PYQS

ANATOMY:
! Q1) All of the following muscles cause adduction of vocal cords except:
A. Posterior cricoarytenoid

Q2) All of the following about endotracheal intubation true EXCEPT:

A. Female tube 8.0-8.5

Q3) Thoracic surgery is one of the indications of the Laryngeal Mask

A. True
B. False

Q4) The commonly used cuffed tube is that with low volume and high pressure cuff:
A. True
B. False

Q5) Endotracheal Intubation can be done Awake under using local anesthesia:
A. True
B. False

Q6) The oxyhemoglobin dissociation curve is shifted to the left by?

A. Acidosis
B. Sickle cell anemia
C. A fall in temperature
D. Chronic anemia
E. An increase in arterial PCO2

Q7) One of the following is true regarding the use of laryngeal mask airway (LMA)?
A. Maintenance of airway
B. One lung ventilation
C. Prevention of aspiration
D. Facilitating laryngeal surgery
E. Removing oral secretions

Q8) Wrong about Factors that cause right shift of Hb oxygen dissociation curve:
A. Sickle cell anemia.
B. Hypothyroidism.
C. Increase CO2.
D. Hyperthermia.

DONE BY: NAWAL & AKRAM 1

 PYQS
Q9) All of the following muscles are innervated by the recurrent laryngeal nerve except:
A. Cricothyroid

Q10) If the thyromental distance is less than it indicates possible difficult intubation:
A. 3 fingerbreadths
B. 9 cm.
C. 10 cm.
D. 2 fingerbreadths.
E. 5 fingerbreadths.

Q11) All of the following shift oxyhemoglobin dissociation curve to the right except :
A. Increase PCO2
B. Acidosis
C. Hyperthermia
D. Decrease PCO2

Q12) Glasgow coma score in which we do ETT is:

A. 11
B. Below 8
C. 9
D. 13

Q13) Central cyanosis occurs when O2 sat:

A. 95%
B. 94%
C. 90%
D. 89%
E. 85%

Q14) All of the following shift the oxyhemoglobin dissociation curve to the left, except?
A. Anemia

Q15) Most reliable sign of ETT:

A. Visualization of tube passing through vocal cords

Q16) In unconscious patient, how do we maintain airways:

A. Head tilt and jaw thrust
B. Jaw thrust
C. Head tilt and chin lift

DONE BY: NAWAL & AKRAM 2

 PYQS
Q17) About Mallampati stage 4?
A. Soft palate is not visible

Q18) One is true about Recurrent laryngeal nerve supplies?

A. Sensation under the vocal cords

Q19) In airway management, the cervical spine should be evaluated during flexion
A. True
B. False

Q20) All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve
A. True
B. False

Q21) Local ETT can be performed in conscious patient and under general anesthesia
A. True
B. False

Q22) Contraction of Stylohyoid muscle elevates larynges

A. True
B. False

Q23) ETT can be inserted to awake patient with local anesthesia

A. True
B. False

Q24) Physiologically, patency of the trachea is maintained by its C shaped cartilage

A. True
B. False

Q25) Reinforced ETT are suitable for prone position

A. True
B. False

Q26) One is true, laryngeal mask airway (LMA) is used for:

A. Removing oral secretions.
B. Prevention of aspiration.
C. One lung ventilation.
D. Facilitating laryngealsurgery.
E. Maintenance of airway

DONE BY: NAWAL & AKRAM 3

 PYQS
Q27) All are true about management of upper airway obstruction except
A. Head flexion
B. Chin left

Q28) All are early signs of successful intubation EXCEPT:

A. Visualize the vocal cords and observing the tube
B. Mid axillary auscultation
C. Pulse oximeter
D. Capnography

Q29) The commonly used cuffed tube is that with low volume and high-pressure cuff
A. True
B. False

Q30) Thoracic surgery is one of the indications of the Laryngeal Mask

A. True
B. False

Q31) Mention the steps of endotracheal intubation:

1. Positioning the patient
2. Opening the patient's mouth
3. Performing laryngoscopy
4. Insertion of the tube through the vocal cord & removing the laryngoscopy
5. Conformation of the correct placement & securing the tube

Q32) In airway management, the cervical spine should be evaluated during flexion.
A. True
B. False

Q33) All intrinsic muscles of the larynx are supplied by the recurrent laryngeal nerve.
A. True
B. False

Q34) All are correct except one, P50:

A. Is increased in increased PaCO2.
B. Is normally 27 mmHg.
C. Is increased in banked red blood cells
D. Is increased in carboxy- & fetal hemoglobin.

DONE BY: NAWAL & AKRAM 4

 PYQS
Q35) The oxyhemoglobin dissociation curve is shifted to the left by
A. A fall in temperature
B. Sickle cell anemia
C. An increase in arterial PCO2
D. Acidosis
E. Chronic anemia

Q36) Patients with Sickle Cell Anemia tend to have a right shift in the Oxygen dissociation curve
A. True
B. False

Q37) Tracheal stenosis is a common early complication of the endotracheal intubation

A. True
B. False

Q38) SaO2 = OxyHb / (OxyHb + DeoxyHb) = 10/(10+5) = 66%

A. True
B. False

Q39) SaO2 of 80% corresponds to PaO2 of only 27mmHg

A. True
B. False

Q40) At paO2 27 mmHg the Hb saturation (Sao2) is around 50%

A. True
B. False

Q41) Increased 2-3 DPG level shift the HB-O2 dissociation curve to the Left
A. True
B. False

DONE BY: NAWAL & AKRAM 5

 PYQS
IV FLUID:
Q1) Calculate maintenance for a 30 kg child:
A. 1680 ml/day

Q2) When we consider blood transfusion in a young healthy man:

A. 30%
B. 20%

Q3) All of the following will be found in a old blood bank except:
A. Increase in platelet

Q4) In comparison between colloids and crystalloids:

A. Crystalloid half life 15-20min
B. Colloids half life 2-3 h
C. Colloids more MW
D. Crystalloids are considered blood volume expanders

Q5) All are true about ringer lactate except:

A. 300 molarity

Q6) Colloids are mainly preferred over crystalloids due to their lower risk of anaphylaxis
C. True
D. False

Q7) Replacement by transfusion of 50% of the patients blood in 2-4 hours is considered a Massive Blood
Transfusion
A. True
B. False

Q8) Ringer’s lactate contains as much potassium per 100 ml as D5NS does
A. True
B. False

Q9) If there is <15% blood loss we use crystalloids because they are safer
A. True
B. False

DONE BY: NAWAL & AKRAM 6

 PYQS
Q10) How many ml/h requirement of 90 kg adult patient?
A. 130 ml hourly

Q11) How many mg per ml does a dextrose 5% solution contain?

A. 50 mg/ml

Q12) Patient has been given the following solutions: 500 ml of 10% lipid solution and 500 ml of 5% dextrose.
Flow many Kilocalories (Kcal) did the patient get?
A. 550 Kcal

Q13) Concerning body fluid compartments, all are true except ?

A. ICF and ECF are separated by cell membrane
B. The extracellular compartment is much greater that the intracellular compartment
C. Neonates contain more water than adults
D. The 70 kg standard male contains 42 liters of water – 60% of his body weight
E. Total body water as a percentage of total body weight decreases progressively with increasing age

Q14) All of the following are colloidal fluids except ?

A. Hartmann’s solution
B. Human albumin
C. Gelofusine infusion solution
D. Hydroxyethyl starch
E. Dextran 40

Q15) ABO compatibility is essential for the transfusion of all the following except ?
A. Full blood
B. Platelets ‫جواب السنوات‬
C. Fresh frozen plasma
D. Cryoprecipitate ‫بس هاظ الجواب الصح‬
E. Packed red blood cells

Q16) One of the following has a higher intracellular than extracellular concentration ?
A. Sodium
B. Potassium
C. Chloride
D. Bicarbonate
E. Calcium

DONE BY: NAWAL & AKRAM 7

 PYQS
Q17) Massive blood transfusion cause all the following except:
A. Hypokalemia.
B. Hyperkalemia
C. Hypothermia
D. Hypocalcemia

Q18) Wrong about ringers lactate:

A. Na=131.
B. 300 mosmol/L.
C. K=5.

Q19) All of the following would be increased in stored blood except?

A. ATP

Q20) All of the following are true except

A. 20% of body water is located intracellularly

Q21) Maintenance fluids for 60 kgs patient:

A. 100 ml/hr

Q22) how many kcal in 1000 ml of 10% Lipids?

A. 900 kcal

Q23) All of the following statements are correct except one:

A. Dextrose water solutions have no role as plasma expanders.
B. While the ICF is 2/3 of total body water, the ECF is only 1/3 of TBW.
C. Half-life for crystalloids is 15-20 minutes while colloids for 2-3 hours.
D. Isotonic solutions used recently, consisting of between 1.8 & 7.5% NACL solutions.
E. If there is less 15% blood loss, we use crystalloids because they are safer.

Q24) Regarding body fluid which of the following is true:

A. Intracellular compartment abot 1/3 body fluid
B. TBW is 60% in infant
C. TBW is 60% in adult male
D. Obese have more body fluid than non-obese

DONE BY: NAWAL & AKRAM 8

 PYQS
Q25) Regarding IV fluid all of the following are true except :
A. Colloid more expensive than crystalloid
B. Colloid half life 3-4 hours
C. Crystalloid half life 15 -20 min
D. Crystalloid consider as plasma volume expander
E. Colloid has a large molecular weight

Q26) Massive blood transfusion causes all of the following except:

A. Hypercalcemia
B. Hypernatremia
C. Hyperkalemia

Q27) What is the true statement about IV fluids:

A. Hemacyl & HES are colloids

Q28) About IV fluids, one is wrong?

A. Chloride in Ringer Lactate is 131

Q29) Wrong about Ringer Lactate:

A. 300 osmolality

Q30) Young patient blood transfusion when blood loss is:

A. 30%

Q31) All of the following are dehydration signs except:

A. Hypotension.
B. Tachycardia.
C. Dry mucous membrane.
D. Bradycardia

Q32) Massive blood transfusion causes all of the following except :

A. Hypokalemia
B. Hypothermia
C. Hypocalcemia
D. Hyperkalemia

Q33) Intravenous fluid therapy is calculated using the 4-2-1 rule.

A. True
B. False

DONE BY: NAWAL & AKRAM 9

 PYQS
Q34) Massive blood transfusions cause hyperkalemia.
A. True
B. False

Q35) Total body water for 75 kg adult male is approximately 40 liter

A. True
B. False

Q36) Dextran 70 is more effective as plasma expander than dextran 40

A. True
B. False

Q37) 1 liter of 5% dextrose contains .... Kcal.

A. 200

Q38) Maintenance using 4-2-1 rule for 62 kg male is ..... ml/hr.

A. 102

Q39) Intracellular ion:

A. Potassium
B. Sodium
C. Chloride
D. Calcium

Q40) One of the following has a higher intracellular than extracellular concentration
A. Sodium
B. Potassium
C. Chloride
D. Bicarbonate
E. Calcium

Q41) Obese individuals tends to have less TBW per weight than non obese individuals
A. True
B. False

Q42) ILIUS is one of the advantages of large volume of crystalloids infusion

A. True
B. False

DONE BY: NAWAL & AKRAM 10

 PYQS
Q43) Colloids have high molecular weight
A. True *
B. False

Q44) Transfused platelets generally survive only 1-7 days following transfusion
A. True *
B. False

Q45) In Extreme emergencies: when there is no time to obtain test sample, transfusion of group ‘O’ Rh-
positives packed RBC can be given
A. True
B. False

Q46) The largest component of extracellular fluid is the interstitial fluid

A. True
B. False

Q47) Hypotonic solutions such as 0.45% NaCl and 5% dextrose Shift the water from the extracellular to the
intracellular space
A. True
B. False

Q48) Colloids can temporarily increase clotting times and cause coagulopathy
A. True
B. False

Q49) Sodium is the main extracellular electrolyte

A. True
B. False

Q50) Normal hemoglobin value is 14 mg/L

A. True
B. False

Q51) Patient was given Lipid 10% in 500 ml, and Dextrose 5% in 1000 ml, how many Kcal did he receive?
A. 650 kcal

DONE BY: NAWAL & AKRAM 11

 PYQS
Q52) If there is 15-30% blood loss we use colloids with replacement volume for volume {3:1}
A. True
B. False

Q53) Hypertonic fluids shift the water from the ICF to the ECF what may cause Cellular edema
A. True
B. False

Q54) Hypercalcemia and Hypokalemia are some changes in stored Blood units and Complications of (massive)
blood transfusion
A. True
B. False

Q55) Hypocalcemia and hyperkalemia are some changes in stored blood units and complications of (massive)
blood transfusion
A. True
B. False

! Q56) The hourly fluid requirement of a 65 kg adult is 105 ml

A. True
B. False

Q57) For platelets transfusion ABO identical or compatible units are not necessary
A. True
B. False

Q58) if there is 15-30% blood loss we use colloids with replacement volume for volume 1:1
A. True
B. False

Q59) Patient who has blood group A can be given fresh frozen plasma A and AB
A. True
B. False

Q60) Colloids may cause renal dysfunction and acute renal failure
A. True
B. False

DONE BY: NAWAL & AKRAM 12

 PYQS
Q61) COMPONENT OF CPDA (an anti-coagulant that is put on blood to preserve it)?
• Citrate - Phosphate - Dextrose - Adenine

Q62) Mention the complications of blood transfusion

1. Hypocalcemia
2. Hyperkalemia
3. Hemosiderosis
4. Thrombophlebitis
5. Pulmonary embolism
6. Circulatory overload

Q63) Fill the table:

Crystalloids: Na+ K+ Cl-
Ringer’s lactate 131 5 112
0.9% NaCl 154 0 154
4% glucose + -18% NaCl 31 0 31

PAIN:
Q1) Chronic pain goes away when there is no longer an underlying cause for the pain
A. True
B. False

Q2) Nociceptive pain are generally classified into somatic and visceral pain
A. True
B. False

Q3) Tramadol for acute pain is stronger than morphine:

A. True
B. False

Q4) Pain of bones, joints, connective tissues and muscles is a peripheral Neuropathic pain
A. True
B. False

! Q5) Regarding opioids, all are true except:

A. Minimal effect on cardiac & pulmonary function
B. Has antiemetic effect
C. Mu receptors cause analgesia, respiratory depression, euphoria & physical dependence
D. Metabolized by the liver

DONE BY: NAWAL & AKRAM 13

 PYQS
Q6) About chronic pain, one is wrong?
A. Onset is well defined

Q7) One of the effect of opioids is diarrhea

A. True
B. False

Q8) Tramadol is weaker than morphine in acute pain management.

A. True
B. False

Q9) Diclofenac (NSAID) can increase the risk of fatal heart attack or stroke
A. True
B. False

Q10) Morphine has a calming effect; therefore, it is used for pain due to myocardial infarction
A. True
B. False

Q11) Chronic pain usually lasts longer than six months

A. True
B. False

Q12) Acute pain goes away when there is no longer an underlying cause for the pain
A. True
B. False

Q13) Ibuprofen as COX inhibitor increases the production of prostaglandin

A. True
B. False

Q14) Chronic pain can continue even after its causes has healed or gone away
A. True
B. False

DONE BY: NAWAL & AKRAM 14

 PYQS
Q15) All are true except one. Naloxone:
A. Is an antagonist at mu receptors
B. Reverses respiratory depression due to morphine
C. May cause pulmonary edema
D. May lead to abrupt return of pain by sudden reversal of analgesic effects
E. Is an agonist at kappa receptors

Q16) Naloxone competes the opioids on Mu, sigms, Kappa receptors

A. True
B. False

Q17) Opioids antagonist is Flumazenil

A. True
B. False

LOCAL ANESTHETIC:
Q1) Headache post spinal LA true except:
A. Related to atraumatic needle
B. Related to CSF leak

Q2) This intermediate linkage is found in Amide local an aesthetic agents:

C. True
D. False

Q3) The space between the ligamentum flavum and dura mater is the epidural space:
A. True
B. False

Q4) The first metabolic product of Ester LA is PABA, which is an allergen

A. True
B. False

Q5) Blood loss during operation is more under spinal anesthesia than when the same operation is done under
general anesthesia
A. True
B. False

DONE BY: NAWAL & AKRAM 15

 PYQS
Q6) Lipid solubility is the primary determinant of a LA’s duration of action
A. True
B. False

Q7) The activity of local anesthesia is higher when injected into tissues with an acid pH (e.g pyogenic abscess)
A. True
B. False

Q8) To get a dilution 1:100000 how many microgram adrenaline have you to add to one ml solution ?
A. 10 microgram/ml

Q9) All of the following are contraindications to spinal anesthesia except ?

A. Patient refusal
B. Uncooperative patient
C. Septicemia
D. Hypervolemia
E. Clotting disorders

Q10) Concerning the advantages and complications of regional anaesthesia, all are true except one ?
A. Reduced peri-operative blood loss
B. The majority of the patients are very happy with this technique
C. Increased incidence of postoperative deep vein thrombosis
D. Decreased postoperative nausea and vomiting
E. There is little risk of unrecognized hypoglycemia

Q11) Which of the following local anaesthesia is considered highly cardiotoxic ?

A. Bupivacaine
B. Procaine
C. Lidocaine
D. Benzocaine
E. Prilocaine

Q12) One is not a Contraindication for spinal anesthesia:

A. Young child.
B. Patient refusal.
C. DM patient.
D. Hypovolemia.

DONE BY: NAWAL & AKRAM 16

 PYQS
Q13) Wrong about factors that affect spread of LA in CSF:
A. Fentanyl with LA.
B. Level of injection.
C. Position of the patient.

Q14) Which of the following is not an amide LA:

A. Procaine.
B. Lidocaine.
C. Bupivacaine.

Q15) Which of the following is not a side effect of Spinal anesthesia ?

A. Tachycardia

Q16) All of the following are advantages of spinal anesthesia except:

A. Peristalsis continues and sphincters are contracted

Q17) All of the following are true regarding bier’s block except
A. We use bupivacaine

Q18) Definition of spinal anesthesia includes all of the following except?

A. Increased aspiration

Q19) All of the following are ester local anesthetic except:

A. Procaine
B. Chloroprpocaine
C. Tetracaine
D. Levobupivacaine
E. Benzocaine

Q20) All about lidocaine are true except:

A. Lidocaine act on fast gated Na+ channel
B. Lidocaine use in IV regional anesthesia
C. Lidocaine is an amide local anesthetic agent
D. Lidocaine has longer duration of action than Bupivacaine
E. Lidocaine is an anti-arrhythmic drug

DONE BY: NAWAL & AKRAM 17

 PYQS
Q21) All of the following are true about spinal anesthesia except :
A. Decrease DVT
B. Return normal gut function after operation
C. Optimal use with hypovolemia
D. Reduce the incidence of anastomotic dehiscence

Q22) According spinal anesthesia all are true about headache except:
A. Occipital headache
B. Postural headache remove when lay down
C. Caused by CSF leakage
D. Less likely to occur in large bore needle
E. Less likely to occur in gauge needle 25 more than 20 gauge needle

Q23) All of the following are contraindications of spinal anesthesia except?

A. Hypervolemia

Q24) Concerning the advantages and complications of regional anesthesia, all are true except one ?
A. Increased incidence of postoperative deep vein thrombosis

Q25) How much mg in 1 ml of 50 ml 1% lidocaine?

A. 10 mg/ml
B. 1 mg/ml
C. 5 mg/ml
D. 50 mg/ml
E. 500 mg/ml

Q26) Not an amide:

A. Procaine

Q27) The recognition of the subarachnoid space is by loss of resistance technique

A. True
B. False

Q28) 6 ml of lidocaine 1% equals 60 mg

A. True
B. False

DONE BY: NAWAL & AKRAM 18

 PYQS
Q29) The onset of hypotension in epidural anesthesia is slow
A. True
B. False

Q30) Bupivacaine and etomidate are high potent long duration of action esters anesthetic agents
A. True
B. False

Q31) TIVA indicated in case of bronchopleural fistula

A. True
B. False

Q32) By adding 12.5 micrograms adrenaline to one mL solution we get a dilution of 1:200000
A. True
B. False

Q33) Lidocaine 2% ampoule: each ml contains 10 mg lidocaine

A. True
B. False

Q34) For spinal anesthesia in obese patients the LA must be corrected

A. True
B. False

Q35) Levobupivacaine & ropivacaine are high potent amide LA with long duration of action
A. True
B. False

Q36) The maximum safety dose of lidocaine without adrenaline is 7mg/kg

A. True
B. False

Q37) Adrenaline 1:20000 is preferred adrenaline dilution in regional anesthesia such Bier's block and finger
ring block
A. True
B. False

DONE BY: NAWAL & AKRAM 19

 PYQS
Q38) In patients with sickle cell disease is one of the advantages of bier's block
A. True
B. False

Q39) First metabolic product of amide LA is PABA which is associated with allergic phenomena and
hypersensitivity reactions
A. True
B. False

Q40) Spinal anesthesia is the injection of small amounts of LA into the CSF at level below the L2
A. True
B. False

Q41) Generally, CVS is more sensitive to LA than CNS

A. True
B. False

Q41) Bupivacaine has intermediate potency and duration of action

A. True
B. False

Q42) Lipid solubility is the primary determine of potency

A. True
B. False

Q43) Bier’s block requires the surgery be concluded within 40-60 minutes
A. True
B. False

Q44) Cardiac manifestations tend to occur earlier than the neurological manifestations during to LA toxicity
A. True
B. False

Q45) Lidocaine can be used in spinal anaesthesia

A. True
B. False

DONE BY: NAWAL & AKRAM 20

 PYQS
Q46) Concerning advantages and complications of regional anesthesia, all are true except one
A. Reduced postoperative blood loss
B. Decreased postoperative nausea and vomiting
C. There is little risk of unrecognized hypoglycemia in an awake patient
D. Increased incidence of post-operative deep vein thrombosis
E. The majority of patients are very happy with the technique

Q47) Which of the following local anesthetics is the most cardiotoxic:

A. Bupivacaine
B. Procaine
C. Lidocaine
D. Benzocaine
E. Prilocaine

Q48) All of the following are contraindications to spinal anesthesia except:

A. Septicemia.
B. Uncooperative patient.
C. Hypervolemia.
D. Clotting disorder.
E. Patient refusal.

Q49) One of the following are false about local anesthesia:

A. 0.1% lidocaine equal to 10 mg
B. Lidocaine is amide local anesthesia
C. 2% bupivacaine equal to 20 mg

! Q50) All are contraindication of spinal anesthesia except

A. Knee replacement surgery
B. Patient refusal
C. DM patient

Q51) Wrong about the factors that effect spread of LA in CSF:

A. Fentanyl with LA
B. Level of injection
C. Position of the patient

DONE BY: NAWAL & AKRAM 21

 PYQS
Q52) All of the following are ester local anesthetic except:
A. Procaine
B. Chloropropocaine
C. Tetracaine
D. Levobupivacaine
E. Benzocaine

Q53) All about lidocaine are true except:

A. Lidocaine act on fast gated Na+ channel
B. Lidocaine use in IV regional anesthesia
C. Lidocaine is an amide local anesthetic agent
D. Lidocaine has longer duration of action than Bupivacaine
E. Lidocaine is an anti-arrhythmic drug

Q54) All of the following are true about spinal anesthesia except:
A. Decrease DVT
B. Return normal gut function after operation
C. Optimal use with hypovolemia
D. Reduce the incidence of anastomotic dehiscence

Q55) According to spinal anesthesia all are true about headache except:
A. Occipital headache
B. Postural headache remove when lay down
C. Caused by CSF leakage
D. Less likely to occur in large bore needle
E. Less likely to occur in gauge needle 25 more than 20-gauge needle

Q56) All of the following are early signs and symptoms of LA overdose except?
A. Respiratory depression

Q57) 6 ml of lidocaine 1% equals 60 mg

A. True
B. False

Q58) Which of the following local anesthesia is considered highly cardiotoxic?

A. Bupivacaine
B. Procaine
C. lidocaine
D. Benzocaine
E. Prilocaine

DONE BY: NAWAL & AKRAM 22

 PYQS
Q59) To get a dilution of 1:200000 how many microgram adrenaline do you have to add to one ml solution?
A. 5 microgram / ml
B. 20 microgram / ml
C. 6 microgram / ml
D. 0.1 microgram / ml
E. 10 microgram / ml

Q60) Adrenaline 1:20000 is preferred adrenaline dilution in regional anesthesia such Bier's block and finger
ring block
A. True
B. False

Q61) Mention 2 causes of toxicity from LA agents:

• Accidental rapid intravenous injection
• Absolute overdose

Q62) Compare between spinal and epidural anesthesia according to: onset, density, hypotension.
Onset Density Hypotension
Spinal anesthesia Rapid More dense Rapid
Epidural anesthesia Slow Less dense Slow

Q63) Name 3 clinical use of LA ?

• Topical
• Infiltration
• Peripheral nerve block
• IV regional
• Spinal
• Extradural

Q64) Mention the contraindications of spinal anesthesia ?

• Patient refusal
• Uncooperative patients (young children and psychiatric or mentally handicapped patients)
• Hypovolemia
• Septicemia
• Clotting disorders
• Inadequate resuscitative drugs and equipment (No regional anesthetic technique should be attempted if
drugs and equipment for resuscitation are not immediately to hand)

DONE BY: NAWAL & AKRAM 23

 PYQS
Q65) What are the signs of LA toxicity?
• CNS is more sensitive to LA than CVS
• Early or mild toxicity: light-headedness, dizziness, tinnitus, circumoral numbness, confusion and
drowsiness. Patients often will not volunteer information about these symptoms unless asked.
• Severe toxicity: tonic-clonic convulsion leading to progressive loss of consciousness, coma, respiratory
depression, and respiratory arrest.

BASIC LIFE SUPPORT:

Q1) Regarding CPR of 5years old child: chest compression: Breathing cycle is
A. 30:2

Q2) One of the following is true of defibrillation

A. Monophasic defibrillator should no longer be used
B. Biphasic defibrillator is more effective than monophasic
C. The maximum energy of a monophasic defibrillator is 200J
D. The monophasic defibrillator requires less energy than a biphasic defibrillator for a successful defibrillation
E. Biphasic waveform is carried out by a smaller and more portable device

Q3) All of the following are in CPR except:

A. Chest compression around 5 cm.
B. Using one hand.

Q4) All of the following vitals are signs of cardiac arrest except
A. Carotid pulse not palpable
B. Pupils will be dilated (Mydriasis)
C. Radial pulse not palpable
D. Femoral pulse not palpable

Q5) Regarding defibrillator all of the following are true except:

A. Monophasic maximum is 360 J
B. Biphasic maximum is 200 J
C. In a biphasic waveform, the current initially flows in one direction then reverses.
D. monophasic waveforms, decrease the incidence of post resuscitation myocardial dysfunction
E. biphasic waveform decreases the incidence of myocardial damage.

! Q6) Head tilt and chin lift jaw thrust to visualize airway in unconscious patient
A. True
B. False

DONE BY: NAWAL & AKRAM 24

 PYQS
Q7) In CPR, you should perform chest compressions as fast as you can and as hard as you can.
A. True
B. False

Q8) The CPR chain of survival is composed of 4 points.

A. True
B. False

Q9) Irreversible death of brain cortex happens after 4 minutes maximum from cardiac arrest
A. True
B. False

Q10) Regarding Defibrillator which is true:

A. Biphasic is more effective than monophasic
B. Biphasic is smaller and portable
C. Both mon and biphasic have the same efficacy
D. The monophasic defibrillator requires less energy than a biphasic defibrillator for a successful defibrillation

! Q11) The speed or rate on compression for CPR:

A. 100-120 / m
B. 100 /m

Q12) During CPR a single compression should depress the chest 4-5 cm
A. True
B. False

Q13) The decision to start CPR should not exceed 10 seconds

A. True
B. False

Q14) Always start CPR with 2 breaths First

A. True
B. False

Q15) In a biphasic defibrillator, the current initially flows in one direction then reverses
A. True
B. False

DONE BY: NAWAL & AKRAM 25

 PYQS
Q16) Patient with pulseless Electrical Activity can be shocked with 360 J monophasic defibrillator
A. True
B. False

Q17) How long should not exceed the checking for pulse and breathing?
A. Up to 10 seconds
B. Up to 5 seconds
C. There is no limit
D. Up to 15 seconds

Q18) Basic life support must only be provided by trained medical personnel
A. True
B. False

Q19) When doing mouth to mouth ventilation we hyperventilate the patient

A. True
B. False

Q20) Two main signs of cardiac arrest are

1. LOC (altered level of consciousness)
2. Pulselessness

PRE-OPERATIVE:
Q1) Red meat before anesthesia :
A. 8 hours

Q2) Clear drinks before anesthesia:

A. 2 hours

Q3) The Fasting time prior to surgery after a meal that includes meat or fatty foods should be a least 18 hours
A. True
B. False

Q4) Mallampati Class III: The Soft palate and only the base of uvula are visible
A. True
B. False

DONE BY: NAWAL & AKRAM 26

 PYQS
Q5) Regarding preoperative planning all of the following are true except:
A. The patient should be kept NPO for 6 hours after eating fried chicken

Q6) Regarding mallampati all of the following are true except:

A. It is performed while the patient opens his mouth, and doesn’t protrude his tongue

Q7) How long should the patient fasted after meal containing fatty foods or meat, prior to induction of
anesthesia:
A. 6 hours.
B. 2 hours.
C. 1 hours.
D. 8 hours.
E. 4 hours.

Q8) How long should clear fluid be avoided before the induction of anesthesia :
A. 8 h
B. 2 h
C. 4 h
D. 6 h

Q9) Fasting of red meat before surgery

A. 8 hours

Q10) Fasting of breast milk before surgery

A. 4 hours

Q11) 1.5-year-old baby should be kept NPO 6 hours after ingesting formula milk
A. True
B. False

Q12) Hyperthyroidism is risk of perioperative thyroid storm.

A. True
B. False

Q13) Taking antihypertensive drugs even at the day of surgery.

A. True
B. False

DONE BY: NAWAL & AKRAM 27

 PYQS
Q14) Mallampati class 4 only hard palate
A. True
B. False

Q15) The leading postoperative cause of death in a non-cardiac surgery is MI.

A. True
B. False

Q16) Patients suffering from GERD are at higher risk of developing Mendelson’s Syndrome.
A. True
B. False

Q17) Generally, all Cardiovascular and pulmonary medications must be stopped at least 1 week preoperatively
A. True
B. False

Q18) Mild (SBP140 - 159mmHg, DBP 90 - 99mmHg) No evidence that delaying surgery for treatment affects
outcome
A. True
B. False

Q19) ASA V describes a patient unlikely to survive without the surgery

A. True
B. False

Q20) According to ASA classification system, ASA III would represent:

A. A normal healthy patient
B. A patient with mild systemic disease
C. A patient with severe systemic disease
D. A patient with sever systemic disease which is consider a threat to life
E. a patient with end stage disease and not expected to survive within 24 hours

Q21) Fasting time prior to surgery after a meal that includes meat or fatty foods should be a least 18 hours
A. True
B. False

DONE BY: NAWAL & AKRAM 28

 PYQS
Q22) All of the following are objectives of premedication except?
A. Allay anxiety and fear
B. Reduce secretion
C. Produce amnesia
D. Reduce the Ph of gastric content
E. Reduce post operative nausea and vomiting

Q23) A 1.5-year old baby should be kept NPO 6 hours after ingesting formula milk.
A. True
B. False

Q24) Pre-oxygenation increase the safe apnea time up to 8 mins

A. True
B. False

Q25) SBP 140–159mmHg, DBP 90–99mmHg: elective surgery should be postponed

A. True
B. False

Q26) Mallampati criteria ClassII: Soft palate, uvula (base + body), fauces
A. True
B. False

Q27) FRC is increased by 20% with induction of anesthesia

A. True
B. False

Q28) Mention the reasons for prescribing pre-medications.

• To ensure the safety of anesthesia
• To minimize the patient's surgical & anesthetic mortality & morbidity risk in the perioperative period.
• To ensure that the patient is in the best (or optimal) condition
• Documentation of the condition(s) for which surgery is needed:
• It offers the anesthetist an opportunity to define the patient's medical and surgical problems
• Further investigation, consultation, & treatment can be arranged for patients whose condition is not
optimal.
• Perioperative risk determination & develop an appropriate perioperative care plan.
• The anesthetist can provide information & reassurance for the patient during this stressful time
• Reduction of costs, shortening of hospital stay, reduction of cancellations & increase of patient satisfaction.

DONE BY: NAWAL & AKRAM 29

 PYQS
INHALATIONAL & CONDUCTION OF ANESTHESIA:
Q1) All of the following affect mac except:
A. Hypocapnea
B. Mexedema
C. Decreased age

Q2) Fastest inhalation agent:

A. Nitrous oxide

Q3) All are true about ketamine except:

A. Decrease intracranial pressure

! Q4) All true except about nitrous oxide: !?

A. Not mixed with natural air
B. No premedication

Q5) Induction of anasthesia with isoflurane carries a risk of Diffusion Hypoxia

C. True
D. False

Q6) Volatile anesthetic agents (fluranes), in general cause vasodilation

A. True
B. False

Q7) Regarding ketamine as an anesthetic. All are true except one ?

A. Contraindicated in patient who has asthma because it causes bronchospasm
B. Produces analgesia
C. Produces dissociative anesthetic state
D. Water soluble and 10 X more lipid soluble in comparison to thiopental
E. Recovery of anesthesia is associated with emergence phenomenon of hallucinations and vivid dreams

Q8) Wrong about MAC:

A. Halothane 0.75%.
B. Desflurane 3%.
C. Sevoflurane 2%.
D. N2O 105%.

Q9) Wrong about indication of inhalational anasthesia:

A. Absolute upper airway obstruction

DONE BY: NAWAL & AKRAM 30

 PYQS
Q10) All of the following affect MAC except:
A. Hypercapnia

Q11) All of the following are properties of N2O except:

A. Good anasthetic week analgesic

Q12) Regarding MAC, one is correct

A. The MAC of Desflurane is 3 times of Sevoflurane
B. The MAC of Enflurane is 2 times of Isoflurane
C. The MAC of Isoflurane in female is less than in male patients
D. Halothane has a MAC of about 0.97%.
E. Nitrous oxide has a MAC of 501%

Q13) Regarding isoflurane, all are true except:

A. It doesn't contain preservative.
B. It has a pungent odor.
C. It causes coronary vasoconstriction.
D. Carcinogenic (not approved).
E. It is supplied in amber colored 100 ml glass bottles.

Q14) Regarding sevoflurane, all are true except:

A. It has a pungent odor
B. Less potent than similar halogenated agents.
C. Lower effect on CVS comparing to other agents.
D. Rapid induction.
E. Does not sensitize the myocardium to catecholamines as much as halothane

Q15) All are true about N2O except:

A. Week analgesic
B. Week anesthetic
C. MAC 105%
D. Not metabolize in the body

Q16) All of the following are indication of inhalational anesthesia except:

A. Partial upper airway obstruction
B. Bronchopleural fistula
C. Needle phobia
D. Complete upper airway obstruction
E. Young patient

DONE BY: NAWAL & AKRAM 31

 PYQS
Q17) All of the following are true regarding halothane except:
A. Arrythmia
B. Post- operation shivering
C. Bronchoconstriction
D. Post operation nausea and vomiting
E. Hepatic toxicity

Q18) All of the following decrease MAC except:

A. Hypothyroidism
B. Hypothermia
C. Increase age
D. Hyperthermia

Q19) Fastest inhalational agent:

A. Nitrous oxide

Q20) Which one is true about MAC?

A. Mac of isoflurane is less than sevoflurane

Q21) Wrong about MAC:

A. Desflurane is 3%

Q22) All are indication for induction of inhalational anesthesia except

A. Partial airway obstruction (epiglottitis)
B. Complete airway obstruction

Q23) Halothane has a pleasant smell.

A. True
B. False

Q24) Increase the rate of gas flow from the anesthetic machine will speed up inhalation induction
A. True
B. False

Q25) N2o is a blue gas that is kept in blue cylinder

A. True
B. False

DONE BY: NAWAL & AKRAM 32

 PYQS
Q26) Halothane and can decrease min. Ventilation and increase RR
A. True
B. False

Q27) Regarding nitrous oxide which one of the following is correct

A. It isn’t metabolized in the body

Q28) All inhalational agents can cause an increase in the tidal volume
A. True
B. False

Q29) Nitic oxide cause significant airway irritation

A. True
B. Fasle

Q30) Fresh gas flow sited: 2 L/min O2 + 4 L/min N20, the Conc. of N20 will be 66%
A. True
B. False

! Q31) One of the side effects of Sevoflurane is Coronary Steal Phenomenon

A. True
B. False

Q32) The MAC of halothane in female patients is less than in male patients
A. True
B. False

Q33) HTN and hyperkalaemia had no effect on MAC

A. True
B. False

Q34) Isoflurane and sevoflurane cause uterine relaxation

A. True
B. False

Q35) The MAC for desflurane is 6%.

A. True
B. False

DONE BY: NAWAL & AKRAM 33

 PYQS
Q36) Increasing the delivered concentrations of the anesthetic let the inhalational agent reach the brain
quicker
A. True
B. False

Q37) 4L of N20 with 2L of O2, percentage of O2 = 33%

A. 33%

Q38) Decrease minute ventilation increases MAC in ventilation

A. True
B. False

Q39) Acid base balance doesn't affect agent MAC

A. True
B. False

Q40) Diffusion hypoxiais caused by Nitric oxide

A. True
B. False

Q41) Isoflurane is color less volatile sweet odor

A. True
B. False

Q42) Halothane is weakest anesthetic

A. True
B. False

Q43) Halothane 0.7% = 75mg/ml

A. True
B. False

Q44) Give 3 indications for absolute inhalation anesthesia:

1- Young child
2- Needle phobia
3- Bronchopleural fistula

DONE BY: NAWAL & AKRAM 34

 PYQS
Q45) Mention 3 late complications of intubation:
• Tracheal stenosis
• Damage to tracheal mucosa
• Trauma to vocal cords may result in ulceration

Q46) Mention the factors that affect the speed in which the inhalational agent diffuses to the alveoli?
1. Increasing the delivered concentrations of anaesthetic
2. The gas flow rate through the anaesthetic machine
3. Increasing minute ventilation (MV = RespiratoryRate × Tidalvolume)

INTRAVENOUS ANESTHETIC:
Q1) All of the following about sevoflurane are true except:
A. Irritant
B. Sweet smell

Q2) In comparison between IV anesthesia and inhalational anesthesia are correct except :
A. Induces bronchospasm More than IV
B. Induces laryngospasm more than IV
C. Gets the patient into third stage anesthesia more rapid
D. Slow induction

Q3) All Of the following are characteristics of ideal IV anesthesthatic EXCEPT:

A. No analgesic effect

Q4) Propofol should be avoided in patients with previous history of malignant hyperthermia
A. True
B. False

Q5) In patients with increased blood pressure, ketamine is more favored than propofol
A. True
B. False

Q6) All are true concerning Sodium Thiopental (Pentothal) except ?

A. It is a yellow powder with Sulphuric acid and bitter taste
B. It is highly protein bound by albumin (75%)
C. It is stable in room temperature for 2 weeks
D. It is bacteriostatic in water and has a pH of 10.6 to 10.8
E. It is highly water soluble with no or minimal lipid solubility

DONE BY: NAWAL & AKRAM 35

 PYQS
Q7) Wrong about propofol:
A. Decrease ICP.
B. Decrease in arterial blood pressure.
C. No pain on injection.
D. Profound respiratory depression.

Q8) Ketamine cause all the following except:

A. Non analgesic effect.
B. Increase arterial blood pressure.

Q9) Which of the following anesthetic agent could be used in malignant hyperthermia?
A. Propofol

Q10) All of the following are characteristics of the ideal anesthetic agent except?
A. Rapid recovery
B. Rapid recovery due to early liver metabolism

Q11) All of the following are contraindications of Propofol except:

A. Porphyria

Q12) All of the following are signs of inadequate anesthesia except?

A. Bradycardia

Q13) Regarding the pharmacodynamics of sodium thiopental, all are true except one
A. It can be used to stop seizure activity in emergency situations
B. It decreases the intraocular and reduces the elevated intracranial pressure
C. Sodium thiopental has an anti-analgesic effect
D. It facilitates inhibitory neurotransmitters such as gamma amino butyric acid
E. It increases both cerebral electrical and metabolic activity

Q14) Regarding sodium thiopental, all are correct except:

A. It's stable at room temperature for 2 weeks
B. It's a yellow powder with a sulfur smell.
C. It's metabolized primarily in the liver.
D. In increases the contractility of the gravid uterus
E. It will decrease the cerebral electrical and metabolic activity.

DONE BY: NAWAL & AKRAM 36

 PYQS
Q15) All are correct except one, BDZs:
A. Have minimal cardio respiratory depressant effect.
B. Inhibit the actions of glycine which results in the antianxiety effect.
C. Facilitate the actions of GABA which results in the anticonvulsant effect.
D. Are highly lipid soluble.
E. Have a high incidence of tolerance & dependence.

Q16) According to diazolam and midazolam all are true except:

A. Midazolam is more potent
B. Midazolam has rapid onset of action
C. Midazolam is more expensive
D. Diazolam need higher dose of flumazenil
E. Midazolam has more post operative sedative effect

Q17) Thiopental intra- arterial injection all are true except:

A. Dilution of the drug by the administration of saline into the artery,
B. Heparinization to prevent thrombosis, and
C. Brachial plexus block.
D. Don’t call for help

Q18) Drug used in malignant hyperthermia:

A. Propofol

Q19) Wrong about ketamine:

A. It is non analgesic

Q20) Flumazenil has a greater elimination half-life than all benzodiazepines

A. True
B. False

Q21) It’s contraindicated to give bupivacaine IV because it causes cardio toxicity

A. True
B. False

Q22) Purified egg phosphatide is one of the components of Fentanyl

A. True
B. False

DONE BY: NAWAL & AKRAM 37

 PYQS
Q23) Diazepam has less postoperative sedative effect than midazolam.
A. True
B. False

Q24) An ideal IV anesthetic agent has low lipid solubility.

A. True
B. False

Q25) Thiopental is yellow powder

A. True
B. False

Q26) Regarding ketamine as an anesthetic. All are true except one:

A. Contraindicated in patient who has asthma because it causes bronchospasm
B. Produces analgesia
C. Produces dissociative anesthetic state
D. Water soluble and 10% more lipid soluble in comparison to thiopental
E. Recovery of anesthesia is associated with emergence phenomenon of hallucinations and vivid dreams

Q27) Regarding the pharmacodynamics of sodium thiopental, all are true except one
A. It can be used to stop seizure activity in emergency situations
B. It decreases the intraocular and reduces the elevated intracranial pressure
C. Sodium thiopental has an anti-analgesic effect
D. It facilitates inhibitory neurotransmitters such as gamma amino butyric acid
E. It increases both cerebral electrical and metabolic activity

Q28) Sodium thiopental is used to decrease the ICP

A. True
B. False

Q29) Propofol increases cerebral blood flow and intracranial pressure

A. True
B. False

Q30) All of the following are true according propofol except :

A. Has no effect on muscle relaxant.
B. Increase cardiac preload
C. Cause profound respiratory depression
D. Decrease cerebral blood flow
E. Decrease cardia contractility

DONE BY: NAWAL & AKRAM 38

 PYQS
Q31) Propofol precipitates histamine release and triggers malignant hyperthermia.
A. True
B. False

Q32) Naloxone is the antidote of benzodiazepines overdose

A. True
B. False

Q33) Benzodiazepines are highly protein bound:

A. True
B. False

Q34) Propofol ampoule contains purified egg phosphatide

A. True
B. False

Q35) Diazepam (valium) ® but not midazolam, provides amnesia and reduction of anxiety
A. True
B. False

Q36) Total intravenous anesthesia (TIVA) is indicated by patients with bronchopleural fistula
A. True
B. False

Q37) Pain on injection occurs more common with Propofol than with thiopental
A. True
B. False

Q38) Thiopental has anti analgesic effect since low dose can decrease pain threshold
A. True
B. False

Q39) Ketamine metabolized in the liver

A. True
B. False

Q40) Etomidate is dissociative anesthesia

A. True
B. False

DONE BY: NAWAL & AKRAM 39

 PYQS
Q41) The anesthetic agent that contains soybean oil and purified egg phosphatide is etomidate
A. True
B. False

Q42) Ketamine has anesthetic but not analgesic

A. True
B. False

Q43) Propofol causes post-operatively nausea and vomiting

A. True
B. False

Q44) Thiopental causes the patient is unconscious but appears awake and doesn't feel pain
A. True
B. False

Q45) Propofol is a sweet drug in the OR , but definitely not for home use
A. True
B. False

Q46) Mention 3 examples of Non-barbiturates:

• Ketamine / Propofol / Etomidate

MUSCLE RELAXANT:
Q1) All non-depolarizing muscle relaxants don’t cross BBB:
A. True
B. False

Q2) Myotonia congenita is one of the main indications of succinylcholine.

A. True
B. False

Q3) Mivacurium is a short acting non-depolarizing muscle relaxant:

A. True
B. False

Q4) Decrease in serum K+ conc. Potentiate the effect of the muscle relaxant
A. True
B. False

DONE BY: NAWAL & AKRAM 40

 PYQS
Q5) There's transient & brief Hypokalemia following succinylcholine:
A. True
B. False

Q6) Regarding the use of Suxamethonium, all are true except ?

A. A lower dose is required in smaller children
B. Can raise the serum potassium by 0.5 mmol/L
C. Bradycardia is a complication
D. It is a triggering substance to malignant hyperthermia
E. Prolonged duration of action may be seen in some patients

Q7) Wrong about side effects of Suxamethonium:

A. Decrease IOP.
B. Myalgia.
C. Increase ICP.

Q8) Regarding succamethonium all of the following are true except?

A. It increases the intra gastric pressure more than the LES (lower esophageal sphincter) tone

Q9) In a patient who fails to breathe 1 hour after administration of only 80 mg Succinylcholine (one is correct):
A. 2.5 mg neostigmine should be given
B. The metabolism of lidocaine may well be impaired
C. A serum potassium of 2 5 mmol/L is a possible cause
D. The same response would be expected in all sibling
E. The pseudocholinesterase gene is likely to be homozygous atypical

Q10) All of the following are features of depolarizing block except:

A. Rapid onset of action
B. Fasciculations
C. Not to be antagonized by anticholinesterase
D. Intermediate duration of action
E. A rise in intraocular pressure

Q11) The duration of non-depolarizing neuromuscular blockers may be prolonged by all of the following except
A. Hypokalemia
B. Hypercarbia
C. Metabolic acidosis
D. Treatment with pyridostigmine
E. Hypothermia

DONE BY: NAWAL & AKRAM 41

 PYQS
Q12) One of the following statements is correct:
A. Patients with extensive 3rd degree burns are prone to hypokalemia following succinylcholine.
B. There is transient and brief hypokalemia following succinylcholine.
C. Mivacurium is a short acting depolarizing muscle relaxant.
D. Myotonia congenita is one of the main indications of succinylcholine.
E. Endotracheal intubation can be done awake under local anesthesia.

Q13) Suxamethonium side effect all are true except:

A. Loss of consciousness
B. Bradycardia
C. Myglobeniemia
D. Increase intraocular pressure

Q14) About Succinylcholine, one is wrong?

A. It decreases the pressure of lower esophageal sphincter

Q15) Increase duration of non-depolarizing blocking agents except:

A. Young patient

Q16) Pancuronium is metabolized by Hoffman degradation in the plasma.

A. True
B. False

Q17) Suxamethonium is the muscle relaxant of choice in open eye surgery.

A. True
B. False

Q18) Myotonia Congenita is an indication for succinylcholine use.

A. True
B. False

Q19) Succinylcholine consists of:

A. 2 acetylcholine

Q20) Mivacurium is short acting non depolarizing muscle relaxant.

A. True
B. False

DONE BY: NAWAL & AKRAM 42

 PYQS
Q21) Transient hypokalemia is Side Effect for succinylcholine.
A. True
B. False

Q22) The synaptic cleft in the NMJ is 20-30 nm

A. True
B. False

Q23) Suxamethonium is safe in patients with K+ level of 5.5 Meq/L

A. True
B. False

Q24) There's transient & brief Hyperkalemia following succinylcholine

A. True
B. False

Q25) Atracurium is an intermediate acting depolarizing muscle relaxant

A. True
B. False

Q26) Metabolic acidosis and hypokalemia decrease the effect of non-depolarizing muscle relaxants
A. True
B. False

Q27) All of the following are features of depolarizing block except one:
A. A rise in intraocular pressure
B. Short duration of action
C. Fasciculations
D. Rapid onset of action
E. Antagonism by anticholinesterases

Q28) Rocuronium has minimal effect on the cardiovascular system

A. True
B. False

Q29) Patients with extensive 3rd degree burns are prone to hypokalemia following succinylcholine
A. True
B. False

DONE BY: NAWAL & AKRAM 43

 PYQS
Q30) All non-depolarizing muscle relaxants don’t cross BBB
A. True
B. False

Q31) Cholinesterase inhibitor inhibit the cholinesterase at NMJ level

A. True
B. False

Q32) Atracuruim elimination by Hoffman degradation reaction.

A. True
B. False

Q33) Suxamethonium cause bradycardia specially in pediatrics

A. True
B. False

Q34) All neuromuscular blocking agents can't be analgesics and anesthetics

A. True
B. False

Q35) Side effects of suxamethonium on these systems?

• CNS:
❖ NO effect on consciousness, pain threshold & cerebral fnx
❖ ↑ intra-ocular pressure ❖ ↑ intracranial pressure
• MSS :
❖ Skeletal muscles paralysis ❖ Myalagia
❖ Myoglobinemia , myoglobinurea ❖ Malignant hyperthermia
❖ Messeter muscle spasm
• GU:
❖ Because metabolites excreted by kidneys, patients with RF may have hyperkalemia
• RS:
❖ Respiratory muscles paralysis
• CVS :
❖ Bradycardia
❖ Dysarrythmia
❖ Sinus arrest

DONE BY: NAWAL & AKRAM 44

 PYQS
MONITORING :
Q1) Pulse Oximetry depends on differences in light absorption between OxyHb and DeoxyHb
A. True
B. False

Q2) Cyanosis is defined as the presence of 5 gm/d1, of deoxygenated hemoglobin (deoxy Hb).
A. True
B. False

Q3) (SBP > 180mmHg , DBP > 109mmHg) At this level, elective surgery should be postponed
A. True
B. False

Q4) Regarding intra-operative monitoring, all of the following are true except?
A. Oxygenation should be monitored by patient color and ventilation
B. 3 or 5 lead electrode system is used for ECG monitoring in the OR
C. Inadequate depth of anesthesia is signaled by bradycardia, hypotension, and sweating
D. Continuous pressure monitoring is mandatory if changes in temperature are anticipated or suspected
E. Arterial blood gas analysis is required for assessing both oxygen and ventilation

Q5) All are early signs of successful intubation EXCEPT:

A. Visualize the vocal cords and observing the tube
B. Mid axillary auscultation
C. Pulse oximeter.
D. Capnography

Q6) ETCO2 decrease in:

A. Pulmonary embolism
B. Hyperthermia
C. Malignant hyperthermia

Q7) All of the following are dehydration signs except:

A. Hypotension.
B. Tachycardia.
C. Dry mucous membrane.
D. Bradycardia.

DONE BY: NAWAL & AKRAM 45

 PYQS
Q8) All of the following are places to measure temperature except:
A. Upper esophagus
B. Lower esophagus

Q9) All of the following would be found after losing 1000 ml of blood except:
A. Urinary output 50 ml per hour
B. Diastolic blood pressure increase
C. Systolic blood pressure normal

Q10) According to the mallampati classification, class 3 represents:

A. Soft palate, faucal pillars & uvula visible.
B. Epiglottis visible only.
C. Soft palate not visible.
D. Soft palate and base of uvula are visible
E. Only tip of uvula, soft palate & faucal pillars visible.

Q11) regarding pulse oximetry, all are correct except one:

A. It depends on differences in light absorption between oxyHb & deoxyHb.
B. Red & Ultraviolet frequencies transmitted through a translucent portion
C. Microprocessors analyze amount of light absorbed the 2 light waves.
D. It allows beat to beat analysis of oxygenation.
E. It can be placed on finger-tip or earlobe.

Q12) According to ASA classification system, one is wrong:

A. ASA4 indicates severe illness

Q13) All of the following are objectives of premedication except ?

A. Reduce post operative nausea and vomiting

Q14) One is a wrong statement about ETCO2?

A. Hyperventilation increases ETCO2

Q15) Increase tidal CO2 except:

A. Hypothermia

Q16) Which is wrong about asa grade:

A. Asa 1 is moderate or mild disease

DONE BY: NAWAL & AKRAM 46

 PYQS
Q17) DM patient have increased risk of post-op wound infection
A. True
B. False

Q18) 12-lead ECG is the standard ECG system used in the OR.
A. True
B. False

Q19) To visualize pulse wave analysis is done by plethysmograph

A. True
B. False

Q20) all of followings are monitoring for cardio except

A. Central venous pressure
B. ECG
C. TEE
D. Capnogram
E. pulmonary artery catheter

Q21) Invasive blood pressure monitoring is most commonly performed using a radial artery catheter
A. True
B. False

Q22) Normal urine production during anesthesia is >=0.5 ml/kg/hr

A. True
B. False

Q23) ETCO2 may increase during laparoscopic surgery

A. True
B. False

Q24) Adequate depth of Anesthesia is signaled by Sweating and tearing in mid-operation

A. True
B. False

Q25) CO poisoning gives an overestimation of the true O2 saturation (SaO2). E.g. Burn victims
A. True
B. False

DONE BY: NAWAL & AKRAM 47

 PYQS
Q26) Central Line insertion in the Right internal jugular vein is preferred for its lack of risk of iatrogenic
pneumothorax
A. True
B. False

Q27) The heightened Production of CO2 and the lowered Elimination CO2 will increase EtCO2 (CO2 retention)
A. True
B. False

Q28) Pulse Oximetry allows beat to beat analysis of oxygenation

A. True
B. False

Q29) Name 4 sites for measurement of core body temperature?

1. Lower Esophagus
2. Tympanic
3. Nasopharynx
4. Rectum.

Q30) Give 3 indication of CVP:

1- Major surgery or trauma
2- Advanced Cardiopulmonary disease
3- Secure vascular access for drugs

Q31) Give 2 complications of CVP:

1- Arrhythmia
2- Pneumothorax

ANTI-CHOLINERGIC:
Q1) All of the following about Glycopyrrolate true except:
A. Cause tachycardia more than atropine
B. Cause tachycardia less than atropine

Q2) Glycopyrrolate doesn’t cross BBB so has no CNS effect

A. True
B. False

Q3) Atropine crosses BBB:

A. True
B. False

DONE BY: NAWAL & AKRAM 48

 PYQS
Q4) All are true about Atropine, except one ?
A. May cause bradycardia at a very low dose
B. Dilates the pupil in premedical dose
C. Has a shorter duration of action that glycopyrrolate
D. May cause mouth dryness
E. Has both muscarinic and nicotinic effects

Q5) One of the following is a reversible Anticholinesterase ?

A. Organophosphates
B. Neostigmine
C. Glycopyrrolate
D. Ranitidine
E. Atropine

Q6) Atropine cause all the following except:

A. Mydriasis.
B. Myosis.
C. Increase IOP.
D. Xerostomia.

Q7) Tachycardia maybe expected by administration of one of the following drugs:

A. Neostigmine
B. Pancuronium
C. Suxamethonium
D. Thiopental
E. Propranolol

Q8) one of the following is true, scopolamine:

A. Produces peripheral effects less atropine.
B. Provokes nausea & vomiting.
C. Causes mydriasis
D. Has less action on CNS than atropine,
E. Has a weaker antisialogogue effect than atropine

Q9) All are use for atropine except :

A. Close angle glaucoma
B. With neostigmine to reverse the effect of acetylcholine
C. Parkinson
D. Poisoning with organophosphate

DONE BY: NAWAL & AKRAM 49

 PYQS
Q10) Atropine causes all of following except:
A. Miosis

Q11) Atropine cause all the following except:

A. Mydriasis
B. Decrease IOP
C. Increase IOP
D. Xerostomia

Q12) One of the following is used to decrease arrhythmia:

A. Neostigmine.
B. Etomidate
C. Suxamethonium.
D. Thiopental.
E. Propranolol

Q13) One is false regarding atropine :

A. Has effect on both muscarinic and nicotinic receptors

Q14) One of the following is a reversible anticholinesterase

A. Organophosphates
B. Neostigmine
C. Glycopyrrolate
D. Ranitidine
E. Atropine

Q15) All are true about Atropine, except one

A. May cause bradycardia at a very low dose
B. Dilates the pupil in premedicate dose
C. Has a shorter duration of action that glycopyrrolate
D. May cause mouth dryness
E. Has both muscarinic and nicotinic effects

Q16) Acetylcholinesterase inhibitors cause bradycardia and hypersalivation

A. True
B. False

DONE BY: NAWAL & AKRAM 50

 PYQS
Q17) Anticholinergic drugs antagonize the action of acetylcholine
A. True
B. False

Q18) What are the effects of Atropin on:

• CVS:
❖ Bradycardia on low dose
❖ Tachycardia on high dose
• GI: Reduce activity
• Eye:
❖ Mydriasis, cycloplegia, increase IOP and reduce lacrimal secretions
• Salivation:
❖ Xerostomia (reduce production)

DONE BY: NAWAL & AKRAM 51