Portal Chunk 12

A) 47 mmHg

B) 103 mmHg

C) 28 mmHg

D) 75 mmHg

A) Intravenous dexamethasone 8 mg

B) Moderate hyperventilation to a PaCO2 of 4.0 kPa

C) Intravenous labetalol to lower MAP

D) Trendelenburg positioning

A) Sevoflurane

B) Isoflurane

C) Halothane

D) Desflurane

A) Cytotoxic oedema

B) Osmotic oedema

C) Vasogenic oedema

D) Hydrostatic oedema

A) Malignant hyperthermia

B) Cushing reflex from critically raised ICP

C) Autonomic dysreflexia from spinal cord injury

D) Adverse reaction to neostigmine

A) 280 mOsm/kg

B) 300 mOsm/kg

C) 320 mOsm/kg

D) 340 mOsm/kg

A) Frusemide 40 mg intravenously

B) Hypertonic saline (3%)

C) Dexamethasone 16 mg intravenously

D) Acetazolamide orally

A) Intraoperative awareness

B) Venous air embolism

C) Hyperkalaemia from blood transfusion

D) Laryngospasm on emergence

A) Ketamine 2 mg/kg intravenously

B) Thiopental 4-5 mg/kg intravenously

C) Propofol 2-2.5 mg/kg with suxamethonium

D) Etomidate 0.3 mg/kg with suxamethonium

A) It is preserved at all MAPs in patients with chronic hypertension

B) It is abolished by all volatile anaesthetic agents regardless of dose

C) It maintains constant CBF between a MAP of approximately 50-150 mmHg in healthy adults

D) It depends primarily on the renin-angiotensin system

A) It reduces ICP through inhibition of NMDA receptors

B) It has no effect on ICP as it is insoluble in blood

C) It increases CBF and ICP; it should be avoided or used cautiously in intracranial hypertension

D) It reduces ICP by causing systemic hypotension

A) 0-5 mmHg

B) 5-15 mmHg

C) 15-25 mmHg

D) 25-35 mmHg

A) Hypoxia causes cerebral vasoconstriction to redirect blood to vital organs

B) Cerebral blood flow remains unchanged until PaO2 falls below 6 kPa, then rises sharply

C) Hypoxia has no direct effect on cerebral vasomotor tone

D) PaO2 below 8 kPa causes a linear reduction in CBF

A) Endobronchial intubation

B) Pulmonary embolism from thrombosis

C) Venous air embolism causing increased dead space

D) Anaesthetic circuit disconnection

A) High-dose volatile anaesthetic with no opioid

B) Total intravenous anaesthesia (TIVA) with propofol and remifentanil

C) Nitrous oxide plus isoflurane at 1 MAC

D) Ketamine alone as the primary anaesthetic agent

A) Vitamin K 10 mg intravenously alone

B) Fresh frozen plasma 15 mL/kg alone

C) Prothrombin complex concentrate (PCC) with intravenous vitamin K

D) Cryoprecipitate 10 units intravenously

A) Reducing cerebral metabolic rate

B) Facilitating venous drainage from the cranial compartment

C) Increasing systemic vascular resistance

D) Reducing CSF production by the choroid plexus

A) Brain tissue unusually firm due to calcification

B) Cerebral swelling with herniation through the craniotomy, preventing adequate surgical exposure

C) Spasm of cerebral vessels following subarachnoid haemorrhage

D) Excessive CSF production causing hydrocephalus during surgery

A) Convert to general anaesthesia immediately

B) Administer propofol infusion to achieve light sedation and reassure the patient verbally

C) Administer suxamethonium to immobilise the patient

D) Abandon the procedure and close the craniotomy

A) Administer atropine 0.6 mg intravenously

B) Ask the surgeon to pause manipulation and reassess haemodynamics

C) Increase the volatile anaesthetic concentration

D) Administer metaraminol to further raise MAP