Anesthesiology & Reanimatology - CM

Bessisy Tamir 1248

1. Monitoring during anesthesia includes
a. [X] Puls oxymetry
b. [ ] Nuclear Magnetic Resonance
c. [ ] Capnometry
d. [X] Cardiac output mesurement
e. [ ] Electroencephalography
2. The common hemodynamic responce to a nociceptive stimulus include:
a. [ ] Hypothermia
b. [X] Tachycardia
c. [ ] Tahyphylaxis
d. [X] Arterial hypertension
e. [ ] Cardiac arrest
3. Ketamine is resposible for:
a. [ ] Minimal depression of the rticular formation
b. [ ] Muscle relaxation
c. [X] Hallucinations
d. [ ] Cardio-vascular depression
e. [X] Increase in blood pressure
4. Fentanyl (F) differs from Morphine(M) by:
a. [X] In equianalgesic dooses F. causes less respiratory depression
b. [ ] F doese not cause Rigid_Chest Syndrome
c. [ ] F. causes less histamine release
d. [ ] In equianalgesic dooses F. causes more severe cardio-vascular depression
e. [X] F is a more potent analgetic
5. Ataractics are used for:
a. [ ] Reducing the effect of opioids and hypnotic drugs
b. [ ] Preventing of postural hypotension
c. [X] Preventing anxiety
d. [X] Inducing calmness/ataraxia
e. [X] Sedation
6. Barbiturates depress:
a. [ ] Baroreceptor reflex
b. [ ] Hypothalamus
c. [ ] Conduction trough autonomic nerves
d. [X] Myocardial contactility
e. [X] Respiratory center
7. Skeletal muscle cell depolarisation is due to:
a. [X] Increase in intracellular sodium concentration
b. [ ] Decrease in intracellular sodium concentration
c. [X] Decrease in intracellular potasium concentration
d. [ ] Increase in intracellular potasium concentration
e. [ ] Decrease in intracellular clorine ion concentration
8. Intravenous Ketamine produces:
a. [X] General anesthesia
b. [ ] Analgesia
c. [X] Moderate increase in blood pressure
d. [ ] Dicrease in cardiac output
e. [ ] Hypotension
9. Tissue uptake (absorbtion) of a local anesthetic depends on:
a. [X] Tissue solubility
b. [X] Tissue blood flow (vascularisation)
c. [X] Anesthetic concentration
d. [ ] Heart rate
e. [ ] Respiratory rate

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10. Findings in local anesthetic Lidocaine overdosage include:
a. [ ] Cough
b. [X] Sentral nervous system excitation (activation)
c. [X] Loss of counsciousness
d. [X] Convulsion
e. [ ] Sharp abdomenal pain
11. High doses of Diazepamum will cause:
a. [X] Respiratory depression
b. [X] Muscle relaxation
c. [X] Anxiolysis
d. [ ] Decreased blood pressure
e. [ ] Increase in respiratory minute volume
12. Midazolamum causes:
a. [X] Amnesia
b. [X] Hypnosys
c. [X] Anticonvulsant effect
d. [ ] Anticoagulation effect
e. [ ] Hypercoagulation
13. Elderly patent shows:
a. [X] Dcreased cardiac output
b. [ ] Increase in total lung capacity
c. [X] Lower tolerance to anesthetic drugs
d. [ ] Increased glomerular filtration rate
e. [ ] Increased cardiac output
14. The following statements concerning the intervertebral disk(s) are correct:
a. [X] Can be damaged by the needle for spinal anesthesia
b. [X] Represents about 25% of the vertebral column lengtht
c. [X] Annulus fibrosus is thicker anteriorly
d. [ ] Can be removed not influencing intervertebral space
e. [ ] Ensure a constant intracranial pressure
15. Ligamentum flavum (LF) at L-2, 3 level:
a. [X] Consists of two converging parts
b. [ ] Its thickness is 9 mm
c. [X] Between LF and dura mater there is a space of 4 to 8 mm wide
d. [ ] It is 38 mm wide
e. [ ] It is binded to dura mater
16. The advantages of a closed anesthesia breathing circuit are:
a. [X] The required volum of anesthetic gases is low
b. [X] Conserve heat
c. [X] Conserve humidity of the inhaled gases
d. [X] Minimal environment pollution
e. [ ] No need for unidirectional valves
17. Epinefrine (adrenaline) is added the local anesthesic solution because provide the following advantages:
a. [X] Increase in the anesthesia block length
b. [X] Decrease the systemic absorbtion of the anesthetic
c. [X] Decrease the hemorhage during the operation
d. [ ] Increase anesthesia risk
e. [X] Facilitate the detection of intravascular injection of the anesthetic
18. The gas blend exhaled by the anesthetised patient is partially or totally re-inhaled in:
a. [ ] Open anesthesia circuit
b. [ ] Semi-open anesthesia circuit
c. [X] Semi-closed anesthesia circuit
d. [X] Closed anesthesia circuit
e. [ ] All listed above

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19. Local anesthesia can be provided by:
a. [X] Local/topic application of the anesthetic
b. [ ] Inhalation of halotane
c. [ ] I/V morphine
d. [X] Tissue infiltration with lidocaine
e. [X] Local application of cold
20. The most common complications of epidural anesthesia are:
a. [X] Arterial hypotension
b. [ ] Arterial hypertension
c. [X] Bradicardia
d. [ ] Tachycardia
e. [X] Allergic reactions
21. Sodium thiopental can produse:
a. [X] Respiratory center depression
b. [ ] Arterial hypertension
c. [X] Arterial hypotension
d. [ ] Activate parasympathetic nervous system
e. [X] Activate sympathetic nervous system
22. Succinylcholine:
a. [X] Produce postsinaptic membrane depolarization
b. [ ] Produce postsinaptic membrane hyperpolarization
c. [X] Acts for approximately 5 min
d. [ ] Acts for approximately 30 min
e. [X] Causes hyperpotassemia
23. The following statements concerning Fentanyl are correct:
a. [X] Is more potent than Morphine
b. [ ] Is less potent than Morphine
c. [ ] Duration of analgesia is 60 minutes
d. [X] Duration of analgesia is from 20 to 30 minutes
e. [ ] Is used for weaning patient from anesthesia
24. The following statements concerning Droperidolum are correct:
a. [ ] Is an anxiolytic
b. [X] Is a neuroleptic (antipsychotic)
c. [X] Produce antiemetic effect
d. [ ] Shows analgesic effect
e. [X] Has extrapyramidal side-effects
25. Sodium Thiopental cause:
a. [X] Hypnosis
b. [X] Respiratory center depression
c. [ ] Arterial hypertencion
d. [X] Arterial hypotencion
e. [X] Can produce bronchospasm
26. Ketamine produces:
a. [X] Dissociative anesthesia
b. [X] Hallucinations during the weaning from anesthesia
c. [X] Moderate incerease in blood pressure
d. [ ] Decrease in cardiac output
e. [ ] Arterial hypotencion
27. The following statements concerning Nitrous oxide are correct:
a. [ ] Can be used as sole anesthetic (monoanesthesia)
b. [ ] The effect develops slowly
c. [ ] Cause airways irritation
d. [X] Provide analgesia
e. [X] Provide hypnosys

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28. The following anesthetics can be used for anesthesia induction:
a. [X] Halotane
b. [ ] Isoflurane
c. [X] Sevoflurane
d. [ ] Nitrous oxide
e. [X] Propofol

Acute cardiac failure

29. High systemic vascular resistance can be seen in:

a. [X] Cardiogenic shock
b. [X] Hypovolemic shock
c. [ ] Septic shock
d. [ ] Neurogenic shock
e. [ ] Anaphylactic shock
30. High systemic vascular resistance can be seen in:
a. [X] Hypovolemic shock
b. [ ] Adrenal insufficiency
c. [X] Acidosis
d. [ ] Anaphylactic shock
e. [X] Pain, anxiety
31. Systemic Vascular Resistance is decreased in:
a. [X] Septic shock
b. [X] Acute pancreatitis
c. [X] Cirrhirosis of the liver
d. [X] High spinal trauma
e. [ ] Hypovolemic shock
32. Cardiac failure with an elevated cardiac output can be present in:
a. [X] Chronic anemia
b. [X] Arteriovenous fistula
c. [ ] Acute myocardial infarction
d. [X] Hypercapnia
e. [X] Hyperthyroidism
33. The most coomon causes of left ventricle failure include:
a. [X] Acute myocardial infarction
b. [X] Aortic dissection
c. [ ] Air embolisation
d. [X] Mitral valve insufficiency
e. [X] Aortic valve stenosis
34. The most coomon causes of right ventricle failure include:
a. [X] Aortic valve stenosis
b. [X] Thrombus pulmonary embolism
c. [ ] Air embolization
d. [X] Amniotic fluid embolization
e. [X] Mechanical ventilation with excessive positive pressure
35. The most common causes of global cardiac failure are:
a. [ ] Hypervolemia
b. [X] Arrhythmia (Ventricular tachycardia , 3rd degree AV block)
c. [X] Myocarditis
d. [X] Hypertrophic and dilated cardiomyopathy
e. [X] Cardiac tamponade
36. Dyastolic acute cardiac failure can develop through following mechanisms:
a. [X] External compression
b. [X] Increased myocardium stiffness
c. [X] Interventricular interference

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d. [ ] Hypertrophic and dilated cardiomyopathy
e. [ ] Compromised pump function of the heart
37. Dyastolic cardiac failure by external compression mechanism can be produced by:
a. [X] Pricardial calcification or effusion
b. [X] Tension pneumothorax
c. [X] Massive pleurisy
d. [ ] Massive acute myocardial infarction
e. [ ] Controlled (artificial) lung ventilation
38. Dyastolic cardiac failure by ventricular interference can be produced by:
a. [ ] Massive myocardial infarction with involvement of interventricular septum
b. [X] Pulmonary hypertension
c. [ ] Mitral valve insufficiency
d. [X] Artificial lung ventilation with excessive PEEP
e. [ ] Tricuspidal valve insufficiency
39. Oxygen transport is dependent on:
a. [X] Hemoglobine level
b. [ ] Carbon dioxyde partial pressure in arterial blood (PaCO2)
c. [X] Hemoglobine saturation with O2 of the arterial blood (SaO2)
d. [X] Oxygen partial pressure in arterial blood (PaO2)
e. [X] Cardiac output
40. Cardiac output is dependent on:
a. [X] Preload
b. [X] Afterload
c. [X] Heart rate and rithm
d. [X] Contractility
e. [ ] Tidal volume
41. Preload is:
a. [X] The myocardium sarcomere length at the end of diastole
b. [X] End- diastolic ventricular volume
c. [ ] End -diastolic myocardium wall stress
d. [X] Is influenced by venous return, dependent on volemic status and venous capacity
e. [ ] Myocardium wall stress during systole
42. Afterload is:
a. [X] Myocardium wall tension during systole
b. [ ] End-diastolic myocardium sarcomere length
c. [ ] End-diastolic ventricular volume
d. [X] The pressure the ventricle must overcome to eject blood
e. [ ] Resistance to the blood flow in the major vessels
43. The final value of afterload is influenced by:
a. [X] Pleural pressure
b. [X] Impedance and resistance
c. [X] Preload with it components
d. [ ] Partial pressure of CO2 in arterial blood
e. [X] In clinical conditions the only component which is measured n order to monitor
afterload is vascular resistance (systemic or pulmonary)
44. Concerning the relation between Heart Rate (HR) and Cardiac Output (CO):
a. [X] In a healthy heart the maximal CO is acheived at a HR of 140 bpm
b. [X] CO gradually decrease by a HR of 180 bpm (short ventricular diastole do not let it to fill)
c. [X] HR over 180 bpm can lead to ventricular fibillation
d. [X] In cardiac failure CO begin to diminish at a HR over 120 bpm
e. [ ] In a healthy heart the maximal CO is acheived at a HR lower than 45 bpm
45. In a hypotensive patient (BP=100/40 mmHg, BPmed= 80 mmHg), with a heart rate of 110
bpm, warm skin and a short capillary refill there is:
a. [X] Increased cardiac output
b. [ ] Low cardiac output
c. [X] Decreased systemic vascular resistance

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d. [ ] Increased systemic vascular resistance
e. [X] High pulse pressure (i.e. 60 mmHg) points on increased stroke volume
46. In a hypotensive patient (BP= 80/65 mmHg, BPmed= 75 mmHg), with a heart rate of 110
bpm, warm skin and delyed capillary refill there is:
a. [ ] Increased cardiac output
b. [X] Low cardiac output
c. [ ] Decreased systemic vascular resistance
d. [X] Increased systemic vascular resistance
e. [ ] High stroke volume
47. The management of a patient undergoing cardiac surgery includes :
a. [ ] Hyperbaric oxygen treatment
b. [X] Respiratory support
c. [X] Nutritional support
d. [X] Analgesia and sedation
e. [X] Prophylactic medication (antibiotics, anticoagulants, antiagregants)
48. Bradycardia requires treatmen when:
a. [X] HR 35 bpm, irrespective to blood pressure (BP)
b. [ ] HR 60 bpm, irrespective to BP
c. [X] HR 50 bpm, and hypotension
d. [ ] HR 90 bpm, and hypotension
e. [ ] HR 65 bpm, irrespective to blood pressure
49. n case of bradicardia the patinet should be re-evalated for:
a. [X] Potasium blood level
b. [ ] Hyperthiroidism
c. [X] Hypothiroidism
d. [ ] Chronic beta-mimetic therapy
e. [X] Cronic beta blockers, cardiac glycosides, calcium channel blockers
50. In a patent with cardiac failure with arterial hypotension or low systemic vascular resistance
are to be administered vasopressors. The target values for Systolic Arterial Pressure (SAP)
and Systemic Vascular Resistance (SVR) will be:
a. [ ] SAP = 70 mmHg
b. [X] SAP = 100 mmHg
c. [ ] SVR >2400 dynescm-5/m2
d. [X] SVR >1600 dynescm-5/m2
e. [ ] SAP > 140 mmHg
51. Vasodilators are indicated in case of:
a. [X] High systemic vascular resistance (>2400 dynescm-5/m2)
b. [ ] Systemic vascular resistance of 1600 dynescm-5/m2
c. [X] Critically ill patent with arterial hypertension (Systolic BP>140 mmHg)
d. [ ] Systolic BP of 100 mmHg
e. [ ] Mean arterial pressure (MAP) of 55 mmHg
52. If high systemic vascular resistance (>2400 dynescm-5/m2) or arterial hypertension
(SAP>140 mmHg or BPmed >100 mmHg) are present, vasodilators are to be used:
a. [ ] Noradrenaline (Norepinephrine)
b. [X] Nicardipine
c. [ ] Adrenaline (Epinephrine)
d. [X] Sodium Nitroprusside
e. [ ] Efedrine

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Acute Respiratory Failure

53. Coditions that can lead to ARDS are:

a. [X] Pulmonar y contusi on
b. [X] Sepsis
c. [ ] Pleuritis
d. [X] Shock satates
e. [X] Pneumonia
54. In hyperventilation it can be found:
a. [ ] Hypercapnia
b. [X] Hypocapnia
c. [X] Respiratory alcalosis
d. [ ] Respiratory acidosis
e. [ ] Hypoxemia
55. Respiratory compensation mechanism in me tabolic acidosis can include:
a. [X] Decrease in PaCO2
b. [ ] Incerase in PaCO2
c. [X] Incerased respiratory rate
d. [ ] Decreased respiratory rate
e. [ ] All listed above
56. Hypercapnia is a consequence of :
a. [ ] Alveolar hyper vent ilation
b. [X] Alveolar hypoventilation
c. [ ] Increase in dead space
d. [ ] Increased O2 concentration in breating air
e. [X] Increased CO2 concentration in the inhal ed blend (reinhalation)
57. Advantages of mechanical ventilation are:
a. [X] Keeping O2 and CO2 values in arterial blood in the nor mall range
b. [X] Decrease wor k of breathing
c. [ ] Decrease venous return
d. [X] Decrease O2 consumption
e. [ ] Increase venous ret urn
58. Objectives f or tracheal intubation are:
a. [X] To performe mechanical ventilation
b. [ ] Securing airways
c. [ ] Performing extracorporeal oxygenation
d. [X] Deliver yng hi gh O2 concentration to the patient
e. [X] To prevent airway obstruction
59. Causes of hypoxemia are:
a. [X] Reduced O2 concentration in the inhaled air
b. [X] Ventilation-perfusi on mismatching
c. [X] Right to left blood shunting
d. [X] Impaired diffusion trouhg al veolar -capillary membrane
e. [ ] Decraesed O2 consumption at the tissue level
60. Tissue hypoxia can lead to:
a. [X] Inhibition of the aerobic metabolism
b. [X] Increased lactic acid production
c. [ ] Metabolic alcalosis
d. [X] Metabolic asidosis
e. [X] Convertion to anaerobic metabolism
61. Complications of the mechanical ventilation include:
a. [X] Barotrauma
b. [X] Ventilator-associated pneumonia
c. [ ] Polyuria
d. [X] Pulmonary volutrauma
e. [X] Ventilator- induced lung injury

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62. Criteria for weaning the patient from ventilator include:
a. [X] PaO2>70mmHg on FiO2<0,4
b. [ ] PaCO2 >60 mmHg
c. [X] SaO2>95% on Fi O2<0,4.
d. [X] PaO2/FiO2 >200.
e. [X] Improvemment on X - ray examination
63. The drugs used in airway obstruction are:
a. [X] Terbutaline
b. [X] Theophilline
c. [X] Salbutamol
d. [X] Dexamethasone
e. [ ] Dopmine
64. The consequences of hyperventilation are:
a. [X] Hypocapnia
b. [ ] Respiratory acidosis
c. [X] Respiratory alcalosis
d. [ ] Metabolic acidosis
e. [ ] Hypoxemia

Nutrition, Fluids and Electrolytes

65. The indications for washed red cell transfusion include:

a. [ ] History oh hemolytic transfusion reactions
b. [X] Congenital deffect of IgA
c. [X] History of sever transfusion reactions
d. [ ] IgM defficite
e. [ ] Hystroy of anaphylactic shock
66. Fresh frosen plasma is used for:
a. [X] Correction of microvascular hemorrhage if the Prothrombinic Time is 1,5 fold higher than normal
b. [X] Correction of microvascular hemorrhage if the Protrombinic Time is 2 fold higher than normal
c. [X] Emergency reversal of cumarinic anticoagulants (warfarin)
d. [ ] Volume replacement
e. [ ] Correction of hypoalbuminemia
67. The following statements concerning Dextranes are correct:
a. [X] Increase the circulating blood volume
b. [ ] Are appropriate for parenteral nutrition
c. [ ] Are usefull for correcting microvascular hemorrhage
d. [X] Can act as an antigen
e. [X] The dose limit is 1,5 g/kg body weight per day
68. The following are electrolyte solutions:
a. [X] Ringers solution
b. [X] Ringers lactate solution (Hartmanns)
c. [X] Normal Saline
d. [ ] Hydroxyethyl starch
e. [X] 10% Glucose solution
69. For nutritional therapy/parenteral nutrition are appropriate:
a. [X] Infesol
b. [ ] Fresh frosen plasma
c. [X] Aminosteril
d. [ ] 5% Glucose solution
e. [X] 10% Glucose solution
70. Fat emulsions used for parenteral nutrition include:
a. [ ] Aminosteril
b. [X] Infezol
c. [X] Intralipid

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d. [ ] Lipofundin
e. [ ] Aminoplasmal
71. Aminoacide solutions used for parenteral nutrition include:
a. [ ] Intralipid
b. [X] Aminosteril
c. [X] Aminoplasmal
d. [ ] Lipofundin
e. [X] Infezol

Shock states

72. Abnormalities indicating for Systemic Inflammatory Responce Syndrom (SIRS) include:
a. [X] Heart rate > 90bpm
b. [X] Respiratory rate > 20 breaths/min or PaCO2<32 mmHg
c. [ ] Arterial hypotension (systolic BP<90mmhg
d. [X] White blood cell count >12000 cells/mm3 or < 4000 cells/mm3
e. [X] Body temperature > 38 C or < 36 C
73. Drugs for Septic shock treatment include:
a. [X] Normal saline
b. [X] Dobutamine
c. [X] Noradrenaline
d. [ ] Hydrocortisone
e. [ ] Nitroglycerine
74. Resuscitation goals for the first 6hrs of the septic shock resuscitation include:
a. [X] CVP 8-12 mmHg
b. [X] SvO2 (sperior vena vena cava) or mixed 70%
c. [X] Mean arterial pressure 65 mm Hg
d. [X] Urine output 0,5 ml/kg/hr
e. [ ] Systolic arterial pressure 120 mm Hg
75. For the treatment of cardiogenic shock in a patent with acute myocardial infarction can be
used the following drugs
a. [X] Fentanyl
b. [ ] Nitroglycerine
c. [X] Noradrenaline
d. [X] Dopamine
e. [X] Dobutamine
76. Cardiogenic schock findings include:
a. [X] Tachycardia
b. [ ] Low systemic vascular resistance
c. [ ] Bradycardia
d. [X] Decreased cardiac output
e. [X] Arterial hypotension
77. Findings in anaphylactic shock will include:
a. [X] Generalized vasoplegia
b. [X] Bronchospasm
c. [X] Increased capillary permeability
d. [ ] Hipervolemia
e. [ ] High cardiac output
78. Tratment of neurogenic shock can include:
a. [X] Adrenalina
b. [X] Normal saline
c. [ ] Nitroglycerine
d. [X] Ringers lactate sol.
e. [X] Noradrenalina

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Coma states

79. Cerebral edema can by caused by the following conditions:

a. [X] Cardiopulmonary resuscitation
b. [X] Cerebral contusion
c. [X] Transient ischemic attack
d. [X] Hemorrhagic stroke
e. [ ] Hypoalbuminemia
80. Causes of an increased Intracranial Pressure can be:
a. [ ] Hyperventilation
b. [X] Hypercapnia
c. [ ] Systemic hypertension
d. [X] Hypoxia
e. [ ] Hyperoxia
81. Glsgow Coma Scale includes:
a. [ ] Oculomotor reflex
b. [X] Verbal response
c. [X] Eye response
d. [ ] Vestibulary response
e. [X] Motor response
82. Which of the following can be usefull in brain death diagnosis:
a. [X] Advanced coma (3 points by GCS)
b. [ ] Miotic pupils
c. [X] Mydriatic pupils
d. [X] Apnea test
e. [X] Atropin test
83. Which of the following increases Cerebral Blood Flow (CBF) and Intracranial Pressure (ICP):
a. [ ] Hyperventilation
b. [X] Hypoxemia
c. [ ] Convulsions
d. [X] Hypercapnia
e. [ ] Hypothhermia
84. Which of the following decreases Cerebral Blood Flow (CBF) and Intracranial Pressure (ICP):
a. [ ] Analgesia and sedation
b. [X] Hyperthermia
c. [X] Positive end expiratory pressure (PEEP)
d. [X] Respiratory alcalosis
e. [X] Acidosis
85. Mydriatic pupils are common for:
a. [X] Posoning with organophosphates
b. [X] Anoxia states
c. [ ] Advanced coma
d. [ ] Use of mydriatic drugs
e. [ ] Intravenous perfusion of adrenomimetics
86. Components of the management of increase Intracranial Pressure (ICP) are:
a. [ ] Patient ventilation
b. [ ] Systemic blood pressure control
c. [X] Horisontal position of the patient
d. [X] Anti-convulsantts
e. [ ] High PEEP values
87. Druds used for osmotic therapy include:
a. [ ] Dextrane 70
b. [X] Normal Saline
c. [X] 3% NaCl solution
d. [ ] Manitolum
e. [ ] Loop diretics

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88. Glucocorticoid side effects include:
a. Hypoglicemia
b. Immunosuppression
c. High gastrointestinal hemorrhage
d. Systemic hypotension
e. Hyponatriemia

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