Anaesthetics solved MCQs

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

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

3. The recommended local anesthetic dose for intercostals blocks is what percentage of maximum forperipheral blocks?

a. 50

B. 25

c. 15

d. 10

e. 5

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

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

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

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

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

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

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

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

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

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

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

15. which of these induction agents increases ICP?

a. ketamine

B. thiopentone

c. propofol

d. fentanyl

e. midazolam

16. Which is not a complication of succinylcholine?

a. increased intragastric pressure

B. histamine release

c. masseter spasm

d. malignant hyperthermia

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

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

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

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

21. Which is the least likely adverse effect of CPAP?

a. increase ICP

B. barotrauma

c. hypertension

d. increase CO2

e. hypoxia

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