Dr. Jensen Anesthesiology Board P.R.E.P.

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The following are sample questions from my Written Board Review PREP I believe it is the best course in the USA for Written Boards. The idea of my program is to relentlessly focus upon and "tweak" the test. This is best done through critical focus upon key words, key concepts, old Board questions, and remembered Board questions. The Big Blue book covers the essential information and the course provides a way to identify strengths and weaknesses through questions and answers.

The Board is many things but it is not stupid! The questions themselves are usually not repeated and so it makes little sense to memorize them. However, the concepts are repeated and therefore questions are a very useful jumping-off point for answers which provide the information to answer similiar questions. At the course, topics are covered systematically, not randomly, as is the case below. Tests (self-graded) are given and then the answers are discussed. Obviously, this is a very useful way to identify weaknesses in one's approach before the exam itself. In addition, it is a very efficient way to cover a vast amount of territory relevant to the Written exam. Trust me, it beats a lecture course by miles.

See you at the Course! --Niels F. Jensen, MD, Director

Sample Web Written PREP Test

Choices will be single best or K type
    K type review: A: 1, 2, 3 only
    B: 1, 3 only
    C: 2, 4 only
    D: 4 only
    E: All are correct

1. Single best answer (1992 Remembered)
A 62-year-old male is brought to the ICU s/p CP bypass. Upon entry to the ICU HR 90, BP 125/75, PADP 12, PAOP 10, and CVP 6. After 30 minutes, HR is 120, BP 80/30, PADP 25, PAOP 25, and CVP 8. The most likely reason for the hemodynamic changes is:

    (A) Anaphylactic Reaction
    (B) Ventricular Ischemia
    (C) Pneumothorax
    (D) Pulmonary Edema
    (E) Septic Shock

2. K type (1994 Remembered)
A 2500 gm infant, 12 hours old, undergoing repair of an omphalocele develops tachycardia to 160, decreased blood pressure to 60/15, difficulty ventilating, and decreased urine output. Appropriate therapy at this time

    (1) increase depth of anesthesia
    (2) additional dose of muscle relaxant
    (3) give bolus D5 1/2 NS
    (4) tell surgeon to forego primary closure

3. single best answer (1995 Remembered) Hyperkalemia after succinylcholine in acute spinal cord injury is

    (A) not clinically significant by EKG changes
    (B) unlikely in the first 24 hours
    (C) unlikely after 60 days
    (D) reliably prevented by pretreatment with a non-depolarizer
    (E) unlikely six months post-injury

4. single best answer (1993 Remembered) The treatment for SVT with blood pressure stable at 120/75 is:

    (A) adenosine
    (B) verapamil
    (C) digoxin
    (D) lidocaine
    (E) synchronized cardioversion

5. single best answer (1992 Remembered) Side effects of magnesium sulfate include all except:

    (A) pulmonary edema
    (B) neonatal hypotonia
    (C) hypokalemia
    (D) sensitivity to nondepolarizers
    (E) maternal hypotension

6. single best answer (1993 Remembered) Meralgia paraesthetica involves:

    (A) pain in lateral aspect of thigh
    (B) inability to abduct thigh
    (C) weakness below the knee
    (D) inability to dorsiflex the foot
    (E) burning pain in the hip

7. K type (1995 Remembered) Landmarks for a superior laryngeal nerve block include:

    (1) angle of the mandble
    (2) cricothyroid membrane
    (3) sternal notch
    (4) greater cornu of the hyoid bone

8. K type (1995 Remembered) A patient presents for transphenoidal resection of a pituitary tumor for acromegaly. Important anesthetic considerations include:

    (1) narrowed subglottic space
    (2) postoperative diabetes insipidus
    (3) TMJ involvement
    (4) large tongue

9. single best answer (1994 Remembered) A 16 year old female is anesthetized with thiopental and succinylcholine. Maintenance of anesthesia is with halothane-oxygen. The patient is spontaneously ventilating. Which is the most reliable sign of malignant hyperthermia?

    (A) tachycardia
    (B) hypertension
    (C) tachypnea
    (D) metabolic alkalosis (severe)
    (E) increased ETCO2

10. single best answer (1993 Remembered) A 55 year old patient undergoes a total hip arthroplasty under epidural anesthesia. She receives post-operative epidural analgesia with Duramorph. On post-op day one she develops weakness of her lower extremities. There are also associated sensory changes. Appropriate action at this time includes:

    (A) reassure the patient and re-evaluate the next morning
    (B) pull the catheter
    (C) add local anesthetic
    (D) obtain magnetic resonance imaging
    (E) add fentanyl

11. K type (1994 Remembered) 66 year old with aortic regurgitation presents for frontal craniotomy. Drugs which would best reach hemodynamic goals include:

    (1) pancuronium
    (2) sufentanyl
    (3) isoflurane
    (4) halothane

12. single best answer (1994 Remembered) What is the maximum amount of leakage current from equiptment:

    (A) 10 milli amps
    (B) 100 milli amps
    (C) 1 amp
    (D) 10 amp
    (E) 10 micro amps

13. K type (1994 Remembered) Cardiovascular effects of pipecuronium include:

    (1) small increase in heart rate, minimal change in SVR
    (2) minimal change in heart rate, slight increase in SVR
    (3) heart rate unchanged, slight decrease in SVR
    (4) minimal change in either heart rate or SVR

14. single best (1994 Remembered) Which of the following statements about ketorolac tromethamine (toradol) is not true?

    (A) 10 mg of ketorolac has the analgesic equivalent of 50 mg meperidine
    (B) 10 mg of ketorolac has the analgesic equivalent of 6 mg of morphine
    (C) Ketorolac is a cyclooxygenase inhibitor which has a half-life of about 3 hours
    (D) Bronchospasm is a contraindication to the use of ketorolac
    (E) Ketorolac may inhibit platelet aggregation and prolong bleeding time

15. K type (1995 Remembered) Landmarks for the sciatic nerve block include:

    (1) Posterior superior iliac spine
    (2) Iliac crest
    (3) Greater trochanter
    (4) Ischial tuberosity

16. single best answer (1993 Remembered) Eight cc's of 2.5% thiopental are injected inadvertantly into an arterial line. The patient complains of pain but the hand remains pink. Appropriate steps include:

    (A) administer sodium nitroprusside IV
    (B) papaverine intra-arterial
    (C) administer nitroglycerine IV
    (D) perform a stellate ganglion block
    (E) reassure the patient and take no action at present

17. single best answer (1995 Remembered) The following are signs of a venous air embolus:

    (A) rise in both end tidal carbon dioxide and end tidal nitrogen
    (B) fall in end tidal nitrogen and rise in end tidal carbon dioxide
    (C) fall in end tidal carbon dioxide with a rise in end tidal nitrogen
    (D) no change in end tidal nitrogen but a fall in end tidal carbon dioxide
    (E) no change in either end tidal nitrogen or end tidal carbon dioxide

18. K type (1995 Remembered) True of the celiac plexus and celiac plexus block:

    1. The celiac plexus is formed by the greater and lesser splanchnic nerves at L3
    2. The celiac plexus is located at L1
    3. One of the side effects is hypertension
    4. When performed with alcohol is one of the most definitive pain treatments for pancreatic cancer pain

19. K type (1995 Remembered) True of trigeminal neuralgia and its treatment

    (1) Is actually a neuralgia in the distribution of the occipital nerve
    (2) Is characterized by a dull, aching pain
    (3) Injection of steroids is most effective
    (4) Treatment is a block of the gasserian ganglion, located in the middle cranial fossa

20. K type (1995 Remembered) A patient with known type 1 von Willebrand's disease presents for emergency appendectomy. Which of the following could be used in management:

    (1) cryoprecipitate
    (2) DDAVP
    (3) FFP
    (4) factor VIII concentrate-Humate-P (virus deactivated)

Niels F. Jensen, M.D.
Anesthesiology Board PREP
Post-graduate Review and Educational Programs
The Best Medicine for Your Oral and Written Boards: Books-Courses
235 Lexington Avenue, Iowa City, Iowa 52246
800-321-PREP (7737) | 319-337-3700 | FAX: 319-341-9818
http://www.boardprep.com | email: njensen@anesthesiologyboards.com