MISSING MCQS Q10: A 75-year-old dialysis patient underwent exploratory laparoscopy and lysis of adhesions.

You are asked to recommend an appropriate postoperative analgesic regimen. Of the following, which is the best treatment option? A. PCA morphine B. PCA meperidine C. IM ketorolac D. Transdermal fentanyl E. PCA hydromorphone ANS: E Q11: All of the following are possible side effects of carbamazepine EXCEPT A. Vertigo B. Thrombocytopenia C. Hypertension D. Diplopia E. Gingival hyperplasia ANS: E Q35: Which of the following statements is true regarding the use of antidepressants as analgesics? A. The analgesic effect is primarily due to the relief of depression B. The antidepressants have no analgesic effect in patients who do not have depression C. To obtain analgesia, a trial of at least 6 months is needed D. Analgesic response usually occurs at a lower dose than that required for treatment of clinical depression ANS: D Q36: Which of the following local anaesthetics is NOT recommended for use in tissue infiltration? A. Procaine B. Tetracaine C. Lidocaine D. Bupivacaine ANS: B SUMMARY OF DIRECTIONS A B C D E 1,2,3 1,3 2,4 4 All are only only only only correct Q61: Which of the following can cause severe drug induced myalgia? 1. Trazodone 2. Amphetamines 3. Acetaminophen 4. Alcohol ANS: C Q62: Compared with morphine, buprenorphine 1. is more potent 2. is more lipid soluble 3. has a greater affinity for opioid receptors 4. is less protein bound ANS: A Q86: Phenol in glycerin, a commonly used subarachnoid neurolytic agent 1. is less painful on injection compared with alcohol 2. is hyperbaric compared with the CSF 3. causes nonselective destruction of nervous tissue 4. produces neurolysis by causing protein degeneration ANS: E

CHOICE THE BEST Q109: The uncommon Sluders neuralgia, characterized by severe pain in the face bellow the eyebrows, primarily involves the A. Gasserian ganglion B. Sphenopalatine ganglion C. Ciliary ganglion D. Geniculate ganglion E. Trigeminal nerve ANS: B Q110: Which of the following types of headaches is most likely to be responsive to inhalation of 100% oxygen? A. Migraine headache B. Tension headache C. Cluster headache D. Cervicogenic headache E. Chronic paroxysmal hemicrania ANS: C Q131: A 50-year old, previously healthy man presented to the emergency room with nausea, dizziness, and headache after eating at a Chinese restaurant. The symptoms subsided over the next several hours. Upon discharge from the emergency room, his physician told him to avoid which of the following? A. Nitrites B. Water chestnuts C. Monosodium glutamate D. Hot pepers ANS: C Q153: Torticollis may be caused by all the following EXCEPT A. Herniated cervical disk B. Ingestion of phenothiazine C. Injection of botulinum toxin D. Syringomyelia ANS: D Q154: A 62-year old man complains of a 6-month history of unilateral, constant neck and occipital pain associated with numbness in the back of his head, which occurred after he was rear -ended in a motor vehicle accident. The most likely diagnosis is A. Malingering B. Occipital migraine C. Occipital neuralgia D. Cervical disk herniation ANS: C Q175: True statements regarding the stress response to injury include all the following EXCEPT A. It is a complex hormonal and neurologic response B. It is mediated via sympathetic pathways C. A catabolic response predominates D. Hypoglycemia is typically observed E. Serum aldosterone levels are elevated ANS: D SUMMARY OF DIRECTIONS A 1,2,3 only

B 1,3 only

C 2,4 only

D 4 only

E All are correct

Q198: Examples of neuropathic pain syndromes include 1. phantom limb pain 2. dyspareunia 3. thalamic syndrome 4. vaginismus ANS: B

Q199: True statements regarding the use of ketamine in trauma patients include 1. it may be used as the sole agent for trauma surgery 2. it possesses sympathomimetic action 3. at lower doses it is an analgesic 4. it can be used in trauma patients with head injuries ANS: A Q222: Advantages of acetaminophen over aspirin when used as an analgesic in children include 1. lack of gastric irritation 2. no association with Reye syndrome 3. lack of platelet dysfunction 4. complete absorption when administered rectally ANS: A Q223: True statements regarding the use of opioids for pain management in children include 1. minor side effects occur more commonly in children than adults 2. the incidence of respiratory depression is directly related to dose 3. meperidine is pereferred over morphine 4. tolerance is an uncommon clinical problem in children ANS: C CHOICE THE BEST Q246: A splanchnic nerve block is correctly characterized by which statement? A. It is performed at the L1 level B. It is performed with the needle at the posterolateral aspect of the vertebral body C. It is recommended for surgical anaesthesia D. It requires a larger volume of local anaesthetic than celiac plexus block E. It can result in a chylothorax ANS: E Q247: When performing an inguinal perivascular block, one should A. Insert the needle just medial to the femoral artery B. Inject a volume of 10 to 15 mL of local anaesthetic C. Hold pressure proximal to the needle insertion site D. Search for a paresthesia ANS: D Q270: A gastroenterologist has referred a patient to you with abdominal pain and the diagnosis of biliary dyskinesia. The patient had increased basal sphincter pressure on biliary manometry and delayed biliary emptying. An endoscopic sphincterotomy was performed. However, the pain was relieved only a slight degree. The patient is told to expect some blocks to be performed. Which prognostic block would be most appropriate? A. Celiac plexus block B. Splanchnic block C. Intercostals nerve block D. Impar ganglion block ANS: B Q271: Which of the following statements is true regarding management of burn pain? A. Narcotics remain the drugs of choice for treatment of acute, severe burn pain B. Tolerance does not develop with the use of ketamine for burn therapy over an extended period of time C. Silver sulfadiazine cream (Silvadene) is a potent topical anaesthetic D. Biofeedback has not been shown to be effective in reducing anxiety and pain in children with severe burns ANS: A SUMMARY OF DIRECTIONS A B C D E 1,2,3 1,3 2,4 4 All are only only only only correct Q291: Intercostal nerve block is highly effective in relieving severe pain resulting from 1. costochondral dislocation

2. rectus nerve entrapment 3. acute herpes zoster 4. pleurisy ANS: E Q317: Important landmarks for a radial nerve block at the wrist include which of the following tendons? 1. Flexor carpi radialis 2. Extensor pollicis longus 3. Palmaris longus 4. Extensor pollicis brevis ANS: C Q318: Radial nerve block at the elbow uses which of the following anatomic landmarks? 1. Lateral epicondyle 2. Intercondylar line 3. Biceps tendon 4. Bracial artery ANS: A Q343: Deep brain stimulation can be used to treat 1. facial anaesthesia dolorosa 2. thalamic syndrome 3. postcordotomy dysesthesia 4. chronic abdominal and perineal pain ANS: E