Free Printable September 2021 Summative Exams

1.

1. Complications of head down positions except:

a)

a. Head and neck injury

b)

b. Brachial plexopathy

c)

c. Cranial vascular congestion

d)

d. Hypotension

2.

1. Excessive cycling of an automated blood pressure cuff may cause injury to what nerve?

a)

a. Median nerve

b)

b. Musculocutaneous nerve

c)

c. Radial Nerve

d)

d. Long thoracic nerve

3.

1. Anatomic differences between men and women that increase the likelihood of perioperative ulnar neuropathy include the following except?

a)

a. The tubercle of the coronoid process is 1.5 times larger in men than women

b)

b. Less adipose tissue over the medial aspect of the elbow of men compared with women

c)

c. Men more likely to have a well-developed cubital tunnel retinaculum than women

d)

d. None of the above

e)

e. All of the above

4.

Maternal hypotension in the supine position during pregnancy is most often due to

a)

a. Decreased blood volume

b)

b. Decreased peripheral vascular resistance

c)

c. Decreased hematocrit

d)

d. Compression of the vena cava

5.

Physiologic effects of supine position except:

a)

a. improved venous return to the heart

b)

b.increased functional residual capacity

c)

c. reflex bradycardia

d)

d. increased cardiac output

6.

16. This nerve may be injured if the head of the fibula is insufficiently padded and compressed against the stirrup canes.

a)

a. sciatic nerve

b)

b. obturator nerve

c)

c. common peroneal nerve

d)

d. saphenous nerve

7.

17. What is the most common perianesthetic neuropathy?

a)

a. radial nerve

b)

b. ulnar nerve

c)

c. musculocutaneous nerve

d)

d. median nerve

8.

18. Ventilation-perfusion mismatching is a risk in what position

a)

a. supine position

b)

b. sitting position

c)

c. beach chair position

d)

d. lateral positions

9.

19. Disadvantages of the sitting position except:

a)

a. VAE

b)

b. spinal cord ischemia

c)

c. hypertension

d)

d. possible airway obstruction

10.

. The most common mechanism for postoperative visual loss during prone position

a)

a. direct pressure to the globe

b)

b. retinal artery occlusion

c)

c. retinal detachment

d)

d. optic nerve hypoperfusion

11.

1.) Principal barrier for medications in the CSF

a)

a. Pia Mater

b)

b. Arachnoid Mater

c)

c. Dura Mater

d)

d. None of the above

12.

1.) Toughest membrane covering the brain and spinal cord

a)

a. Pia Mater

b)

b. Arachnoid Mater

c)

c. Dura Mater

d)

d. None of the above

13.

1.) Toughest ligament pierced by the spinal needle when performing SAB

a)

a. Supraspinous ligament

b)

b. Interspinous ligament

c)

c. Ligamentum flavum

d)

d. Ligamentum nuchae

14.

1.) Cerebrospinal fluid (CSF) is reabsorbed by the

a)

a. Granulations

b)

b. Arachnoid villi

c)

c. Both a and b

d)

d. None of the above

15.

1.) The following are contraindications of neuraxial blockade except:

a)

a. Patient refusal

b)

b. Infection at the site of injection

c)

c. Coagulopathy and other bleeding disorders

d)

d. None of the above

16.

1.) The following are complications of subarachnoid block except:

a)

a. Hypotension

b)

b. Bradycardia

c)

c. Cauda equina syndrome

d)

d. None of the above

17.

1.) The following are complications of epidural anesthesia except:

a)

a. Backache

b)

b. Infection

c)

c. Post dural puncture headache

d)

d. None of the above

18.

1.) Epidural space if identified using:

a)

a. Hanging drop technique

b)

b. Loss of resistance technique

c)

c. Both a and b

d)

d. None of the above

19.

1.) Subarachnoid space is identified be the presence of:

a)

a. Blood

b)

b. CSF

c)

c. Both a and b

d)

d. None of the above

20.

1.) The following patient positions can be used while providing neuraxial blockade except:

a)

a. Jack knife position

b)

b. Sitting position

c)

c. Lateral decubitus

d)

d. None of the above

21.

1. What organization/association declared PAIN as the 5^th Vital Signs?

a)

a. American Society of Pain

b)

b. ASRA

c)

c. JCAHO

d)

d. ASA

22.

1. This can cause sensitization of the nervous system resulting in allodynia and hyperalgesia.

a)

a. Neuronal plasticity

b)

b. Wind-up phenomenon

c)

c. Facilitation

d)

d. Long term potentiation

23.

1. Surgical procedures associated with chronic painful conditions include the following, Except.

a)

a. Amputation of limb

b)

b. Lateral thoracotomy

c)

a. Appendectomy

d)

d. Open cholecystectomy

24.

1. Neurons located primarily in Lamina 1, responding only to noxious stimuli thought to be involved in the sensory-discriminative aspects of pain.

a)

a. Nociceptive Specific

b)

b. WDR neurons

c)

c. 1^st order neurons

d)

d. 3^rd order neurons

25.

1. What afferent pathway transmits the Epicritic pain?

a)

a. A Beta

b)

b. A Alpha

c)

c. A Delta

d)

d. C Fibers

26.

1. These are the elements of pain processing Except?

a)

a. Transduction

b)

b. Transmission

c)

c. Modulation

d)

d. Potentiation

27.

1. This transmitter compounds integral to pain transmission is an Excitatory Neuropeptide?

a)

a. Glutamate

b)

b. GABA

c)

c. Aspartate

d)

d. Substance P

28.

1. This pain receptor is Calcium dependent, and is only activated following prolonged depolarization of the cell membrane?

a)

a. NMDA

b)

b. AMPA

c)

c. Kainate

d)

d. Metabotropic

29.

1. Release of this transmitter compound into the spinal cord will remove the magnesium block on the channel of NMDA receptor?

a)

a. Neurokinin A

b)

b. Substance P

c)

c. Glycine

d)

d. Aspartate

30.

1. Painful response to a typically non-painful stimulus.

a)

a. Hyperalgesia

b)

b. Allodynia

c)

c. Paresthesia

d)

d. Hyperesthesia

31.

1. Regarding glucose management in critically ill patients, all of the following are true EXCEPT:

a)

a. Hyperglycemia is associated with increased risk of postoperative infection

b)

b. The blood glucose level is a risk factor for mortality in diabetic patients admitted with acute myocardial infarction

c)

c. Patients in the ICU may have elevated blood glucose levels because of total parenteral nutrition (TPN) or steroid administration

d)

d. Elevated blood glucose levels with traumatic brain injury are expected and do not require intervention

32.

1. Which of the following statements about dexmedetomidine is FALSE?

a)

a. It is an alpha2-adrenergic receptor agonist

b)

b. It produces sedation without inducing unresponsiveness

c)

c. It is an alpha1-adrenergic receptor agonist

d)

d. It has some analgesic effects

33.

1. Advantages of the Glasgow Coma Scale in patients with traumatic brain injury (TBI) include all EXCEPT:

a)

a. It provides an objective method of measuring the level of consciousness

b)

b. It has high intra- and inter-rater reliability across observers with a wide variety of experience

c)

c. It is accurate even when only the partial score is used, such as in patients with endotracheal intubation

d)

d. It is a powerful predictor of poor outcome in TBI

34.

1. The pulmonary artery catheter (PAC):

a)

a. Improves mortality in elderly, high-risk surgical patients

b)

b. Needs further research to establish utility in critically ill patients

c)

c. Can guide supraphysiologic resuscitation to improve outcomes

d)

d. Improves survival in acute respiratory distress syndrome

35.

1. In ABG interpretation, an increase in [HCO3-] of 10 mEq/L will result in an increase in pH of

a)

a. 0.10 pH unit

b)

b. 0.15 pH unit

c)

c. 0.20 pH unit

d)

d. 0.25 pH unit

36.

1. Which of the following statements concerning the distribution of CO2 and O2 in the upright lungs is TRUE?

a)

a. PaO2 is greater at the apex than at the base

b)

b. PaCO2 is greater at the apex than at the base

c)

c. PaO2 is greater at the base than at the apex

d)

d. Both PaO2 and PaCO2 are greater at the base than at the apex

37.

1. Each of the following will shift the oxyhemoglobin curve to the right EXCEPT:

a)

a. Volatile anestheticsb.

b)

b. Decreased PaO2c.

c)

c. Decreased pHd.

d)

d. Increased temperature

38.

1. Which of the following conditions would be associated with the LEAST risk of venous air embolism during removal of a central line?

a)

a. Spontaneous breathing, head up

b)

b. Spontaneous breathing, flat

c)

c. Spontaneous breathing, Tredelenberg

d)

d. Mechanical ventilation, Tredenlenberg

39.

1. Which of the following drugs is the best choice for treating hypotension in the setting of severe acidemia?

a)

a. Norepinephrine

b)

b. Epinephrine

c)

c. Phenylephrine

d)

d. Vasopressin

40.

1. The time course of anticoagulation therapy is variable after different percutaneous coronary interventions (PCIs). Arrange the interventions in order starting with the one requiring the shortest course of aspirin and clopidogrel therapy to the one requiring the longest course.

a)

a. Bare-metal stent, percutaneous transluminal coronary angioplasty (PTCA), drug-eluting stent

b)

b. Drug eluting stent, bare-metal stent, PTCA

c)

c. PTCA, drug-eluting stent, bare-metal stent

d)

d. PTCA, bare-metal stent, drug-eluting stent

September 2021 Summative Exams

Total questions: 40

Worksheet time: 40mins

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