ANAESTHESIA

QUESTIONS 3 Critical care and anaesthesia - i

Multiple Choice Questions
Multiple True-False

1) During pre-operative care of surgical patients
a) The effects of warfarin can be reversed with either fresh frozen plasma (FFP) or cryoprecipitate
b) Stopping clopidogrel less than 18 months after bare metal stent increases the risk of stent occlusion
c) 70% of platelets regenerate 7 days after stopping aspirin
d) Heparin-induced thrombocytopenia is treated with direct thrombin inhibitors
e) Factor V Leiden mutation is a risk factor for hypo-coagulability

2) During the definitive treatment for hypovolemic shock
a) The TRICC trial concluded that transfusion should start when Hb is less than 7 g/dl
b) The SAFE study found that that 4% albumin is superior to saline for fluid resuscitation
c) Epinephrine has more vasopressor than inotropic effects
d) Low dose (1-3 mcg/Kg/min) dopamine infusion has been shown to be of significant benefit in the treatment of renal dysfunction
e) Vasopressin has only vasopressor and no inotropic effects

3) Criteria from weaning from ventilators include
a) RR/VT index more than 100
b) PO2 more than 8 kPa (60 mmHg)
c) Respiratory rate less than 25/min
d) Temperature less than 370 C
e) Pmax (NIF) values less negative than -20 cmH2O

4) During the treatment of neurogenic spinal shock
a) Insertion of a pacemaker is contraindicated for the treatment of persistent bradycardia
b) Hypotension is more severe when the spinal cord injury is above the T4 level due to loss of cardiac accelerator fibres
c) Patients have increased sympathetic activity below the level of spinal cord injury
d) The risk for autonomic hyperreflexia (AHR) is higher 4 weeks after the spinal cord injury
e) Autonomic hyper-reflexia can be prevented using regional anaesthesia

5) During anaesthesia for epilepsy surgery
a) Patients on phenyntoin require decreased doses of muscle relaxants and barbiturates
b) Isoflurane should be avoided as can produce epileptiform activity
c) Thiopental can activate a seizure focus
d) Local anaesthetics can cause seizures at higher doses
e) Benzodiazepines may affect EEG recordings

6) Neurogenic diabetes insipidus may result from the following
a) Meningitis or encephalitis
b) Suprasellar or infrasellar tumours
c) Brain death
d) Corpus callosum agenesis
e) Sickle cell disease

7) Compared with the syndrome of inappropriate secretion of anti-diuretic hormone (SIADH), cerebral salt wasting
a) Is more common in neurosurgical patients
b) Has normal plasma uric acid
c) Has later (several days/weeks) onset
d) Has urine sodium >20 mmol/L
e) Is associated with normal intravascular volume and central venous pressure

8) Venous air embolism in the sitting position
a) Is more frequent in the seated cervical laminectomies than in posterior fossa approaches
b) Can be treated by increasing the N2O
c) Can be recorded by using pre-cordial Doppler ultrasound
d) Should be routinely monitored with ETCO2
e) Produces nitrogen in the exhaled gas

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