Anaesthesiology End of Posting

Theme : ABG
1. Which of the following is an absolute contraindication to performing an arterial
blood gas?
a. Infection at the ABG site
b. patient taking anti-coagulant
c. Patient has a coagulopathy
d. All of the above
e. None of the above
2. What is the most common site for an arterial blood gas puncture?
a. Brachial artery
b. Femoral artery
c. Radial artery
d. Dorsalis pedis artery
3. What complication of performing an ABG does the Allen test attempt to avoid?
a. Infection
b. Hand ischemia
c. Hematoma
d. Thrombus in artery
4. When you observe a flash of blood in hub of needle while performing an ABG,
you should :
a. Freeze the needle in place to allow blood to fill the syringe
b. Advance approximately 1 cm further to ensure you are in the artery and
then allow for
blood to fill the syringe.
c. Remove the needle and try again as you have likely entered a vein
5. How do air bubbles in the syringe affect the results of the ABG?
a. Air bubbles decrease the reported pO2.
b. Air bubbles increase the reported pO2.
c. Air bubbles decrease the reported ph.

d. Air bubbles increase the reported ph.

e. Air bubbles do not affect the results of ABG.
Theme :Airway Management
6. How long does it take for hypoxia to begin to cause irreversible brain injury in a
patient?
a. 1 minute
b. 5 minute
c. 10 minute
d. Immediately
e. Hypoxia alone does not cause irreversible brain injury
7. Which of the following protects trachea from aspiration of secretions and
stomach contents?
a. Oropharyngeal airway
b. Nasopharyngeal airway
c. Cuffed endotracheal tube
d. All of the above
e. None of the above
8. The most common cause of airway obstruction in the unconscious patient is :
a. Food bolus in the posterior pharynx
b. Loss of tone in the submandibular muscles resulting in prolapse
of the tongue into the posterior pharynx
c. Collapse of the trachea due to loss of tone in the supporting muscles
d. Laryngospasms due to aspirations of oral secretions
9. When managing an unconscious patient who is making labored and noisy
respirations, the physician must first :
a. Commence positive pressure ventilation with a bag mask device
immediately
b. Immediately perform endotracheal intubation
c. Perform a finger sweep to clear the oropharynx of foreign material
d. Perform a simple manouvre such as head tilt chin lift to open
the airway

10. The jaw thrust manouvre for opening the airway has the advantage of the
head tilt chin lift manouvre in that :
a. It is easier to perform
b. It permits the use of either an oropharyngeal or nasopharyngeal airway
c. It can be performed without neck manipulation
d. It more closely approximates the natural airway anatomy
11. To perform a jaw thrust manouvre the physician :
a. Stands to the left of the patient, gasps the chin between the thumb and
index finger of the left hand and pulls the jaw forward
b. Stands at the patients head looking down at the patient, and
pushes up on the angle of
the mandible using the middle fingers of
each hand
c. Encourages the patient to thrust their jaw forward to maintain an open
airway
d. Pushes down on the patients forehead with his left hand to extend the
neck and elevates the mandible using the tips of his right index and middle
fingers
12. Airway adjuncts such as oropharyngeal and nasopharyngeal airways :
a. Prevent the tongue from occluding the airway and therefore
create an open conduit for air to pass
b. Free the physicians left hand so he can deliver a larger volume of air by
squeezing the bag- mask device with both hands
c. Provide an open conduit for air to pass into the trachea and protect the
trachea from
aspiration of oral secretions
d. Allow the physician to ventilate the patient without the use of a mask
device
13. The nasopharyngeal airway has the advantage over the oropharyngeal airway
in that it :
a. Is made of soft plastic and therefore is less traumatic during insertion
b. Is usually better tolerated in a semi-conscious patient and can
be inserted in a patient
who has their teeth clenched.
c. Has a larger internal diameter and therefore allows a greater volume of
gas exchange

d. Makes it easier to suction the oropharynx of excess secretions

14. Bag-mask ventilation :
a. Will deliver a larger volume of air than mouth-to-mouth ventilation
b. Is a relatively easy skill that permits positive pressure
ventilation with oxygen rich air
c. Difficult skill to master, has advantage of delivering oxygen rich air if
performed correctly
d. If performed correctly, can avoid the need for endotracheal intubation
15. The correct size of mask to use with the bag ventilator :
Should cover the mouth and nose and create a tight seal to avoid air
leaks during positive pressure ventilation.
16. To create a tight seal with the mask during positive pressure ventilation the
physician should :
Lift up on the mandible with the third, fourth and fifth fingers to
maintain an open airway, while holding the mask firmly in place with the
thumb and index finger.
17. Endotracheal intubation with a cuffed tube :
Should be performed as soon as possible in a patient who is unable to
protect their own airway, but only by a person with specific training and
expertise in the technique.
18. The imaginary line connecting the posterior superior iliac crests crosses what
spinal interspace?
L3-L4
19. The number and type of white blood cells in normal CSF is :
<5WBC/mm all lymphocyte
20. Which of the following does not need a CT scan prior to lumbar puncture?
a. A well patient with new onset right arm weakness
b. A known cancer patient with headache and new onset right arm
weakness
c. An acute trauma patient with headache and bilateral leg weakness
d. A twelve year old boy with normal exam but fever and nuchal
rigidity
21. Which of the following is an absolute contraindication to lumbar puncture?

Uncorrected coagulopathy prevent hematoma compressing cauda

equine.
22. Lumbar puncture is not used to diagnose which condition?
a. Subarachnoid haemorrhage
b. Cerebral abscess
c. Meningitis
d. Idiopathic intracranial hypertension
23. What needle type is best used for reducing the incidence of post lumbar
puncture headache?
Small blunt-tipped needle
24. When advancing the lumbar puncture needle, it should be parallel to the bed
and aimed towards the patients umbilicus
25. Which of the following is not a complication of lumbar puncture?
a. Local back pain
b. Epidermoid tumour implantation
c. Olfactory disturbances
d. Post-lumbar puncture headache
26. Which of the following is not a way to reduce post-lumbar puncture
headache?
a. Using a blunt tipped spinal needle
b. Replacing the stylet in the lumbar puncture needle prior to the needles
removal
c. Keeping the patient on their back for 4 hours after the lumbar
puncture
d. Using smaller spinal needle.
27. Correctly orienting the bevel of a cutting type spinal needle can reduce the
incidence of post lumbar puncture headache. In a patient in the lateral decubitus
position, the notch of the stylet should point
Up at the ceiling
28. In an adult, the spinal cord may reach as low as what vertebral body? L2
29. Which of the following gives the correct order of tissues penetrated in a
lumbar ouncture?

Skin supraspinal ligament ligamnetum flavum dura arachnoid

mater
30. The pop that is often felt in performing a lumbar puncture is caused by the
penetration of what tissue? Ligamentum flavum
31. If bony resistance is encountered in performing a lumbar puncture, brinjg the
spinal needle back to the skin and direct It more towards the head
32. Which of the following is not routinely ordered on CSF samples? Gram stain
33. Xanthocromia is caused by lysis of red blood cells.
34. A cell count in viral meningitis might demonstrate >5 WBC/mm and all
lymphocytes
35. The normal colour of CSF is crystal clear.
36. The position of a patient for lumbar puncture should be
Back arched out with hips and shoulders perpendicular to the bed
37. A patient with fever, nuchal rigidity and a normal neurological exam requires
a CT scan? False
38. Mr. LN a 22 year old man, presents to the emergency department with severe
abdominal pain after being involved in a motor vehicle accident. Free fluid in the
abdominal cavity is diagnosed on ultrasound. You are asked to establish
intravenous access( IV line). Which of the following would be an appropriate
location to insert the needle? In the upper limb
39. The main complications of attempting to establish IV access are : superficial
thrombophlebitis
40. In general, initial IV access is established at : the most peripheral site
(distal)
41. For trauma patients, what is the most common location for establishing an
intravenous line?
Veins of the dorsum of the hands.