1. Which of the following is the BEST indication for transfusion of pooled platelet concentrates (SEE 13 B)

A. Clinical coagulopathy
B. Massive blood trransfusion (>1 blood volume)
C. Thrombocytopenia purpura
D. Weaning from cardiopulmonary bypass
 
a
2. Which of the following preoperative findings has the GREATEST association with an adverse perioperative cardiac event? (SEE 16 A)

A. Increased systolic blood pressure only
B. Increased diastolic blood pressure only
C. History of chronic hypertension
D. Increased systolic and diastolic blood pressure
 
a
3. The effect of succinylcholine is terminated at postsynaptic effector cells by : (In-Training ASA 1993)

A. binding and uptake by effector cells
B. diffusion into capillaries
C. hydrolysis by junctional cholinesterase
D. hydrolysis by pseudocholinesterase
E. spontaneous degradation to succinylmonocholine
 
a
4. Which statement about pain after inguinal herniorhaphy is MOST likely true ? (SEE 15 A)

A. It should not be treated with ketorolac
B. It is less after general anesthesia
C. It is not altered by injection of wound edges with local anesthetics at the conclusion of surgery
D. It is less after laparoscopic herniorhaphy compared to open herniorrha phy when the anesthetic technique is the same.
 
a
5. When comparing the ventilatory effects of 1.4 MAC of halothane and sevoflurane in spontaneously ventilating patients, sevoflurane will MOST likely cause a (SEE 13 A)

A. lower PaCO2
B. larger tidal volume
C. similar minute ventilation
D. lower respiratory rate
 
a
6. Which statement about the pharmacokinetics of alfentanil is MOST likely true (SEE 14 A)

A. Alfentanil is more lipid soluble than fentanyl
B. Alfentanil is mostly un-ionized at physiologic pH
C. The short elimination half-life of alfentanil is due to its rapid clearance
D. Alfentanil is largely excreated unchanged in the urine
 
a
7. Compared with a patient without liver disease, a patient with cirrhosis will have (In-Training ASA 1993)

A. greater accumulation of vecuronium with infusion
B. increased unbound plasma vecuronium concentration
C. more frequent occurence of phase II block after succinylcholine adminis tration
D. prolonged elimination half-life of atracurium
E. unchanged volume of distribution for pancuronium
 
a
8. Which comparison of propofol/N2O with sevoflurane/N2O for induction and maintenance of general anesthesia is MOST likely true ? : (SEE 13B)

A. Induction times are the same
B. Emergence times are significantly shorter with propofol/N2O
C. The incidence of nausea and vomiting is the same in both groups.
D. Postop analgesia is required earlier for patients who recieve propofol/N2O anesthesia
 
a
9. Which of the following preoperative pulmonary function tests is NOT associated with an increased operative risk for pneumonectomy (Anesthesia : comprehensive review)

A. FEV1 < 50 % of the FVC
B. FEV1 < 2 L
C. Maximum breathing capacity < 50 % of predicted
D. Residual volume/total lung capacity < 50 %
E. Hypercarbia on room air arterial blood gases
 
a
10. Which statement about PONV after general anesthesia is MOST likely true ? (SEE 14A)

A. PONV occurs more often inadults, compared to children
B. PONV occurs infrequently after strabismus surgery
C. PONV always increases the length of hospitalization
D. Further episodes of PONV are not uniformly prevented by administration of ondansetron
 
a
11. A parturient received 1000 ml of dextrose 5% in RLS 20 minutes prior to deliver. Ten minutes later her blood glucose concentration is 580 mg/dl. In this situation (In-Training ASA 1992)

A. the risk for fetal intraventricular hemorrhage is increased
B. the risk for neonatal hypoglycemia is increased
C. placental glucose transport is insulin dependent
D. the neonate should be given dextrose 50% W if depressed at delivery
E. The mother should be given insulin prior to delivery
 
a
12. A 72-year-old male patient with a histomy of MI 12 months earlier is scheduled to undergo elective repair of 6-cm AAA under GA. When would this patient be most likely to have a reinfarction ? (Anesthesia : comprehensive review)

A. On induction of anesthesia
B. During placement of the aortic crossclamp
C. Upon release of the aortic crossclamp
D. 24 hours postoperatively
E. On the third postoperative day
 
a
13. Which statement about the major degradation of sevoflurane is MOST likely true ? (SEE 16A)

A. It is difluorovinyl ether (compound A)
B. It is produced in the cytochrome P450 system in the liver, leading to mild hepatotoxicity in some patients after prolong exposure
C. It is not produced when a closed circuit technique is employed because of low gas flows
D. It may occur in the anesthesia circuit in greather concentration if the carbondioxide absorbent is near exhaustion
 

Key type for the following items
A : 1,2,3      B : 1,3      C : 2,4      D : only 4     E : all
a
14. Brain stem auditory evoked potentials (BAEPs) are superior to somato-sensory evoked potentials (SSEPs) for intraoperative monitoring because BAEPs are (In-Training ASA 1992)

1. affected less by hypothermia
2. affected less by patient cooperation
3. more likely to detect spinal cord ischemia
4. more resistant to the effects of anesthesia
 
a
15. Patients undergoing spinal or epidural anesthesia are clearly predisposed to epidural hematomas by (SEE 15A)

1. coagulation abnormalities
2. use of larger needles
3. difficult needle placement
4. aspirin therapy
 
a
16. When compared to placebo, oral transmucosal fentanyl citrate (15mcg/kg) given as a premedication to children under 6 years of age results in (SEE 14 B)

1. an increase in the incidence of PONV
2. occasional chest wall rigidity
3. an increase in the incidence of pruritus
4. occasional respiratory depression
 
a
17. Nasotracheal intubation may be used safely in a patient who has (MGH)

1. fractures of the lower C spine and the ethmoid bone
2. a LeFort II fracture of the maxilla
3. a LeFort III fracture of the maxilla
4. a LeFort I fracture of the maxilla
 
a
18. Symptoms of transient neurological syndrome (TNS) associated with spinal anesthesia include (SEE 16A)

1. lower extremity pain
2. urinary retention
3. buttocks dysthesia
4. headache
 
 
Answer ( * In-traning Exam - no answer available - find out by yourself)
1. A     2. C     3. -     4. D     5. D     6. B     7. -     8. C     9. D     10. D     11. -     12. E     13. A     14. -     15. B     16. E    17. D     18. B