ANZCA MCQ 2001b Exam with precise detailed solutions ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and rationales ||\\//||
92. The LEAST effective method of protecting the spinal cord during surgery on the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
descending thoracic aorta is ||\\//|| ||\\//|| ||\\//||
A. reducing the duration of ischaemia
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. lowering the CSF (cerebrospinal fluid) pressure
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. spinal cord hypothermia
||\\//|| ||\\//|| ||\\//||
D. administration of a thiobarbiturate
||\\//|| ||\\//|| ||\\//|| ||\\//||
E. use of shunts to bypass the aortic cross-clamp - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
thiopentone will decrease the metabolic activity of the spinal cord, but this is probably the ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
least effective ||\\//||
91. The LEAST correct statement regarding anterior spinal artery syndrome is that
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. most patients are elderly
||\\//|| ||\\//|| ||\\//|| ||\\//||
B. the onset is sudden
||\\//|| ||\\//|| ||\\//|| ||\\//||
C. there are no systemic symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. the myelogram and CAT scan are abnormal
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. sensory involvement is minor or patchy - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Neurologic Complications of Spinal and Epidural Anesthesia - Regional Anesthesia & Pain ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Medicine 2000, table 3 ||\\//|| ||\\//|| ||\\//||
• Usually elderly
||\\//|| ||\\//||
• sudden onset
||\\//|| ||\\//||
• no generalized, systemic symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//||
,• Myelogram and CT normal
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Minor or patch sensory involvement
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
90. The most commonly reported cause of awareness during general anaesthesia for a non-
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
obstetric procedure is ||\\//|| ||\\//||
A. inadequate intra-operative opiate analgesia
||\\//|| ||\\//|| ||\\//|| ||\\//||
B. equipment failure
||\\//|| ||\\//||
C. the use of total intravenous anaesthesia
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. faulty anaesthetic technique
||\\//|| ||\\//|| ||\\//||
E. use of a laryngeal mask airway - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
CEACCP 2005: "Awareness is frequently associated with poor ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
anaesthetic technique" ||\\//||
89. In patients with mitral regurgitation
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. left ventricular damage does NOT occur before the onset of symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. mitral valve replacement has a lower operative mortality and incidence of late adverse
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
outcomes compared to mitral valve repair ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. an ejection fraction of less than 60% may be an indication for surgery, even in the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
absence of symptoms ||\\//|| ||\\//||
D. long term vasodilators have been shown to delay the need for surgery
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. the presence of a third heart sound always indicates heart failure - correct answer✔✔C
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Stoelting:
• Development of ventricular hypertrophy and increased compliance of the left atrium
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
permit the accommodation of the regurgitant volume without a major increase in left atrial
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
pressure. This allows patients to maintain cardiac output and remain free of pulmonary ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
congestion and be asymptomatic for many years ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,• Mitral valve repair is preferred to mitral valve replacement because it restores valve
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
competence, maintains the functional aspects of the mitral valve apparatus, and avoids ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
insertion of a prosthesis. The mitral valve apparatus is very important in sustaining left ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ventricular function. The absence of the subvalvular apparatus causes distortion of the left ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ventricular contractile geometry and impairment of left ventricular ejection ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Survival may be prolonged if surgery is performed before the ejection fraction is less than
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
60% or before the left ventricle is unable to contract to an end-systolic dimension of 45 mm
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
(normal < 40 mm). ||\\//|| ||\\//|| ||\\//||
• Although vasodilators are useful in the medical management of acute mitral regurgitation,
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
there is no apparent benefit to long-term use of these drugs in asymptomatic patients with
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
chronic mitral regurgitation ||\\//|| ||\\//||
• S3 can be heard and recorded in healthy young adults. However, it is usually abnormal in
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
patients over the age of 40 years, suggesting an enlarged ventricular chamber (uptodate)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
88. With respect to acute myocardial infarction
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. true posterior infarcts manifest on the ECG as a tall R wave in Lead V3
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. aspirin should NOT be given unless myocardial infarction is confirmed
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. regional anaesthesia is NOT recommended if thrombolytic therapy has been used within
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
the previous 2 weeks ||\\//|| ||\\//|| ||\\//||
D. Angiotensin Converting Enzyme (ACE) inhibitors may be indicated in the acute period
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. Troponin I testing is unsuitable in the peri-operative period - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
87. The standard error of the mean is
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. dependent for its validity on a normal distribution in the population
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. an indication of the likelihood of making a type II error
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. about 2, if the standard deviation is 15 and the sample size 50
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. NOT necessary for calculating the confidence interval for the mean
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. the variance of the population of sample means - correct answer✔✔C
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, • The population does not have to be normally distributed because of central limit theorem:
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
the shape of a a sampling distribution will approximate a normal distribution when the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
number of samples is high, even when the underlying population is not a normal distribution ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• "Standard error is also known as the standard error of the mean. If one takes a number of
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
samples from a population, we will have a mean for each sample. The SD of the sample ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
means is the standard error" Myles and Gin ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• "type II error occurs when one accepts the H0 incorrectly and the probability of this
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
occurring is termed beta" Myles and Gin ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• SE = SD / square root of sample size. So SE = 15/7
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• "standard error is used to calculate confidence intervals, and so is a measure of precision"
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• No, it is the standard deviation no variance of population means
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
86. The laryngeal mask when correctly inserted
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. may be safely used in a patient with latex allergy
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. lies with the sides facing the pyriform fossa
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. lies with the upper border under the base of the tongue
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. forms a seal around the laryngeal perimeter
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. has the black line on the tube, always facing the lower lip of the patient - correct
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
answer✔✔A
Thouhg B,C & D also seem mostly correct ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Product information: ||\\//||
||\\//|| Latex free ||\\//||
"When fully inserted using the recommended insertion technique, the distal tip of the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
LMA™ airway cuff reaches the distal end of the hypopharynx immediately above the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
oesophageal sphincter. Its sides face into the pyriform fossae and the upper border rests ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
against the base of the tongue" ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
||\\//|| lies with the upper border under the base of the tongue - almost true See above
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and rationales ||\\//||
92. The LEAST effective method of protecting the spinal cord during surgery on the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
descending thoracic aorta is ||\\//|| ||\\//|| ||\\//||
A. reducing the duration of ischaemia
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. lowering the CSF (cerebrospinal fluid) pressure
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. spinal cord hypothermia
||\\//|| ||\\//|| ||\\//||
D. administration of a thiobarbiturate
||\\//|| ||\\//|| ||\\//|| ||\\//||
E. use of shunts to bypass the aortic cross-clamp - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
thiopentone will decrease the metabolic activity of the spinal cord, but this is probably the ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
least effective ||\\//||
91. The LEAST correct statement regarding anterior spinal artery syndrome is that
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. most patients are elderly
||\\//|| ||\\//|| ||\\//|| ||\\//||
B. the onset is sudden
||\\//|| ||\\//|| ||\\//|| ||\\//||
C. there are no systemic symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. the myelogram and CAT scan are abnormal
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. sensory involvement is minor or patchy - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Neurologic Complications of Spinal and Epidural Anesthesia - Regional Anesthesia & Pain ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Medicine 2000, table 3 ||\\//|| ||\\//|| ||\\//||
• Usually elderly
||\\//|| ||\\//||
• sudden onset
||\\//|| ||\\//||
• no generalized, systemic symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//||
,• Myelogram and CT normal
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Minor or patch sensory involvement
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
90. The most commonly reported cause of awareness during general anaesthesia for a non-
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
obstetric procedure is ||\\//|| ||\\//||
A. inadequate intra-operative opiate analgesia
||\\//|| ||\\//|| ||\\//|| ||\\//||
B. equipment failure
||\\//|| ||\\//||
C. the use of total intravenous anaesthesia
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
D. faulty anaesthetic technique
||\\//|| ||\\//|| ||\\//||
E. use of a laryngeal mask airway - correct answer✔✔D
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
CEACCP 2005: "Awareness is frequently associated with poor ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
anaesthetic technique" ||\\//||
89. In patients with mitral regurgitation
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. left ventricular damage does NOT occur before the onset of symptoms
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. mitral valve replacement has a lower operative mortality and incidence of late adverse
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
outcomes compared to mitral valve repair ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. an ejection fraction of less than 60% may be an indication for surgery, even in the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
absence of symptoms ||\\//|| ||\\//||
D. long term vasodilators have been shown to delay the need for surgery
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. the presence of a third heart sound always indicates heart failure - correct answer✔✔C
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Stoelting:
• Development of ventricular hypertrophy and increased compliance of the left atrium
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
permit the accommodation of the regurgitant volume without a major increase in left atrial
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
pressure. This allows patients to maintain cardiac output and remain free of pulmonary ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
congestion and be asymptomatic for many years ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,• Mitral valve repair is preferred to mitral valve replacement because it restores valve
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
competence, maintains the functional aspects of the mitral valve apparatus, and avoids ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
insertion of a prosthesis. The mitral valve apparatus is very important in sustaining left ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ventricular function. The absence of the subvalvular apparatus causes distortion of the left ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
ventricular contractile geometry and impairment of left ventricular ejection ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Survival may be prolonged if surgery is performed before the ejection fraction is less than
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
60% or before the left ventricle is unable to contract to an end-systolic dimension of 45 mm
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
(normal < 40 mm). ||\\//|| ||\\//|| ||\\//||
• Although vasodilators are useful in the medical management of acute mitral regurgitation,
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
there is no apparent benefit to long-term use of these drugs in asymptomatic patients with
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
chronic mitral regurgitation ||\\//|| ||\\//||
• S3 can be heard and recorded in healthy young adults. However, it is usually abnormal in
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
patients over the age of 40 years, suggesting an enlarged ventricular chamber (uptodate)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
88. With respect to acute myocardial infarction
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
A. true posterior infarcts manifest on the ECG as a tall R wave in Lead V3
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
B. aspirin should NOT be given unless myocardial infarction is confirmed
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
C. regional anaesthesia is NOT recommended if thrombolytic therapy has been used within
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
the previous 2 weeks ||\\//|| ||\\//|| ||\\//||
D. Angiotensin Converting Enzyme (ACE) inhibitors may be indicated in the acute period
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
E. Troponin I testing is unsuitable in the peri-operative period - correct answer✔✔D
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87. The standard error of the mean is
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A. dependent for its validity on a normal distribution in the population
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B. an indication of the likelihood of making a type II error
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C. about 2, if the standard deviation is 15 and the sample size 50
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D. NOT necessary for calculating the confidence interval for the mean
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E. the variance of the population of sample means - correct answer✔✔C
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, • The population does not have to be normally distributed because of central limit theorem:
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the shape of a a sampling distribution will approximate a normal distribution when the
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number of samples is high, even when the underlying population is not a normal distribution ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• "Standard error is also known as the standard error of the mean. If one takes a number of
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samples from a population, we will have a mean for each sample. The SD of the sample ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
means is the standard error" Myles and Gin ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• "type II error occurs when one accepts the H0 incorrectly and the probability of this
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occurring is termed beta" Myles and Gin ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• SE = SD / square root of sample size. So SE = 15/7
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• "standard error is used to calculate confidence intervals, and so is a measure of precision"
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• No, it is the standard deviation no variance of population means
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86. The laryngeal mask when correctly inserted
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A. may be safely used in a patient with latex allergy
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B. lies with the sides facing the pyriform fossa
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C. lies with the upper border under the base of the tongue
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D. forms a seal around the laryngeal perimeter
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E. has the black line on the tube, always facing the lower lip of the patient - correct
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answer✔✔A
Thouhg B,C & D also seem mostly correct ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Product information: ||\\//||
||\\//|| Latex free ||\\//||
"When fully inserted using the recommended insertion technique, the distal tip of the
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LMA™ airway cuff reaches the distal end of the hypopharynx immediately above the
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oesophageal sphincter. Its sides face into the pyriform fossae and the upper border rests ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
against the base of the tongue" ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
||\\//|| lies with the upper border under the base of the tongue - almost true See above
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