MIDTERM

1. The narcotic analgesics include

a) Non-steroidal anti-inflammatory
b) Aspirin
c) Fentanyl
d) Paracetamol

2. Factors predisposing to pulmonary aspiration of gastric contents include the following except
a) Elective surgery
b) Recent food intake, opioid intake and abdominal distention
c) Emergency surgery and trauma
d) Diabetes mellitus , renal failure and difficult airway intubation

3. We get cryoprecipitate from

a) Packed RBCs
b) Fresh frozen plasma
c) Platelets
d) Crystalloids

4. The following is used as inhalational induction agent in pediatric patient

a) Sevoflurane
b) Isoflurane
c) Ketamine
d) Air

5. Healthy infant undergoing elective procedure should fast at least-------- after breast milk
a) 4 hours
b) 6 hours
c) 8hours
d) 2 hours

6. To treat local anesthetic toxicity, you should

a) At first sign of toxicity, stop injection of local anesthetic
b) Give; 02, maintain airway, assist respiration, and iv fluids
c) Ephedrine for hypotension, atropine for bradycardia, and midazolam or thiopentone to control
convulsions
d) All of the above

7. You may postpone an elective operation when

a) Co-morbid conditions not under optimal control
b) Recent food intake OR Refusal to sign the informed written consent
c) Acute upper respiratory tract infection
d) All of the above

8. The reverse of action of non-depolarizing muscle relaxant is

a) Neostigmine + atropine
b) Adrenaline
c) Morphine + atropine
d) Fentanyl + atropine
9. Intravenous anesthetics include the following except
a) Propofol
b) Ketamine
c) Thiopental
d) Halothane

10. To replace moderate blood loss by crystalloid, we give

a) Crystalloids 1:3 ratio of blood loss
b) Crystalloids 3:1 ratio of blood loss
c) Crystalloids 1:1 ratio of blood loss
d) Crystalloids 3:3 ratio of blood loss

11. Local anesthetics could be used for

a) EMLA cream as a topical skin anesthetic cream
b) Regional and Local Anesthesia
c) Acute and chronic pain therapy
d) All of the above

12. For patients scheduled for regional anesthesia you should

a) Routinely ask for cardiac consultation
b) Ask about history of anti-coagulant drugs, examine anatomical landmarks and exclude
infection at injection
c) Do regional anesthesia anywhere
d) Transfer the patient for ICU postoperatively

13. Antibiotic prophylaxis should be

a) Before tourniquet inflation to reduce Surgical site infection (SSI)
b) Within ONE hour before skin incision
c) Given after test for allergic reaction
d) All of the above

14. The line joins the top of the iliac crests is at

a) L4 to L4-5
b) S1
c) L5
d) L3

15. The anaesthetized supine patient is liable to aspirate secretion or vomitus because
a) Anesthesia inhibits the protective airway reflexes
b) Hyperacidity of vomitus
c) Anesthesia stimulate the protective airway reflexes
d) Large volume of secretion

16. Standard monitoring include the following except

a) Blood pressure measurement
b) Pulse oximeter
c) ECG
d) Arterial blood gases

17. The following precautions for blood transfusion are recommended except
a) Warm blood to room temperature
b) Proper monitoring of the blood loss
c) Thoroughly check name and blood group with that of the patient
d) Narrow bore venous cannula
18. Capnography is important to detect
a) Pain level
b) Proper endotracheal intubation.
c) Muscle tone
d) Conscious level

19. Healthy adult patient undergoing elective procedure should fast at least-------- after heavy (fat,
meat) meals
a) 4hours
b) 8 hours
c) 6hours
d) 2 hours

20. During medical history taking from a female patient ask about last menstrual period as
a) Anesthetic agents may be teratogenic or could induce abortion.
b) In late pregnancy there is an increased risk of aspiration of gastric contents and premature
labor
c) Oral contraceptive bills increase the risk of DVT
d) All of the above

21. The anesthetic drug suitable for induction of anesthesia in asthmatic patients is:-
a) ketamine
b) thiopental
c) atracurium
d) morphine

22. Epidural space is a potential space between:

a) ligmentum flavium and dura matter
b) dura and arachnoid matter
c) arachnoid and pia matter
d) all the above

23. The anesthetic drug potency depends on:

a) Dose
b) Route of administration
c) Lipid solubility
d) Water solubility

24. Causes of hypoxia during recovery from anesthesia is

a) Loss of respiratory derive
b) Aspiration pneumonia
c) Improper reversal of non-depolarizing muscle relaxant
d) All of the above

25. The maintenance requirement in a patient 70Kg is :

a) 130ml/kg/h
b) 120ml/kg/h
c) 110ml/kg/h
d) 70ml/kg/h
26. In personal history, the following are included except
a) Age
b) Sex
c) Residency
d) Menstrual cycle
e) Consent

27. Fentanyl is an opioid equal :

a) 10 times like morphine.
b) 1/10 times like morphine.
c) 100 times like morphine.
d) 2 times like morphine.

28. One unit of packed RBCs raise the hemoglobin:

a) 2 gm/dl and hematocrit by 5%
b) 1gm/dl and hematocrit by 2-3
c) 3 gm/dl and hematocrit by 1%
d) 4 gm/dl and hematocrit by 4%

29. A case of suspected cervical spine fracture, to open airway do:

a) head tilt chin left
b) jaw thrust
c) a,b
d) none of the above

30. Shockable rhythm :

a) managed by effective chest compression
b) includes pulseless ventricular tachycardia and pulseless electrical activity
c) 1 mg adrenaline iv is given after the 3rd shock
d) Atropine is used from the start

31. Which of the following is present in old stored packed RBCs:

a) Hyperkalemia
b) Hypocalcemia
c) Metabolic acidosis
d) All of the above

32. Which of the following are contraindications of LMA:

a) Vomiting
b) Inability to open mouth
c) Need of high pulmonary pressures
d) All of the above

33. Blood Transfusion is indicated when Hg is :

a) 11 g /dl
b) 15g/dl
c) Less than 7g/dl
d) 9 g/ dl

34. Regarding the fluid therapy during shock :

a) Saline is the best crystalloid of choice
b) 1ml of blood loss is replaced by 1 ml of crystalloid
c) Ringer lactate is given in a dose of 20 ml/ kg
d) Given only if blood loss>40
35. Transient response to fluid resuscitation:
a) Occurs with 20-40% blood loss
b) There is recurrent decrease in BL.P and increase in HR
c) Need operative intervention
d) All of the above

36. All of the following are indications of laryngeal Mask Airway except :
a) Cannot ventilated using endotracheal tube
b) Cannot visualize larynx
c) Suspected cervical injury
d) Vomiting

37. Monitoring intra operative should present

a) Before induction
b) Before & throughout surgery
c) Before, throughout and after recovery till the delivery to ICU
d) Just throughout surgery

38. Components of adequate anesthesia

a) Narcotics
b) Analgesics
c) Spasm relaxants
d) All of the above

39. The optimal period of providing and maintaining a clear airway

a) Nasopharyngeal airway.
b) Endotracheal tube.
c) Combi tube.
d) Laryngeal mask airway.

40. During BLS, if the patient is not breathing:

a) Turn him into recovery position.
b) Start chest compression.
c) Give him two effective breathes.
d) DC shock is given.

41. The first sign of the blood transfusion is

a) Anaphylactic shock
b) Dyspnea
c) Edema of cannula
d) Itching

42. Is endotracheal intubation is superior on oral airways?

a) TRUE
b) FALSE

43. Obtaining informed consent is considered part of:

a) Intraoperative Monitoring
b) Pre-operative Assessment
c) Postoperative Assessment
d) All of the above

44. ECG is part of intraoperative Monitoring

a) YES
b) NO
45. Heart rhythms associated with shockable cardiac arrest includes all Except
a) Asystole.
b) Ventricular fibrillation.
c) Pulseless ventricular tachycardia.
d) All of the above.

46. What percentage of body weight of adult male is made of water?

a) 20%.
b) 40%.
c) 60%.
d) 80%.

47. When you give crystalloid to replace volume loss it is given in ratio of :
a) 1:1
b) 6:1
c) 4:1
d) 3:1

48. Which of the following is lost first in local anesthesia:

a) Autonomic - Sensory - Motor
b) Sensory -Motor-Autonomic
c) Motor -Sensory -Autonomic
d) All of the above

49. Malignant Hyperthermia is allergy to :

a) Ephedrine
b) Novocain
c) Succinylcholine
d) Histamine

50. Which of the following is gold standard for assessment of cardiac function
a) Peripheral pulse
b) Invasive blood pressure
c) Capnography
d) Capillary reperfusion

51. The major intracellular cation is:

a) Sodium.
b) Chloride.
c) Potassium.
d) Calcium

52. All the following can cause respiratory depression EXCEPT:

a) Morphine.
b) Atropine.
c) Midazolam.
d) Fentanyl.

53. All of the following are crystalloid except:

a) Ringer Lactate
b) Saline
c) Water
d) Albumin
54. Airway obstruction is more likely to present upper than lower:
a) TRUE
b) FALSE

55. 15 years old female presented to ER with acute appendicitis & should perform operation, thus
she signed the consent without waiting to her guardians this consent is medico-legal:
a) YES
b) NO

56. All the followings are criteria to discharge the patient safely EXCEPT:
a. Oral feeding.
b. Orientation.
c. Good muscle strength.
d. Urine output more than 30ml/h.

57. Postdural puncture headache may be due to:

a) Decrease blood pressure.
b) Increase blood pressure.
c) Decrease CSF pressure.
d) Increase CSF pressure.

58. Which of the following is the most common cause of air way obstruction
a) Laryngeal edema
b) Laryngeal spasm
c) Fall of tongue
d) Foreign bodies

59. Heparin is contraindicated in DVT treatment Protocol:

a) YES
b) NO

60. The following type of shock is associated with Bradycardia:

a) Septic shock.
b) Hypovolemic shock.
c) Neurogenic shock.
d) Anaphylactic shock.

61. Nasopharyngeal airway is avoided in:

a) Trismus
b) Clenched airway
c) Suspected fracture base of the skull

62. Intra operative fluid replacement should include :

a) Operative fluid replacement
b) Preoperative fluid defect
c) Basal hourly requirement
d) All of the above

63. To secure airway in patient with laryngeal oedema:

a) Surgical cricothyroidotomy is indicated
b) Endotracheal intubation can be used
c) Combi tube is indicated
64. During epidural block, the epidural space can be identified by:
a) Loss of resistant technique.
b) Free flow of cerebrospinal fluid.
c) hanging drop technique.
d) Both(a)and (c).

65. Extra cellular component consists of :

a) Intravascular
b) Intravascular plus intra cellular
c) Interstitial tissue
d) A&C

66. 6 kgs 4-month infants is going to perform congenital diaphragmatic hernia repair should get
fasting for
a) 8 hours
b) 6 hours
c) 12 hours
d) 4 hours

67. The preexisting fluid deficit for 60 kg patient fasting for 7hours is:
a) 900ml
b) 700ml
c) 800ml
d) 600ml

68. What is the most significant disadvantage of the laryngeal mask airway (LMA) over an
endotracheal tube?
a) Failure to provide a competent airway
b) Risk of pulmonary aspiration
c) Unreliable placement
d) Enhanced risk of tube obstruction
e) Failure to allow tracheal suction.

69. Intravascular component represent of total body water :

a) 1/4
b) 1/8
c) 1/12
d) 2/3

70. Epidural anesthesia is given in:

a) Level of L3
b) Level of L2
c) Level of T10
d) All vertebral level

71. Total body water is :

a) 90 %
b) 30 %
c) 60%
d) 10%
72. What is level of sedation from least to Maximum?
a) General anesthesia - Deep sedation - conscious sedation
b) Deep sedation- General anesthesia - conscious sedation
c) Conscious sedation- General anesthesia - Deep sedation
d) Conscious sedation - Deep sedation - General anesthesia

73. What is the most reliable way to ascertain correct placement of an endotracheal tube?
a) Detection of a pressure waveform on inflation
b) Direct visualization
c) Detection of breath sounds on auscultation
d) Measurement of end-tidal carbon dioxide concentration
e) Movement of the chest wall on manual inflation.

74. Local anesthetics exert their effect on:

a) Potassium channel.
b) Sodium channel.
c) Calcium channel.
d) Magnesium channel.

75. Non-invasive monitoring of blood pressure is superior on invasive

a) YES
b) NO

76. Which of the following types of anesthesia is more prone to systemic side effects
a) Epidural
b) Spinal
c) Local Nerve
d) Local skin anesthesia

77. Which of the following considered anesthetic agent

a) IV drugs
b) Inhalation
c) Muscle relaxants
d) All of the above

78. Thiopental is considered as:

a) Barbiturates
b) Benzodiazepines
c) Opioids
d) Dantrolene

79. Adults are more prone to dehydration than infants since they lose more fluid
a) YES
b) NO

80. GABA receptor stimulation gives :

a) CNS stimulation
b) CNS depressant
c) CVS stimulation
d) Respiratory center over activation
81. Sudden loss of the end tidal CO2 is due to
a) PE
b) Cardiac Arrest
c) Esophageal intubation
d) All of the above

82. Thiopental could get used for induction in children

a) TRUE
b) FALSE

83. Normal PaCO2 ranges from

a) 75-85 mmHg
b) 100 mmHg
c) 35-45 mmHg
d) 10-20 mmHg

84. General anesthesia consists of :

a) 5 phases
b) 3 phases
c) 7 phases
d) 2 phases

85. Spinal anesthesia should be injected below the level of :

a) L1
b) T12
c) S5
d) L2

86. Which of the following is antidote to benzodiazepines?

a) Naloxone
b) Protamine
c) Flumazenil
d) Salbutamol

87. A line joining the iliac crest can get marked through which plane
a) T7
b) T10
c) T4
d) L4-L5

88. IV drugs can be used as:

a) Induction in Children
b) Induction in Adult with normal airways
c) Maintenance during operation
d) All of the above
89. Arrange the following structure penetrated from outside in during spinal anesthesia:
a) Dura matter 6
b) Skin 1
c) SC fat 2
d) Ligamentum flavum 5
e) Supraspinous ligament 3
f) Interspinous ligament 4
g) Arachnoid matter 8
h) Subdural space 7

1. Skin
2. Subcutaneous (SC) fat
3. Supraspinous ligament
4. Interspinous ligament
5. Ligamentum flavum
6. Dura mater
7. Subdural space
8. Arachnoid mater

90. Opioid can get used :

a) Preoperative
b) Intraoperative
c) Postoperative
d) All of the above

91. All of the following nerves are blocked by epidural anesthesia except:
a) Parasympathetic.
b) Motor.
c) Sensory.
d) Sympathetic.

92. All of the following cause pinpoint pupil except :

a) Morphine
b) Pilocarpine
c) Organophosphorus
d) Pethidine

93. Regional anesthesia includes

a) Nerve block
b) Sensory block
c) Central block
d) All of the above

94. Post spinal anesthetic headache is usually due to:

a) Using large bore needle.
b) Slow injection.
c) Increase narcotics.
d) All of the above.
 Final
95. A patient with a no obstructing carcinoma of the sigmoid colon is being prepared for elective
resection. Which of the following reduces the risk of postoperative infectious complications?
a) A single preoperative parenteral dose of antibiotic effective against aerobes and anaerobes
b) Avoidance of oral antibiotics to prevent emergence of Clostridium difficile
c) Postoperative administration for 48 hours of parenteral antibiotics effective against aerobes and
anaerobes
d) Postoperative administration of parenteral antibiotics effective against aerobes and anaerobes until
the patient's intravenous lines and all other drains are removed
e) Redosing of antibiotics in the operating room if the case lasts for more than 2 hours

96. A 75-year-old man with a history of myocardial infarction 2 years ago, peripheral vascular
disease with symptoms of claudication after walking half a block, hypertension, and diabetes
presents with a large ventral hernia. He wishes to have the hernia repaired. Which of the
following is the most appropriate next step in his preoperative workup?
a) He should undergo an electrocardiogram (ECG).
b) He should undergo an exercise stress test.
c) He should undergo coronary artery bypass prior to operative repair of his ventral hernia.
d) He should undergo a persantine thallium stress test and echocardiography.
e) His history of a myocardial infarction within 3 years is prohibitive for elective surgery. No further
testing is necessary.

97. A 53-year-old woman has been intubated for several days after sustaining a right pulmonary
contusion after a motor vehicle collision as well as multiple rib fractures. Which of the
following is a reasonable indication to attempt extubating?
a) Negative inspiratory force (NIF) of -15 cm H,O
b) PO of 60 mm Hg while breathing 30% inspired FiO2 with a positive end-expiratory pressure
(PEEP) of 10 cm H,O
c) Spontaneous respiratory rate of 35 breaths per minute
d) A rapid shallow breathing index of 80
e) Minute ventilation of 18 L/min

98. A 74-year-old woman with a history of a previous total abdominal hysterectomy presents with
abdominal pain and distention for 3 days. She is noted on plain films to have dilated small-
bowel and air-fluid levels. She is taken to the operating room for a small-bowel obstruction.
Which of the following inhalational anesthetics should be avoided because of accumulation in
air-filled cavities during general anesthesia?
a) Diethyl ether
b) Nitrous oxide
c) Halothane
d) Methoxyflurane
e) Trichloroethylene

99. The most frequent complication of general anesthesia in obese patient is:
a) Cardiac arrest.
b) Hypercapnia.
c) Hypotension.
d) Atelectasis.
e) Fat embolism.
100. The most common complication of spinal anesthesia is:
a) Hypotension.
b) Headache.
c) Urinary retention.
d) Meningitis
e) Injury to the inter vertebral disc.

101. The most reliable method for diagnosing hypoventilation is by determination of:
a) The tidal volume and respiratory rate.
b) Arterial PO2.
c) Arterial PCO2
d) Minute volume.
e) Cardiac output.

102. The method of pulmonary ventilation most likely to result in tension pneumothorax is:
a) Pressure control.
b) Volume control.
c) Intermittent positive pressure (IPP)
d) Positive end expiratory pressure (PEEP)
e) Intermittent mandatory ventilation (IMV).

103. The most frequent cause of cardiac arrest under general anesthesia is:
a) Inadequate ventilation.
b) Vascular collapse.
c) CNS depression.
d) Direct myocardial irritability.
e) Renal insufficiency.

104. The arterial blood gases in a distressed post operative patient breathing room air were: PO2 =
60mmHg, PCO2= 60mmHg, and pH =7.25. The proper management should be:
a) Administration of bronchodilators.
b) Oxygen inhalation.
c) Infusion of sodium bicarbonate.
d) Mechanical ventilation.
e) Sedation.

105. The maximum volume of air that can be expelled after a maximum inspiration is called:
a) Vital capacity.
b) Total lung volume.
c) Inspiratory capacity.
d) Tidal volume.
e) Functional residual capacity.

106. The commonest early post operative complication in a patient undergoing general anesthesia
is:
a) Atelectasis.
b) Deep vein thrombosis.
c) Myocardial infarction.
d) Chest infections.
e) Thrombophlebitis.

107. Local anesthetics exert their effect on:

a) Potassium channel.
b) Sodium channel.
c) Calcium channel.
d) Magnesium channel.

108. Which of the following drugs produces amnesia and analgesia?

a) Propofol.
b) Ketamine.
c) Thiopental.
d) All of the above.

109. Neuromuscular blockade is reversed by:

a) Acetylcholine increase.
b) Breakdown of the neuromuscular agent.
c) Drug antagonist.
d) All of the above.

110. As a local anesthetic, the maximum safe dose of lidocaine is:

a) 5 mg/kg.
b) 10mg/kg.
c) 15mg/kg.
d) 20mg/kg.
e) 25mg/kg

111. All of the following nerves are blocked by epidural anesthesia except:
a) Parasympathetic.
b) Motor.
c) Sensory.
d) Sympathetic.

112. Which of the following opioid analgesic has respiratory depression effect?
a) Sufentanil.
b) Remifentanil.
c) Fentanyl.
d) All of the above.

113. Malignant hyperthermia can be triggered by:

a) Sevoflurane.
b) Ketamine.
c) Propofol.
d) None of the above.

114. Inhalation anesthesia induces:

a) Airway dilatation.
b) Airway constriction.
c) Decrease sputum production.
d) None of the above.

115. Which of the following is the preferred technique for general anesthesia induction that is most
commonly used in adults?
a) Intravenous induction.
b) Inhalation induction.
c) Rapid sequence induction.
d) All of the above.
116. For intubated patients in the ICU, which of the following is an indication for extubating?
a) Good muscle power.
b) Obey command.
c) Satisfactory blood gas analysis data.
d) All of the above

117. Which of the following are true of preoperative patient preparation?

a) It includes a thorough history-taking and medical examination.
b) The patient's medical state is optimized
c) It is to anticipate and plan for management of perioperative problems
d) Good communication is required.
e) It involves taking informed consent.
f) All of the above

118. Which of the following statements regarding preoperative investigations are true?
a) Chest X-ray is routinely requested in all patients over 60 years old.
b) A ventricular ejection fraction of less than 35 per cent indicates high risk of cardiac
complications.
c) A body mass index (BMI) <15 is associated with significant hospital mortality.
d) ECG is usually required in patients above 65 years.
e) HIV testing requires patient consent.

119. Which of the following statements regarding preoperative management of specific medical
problems are true?
a) Patients with a diastolic pressure above 95 mmHg should have their elective operations
postponed.
b) Elective surgery should be delayed until at least 1 year after a myocardial infarction (MI).
c) There is no need to control tachyarrhythmias preoperatively.
d) Preoperative transfusion should be considered if the Hb level <10 g/dL.
e) In patients with malnutrition, preoperative nutrition therapy should be started 2 weeks prior to
surgery.
f) A&E

120. Which of the following is not part of the anesthetic triad used during surgery?
a) Unconsciousness
b) Pain relief
c) Amnesia
d) Muscle relaxation.

121. What is the most significant disadvantage of the laryngeal mask airway (LMA) over an
endotracheal tube?
a) Failure to provide a competent airway
b) Risk of pulmonary aspiration
c) Unreliable placement
d) Enhanced risk of tube obstruction
e) Failure to allow tracheal suction.

122. What is the most frequent complaint made by patients in whom suxamethonium
(succinylcholine) has been used?
a) Pain at the site of injection
b) Prolonged action in those with pseudocholinesterase deficiency
c) Diplopia
d) An increase in body temperature
e) Diffuse muscle pains.
123. Lidocaine can be injected intravenously, but what is the main reason why bupivacaine should
not be injected into a vein during local anesthesia?
a) It lasts longer.
b) It is often used with adrenaline.
c) t can cause methemoglobinemia.
d) lt may cause convulsions.
e) It is cardiotoxic.

124. Patients vary greatly in their requirement for postoperative analgesia. What is the best way to
assess adequacy of pain relief?
a) Measure the degree of tachycardia.
b) Ask the patient to measure the pain.
c) Assess the level of hypertension.
d) Look for tachypnoea.
e) Examine for wound splinting.

125. Which of the following statements regarding use of a tourniquet are true?
a) The theatre charge nurse has overall responsibility in its use.
b) Distal neurovascular status must be checked before and after its use.
c) The tourniquet must be placed as proximally as possible.
d) The tourniquet must be placed snugly enough so as not to slide during the operation.
e) Always note the time of inflation and deflation.

126. Normal lactate level:

a) 5 mmol/L
b) 7 mmol/L
c) Less than 2 mmol/l
d) 10 mmol/L

127. FIO2 in ventilator setting represent :

a) Amount of air inhaled with every effortless breath
b) The residual of air in alveoli after expiration
c) % of oxygen in inhaled air
d) Rate of respiration

128. As PEEP increases as the lung compliance get worse :

a) TRUE
b) FALSE

129. Sudden loss of the end tidal CO2 is due to :

a) PE
b) Cardiac Arrest
c) Esophageal intubation
d) All of the above

130. The first sign of the blood transfusion is :

a) Anaphylactic shock
b) Dyspnea
c) Edema of cannula
d) Itching

131. Which of the following agent is used in cirrhotic patient :

a) Etomidate
b) Midazolam
c) Ketamine
d) Thiopental

132. Ketamine is neuro- protective in children :

a) YES
b) NO

133. Which of the following drugs could result in hallucination :

a) Fentanyl
b) Propofol
c) Ketamine
d) Haloperidol

134. How does propofol acts as anesthetic agent ?

a) Increase the duration of opening of chloride channels
b) Increase the frequency of opening chloride channels
c) Stimulate Glutamate receptors
d) None of the above

135. Which of the following does not causes red man syndrome ?
a) Atracuriam
b) Morphine
c) Niacin
d) Vancomycin
e) Pancuronium

136. An agents is used for spinal anesthesia with density higher than the CSF :
a) Hyper baric
b) Isobaric
c) Hypo baric
d) All of the above

137. All of the following are true regarding spinal cord except :
a) Starts at medulla and ends at conus medullaris
b) Ends at L1 in adults
c) Ends at L3 in children
d) Spinal nerves are 29 pairs

138. The doctor gave the patient post-operative anesthetic agent using epidural technique through
Tuohy needle , is this decision :
a) TRUE
b) FALSE

139. Which of the following local aesthetic agents could cause hypertension as side effect ?
a) Tetracaine
b) Proparacaine
c) Procaine
d) Cocaine

140. Which of the following inhalational agents is the least effective on blood pressure ?
a) Desflurane
b) Isoflurane
c) NO
d) Sevoflurane
141. Complications of general anesthesia differs according to
a) Pt. Medical conditions
b) Surgical procedure
c) Available facilities
d) Surgeon skill
e) All of the above

142. How many phases of anesthesia complications?

A) 3
B) 5
C) 4
D) 6

143. Complications during induction involves all except:

A) Hypoxia
B) Hypoxemia
C) Secondary hemorrhage
D) Cyanosis
E) Drug overdose

144. Causes of hypoxia involve all except :

a) Failure of endotracheal tube
b) Aspiration
c) Drug overdose
d) Reflex laryngospasm
e) All of the above
F) None of the above

145. Which electrolyte disturbance could cause cardiac arrest ?

a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypernatremia
e) Hypercalcemia

146. Prolonged apnea during recovery could occurs as a result of :

a) Opioid overdose
b) Thiopental overdose
c) Acidosis
d) Inadequate reversal of muscle relaxant
e) All
f) None

147. Anesthesia record chart should include all of the following except:
a) Patients’ personal information
b) Site of procedure
c) Fluid balance
d) Consent
e) Vital signs
148. In pain management you have to determine the:
a) Onset
b) Course
c) Duration
d) Character
e) All of the above

149. Methods of pain assessment includes:

a) Body weight
b) Special habits of medical importance
c) Parkland formula
d) Face scale

150. Which of the following is best for children assessment in pain ?

a) Face scale
b) Numerical scaling
c) Visual scaling
d) All of the above

151. Cupping is considered as a method of :

a) Drug administration
b) Electrolytes balance
c) Pain control
d) Arterial blood gas sampling

152. Pain managements involve inhibition of :

a) Na channels
b) K channels
c) Norephinerine
d) NNDA
e) All of the above

153. All of the followings in step ladder management is not true except :
a) Step 1-weak opioids
b) Step 3-nonsteriodal
c) Step 2- weak opioids + - non steroidal + - adjuvant
d) Step 4 - impaired conscious level

154. An addict man visit the doctor after got convinced with his wife to search for a way to help
him to get out this stage in addiction is
a) Preparation
b) Contemplation
c) Taking action
d) Pre-contemplation

155. Which of the following occurs after 72 hours from stoppage of alcohol :
a) Mood swings
b) Insomnia
c) Fever
d) Delirium tremens

156. Hypoxia occurs when Pa02 gets less than

a) 40 mmHg
b) 45mmHg
c) 60 mmHg
d) 70 mmHg

157. ……… % of 02 in inhaled air is :

A) 0.30
B) 0.21
C) 0.40
D) 0.60

158. Indications of oxygen therapy occurs in all except:

a) Hypoxemia
b) LTOT
c) Pulmonary hypertension
d) Met-hemoglobinemia
e) Acute MI

159. 02 premature retinopathy occurs due to

a) Premature infants
b) Weak retina
c) High 02 tension
d) All of the above

160. All of the following are low flow systems of O2 therapy except:
a) Nasal cannula
b) Simple mask
c) T-piece
d) Non - rebreather mask

161. Tracheostomy should be done:

a) > 4 weeks
b) 2 weeks
c) 1 week
d) 6 weeks

162. All of the following are indications of ventilation except

a) Flail chest
b) Hypoxia
c) Hypoventilation
d) Raised ICT
e) None of the above

163. Increase in PEEP indicates:

a) COPD
b) Pulmonary fibrosis
c) Aspiration
d) Increase in chest wall compliance

164. All of the following are advantages of SIMV except :

a) Allow the patient to assume portion of their spontaneous breathing
b) Can deliver volume control
c) Can deliver pressure control
d) Preparation to weaning of ventilator
e) None of the above
165. Triage for ICU includes which of the following :
a) Identifications of the patient according to diagnosis
b) Assessment of severity
c) Prioritization
d) All of the above

166. Discharge criteria includes all except :

a) Physiological status has stabilized
b) Hope less case with no longer benefits in ICU with necessary requirement for the bed
c) The patient’s family will delay the deposit of ICU for hours
d) Dead patient

Sigma
1) The Routine intraoperative monitoring include:
1.Temperature 2. RR 3. BP 4. Pulse 5. ECG 6. O2 Saturation 7. End Tidal Co2 8. Urine output
2) Most common fluid used in replacement in cases of shock: Ringer lactate.
3) Our Most commonly used isotonic crystalloid: Ringer lactate.
4) limitation of the use laryngeal mask: COPD
5) The method that may cause rupture esophagus severe Sc emphysema: Combitube
6) ASA expect: Class 3 brain death
7) ASA: Class III : brain death
8) Patient in which ASA: CLASS I
9) Should stop of smoking before surgery by ......to decrease of Carboxyl hemoglobin & decrease
coronary artery resistance: 12 hours
10) Airway assessment except: None of above
11) Spinal anesthesi: below L1 L1-2
12) Maintain airway: Head tilt, chin lift
13) False: minor surgery and hydration
14) Hyperbaric: below
15) Local anesthesia: all
16) Severity of pain except: GCS
17) Complication of general anesthesia maintenance except: Hypoxia due to ADEQUATE
VENTILATION
18) Cardiac arrest: all of the above
19) CPR except: one hand in adult and two hands in infant
20) Epidural anesthesia: all of the above
21) Check breathing and pulse: all of the above
22) Asking about menstrual cycle: all of the above
23) Regional anesthesia: Give anticoagulant and make sure no infection
24) Chest compressions: all of the above
25) Factors encouraging aspiration: both A + B
26) DC shock: on pacemaker
27) Cardiac arrest: both a & b
28) Nasal cannula: Low flow mask
29) Venturi mask: High flow mask
30) Tidal volume: 8-10
31) All are regular monitoring indices: pulmonary catheterization
32) Most common preoperative: CBC
33) Preoperative assessment: memorizing the topic – All of the above
34) Goals for mechanical ventilation: memorizing the topic – All of the above
35) Indication for postponing: memorizing the topic – All of the above
36) Pulse oximetry: oxygen saturation
37) If failed manual: oropharyngeal or nasopharyngeal intubation
38) Case: wake up the patient
39) Difficulty in air management: a & b
40) CPR: 5-10 sec
41) ECG of v tach (picture) and pulse 210: Ventricular tachycardia with pulse
42) Peripheral pulse ttt: CABD
43) If the case becomes unstable and BP 70/20 and carotid pulse ttt: cardioversion 100J
44) ECG of the case changed to (picture): VF
45) Ttt of VF without pulse: Defib 200
46) Cardioversion for: Unstable tachy with pulse
47) Advanced airway: Any of above
48) Aims of assessment: all of the above
49) Complications of anesthesia: all of the above
50) Tracheal drug except: atracurium
51) Terminate operation if patient: all of the above
52) Complications of maintaining anaesthesia except: loss of consciousness
53) ain scale except: glasgow
54) Mild pain: NSAIDS
55) muscle relaxant has the fastest onset of action: Succinylcholine
56) Upper limb tourniquets pressure: systolic P +100
57) Systemic life threatening: Class 4
58) Relative surgery postponed indication except: consent
59) Early manifestation of local anthesia toxicity: numbness
If except choose coma
60) Impaired cardiovascular: General anesthesia
61) Opioid not used as: muscle relaxant
62) CPR except one hand in adults

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