Cartes mémoires Anesthesiology 2020

Cartes-fiches	116
Langue	Deutsch
Catégorie	Médecine
Niveau	Université
Crée / Actualisé	08.02.2020 / 11.02.2020
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114. What is the correct treatment of an adult patient with VF?

administer 500mcg digoxin i.v.

administration of 1mg of adrenaline after each defibrillation

administration of 3mg of atropine after eacht two loops of CPR

performing the first defibrillation with energy 150-200J (biphasic)

administer 500mcg digoxin i.v.

administration of 1mg of adrenaline after each defibrillation

administration of 3mg of atropine after eacht two loops of CPR

performing the first defibrillation with energy 150-200J (biphasic)

Version C
1. A 16-year-old girl has intermittent bifrontal and occipital headaches, which she describes as “squeezing, bandlike, or vinelike” that are worse when she is at school. She has undergone counseling at school for depression and anxiety. Which of the following is the most likely diagnosis?

temporal arteritis

migraine headache

malingering

tension type headache

temporal arteritis

migraine headache

malingering

tension type headache

Version C
2. A 55-year-old man has severe pain on gentle touching of the arm. Six months ago, the median n. was damage during creation of an arteriovenous fistula for dialysis. Which of the following terms best describes this phenomenon?

hypesthesia

hyperalgesia

allodynia

hypersensitivity

hypesthesia

hyperalgesia

allodynia

hypersensitivity

Version C
3. The placebo effect is mediated by

opioid mechanism

oxytocin mechanism

cannabinoid mechanism

all of them

opioid mechanism

oxytocin mechanism

cannabinoid mechanism

all of them

Version C
4. According to international definition, pain is:

a. An unpleasant sensory or emotional experience described in terms of tissue damage

b. Actual or potential tissue damage associated with unpleasant experience

An acute sensory experience associated with local tissue damage

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

a. An unpleasant sensory or emotional experience described in terms of tissue damage

b. Actual or potential tissue damage associated with unpleasant experience

An acute sensory experience associated with local tissue damage

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

Version C
5. In the study of placebo effect the highest decrease of pain intensity was observed in:

open (expected) injection of analgetic

hidden (unexpected) injection of analgetic

no difference between both interventions

hidden injection was effective in neuropathic pain only

open (expected) injection of analgetic

hidden (unexpected) injection of analgetic

no difference between both interventions

hidden injection was effective in neuropathic pain only

Version C
6. What kind of treatment is not used in the postoperative pain theory: (unsure!)

epidural blockade

intrapleural blockade

spinal blockade

neurolytic blockade

epidural blockade

intrapleural blockade

spinal blockade

neurolytic blockade

Version C:
7. The capnograph is showing that your patient just had....

pulmonary embolism

a severe bronchospasm

malignant hyperthermia

a return of spontaneous circulation ROSC after cardiac arrest

pulmonary embolism

a severe bronchospasm

malignant hyperthermia

a return of spontaneous circulation ROSC after cardiac arrest

Version C
8. Which of the following is an inotrope?

metoprolol

milrinone

diltiazem

ramipril

metoprolol

milrinone

diltiazem

ramipril

Version C.

9. The patient is admitted with cardiogenic shock and oliguric acute kidney injury. Hemodynamics reveal the following: BP 105/60 mmHg, sinus rhythm 108/min, CI 1.8 (CO 2.4), CVP 23 mmHg, PCWP 25 mmHg, SVRI 2088 (SVR 1566). The most appropriate management is administration of:

(unsure=

captopril 6.5mg q6h

dobutamine at 5mcg/kg/min

dopamine at 2mcg/kg/min

metoprolol 25mg BID

captopril 6.5mg q6h

dobutamine at 5mcg/kg/min

dopamine at 2mcg/kg/min

metoprolol 25mg BID

Version C
10 . Clopidogrel is classified as:

Inhibitor of platelets’ aggregation (ADP receptor antagonist – clopidogrel, ticagrelor, prasugrel)

Factor Xa inhibitor

Vit K antagonist

Anti-hypertensice

Inhibitor of platelets’ aggregation (ADP receptor antagonist – clopidogrel, ticagrelor, prasugrel)

Factor Xa inhibitor

Vit K antagonist

Anti-hypertensice

Version C.

11. Dabigatran (Pradaxa) is classified as an:

Factor Xa inhibitor (rivaroxaban, apixaban..)

Direct thrombin inhibitor

inhibitor of platelet aggregation

vit k antagonist

Factor Xa inhibitor (rivaroxaban, apixaban..)

Direct thrombin inhibitor

inhibitor of platelet aggregation

vit k antagonist

Version C.
13. Which of the following is TRUE information about Naloxone?

Naloxone is a pure opioid antagonist that competitively binds to u-opioid receptors

Naloxone has a short duration of activity about 30-90 minutes

No tolerance or dependance are associated with naloxone use

All information are true

Naloxone is a pure opioid antagonist that competitively binds to u-opioid receptors

Naloxone has a short duration of activity about 30-90 minutes

No tolerance or dependance are associated with naloxone use

All information are true

Version C
12. Amiodarone is indicated for the treatment of:

Arrhythmia

Hypertension

Seizure

Hyperthyroidism

Arrhythmia

Hypertension

Seizure

Hyperthyroidism

Version C
22. Which ONE of the following statements about PCWP (PAOP) is TRUE: (unsure)

measurement involves passage of pulmonary artery catheter across the interarterial septum

is typically raised in ARDS

is typically raised in septic shock

is a reflection of left atrial pressure

measurement involves passage of pulmonary artery catheter across the interarterial septum

is typically raised in ARDS

is typically raised in septic shock

is a reflection of left atrial pressure

1 All of the following are examples of distributive shock, EXCEPT: (unsure)

Drugs that cause vasodilatation

Hemorrhage

Sepsis

Anaphylaxis vasodilatation

Commandes clavier:

= tourner,

= avant/arrière,

= faire défiler

Drugs that cause vasodilatation

Hemorrhage

Sepsis

Anaphylaxis vasodilatation

2 ET CO2 is increased in the following conditions, EXCEPT:

Hyperthermia

COPD

Malignant Hyperthermia

Hyperventilation

Commandes clavier:

= tourner,

= avant/arrière,

= faire défiler

Hyperthermia

COPD

Malignant Hyperthermia

Hyperventilation

3 Which of the following laboratory values are most likely to confirm adequate synthetic hepatic function? (unsure)

Partial thromboplastin time

Prothrombin time

Serum alanine aminotransferase concentration

Total serum bilirubin concentration

Commandes clavier:

= drehen,

= vor-/rückwärts,

= scrollen

Partial thromboplastin time

Prothrombin time

Serum alanine aminotransferase concentration

Total serum bilirubin concentration

4 If you are having difficulty in ventilating a patient and a foreign body has been ruled out, which of the follwing maneuvers may assist you in mask ventilation? (unclear)

Head tilt, Jaw lift

Oral airway

Nasopharyngeal airway

All of the above

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

Head tilt, Jaw lift

Oral airway

Nasopharyngeal airway

All of the above

5 Oxygen delivery is directly dependent on: (unsure)

Central venous oxygen content

Haemoglobin concentration

Systemic vascular resistance

Oxygen extraction rate

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

Central venous oxygen content

Haemoglobin concentration

Systemic vascular resistance

Oxygen extraction rate

6 The major difference between cardiogenc (CS) and septic shock (SS) is... (unsure )

CS patients are more tachycardic

SS patients have more often severe lactic acidosis

Diastolic pressure is very low in patients with CS

SS patients are usually more vasodilated.--- (skin feels warm and looks pinkish...)

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

CS patients are more tachycardic

SS patients have more often severe lactic acidosis

Diastolic pressure is very low in patients with CS

SS patients are usually more vasodilated.--- (skin feels warm and looks pinkish...)

7 What is the definition of cardiac output (CO)?

CO = BP x HR

CO = HR x SVR

CO = BP x SVR

CO = HR x SV

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

CO = BP x HR

CO = HR x SVR

CO = BP x SVR

CO = HR x SV

8 A sudden fall in end-expiratory PCO2 in capnometry may be triggered by all, EXCEPT: (unsure)

Acute pulmonary embolism

Pneumonia

Pulmonary edema

Alveolar hypoventilation

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

Acute pulmonary embolism

Pneumonia

Pulmonary edema

Alveolar hypoventilation

9 The cornerstones of therapy of hyperglycaemic emergencies include: (Unsure)

1 Fluid restriction

2 Correction of acidosis

3 Normalization of blood glucose with insulin

4 Correction of electrolyte levels

1, 3 and 4

2, 3 and 4

2 and 3

all of the above

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

1, 3 and 4

2, 3 and 4

2 and 3

all of the above

10 The acute treatment of life-threatening hyperkalaemia include:

1. IV magnesium

2. IV calcium

3. Glucose/insulin infusion

4. IV lidocaine

1, 2, 3

1, 3

2, 3

3, 4

Tastatur-Befehle:

= drehen,

= vor-/rückwärts,

= scrollen

1, 2, 3

1, 3

2, 3

3, 4

11 Pathophysiologic changes observed in sepsis are ...

impaired endothelial function of blood vessels leading to increased vascular permeability and extensive(?) tissue swelling

hemostasis disorders, reduced energy production in the mitochondria

circulatory insufficiency and hypotension

a, b , c

impaired endothelial function of blood vessels leading to increased vascular permeability and extensive(?) tissue swelling

hemostasis disorders, reduced energy production in the mitochondria

circulatory insufficiency and hypotension

a, b , c

12 In patients with sepsis an increased fibrin formation associated with impaired fibrinolysis may contribute to... (unsure)

loss of barrier function of endothelium leading to widespread tissue edema

vasodilatation leading to a decreased systemic vascular resistance

increased leukocyte adhesion to endothelium with increased transmigration of the leukocytes into tissues

vascular occlusion, organ ischemia, organ damage and development of multiple organ dysfunction syndrome (MODS)

loss of barrier function of endothelium leading to widespread tissue edema

vasodilatation leading to a decreased systemic vascular resistance

increased leukocyte adhesion to endothelium with increased transmigration of the leukocytes into tissues

vascular occlusion, organ ischemia, organ damage and development of multiple organ dysfunction syndrome (MODS)

13 The current, full definition of sepsis is as follows:

Sepsis is a life threatening organ dysfunction caused by a dysregulated host's response to a bloodstream infection. Organ dysfunction can be identified as an acute change in total SOFA score >4 p. consequent to the infection.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total SOFA score >2p.consequent to the infection.

Sepsis is defined as life-threatening syndrome shaped by pathogen factors and host factors e.g.sex, race, other genetic determinants, age, comorbidities, environment

Sepsis is a life-threatening organ dysfunction identified as an acute change in total SOFA score <4 p.

Sepsis is a life threatening organ dysfunction caused by a dysregulated host's response to a bloodstream infection. Organ dysfunction can be identified as an acute change in total SOFA score >4 p. consequent to the infection.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction can be identified as an acute change in total SOFA score >2p.consequent to the infection.

Sepsis is defined as life-threatening syndrome shaped by pathogen factors and host factors e.g.sex, race, other genetic determinants, age, comorbidities, environment

Sepsis is a life-threatening organ dysfunction identified as an acute change in total SOFA score <4 p.

14 The current full definition of septic shock is as follows..

Septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients with septic shock can be indentified with aclinical construct of sepsis with persisting hypotension, requiring vasopressors to maintainMAP>65mmHg and serum lactate>2mmol/L (18mg/dL)despite adequate volume resuscitation.

Septics shock is a ...(the same as above) ... patients with septic shock can be identified with a clinical construct of sepsis and hypotension requiring vasopressors to maintain MAP>65mmHg.

Septic shock is a ...(same) ... patients with septic shock can be identified based on the presence of hypotension requiring vasopressors to maintain MAP>85mmHG and having a serum lactate level >2,5mmol/mL.

Septic shock is a ...(same)... patients with septic shock can be identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP>100mmHg and having a serum lactate level >2,5mmol/mL.

Septic shock is a subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality. Patients with septic shock can be indentified with aclinical construct of sepsis with persisting hypotension, requiring vasopressors to maintainMAP>65mmHg and serum lactate>2mmol/L (18mg/dL)despite adequate volume resuscitation.

Septics shock is a ...(the same as above) ... patients with septic shock can be identified with a clinical construct of sepsis and hypotension requiring vasopressors to maintain MAP>65mmHg.

Septic shock is a ...(same) ... patients with septic shock can be identified based on the presence of hypotension requiring vasopressors to maintain MAP>85mmHG and having a serum lactate level >2,5mmol/mL.

Septic shock is a ...(same)... patients with septic shock can be identified with a clinical construct of sepsis with persisting hypotension requiring vasopressors to maintain MAP>100mmHg and having a serum lactate level >2,5mmol/mL.

15 A patient with COPD admitted for surgery. On admission his labwork reveals an arterial blood gas with the following values:

ph: 7,35 PaCO2: 48mmHg HCO3: 28mmol/L

Based on those parameters, this patient can be diagnosed with:

fully compensated metabolic acidosis

fully compensated metabolic alkalosis

fully compensated respiratory alkalosis

fully compensated respiratory acidosis

fully compensated metabolic acidosis

fully compensated metabolic alkalosis

fully compensated respiratory alkalosis

fully compensated respiratory acidosis

Anesthesiology 2020

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