| 1. |
If adrenaline is used with local anesthetic in a finger block, which drug can be used to reverse vasospasm? |
| A. | aramine |
| B. | GTN |
| C. | Hydrallazine |
| D. | Phentolamine |
| E. | Theophylline |
| Answer» D. Phentolamine | |
| 2. |
the absorption from highest to lowest is |
| A. | intercostals, peripheral nerve, subcutaneous |
| B. | subcutaneous, peripheral nerve, intercostals |
| C. | peripheral nerve, intercostals, subcutaneous |
| D. | intercostals, subcutaneous, peripheral nerve |
| E. | they are all the same |
| Answer» A. intercostals, peripheral nerve, subcutaneous | |
| 3. |
The recommended local anesthetic dose for intercostals blocks is what percentage of maximum for peripheral blocks? |
| A. | 50 |
| B. | 25 |
| C. | 15 |
| D. | 10 |
| E. | 5 |
| Answer» D. 10 | |
| 4. |
For a median nerve block at the wrist the needle is inserted |
| A. | lateral to flexor carpi radialis |
| B. | directly lateral to palmaris longus |
| C. | at the medial border of palamaris longus |
| D. | through palmaris longus |
| E. | none of the above |
| Answer» B. directly lateral to palmaris longus | |
| 5. |
Which statement is incorrect with regards to ulnar nerve blocks at the wrist |
| A. | the ulnar nerve lies lateral to the artery |
| B. | the ulnar nerve lies lateral to flexor carpi ulnaris |
| C. | the site of needle insertion is directly lateral to flexor carpi ulnaris |
| D. | lignocaine with adrenaline can be used safely |
| E. | if lignocaine is used the block lasts for 1-2 hours |
| Answer» C. the site of needle insertion is directly lateral to flexor carpi ulnaris | |
| 6. |
Which statement is incorrect? |
| A. | the nail bed of the middle finger is supplied by the median nerve |
| B. | the nail bed of the fifth finger is supplied by the ulnar nerve |
| C. | the total anaesthetic agent which should be used in a finger block is 4 ml |
| D. | the palmer and dorsal digital nerves are superficial to their arteries |
| E. | the dorsum of the whole hand distal to the DIP is supplied by the radial nerve |
| Answer» E. the dorsum of the whole hand distal to the DIP is supplied by the radial nerve | |
| 7. |
Which statement is incorrect with regards to the plantar surface of the foot? |
| A. | it is mostly supplied by the posterial tibial nerve |
| B. | the saphenous nerve is blocked between the medial mallelous and tibialis anterior |
| C. | often two nerves need to be anaesthatised for an adequate block |
| D. | for a posterior tibial nerve block anaesthetic is injected lateral to the posterial tibial artery at the upper border of the medial mallelous |
| E. | the sural nerve is blocked inferior to the lateral malleolus |
| Answer» E. the sural nerve is blocked inferior to the lateral malleolus | |
| 8. |
With regards to local anesthesia of the oral region which is incorrect? |
| A. | to anaesthasise the chin and lower lip a mental nerve block or an inferior alveolar nerve block can be done |
| B. | an intra oral mental nerve block is done where the lip meets the gum at the level of the first pre molar |
| C. | an external mental nerve block can be done in the same region |
| D. | local anaesthetic with adrenaline should not be used |
| E. | a midline laceration may need a bilateral block |
| Answer» D. local anaesthetic with adrenaline should not be used | |
| 9. |
Which is false with regards to intra oral nerve blocks? |
| A. | the technique is similar to that for a lingual nerve block |
| B. | and inferior alveolar nerve block will anaesthatise the chin and lower lip |
| C. | a lingual nerve block will anaesthatise the anterior two thirds of the tongue plus the floor of the mouth and the gums |
| D. | in such block the needle is inserted two cm along the lateral border of the ramus of the mandible |
| E. | the site of needle insertion is 1 cm above the third molar |
| Answer» D. in such block the needle is inserted two cm along the lateral border of the ramus of the mandible | |
| 10. |
which is true with regard to a laceration of the pinna of the ear? |
| A. | direct infiltration is a safe option |
| B. | adequate regional block is achieved by injecting LA from both a superior and inferior direction anterior to the ear |
| C. | adequate regional block is achieved by injecting LA from both superior and inferior directions posterior to the ear |
| D. | adequate regional block requires both and anterior and posterior block |
| E. | an intraoral approach provides the longest anaesthesia |
| Answer» D. adequate regional block requires both and anterior and posterior block | |
| 11. |
Which is not true with regional blockade of the infraorbital nerve? |
| A. | it is found one cm inferior to the mid point of the lower margin of the orbit |
| B. | anesthesia by an percutaneous route lasts longer than a intraoral route |
| C. | it anaesthatises the upper lip |
| D. | it anesthatises the lower eyelid |
| E. | it anaesthatises the lateral side of the nose |
| Answer» B. anesthesia by an percutaneous route lasts longer than a intraoral route | |
| 12. |
Which is false with regards to a Biers Block? |
| A. | If regional block lasts for 40 – 60 mins |
| B. | the minimal duration of cuff inflation is 20 mins |
| C. | bupivicaine can be used at a smaller dose of 1/mg/kg, but the cuff must remain up for at least 40 mins |
| D. | lignocaine can be used safely |
| E. | it is contraindicated in patients with sickle cell disease and Raynauds disease |
| Answer» B. the minimal duration of cuff inflation is 20 mins | |
| 13. |
Which is false of methoxyflourane? |
| A. | it is found in the green sticks used for pain control in the ambulance |
| B. | its is an ether like substance |
| C. | it produces good analgesia with no anaesthesia |
| D. | adverse effects include delerium, hypotension, arythmias, and respiratory depression |
| E. | it is flammable |
| Answer» E. it is flammable | |
| 14. |
Which is a false statement with regards to nitrous oxide? |
| A. | when supplied as Entonox, it is 30% oxygen and 70% nitrous oxide |
| B. | it does not cause hypoxia when used as entonox |
| C. | it does not cause significant depression or loss of airway reflexes |
| D. | it is a clear, odourless gas |
| E. | it supports combustion but is not explosive |
| Answer» A. when supplied as Entonox, it is 30% oxygen and 70% nitrous oxide | |
| 15. |
which of these induction agents increases ICP? |
| A. | ketamine |
| B. | thiopentone |
| C. | propofol |
| D. | fentanyl |
| E. | midazolam |
| Answer» A. ketamine | |
| 16. |
Which is not a complication of succinylcholine? |
| A. | increased intragastric pressure |
| B. | histamine release |
| C. | masseter spasm |
| D. | malignant hyperthermia |
| E. | hypotension |
| Answer» E. hypotension | |
| 17. |
Which is not a feature of the non-depolarising neuromuscular relaxant mentioned? |
| A. | pancuronium – tachycardia, long half life |
| B. | atracurium - short half life |
| C. | rocuronium – short duration of onset (1-3 mins) |
| D. | vecuronium – brief increase ICP |
| E. | vecuronium – lack of haemodynamic alterations |
| Answer» D. vecuronium – brief increase ICP | |
| 18. |
Which statement is false? |
| A. | lignocaine 1mg/kg may blunt the increase in ICP with instrumentation of the larynx. |
| B. | In this setting lignocaine should be given no more than 20 secs prior to other agents |
| C. | The standard adult blade for intubation is called the Macintosh blade |
| D. | The straight blade for paediatric intubation is the Miller blade |
| E. | The adult blade with a hinged tip that lifts the epiglottis is the McCoy blade |
| Answer» B. In this setting lignocaine should be given no more than 20 secs prior to other agents | |
| 19. |
Which is an incorrect statement with regards to TAC? |
| A. | it is nuch more effective on scalp and facial wounds than extremities |
| B. | application is for 1 hour minutes to achieve sufficient local anaesthesia |
| C. | It must be kept in a locked cupboard |
| D. | It should not be used in wounds where adrenaline is contraindicated |
| E. | Significant toxicity throught mucous membranes occurs, though low dose application on mucous membranes can occur safely |
| Answer» B. application is for 1 hour minutes to achieve sufficient local anaesthesia | |
| 20. |
With regards to non invasive ventilation, CPAP, which is false? |
| A. | it recruits collapsed alveoli |
| B. | it prevents alveoli collapse |
| C. | it increases FEV1 |
| D. | it improves FRC |
| E. | it improves alveolar fluid distribution |
| Answer» C. it increases FEV1 | |
| 21. |
Which is the least likely adverse effect of CPAP? |
| A. | increase ICP |
| B. | barotrauma |
| C. | hypertension |
| D. | increase CO2 |
| E. | hypoxia |
| Answer» C. hypertension | |
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