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CONTROL QUESTIONS AND TASKS. 1. A 30-year old female patient was admitted, on an emergency, to the operating room with a diagnosis of extrauterine pregnancy

1. A 30-year old female patient was admitted, on an emergency, to the operating room with a diagnosis of extrauterine pregnancy. Objectively: mental confusion, skin integument and mucous membranes are pale. Peripheral pulse is thready. HR 140 beats per minute. AP=50/0 mm Hg. What anesthetic is indicated for initial anesthesia?

A. Calypsol

B. Thiopental sodium

C. Hexenal

D. Fluothane

E. Halothane.

2. A patient is being prepared for operation with a large irreducible hernia.
No associated diseases and systemic disorders are revealed. What is the extent
of risk according to V.A. Gologorsky's classification?

A. Ill A

B.IIIB

C.IVD

D.I B

E.I A

3. A 59-year old patient is in for the operation — stomach resection for a
duodenal ulcer. Associated diseases: bronchial asthma with frequent attacks,
hypertension. What is the extent of risk according to V.A. Gologorsky's
classification?

A. IIA

B.IIIB
C.IVD
D.IB
E.I A

4. A patient with very labile psychics is in the state of drastic emotional
exertion before the operation with a predominance of phobia. What preparation
will you prefer as the agent for premedication?

A. Droperidol

B. Promedol

C. Morphine

D. Relanium

E. Omnopon

5. A patient, 54 years of age, suffering from bronchial asthma for many
years, is in for appendectomy under endotracheal anesthesia. It is
contraindicated to apply:

A. Fluothane

B. Corticosteroids

C. Ketamine

D. Lysthenon

E. Tubocurarine

6. In the patient in the course of operation, performed under mask narcosis,
pupils have sharply dilated while their reaction to light is preserved and
increased lacrimation is marked. What is the most probable cause of pupils
dilatation?

A. Overdosage of narcotic substance

B. Too superficial narcosis

C. Myocardial fibrillation

D. Reflex cardiac arrest

E. Cerebral circulation disorder

7. What preparation, from those given below, has the least toxic properties
in relation to vitally important human organs?

A. Nitrous oxide

B. Fluothane

C. Ether

D. Cyclopropane

E. Halothane

8. A patient, 53 years of age, with disturbed hepatic function, is admitted
for the operation on the abdominal cavity. Which of the given below
preparations has the greatest hepatotoxicity and undesirable in carrying out
general anesthesia?

A. Cyclopropane

B. Nitrous oxide

C. Ether

D. Fluothane

E. Ketamine

9. A patient with myocardial infarction in the course of his transportation
to the hospital is being performed a mask anesthesia with oxygen-nitrous oxide

mixture for analgesia. What is the maximum allowable concentration of nitrous oxide in the mixture with oxygen?

A. 20%

B.40%

C. 60%

D.80%

E.95%

10. In the process of anesthesia for a short-term operation a motor excitation
was noted, then an increase of arterial pressure was observed, a heightened
muscular rigidity took place in the patient. After anesthesia the patient was
worried, delirium and hallucinations were noted. The depth of narcosis was
sufficient. What preparation action is the described clinical symptomatology
typical for?

A. Hexenal

B. Viadril

C. Thiopental sodium

D. Sombrevin

E. Ketamine

11. After the operation performed under neuroleptanalgesia without
administration of relaxants, we noted a depression of respiration combined
with spastic rigidity of the patient's trunk muscles, particularly in the chest.
What preparation is indicated to apply in this case, in order to eliminate
described symptomatology?

A. Nalorphine

B. Bemegride

C. Proserin

D. Atropine

E. Cytiton

12. After carrying out anesthesia in the patient with the use of arduan as a
myorelaxant, a respiratory depression has occurred as a result of residual
curarization. What preparation should be applied?

A. Adrenalin

B. Euphylline

C. Proserin

D. Bemegride

E. Unithiolum

13. In the immediate postanesthetic period the patient developed a
complication, named as "Mendelson's syndrome". What is the essence of this
complication?

A. Reflex cardiac arrest

B. Ventricular fibrillation

C. Hypertension as a result of hypercapnia

D. Sharp depression of respiration

E. Acute exudative pneumonitis

14. In the process of anesthesia and controlled respiration by semiclosed
circuit because of the technical error, committed in the operation of narcosis
apparatus, the patient developed progressively increasing hypertension and
tachycardia, replaced by bradycardia and catastrophic drop of blood pressure.
The attention was paid to the increased skin moisture. What error, in all
probability, was committed by anesthesiologist?

A. Oxygen dosimeter is not open

B. Absorber is not switched on

C. A bend of corrugated hose occurred

D. Depressurization of the apparatus has occurred

E. Intubation tube came out from the trachea

15. The patient, with severe hypovolemic shock, developed as a result of
profuse gastric hemorrhage, is indicated an operative intervention. What
relaxant, from the number given below, will you give preference to?

A. Diacetylcholine

B. Tubarin

C. Arduan

D. Diplacin

E. Anatruxonium

16. A 35-year old patient, suffering from bronchial asthma of infectious-
and-allergic genesis with frequent exacerbations for 10 years and receiving
20 mg of prednisolone daily and frequent asthmopent inhalations, was admitted
to the surgical department for a strangulated inguinal hernia. Which of the
anesthetics is contraindicated for this patient?

A. Fluothane

B. Nitrous oxide

C. Hexenal

D. Thiopental sodium

E. Ketamine

17. A 30-year old man is in for the operation — cranial trepanation for
epidural hematoma. Which of the anesthetics should not be applied while
carrying on a general anesthesia?

A. Fluothane

B. Barbiturates

C. Calypsol

D. Lidocaine

E. Neuroleptanalgesia

18. A 60-year old man, a heavy smoker, is in for the operative intervention
on the lungs. Which of the factors, given below that increase an operative risk,
is not associated with smoking?

A. A decrease of oxygen capacity as a result of the increase of methemoglobin concentration in the blood

F. A decrease of hemostatic properties of blood

G. Disturbance of the ciliated epithelium function
H. Bronchoconstrictive effect of nicotine

I. Deterioration of coronary blood flow

19. In a 20-year old female patient being on the operating table after an
extubation of trachea, bradypnea, tachycardia and acrocyanosis were noted. A
muscular tension, in hand shaking, is diminished. She cannot lift her head
independently. What is the doctor's tactics?

A. To anesthetize

B. To administer cardiac glycosides

C. APV with a mask method

D. Administration of anticoagulants

E. To transfer to the ward

20. While carrying out an intravenous anesthesia for opening a panaritium
in the 20-year old female patient after administration of thiopental sodium, we
marked a relaxation of masticatory muscles, absence of independent respiration,
tachycardia that gradually was turning into bradycardia, cyanosis of lips. What
is the doctor's tactics?

A. Administration of analgetics

B. Administration of anesthetics

C. Administration of myorelaxants

D. APV with a mask method

E. Administration of cardiac glycosides

21. While carrying out a preoperative preparation of a 55-year old patient,
going to a planned operation for an inguinal hernia, the anesthesiologist pays
the least attention to:

A. Patients psychologic preparation

B. Time of the last intake of meals

C. Treatment of the operative field

D. Premedication

E. Evacuation of the urinary bladder

22. For the patient suffering from bronchial asthma the anesthetic of choice is:

A. Significant doses offentanyl

B. Morphine

C. Fluothane

D. Thalamonal

E. Thiopental sodium

23. Esophagoscopy is planned for the patient with esophageal obstruction
under general anesthesia. Esophagography was performed in the preceding 24
hours with the use of barium. The most dangerous complication, in all
probability, may become:

A. Bleeding from vessels of the esophagus

B. Arterial hypotension

C. Labored intubation of trachea

D. Disturbance of cardiac rhythm

E. Aspiration into respiratory tracts

24. The patient, aged 41, with phlegmon of the oral cavity and disturbance
of patency of the air conducting ways owing to this phlegmon, is indicated
narcosis with:

A. Calypsol i/v without APV

B. NLA i/v without APLV

C. Thiopental i/v without APV

D. I/v with APV through tracheostoma

E. With a mask

25. Reducer it is a device:

A. For elevation and maintenance at the constant, preset level of
pressure of gas flowing out from a cylinder

B. For reduction and maintenance at the constant level of the pressure
of gas flowing out from cylinders

C. For a decrease of carbon dioxide concentration in the inhaled
gas mixture

D. To absorb excessive water vapors

E. For a control of pressure in the cylinders with condensed gas

26. Signs of threatening disturbance of vital functions are:

A. Systolic AP 60 mm Hg

B. Temperature 39° C

C. Dyspnea at rest

D. Coma

27. For a continuous monitoring of basic vital functions we should use:

A. Cardiostimulator

B. Computer

C. Echoencephalograph

D. Monitor

28. While carrying out APV it is the most important to properly establish:

A. Respiratory volume

B. Respiration rate

C. Pulmonary minute volume

D. Inhale/exhale ratio

29. In order to conduct any inhalation anesthesia it is necessary to have:

A. Respirator

B. Anesthetic apparatus

C. Suction unit

D. Laryngoscope

30. General anesthesia may be:

A. Endotracheal

B. Mask

C. Epidural

D. Intramuscular

31. Indications for hospitalization to DAIC are:

A. Acute and dangerous for life respiratory disorders

B. Acute and dangerous for life circulatory disorders

C. Comatose conditions

D. Grave incurable oncologic patients

32. In anesthesiology the intubation of trachea is applied for:

A. Use of inhalation anesthetics

B. Decrease of dead space

C. Possibility to use myorelaxants

D. Ventilation control

33. In order to intubate trachea they apply:

A. Fogg's straight blade

B. Mackintosh's curved blade

C. Air duct

D. Gegars retractor

34. Endotracheal anesthesia may be:

A. Intravenous A. Inhalation

C. Mask

D. Combined

35. For the first time ether anesthesia was applied by:

A. Bier

B. Mackintosh

C. Pirogov

D. Morton

36. Anesthesia apparatus is necessary for:

A. All forms of anesthesia

B. All forms of general anesthesia

C. Only in inhalation anesthesia

D. Only in endotracheal anesthesia

37. Narcosis may be:

A. General

B. Local

C. Mask

D. Endotracheal

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