Candidate # (

Palestine Medical Council Certificate Examination

Specialty : Anaesthesia
Please answer all the 100 questions provided
Time Allowed :

3 hours

Please for each question , select the most appropriate

answer

1. Regarding two compartment pharmacokinetics witch statement is false?

a adrug is removed from the peripheral compartment
b) the central compartment is blood volume
c) a drug with a high volume of distribution is likely to be lipophillic
d) a drug can have a short duration of action while being eliminated very slowly
e) most anaesthetic drugs are modelled well with a two-compartment model

2.Atropine has the following characteristics except:

a) may cause bradycardia
b) dilates the pupil in premedicant dose
c) has a shorter duration of action than glycopyrrolate
d) increases the physiological dead space
e) has both muscarinic and nicotinic effects

3.The following increase during pregnancy except:

a) plasma volume
b) fibrinogen
c) gastric emptying time
d) glucose tolerance
e) arterial PCO2

4.Bacteria develop resistance to antibiotics by the following except:

a) by changing permeability of porin channels in cell wall
b) by producing enzymes to inactivate antibiotics
c) by altering target sites (DNA gyrase and topoisomerase) for antibiotics
d) by active extrusion of antibiotic once it enter the cell
e) easily in presence of necrotic tissuerterial PaCO2 has both muscarinic and nicotinic effects
decreased in hypothermia

5.The respiratory centre in the brain stem receives input from the following except:
a) the aortic and carotid bodies
b) bronchiolar stretch receptors via vagal afferents
c) oxygen-sensitive chemoreceptors in the medulla
d) receptors which respond to the hydrogen ion concentration in the cerebrospinal fluid
e) mechanoreceptors of the larynx

6.The carotid bodies has the following properties except the following except :
a) have cells which respond only to decrease in PaO2
b) have the highest blood flow (ml/unit weight) in the body
c) maximally stimulate the respiratory centre between 4-8 kPa
d) increase the respiratory drive when mean arterial pressure decreases below 70 mmHg

7.With a decrease in body temperature the false statement is:

a) P50 and PaCO2 are decreased
b) pH is increased
c) arrhythmias are increasingly common at temperatures below 30 degrees C
d) blood becomes more viscous
e) the EEG becomes isoelectric at about 20 degrees C

8.Nitrous oxide (N2O) has the following except:

a) has a blood:gas partition coefficient of 0.47
b) is 34 times less soluble than N2
c) may be associated with postoperative hearing loss
d) inactivates methionine synthetase after prolonged administration
e) when inhaled at 66% can double a pneumothorax in 10 min

9.With reference to the skeletal muscle myofilaments:

a) actin is the major constituent of thin filaments
b) myosin and tropomyosin combine to form the thick filaments
c) troponin is a constituent of thin filaments
d) tropomyosin prevents the interaction between actin and myosin in the resting state
e) troponin C has 4 calcium binding sites

10.Regarding defibrillation the false statement is:

a) the greater the time interval between onset of ventricular fibrillation and defibrillation,
less the success of defibrillation
b) 5-40 joules should be applied to the heart if the chest is open
c) paddles should be of 13 cm in diameter in adults
d) defibrillation is most effective when the electric shock is delivered during inspiration
e) the myocardium is refractory to defibrillation in hypothermia

11.Regarding acid-base balance the false statement is :

a) chronic obstructive airways disease patients have high serum bicarbonate levels
b) the normal anion gap is 20-25 mmol/L
c) mixed venous pH is always lower than arterial pH
d) the pKa for bicarbonate buffer is 6.1
e) kidneys cannot produce urine with a pH <4.4

12.Hyponatraemia has the following aspect except :

a) may increase intracellular fluid volume
b) may be seen in syndrome of Inappropriate antidiuretic hormone
c) may increase the secretion of atrial natriuretic peptide
d) may increase the plasma osmolality
e) of acute onset may be associated with cerebral oedema
3

the

13.Adrenaline characterized by the following except:

a) can be nebulised
b) is a bronchodilator
c) may elevate the blood sugar
d) has an almost equal effect on both alpha- and beta-adrenergic receptors
e) tracheal administration of adrenaline should be used even in presence of IV access during
cardiopulmonary resuscitation

14.Heparin has the following except:

a) has a molecular weight between 3,000-60,000 daltons
b) acts by binding to antithrombin III
c) has antiplatelet activity
d) prolongs the prothrombin time
e) has a shorter duration of action than low molecular weight heparin

15.Pulmonary artery wedge pressure will be greater than left ventricular end
diastolic pressure in the following situations except:
a) presence of mitral valve prosthesis
b) positive end-expiratory pressure during mechanical ventilation
c) catheter tip in Zone I
d) non-compliant left ventricle
e) mitral stenosis

16.Factors determining urinary sodium loss include except:

a) plasma sodium concentration
b) glomerular filtration rate
c) circulating renin levels
d) distal tubular fluid anion concentration
e) plasma hydrogen ion concentration

17.Cardiac output may be measured by the following except:

a) thermodilution
b) electromagnetic flow meter
c) Doppler ultrasound
d) limb plethysmography
e) ballistocardiography:

18.Regarding the dopamine the false statement is :

a) increases cardiac output
b) in high doses causes peripheral vasodilatation
c) increases renal blood flow
d) increases ventricular excitability
e) increases splanchnic blood flow

19.Severe hyperkalaemia is suggested by the following except:

a) absent p waves in the ECG
b) chronic ACE inhibitor intake
c) decreased serum bicarbonate level
d) suxamethonium administration in immediate burn
e) aldosterone deficiency

20.Concerning the physiology of the stomach all are correct except:

a) acid secretion in response to hypoglycaemia is mediated by gastrin
b) gastric emptying is quickened by sympathetic stimulation
c) acid secretion is mediated by H2, M1 and gastrin receptors
d) gastric pH is normally around 2-3
e) acidity is reduced by proton pump inhibitors

21.Non-depolarising muscle relaxants has the following aspect except:

a) demonstrate fade due to their presynaptic action
b) may not show post-tetanic facilitation
c) with large dose may block the diaphragm first before adductor pollicis
d) have onset defined as time from administration to abolition of response to single twitch

22.The sequence of events in muscle contraction include the following except:

a) action potential depolarises the T-tubules
b) depolarisation of T-tubules release calcium from sarcoplasmic reticulum
c) calcium binds to the troponin-tropomyosin complex
d) actin combines with myosin ATP leading to cross-bridge activation
e) calcium moves back into the sarcoplasmic reticulum by passive transport

23. Morphine has the following properties excpt:

a) 10-30% of oral morphine reaches the systemic circulation
b) has a terminal half-life of approximately 3 hours
c) has morphine-3-glucoronide as principal metabolite
d) morphine-6-glucoronide has no analgesic effect
e) increases the secretion of antidiuretic hormone

24.Regarding the pharmacokinetics of volatile agents all are correct except:

a) blood/gas partition coefficient of desflurane is 0.69
b) sevoflurane can be used for inhalational induction in adults
c) inspired concentration influences the rate at which alveolar concentration is attained
d) alveolar concentration during recovery decreases more slowly after prolonged anaesthesia

25.The false statement regarding an excitatory post-synaptic potential (EPSP) is:

a) is itself propagated by the post-synaptic cell
b) comprises depolarisation of the membrane to zero, transient reversal of potential and then
repolarisation
c) is related in amplitude to the concentration of the initiating transmitter at the presynaptic
membrane
d) may summate both temporally and spatially with other EPSPs
e) is reduced in amplitude by drugs which block the post-synaptic receptors for the transmitter
substance

26.Concerning absorption of carbon dioxide in breathing systems the following are

correct except:
a) soda lime granules are sized 4-8 mesh
b) baralyme contains calcium hydroxide in addition to barium hydroxide
c) soda lime produces more compound A during low fresh gas flow
d) dry soda lime absorbs more carbon dioxide
e) carbon dioxide first reacts with sodium and potassium hydroxide of soda lime

27.Total body oxygen consumption can be measured by the following methods

except:
a) oxygen loss from a closed breathing system
b) subtraction of expired from inspired volume of oxygen
c) ventilated hood technique
d) multiplying cardiac output by arterial-mixed venous oxygen content difference
e) tissue PO2 electrodes

28.Regarding mivacurium the false statement is:

a) it releases more histamine than atracurium in equipotent doses
b) it is broken down by plasma cholinesterase as rapidly as suxamethonium
c) it is a bisquaternary benzylisoquinolinium compound
d) 10% of a bolus dose is excreted in the urine over 24 hours
e) at an equipotent dose it has a similar onset of action to pancuronium

29.In a normal resting man, a fall in heart rate would be expected to occur following
except :
a) increased carotid sinus pressure
b) increased right atrial pressure
c) application of pressure to the eyeball
d) the release of a Valsalva manoeuvre
e) inspiration

30. Which of the following is false:

a) the [H+] electrode relies for its action on the hydrogen ion sensitivity of a glass
electrode
b) A CO2 electrode is, in principle, a modified [H+] electrode
c) The [H+] electrode requires no temperature compensation
d) CO2 may be measured by an infrared absorption spectrometer
e) N2O may be measured by an infrared absorption spectrometer

31. The capnograph trace has the following characteristics except:

a) plots CO2 on the X-axis versus time on the Y-axis
b) elevated phase I is due to rebreathing of CO2
c) a flattened upstroke of phase II represents slow exhalation secondary to obstruction
d) phase III shows a flat curve with a slight upstroke
e) undulations in phase III may be due to cardiac oscillations

32. In the adult human the false statement:

a) albumin is synthesised only in the liver
b) elevated serum lactate dehydrogenase is a good indicator of liver damage
c) plasma urea concentration may be low in hepatic failure
d) plasma fibrinogen is synthesised in the liver
e) the pressure in portal vein is normally about 2 kPa

33. Concerning the opioids used in the perioperative period all are correct except:
a) the volume of distribution of fentanyl is greater than that of morphine
b) at physiological pH morphine is more ionised than alfentanil
c) morphine is more protein bound than fentanyl
d) fentanyl penetrates the blood-brain barrier more quickly than morphine
e) pethidine has a metabolite with epileptogenic potency

34.These are true in the SI system of measurement except:

a) the basic unit of mass is the gram
b) pico is the prefix denoting 10-12
c) the Hertz is the derived unit of frequency
d) it is still allowable to use temperature on the Celsius scale
e) the unit of time in the metric and SI unit system are the same

35. With increasing altitudethe false statement is:

a) the concentration of oxygen in the atmosphere falls
b) the atmospheric pressure decreases exponentially
c) water will boil at a temperature of less than 100 degrees C
d) PaCO2 will decrease at first
e) acetazolamide can reduce the incidence of pulmonary oedema

36. The physiological dead space has the following except:

a) increases with induction of anaesthesia
b) decreases during controlled ventilation
c) increases with a short inspiration time
d) increases with the use of positive

37 Warfarin the false statement is:

a) competes with vitamin K
b) displaces phenylbutazone from plasma protein binding sites
c) blocks prothrombin synthesis
d) is contraindicated in malignant hypertension
e) prevents normal fibrinolysis

38. Which of the following are partial agonists at opioid receptors:

a) nalbuphine
b) nalorphine
c) naloxone
d) buprenorphine
e) meptazinol

39.Ketamine the statement is:

a) raises the plasma noradrenaline level
b) can cause unpleasant side-effects in adults for 24 hours after administration
c) is a depressant to denervated cardiac muscle
d) produces a loss of consciousness in one arm-brain circulation time
e) is a bronchdilator

40.Pulse pressure the statement is:

a) depends on left ventricular stroke volume
b) increases with increase in the velocity of blood flow
c) depends on the compliance of the arterial tree
d) is higher in peripheral arteries than that in the aorta
e) is low in high cardiac output states

41 . ABOUT AIR TRAQ, ALL TRUE ,EXCEPT

A.
B.
C.
D.
E.

It has abuilt in Anti fog system and low temperture light.

Set up time lower than 30 - 60 seconds.
Easy to use.
Allows intubationin in any position.
Mild hyperextension of the neck is recquired.

42 . About Atracorium infusion solution period of stability, all true EXCEPT:

A.
B.
C.
D.
E.

Sodium chloride infusion 24 hours period of stability.

Ringers injection 8 hours period of stability.
Dextrose 5% 8 hours period of tability.
Glucose 4% 8 hours period of stability.
Compound sodium lactate (heart mans solution) 8 hours period of stability.

43. About Atracorium, WHICH IS TRUE:

A. Its colour is faint white.
B. Monitoring of serial (CPK) should be considered in Asthmatic patients receiving
high doses of atracuriumin icu.
C. Tracorium has significant vagal properties in range doses.
D. Shoud be used in cautions with patients had renal failure.

44. Abut Tracurium, WHICH IS FALSE:

A.
B.
C.
D.

It is eleminated by Hoffman phenomena.

Tracorium is inactivated by high pH.
Should not be mixed with same syringe of thiopentone.
Hypophosphatemia may shorten recovery.

45. About ultiva (remifentanil), WHICH IS FALSE:

A.
B.
C.
D.

Easy to titrate.
Intermediate acting opiods agonist
Rapid predictable recovery.
Permits an analgised based sedation with increased patient awarness .

46 V erapamil must be used carefully in the presence of :

A. Aminoglycerides.
B. High cervical spinal injury.
C. Extensive burn.
D. Tricyclic atidepressents.
E. Beta-adrenegic blocking agents.
9

47. Local anesthetic that is effective topically:

A.
B.
C.
D.

Cocaine.
Mepivacaine.
Procaine.
Chloraprocaine.

48. About fentanyl, WHICH IS FALSE:

A.
B.
C.
D.

Each ampule contains fentanyl as citrate, sodium chloride, water for injection.
IT is narcotic analgesic . .
Contraindicated in severe hemorrhage as shock when administered epidurally.
Can breast feed when the mother takes fentanyl in 8 hours duration post fentanyl.

49. About TRAMAL solution for injection, WHICH IS TRUE:

A.
B.
C.
D.

The active material is tramadol hydrochloride ..

Each ampule has 3ml.
Each ampule has 4ml.
With the ampule other ingredients as sodium citrate and water for injection.

50. METHERGINE contraindicated in:

A.
B.
C.
D.

Treatment of uterine atony.

Active management of 3rd stage of labor.
In association with C/S and following abortion.
Can be safely given in sepsis.

51. About MIDAZOLAM WHICH

A.
B.
C.
D.

Can be used simply by any doctor.

Contraindicated in ischemic heart disease patients.
Contraindicated in acute Narrow angle glycoma.
Containdicated in asthmatic patients.

52. All are true, EXCEPT: -about

detremination.
A.
B.
C.
D.

IS TRUE:

infrared

analysis

may

be

used

Carbondioxide
Oxygen.
nitrous oxide
Carbonmonoxide.

52. Regarding Neostigmine, WHICH IS TRUE:

A.
B.
C.
D.
E.

Treatment prevention of post-operative intestinal and urinary retention.

Does not increase salivery salivery secretion.
Does not increase intestinal secretion.
Does not cause abdominal cramps.Does not cause headache and weakness.

53. Precautions taking in using Neostigmine includes all EXCEPT:

A.
B.
C.
D.
E.

Caution in patient with bronchial asthma.

Caution in patient with recent coronary occlusion
Epilepsy.
Hyperthyroidism .
High blood pressure.
10

for

54. Regarding Propofol side effects includes all , EXCEPT:

A.
B.
C.
D.
E.

Hypertesion.
Bradycardia.
Tachycardia.
Hiccup.
Hpoventilation.

55. In pregnancy, which is the following physiological changes is TRUE:

A.
B.
C.
D.

Increase leukocyte count.

Decrease in blood volume.
Increase in platelet count.
Decrease in cardiac output.

56. Optimal oxygen transport occurs when hematocit is:

A.
B.
C.
D.

Between 30% and 35%.

Between 40% and 45%.
Between 436% and 50%.
Is independent of the hematocite.

57. Anatomic dead space is estimated as follows:

A.
B.
C.
D.

1ml/Ib/body wt.
2ml/Ib/body wt.
3ml/Ib/body wt.
4ml/Ib/body wt.

58. Clinical signs of venous air ebolism include all , EXCEPT:

A.
B.
C.
D.

Cardiac arrhythmias.
Rising ETCO2.
Neck vein distension.
Bronchospasm .

59. Lung compliance will decrease in the presence of all , EXCEPT:

A.
B.
C.
D.

Pulmonary edema.
Lt pneumonectomy.
Pulmonary fibrosis.
Emphysema.

60. The greatest portion of air way resistance ccurs at:

A.
B.
C.
D.

Mainstem brochi.
Bronchiols.
Terminal bronchiols.
Vocal cord.

11

61. To calculate total peripheral resistance which of the following MUST be

Determined:
A.
B.
C.
D.

Heart rate.
Pulmonary capillary wedge pressure.
Central versus pressure.
Systolic atrial pressure.

62. The human blood product with lowest risk of hepatitis trasmission is :
A. Whole blood.
B. F.F.P.
C. Frozen washed red blood cells.
D. Salt, poor albumin.

63. The most common coagulopathy following massive transfusion is due to :

A. DIC.
B. Citrate intoxicotion.
C. Metabolic acidosis.
D. Dilution coagulopathy.
E. Hemolytic reaction.

64. If a vassopressor is to be used in hemorrhagic shock, the best drug is :

A. Norepinephrin.
B. Epinephrin.
C. Dopomine.
D. Phenylephrine.

65. Dextran 70 may produce coagulation difficulties if given in doses exceeding :

A. 25oml.
B. 750ml.
C. 500ml.
D. 1000ml.
E. 1500ml.

66. The most common complication seen in the recovery room is :

A.
B.
C.
D.

Mild to moderate hyperthermia.

Brochospasm .
Cardiac arrhythmias .
Mild to moderate hypothermia.

67. One lung ventilation is manditory in all , EXCEPT:

A.
B.
C.
D.

Pronchopulmonary lavage.
Bronchopulmonary fistula.
Pulmonary abscess.
Pneumonectomy for cancer.

12

68. Nor epinephrin is synthesized from:

A.
B.
C.
D.

Arginine.
Lecine.
Tyrosine.
Tryptamin.

69. The ketone bodies which are part of fatty acid metabolism in diabetic patients
include all , EXCEPT:
A.
B.
C.
D.

Acetone.
Beta hydroxy glutamic acid.
Beta hydroxybutyric acid.
Acetoacitic acid.

70. Endonphins are :

A.
B.
C.
D.

A.Polypeptides.
Glycopurvate -.
Found in lowest concentration in areas with high cocentration of opiod receptors.Likely to be used as I.V. agents in the future.

71. The most sesitive diagnostic method for recognizing air embolism:
A.
B.
C.
D.

E.T.CO2.
Invasive arterial pressure.
Central versus pressure.
Pericardial dopplar monitors.

72. In the management of patient with severe aortic stenosis, it is important to

mantain:
A.
B.
C.
D.
E.

Maximum beta-blockade.
Sinus tachycardia.
Sinus bradycardia.
Low preload.
Propebly timed atrial contractions.

73. In anesthesia of repair of lacerated cornea , which of the following drugs should
be AVOIDED:
A.
B.
C.
D.

Halothane.
Ketamine.
Atracorium.
Pancrium ..

74. The anesthetic considerations in patients with mitral stenosis includes all
EXCEPT:
A.
B.
C.
D.

Adequate cardiac rate control.

Use of trendelenburg position.
Avoidance of even minimal hypoxia and acidosis.
Careful avoidance of increased sympathetic nervous system activity.

13

75. Common to both atrial and venticular premature contraction is:

A.
B.
C.
D.

Prolonged QRS complex.

Normal stroke volume.
Presence of full compensotary pauze.
Presence of an ectopic focus.

76. Both adre naline and Noradrenaline produce:

A.
B.
C.
D.

Increased diastolic blood pressure.

Increased total peripheral resistance.
Constriction of the coronary circulation.
Increased systolic blood pressure.

77. Following spinal anesthesia, the most fibers to be affected are usually serving:
A.
B.
C.
D.

Pressure.
Touch.
Propioception.
Temperature.

78. An epidural injection spreads further in all EXCEPT:

A.
B.
C.
D.

In debilated patients.
In aged patients.
With rapid injection.
With injection at T12- than L5.

79. Epinephrine added to the anesthetic solution for spinal anesthesia:

A.
B.
C.
D.

Adds no danger of neural anesthesia.

prevents or minimizes hypotension.
Prolongs average of anesthetic duration by 70%.
Prolongs the average of anesthetic duration by 50%.

80 . ABOUT SPINAL HEADACHE WHICH IS TRUE .

A.
B.
C.
D.

A.More common at midle age group .

More common in males
C . Less frequent with lancet type of needles .
D. Treated mainly with IV fluids .

81- Ankle block : all false except

Indicated for foot and ankle surgery

Dorsalis pedis artery is related to the tibial nerve
Deep peroneal nerve supplies the dorsum of the foot
Saphenous nerve is the continuation of the femoral nerve
The sole of the foot is supplied by the Sural nerve

14

82-Femoral nerve block: all true except

A.
B.
C.
D.
E.

The nerve lies lateral to the femoral artery.

Used solely for postoperative analgesia for knee surgery
Sartorius muscle twitch is positive indication of nerve stimulation
Keep close to the inguinal ligament as the nerve soon divides after that .
Pectineus and Sartorius muscles are posterior to the femoral sheath

83-In children all true except

A.
B.
C.
D.
E.

propofol is contraindicated under one year of age

desflurane is a useful agent for inhalational induction
a parent should always be present at induction
the induction dose of thiopentone is 3
ocuronium causes pain on injection

84-The following conditions do not require immediate surgical intervention all true
except
A.
B.
C.
D.
E.

necrotising enterocolitis
congenital diaphragmatic hernia
pyloric stenosis
gastroschisis
imperforate anus

85-With respect to cardiac auscultation in children all true

except
A.
B.
C.
D.
E.

an innocent murmur is usually heard in diastole

a ventricular septal defect typically produces a pansystolic murmur
a fixed split second heart sound suggests the presence of an atrial septal defect
if heard pre-operatively, an electrocardiogram provides useful further information
it should be performed on all neonates

86-After reinfusion of shed blood: all false except

A.
B.
C.
D.
E.

Plasma free haemoglobin increases

Haptoglobin decreases
Creatinine and urea normally increase
LDH decreases
Infused red cell survival is about half that of normal Blood

87-When wash and centrifugation technique is used for blood salvage : true except

A. The plasma fraction is discarded

B. Inflammatory mediators are eliminated to a great extent
C. The cost is lower than that of filter systems
D. The concentration of free haemoglobin is low as compared to
filter systems
E. The need for allogeneic blood may be reduced both when used
during and after surgery .

15

88-AnswerTrue or False.Aims of POPM: true except

A.
B.
C.
D.
E.

Promote autonomic nociceptive impulses

Combine different approaches for optimal pain alleviation
Improve surgical outcome and reduce hospital stay and costs
Reduce pain experiences and risks associatedwith unrelieved pain
Aggressive approach to pain assessment andmanagement

89-Answer True or False. Remaining concerns related to POPM: true except

A.
B.
C.
D.
E.

60--80% of surgical patients still experiencemoderate or severe pain

Inadequate routines for pain assessment
Irrational choices of analgesic medications
Risk of addiction of the medication never considered
Prescribed dose of analgesic not administered.

90-AnswerTrue or False.Medical staff related POPMconcerns:

true except

a.
b.
c.
d.

Drugs prescribed and administered with too little attention to patients response
Concerns about adverse effects to drugs and opioid dependence
Workload and lack of staff are causes of suboptimal pain management
Availability of effective analgesics and new technologies for drug administration have
eliminated present concerns
e. Critical review of present routines is usually indicated to improve POPM .

91-Answer True or False. Essentials of POPM: true except

a) Develop and use formal procedures to assess and treat pain
b) Regular documentation and evaluation of pain, the effects of pain therapy and sideeffects are necessary
c) Pain assessment at rest is suff|cient
d) After a painmanagement intervention a reassessment shouldbe done and documented
e) Patient satisfactionwith pain management should be evaluated.

92-Answer True or False. Important components of acute pain services:

except

true

A. Organization of an interdisciplinary groupwith varying professional skills and

approaches to patient care
B. Co-ordination and communication
C. Intermittentmeetings between the core team and clinical unit
D. Acute pain nursesFleaders of the APS team
E. Designatedward nurses responsible formaintenance of adopted routines for POPM
on the surgical ward.

93- Answer True or False. Acute pain services should include:

A.
B.
C.
D.
E.

true except

Designate personnel responsibility for 24-h services

Regular pain assessment and documentation at rest and movement
Regular audit of costeffectiveness is of minor importance
Patient education regarding pain monitoring and treatment options
Ongoing teaching programmes for staffmembers involved
16

94-Answer True or False. Patient satisfactionwith POPM:

true except

A. The adequacy of pain management should be measured also in terms of patient

satisfaction
B. Patients often report satisfactionwith their POPM despite experiencing signif|cant
levels of pain
C. Satisfactionwith POPMin spite of pain indicates a poor variable that should be
omitted at the clinical audit evaluation
D. Patient satisfactionmay be def|ned in terms of the degree towhich patients
expectations are fulf|lled
E. Patient satisfactionmay be influenced by the communication process between the
patient and staff members.

95-AnswerTrue or False.Nasotracheal intubation for head andneck surgery:

except
A.
B.
C.
D.
E.

false

Is frequently traumatic
Should be reserved for major intra-oral operations
Cuffed tubes are more likely to cause bleeding than non-cuffed ones
Awake evaluation of the nasal airway patency is reliable
Cocaine remains the most effective vasoconstrictor for nasotracheal intubation.

96-Answer True or False. Concerning Capnography

true except

A. The arterial-capnography difference is greater with mainstream rather than sidestream sampling
B. Helium causes infra-red capnographs to underestimate carbon dioxide levels
C. Mainstream sampling is more stable within patients than side-stream sampling
D. Errors caused by dilutionwill be exacerbated by long beam lengths in the measuring
cells
E. Smoking will also increase the arterial-capnography difference.

97-Answer True or False. Concerning sedation in intensive care with inhalational

anesthetics: true except
A. Inhalational agents are associated with a faster recovery time than intravenous
sedation over the same time
B. Scavenging is a major technical problem with intensive-care ventilators
C. Excessive sedationFeither too little or too muchFincreases ICU stay and morbidity
D. In the absence of pulmonary damage, rapid response to stimulation is possible
E. The majority of ICUs already use sedation protocols enabling inhalational sedation to
be safely introduced.

98- Answer True or False. Concerning diabetes mellitus (DM):

A.
B.
C.
D.
E.

true except

The age-adjusted death rate for diabetics has increased by 30% since1980
The life-expectancy of a patient with DM is shortened by 15 years
Volatile anesthetic agents may adversely affect non-insulindependent DM(Type 2 ).
Regional anesthesia improves outcome in diabetic patients
a2 agonists reduce insulin secretion.
17

99-AnswerTrue or False .The following statements are true:

A.
B.
C.
D.
E.

true except

Intraoperative hypothermia increases wound infection rates

Rectal temperature can be 11C higher than core temperature
The resistance of a thermistor increases as its temperature increases
The resistance of platinum wire increases as its temperature increases
Defibrillation is a useful treatment of ventricular fibrillation when the core
temperature is 33 Centigrade.

100-AnswerTrue or False. Thrombolysis is contraindicated in patients with: true

except
A.
B.
C.
D.
E.

Acute STelevation
Aortic regurgitation due to aortic dissection
Duodenal ulcer
Pericarditis
Minor STelevation.

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