Emergency physician file MCQ pretest
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Emergency physicians anesthesia workshop
Anesthesia department at King Khalid University Hospital
Pretest questions
Read every question’s stem and select the most appropriate choice from
the items which follow it.
1. Intubation with an endotracheal tube:
1.
2.
3.
4.
allows adjunctive ventilatory equipment to be used more effectively with less
effort on the part of the rescuer
reduces the risk of aspiration of gastric contents
is the immediate priority in ventricular fibrillation
when improperly performed can result in only one lung being inflated
a.
b.
c.
d.
e.
1, 2, 4
1, 2, 3
2, 3, 4
all of the above
none of the above
2. You have intubated a 60-year old female patient in cardiac arrest. Which of the
following would indicate inadvertent esophageal intubation?
a.
b.
c.
d.
e.
subcutaneous emphysema
external jugular vein distention
gurgling sounds heard over the epigastrium
breath sounds present on only one side of the chest
Bilateral expansion of the chest
3. Which of the following is an indication for endotracheal intubation?
a. Difficulty of qualified rescuers to ventilate an apneic patient with a
bag-valve mask
b. A respiratory rate of less than 20 breaths per minute in a patient with
severe chest pain
c. Presence of premature ventricular contractions (PVCs)
d. For airway protection in a conscious patient severely traumatized with
an adequate gag reflex
e. Transporting trauma patient to another hospital
Emergency physician file MCQ pretest
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4. You are preparing to perform endotracheal suction on an intubated patient. Which of
the following statements about suctioning is correct?
a. Each suction attempt should be limited to 30 to 45 seconds
b. Each suction attempt should be preceded by increased ventilation with
supplemental oxygen
c. Suction should be applied as the catheter is inserted into the
endotracheal tube
d. If arrhythmias are present, avoid ventilating the patient manually
e. Allow the patient to get oxygenation in case of arrhythmia by ventilating
his lungs with oxygen enriched air.
5. You are providing hand ventilation with a bag-valve mask for a patient with no
spontaneous ventilation. You are explaining the use of bag-valve-mask ventilation to
a group of new nurses and residents who are observing your technique. Which of the
following statements would most accurately describe the use of bag-valve-mask
ventilation during resuscitation?
a. It can be performed effectively with minimal training and practice
b. It will deliver nearly 100% oxygen if reservoir and high oxygen flow
rate are used
c. It cannot be performed effectively by one person during resuscitation
d. It should be avoided if the patient has any spontaneous respiratory effort
e. Only expert in its use should handle it
6. An oropharyngeal airway:
a.
b.
c.
d.
e.
eliminates the need for head positioning of the unconscious patient
eliminates the possibility of complete upper airway obstruction
is of no value once an endotracheal tube is placed
may stimulate vomiting or laryngospasm in the semi-conscious patient
Protect the lungs from aspiration
7. Which of the following indices indicates severe blood loss:
a.
b.
c.
d.
e.
Estimated loss of 20% of the blood volume
CVP readings of –5 cm H2O
Systolic blood pressure below 80 mmHg
Restless patient
Cold and pale skin
Emergency physician file MCQ pretest
8. Propofol;
a.
b.
c.
d.
e.
is metabolized in the plasma
is painless on injection
is composed of two steroids
inhibits synthesis of adrenaline cortical hormones
can be given safely in renal failure patient
9. Which of the following is true regarding Thiopentone:
a.
b.
c.
d.
e.
It increases the cerebral oxygen consumption
It increases ischemic damage in head injury patient
It increases cerebral vascular tone
It increases cerebral blood flow in mechanically ventilated patient
It increases the convulsion threshold of the brain
A young strong male was involved in road traffic accident. In the emergency room
Indrowing of the chest wall during inspiration, cyanosis,he had rapid shallow breathing,
inward movement hypotension.
10. What is the proper diagnosis ?
a.
b.
c.
d.
e.
Ruptured stomach
Cardiac tamponade
Barotraumas to the lung
Flail chest
Hemopneumothorax
11. What should be the immediate step
a.
b.
c.
d.
e.
Chest CT-Scan
Chest drain placed in the second intercostals space
Intubation of the trachea
Nasogastric tube insertion
Peritoneal lavage
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Emergency physician file MCQ pretest
12. If after responding to emergency doctor request of intubation and ventilation the
cyanosis increased and reduction in blood pressure persists. How it would be the
cause of this clinical picture?
a.
b.
c.
d.
e.
Ruptured major artery
Aspiration asphyxia
Acute lung injury
Tension pneumothorax
Electromechanical dissociation
13. The anesthetic technique of choice for rapid sequence intubation is:
a.
b.
c.
d.
e.
Propofol: Atracurium infusion
Thiopentone: Suxamethonium
Fentanyl suxamethonium
Awake intubation
Ketamine: Cisatracurium block
14. All of the following statements regarding midazolam are true, EXCEPT:
a.
b.
c.
d.
e.
water soluble benzodiazepines
possess anti anxiety effects
It possesses amnesic effect
It has analgesic effect
It has anticonvulsant effect
15. All of the following statements regarding atracurium, are true EXCEPT:
a.
b.
c.
d.
e.
It undergoes spontaneous metabolism by Hofmann elimination
It undergoes metabolism by ester hydrolisis
It undergoes some hepatic metabolism
It is contraindicated in liver dysfunction
It can be used in renal failure
16. All of the following statements regarding suxamethonium are true EXCEPT:
a.
b.
c.
d.
e.
It undergoes spontaneous metabolism by the kidneys
IT undergoes metabolism by liver ester hydrolysis
It is non depolarizing agent
It should be avoided in young patient
It Can quickly produce muscle relaxation for intubation
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Emergency physician file MCQ pretest
17. Which of the following agent is suitable to be used in patient suffering from
hemorrhagic shock:
a.
b.
c.
d.
e.
Thiopentone
Ketamine
Midazolam
Diazepam
Propofol
18. Thiopentone is used in rapid sequence intubation because:
a.
b.
c.
d.
e.
It produce muscle relaxation.
It quickly produce unconsciousness
It is suitable in internal bleeding trauma patient
It gives degree of sedation which facilitate intubation
|It prevents vomiting
19. All the following agents are in emergency EXCEPT
a.
b.
c.
d.
e.
midazolam
propofol
sevoflurane
ketamine
Thiopental
20. Which of the following statements concerning fentanyl is true?
a.
b.
c.
d.
e.
It is a muscle relaxant for rapid sequence intubation
It has an analgesic potency approximately 100 times that of morphine.
It is a benzodiazepine derivative.
It is associated with local infiltration.
It causes tacypnea in clinical doses.
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