Set of flashcards Anästhesie final exam (Page 2 of 4)

Flashcards	156
Students	21
Language	English
Category	Medical
Level	University
Created / Updated	07.02.2020 / 16.01.2025
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41) Regarding to succinylcholine the following statements are true EXCEPT:

a) it is depolarizing relaxant drug

b) succinylcholine has short duration due to plasma cholinesterase

c) side effects include malignant hyperthermia, muscle pains, acute rhabdomyolysis with high blood levels of potassium

d) it is a medication used as a part of general anesthesia for long-term paralysis to help with tracheal intubation

42) Regarding CVP find FALSE STATEMENT:

a) mean pressure in VCS or RA

b) it is increased in hypovolemia

c) measurement performed with central venous catheter

d) to estimate the filling of vascular bed and preload of the right heart

43) Find TRUE STATEMENT regarding pulsoximetry

a) SpO2 90% = 75mmHg

b) Falsely high SpO2 during CO inhalation

c) Normal value: SpO2 ≤96%

d) Falsely high SpO2 during hyperbilirubinemia

44) CVP is typically elevated in all EXCEPT

a) congestive heart failure

b) cardial tamponade

c) hypervolemia

d) Sepsis

45) Interpret the following blood gas: PaO2 78mmHg, PaCO2 29mmHg, pH 7.29, HCO3 14, BE - 10

a) respiratory alkalosis

b) respiratory acidosis

c) metabolic acidosis

d) metabolic alkalosis

46) The patient with confirmed sudden cardiac arrest presents PEA on ECF tracing. You should:

a) administer 3mg of atropine each 2-5min of CPR

b) debibrilate the patient with 360J energy

c) administer 1mg of adrenaline each 2-5 mins of CPR

d) perform cardioversion with 150J energy

47) The best indicator of adequate fluid resuscitation in the trauma patient is:

a) Arterial pH

b) Blood pressure

c) core temperature

d) serum lactate level

49) A 24-year-old man is brought to the emergency department following a car accident. He is unconscious and has an obvious fractured right femur, as well as a taut abdomen. His BP is 92/58 and pulse 110. Prior to going to CT, radiology, and then surgery, the anesthesiologist request that a PA catheter be inserted. This is done, and the following values are obtained: SvO2 = 54%

Cl = 2.5/L/min/m2 PAOP = 3 mmHg

a) left ventricular failure

b) fluid overload

c) sepsis

d) hypovolemia

50) A 40-year old woman is undergoing an internal fixation of her tibia under general anesthesia.

While the surgeon is inserting the implant she develops sudden hypotension and her EtCO2

shows a sudden drop from 40 mmHg to 22 mmHg. What is the most likely diagnosis?

a) Anesthetic – induced myocardial depression

b) Hypothermia

c) pulmonary embolism

d) massive hemorrhage

51) Which one of the following findings would be contraindication to spontaneous breathing?

a) FiO2 0.4

b) PEEP 5

c) GCS 4

d) Minute volume 10 L/min

52) You are in the library when a gentleman who was standing at the desk collapses. He falls to the ground and does not appear to be breathing. You ask the clerk to call for help and to get the AED. Because the man is not responding and does not appear to be breaking normally you should immediately

a) Do nothing until the AED arrives

b) start compressions at least 100 per minute but no more than 120 per minute

c) Deliver 2 breaths followed by 15 compressions

d) open the airway, deliver 4 breaths and await to the arrival of the AED

53) the FALSE STATEMENT concerning cardiogenic shock is:

a) is characterized by low cardiac output

b) is characterized by a low systemic vascular resistance

c) may be caused by papillary muscle rupture

d) is inability of the heart to maintain the circulation

54) Subarachnoid anaesthesia is contraindicated in:

a) Obstetiric patients

b) transurethral resection of bladder tumors

c) total hip replacement

d) thrombocytopenia

55) Amiodarone is indicated for the treatment of:

a) hypertension

b) arrhythmia

c) hyperthyroidisms

d) seizure

56) The patient is admitted with cardiogenic shock and oliguric acute kidney injury. Hemodynamics parameters reveal the following:
BP 105/60 mmHg, Sinus rhythm (108/min), Cl 1.8 (CO2.4), CVP 23 mmhG, PCWP 25mmHg, SVRI 2088 (SVR 1566). Which one of the following interventions would you anticipate?

a) Dopamine at 2mcg/kg/min

b) captoprin 6.5 mg q6h

c) metoprolol 25mmHg

4) Dobutamine 5mcg/kg/min

57) Calculate the PaO2: FiO2 ratio passed on the following data:
FiO2 1.0, PEEP 10, PaO2 65mmHg, pH 7.34 mmHg, PaCO2 45mmHg, SpO2 90%

a) 100

b) 95

c) 65

d) 35

58) The inotropic drug of the first choice for septic shock is:

a) dopamine

b) dobutamine

c) epinephrine

d) dopexamine

59) Pneumothorax as a complication occurs more often during cannulation of:

a) jugular internal vein

b) jubgular extral vain

c) Subclavian vein

d) Femoral Vein

60) What is the correct treatment of an adult patient with VF:

(kann auch B sein)

a) administer 500ug of digoxin IV

b) administration of 1mg of adrenaline after each defribrillation

c) administration of 3mg of atropine after each two loops of CPR

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

1. All of the followeing are examples of distributive shock except

a) drugs that cause vasodilation

b) hemorrhage

c) sepsis

d) anaphylaxis- vasodilation

2. ET CO2 is increased in the following condition except:

a) hyperthermia

b) COPD

c) malignant hyperthermia

d) hyperventilation

3. Which of the following laboratory values are most likely to confirm adequate synthetic hepatic function:

a) partal thromboplastin time

b) prothrombin time

c) serum alanine aminotransferade concentration

d) 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 followeing meneuvers may assist you in mask ventilation?

a) head tilt jaw lift

b) oral airway

c) nasopharyngeal airway

d) all of above

5. Oxygen delivery is direcly dependent on:

a) central venous oxygen content

b) heamoglobin concentration

c) systemic vascular resistance

d) oxygen extraction rate

6. The major difference between cardiogenic and sepitc shock is:

a) CS patients are more tachycardic

b) SS patients have more often severe lactic acidosis

c) diastolic pressure is very low in patients with CS

d) SS patients are unsually more vasodilated

7. What is the definition of cardiac ouput?

a) CO= (BP) x (HR)

b) CO= (HR) x (SVR)

c) CO= (BP) x (SVR)

d) CO= (HR) x (SV)

8. A sudden falll in end expiratory PCO2 in capnometry may be triggered by all EXCEPT:

a) acute pulmonary embolism

b) pneumonia

c) pulmonary edema

d) alveolar hypoventilation

9. The cornerstones of therapy of hyperglycaemic emergencies include:

1. fluid restiction

2. correction of acidosis

3. normalisation of blood glucose with insulin

4. correction of electrolyte levels

1,3,4

2,3,4

2,3

all of the above

10. The acute treatment of life threatening hyperkalaemia include:

1. Intrvenous magnesium

2. Intravenous calcium

3. Glucose/insulin infusion

4. Intravenous lidocaine

1,2,3

1,3

2,3

3,4

11. Pathophysiological changes observed in sepsis are:

a) impaired endothelial function of blood vessels leading to increased vascular permeability and extensice tissue swelling

b) hemostasis disorders, reduced energy production in the mitochondria

c) circulartory insufficiency and hypotension

d) a,b,c

12. In patients with sepsis an decreased fibrin formation associated with impaired fibrinolyis may contribute to:

a) loss of barrier function of endothelium leading to widespread tissue oedema

b) vasodilation leading to a decreased systemic vacular restistance

c) increased leukocyte adhesion to endothelium with increaded transmigration of leukocytes into tissue

d) vascular occlusion, oragan ischemia, organ damage and development of multiple oran dysfuntion syndrome

13. The current full definition of sepsis is as follow:

a) sepsis is a life-threating organ dysfuction caused by a dysregulated host´s response to a bloodsteam infection. Oran dysfunction can can be identified as an acute change in total SOFA score >4 points cosequent to the infection

b) sepsis is defined as life threatening organ dysfunction caused by dysregulated host responxe to infection. Organ dysfunction can be identified as an acute change in total SOFA score >2 points consequent to the infection

c) sepsis is defined as life threatening syndrome shape by pathogen factors and host factors (eg. sex, race and other genetic determiants, age, comorbidities, environment)

d) sepsis is a life threating oran dysfunction identified as an acute changes in total SOFA score >4 points

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

A) 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 identified with a clinical construct of sepsis with persistent hypotension requiring vasopressors to maintain MAP > 65 mm Hg and having a serum lactate level >2 mole/L (18mg/dL) despite adequate volume resuscitation.

B) 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 identified with a clinical construct of sepsis and hypotension requiring vasopressors to maintain MAP > 65 mm Hg and having a serum.

C) 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 identified based On the presence of hypotension requiring vasopressors to maintain MAP > 55 mm Hg and having a serum lactate level >2,5 mole/L (18mg/dL) despite adequate volume resuscitation.

D) 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 identified with a clinical construct of sepsis with persistent hypotension, requiring vasopressors to maintain MAP >100 mm Hg and having a serum lactate level >2,5 mole/L.

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

pH 7,35

PaCO2 48mmHg

HCO3 28mmol/L

What is the diagnosis?

a) fully compensatied metabolic acidosis

b) fully compensated metabolic alkalosis

c) fully compensated respiratory alkalosis

d) fully compensated respiratory acidosis

16. 40 year old male has been admitted to the emergency department with a severe asthma attack. He has been experiencing increasing shortness of breath since admission. His arterial blood gas results is as follows:

pH 7,22

PaCO2 55mmHg

HCO3 25mmol/L

What is die diagnosis?

a) uncompensated metabolic acidosis

b) uncompensated metabolic alkalosis

c) uncompensated respiratory alkalosis

d) uncompensated respiratiory acidosis

17. Hypothermia refers to any state in which the O2 content of arterial blood is reduced. It may result from:

a) impaired oxygention (PaO2)

b) low hemoglobin level (anemia)

c) reduced affinity of hemoglobin for O2 (e.g carbon monoxide poisoning)

d) a,b,c

18. Measurement of the concentration of procalcitonin in patients treated in the intensive care unit is useful

a) for the diagnosis of severe fungal infection

b) for the diagnosis of serious viral infection

c) for the diagnosis and monitory of treatment of serious bacterial infection

d) for the diagnosis and monitoring of severe coagulation disorders (DiC)

19. Indicate false statement:

a) in systemic bacterial infections, procalcitonin is produced in all parenchymal and excreted into the bloodsteam, where it reaches a high concentration

b) in severe viral infection, procalcitonin is produced in all parenchymal tissues and excreted into the bloodstream, where it reaches a high concentration

c) the level of procalcitonin my increase after major surgery, reaching the highest values after 24-48 hours. PCT returns to normal values within a few days in there were no complications after surgery

d) daiy measurement of the concentration of procalcitonin in patients with bacterial sepsis allows monitoring the progress of treatment

20. qSOFA is considered positive if the patient has at least 2 of the following clinical criteria. Which of the following is not included in qSOFA?

a) respiratory rate of 22/min or greater

b) altered metal state (GCS of less than 15)

c) systolic blood pressure of 100 mmHg or less

d) body temperature >38 degree or more

21. The best indicator of adequate fluid resuscitation in the trauma patient is:

a) arterial pH

b) blood pressure

c) core temperature

d) serum lactate level

Anästhesie final exam

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