1.

The following are determinants of what type of premedication and dosage to be given to patients
EXCEPT:
A. Patient’s age and weight
B. ASA physical status classification
C. Marital status
D. Level of anxiety

2. The following are the advantage when using anticholinergic agents EXCEPT:
A. Lessen airway secretion
B. Vagolytic action
C. Pyrexia

3. Vasoconstrictors mixed with local anesthetics:

A. Will form precipitate
B. Will produce hypotension
C. Vasoconstrict surrounding blood vessels
D. Hasten absorption
E. Maximize toxicity

4. Amide anesthetic:
A. Bupivacaine
B. Cocaine
C. Tetracaine
D. Pancuronium
E. Procaine

5. Patients extreme of ages are classified as:

A. ASA I
B. ASA II
C. ASA III
D. ASA IV
E. ASA V

6. Conclusion of pre-anesthetic visit to a 27 years old female with cholelithiasis EXCEPT:

A. Assign physical status of patient
B. Write anesthetic plan
C. Order pre-medication
D. Request additional laboratory work-up
E. None

7. During the preoperative evaluation of the patient, the following may lead to difficult intubation:
A. Short neck
B. Presence of cervical fracture
C. Obese patient
D. All of the above

8. During laryngoscopy, accidental extraction of a tooth may occur, the following must be done:
A. Wake up the patient
 B. Look for the missing tooth
C. Provide a better mask seal
D. Be careful not to extract another tooth

9. When the patient has a problem in the mobility of the neck, which of the axis/axes will be able to to
align in order to have a straight line:
A. Laryngeal
B. Pharyngeal
C. Oral
D. Pharyngeal and Laryngeal

10. Sellick’s maneuver is:

A. Gentle pressure at the cricoids cartilage
B. May prevent aspiration pneumonitis
C. Done by an assistant
D. All of the above

11. The ideal position of the endotracheal tube is midtrachea. This can be ascertained by:
A. Absence of sound in the epiglottis area
B. Equal breath sounds
C. Use of capnograph
D. An oxygen saturation greater than 95%

12. When the patient can NOT be ventilated and incubates, the first thing to do is:
A. Limit attempt to intubate up to 3x
B. Sedate the patient
C. Wake up the patient
D. Call surgeon to do surgical access

13. Most dangerous stage of general anesthesia because complications like aspiration pneumonia can
occur:
A. Stage I
B. Stage II
C. Stage III
D. Stage IV

14. The most nephrotoxic inhalational anesthetic because of its free fluoride metabolites is:
A. Sevoflurane
B. Deflurane
C. Enflurane
D. Methoxyflurane

15. The best estimate of inhalational anesthetic potency is its:

A. Partial pressure
B. Solubility
C. Uptake
D. MAC
16. A gaseous anesthetic with prominent analgesic effect that can cause diffusion hypoxia on
discontinuation:
A. Sevoflurane
B. Cyclopropane
C. Nitrous Oxide
D. Ether

17. An inhalational anesthetic that is associated with “coronary steal syndrome”:

A. Halothane
B. Nitrous oxide
C. Isoflurane
D. Sevoflurane

18. Major route of elimination of inhalational anesthetics is:

A. Skin
B. Urine
C. Feces
D. Respiratory system

19. Case 1: A 69 year old male will undergo thyroidectomy. The anesthetic plan will consist of:
A. Cormack Lethane Class II
B. General Anesthesia
C.Regional Anesthesia
D. Mallampati Class I
E. Sedation

20. The laboratory examination that must be done to the patient in case 1 is:
A. Prothrombin time
B. Chest xray
C. CBC
D. Urinalysis

21. The rationale for the request of the laboratory examination in no. 19 is:
A. Patient’s age
B. Possibility of bleeding due to surgery
C. Presence of UTI
D. Only A and B
E. All of the above

22. On history taking, the patient informed you that he had a history of jaundice,heavy…..beverage
drinker and smoker. Physical examination showed no organomegaly. He added that he had a liver
function test during his annual physical examination. The LFT is valid for
A. 1 month
B. 2 months
C. 3 months
D. 6 months
E. 12 months
23. A 9 years old boy will undergo herniorrhapy under general anesthesia. The boy drank Nido on the
scheduled time of the operation. The operation must be rescheduled after
A. 1 hour
B. 2 hours
C. 3 hours
D. 5 hours
E. 6 hours

24. Spinal anesthesia for surgeries of the lower extremities can have a block up to the umbilicus which is
consistent with the ff. dermatomal level:
A. T4
B. T6
C. T10
D. T12

25. A line drawn between the highest points of iliac crests which is perpendicular to L4 vertebral body is
known as:
A. Taylor’s line
B. Tuffler’s line
C. Superficial back line
D. Linea alba

26. The ff. approach is directed towards insertion of the spinal needle into the largest interspace in the
vertebral column:
A. midline
B. paramedian
C. lumbosacral
D. caudal

27. If the sensory block of a neuroaxial blockade is at T8, what is the level of the sympathetic blockade
A. T4
B. T6
C. T8
D. T10 ?

28. Factors that influence the height of spinal anesthesia block includes the ff. except:
A. volume of drug
B. specific gravity of drug
C. position of patient
D. height of patient

29. Which of the ff. is the correct sequence of modalities lost after spinal anesthesia?
A. Pain > Temperature > Pressure > Motor
B. Pain > Pressure > Temperature > Motor
C. Pain > Proprioception > Motor > Pressure
D. Pain > Touch > Temperature > Motor
30. Intermediate recovery refers to:
A. The discontinuation of anesthetic agents until recovery of protective reflexes and motor
function
B. when the patient achieves criteria for discharge
C. when the patient returns to his/her preoperative physiological state
D. none of the above

31. Pre-operative history is part of post anesthesia care unit admission report, it includes the following
except:
A. patient’s medications, allergies or reactions
B. underlying medical illness
C. relaxant/relaxation status
D. NPO status

32. Estimated blood loss and urine output is included in which part of PACU admission report:
A. Pre-operative history
B. Intra-operative factors
C. current status
D. post-op instructions

33. Once the patient arrives in PACU, level of consciousness an vital signs should be determined. This
information is included in:
A. Pre-operative history
B. Intra-operative factors
C. current status
D. post-op instructions ?

34. Name, contact number and location of the anesthesiologist is ideally written in:
A. Pre-operative history ?
B. Intra-operative factors
C. current status
D. post-op instructions

35. The ideal ratio of nurse to patient in PACU

A. 1:3 regular patients and 1:1 critical patient
B. 1:4 regular patients and 1:2 critical patients
C. 3:1 regular patients and 2:1 critical patients
D. always 1:1

36. To be efficient, PACU should be except:

A. 2 beds for every 4 procedures in 24hours
B. near the operating room complex
C. have access to anciliary services like radiology, laboratory etc.
D. be located at the ground floor

37. In PACU, pulmonary complication is usually due to, except:

A. airway obstruction
B. aspirationn
 C. pain
D. hypoxemia

38. In PACU, the following are common cardiovascular complications except:

A. hypotension
B. hypertension
C. arrhythmia
D. myocardial infarction

39. Usual presentation of renal problem post operatively:

A. oliguria
B. hypotension
C. flank pain
D. loss of consciousness

40. The beginning of the geriatric period is:

A. 60 years old
B. 65 years old
C. 70 years old
D. 80 years old

41. Cardiovascular changes in geriatrics include the ff. except:

A. Myocardial fibrosis
B. unchanged or decreased diastolic BP
C. intact baroreceptor reflexes
D. decline in cardiac output

42. Perioperative hypoxia in geriatrics can be prevented by:

A. small increments of PEEP
B. Giving higher inspired oxygen concentration
C. Aggressive pulmonary toilet
D. A and C only
E. all of the above

43. The principal pharmacologic change in geriatric patients with regards to anesthetic drugs is:
A. reduction in volume of distribution
B. increase in MAC
C. reduction in anesthesia requirements
D. delayed onset of action

44. The requirement of geriatric patients to the following drugs decreased except:
A. Succinylcholine
B. Thiopental
C. Diazepam
D. Isoflurane

45. The maximal heart rate of an adult declines by approximately how much?
A. 1 beat/min per year of age over 50
 B. 10 beats/min per year of age over 50
C. 1 beat/min per year of age over 60
D. 10 beats/min per year of age over 60

46. The decrease in arterial oxygen tension in an adult is approximately how much per year of age over
50:
A. 0.25 mmHg
B. 0.35 mmHg
C. 0.5 mmHg
D. 1 mmHg

47. Progressive and generalized loss of skeletal muscle mass (approximately 10%) can result in:
A. decrease in maximal and basal oxygen consumption
B. slightly lowered cardiac output
C. diminished production of body heat
D. A and C only
E. all of the above

48. Renal tissue mass in geriatric patients is noted to exhibit the following:
A. reduction by 30% by age 70
B. reduction by 30% by age 80
C. A and C only
D. B and C only

49. Recovery of geriatrics from volatile anesthetics is prolonged due to:

A. decreased volume of distribution
B. decreased hepatic function
C. increased pulmonary exchange
D. all are correct

50. Chronic cancer pain is described as:

A. Hyposensitivity to pain
B. pain is evoked
C. occurring with nonpainful stimulus
D. localized
E. requiring the presence of stimulus always

51. An example of graduated somatic approach is:

A. Surgery to alleviate pain
B. morphine (sorry di ko mabasa sulat niyo na lang kung nababasa nyo)
C. use of neuroaxial analgesia which is the gold standard
D. parenteral route is preferred to oral route for faster onset of action
E. Chemotherapy

52. Pain described as pins and needles is seen:

A. postherpetic neuralgia
B. diabetic neuropathy
C. trigeminal neuralgia ?
 D. viral neuropathy
E. facial nerve injury

53. The last neural pain pathway is:

A. perception
B. transduction
C. disinhibition
D. Modulation
E. Transmission

54. Pain in the surrounding normal tissue is called:

A. primary hyperalgesia?
B. secondary hyperalgesia
C. allodynia
D. hyperpathia
E. hyperesthesia

55. Pain arising from lesions of the central nervous system is:
A. psychogenic pain
B. referred pain
C. autonomic pain
D. sympathetic pain
E. central pain

56. Placebo is administered:

A. for psychogenic pain
B. research study where participants gave their consent
C. for malingerers
D. chronic back pain in remission
E. palliative care

57. Management of pain involves:

A. adequate pain relief
B. multidisciplinary approach
C. graduated somatic approach
D. all of the above
E. none of the above

58. In referred pain, pain is felt remote to the area of origin. The following describe/s referred pain
A. mechanism of action is convergence in the lamina VI
B. spinal convergence of visceral and somatic afferent fibers on spinothalamic neurons
C. drying of the mouth is the first manifestation
D. NSAIDS are the drug of choice
E. strong opiods can be given only if treatment with NSAIDS failed

59. The gold standard of pain intensity assessment is the visual analog scale:
A. a score of 4.5 is considered as moderate pain ?
B. the patients verbalize the pain score
 C. described as a horizontal line with descriptors of pain at both ends
D. this is commonly used in the wards
E. easy to use

TRUE or FALSE

TRUE 60. Barbiturates are contraindicated with patients who has porphyria manifested as abdominal
pain, muscle paralysis and passage of reddish urine.
TRUE 61. Flumazenil is the specific benzodiazepine antagonist which antagonizes the sedative effects of
adenosine.
FALSE 62. Naloxone is an agonist and antagonist drug which is used to detect suspicious physical
dependence
FALSE 63. Desmethyydiazepam is the component which is responsible for the long duration of action of
diazepam.
TRUE 64. Ketamine is a phencyclidine derivative which occupies the sigma opioid receptor causing
tachycardia, tachypnea and dystonia.
TRUE 65. Epidural anesthesia is recommended for caesarian delivery in preeclamptic patient who is
volume repleted and has a normal clotting profile.
FALSE 66. Pure alpha-adrenergic agent and mixed alpha agonists are vasoconstrictors that will increase
the maternal blood pressure as well as increase uteroplacental blood flow.
TRUE 67. Most sedatives and analgesics are of low molecular weight, high lipid solubility which accounts
for their early passage across the placenta.
FALSE 68. Factors VII, VIII, X and fibrinogen are markedly elevated which leads to increased blood loss at
delivery
TRUE 69. Lung volumes and capacities are not greatly changed in the pregnant patient but functional
residual capacity is decreased at term.
TRUE 70. In the early second stage of labor and delivery, pain is due to the perineal stretching and travels
through S2-S4 segments via the pudendal nerve.
TRUE 71. Hypotension during labor and delivery can result from regional anesthesia, aortocaval
compression or peripartum hemorrhage.
FALSE 72. Ergot alkaloids is given through the intramuscular route it can cause hypertension, convulsion,
stroke, retinal detachment and pulmonary edema.
TRUE 73. Hydralazine is the most common vasodilator used in preeclampsia and eclampsia because it
increases both uteroplacental blood flow and renal blood flow.
FALSE 74. The pregnant patient requires less regional anesthetic because they have low cerebrospinal
fluid protein which will increase the unbound fraction of the drug resulting in more free active drug.

NEUROMUSCULAR BLOCKING DRUGS

A. STIMULATES
B. BLOCKS
C. NO EFFECT

DRUG NICOTINIC RECEPTOR CHOLINERGIC RECEPTOR HISTAMINE RELEASE

Succinlycholine 75. STIMULATES 76. STIMULATES 77. NO EFFECT
Pancuronium 78. BLOCK
Mivacurium 79. STIMULATES
(80-100)

I. A 12kg female pediatric patient is scheduled for an elective bowel resection. NPO for 6 hrs.
A. Compute for the following
1. MFR (Maintenance Fluid Requirement)
2. EFD (Estimated Fluid Deficit)
3. Fluid requirement for the first hour
4. Fluid requirement for the 2nd hour
5. Third space intraoperative fluid requirement per hour

II. A 75kg male patient is scheduled for an elective cholecystectomy. NPO for 6 hours. Pre-op
hematocrit is 0.39 and post-op hematocrit is 0.34. Compute for the following:
1. Allowable blood loss
2. MFR
3. EFD

III. Local Anesthetic formulation

Compute for the:
1. Number of milligrams/cc in 5% lidocaine solution
2. Number of milligrams/cc in 1:1000 preparation of epinephrine
3. Number of grams of glucose in 1 liter of D5 W crystalline solution