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Israr Hussain Yousafzai
ANESTHESIA KMU PESHAWAR, PAKISTAN
ANESTHESIA
COMPLICATIONS MCQ’S
Page1
1. In the mnemonic ‘LEMON’ assessment, ‘E’ stands for.
a. Elder patient
b. Evaluate 3, 3 ,2 rule
c. Emergency patient
d. Evaluate 9, 6, 3 rule.
2. A 35 years old man whom distance between mentum and hyoid bone is 4.5 cm.
to which grade this patient you will classify.
a. Grade I
b. Grade II
c. Grade III
d. Grade IV
3. 40 years old women were asked to extend her head. The Atlanto occipital angle
are measured which was 17 degree.in which grade you will classify this patient.
a. Grades I
b. Grade II
c. Grade III
d. Grade IV
4. In which of the following patient difficult intubation should not predictable
a. protruding of teeth
b. osteomyelitis
c. mouth opening<3cm
d. micrognatia
5. According to Mallampati classification which of the following patient should
place in class III.
a. nothing appears
b. uvula, plates, and tongue appear
c. tongue and plates appear
d. none
6. Which of the following are indicators for a potentially difficult airway?
a. Cervical spinal injury
b. TMJ problem
c. BMI>30
d. All of the above
7. Which of the following relates with the evaluation of thyromental distance
a. Benumof’s analysis
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b. Saghei and safavi test
c. Lemon assessment
d. Patil’s test
8. The blood brain barrier is not readily crossed by
a. Oxygen
b. Potassium
c. Water
d. Carbon dioxide
e. Bicarbonate
9. A 25 year old come to emergency of RTA .after perform the RSI the oxygen
saturation decrease until hypoxemia develop what causes can be expected:
a. decrease IE ratio
b. plural effusion
c. pulmonary edema
d. endobronchial intubation
e. all of the above
10. Which of the following is not an indication for endotracheal intubation?
a. Maintenance of a patent airway
b. To provide positive pressure ventilation
c. Pulmonary toilet
d. Pneumothorax
11.The following are recognized strategies in the prevention of ventilator-
associated pneumonia (VAP): except
a. Daily sedation holds.
b. Head-up positioning of 30 to 45°.
c. Prone positioning.
d. Chlorhexidine mouth care.
12. Effective methods to decrease an elevated PaCO2 may include all of the
following EXCEPT:
a. Increase tidal volume
b. Increase frequency
c. Decrease circuit dead space
d. Increase PEEP
e. Increase inspiratory pressure
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13.All of the following feature of acromegaly lead to difficulty in intubation
EXCEPT
a. Increased interdental space
b. Macroglossia
c. Prognathism
d. beetle brow
e. buccal teeth
14.Which of the following does not represent a significant anesthetic problem in
the morbidly obese patient
a. Difficulty in the endotracheal intubation
b. Increase metabolism volatile agent
c. Decrease cardiac output relative to total body mass
d. Suboptimal arterial oxygen tension
e. None of these
15.When a patient developed supraventricular tachycardia with hypotension under
general anesthesia all of the following treatments may be instituted except?
a. Carotid sinus massage
b. Adenosine 3-12 mg IV
c. Direct current cardio version
d. Verapamil 5mg IV
e. Both A and B
16.Most anesthetist choose to set the arterial oxygen saturation alarm limit on the
pulse oximeter at
a. 94 - 96 %
b. 92 -94 %
c. 90 -92 %
d. only 84%
17.In sever hypoxemia which one of the following is common in children as
a. Tachycardia
b. hypertension
c. bradycardia
d. arrhythmia
18.When the arterial desaturation progresses which of the following can cause
cardiac arrest usually in a systole
a. Tachycardia and hypotension
b. bradycardia hypotension
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c. hypoventilation and hypertension
d. hyperventilation and hypotension
19.The pulmonary shunting and atelectasis which can occur during anesthesia are
much more likely to cause
a. Hypoventilation
b. hypoxia
c. hypoxemia
d. Hypocapnea
20.All are seen in Malignant hyperthermia except :
a. Bradycardia
b. Hyperkalemia
c. Metabolic acidosis
d. Hypertension
21.Which of the following anesthetic agents does not trigger malignant
hyperthermia?
a. Halothane
b. Isoflurane
c. Suxamethonium
d. Thiopentone
22.Most clearly associated with MH is
a. Central core temperature
b. Bilateral strabismus
c. Myotonia congenita
d. Down syndrome
23.In MH the increase heat production due to the?
a. Thermal effect of blood
b. Increase sympathetic discharge
c. Increase muscle metabolism by excess calcium ions
d. Mitochondrial thermogenesis
24.MH trigger should be avoided in patient with each of the following except
a. Central core diseases
b. Carnitine palmityl transferase deficiency
c. Neuroleptic malignant syndrome
d. Marked masseter muscle rigidity
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25.Three-year-old boy with no other medical problem is schedules for elective
inguinal hernia repair. Birth weight 3.7 kg first talked 13 months .first walked
17 months. NPO since midnight .negative family history .safe induction for
anesthesia in this case should be:
a. A major inhalational plus N2O
b. Intravenous agent only
c. Avoiding the inhalational plus succinylcholine
d. Postponing the case until neuron evaluation is done
26.Incomplete jaw relaxation after inhalation agent use (halothane) plus
succinylcholine administration in children most like:
a. A harbinger of malignant hyperthermia
b. Due to overdose of succinylcholine
c. Found only in atypical pseudo-cholinesterase
d. A normal response
27.Which of the following are useful in the treatment of malignant hyperpyrexia?
a. 100% 02
b. Ringer lactate
c. Sodium dantroline
d. Dextrose
e. Sodium bicarbonate
28.The 45 year old male patient presenting for bowel obstruction NPO time 8
having sign and symptoms of nausea vomiting colic pain .but he is susceptible
for the MH what tests should be done screening test of MH except:
a. Genetic test
b. CHCT (caffeine halothane contracture test)
c. Muscle biopsy
d. CMP comprehensive metabolic panel
29.What should be the duration of Post-operative monitoring for Temperature and
ECG in MH patient:
a. 1-2 hours
b. 4-5 hours
c. 3-4 hours
d. 6-11 hour
e. >15 hours
30.The normal range of mean arterial pressure varies in between.
Page6
a. 60-120mm Hg
b. 70-110mm Hg
c. 60-160mm Hg
d. 70-150mm Hg
31. ………….. Is a good choice for a patient with a good ventricular function and
elevated heart rate?
a. Beta adrenergic blocked
b. Calcium channel blocker
c. Vasodilators
d. Central alpha 2 agonist
32.A 40 years old man having a history of Broncho septic disease and his
preoperative blood pressure was 120/80 mm Hg. During procedure his BP
elevated to 155/90, mmHg .which of the drug is the choice of agent for
reduction of BP in this patient.
a. Nicardipene
b. Esmolol
c. Metoprolol
d. Nitroprusside
33.Intraoperative hypertension if it is > -------- percentage of the preoperative
value.
a. 15
b. 25
c. 35
d. 50
34.All of the following may cause intraoperative hypertension except.
a. Pregnancy
b. Hypocapnea
c. Inadequate analgesia
d. Aortic cross clamp
35.According to COMARCK –LEHANE grading if only if “ only epiglottis is
visualized” so this will be :
a. Grade I
b. Grade II
c. Grade III
d. Grade IV
Page7
36.The decrease in one centigrade temperature effect on BMR basal metabolic
ratio up to
a. 2-4%
b. 3-6%
c. 7-10%
d. 15-20
37.ASA classification is based on ___
a. Physical status
b. Drug interaction
c. Antibiotic selection
d. Difficult intubation class
38.Which of the following groups constitute high-risk patients?
a. Elderly
b. Significant co-morbidities
c. Emergency surgery
d. Complex major surgeries
e. All of the above
39.In ASA classification brain dead organ donor address to ___ category.
a. P6
b. P5
c. P1
d. E
40.The intraoperative and postoperative factors for the identification of high risk
patients include:
a. Inability to increase oxygen delivery after surgery
b. Reduced central or mixed oxygen saturation
c. Reduced gastric mucosal PH indicating gut microcirculation
d. All of the above
41.The Trans and postoperative period collection is done in
a. ASA classification
b. New York heart classification
c. Glasgow coma scale
d. Surgical variables in possum score
42.ASA classification consists of ___ categories.
a. 6
b. 8
c. 7
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d. 10
43.Following belong to physiological variables of possum score except :
a. Age 5 serum potassium concentration , white cell count
b. Glasgow coma scale , hemoglobin count
c. Serum potassium , urea , sodium concentration
d. Peritoneal soiling , urgency surgery
44.Which of the following is not preventable factor of mortality in high-risk
patients?
a. Pain
b. Insufficient pain monitoring
c. Advanced age
d. Inadequate critical care facilities
45.The physiological variables in possum score are collected in
a. Trans operative period
b. Postoperative period
c. Late operative period
d. Preoperative period
46.In 1940, ___ is established to collect and tabulate statistical data that would be
used to predict operative risk.
a. Possum score
b. Glasgow coma scale
c. ASA classification
47.Which of the following statements are true about specific management
therapies of high-risk patients?
a. Prophylactic beta receptor antagonist agents have been used to decrease
perioperative myocardial infarction
b. Esophageal Doppler guided fluid therapy is an accurate estimation of the
patients fluid needs.
c. Sustained use of goal directed therapy in patients with established critical
illness is beneficial.
d. Both A & B
48.The physiological part of possum score includes ___ variables divided into four
variables.
a. Eleven
b. Six
c. Fourteen
d. Twelve
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49.In ASA, classification patients with severe systemic disease that is a constant
threat to life have ____.
a. Some functional limitation
b. Emergency procedure
c. No functional limitation
d. Functional incapacitation
50.Regarding preoperative management of high-risk patient, which of the
following statements are true?
a. Perioperative physiotherapy has no role
b. Stopping smoking prior to surgery is of little benefit
c. A course of steroids prior to surgery may be necessary in patients with
chronic obstructive airway disease
d. None of the above
51.Possum stands for
a. The physiological and operative severity score for the enumeration of
mortality and morbidity
b. The psychological and operative severity score for the enumeration of mortality
and morbidity
c. The physiological and operative surgical score for the enumeration of mortality
and morbidity
d. None
52.Following belong to surgical variables except
a. Blood loss, urgency surgery
b. Degree of cancer spread, operative severity
c. Systolic BP, heart rates , ECG abnormalities
d. Peritoneal soiling
e. Mallampati classification
53.In ASA classification of physical status E stands for
a. Emaciated patients
b. Electric burn patient
c. Electrolyte disturbance
d. Emergency surgery
54.Thyromental distance is used to predict_____.
a. Difficult extubation
b. Airway obstruction
c. Both A&b
d. Difficult intubation
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55. The following feature may be predictive of a difficult intubation______.
A) Increased atlantoccipital distance
B) Decreased posterior mandibular depth
C) Mallampati grade3
D) A thyromental distance less than 6cm
56. Upper parts of facial pillars and most of uvula is visible _____.
A) Grade 1
B) Grade 2
C) Grade 3
D) Grade 4
57. Mouth opening and incisor distance of greater than ------- is desirable in an
adult.
A) 5cm
B) 6 cm
C) 8 cm
D) 3 cm
58. Nasopharyngeal airway is contraindicated during CPR.
A) chest
B) Anticoagulant patient
C) Liver
D) None of above
59.Most common cause of airway obstruction in unconscious patient is_____?
A) Tongue fall
B) Foreign body
C) Lax posterior wall, pharyngeal wall
D) Lax epiglottis occluding the vocal cord
60. According to Mallampati grading, grade 1 represent
A) Hard palate
B) Soft palate
C) Soft palate, hard palate, uvula, tonsillar pillars
D) Soft palate, hard palate, base of uvula
61. in severely injured patient the first thing to do that.
A) Maintenance of airway
B) Start IV line
C) Vasopressor drug
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D) Blood transfusion
62. Which of the following is not considering predictors of difficult intubation in
pre-anesthetic examination?
A) Mallampati classification
B) Thyromental distance
C) TMJ
D) Cormack-lehane grade
63. The anterior spinal artery syndrome is characterizes by a (n)
a. Insidious onset
b. Flaccid motor paralysis
c. Abnormal CSF glucose and protein
d. Normal myelogram
e. Both B & D are correct
64.During deep hypothermia, the brain temperature is measured most accurately in
a. Skin
b. Esophagus
c. Rectum
d. Middle ear
e. Nasopharynx
65.Stereospecific opiate binding sites have been identified in all of the following
EXCEPT
a. Kidney
b. Carotid chemoreceptors
c. Pulmonary J receptors
d. Heart
e. Smooth muscle
66.Cerebral metabolic rate and cerebral blood flow are NOT reduced by
a. Ketamine
b. Morphine
c. Thiopental
d. Diazepam
e. Halothane
67.Which of the following physiologic changes occurs in the geriatric patient?
a. Decreased lung compliance
b. Decreased chest wall compliance
c. Decreased residual volume
d. Decreased closing volume
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68.The commonest site for obstruction are the
a. larynx
b. tracheal tube
c. bronchi
d. All
69.Inadequate ventilation and impaired gas exchange cause
a. Hypercapnia
b. Hypoxemia
c. Hypocapnea
d. Both a, b
70.Which of the following is indicated by the partial obstruction of respiratory
system
a. Noisy breathing
b. stridor
c. silent
d. Both a, b
e. both b, c
71.Complete obstruction is
a. silent
b. Stridor
c. Both
d. Noisy
72.A patient whose lungs are mechanically ventilated respiratory obstruction May
Be associated with
a. Increased inflation pressure
b. Hypercapnia
c. Prolonged expiratory phase
d. All
e. None of them
73.Which of the following can cause prolong closure of vocal cord reflex
a. Bronchospasm
b. laryngospasm
c. Trachospasm
d. all of the above
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74.Laryngospasm is mostly common during
a. Induction
b. emergence
c. Extubation
d. Both a, b
e. All
75.Inadequate partial pressure of oxygen in arterial blood is called
a. Hypoxia
b. Hypoxemia
c. Hypocapnea
d. All
76.Due to persistent deficiency of oxygen supply to the body which organ may
damage first
a. Heat and lungs
b. Brain and liver
c. Brain and heart
d. Liver and lungs
77.The risk presented by a level of hypoxemia is dependent upon the patient
a. Hemoglobin conic
b. Cardiac output
c. State of concurrent disease
d. All of above
e. None of them
78.Which of the following is the indication of complete laryngospasm?
a. Stridor
b. Absence of breath sounds
c. Suprasternal retraction
d. Use of accessory muscles
e. Paradoxical chest movement
79.Laryngospasm is mostly common during
a. Induction/emergence
b. Maintenance
c. Extubation
d. After intubation
e. In all these situations
Page14
80.Organs which are damaged most rapidly by deficiency in o2 supply include
the_______
a. Heart and lungs
b. Brain and liver
c. Brain and heart
d. Liver and lungs
e. Liver and lungs
81.The risk presented by a level of hypoxemia is dependent upon the patient
a. Hemoglobin concentration
b. Cardiac output
c. State of concurrent disease
d. a ,b and c
e. none of them
82.The pulmonary shunting and atelectasis which can occur during anesthesia are
much more likely to cause
a. Hypoventilation
b. Hypoxia
c. Hypoxemia
d. Hypocapnea
e. a and b
83.Which of the following anesthetic agents does not trigger malignant
hyperthermia?
a. Halothane
b. Isoflurane
c. Suxamethonium
d. Propofol
e. Sevoflurane
84.In severely injured/unconscious patient, the first line of treatment should
be______
a. History of the patient
b. Pass large bore IV line
c. Maintenance of airway
d. Vasopressor drug
e. Hemodynamic stability
85.Which of the following is not related to light plane of anesthesia?
a. Sweating
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b. Tachycardia
c. Hypertension
d. Hypothermia
e. Tear formation
86.Regarding difficult laryngoscopy/intubation, the minimal acceptable
thyromental distance is
a. 8.5 cm
b. 9.5 cm
c. 11.5 cm
d. 12.5 cm
e. 14.5 cm
87.Which of the following is not related to physiological cause of hypoxemia;
a. High altitude
b. Diffusion
c. Hyperventilation
d. Shunting
e. V/Q mismatch
88.Epidural space is the potential space between the ___________
a. Dura mater and ligamentum flavum
b. Ligamentum flavum and intraspinous ligament
c. supraspinatus ligament and intraspinous
d. Dura mater and arachnoid mater
e. Dura mater and post longitudinal ligament
89.The most common complication of spinal anesthesia is______
a. Post spinal headache
b. Hypotension
c. Shivering
d. Meningitis
e. Tinnitus
90.Ankylosing spondylitis causes rigidity of the entire spinal column and may
present problems with;
a. Tracheal intubation
b. Laryngoscopy
c. Obstruction of local anesthetics
d. Spinal anesthesia
e. All of these
91.Sign and symptoms of hypertension include.
Page16
a. Increased ICP
b. Flushing face
c. Sweating
d. Tachycardia
e. All of these
92.Hypertensive crisis occur when systolic and diastolic pressure become
a. >180/ 110mmHg
b. >140/120mmHg
c. >160/100mmHg
d. >150/90mmHg
e. >190/110mmHg
93.Post spinal headache can be prevented by;
a. Use of thinner/small bore needle
b. Use of NSAID
c. Preanesthetic medication
d. Plenty of oral fluid
e. Use of opioids
94.Cauda equina syndrome is associated with _____
a. Epidural anesthesia
b. Spinal anesthesia
c. Caudal block
d. Bier block
e. None of these
95.Fasciculation due to suxamethonium is absent in which patient/disease?
a. Young male
b. Young female
c. Diabetic patients
d. Myasthenia gravis patients
e. Hypotensive patients
96.Sodium nitroprusside may cause;
a. Hypertension
b. Pulmonary edema
c. Cyanide toxicity
d. Heat block
e. Chest pain
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97.A five year-old pre-fit patient is presented for tonsillectomy. During
inhalational mask Induction, you are suddenly unable to ventilate the patient,
what will be the possible cause?
a. Laryngospasm
b. Bronchospasm
c. Pneumothorax
d. Atelectasis
e. Pulmonary edema
98.Urinary bladder distention may results in
a. Bradycardia
b. Tachycardia
c. Hypertension
d. B and C
e. A and C
99.Which of the following fluids is fluid of choice for resuscitation
a. 0.9% Nacl
b. 6% Nacl
c. 3% Nacl
d. 0.33% Nacl
e. Dextrose Water
100. Which of the following agent causes histamine release?
a. Atracurium
b. Pancronium
c. Cisatracurium
d. Vacuronium
e. Suxamethonium
101. Which of the following is not indicated for intubation with suxamethonium?
a. Full stomach patient
b. Pregnant patient
c. Diabetic patient
d. Patient with head injury
e. Patient with large abdominal mass
102. Correct placement of endotracheal tube is confirmed by
a. Chest Auscultation
b. Pulse Oximetry
c. End Tidal CO2
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d. Epigastric auscultation
e. Increased airway pressure
103. A 35 year old lady presented for elective cesarean section,15 minutes after
giving spinal anesthesia, she complained of difficulty in breathing and
numbness at hand, what might be the possible reason;
a. Drug toxicity
b. Anaphylaxis
c. High block
d. Fluid overloud
e. Low oxygen concentration
104. All of the following are the manifestations of high block except
a. Hypertension
b. Vasodilation
c. Hypotension
d. Bradycardia
e. Unconsciousness
105. Spinal anesthesia is contraindicated in all of the following except.
a. Platelets level below 150`000
b. Stenosis valve diseases
c. Infants
d. Hernia
e. Hypovolumia
106. Which of the following cause of hypoxemia does not respond to 100%
oxygen?
a. Diffusion
b. V/Q mismatch
c. Shunting
d. Hypoventilation
e. High altitude
107. Intraoperative hypotension is, MAP less than
a. 15% of baseline
b. 20% of baseline
c. 25% of baseline
d. 30% of baseline
e. 35% of baseline
108. Which of the following technique is not true regarding management of
intraoperative hypotension?
Page19
a. Large bore I/V line
b. Reduce volatile agent
c. Elevate head end and foot end down
d. Administer vasoconstrictors
e. Manual ventilation with 100% oxygen
109. The common contributor to anesthetic complication is
a. Human error
b. Equipment failure
c. Respiratory diseases
d. Congenital diseases
e. Airway devices
110. Management of laryngospasm, which of the following is incorrect?
a. Gentle suctioning
b. Apply manual ventilation with 100% o2
c. Apply CPAP
d. Apply PEEP
e. Jaw thrust maneuver
111. Which of the following cause of hypoxemia is not true?
a. Reduced partial pressure of oxygen in inspired air
b. Alveolar hypoventilation
c. Intrapulmonary shunt
d. Ventilation perfusion mismatch
e. All of these are true
112. A 25 years old female presented for inguinal hernia with general anesthesia
the pre-op BP 130 systole and 85 diastole with HEART RATE of 79 and NBM
from last 5hour and 10 min .in recovery phase of general anesthesia the patient
have paradoxical chest movement and crowing inspiratory noise. What should
be the dose of propofol to relief laryngospasm
a. 1.5 -2.5 mg/kg
b. 0.1 -0.2 mg/kg
c. 0.25 -0.8mg/kg
d. 20 -30 mcg/kg
e. 2.5 -3.5mg/kg
113. In young patient who had extensive soft tissue and muscle injury relaxant
which of these muscle relaxant used for the endotracheal intubation might lead
to cardiac arrest
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a. Atracurium
b. Vacuronium
c. Suxamethonium
d. Pancronium
e. Cisatracurium
114. In recovery a patient with the stridor and delirium having paradoxical chest
movement while patient didn’t resolve the laryngospasm with iv dose of
propofol at that time the iv cannula dislodge from vein .What should be the IM
dose of Suxamethonium ?
a. 0.1 -2 mg/kg
b. 2.0 -2.8mg/kg
c. 3.0 -4.0mg/kg
d. 0.1 -0.15mg/kg
e. 5.0 -6.0 mg/kg
115. To maintain the airway of a trauma patient by using which maneuver?
a. Jaw thrust method
b. Jaw thrust head tilt method
c. Head tilt chin lift method
d. Head tilt neck lift method
e. Sellick’s method
116. To increase oxygenation during IPPV all of the following are useful
EXCEPT;
a. Increase FiO2
b. Increase PEEP
c. Decrease I:E ratio
d. Increase peak inspiratory pressure
e. Alveolar recruitment
117. In bronchospasm a long expiratory phase prevent the development all of the
following except
a. High end-expiratory alveolar pressure
b. Hypotension
c. Alveolar Barotrauma
d. Thoraces Hyper-expansion
e. ARDs
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118. While recovering a patient having a complication of aspiration. To treat the
aspiration by trendelenburg position .this position produce the decrease in all of
the following except
a. Vital capacity
b. Functional residual capacity
c. Compliance
d. Respiratory rate
e. All are false
119. Intra-operative events that correlate with onset of suspected malignant
hyperthermia episode include:
a. Progressive mixed acidosis
b. Un explained tachycardia
c. Rise end-tidal PaCO2 fixed minute volume
d. Hypokalemia
e. Aspiration
120. Intra-operative hypothermia manifestation are of the following except:
a. Decrease cardiac output
b. Increased affinity of hemoglobin toward the oxygen
c. Metabolic alkalosis
d. Altered platelets and coagulation factor
e. Increase afterload
121. According to the Benumof’s parameter analysis what should be the
minimum acceptable valve for buckteeth is?
a. >5.0 cm
b. >6.0 cm
c. < 1.5 cm
d. >1.5 cm
e. >2.0 cm
122. Which of the following is not the cause of atelectasis?
a. Mucus plug
b. Pneumothorax
c. Foreign body
d. Positive end expiratory pressure
e. Chest trauma
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123. Air leakage into the space between lung and chest wall collapsing partial or
complete lung is called
a. Atelectasis
b. Pneumothorax
c. Aspiration pneumonia
d. Pulmonary air embolism
e. Anoxemia
124. Which of the following is not the cause of intraoperative hypertension?
a. Light anesthesia
b. Hypoxia
c. Elevated intra-abdominal pressure
d. Hypercapnia
e. Malignant hyperthermia
125. Which of the following is not true regarding prediction of difficult
placement of supraglottic devices
a. Restricted mouth opening
b. Obstruction of the upper airway
c. Disrupted upper airway as following trauma, burn, caustic ingestion
d. Stiff lung (poor lung or thoracic compliance)
e. All of the above are true
126. Following increases End-Tidal CO2 intra-operatively
a. 2 mg lignocaine per ml
b. 10 mg lignocaine per ml
c. 20 mg lignocaine per ml
d. 100 mg lignocaine per ml
e. 200 mg lignocaine per ml
127. Which of the following increases End-Tidal CO2 intra-operatively
a. Hyperventilation
b. Pulmonary embolism
c. Hypothermia
d. Rebreathing
e. Hypo metabolism
128. Early and reliable indication of air embolism during anaesthesia can be
obtain by continuous monitoring of
Page23
a. ECG
b. Blood pressure
c. End Tidal CO2
d. Oxygen saturation
129. Vomiting is NOT affected by:
a. Age
b. Weight
c. the choice of premedicant
d. intraoperative hypotension
e. the duration of anaesthesia
130. Hypertension with tachycardia can be treat with
a. beta blocker-diuretics vasodilators
b. ACE inhibitor, H2blocker, vasodilator
c. CCB, ACE inhibitor, diuretics
d. CCB with vasodilators
e. Alpha blocker, diuretic
131. All of the following are known side effects with the use of tocolytic therapy
except
a. Tachycardia
b. Hypotension
c. Hyperglycemia
d. Fever
132. Which of the following agents is not associated with Hyperthermia
a. Amphetamines
b. MAO inhibitors
c. Atropine
d. Alcohol
133. Prevention of laryngospasm include all of the following except.
a. Premedication with oral benzodiazepine
b. Anticholinergic
c. Lidocaine spry
d. 5% C02 inhalational for 5 minute before extubation.
e. Use of cholinergic
134. The incidence of laryngospasm occur during emergence.
A) 20%
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B) 25%
C) 35%
D) 80%
E) 48%
135. Risk factors for laryngospasm include all of the following except
A) Insufficient depth of anesthesia
B) GERD
C) Ketamine
D) Airway anomaly
E) Propofol
136. Sign and symptoms of bronchospasm include all of the following except.
A) Self-induced PEEP
B) Gradually increase cyanosis
C) Gradually decrease ETCO2
D) Hypotension with bradycardia
E) Rapidly increase cyanosis
137. Drug use for management of bronchospasm as.
A) steroid
B) Antihistamine
C) Bronchodilators
D) Both A and C
E) all of the above
138. Which of the following drug is not recommended in children to treat
bronchospasm
A) Hydrocortisone
B) Salbutamol
C) Avil
D) Aminophylline
E) None of these
139. Hypoxemia is a condition in which partial pressure of O2 become.
A) Below 60 mmHg
B) Below 70 mmHg
C) Below 80 mmHg
D) Below 40 mmHg
E) Below 35 mmHg
Page25
140. Normal partial pressure of O2 in arterial side is.
A) 70 mmHg
B) Above 60 mmHg
C) Above 50 mmHg
D) Above 80 mmHg
E) Above 85mmHg
141. Causes of hypoxemia includes.
A) Decrease IE ratio
B) Plural effusion
C) Pulmonary edema
D) Endobronchial intubation
E) all of the above
142. Loss of pharyngeal reflex is more with which anesthetic
A) Isoflurane
B) Ketamine
C) N2O/O2
D) Thiopental
E) Narcotic
143. Hypotension in anesthesia is induced all of the following drugs EXCEPT
A) Halothane
B) Propofol
C) Pancronium
D) Suxamethonium
E) Sodium Nitroprusside
144. Anesthetic agent that predisposes to maximum arrhythmias
A) Isoflurane
B) Enflurane
C) Halothane
D) Desflurane
E) None of these
145. Which of the following is in incorrect statement about blind intubation
A) Can be done awake
B) May be done with inhalational anaesthesia
Page26
C) Always use muscle relaxant
D) Preferably done by nasal route
146. All of the following are benefits of oral intubation over nasal intubation
except.
A) Better oral hygiene
B) Less bleeding
C) Less incidence of sinusitis
D) Easy tube placement
147. In the immediate post-operative period the common cause of respiratory
insufficiency could be because of the following except
a. Residual effect of muscle relaxant
b. Overdose of narcotic analgesic
c. Mild hypovolemia
d. Myocardial infarction
148. Muscle relaxant in hepatic and renal failure.
a. atracurium
b. Suxamethonium
c. Tubocurarine
d. Vacuronium
149. Disadvantages of endotracheal intubation includes all of the
following, EXCEPT
a. Loss of the protective function of the upper airway
b. Loss of phonation
c. Decreased airway resistance
d. Damage to the subglottic area
e. Need for sedation and or analgesia
150. Preoperative causes of tachycardia include
A) Anxiety
B) Tension
C) Fear
D) Pyrexia
E) all of the above
151. the most frequent causes of cardiogenic pulmonary edema.
A) ARDS
B) Inhalational toxic gases
C) Over hydration
D) Congestive heart failure
E) VSD
152. If the blood pressure is high, after the initial treatment you should administer
Page27
A) Ionotropic
B) Saline water
C) Nitroglycerine I/V
D) Beta blocker
E) Calcium channel blocker
153. which of the following inhalational agent is contra indicated in a patient with
history of epilepsy
A) Isoflurane
B) Enflurane
C) Halothane
D) Sevoflurane
E) Desflurane
154. At the end of anesthesia after discontinuation of nitrous oxide in removal
EET, 100% oxygen is administered to patient, to prevent
A) Diffusion hypoxia
B) Second gas effect
C) Hyperoxia
D) Bronchospasm
E) Laryngospasm
155. All of the following factor decrease MAC value of inhalational anesthetic
agent EXCEPT
A) Hypothermia
B) Hyponatremia
C) Anemia
D) Hypocalcemia
E) Hypercalcemia
156. The laryngeal mask airway used for securing airway of patient in all of the
following except
A) In difficult intubation
B) In cardiopulmonary resuscitation
C) In a child undergoing in elective eye surgery
D) In a patient with large tumor in the oral cavity
E) Bronchospasm
157. Manual pressure at the cricoid cartilage is used to prevent
A) Laryngospasm
Page28
B) Regurgitation of gastric content
C) Vocal cord trauma
D) Vomiting
E) Esophageal intubation
158. An adult breathing 100% oxygen at sea level may suffer from.
A) Pneumothorax
B) Atelectasis
C) Confusion
D) Asthma
E) COPD
159. What can cause a close pneumothorax?
A) Gun shot
B) Blunt trauma
C) Thoracocentasis
D) Bite wound
E) None of these
160. All of the following features occur during pneumothorax except
A) Pneumothorax lead to V/Q mismatch
B) Hypoxemia
C) Pulse will increase
D) Inspiratory wheeze
E) Ischemia
161. In all respiratory complication the main indicated sign is
A) Tachycardia
B) Bradycardia
C) Hypotension
D) Hypertension
E) None of these
162. Following are the causes of bradycardia except.
A) Opioids
B) Propofol
C) Neostigmine
D) Succinylcholine
E) Atropine
163. Intraoperative complication of hypertension include
Page29
A) Renal failure
B) Intracranial hemorrhage
C) Pulmonary edema
D) Aortic dissection
E) all of the above
164. Management of difficult intubation include all of the following except.
A) Retrograde intubation
B) Fibroptic intubation
C) Awake nasal intubation
D) Blind nasal intubation
165. In malignant hyperthermia the increase heat production is due to
A) Thermic effect of blood
B) Increase sympathetic discharge
C) Increase muscle metabolism by excess of calcium ions.
D) Mitochondrial thermogenesis
166. A 30 year old patient presented for laparotomy and his HB is 9 then
anesthetist agree with the doctor to continue the operation
A) Yes, in case of emergency surgery
B) No, in case of elective surgery
C) Both are correct
D) Only A
E) None of these
167. Which of the following causes of Arrhythmias during Anesthesia
A) Hypoxemia
B) Hypotension
C) Myocardial ischemia
D) Hypercapnia
E) All are correct
168. All are the following causes of Hypovolumia and fluid loss except
a. Trauma
b. Diarrhea
c. Sweating
d. Major blood vessel rapture
e. Urine out put
169. Which of the following not the causes of Hypotension during Anesthesia.
a. Head up position
Page30
b. Raised intrathoracic pressure
c. Hypercapnia.
d. Hypovolumia
e. obstruction
170. Which of the following drug over dose which cause hypertension during
Anesthesia
a. propofol
b. tramadol
c. Nalbupin
d. Dubatamine
e. All are false
171. Following indication show Respiratory obstruction occur during anesthesia
except
a. Oropharynx
b. Tracheal tube
c. Larynx
d. Pneumonia
e. bronchi
172. The most effective steps in preventing harm from complication
are………….except.
a. Preoperative assessment of the patient.
b. Preoperative assessment of the equipment
c. Without the use of monitoring
d. The availability of trained assistant
e. Preoperative consultation
173. If the patient is not cyanosed and ventilation appears to continue
uninterrupted then which of the following monitoring should be mostly check
a. ECG electrodes
b. Capnograph
c. Nerve stimulator
d. Only ECG and pulse oximeter
e. Pulse oximeter
174. Inadequate ventilation may be cause by
a. Poorly managed tracheal intubation
b. Pulmonary aspiration of gastric content
c. Breathing system disconnection
d. Gas supply failure.
e. All of the above
Page31
175. Which one are not the causes of complication
a. Human error
b. Equipment failure
c. inevitable complication
d. without consent
e. coexisting disease
176. In the absence of laryngeal mask airway or tracheal tube, apposition of the
tongue and pharyngeal soft tissue is a common cause of
a. Upper airway obstruction
b. Middle airway obstruction
c. Lowe airway obstruction
d. Nasal obstruction
e. Oropharyngeal obstruction
177. All the following characteristic concern to surgical except
a. Blood loss, urgency surgery
b. Degree of cancer spread, operative severity
c. ECG abnormalities
d. Peritoneal soiling
e. Mallampati classification
178. The Mallampati test is widely used and simple classification of the
………….view obtained during maximal mouth opening and tongue protrusion.
a. Laryngeal
b. Pharyngeal
c. Nasopharyngeal
d. Nasal
e. Uvula
179. If intubation is unsuccessful, no further doses of ………………… blocking
drug should be used.
A. Muscle relaxant
B. neuromuscular
C. Both A and B
D. Benzodiazepine
E. Propofol
180. The injection of 3 to 5ml of 2% of lidocaine through the cricothyroid
membrane induces coughing and anesthetizes the tracheal and laryngeal mucosa
for
A. awake intubation
Page32
B. failed intubation
C. difficult intubation
D. airway obstruction
E. All of these
181. Carbon dioxide production increases during …………….
A. pyrexia
B. malignant Hyperthermia
C. shivering
D. Hypoxia
E. All are correct
182. All are the following concern in which pneumothorax may develop
spontaneously except
A. Asthma
B. COPD
C. bronchitis
D. congenital l cystic pulmonary disease
E. Marian’s Syndrome
183. Surgical manipulation such as traction on the Eye, cervical, or anal dilatation
and peritoneal traction may increase vagal tone producing
a. tachycardia
b. bradycardia
c. tachyarrhythmia
d. Brady arrhythmia
e. All is correct.
184. Sympathetic nervous system activity is increased by all of the following
except
A. Hypoxemia
B. Hypercapnia
C. inadequate analgesia
D. inadequate opioids
E. Hypovolumia
185. Tran esophageal echocardiography and Precordial Doppler ultrasound are
the most sensitive monitors for
A. gas embolus
B. thromboembolus
Page33
C. myocardial ischemia
D. Hemorrhage
E. pneumothorax
186. Which one is not the sign of Awareness in a paralyzed patient arise from
activation of the sympathetic nervous system during anesthesia
A. sweating
B. tachycardia
C. Hypertension
D. Tear formation
E. Hypothermia

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Anesthesia complications mcqs by israr ysfz

  • 1. Israr Hussain Yousafzai ANESTHESIA KMU PESHAWAR, PAKISTAN ANESTHESIA COMPLICATIONS MCQ’S
  • 2. Page1 1. In the mnemonic ‘LEMON’ assessment, ‘E’ stands for. a. Elder patient b. Evaluate 3, 3 ,2 rule c. Emergency patient d. Evaluate 9, 6, 3 rule. 2. A 35 years old man whom distance between mentum and hyoid bone is 4.5 cm. to which grade this patient you will classify. a. Grade I b. Grade II c. Grade III d. Grade IV 3. 40 years old women were asked to extend her head. The Atlanto occipital angle are measured which was 17 degree.in which grade you will classify this patient. a. Grades I b. Grade II c. Grade III d. Grade IV 4. In which of the following patient difficult intubation should not predictable a. protruding of teeth b. osteomyelitis c. mouth opening<3cm d. micrognatia 5. According to Mallampati classification which of the following patient should place in class III. a. nothing appears b. uvula, plates, and tongue appear c. tongue and plates appear d. none 6. Which of the following are indicators for a potentially difficult airway? a. Cervical spinal injury b. TMJ problem c. BMI>30 d. All of the above 7. Which of the following relates with the evaluation of thyromental distance a. Benumof’s analysis
  • 3. Page2 b. Saghei and safavi test c. Lemon assessment d. Patil’s test 8. The blood brain barrier is not readily crossed by a. Oxygen b. Potassium c. Water d. Carbon dioxide e. Bicarbonate 9. A 25 year old come to emergency of RTA .after perform the RSI the oxygen saturation decrease until hypoxemia develop what causes can be expected: a. decrease IE ratio b. plural effusion c. pulmonary edema d. endobronchial intubation e. all of the above 10. Which of the following is not an indication for endotracheal intubation? a. Maintenance of a patent airway b. To provide positive pressure ventilation c. Pulmonary toilet d. Pneumothorax 11.The following are recognized strategies in the prevention of ventilator- associated pneumonia (VAP): except a. Daily sedation holds. b. Head-up positioning of 30 to 45°. c. Prone positioning. d. Chlorhexidine mouth care. 12. Effective methods to decrease an elevated PaCO2 may include all of the following EXCEPT: a. Increase tidal volume b. Increase frequency c. Decrease circuit dead space d. Increase PEEP e. Increase inspiratory pressure
  • 4. Page3 13.All of the following feature of acromegaly lead to difficulty in intubation EXCEPT a. Increased interdental space b. Macroglossia c. Prognathism d. beetle brow e. buccal teeth 14.Which of the following does not represent a significant anesthetic problem in the morbidly obese patient a. Difficulty in the endotracheal intubation b. Increase metabolism volatile agent c. Decrease cardiac output relative to total body mass d. Suboptimal arterial oxygen tension e. None of these 15.When a patient developed supraventricular tachycardia with hypotension under general anesthesia all of the following treatments may be instituted except? a. Carotid sinus massage b. Adenosine 3-12 mg IV c. Direct current cardio version d. Verapamil 5mg IV e. Both A and B 16.Most anesthetist choose to set the arterial oxygen saturation alarm limit on the pulse oximeter at a. 94 - 96 % b. 92 -94 % c. 90 -92 % d. only 84% 17.In sever hypoxemia which one of the following is common in children as a. Tachycardia b. hypertension c. bradycardia d. arrhythmia 18.When the arterial desaturation progresses which of the following can cause cardiac arrest usually in a systole a. Tachycardia and hypotension b. bradycardia hypotension
  • 5. Page4 c. hypoventilation and hypertension d. hyperventilation and hypotension 19.The pulmonary shunting and atelectasis which can occur during anesthesia are much more likely to cause a. Hypoventilation b. hypoxia c. hypoxemia d. Hypocapnea 20.All are seen in Malignant hyperthermia except : a. Bradycardia b. Hyperkalemia c. Metabolic acidosis d. Hypertension 21.Which of the following anesthetic agents does not trigger malignant hyperthermia? a. Halothane b. Isoflurane c. Suxamethonium d. Thiopentone 22.Most clearly associated with MH is a. Central core temperature b. Bilateral strabismus c. Myotonia congenita d. Down syndrome 23.In MH the increase heat production due to the? a. Thermal effect of blood b. Increase sympathetic discharge c. Increase muscle metabolism by excess calcium ions d. Mitochondrial thermogenesis 24.MH trigger should be avoided in patient with each of the following except a. Central core diseases b. Carnitine palmityl transferase deficiency c. Neuroleptic malignant syndrome d. Marked masseter muscle rigidity
  • 6. Page5 25.Three-year-old boy with no other medical problem is schedules for elective inguinal hernia repair. Birth weight 3.7 kg first talked 13 months .first walked 17 months. NPO since midnight .negative family history .safe induction for anesthesia in this case should be: a. A major inhalational plus N2O b. Intravenous agent only c. Avoiding the inhalational plus succinylcholine d. Postponing the case until neuron evaluation is done 26.Incomplete jaw relaxation after inhalation agent use (halothane) plus succinylcholine administration in children most like: a. A harbinger of malignant hyperthermia b. Due to overdose of succinylcholine c. Found only in atypical pseudo-cholinesterase d. A normal response 27.Which of the following are useful in the treatment of malignant hyperpyrexia? a. 100% 02 b. Ringer lactate c. Sodium dantroline d. Dextrose e. Sodium bicarbonate 28.The 45 year old male patient presenting for bowel obstruction NPO time 8 having sign and symptoms of nausea vomiting colic pain .but he is susceptible for the MH what tests should be done screening test of MH except: a. Genetic test b. CHCT (caffeine halothane contracture test) c. Muscle biopsy d. CMP comprehensive metabolic panel 29.What should be the duration of Post-operative monitoring for Temperature and ECG in MH patient: a. 1-2 hours b. 4-5 hours c. 3-4 hours d. 6-11 hour e. >15 hours 30.The normal range of mean arterial pressure varies in between.
  • 7. Page6 a. 60-120mm Hg b. 70-110mm Hg c. 60-160mm Hg d. 70-150mm Hg 31. ………….. Is a good choice for a patient with a good ventricular function and elevated heart rate? a. Beta adrenergic blocked b. Calcium channel blocker c. Vasodilators d. Central alpha 2 agonist 32.A 40 years old man having a history of Broncho septic disease and his preoperative blood pressure was 120/80 mm Hg. During procedure his BP elevated to 155/90, mmHg .which of the drug is the choice of agent for reduction of BP in this patient. a. Nicardipene b. Esmolol c. Metoprolol d. Nitroprusside 33.Intraoperative hypertension if it is > -------- percentage of the preoperative value. a. 15 b. 25 c. 35 d. 50 34.All of the following may cause intraoperative hypertension except. a. Pregnancy b. Hypocapnea c. Inadequate analgesia d. Aortic cross clamp 35.According to COMARCK –LEHANE grading if only if “ only epiglottis is visualized” so this will be : a. Grade I b. Grade II c. Grade III d. Grade IV
  • 8. Page7 36.The decrease in one centigrade temperature effect on BMR basal metabolic ratio up to a. 2-4% b. 3-6% c. 7-10% d. 15-20 37.ASA classification is based on ___ a. Physical status b. Drug interaction c. Antibiotic selection d. Difficult intubation class 38.Which of the following groups constitute high-risk patients? a. Elderly b. Significant co-morbidities c. Emergency surgery d. Complex major surgeries e. All of the above 39.In ASA classification brain dead organ donor address to ___ category. a. P6 b. P5 c. P1 d. E 40.The intraoperative and postoperative factors for the identification of high risk patients include: a. Inability to increase oxygen delivery after surgery b. Reduced central or mixed oxygen saturation c. Reduced gastric mucosal PH indicating gut microcirculation d. All of the above 41.The Trans and postoperative period collection is done in a. ASA classification b. New York heart classification c. Glasgow coma scale d. Surgical variables in possum score 42.ASA classification consists of ___ categories. a. 6 b. 8 c. 7
  • 9. Page8 d. 10 43.Following belong to physiological variables of possum score except : a. Age 5 serum potassium concentration , white cell count b. Glasgow coma scale , hemoglobin count c. Serum potassium , urea , sodium concentration d. Peritoneal soiling , urgency surgery 44.Which of the following is not preventable factor of mortality in high-risk patients? a. Pain b. Insufficient pain monitoring c. Advanced age d. Inadequate critical care facilities 45.The physiological variables in possum score are collected in a. Trans operative period b. Postoperative period c. Late operative period d. Preoperative period 46.In 1940, ___ is established to collect and tabulate statistical data that would be used to predict operative risk. a. Possum score b. Glasgow coma scale c. ASA classification 47.Which of the following statements are true about specific management therapies of high-risk patients? a. Prophylactic beta receptor antagonist agents have been used to decrease perioperative myocardial infarction b. Esophageal Doppler guided fluid therapy is an accurate estimation of the patients fluid needs. c. Sustained use of goal directed therapy in patients with established critical illness is beneficial. d. Both A & B 48.The physiological part of possum score includes ___ variables divided into four variables. a. Eleven b. Six c. Fourteen d. Twelve
  • 10. Page9 49.In ASA, classification patients with severe systemic disease that is a constant threat to life have ____. a. Some functional limitation b. Emergency procedure c. No functional limitation d. Functional incapacitation 50.Regarding preoperative management of high-risk patient, which of the following statements are true? a. Perioperative physiotherapy has no role b. Stopping smoking prior to surgery is of little benefit c. A course of steroids prior to surgery may be necessary in patients with chronic obstructive airway disease d. None of the above 51.Possum stands for a. The physiological and operative severity score for the enumeration of mortality and morbidity b. The psychological and operative severity score for the enumeration of mortality and morbidity c. The physiological and operative surgical score for the enumeration of mortality and morbidity d. None 52.Following belong to surgical variables except a. Blood loss, urgency surgery b. Degree of cancer spread, operative severity c. Systolic BP, heart rates , ECG abnormalities d. Peritoneal soiling e. Mallampati classification 53.In ASA classification of physical status E stands for a. Emaciated patients b. Electric burn patient c. Electrolyte disturbance d. Emergency surgery 54.Thyromental distance is used to predict_____. a. Difficult extubation b. Airway obstruction c. Both A&b d. Difficult intubation
  • 11. Page10 55. The following feature may be predictive of a difficult intubation______. A) Increased atlantoccipital distance B) Decreased posterior mandibular depth C) Mallampati grade3 D) A thyromental distance less than 6cm 56. Upper parts of facial pillars and most of uvula is visible _____. A) Grade 1 B) Grade 2 C) Grade 3 D) Grade 4 57. Mouth opening and incisor distance of greater than ------- is desirable in an adult. A) 5cm B) 6 cm C) 8 cm D) 3 cm 58. Nasopharyngeal airway is contraindicated during CPR. A) chest B) Anticoagulant patient C) Liver D) None of above 59.Most common cause of airway obstruction in unconscious patient is_____? A) Tongue fall B) Foreign body C) Lax posterior wall, pharyngeal wall D) Lax epiglottis occluding the vocal cord 60. According to Mallampati grading, grade 1 represent A) Hard palate B) Soft palate C) Soft palate, hard palate, uvula, tonsillar pillars D) Soft palate, hard palate, base of uvula 61. in severely injured patient the first thing to do that. A) Maintenance of airway B) Start IV line C) Vasopressor drug
  • 12. Page11 D) Blood transfusion 62. Which of the following is not considering predictors of difficult intubation in pre-anesthetic examination? A) Mallampati classification B) Thyromental distance C) TMJ D) Cormack-lehane grade 63. The anterior spinal artery syndrome is characterizes by a (n) a. Insidious onset b. Flaccid motor paralysis c. Abnormal CSF glucose and protein d. Normal myelogram e. Both B & D are correct 64.During deep hypothermia, the brain temperature is measured most accurately in a. Skin b. Esophagus c. Rectum d. Middle ear e. Nasopharynx 65.Stereospecific opiate binding sites have been identified in all of the following EXCEPT a. Kidney b. Carotid chemoreceptors c. Pulmonary J receptors d. Heart e. Smooth muscle 66.Cerebral metabolic rate and cerebral blood flow are NOT reduced by a. Ketamine b. Morphine c. Thiopental d. Diazepam e. Halothane 67.Which of the following physiologic changes occurs in the geriatric patient? a. Decreased lung compliance b. Decreased chest wall compliance c. Decreased residual volume d. Decreased closing volume
  • 13. Page12 68.The commonest site for obstruction are the a. larynx b. tracheal tube c. bronchi d. All 69.Inadequate ventilation and impaired gas exchange cause a. Hypercapnia b. Hypoxemia c. Hypocapnea d. Both a, b 70.Which of the following is indicated by the partial obstruction of respiratory system a. Noisy breathing b. stridor c. silent d. Both a, b e. both b, c 71.Complete obstruction is a. silent b. Stridor c. Both d. Noisy 72.A patient whose lungs are mechanically ventilated respiratory obstruction May Be associated with a. Increased inflation pressure b. Hypercapnia c. Prolonged expiratory phase d. All e. None of them 73.Which of the following can cause prolong closure of vocal cord reflex a. Bronchospasm b. laryngospasm c. Trachospasm d. all of the above
  • 14. Page13 74.Laryngospasm is mostly common during a. Induction b. emergence c. Extubation d. Both a, b e. All 75.Inadequate partial pressure of oxygen in arterial blood is called a. Hypoxia b. Hypoxemia c. Hypocapnea d. All 76.Due to persistent deficiency of oxygen supply to the body which organ may damage first a. Heat and lungs b. Brain and liver c. Brain and heart d. Liver and lungs 77.The risk presented by a level of hypoxemia is dependent upon the patient a. Hemoglobin conic b. Cardiac output c. State of concurrent disease d. All of above e. None of them 78.Which of the following is the indication of complete laryngospasm? a. Stridor b. Absence of breath sounds c. Suprasternal retraction d. Use of accessory muscles e. Paradoxical chest movement 79.Laryngospasm is mostly common during a. Induction/emergence b. Maintenance c. Extubation d. After intubation e. In all these situations
  • 15. Page14 80.Organs which are damaged most rapidly by deficiency in o2 supply include the_______ a. Heart and lungs b. Brain and liver c. Brain and heart d. Liver and lungs e. Liver and lungs 81.The risk presented by a level of hypoxemia is dependent upon the patient a. Hemoglobin concentration b. Cardiac output c. State of concurrent disease d. a ,b and c e. none of them 82.The pulmonary shunting and atelectasis which can occur during anesthesia are much more likely to cause a. Hypoventilation b. Hypoxia c. Hypoxemia d. Hypocapnea e. a and b 83.Which of the following anesthetic agents does not trigger malignant hyperthermia? a. Halothane b. Isoflurane c. Suxamethonium d. Propofol e. Sevoflurane 84.In severely injured/unconscious patient, the first line of treatment should be______ a. History of the patient b. Pass large bore IV line c. Maintenance of airway d. Vasopressor drug e. Hemodynamic stability 85.Which of the following is not related to light plane of anesthesia? a. Sweating
  • 16. Page15 b. Tachycardia c. Hypertension d. Hypothermia e. Tear formation 86.Regarding difficult laryngoscopy/intubation, the minimal acceptable thyromental distance is a. 8.5 cm b. 9.5 cm c. 11.5 cm d. 12.5 cm e. 14.5 cm 87.Which of the following is not related to physiological cause of hypoxemia; a. High altitude b. Diffusion c. Hyperventilation d. Shunting e. V/Q mismatch 88.Epidural space is the potential space between the ___________ a. Dura mater and ligamentum flavum b. Ligamentum flavum and intraspinous ligament c. supraspinatus ligament and intraspinous d. Dura mater and arachnoid mater e. Dura mater and post longitudinal ligament 89.The most common complication of spinal anesthesia is______ a. Post spinal headache b. Hypotension c. Shivering d. Meningitis e. Tinnitus 90.Ankylosing spondylitis causes rigidity of the entire spinal column and may present problems with; a. Tracheal intubation b. Laryngoscopy c. Obstruction of local anesthetics d. Spinal anesthesia e. All of these 91.Sign and symptoms of hypertension include.
  • 17. Page16 a. Increased ICP b. Flushing face c. Sweating d. Tachycardia e. All of these 92.Hypertensive crisis occur when systolic and diastolic pressure become a. >180/ 110mmHg b. >140/120mmHg c. >160/100mmHg d. >150/90mmHg e. >190/110mmHg 93.Post spinal headache can be prevented by; a. Use of thinner/small bore needle b. Use of NSAID c. Preanesthetic medication d. Plenty of oral fluid e. Use of opioids 94.Cauda equina syndrome is associated with _____ a. Epidural anesthesia b. Spinal anesthesia c. Caudal block d. Bier block e. None of these 95.Fasciculation due to suxamethonium is absent in which patient/disease? a. Young male b. Young female c. Diabetic patients d. Myasthenia gravis patients e. Hypotensive patients 96.Sodium nitroprusside may cause; a. Hypertension b. Pulmonary edema c. Cyanide toxicity d. Heat block e. Chest pain
  • 18. Page17 97.A five year-old pre-fit patient is presented for tonsillectomy. During inhalational mask Induction, you are suddenly unable to ventilate the patient, what will be the possible cause? a. Laryngospasm b. Bronchospasm c. Pneumothorax d. Atelectasis e. Pulmonary edema 98.Urinary bladder distention may results in a. Bradycardia b. Tachycardia c. Hypertension d. B and C e. A and C 99.Which of the following fluids is fluid of choice for resuscitation a. 0.9% Nacl b. 6% Nacl c. 3% Nacl d. 0.33% Nacl e. Dextrose Water 100. Which of the following agent causes histamine release? a. Atracurium b. Pancronium c. Cisatracurium d. Vacuronium e. Suxamethonium 101. Which of the following is not indicated for intubation with suxamethonium? a. Full stomach patient b. Pregnant patient c. Diabetic patient d. Patient with head injury e. Patient with large abdominal mass 102. Correct placement of endotracheal tube is confirmed by a. Chest Auscultation b. Pulse Oximetry c. End Tidal CO2
  • 19. Page18 d. Epigastric auscultation e. Increased airway pressure 103. A 35 year old lady presented for elective cesarean section,15 minutes after giving spinal anesthesia, she complained of difficulty in breathing and numbness at hand, what might be the possible reason; a. Drug toxicity b. Anaphylaxis c. High block d. Fluid overloud e. Low oxygen concentration 104. All of the following are the manifestations of high block except a. Hypertension b. Vasodilation c. Hypotension d. Bradycardia e. Unconsciousness 105. Spinal anesthesia is contraindicated in all of the following except. a. Platelets level below 150`000 b. Stenosis valve diseases c. Infants d. Hernia e. Hypovolumia 106. Which of the following cause of hypoxemia does not respond to 100% oxygen? a. Diffusion b. V/Q mismatch c. Shunting d. Hypoventilation e. High altitude 107. Intraoperative hypotension is, MAP less than a. 15% of baseline b. 20% of baseline c. 25% of baseline d. 30% of baseline e. 35% of baseline 108. Which of the following technique is not true regarding management of intraoperative hypotension?
  • 20. Page19 a. Large bore I/V line b. Reduce volatile agent c. Elevate head end and foot end down d. Administer vasoconstrictors e. Manual ventilation with 100% oxygen 109. The common contributor to anesthetic complication is a. Human error b. Equipment failure c. Respiratory diseases d. Congenital diseases e. Airway devices 110. Management of laryngospasm, which of the following is incorrect? a. Gentle suctioning b. Apply manual ventilation with 100% o2 c. Apply CPAP d. Apply PEEP e. Jaw thrust maneuver 111. Which of the following cause of hypoxemia is not true? a. Reduced partial pressure of oxygen in inspired air b. Alveolar hypoventilation c. Intrapulmonary shunt d. Ventilation perfusion mismatch e. All of these are true 112. A 25 years old female presented for inguinal hernia with general anesthesia the pre-op BP 130 systole and 85 diastole with HEART RATE of 79 and NBM from last 5hour and 10 min .in recovery phase of general anesthesia the patient have paradoxical chest movement and crowing inspiratory noise. What should be the dose of propofol to relief laryngospasm a. 1.5 -2.5 mg/kg b. 0.1 -0.2 mg/kg c. 0.25 -0.8mg/kg d. 20 -30 mcg/kg e. 2.5 -3.5mg/kg 113. In young patient who had extensive soft tissue and muscle injury relaxant which of these muscle relaxant used for the endotracheal intubation might lead to cardiac arrest
  • 21. Page20 a. Atracurium b. Vacuronium c. Suxamethonium d. Pancronium e. Cisatracurium 114. In recovery a patient with the stridor and delirium having paradoxical chest movement while patient didn’t resolve the laryngospasm with iv dose of propofol at that time the iv cannula dislodge from vein .What should be the IM dose of Suxamethonium ? a. 0.1 -2 mg/kg b. 2.0 -2.8mg/kg c. 3.0 -4.0mg/kg d. 0.1 -0.15mg/kg e. 5.0 -6.0 mg/kg 115. To maintain the airway of a trauma patient by using which maneuver? a. Jaw thrust method b. Jaw thrust head tilt method c. Head tilt chin lift method d. Head tilt neck lift method e. Sellick’s method 116. To increase oxygenation during IPPV all of the following are useful EXCEPT; a. Increase FiO2 b. Increase PEEP c. Decrease I:E ratio d. Increase peak inspiratory pressure e. Alveolar recruitment 117. In bronchospasm a long expiratory phase prevent the development all of the following except a. High end-expiratory alveolar pressure b. Hypotension c. Alveolar Barotrauma d. Thoraces Hyper-expansion e. ARDs
  • 22. Page21 118. While recovering a patient having a complication of aspiration. To treat the aspiration by trendelenburg position .this position produce the decrease in all of the following except a. Vital capacity b. Functional residual capacity c. Compliance d. Respiratory rate e. All are false 119. Intra-operative events that correlate with onset of suspected malignant hyperthermia episode include: a. Progressive mixed acidosis b. Un explained tachycardia c. Rise end-tidal PaCO2 fixed minute volume d. Hypokalemia e. Aspiration 120. Intra-operative hypothermia manifestation are of the following except: a. Decrease cardiac output b. Increased affinity of hemoglobin toward the oxygen c. Metabolic alkalosis d. Altered platelets and coagulation factor e. Increase afterload 121. According to the Benumof’s parameter analysis what should be the minimum acceptable valve for buckteeth is? a. >5.0 cm b. >6.0 cm c. < 1.5 cm d. >1.5 cm e. >2.0 cm 122. Which of the following is not the cause of atelectasis? a. Mucus plug b. Pneumothorax c. Foreign body d. Positive end expiratory pressure e. Chest trauma
  • 23. Page22 123. Air leakage into the space between lung and chest wall collapsing partial or complete lung is called a. Atelectasis b. Pneumothorax c. Aspiration pneumonia d. Pulmonary air embolism e. Anoxemia 124. Which of the following is not the cause of intraoperative hypertension? a. Light anesthesia b. Hypoxia c. Elevated intra-abdominal pressure d. Hypercapnia e. Malignant hyperthermia 125. Which of the following is not true regarding prediction of difficult placement of supraglottic devices a. Restricted mouth opening b. Obstruction of the upper airway c. Disrupted upper airway as following trauma, burn, caustic ingestion d. Stiff lung (poor lung or thoracic compliance) e. All of the above are true 126. Following increases End-Tidal CO2 intra-operatively a. 2 mg lignocaine per ml b. 10 mg lignocaine per ml c. 20 mg lignocaine per ml d. 100 mg lignocaine per ml e. 200 mg lignocaine per ml 127. Which of the following increases End-Tidal CO2 intra-operatively a. Hyperventilation b. Pulmonary embolism c. Hypothermia d. Rebreathing e. Hypo metabolism 128. Early and reliable indication of air embolism during anaesthesia can be obtain by continuous monitoring of
  • 24. Page23 a. ECG b. Blood pressure c. End Tidal CO2 d. Oxygen saturation 129. Vomiting is NOT affected by: a. Age b. Weight c. the choice of premedicant d. intraoperative hypotension e. the duration of anaesthesia 130. Hypertension with tachycardia can be treat with a. beta blocker-diuretics vasodilators b. ACE inhibitor, H2blocker, vasodilator c. CCB, ACE inhibitor, diuretics d. CCB with vasodilators e. Alpha blocker, diuretic 131. All of the following are known side effects with the use of tocolytic therapy except a. Tachycardia b. Hypotension c. Hyperglycemia d. Fever 132. Which of the following agents is not associated with Hyperthermia a. Amphetamines b. MAO inhibitors c. Atropine d. Alcohol 133. Prevention of laryngospasm include all of the following except. a. Premedication with oral benzodiazepine b. Anticholinergic c. Lidocaine spry d. 5% C02 inhalational for 5 minute before extubation. e. Use of cholinergic 134. The incidence of laryngospasm occur during emergence. A) 20%
  • 25. Page24 B) 25% C) 35% D) 80% E) 48% 135. Risk factors for laryngospasm include all of the following except A) Insufficient depth of anesthesia B) GERD C) Ketamine D) Airway anomaly E) Propofol 136. Sign and symptoms of bronchospasm include all of the following except. A) Self-induced PEEP B) Gradually increase cyanosis C) Gradually decrease ETCO2 D) Hypotension with bradycardia E) Rapidly increase cyanosis 137. Drug use for management of bronchospasm as. A) steroid B) Antihistamine C) Bronchodilators D) Both A and C E) all of the above 138. Which of the following drug is not recommended in children to treat bronchospasm A) Hydrocortisone B) Salbutamol C) Avil D) Aminophylline E) None of these 139. Hypoxemia is a condition in which partial pressure of O2 become. A) Below 60 mmHg B) Below 70 mmHg C) Below 80 mmHg D) Below 40 mmHg E) Below 35 mmHg
  • 26. Page25 140. Normal partial pressure of O2 in arterial side is. A) 70 mmHg B) Above 60 mmHg C) Above 50 mmHg D) Above 80 mmHg E) Above 85mmHg 141. Causes of hypoxemia includes. A) Decrease IE ratio B) Plural effusion C) Pulmonary edema D) Endobronchial intubation E) all of the above 142. Loss of pharyngeal reflex is more with which anesthetic A) Isoflurane B) Ketamine C) N2O/O2 D) Thiopental E) Narcotic 143. Hypotension in anesthesia is induced all of the following drugs EXCEPT A) Halothane B) Propofol C) Pancronium D) Suxamethonium E) Sodium Nitroprusside 144. Anesthetic agent that predisposes to maximum arrhythmias A) Isoflurane B) Enflurane C) Halothane D) Desflurane E) None of these 145. Which of the following is in incorrect statement about blind intubation A) Can be done awake B) May be done with inhalational anaesthesia
  • 27. Page26 C) Always use muscle relaxant D) Preferably done by nasal route 146. All of the following are benefits of oral intubation over nasal intubation except. A) Better oral hygiene B) Less bleeding C) Less incidence of sinusitis D) Easy tube placement 147. In the immediate post-operative period the common cause of respiratory insufficiency could be because of the following except a. Residual effect of muscle relaxant b. Overdose of narcotic analgesic c. Mild hypovolemia d. Myocardial infarction 148. Muscle relaxant in hepatic and renal failure. a. atracurium b. Suxamethonium c. Tubocurarine d. Vacuronium 149. Disadvantages of endotracheal intubation includes all of the following, EXCEPT a. Loss of the protective function of the upper airway b. Loss of phonation c. Decreased airway resistance d. Damage to the subglottic area e. Need for sedation and or analgesia 150. Preoperative causes of tachycardia include A) Anxiety B) Tension C) Fear D) Pyrexia E) all of the above 151. the most frequent causes of cardiogenic pulmonary edema. A) ARDS B) Inhalational toxic gases C) Over hydration D) Congestive heart failure E) VSD 152. If the blood pressure is high, after the initial treatment you should administer
  • 28. Page27 A) Ionotropic B) Saline water C) Nitroglycerine I/V D) Beta blocker E) Calcium channel blocker 153. which of the following inhalational agent is contra indicated in a patient with history of epilepsy A) Isoflurane B) Enflurane C) Halothane D) Sevoflurane E) Desflurane 154. At the end of anesthesia after discontinuation of nitrous oxide in removal EET, 100% oxygen is administered to patient, to prevent A) Diffusion hypoxia B) Second gas effect C) Hyperoxia D) Bronchospasm E) Laryngospasm 155. All of the following factor decrease MAC value of inhalational anesthetic agent EXCEPT A) Hypothermia B) Hyponatremia C) Anemia D) Hypocalcemia E) Hypercalcemia 156. The laryngeal mask airway used for securing airway of patient in all of the following except A) In difficult intubation B) In cardiopulmonary resuscitation C) In a child undergoing in elective eye surgery D) In a patient with large tumor in the oral cavity E) Bronchospasm 157. Manual pressure at the cricoid cartilage is used to prevent A) Laryngospasm
  • 29. Page28 B) Regurgitation of gastric content C) Vocal cord trauma D) Vomiting E) Esophageal intubation 158. An adult breathing 100% oxygen at sea level may suffer from. A) Pneumothorax B) Atelectasis C) Confusion D) Asthma E) COPD 159. What can cause a close pneumothorax? A) Gun shot B) Blunt trauma C) Thoracocentasis D) Bite wound E) None of these 160. All of the following features occur during pneumothorax except A) Pneumothorax lead to V/Q mismatch B) Hypoxemia C) Pulse will increase D) Inspiratory wheeze E) Ischemia 161. In all respiratory complication the main indicated sign is A) Tachycardia B) Bradycardia C) Hypotension D) Hypertension E) None of these 162. Following are the causes of bradycardia except. A) Opioids B) Propofol C) Neostigmine D) Succinylcholine E) Atropine 163. Intraoperative complication of hypertension include
  • 30. Page29 A) Renal failure B) Intracranial hemorrhage C) Pulmonary edema D) Aortic dissection E) all of the above 164. Management of difficult intubation include all of the following except. A) Retrograde intubation B) Fibroptic intubation C) Awake nasal intubation D) Blind nasal intubation 165. In malignant hyperthermia the increase heat production is due to A) Thermic effect of blood B) Increase sympathetic discharge C) Increase muscle metabolism by excess of calcium ions. D) Mitochondrial thermogenesis 166. A 30 year old patient presented for laparotomy and his HB is 9 then anesthetist agree with the doctor to continue the operation A) Yes, in case of emergency surgery B) No, in case of elective surgery C) Both are correct D) Only A E) None of these 167. Which of the following causes of Arrhythmias during Anesthesia A) Hypoxemia B) Hypotension C) Myocardial ischemia D) Hypercapnia E) All are correct 168. All are the following causes of Hypovolumia and fluid loss except a. Trauma b. Diarrhea c. Sweating d. Major blood vessel rapture e. Urine out put 169. Which of the following not the causes of Hypotension during Anesthesia. a. Head up position
  • 31. Page30 b. Raised intrathoracic pressure c. Hypercapnia. d. Hypovolumia e. obstruction 170. Which of the following drug over dose which cause hypertension during Anesthesia a. propofol b. tramadol c. Nalbupin d. Dubatamine e. All are false 171. Following indication show Respiratory obstruction occur during anesthesia except a. Oropharynx b. Tracheal tube c. Larynx d. Pneumonia e. bronchi 172. The most effective steps in preventing harm from complication are………….except. a. Preoperative assessment of the patient. b. Preoperative assessment of the equipment c. Without the use of monitoring d. The availability of trained assistant e. Preoperative consultation 173. If the patient is not cyanosed and ventilation appears to continue uninterrupted then which of the following monitoring should be mostly check a. ECG electrodes b. Capnograph c. Nerve stimulator d. Only ECG and pulse oximeter e. Pulse oximeter 174. Inadequate ventilation may be cause by a. Poorly managed tracheal intubation b. Pulmonary aspiration of gastric content c. Breathing system disconnection d. Gas supply failure. e. All of the above
  • 32. Page31 175. Which one are not the causes of complication a. Human error b. Equipment failure c. inevitable complication d. without consent e. coexisting disease 176. In the absence of laryngeal mask airway or tracheal tube, apposition of the tongue and pharyngeal soft tissue is a common cause of a. Upper airway obstruction b. Middle airway obstruction c. Lowe airway obstruction d. Nasal obstruction e. Oropharyngeal obstruction 177. All the following characteristic concern to surgical except a. Blood loss, urgency surgery b. Degree of cancer spread, operative severity c. ECG abnormalities d. Peritoneal soiling e. Mallampati classification 178. The Mallampati test is widely used and simple classification of the ………….view obtained during maximal mouth opening and tongue protrusion. a. Laryngeal b. Pharyngeal c. Nasopharyngeal d. Nasal e. Uvula 179. If intubation is unsuccessful, no further doses of ………………… blocking drug should be used. A. Muscle relaxant B. neuromuscular C. Both A and B D. Benzodiazepine E. Propofol 180. The injection of 3 to 5ml of 2% of lidocaine through the cricothyroid membrane induces coughing and anesthetizes the tracheal and laryngeal mucosa for A. awake intubation
  • 33. Page32 B. failed intubation C. difficult intubation D. airway obstruction E. All of these 181. Carbon dioxide production increases during ……………. A. pyrexia B. malignant Hyperthermia C. shivering D. Hypoxia E. All are correct 182. All are the following concern in which pneumothorax may develop spontaneously except A. Asthma B. COPD C. bronchitis D. congenital l cystic pulmonary disease E. Marian’s Syndrome 183. Surgical manipulation such as traction on the Eye, cervical, or anal dilatation and peritoneal traction may increase vagal tone producing a. tachycardia b. bradycardia c. tachyarrhythmia d. Brady arrhythmia e. All is correct. 184. Sympathetic nervous system activity is increased by all of the following except A. Hypoxemia B. Hypercapnia C. inadequate analgesia D. inadequate opioids E. Hypovolumia 185. Tran esophageal echocardiography and Precordial Doppler ultrasound are the most sensitive monitors for A. gas embolus B. thromboembolus
  • 34. Page33 C. myocardial ischemia D. Hemorrhage E. pneumothorax 186. Which one is not the sign of Awareness in a paralyzed patient arise from activation of the sympathetic nervous system during anesthesia A. sweating B. tachycardia C. Hypertension D. Tear formation E. Hypothermia