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Multiple Choice Questions

58. The glomerular filtrate: mismatch rather than diffusion across alveolar capillaries.
(a) Passes through two layers to enter Bowmans capsule. (d) Does not bind to iron atoms in the ferric state.
(b) Contains albumen. (e) Scarcity is responsible for the green house effect.
(c) Allows the passage of molecules less than 70 kDa.
64. Oxygen toxicity:
(d) Contains glucose in a concentration similar to that in
the afferent arteriole. (a) May cause convulsions.
(e) Is produced at a rate of 200 ml min1. (b) May result from damage to sulphydryl-containing
59. Mannitol: (c) May occur after 10 h of exposure at 1 atmosphere pres-
(a) Is a plant derivative. sure.
(b) Reduces the effective sodium concentration in the renal (d) Is treated by xanthene oxidase inhibitors.
tubule. (e) Occurs mainly via superoxide anions in humans.
(c) Increases blood viscosity.
65. Blind nasal intubation is contra-indicated in the
(d) Increases the amount of water more than the amount of
following circumstances:
sodium excreted.
(e) Should be used with furosemide in rhabdomyolysis. (a) Horizontal fracture of the lower maxilla.
(b) Le Fort III facial fractures.
60. Bumetanide: (c) In the presence of Battles sign.
(a) Inhibits the Na+K+2Cl co-transporter in the descending (d) In the presence of Cullens sign.
loop of Henle. (e) In the presence of peri-orbital haematoma, but normal
(b) Is secreted into the tubular lumen. skull X-rays.
(c) Increases oxygen consumption in the nephron.
66. The following are indications for urgent endotra-
(d) Can reduce ventricular preload.
cheal intubation:
(e) Causes a metabolic acidosis.
(a) Glasgow Coma Score less than 10.
61. Thiazide diuretics: (b) Glasgow Coma motor score of 2.
(a) Are vasodilators. (c) Le Fort III facial fractures.
(b) Affect chloride transport in the distal tubule. (d) Patient agitation when supine.
(c) Can reduce plasma cholesterol. (e) Facial surgical emphysema.
(d) Are indicated for treatment of ascites in liver failure.
67. In the UK, isolated Le Fort fractures are
(e) May cause gout.
commonly associated with the following
62. The P50 of the haemoglobin oxygen complications:
dissociation curve: (a) Airway obstruction.
(a) Increases in acidosis. (b) Cervical spine injury.
(b) Is affected by carbon monoxide. (c) Life-threatening haemorrhage.
(c) For myoglobin is less than that for haemoglobin. (d) Intracranial hypertension.
(d) May be related to glycolysis within erythrocytes. (e) Negative pressure pulmonary oedema.
(e) Alters with changes in haemoglobin concentration.
68. The following statements are true:
63. Oxygen: (a) All complex facial fractures should be surgically repaired
(a) Is an inert gas. within 24 h of injury.
(b) Is a paramagnetic gas. (b) Trismus is a contra-indication to using the intravenous
(c) Alveolar-arterial gradient usually reflects regional V/Q route for induction of anaesthesia.

British Journal of Anaesthesia | CEPD Reviews | Volume 1 Number 4 2001

The Board of Management and Trustees of the British Journal of Anaesthesia 2001 125
Multiple choice questions and answers

(c) Intermaxillary fixation (IMF) may allow adequate mouth (c) Anaesthesia should be deepened to avoid vomiting.
opening at the end of operation. (d) A head down position is advisable to prevent aspiration.
(d) Submental intubation is a recognised alternative to tra- (e) A laryngeal mask airway is appropriate.
cheostomy in some elective maxillofacial trauma.
(e) Submental intubation is associated with more anaerobic 74. When a cricothyrotomy has been performed:
infections than standard tracheostomy. (a) It is not possible to ventilate using a bag through a
4.0 mm cannula.
69. First aid (b) With a 13G cannula, exhalation occurs through the mouth.
(a) Wet towels are an effective way of cooling the burn (c) Posterior tracheal wall damage is a risk.
wound. (d) Surgical emphysema cannot occur if a resuscitation bag
(b) Ice packs are used to cool the burn wound and stop the is used for ventilation.
burning process. (e) Cricoid pressure cannot be maintained.
(c) Human albumin solution is the most popular resuscitation
fluid. 75. When using the laryngeal mask airway in a failed
(d) To extinguish burning clothing the victim should be rolled intubation drill:
on the ground. (a) Cricoid pressure should be temporarily released.
(e) Cling film is a useful emergency dressing. (b) A size 3 is most appropriate for women.
(c) The airway reflexes should be obtunded with a small
70. Intravenous fluid resuscitation dose of intravenous induction agent.
(a) Is unnecessary for superficial burns. (d) It can form a conduit for subsequent tracheal intubation.
(b) Is unnecessary for electrical burns. (e) The patient should be paralysed after successful
(c) Fluid volumes should be reduced in patients with smoke insertion.
(d) Fluid requirements are maximal in the first hours after the 76. Carbon monoxide:
injury. (a) In smokers may result in COHb values of 25%.
(e) Adequacy is poorly assessed without invasive monitoring. (b) Shifts the oxygen haemoglobin curve to the left.
(c) Induces cytochrome oxidase.
71. Inhalation injury (d) Clearance is greater in men than in women.
(a) Should be suspected in patients with facial burns. (e) Concentrations of approximately 5% reduce onset time
(b) Almost always presents with stridor. of exercise induced angina.
(c) Pulse oximetery may give false low readings.
(d) Always requires early intubation. 77. Smoking cessation:
(e) May cause respiratory failure without airway compromise. (a) Returns the rate of decline in FEV1 to near normal levels.
(b) Of 12 months duration may increase postoperative
72. Carbon monoxide poisoning pulmonary complication rates.
(a) Causes a right shift of the oxyhaemoglobin dissociation (c) Of 12 h duration has minimal effect on maximal work
curve. capacity.
(b) Levels of 60% or greater are usually fatal. (d) Improves airway reactivity over 210 days.
(c) Hyperbaric oxygen is the treatment of choice. (e) Rates can be doubled using nicotine replacement
(d) COHb has a half-life of 4 h when breathing air. therapy.
(e) Abnormal COHb levels could indicate airway oedema.

73. After induction of general anaesthesia for a 78. Smoking:

Caesarean section and initial attempts at (a) Is protective against Crohns disease.
tracheal intubation have failed: (b) Is a strong risk factor for arterial thrombosis.
(a) The patient should be turned into the left lateral (c) Reduces the risk of postoperative nausea and vomiting.
position. (d) Reduces end-organ responsiveness to barbiturates.
(b) The patient must always be woken up. (e) Causes a reduction in plasma volume.

126 British Journal of Anaesthesia | CEPD Reviews | Volume 1 Number 4 2001