Paper 1

Yemeni Council for Medical Specialization

Aden Branch
Specialization degree in Anesthesia and ICU
Re-Examination 2016

Time : 1H Date : 12 April 2016

Name: .

Answer the following questions: -

1. Write th

2. Anesthetic complications of obesity . (10 marks)

3. laryngospasm : define laryngospam , and how to ovoid its

occurrence and what's the immediate management ? (10 marks )

4. Write short notes about the following :

a. ASA : what does it means and explain each one (5 marks )

b. Dual block and its management ( 5 marks )
c. Problems of prone position. ( 5 marks )
d. Complication of CVP ( 5 marks )

Paper 2
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 Yemeni Council for Medical Specialization
Aden Branch
Specialization degree in Anaesthesia and ICU
Re- Examination – 2016

Time : 1 H Date : 12 April 2016

Name : -----------------------------------------------

Write the letter ( T) for true and (F ) for false at the end of each
of the following statements :

1. The first line of management to decrease intracranial

pressure during during neurosurgical operation :
a. Direct drainage of CSF by PV shunt.F
b. Hyperventilation. T
c. Hyperventilation with manitol .
d. Hypotensive anaesthesia .F

2. Cardiac dysarryhmias during anaesthesia :

a. Are more frequent during hypercapnea . T
b. Can de terminated by lignocain or beta blocker T
c. Are more frequent in the presence of hypoxia. T
d. Potentiated by halothane . T

3. In un-correct lithothomy position may lead to the

following:
a. Saphenous nerve damage.F (Femoral nerve)
b. Lateral popliteal nerve damage.F
c. Sacro-iliac strain.F
d. Hip dislocation T

4. The fallowing are features of the TURP (Transurethral

resection of the prostate )
a. Confusion. T
b. Hyperthermia. F (Hypothermia)
c. Haemolysis .T
d. Hypotension. F (Hypertension)

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 5. Isoflurane :
a. Is the drug of choice for neurosurgery.F
b. Is safer than halothane when used with adrenaline.T
c. Is more potent than halothane. F (Halothane more
potent)
d. MAC is more than N2O. F (less)

6. The blood brain barrier is :

a. Not crossed by all muscle relaxant . T
b. Crossed by all opiodes . T
c. Crossed by atropine . T
d. Not present in neonates . T

7. The oxygen –dissociation curve shift to the left :

a. Metabolic alkalosis . T
b. Hyperthermia F
c. Hypothermia . T
d. Respiratory acidosis . F

8. Tracheostomy :
a. Is indicated in upper airway obstruction.T
b. Increase anatomical dead space . F (Decrease)
c. May cause tracheal stenosis. T
d. By pass the humidified gases. T

9. The following MAC are correct at normal atmospheric

pressure.
a. Nitrous oxide 104 T
b. Halothane 0.75. T
c. Ether 12 F (3.2)
d. Isoflurane 102 T

10. Mechanical ventilation :

a. High frequency ventilation (HFV) provide high
respiratory rate reach up to 3000 in oscillation. F
(300-900)
b. CPAP used for conscious and unconscious. F
(unconscious only)
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 c. PEEP improve gas exchange but lead to
pneumothorax in more than 50 cm H2o. T
d. IMV used for start and weaning a patient from
mechanical ventilation . F

11. Myalgia ( Muscle pain ) found in 20 -30 % of the patients,

can be treated post operatively by :
a. NSID as volteran .
b. Epidural patch .
c. Heavy premedication.
d. High dose of suxamethonium

12. Halothane hepatitis because of :

a- Excessive administration of halothane , enflourane and
isoflurane .
b- Repeated dose of halothane in less than 3 months .
c- Commonly in liver disease patient .
d- When halothane exceed 0.9% .

13. O2 dissociation curve shift to the right when there is :

a- Increase temperature. T
b- Decrease temperature. F
c- Decrease H ion concentration ( alkalosis ) F
d- Increase H ion concentration ( acidosis ) T

14. Drugs employed in anesthesia causing hypertension

resulting increase in blood loss during surgery :
a- Ketamine . T
b- Morphine . F
c- Tubocurarine F
d- Halothane . F

15. Hyperkalemia is a potentially life threatening clinical

problem :
a- During massive haemolysis by mismatch blood T
b- During massive administration of suxamethonium T
c- During massive transfusion of old blood .T
d- Due to excessive vomiting . F
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16. Exhaled air (expired air ) contain :
a- 40-50% oxygen . F
b- 21-40% oxygen . F
c- 16- 18 % oxygen . T
d- 10-20 % oxygen . F

17. Post operative respiratory insufficiency might be due to :

a- Hemorrhage.
b- Over dose of the narcotic analgesic .
c- Pain especially in abdominal operation.
d- Un adequate ventilation.

18. Regarding tracheostomy.

a- It is the procedure of choice in case of respiratory
failure . F
b- It is the procedure of choice in a case of upper air way
obstruction . T
c- Tracheal stenosis is one of the late complication T
d- Surgical emphysema is one of the late complication. F

19. Malignant hyperpyrexia lead to increase temperature

and muscle rigidity .
a- Oxygen and nitrous oxide are given T
b- Dantroline has been administered IV F
c- Halothane has been administered T
d- Suxamethonium the main cause T

20. Features of thyrotoxicosis in young adult patient include:

a- Large goiter .T
b- Hypertension .T
c- Arterial fibrillation .T
d- Tremor .T

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21. The first line of management to decrease intracranial
pressure during neurosurgical operation :
e. Direct drainage of CSF by PV shunt.F
f. Hyperventilation.T
g. Hyperventilation with manitol .
h. Hypotensive anaesthesia F

22. Delayed recovery in pediatric anaesthesia because of :

a. Redistribution of the drugs.
b. Hypothermia.
c. Airway resistance
d. Hypoxia.

23. Laryngeal mask is a recent device which an alternative to

both face mask and tracheal tube to secure the airway:
a. Need deep anaesthesia for its insertion F
b. Used for difficult and non difficult intubation. T
c. Gastric aspiration one of its complication.F
d. Available only in adult size .F

24. Nasal intubation is recommended in :

a- Post tonsillectomy bleeding.T
b- Pediatric anaesthesia.
c- Nasal polyp.F
d- Foreign body aspiration.F

25. Patient can die on the table because of :

a- Light anesthesia .F
b- Esophageal intubation .T
c- Low dose of muscle relaxant .F
d- In adequate ventilation .T

26. Post operative hypoxemia may occur as a result of:

1. N2O diffusion.
2. Central depression of the ventilation.

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 3. Fentanyl given 2 hours previously.
4. Incomplete reversal.

27. Mallampati test :

a- Obtained only by laryngoscopy .
b- Grade 3 no part of the glottis is visible ( difficult
intubation ).
c- Identified the size of the base of the tongue .
d- Grade 1-2 good intubation .

28. Ventimask .
a- Depend on venturi principle.T
b- Can introduce 100 % oxygen to the patient.F
c- Can be used in associated with CPAP .F
d- Can give oxygen percentage more than 21% .T

29. Which of the fallowing induction increase ICP:

a- Thiopenthane
b- Propofole F
c- Ketamine F
d- Midozalam F

30. 3 years old child is scheduled for hernictomy, clear liquids

my be consumed up to how many hours preoperatively :
a- 2 Hours T
b- 4 Hours
c- 6 Hours
d- Any time before induction

31. The main component of the soda lime granule is :

a- Silica.
b- Sodium hydroxide T
c- Potassium hydroxide
d- Calcium hydroxide

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32. Which of the muscle relaxant is eliminated mainly by renal
excretion :
a- Panacronuim T
b- Vecronuim F
c- Rocuronium F
d- Doxacurium T

33. 10 kg baby has been fasting for 4 hours , during the first
hour of surgery , the amount of the intravenous fluids the child
should received is :

a- 60 ml
b- 80 ml
c- 120 ml
d- 100 ml T

34. The blood volume of a 10 kg – I year old is:

a- 650ml T
b- 800 ml
c- 1100ml
d- 1500 ml

35. The expected complication of Hypotensive anaesthesia

immediately after anaesthesia is :
a. Convulsion.
b. Spastic and shivering for at least 2 hours.
c. Rebound hypertension.
d. Prolonged recovery

36. Which of the fallowing nerve is most likely to become

injured under GA:
a- Ulner nerve T
b- Median nerve
c- Radial nerve
d- Femoral nerve

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37. The physiological reflex during laryngoscopy and intubation
are the fallowing except :
a- Hypertension F
b- Increase intracreanial pressure T
c- Laryngospasm T
d- Arythmisasis T

38. Administration of ketamine cause:

a- Decrease heart rate F
b- Increase heart rate T
c- Decrease in cardiac out put F
d- No change in cardiac out put F

39. The advantage of the closed circuit anaesthesia are all

except:
a- Decrease anaesthetic prolusion
b- Humidification of the inspired air
c- Economic for the inhalation agent .
d- Allow early leakage of circuit

40. Which of the fallowing intravenous fluids used to decrease

the viscosity of packed RBC :
a- Normal saline
b- Dextrose5%
c- DNS
d- Ringer lactate
41. Regarding post operative shivering :
a- It may increase the oxygen consumption
b- It may increase the metabolism
c- Can be treated with small dose of opiods
d- Mainly due to suxamethonuim

42. The best method to decrease the intraocular reflex is :

a- Preoperative IV atropine
b- A reterobulbar block .
c- Administration of suxamethonium
d- Control the bleeding during surgery .

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43. The effect of auto PEEP all except:
a- Decrease venous return T
b- Increase the work of the breathing F
c- Easier triggering of the ventilator .T
d- Alveolar distension T

44. Post operative hypoxemia may occur as a result of :

a. N2O diffusion .
b. Central depression of the ventilation.
c. Fentanyl given 2 hours previously.
d. Incomplete reversal.

45. Lesion of the cauda equine may produce:

a. Drop foot .F
b. Upper motor neuron lesion F
c. Incontinence of urine .T
d. Weakness of the lower limb muscle.F

46. Immediate treatment of anaphylaxis includes :

a. Corticosteroid administration.T
b. 0.5 mg adrenaline.T
c. Oxygen.T
d. Diazepam.F

47. Concerning pulse oximetry :

a. Measurements are accurate in carbon mono oxide
poisoning.F
b. Measure oxygen saturation in relation to hemoglobin .T
c. Measure the partial pressure of oxygen (PO2) F
d. It is accurate in dark colored skin people .F

48. Fibro- optic intubation :

a. Excellent for upper airway bleeding .F
b. Used if difficult intubation predictable .T
c. Insertion can be oral or nasal .T

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 d. No need for laryngoscopy for insertion .(fibro-optic
laryngoscope)

49. Epidurall space can be identify by :

a- Leakage of CSF .
b- Loss of resistance method .
c- Negative pressure sign by hanger drop sign .
d- Positive pressure sign by odam's indicator .

50. In ring block xylocine can be used :

a- Without adrenaline .
b- With adrenaline .
c- In low concentration as 7 mg/kg .
d- 7.5% xylocain is the best .

Prof. Dr. Raga Ahmed Ali Musaid

Coordinator of the anesthesia Medical Specialization
Aden – Yemen 2016

12 April 2016

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