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Sample questions IT A/Part I

Paper A

<$ r^ \y' Inadequate tissue oxygenation may occur, in spite of a normal Pa0 2 ,
in the
presenceof 02 /H±> Ji^CdAfo*
? A.
B.
anaemia ^
a shift to the left of the^oxyhemoglobin dissociation curve »
~w~
. tCo^
C. low cardiac output ""f -ky fatter
D. local vasoconstriction “V*
-J* l, * pfQ
E. metabolic alkalosis “T £f6
k
>e/e*c4ifi—
fytsbock
Which of the following statements are true? -ft O 2-
la l~(lC

<;V<^ rt^tcc, fa, r & N

^
A. the parotid bogies are sensitive to arterial blood pressure
y Un bod1*4
p\ B. hypotension produces increased barorecepto r discharge p
C. increased plasma renin activity stimulates aldosterone production T
A D. posture influences aldosterone production
E. antidiuretic hormone secretion is increased
\systemic hypotension^"
in

3. The elastic tissue within the arterial system

A. allows transitory storage of the major part of the stroke volume during the ejection
phase f
B. contributes to theonward flow of blood during ventricular diastole
? minimises the effects of intrathoracic pressure upon aortic pressure
f
D. contributes to conversion from intermittent to continuous blood flow
“f
E. maintains coronary perfusion"!"

During sustained severe exercise the

A. oxygen saturation of mixed venous blood remains above 70 per cent f

B. minute volume of ventilation may reach 130 litres
C. pulmonary vascular resistance falls "T
T rJf kD lo»

D. cardiac output may reach 50 litres/min^ 23

E. core temperature may reach 40
Z 2.1 l + °dive.

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<te*» 2y- 3!>-

65 -7fy. Page of 26

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thesioiogy

Ventricular c increased by an increase

A after- load
B. pre-load
C. myocardial contractility
D. ionized calcium concentration
E. heart rate

In the normal pulmonary vascular bed

pressure is half the mean aortic pressure f

A. the mean arterial
B. the vascular resistance is lower than the systemic vascular resistance
^
»

C. 50% of the total blood volume is present at rest

f
D. the wedge pressure equals the capillary pressure'
E. hypoxia causes dilation of vessels C

(®
Intra-pleural pressure is

A. subatmospheric T
B. related to mid-oesophageal pressure ”T
C. changing throughout the ventilatory cy$ le T
f). equal throughout the pleural space
^
E. increased by coughing
^
Closing YoUm\*_ o p gjL uJ l\K-b ^ f^Q

A. norrhallyexceeds residual volume ~V

B. decreases in the supine position f - ( c\<? six 4} -
z
C. e and residual volume "^
is the sum of closing volume T J *
<J £lo r»V?
D. decreases with age f t "J'
E. is normally less than functional residual capacity"!""
„
€>
“SiJb J.
.

V4
(

C* ?y l a! '

Intrapulmonary shunts increase

.

C ^
\ ? \ A. mixed venous oxygen tension f 1
B. arterialoxygen saturation JP x|
f
C when pulmonary blood flow is part ially Obstructed f KTo
D. in the presence of atelectasis
"p"
\
E. with severe fluid overload

)\Jo CD>>l3e^r-
y*
1
*
rL c^pUroi^' P. , I
'srfo*^
Page 2 of 26

„ $>/ /ncM*1
w
10 . The symbol P50 refers to the

,.ci?
A. partial pressure of oxygen at 50 mmH^ (6.7 kPa) f
^
which the oxygen content is 50rnl/To6 ml blood r
B. Pa02 at

C. percentage saturation of hemoglobin at a Pa0 2 of 50 mmHg (6.7kPa)

D. oxygen content of plasma at a Pa0 2 of 50 mmHg (6 7kPa) p
E. P0 2 at which the hemoglobin is 50% saturated

1 1 . Pituitary feedback mechanism regulates secretion of

A. ACTH ^
B. adrenaline
C. cortisol^
D. insulin
E. thyroxine

12 . Cerebrospinal fluid
2
A. production m
an adult is 150 ml/24 h r
p '
B. is mainly reabsorbed in the lateral ventricles
C. does not accurately reflect acute changes in base excess in arterial blood
*
D. is virtually free of glucose f / » /
E. specific gravity (relative density) is 1015-1 oc
020^ (l
^

13. The transmitter substances in all the ganglia of the autonomic nervous system
include \

A. acetylcholine \
B. noradrenaline
C. 5-hydroxytryptamme
j
D. butyrylcholine
E. dopamine ^J s M*"'

Inulin Ly

A. is removed from blood passing through the kidney

totally f
B. is not reabsorbed by the renal tubules'T
C. is secreted by renal tubular cells f _
D. ismetabolised by renal tubular cells p
E. has a concentration in glomerular filtrate which is the same as that in plasma 1

, UeMh ryu*S«HL CJrcL ij & V'TX*/

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fit .
k A ffr<.uaJ 6—
/
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fUJ*'*
Society of
Anaesthesiology

^
Concerning water excretion /*

A. the ascending limb ot the Loop of Henle is impermeable to water^ i

B. chloride reabsorption from

the Loop of Henle occurs passively *f
r v
£. under conditions maximum
of antidiuresis, 5% of water lion
reabsorj^tio occurs in I

distal tubule #
\£«
D. the maximun medullary osmolality is 800 mosmols/L^
E. dehydration induces
aldosterone production

‘
6-12.
16. The anion gap ^<x ( a r y\£ CAct**/

A. is normally l2mmol/L \
B. increases in lactic acidosis
\ r
C. s decreased in aspirin poisoning
f
D. decreases in diabetic ketoacidosis f
E. increased
is in renal lalurej-
f ( A^oLaC •

Concerning carbonic acid and bicarbonate

y
in the blood^ 7 *'w ll , * /
^ in- rryurJ^fn^jL
~A. at pH 7.4, the ratio of bicarbonate to carbonic acid is 20t^l 1

OK: B- the buffersystem depends upon carbonic anhydrase ~T ^

C. the hydrogen ion formed by carbonic acid is buffered by reduced haemoglobin I
D. the Henderson-Hasselbalch equation describes the buffer equilibrium
E. extracellular buffering of excess hydrogen ions occurs instantaneously "p

18.

A. is an enzyme which regulates the speed of oxygen release from haemoglobin P

B. present in sympathetic nerve 6numy®^
is endings
£ ^ _L
C. participates in the metabolism of noradrenaline^
D. is a terminal oxidase important in biotransformation of drtjgs~T ,vf
E. is a potent enzyme inducer C

In the movement of fluids and dissolved molecules

is proportional to the permeability of the membrane

\
A. diffusion
B a non-diffusible anion will slow transfer of a diffusible cation
C. the trans-membrane potential depends upon the presence of non diffusible ions\
D. the osmotic pressure is necessary to prevent ionic migration f
hydrostatic pressure dependent
-
E. filtration is

Page 4 ot 26
 20. The stomach
c
25% of the ingested protein
A. is responsible tor the absorption of approximately
B. secretes vitamin B1 2 f
in its parietal cells
C. acidity depends upon the activity of carbonic anhydrase
I

D. decreases its motility when fat enters the intestine "T

pressure
capacity with small changes
E. capable in
is of large changes in

2W etalol

Ar'can cause postural

al hypotension^
hypotension \ < ,
B. reduces heart rate*- r tv 1^)
! .
T^)(^ £ 5
C. has an elimination half-life of 24 hoursf"
* D. is a more potent alpha than beta adrenoceptor blocker
^
’

E. may cause bronchoconstrictiorv^

<v ' l >n
c ^
_
r

22 Beta adrenoceptor stimulant drugs can cause

U A. hyperglycaemia ”T
B. hypokalaemia'f
C. increased gastrointestinal motility r
/ i

D. skeletal muscle tremor -r

E. increased contractility orthe pregnant uterus
r Qb/T* (tW&l-O
^

(Q)
Reliable earlyLsions of cyanide toxicity due to sodium nitroprusside infusion
include',/ C
ty/krtV* »
G C c. C L
A. progressive metabolic acidosis
B. abnormal electroencephalographs changes
_
f
.
T « •
<2.o>‘

K‘lJv
^
fief
\ 5

C. increased mixed venous oxygen tension T ^ J

r
-
*
D. constant response to low dose infusion of sodium nitroprusside r
, K
^—
i <\U
— -> K
E. a decrease in haemoglobin saturation t-
p

'Jr

Eflects of atropine instillation in the normal eye include

‘Pvfam. t
Up
C c%r

A. paralysis of the sphincter pupilla§.

.
ja&rmuscle \
.

B. paralysis of the ciliary muscle ^

\
C. increase intra-ocular pressure
in \-
D. enophthalmos Y~
E. photophobia
^ '

cV
Page 5 of 26
 1

•
'jn pi
I
i

Scvioty of

25. Intracranial blood volume is increased by

[Link]^ -
B vecuronium X
C. thiopentone \
D nitroglycerine^
E. ketamine^*

26. Tinnitus may be caused by

A. codeine \
B. aspirirr^T
C. cocaine f
D. lidocaine (lignocaine) •>\
gentamycin
E.
^ ^
27. Cerebral oxygen consumption is significantly decreased by

A. propofol
B. thiopentone"^.
?o>
C. mmodipine ir
D. nitrous oxide
E. fentanyl C p '

28. Uptake of an inhalational anaesthetic from the alveoli to the blood is influenced by
the

A. blood/gas partition coefficient of the agent

B. alveolar ventilation
C. cardiac output
D. ventilation/perfusion ratio in the lung
E. partial pressure gradient across the alveolar capillary membrane
!

J .(f
>%V.V3
29. Prolonged exposure to nitrous oxide v

A. inactivates vitamin B12

metabolism(sJ^'* *’
.. Alls*.
3
B. interferes with methionine
'

C. interferes with folate metabolism (ZD

D. impairs desoxyribonucleic acid (DNA) synthesis.
E. produces megaloblastic haemopoesis J

Page 6 of 26
 t—r

European
Society of
Anaesthesiology

30. Inhalational anaesthetic agents with a

blood/qas partition coefficient of less than i ,
i
2.6 include

*
v
A. sevoflurane~T~
B isoflurane\Xi 1

C desfluraneo*#!
D. halothane2^ll
E. diethyl ether C)

31 *
Intravenous anaesthetics

A. prevented by antihistamine premedication^

is

B characterised by profound hypotension

is

C. only occurs with prior exposure *

D is
f
associated with elevated serum tryptase concentrations \
E. is dose related
^

32. Ketamine

A sensitises the myocardium to adrenaline T,

B. is a butyrophenone derivative f
C. is poorly soluble in water ’

D causes bronchoconstriction f
E. has a marked chronotropic effect T
Concerning propofol
''"V
A. ithas a high clearance rate in excess of liveThinnri finw \
B. extra-hepatic metabolism occurs to a significant extent \ -jw
LX. significant reduction m the volume of distribution occurs in elderly patients p
D. it may induce burst suppression of EEG activity T
E. clearance is 870-2140 ml/mm
* -» I

Local anaesthetic agents primarily biotransformed

A. ropivacame
B. prilocaine’T
\
,
in

;#
the liver include

cU,r P~
C. lignocame (lidocame) \
•O. procaine f
E. Dupivacam^j B<*fiVaC
.

. <2jh‘ <# Ccj\^

. Uocj*uu-
- /M
cL*'**<~ Pc/So
• f?o ^ ;VA^cvjU«

Page 7 of 26
 15 '
- - .

-f
r

(&6f^ sir*
Toxic effects of amide local
anaesthetics include

A. myocardial depression
B.
methaemoglobinemia
g t* EMLA Cte^^
C. central nervous system
depression

^
]
€. bronchospasm y
E. convulsions-
sUe'P^ »»

* x Jr*1

^ '— x

Concerning pharmacokinetics:

A. only non-ionised drugs will readily distribute into the fipicrpFiase of membranes
B. propofol has a high
clearance -p
C. for a given clearance, the elimination
half life of a drug is directly proportional to the
volume of distribution
drugs with ajgyy^traction ratio are"
-Ca^A^ r
arfectedbyhepaticbi^d flow t _____
E. the clearance of lidocaine
(lignocaine) approaches hepatic blood flow ”l

37. Recognised factors in the inactivation of mivacuriu

vacuriumm include
mcjuaej\
A. glomerular filtration - "Wj floSWu* C (j (l(L^tfr€z£z^
B. protein binding y-* *
C. hepatic biotransformation _J fu-
\
D. hydrolysis by plasma cholinesterase "T
E. blood pH
^
> -tpjyA&PfrU*—
38. Morphine may provoke

A. nausea and vomiting!^

B. bronchoconstriction
C. increased outputjjf urine t"
D. constipation
^ £
4^
E. constriction of the pupiis»

39. Platelet aggregation is reduced by

A acetylsalicylic aclc
B. dipyridamole^^
^^^tranexamicacid
- f"'
^i). ketorolac "T
E. dextran ^

Page 8 of 26
 Co, a-
^ /" 7
,

'
European
Society of
Anaesthesiology

45. The reaction of carbon dioxide with soda lime includes the

A. formation of sodium carbonate 'X

B formation calcium carbonate
of -T
C. release of heat
D. release of water
E. production of carbon
monoxide
^

y* Poiseuille s law states that flow

A. square of the
rale

radtuSof the tubef

is

'
proportional to the

B length of the tube t^st^

C. density of the fluid
D. viscosity of the fluid
E. pressure gradient-^
' w' ^
v
V
^^47- Concerning fhe^neumot^^gr|gh:

a. ii measures pressure change across a resistance- r\ fW aCC^rzJi*^ i*

Q* Bi its accuracy does not require laminar gas flow T V&Uia,' efthd.
** C. it is not suitable for accurate
p <T oaken flau/tij ^< Q ryayrouj
breath-by-breath measurement \
D. accuracy is affected by temperature changrT
its S*diov >
E. changes in gas composition require
recalibration
V
48. Recognised methods of effectively reducing operating room
concentrations of
waste volatile anaesthetic gases include
n.
A the use of a condenser humidifier X
B the use of low flow anaesthesia T
C. piping waste gases to floor level
D. passing waste
f
gases through activated charcoal!
^
B passive ducting to the external atmosphere
T

Concerning heat loss during anaesthesia: evj

Cso/. )
is the most important phenomenon /- __
^ lo/
B convectignjs decreased when the air adjacent
. fo the body is warnT
C radiation is decreased by aluminium foil blankets"!"*
D. respiration Equals 30% of the total heat loss
sweating is decreased when the
th relative humidity
f
increases!

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.

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50. The humidity of the atmosphere is measured by V/ \^
A determining
«
1C dew
"Illy he Uf w puim
point
tII ^ euki c V\ ?H l*> /, w^J^r Vojir
B a wet and dry bulb thermometer
1

1 f^K A ^or&v&e_ t* V*Jl>r *

C. cooling a known volume of air

D absorption of water by a hair-v 1

£ measurm^barometric pressure'
^

51 . Techniques for measuring blood flow include

A ultrasound
B. dye dilution
C. plethysmography
- D. thermal dilution
E. electromagnetism

52. Pressure in the superior vena cava is influenced by the

A right ventricular performance

B. position of the patient
C. intra-abdominal pressure
D. mean airway pressure
E. competence of the tricuspid valve

S 11 is necessary to know the artinal PCO^ in

* *i fa order to measure
yaW* At
/•
***
k-
V
1
5fc>
^c-K A. carbon dioxide output \ ^ ^ s
+.tc *
I"
— r
-<§. physiological dead space rr
C. minute volume of ventilation C
\/ v
Cn ^ f> <-*
P1-0 r<^Ttf^O/
'L»AiutV>*‘ # D. residual
.
lung volume
<_ J'uuai luny vuiumtf v_ . —r „
E- functional residual-capacity
Qt f»(A <r<u \ \ t

^ ?'nrs
(Vvy
\ l * -- vt

A pressure volume loop can measure ^/ 3

A. lung compliance
B. airway resistance fir
C. intra pleural pressure -V-
D. functional residual capacity \
E. closing volume

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55. Measurement of the relationship between Intracranial pressure and volume

assesses

A the integrity of the blood^brainbarrier -f

'B. cerebral compliance^ " \
C. cerebral blood flow C*
D cerebral metabolic rate V.
E. cerebral vascular diameter

In a supine young adult with a residual volume of 1200

A. closing volume will debase with increasing age P

B. closing volume Beapproximately 1 000 mt
will
C. closing capacity will be decreased by general
^ \^
anesthesi,
D. closing capacity is approximately 1 700 ml
E total lung capacity is about 5000 ml
^

57. Concerning manometers/

i
A»/fp
A^P ressur

B. 1 kPa
^J^ ,ch su PP° rts a

equal to a pressure of 7.5mm Hg~"V

is
10mm column of mercury will support a 13.6cm column of
1MT
P C the two limbs of a fluid manometer must
r
be of equal diameter r
D_ a mercury barometer used to
measure atmospheric pressure is sealed with a vacuum
above the surface of the liquid
E. aneroid gauges do not contain liquid
'"T

'v Ujk
58. Concerning the measurement of body fluid spaces-

-A indocyanine green is excreted unchanged in the urine

r
'

C extracellular fluid volume is measured using deuterium f~ -

>

,,U ' d V0 Ume S measured1n®«<% ,r ° m

' '
extracellulaFVolume and
body wafers total
l

D plasma volume is measured with iodine labelled

serum albumin'T
t. chromium labelled red cells are
used to measure blood volume -r—

Page 12 of 26
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59. The following can be used In the statistical analysis of the results of a clinical
.
;
Investigation
“
A unpaired test t

B X* (chi-squared) tesi
C analysis ol variance
D sequenlial analysis
E. paired t test

60. Concerning the following statements:

(

^ nu *' hypothesis states that the two treatments are equally effective^ ^

B the significance level is a probability value

that ensures that the outcome is clinically
significant
f r
C the standard deviation is a measure of the
central value of the sample »

D the standard error is used for the estimation

E blood pressure is measured on an
of
ordinal scale
confidence intervals ”
j

p
(i r

Page 13 of 26
 European mm
Society of
Anaesthesiology mm^m

Sample questions ITA/Part I

Paper B

Mechanical hvng Y entilation in a normal

t patient during the entire course of
anaesthesia is associated with

ly m,n Shed repuirem ents

*r T^??
B a shift to
.?'
'

the right of the

for post-operative analgesia C
r
oxyhaemoglobm dissociation curve f
C. a decrease in Pa0 2 f Os
V
D. postoperative
hypoventilation T
(
v
s
E. cutaneous vasodilatation (T

Predictors of cardiac morbidity

and mortality include

A aortic stenosis
B myocardial infarction occurring
2 months previousl^T
z-
a P ro,on 9 ed QT
(frequency corrected) interval
D. occasional ventricular
X'

E. intra-operative
extra-systoles
~|~
f
nodal rhythm

-> £XAf&tra~- <£k)SI trY'^jf

Patients with untreated

hypothyroidism show >
fyol>ab‘L~k of Soise**. nr>f. ckf.

vl
;
A resistance to hypnotics
B depression
-
of cardiac
\

performance^
m Wr htJfc'rrM
C. high voltage T waves on the ECG
\

•*;

t
* E rr= rr" e
de| ayed return of conciousness
after anaesthesia
—r
V ,0 non depolariSin g neuromuscular blockmo
-

drugsX
a 1

- Pt*

.wti. «£S3lk- m ** **• -if fiesta

- — i-
rV »
K Ik* ^
T
I <
A. the action of
glycopyrrolate is longer than atropine
B L
atropine increases dead space -r °* £g/«i J-
C e premedication
atropine >remedlCa, n st
!° shoujdbe
)9iMbe avoided in febrile childrenT
f
n
L). n mn atroDine
'„° mo a
1 .0 ,E' ropine nrnHiiroc\rr>mi-kio*A\,«~~i ui_ -i

p josaneiscopolamme)
P r oduces\compi
fi teVagal blockade in a 70 kg

premedication should be avoided in

man P
— *
. V
^ " 1

J ^
elderly patientsT

(AW T Irvf^W^p ?

4yp 0 U
—
:

\ • cO£r5

Pi
ft*.

I
 Furopean p»
Society of pM

5. Intense peripheral vasoconstriction can be reversed with

A phentolamine
B )Sodium mtroprusside \

O' esmolol y
D nifedipine Y
spinal anaesthesia
E high \.

c^b

Drugs known to increase b arrier pressure at the gasti oesophageal junction

include
,
— M&JiwW-
-

A droperidol
£VnJ.iC__x
B atropine f
s<e. metoclopramide*T
D fentanyl p
r E neostigmine *T

Recognised treatment of a post-operative thyrotoxic crisis includes

A sedation _.
'
B. plasmapheresis
C. corticosteroids. 'T
D. propranolol \

z E calcitonin

Recognised complications of abdomino-perineal resection of the rectum include

A. deep venous thrombosis

B paralytic ileus
C. air embolism
*
D postoperative atelectasis
E. uraemia
^
Factors associated with the development of postoperative atelectasis include

A. abdominal pain \
P
B COPD ^
ankylosing spondvjjti^
^
D. thoracic surger/\
E spinal anaesthesia

Page 15 of 26
 European
Society of
Anaesthesiology

14. Problems with routine preoperative chest X-rays include

7 A. a high percentage of false positive

a high percentage of false negative

¥
B. \

C. a considerable risk of radiation induced cancer f

D. very few unsuspected positive findings 'T~
E. a high percentage of clinically insignificant, positive findings

15. Venous air embolism is associated with

A. arterial hypotension
a decrease
'

end-tidal carbon dioxide concentration

^
\
. T J,
B.
C. cardiac arrhythmias""^"
in

r i r
x i
n* ; -?
D. a decrease in pulmonary vascular resistance \
• LV [Link], ^,±0,f
E. a decrease in intracranial pressure C
- «cr •
yff
• fcvp
16. Postoperative cerebral vasospasm in a patient with a subarachnoid haemorrhage

A. does not occur provided that the aneurysm has been clipped successfully f*
B. may be treated with calcium antagonists Wlt> e)<H
*-*
C. usually occurs two weeks after operation
f
D. prevented by postoperative ventilation
is
p
E. may produce a hemiplegia
^
17. In the diagnosis of brain-stem death

A. clinical criteria are invalid in a hypothermic patient f

' n
B . caloric test ing is used to test the integrity,of the Vth cranial nerve
*
T
C. an isoelectric EEG is pathognomonic \
D. absence of neuromuscular blockade should be confirmed with a peripheral nerve
stimulator —
E. reflex movements of the legs may occur *
still
ST

18. Methods of reducing intracranial pressure include

A. mannitol '
c‘
B. sodium nitroprusside
C. ventricular drainage "T
D. isoflurane
f
E. nimodipme
£

Page 17 of 26
 European
Society of
Anaesthesiology

include
preoperative chest X-rays
14. Problems with routine
'
X A.
B a
a high percentage
high percentage oi talse
ot false positive
negative \

radiation induced cancer

'

-+

C a considerable risk oi ___

findings ri
D very few unsuspected positive
\

positive finding
clinically insignificant,
E. a high percentage of

* _ C• i r* •LairJ
Venous air embolism is associated with
15.
"T J,
A arterial hypotension '
. ? rvi? I*
concentration
B. a decrease m [Link] carbon [Link]
C. cardiac arrhythmias"^ f .L\ [Link] l
resistance \
D a decrease m pulmonary vascular
E a decrease in intracranial pressure C
\ or
.f cvp
haemorrhage
a patient with a subarachnoid
Postoperative cerebra. vasospasm
,n
16.

aneurysm has been clipped successfully f

A does not occur [Link] that the
B. may be treated with
calcium antagonists ' j --*10 An d+J
C usually occurs two weeks
after operation f C/

D is prevented by
postoperative ventilation f
E. may produce a hemiplegia

the diagnosis of brain-stem

death
17 . In

o ~~\™*
stimulator "V of the legs may still occur
E. reflex movements

Methods of reducing intracranial pressure include

A. mannitol '
P
B. sodium mtroprusside
C ventricular drainage T
D. isoflurane f
E mmodipine
£

Page 17 of 26

h
 l%
-v^
J

19. Acute subdural haematoma.

A. results from haemorrhage from the middle meningeal artery

B. is frequently bilateral f
C. is often associated with secondary bleeding following decompression
D. a complication of chronic alcoholism
is

E carries a good prognosis when associated with a basal skull fracture

e
20. The following are associated with increased intracranial pressure following head
trauma:

A papilloedema ^
B. pulmonary oedema
C. hypertension y
D. a Glasgow com^ score greater than 12 r
E. bradycardia

21 . A left sided double lumen endobronchial tube

A can be used for left lower lobectomyT

B. is suitable for a nght sided broncho pleural fistula T
C. has a dedicated orifice for the left upper lobe bronchus
f
D is used in preference to a right sided tube wherever possible
is contraindicated in a patient with a right pneumothorax

22. Recognised advantages of controlled ventilation in the treatment of flail chest

Include

A. reduction of paradoxical ventilation

B. the ability to use positive end-expiratory pressure (PEEP) \
C. decreased pain '
\ ^
^ D. prevention of pneumothorax p*
E accelerated healing of rib fractures \-

23. Appropriate treatment of moderate postoperative hypoxaemia following coronary

arterybypass grafting in a ventilated patient with normal cardiovascular
parameters includes

A digitalisation
B. addition of positive end-expiratory pressure (PEEP) \

C.
D.
dopamine infusion
sodium mtroprusside
{ f
infusion V
E. increasing the Fi0 2

Page 18 of 26
r

Soiiotyof
Anaesthesiology
[Link] f
pB
hi^r

Impairment of left ventricular function resulting from ischaemia during general

anaesthesia

A occurs prior to ST segment depression f

B fully recovers when ST segment depression returns to normal
^
r
C isbest recognised by monitoring the pulmonary capillary wedge pressure f
D involves a decrease in left ventricular compliance
E. can occur in a normal heart — r* $
11. True statements about endotracheal intubation include

A. severe laryngeal lesions can be caused by endotracheal tubes

C
B. pneumomediastinum can occur T
diffusion of nitrous oxide into air-inflated cuffs can double intracuff pressure ^
D. after 48 hours of intubation, endotracheal tubes should be replaced by tracheostomy
tubes f
E. most major cuff-related injuries result from use of inappropriately high cuff-to-tracheal-
wall pressures
^

12 . Compared with the adequately spontaneously breathing patient, neuromuscular

paralysis and controlled ventilation in the supine, anaesthetised patient are
associated with

^ * $
A improved
B. increased
overall
VD/VT*^
matching of ventilation to perfusion S *.1*^
C decreased anterior diaphragmatic motion V
D increased posterior diaphragmatic motionC
E. improved venous return to the right heart 2
X

13. Possible mechanisms for the bronchodilation, which occurs

during halothane
anaesthesia, include

A. inhibition of release of bronchoactive

substances *
B. stimulation of beta-adrenergic receptors
.f
-
inhibition of acetylcholine
release within the lung parenchyma V
r* D. inhibition of alpha-adrenergic receptors
\ f 'w 0>
E. stimulation of carotid body chemoreceptors
T

csiuE s*^1K(yy -

Page 16 of 26
 European
Society of
Anaesthesiology

24. Atropine administration during anaesthesia to a patient with severe mitral stenosis
can cause increased

'
A myocardial oxygen consumption
B left atrial pressure “T r
C left ventricular filling pressure \
D pulmonary capillary wedge pressure T
E. cardiac output
^

5. Recognised anaesthetic techniques for septoplasty i

A. a throat pack \ p
^rB sodium mtroprusside induced hypotension V
-
C nasal preparation witp topical cocaine
^
D a nasogastric tube r
E. anticholinergic premedication
\

*£ r*.
•

26. Traction on the medial rectus muscle the eye produces

of tne
:ie ot
K

A hypertension F |
-r V CU —
B bradycardia ^ \l- ‘^+£,'0

C. mydriasis “T P
D. Homer s syndrome*
E cardiac dysrhythmias
fe-

lt V "/ frc£fcr k

/ aC^Y
27. Recognised methods of providing pain relief in the early stages of labour include
e n ^cU^t & .

A. thoracic epidural £ p.
? B intrathecal analgesia \

C. intramuscular pethidine T
—
U D. hypnosis
nitrous oxide in
'S
oxygen l

28. During the third trimester of pregnancy there is

A an increase in alveolar ventilation“T

B a decrease haematocrit *T
in

C decreased basal metabolic rate£

D an increased blood volume
-"Y
E. an increase in functional residual capacity C

Page 19 of 26
 European
Society of
Anaesthesiology

29. Drugs which should be avoided in the first trimester of pregnancy include

A. ondansetron
B. penicillin
T_
C. metoclopramide V
D. tetracycliner^ uJ
metronidazole
E.
s-ffj?
k

30. The umbilical arteries

A. originate from the fetal jntemal iliac arteries ^ ut i A ci

B. convey venous blood from the fetus' \ r
C. contain blood at a P0 2 of 5.3 KPa (40mmHg) l
V
D. inserftnto the fetal inferior vena cava £~
E. are unaffected by autoregulation

Post-laparotomy pain contributes to

A polyuria \
B. naus^aY"
C. hypoxaemiaj
D. decreased functional residual capacity (FRC) \
E. tachycardicT'l"

32. Section of the trigeminal ganglion results in

A. facial paralysis \ ,
B. loss of salivary secretion,-
C. ptosis of the eyelid (
D. vasodilatation of the racial skin
^
E. corneal anaesthesia
^
\ + o&f
33. Meralgia paraesthetica is relieved by nerve block of the

A. lingual nerve f*
p
B. trigeminal nerve r '
C. lateral femoral cutaneous nen/£
D. lumbar sympathetic nerve
E. femoral nerve
y
^

Page 20 of 26
r

European
Society of
f
pB

34. Side effects of opioid epidural analgesia include

A. itching
B.
T„
hypotension \

C. hypoventilation \
D. sedation^”
E. urinary retention

35. Factors influencing the level of a spinal block include the

A. specific gravity of the anaesthetic solution \

B. volume of the anaesthetic solution
C. dose of local anaesthetic
D. age of the patient
E. position of the patient

36. Likely causes of coagulopathy in a patient who becomes septic following colonic
resection include:

A. deficiency of vitamin K ^
B. liver damage due to halothane l
C. disseminated intravascular coagulationT
D. unsuspected von Willebrand's disease
E. administration oflow-dose subcutaneous heparin
^

37. Reduction in cardiac output associated with high positive end expiratory pressure
therapy (PEEP) is secondary to

A. diminished venous return to the right heart ^

B. diminished left ventricular performance due to shift of the intraventricular septum '

C. increased right ventricular afterload -y*

D. decreased heart rate £
E. carbon dioxide retention T

38. Positive end expiratory pressure (PEEP) decreases

A. intrathoradc blood volume^

B. PaC0 2 'X r:
'
C. functional residual capacity
D. intracranial pressure r
E. pulmonary capillary wedge pressure*

Page 21 of 26
Anaesthesiology

JVt>

A decrease in
/ J-
mixed venous oxygen saturation is commonly due to Jt ,wr
A. decreased cardiac output \
decreased metabolic rate r
B.
^
C increased pulmonary agery pressure y
D a
E.
left

decreased
to right shunt
arterial
\
oxygen content^
v
^-e.
40. Possible causes of sudden onset of systolic and diastolic murmurs in a patient
with infective endocarditis include V
Vi^
A. pulmonary embolism
^
_
B. myocardial mfarctionV
inferiorr infarctiorfc'

C. prolapsed mitral valve cusp A

D. aortic valve rupture ^ ^
E dissecting aortic aneurysm y

41. A high urinary osmolality is associated with

A. diabetes insipidus
e r*
'
B impaired renal function
-
C mannitol administration ^
D. diabetic ketoacidosis
E. dehydration A

42. Suitable sedative agents for use in intensive care include infusion of

A propofol
B. midazolarrfT
C. droperidol
f
D. etomidate\
E clonidme A

43. A low arterial P0 2 with a high PC0 2 is associated with

A. pulmonary oedema
B upper airway obstruction
C. lobar pneumonia
*
D. acute salicylate poisoning F
E. exercise at high altitude
F

Page 22 of 26
 % IV vC 'bTtt *>f Sfilk&r 4 An CoA-MflCtj AA\
£ ^(^J^\ >• tiS5^Q ~ft* <sh\bv ,i/^ ly.
^V SIC
MA F r
^ Anaesthesiology
European

ES £ V*^«
J

^.tTT^TS^
cft'f
fijjW
^f
1

44. In acute'bepatrctatture

A. the prothrombin time is normal ^ -_r-

^ hu
^ — 7t

1
L

J
u°^ ^ Clot
i ,—t-^i-

1° H&ftrliyy
r B. serum alkaline phosphatase may be normal!
C. serum albumin is often below lOgm/L f
D. pulse oximetry is inaccurate in the presence of jaundice f
^>|yatf»5oro —
E. serum LDH is a sensitive index of hepatocellular damage F C fjij

y, -£,<> St c
The urinary output of creatinine depends upon
rj^yC *-£
A. protein intake
B. urinary volume^ ^
C. glomerular
D. catabolism
E. the muscle mas
ma§s
filtration rate \

of the individual
» if T —
\

46. Probable causes of profound hypotension on commencement of

X
artificial
ventilation in a patient suffering multiple
trauma include r

A. tension pneumothorax t
B hypovolaerma \

C. cardiac tamponadg *T
D. fat embolism >rf
E. flail chest \

47. Physical signs characteristic of acute pulmonary embolism include

A. dyspnoea f

B. large a wave on the central venous pressure (CVP) curve *

C. systolic arterial hypertension
D. cyanosis -T
p
E. tachycardia "T

Decompression sickness

A. is associated with avascular necrosis of bone i

B. is due
an alveolar oxygen deficit
to
C. is cured by breathing a mixture of oxygen and helium at atmospheric '
pressure
D. symptoms can occur four hours after the initial drop in
pressure *
—
E. is avoided if nitrogen is included in the inspired gas mixture
p"

Page 23 of 26
 European
Society of
f
pB

49. Acute pancreatitis is associated with

A retroperitoneal haemorrhage ^
B tetany T
C pleural effusions^
D gastric distension “T
E. hyperglycaemia “p

50. Appropriate agents for reversal of acute bronchoconstriction include

A. salbutamol ^
ketamine “T
B.
-
C. adrenaline T
p
D. sodium chromoglycate \
E. atropine
^

Factors correlated with increasing P(A-a)0 2 after surgery in the morbidly obese
Include

A. location of incision
B. type of incision
C. weight/height ratio *\

D location of excess body fat

\
E. intraoperative paralysis and artificial ventilation \

52. Findings associated with near drowning in fresh water include

A. atelectasis T r
B. increased lung compliance »

C. loss of pulmonary surfactant “T

D. increase in pulmonary venous admixture"X
E haemolysis

53. The “blood-brain barrienV \.A '

f
r
A. is formedLy the arachnoid villi \
B less permeable in the newborn
C.
is

permeable to bicarbonate ions

p
is freely * C
D doe s not permit freejpassage of organic anions I

1 E. has similar functional characteristics to a cell membrane

\

o c(j»l &Jot3 k*

Page 24 of 26
 European
Society of
Anaesthesiology

4- Neonates with respiratory distress syndrome have

s*
A decreased alveolar perfusion
shunts f-*
B. left-to-right cardiac
C increased workof breathing^T*
D. normal alveolar surfactant activity
E. a metabolic alkalosis
^

55. Concerning the neonatal respiratory system:

A the narrowest part of the airway is below the glottis^

thoraco-pulmonary compliance higher than in the adult
^ B. is
p
C. the mamstem bronchi leave the trachea at roughly equal angles \

D. the glottis lies higher in the neck than in the adult—

predominantly diaphragmatic
^
E. inspiration is "f

Ojy —
56.
( Immediateyueatment of an asthmatic child, unsuccessfully treated with
epinephrine (adrenaline), who has become hypoxic, drowsy, hypercarbic and
acidotic includes

A. administration ofsodium bicarbonate f

B. intravenous diazepam P
C. ammophyllme infusion f
D. intubation and ventilation—
E. nebulised salbutamol C.

57. Concerning low platelet counts:

A. before major surgery they should be increased to at least 50,000/ml T

B. m the non-surgical patient, counts of 40.000/ml are associated with increased
haemorrhage f —
C. platelet concentrate administration is the preferred method of treatment
\

D. fresh frezen plasma should be administered to thrombocytopaemc patients

prior to

surgery Q JO
E. they are invariably associated with altered platelet function ^

58. Thyroid stimulating hormone (TSH)

A. increases blood flow to the thyroid gland T

B. is released from the hypothalamus
available as a synthetic pro duct
£
C. is \

D. is elevated in iodine deficiency

E concentration is used to monitor thyroid hormone replacement therapy

Page 25 ot 26
 European
Society of
Anaesthesiology ES
^^£9. In pre-renal oliguria

A. urinary sodium concentration

B. urinary specific gravity
is greater than 1015

C. urme/plasma osmolality ratio is greater than 1 .8

D urme/plasma urea ratio is greater than 10
E. urine/plasma creatinine ratio is greater than 30

60. Differential
include
diagnoses of
— — — ——
an enlarged heart shadow observed on a chest X-ray
— --

A. congestive cardiac faijyre ^

B pericardial effusion \

C. mitral valve disease

D. hypertrophic subaortic stenosis
E. hiatus hernia
—

Page 26 of 26