 minutes
(4) 200 minutes
36. In the O2 pressure-sensor shut off valve, what is the minimum O2 pressure required to keep it open and allow NO to flow into the N2O rotameter ?
(1) 25 psi
(2) 10 psi
(3) 50 psi
(4) 100 psi
37. The highest trace concentration of NO allowed in the operative room atmosphere by the National Institute for Occupational Safety and Health (NIOSH) is
(1) 35 ppm
(2) 15 ppm
(3) 25 ppm
(4) 45 ppm
38. Which of the following combinations would result in delivery of a higher than expected concentration of volatile anesthetic to the patient ?
(1) Sevoflurane vaporizer filled with halothane
(2) Halothane vaporizer filled with isoflurane
(3) Isoflurane vaporizer filled with halothane
(4) Isoflurane vaporizer filled with sevoflurane
39. If the anesthesia machine is discovered Monday morning having run with 5 L/min of oxygen all weekend long, the most reasonable course of action to take before administering the next anesthetic would be
(1) Turn machine off for 30 minutes before induction
(2) Administer 100% oxygen for the first hour of the next case
(3) Avoid use of sevoflurane
(4) Change the CO2 absorbent
40. Which of the following systems prevent attachment of gas- administering equipment to the wrong type of central gas pipe line gas line ?
(1) Pin-index safety system
(2) Diameter-index safety system
(3) Fail-safe system
(4) Proportion-limiting control system
41. At high altitudes, the flow of a gas through a rotameter will be
(1) Greater than expected at high flows but accurate a low flows
(2) Greater than expected
(3) Greater than expected at high flows but less than expected at low flows
(4) Less than expected at high flows but greater than expected at low flows
42. Frost develops on the outside of an N2O compressed-gas cylinder during general anesthesia. This phenomenon indicates
(1) The saturated vapour pressure of N2O within the cylinder is rapidly increasing
(2) The cylinder is almost empty
(3) There is a rapid transfer of heat to the cylinder
(4) The flow of N2O from the cylinder into the anesthesia machine is rapid.
43. How long would a vaporizer filled with 100 mL volatile deliver 1% halothane if total flow is set at 5.0 L/minute ?
(1) 452 minutes
(2) 445 minutes
(3) 365 minutes
(4) 515 minutes
44. Which of the following explanations would not cause an increase in inspired CO2 during a laparoscopic cholecystectomy ?
(1) Channelling through soda lime
(2) Faulty expiratory valve
(3) Exhausted soda lime.
(4) Absorption of CO2 through peritoneum
45. Which factor does not determine the alveolar gas concentration ?
(1) Fresh gas flow rate
(4) Concentration and second gas effect
46. Which compressed gas can be liquified at room temperature ?
(1) Carbon dioxide
47. Most frequently reported malfunction in a medical gas pipeline system is
(1) Cross connection
(2) Excessive pressure
(3) Contamination of gases
(4) Inadequate pressure
48. Which is not an advantage of close suction in infectious intensive care unit ?
(1) Reduction nosocomial infection
(2) Not as effective in removing secretions as open suctioning
(3) Decrease coughing and agitation
(4) Better oxygenation during suction
49. In an O2 concentrator, __________ is most likely to cause deterioration of adsorbent medium.
(1) Carbon dioxide
(3) Water vapour
50. Carlen double lumen tube
(1) Is intended to be inserted into the left mainstem bronchus
(2) It not has carinal hook
(3) Connector not has port for fiberscope
(4) Not useful with massive hemoptysis
51. Which of the following would result in an increase in the production of compound A from the interaction between soda lime and sevoflurane ?
(1) Low soda lime absorbent temperatures
(2) Short duration of sevoflurane administration
(3) Soda lime desiccation
(4) High fresh gas flows
52. How long after intravitreal injection of sulphur hexafluoride and air can N2O be used without risk of increasing intra-ocular pressure ?
(1) 1 hour
(2) 10 days
(3) 24 hours
(4) 1 month
53. A retrobulbar block anaesthetizes each of the following nerves except
(1) Cranial nerve VII (Facial nerve)
(2) Cranial nerve IV (Trochlear nerve)
(3) Cranial nerve III (Oculomotor nerve)
(4) Cranial nerve VI (Abducens nerve)
54. A 50 kg woman is lethargic and is found to have plasma Na of 116 Megq/l. How much NaCl ml/hr. must be given to raise her plasma sodium to 130 Meq/l ?
(1) 105 ml/hr.
(2) 110 ml/hr.
(3) 95 ml/hr.
(4) 115 ml/hr.
55. Hetastarch interferes with coagulation through interacting with
(1) Antithrombin III
(2) Factor VIII
(4) Protein S
56. Electrocardiographic changes associated with hyperkalemia include
(1) Increased P wave amplitude
(2) Shortened PR interval
(3) Narrowed QRS complex
(4) Narrowed and peaked T waves
57. Which of the following is not a sign of severe hypovolemia ?
(1) Parched mucus membrane and obtunded sensorium
(2) Marked increased heart rate and decrease blood pressure
(3) Pretibial or presacral edema and elevated jugular pulse pressure
(4) Decrease urinary flow.
58. Which crystalloid solution is hyperosmolar ?
(1) D5 1/2NS
(2) Lactated Ringer solution
(3) Normal Saline
59. Which body fluid has maximum HCO3 (Med/liter) ?
(2) Diartheal stool
(3) Pancreatic secretion
(4) Biliary secretion
60. Calculate the amount of NaHCO3 necessary to correct base deficit of -10 Meq/L for a 50 kg man with an estimated HCO3 space of 30% ?
(1) 150 Meq
(2) 160 Meq
(3) 170 Meq
(4) 180 Meq