Download Update 11 - Update in Anaesthesia - WFSA

84Update in AnaesthesiaSELF ASSESSMENT SECTIONDr Andrew Longmate, Stirling Royal Infirmary, Scotland, UK1. In significant aortic stenosis:A there is an early diastolic murmurB the ECG often shows evidence of left ventricularhypertrophyC can be caused by rheumatic feverD collapse may be the first manifestationE cannot be present if the patient is hypertensive2. With aortic stenosis:A a pulse rate of 40 per minute is good forhaemodynamicsB ketamine is a useful anaesthetic agentC antibiotic prophylaxis is necessary for surgicalprocedures on the bladderD neuromuscular relaxation is contraindicatedE hydralazine is a safe drug to use3. In cardiac tamponade there may be:A hypotensionB distended neck veinsC Kussmaul’s signD pulsus paradoxusE cardiac arrest4. Concerning cardiac tamponade:A may be caused by penetrating traumaB may be secondary to a pericardial effusionC general anaesthesia is required to drain thepericardiumD can follow blunt traumaE ECG complexes may be small5. Constrictive pericarditis:A may be caused by TBB causes abdominal swellingC may lead to hepatomegalyD peripheral oedema may be minimalE may cause peritonitis6. Rheumatic fever:A affects only the heart valvesB occurs after streptococcal infectionC may cause a large joint polyarthritisD does not affect the mitral valveE may cause elevated ST segments on the ECG7. Elevated blood urea may occur:A in renal failureB after bleeding into the gutC in dehydrationD in liver failureE in overhydration8. Concerning tuberculosis:A miliary TB may be associated with a negativemantoux testB the X-ray of miliary TB may mimickstapylococcal pneumoniaC primary TB can cause hilar adenopathy on chestX-rayD the primary complex causes upper lobe cavitationE may present in conjunction with malnutrition9. The Apgar score:A should be measured at 0 and 3 minutesB has a maximum score of 8C includes assessment of respirationD includes assessment of colourE each measure is scored 0-110. The GCS (Glasgow Coma Scale):A has a minimum score of 0B scores pupil sizeC a confused patient would score 13D if reduced in presence of a skull fracture is aworrying signE if 15 in presence of a skull fracture is reassuring11. After head injury:A a lucid interval may occur with an extraduralhaematomaB craniotomy will take preference over surgery forabdominal bleedingC depressed skull fracture always requires operativerepairD wound toilet may be safely accomplished underlocal anaestheticE hypertension and bradycardia may occur with