最新麻醉多选题-有答案和详细解释

1. The duration of action of non-depolarizing neuromuscular blocking drugs may be prolonged by:(a)Amitriptyline.(b)Verapamil.(c)Hypothermia.(d)Hypercarbia.(e)Lidocaine.

2. Succinylcholine:(a)Causes a transient rise in blood pressure.(b)Is metabolized by acetylcholinesterase in the plasma.(c)Is antagonized by neostigmine.(d)Causes an exaggerated rise in serum potassium in renal failure patients.(e)Reduces the permeability of the nicotinic acetylcholine receptor to sodium.

3. Mivacurium:(a)Has a duration of action which may be increased in hepatic failure.(b)Is metabolized at 50% of the rate of succinylcholine.(c)Has active metabolites which accumulate during continuous infusion.(d)Causes at least as much histamine release as atracurium.(e) cis–cis and cis–trans isomers are more potent than the trans–trans isomer.

4. Cisatracurium:(a)Undergoes no urinary excretion.(b)Is metabolized primarily by Hofmann degradation.(c)Is a monoquaternary benzylisoquinolinium compound.(d)Has an onset of action that is slower than an equipotent dose of atracurium.(e)Produces more laudanosine than an equipotent dose of atracurium.

5. Rocuronium:(a)Is a bisquaternary aminosteroid compound.(b)Is more lipid-soluble than vecuronium.(c)Has a rapid onset of action because of its high potency.(d)Is excreted mainly into the bile and urine unchanged.(e)Has an ED95 dose of 0.6 mg kg-1.

6. The following are causes of direct maternal deaths:(a)Pulmonary embolus.(b)Suicide.(c)Haemorrhage.(d)Road traffic accident.(e)Failed intubation.

7. Regarding oxytocin:(a)It can cause severe hypertension.(b)It should always be administered as an intravenous infusion.(c)The best dose after delivery is 5 iu.(d)Administration should follow British National Formulary guidelines.(e)It should always be administered by an anaesthetist.

8. Regarding women with congenital heart disease:(a)They are at increased risk of direct maternal deaths.(b)They are at increased risk of indirect maternal deaths.(c)They should always be delivered in a cardiac centre.(d)They should always be delivered by Caesarean section, with a careful regional block being the technique of choice.(e)Regional techniques may be contraindicated.

9. Direct maternal deaths:(a)Are most commonly caused by anaesthetic complications.(b)Are most commonly caused by thromboembolism.(c)Are on the increase.(d)Are more common than indirect maternal deaths.(e)Can occur in early pregnancy.

10. Risk factors for maternal deaths include:(a)Obesity.(b)Twin pregnancy.(c)Women of Afro-Caribbean descent.(d)Women from anywhere outside the UK.(e)Delivery by Caesarean section.

11. Regarding the epidemiology of sepsis in children:(a)Adolescents have the highest incidence of sepsis.(b)The hospital mortality for children with severe sepsis is 30%.(c)The mortality of severe sepsis in adults is three times that in children.(d)Underlying disease states are rare in children presenting with sepsis.(e)Cardiac failure is the most common cause of death in children with severe sepsis.

12. Regarding the resuscitation of children with severe sepsis:(a)Aggressive early volume resuscitation is associated with improved outcome.(b)Aggressive early volume resuscitation is associated with the development of cerebral oedema.(c)Increments of 20 ml kg-1 should be used during initial resuscitation.(d)Children with meningococcal sepsis may need more than 150 ml kg-1 of fluid in the first 24 h after admission.(e)5% human albumin solution is routinely used for volume resuscitation in paediatric intensive-care units around the world.

13. Regarding the ongoing management of severe sepsis:(a)Oxygen delivery in sepsis is independent of haemoglobin concentration.(b)Reduced cardiac output is associated with mortality in paediatric septic shock.(c)Any measurement of cardiac output must be interpreted in the light of markers of global metabolic well-being, such as lactate concentration.(d)Achieving an oxygen consumption of more than 200 ml min-1 m-2 is associated with improved outcome.(e)The haemodynamic profile of septic children rarely changes during the first 48 h after presentation.

14. Regarding vasoactive drugs in sepsis:(a)Inotropic agents must never be started through a peripheral intravenous cannula.(b)Norepinephrine is a potent [beta]-adrenergic agonist with little [alpha]-adrenergic agonist effect.(c)Dopamine acts solely as a [beta]-adrenergic agonist.(d)Patients less than 12 months old may be resistant to dopamine.(e)Milrinone is a very short-acting drug.

15. Regarding adjunctive treatments in sepsis:(a)Activated protein C is the first anti-inflammatory agent that has been shown to be effective in the treatment of sepsis.(b)There is insufficient evidence to support the routine use of haemofiltration.(c)Tight glycaemic control improves the outcome of children with severe sepsis.(d)The aim of mechanical ventilation should be to normalize blood gases.(e)A recent meta-analysis has demonstrated a significant reduction in mortality among adult patients with sepsis treated with polyclonal immunoglobulin.

16. Compared with the anatomy of the lumbar epidural space, the thoracic epidural space:(a)Has less epidural contents.(b)Is narrower.(c)Is more likely to impede spread of local anaesthetic.(d)Contains less midline fibrous tissue.(e)Is more likely to be discontinuous in the midline.

17. Spread of local anaesthetics within the thoracic epidural space:(a)Is greater in the elderly.(b)Follows a linear relationship to dose.(c)Is similar for both high- and low-thoracic epidurals.(d)Should avoid the cardiac sympathetic innervation if possible.(e)Necessitates urinary catheterization.

18. Regarding the side-effects of thoracic epidural analgesia:(a)The degree of hypotension depends on the site of thoracic injection.(b)Hypotension after surgery is an indication to stop the epidural infusion.(c)Dural puncture is more common with higher insertion sites.(d)More than 1 in 20 patients suffer a technical complication.(e)Anastomotic dehiscence is no more common compared with pain relief using intravenous morphine.

19. Epidural anaesthesia and analgesia:(a)Allows earlier feeding after surgery.(b)Has no effect on postoperative nitrogen balance.(c)Reduces the incidence of nosocomial pneumonia.(d)Should be integral to a postoperative rehabilitation programme.(e)Has no impact on long-term functional outcomes.

20. Phantom pain:(a)After limb amputation has an incidence of 90%.(b)Can be exacerbated by spinal anaesthesia.(c)Occurs with the same frequency in both traumatically amputated limbs and in congenitally absent limbs.(d)Occurs only after limb amputation.(e)Is characteristically localized in the proximal area of the amputated limb.

21. Risk factors for phantom pain include:(a)Bilateral limb amputation.(b)Persistent stump pain.(c)Male gender.(d)Lower limb amputation.(e)Pre-amputation pain.

22. Treatment for phantom pain may include:(a)Preoperative epidural analgesia.(b)Provision of a well-fitting prosthesis.(c)Surgery.(d)Use of the mirror box, which has been successful in the treatment of spasms in the phantom hand.(e)Multimodal therapies.

23. Components of the alveolar gas equation (AGE) include:(a) PaO2.(b) PaCO2.(c) PACO2.(d) PICO2.(e) PIO2.

24. The AGE:(a)Only applies to steady-state conditions.(b)Always describes a linear relationship.(c)Is useful for determination of alveolar–arterial P O2 difference.(d)Uses Charles's law of partial pressures.(e)Shows that hypercapnia can cause a decrease in P AO2.

25. PaCO2:(a)Is increased by metabolic acidosis.(b)Is directly proportional to [latin capital V with dot above] A.(c)Is increased by increasing [latin capital V with dot above] O2.(d)May be halved by doubling [latin capital V with dot above] A.(e)Is reduced in uncomplicated carbon monoxide poisoning.

26. Which of the following statements are true?(a) P aO2 is inversely related to blood pH.(b) P AO2 is directly related to P aCO2 by the AGE.(c) P aO2 is linearly related to S aO2.(d)If P aCO2 increases while HCO3 remains unchanged, pH always increases.(e) P aCO2 approximately equals P ACO2.

27. A blood transfusion may lawfully be administered to:
(a) An adult Jehovah's Witness undergoing elective surgery if the anaesthetist feels it would be in the patient's best interests.
(b) An adult patient in an emergency whose Jehovah's Witness status is uncertain.
(c) An unconscious adult patient who is carrying an advance directive indicating his Jehovah's Witness status and refusing transfusion of blood products.
(d) A child of Jehovah's Witness parents for whom a specific issue order has been obtained.
(e) A child of Jehovah's Witness parents in an emergency.

28. The following may reduce intraoperative blood transfusion requirements:
(a)High starting packed cell volume.
(b)High percentage of hypochromatic red cells.
(c)High central venous pressure.
(d)High thoracic epidural.
(e)High-dose recombinant factor VIIa.

29. Desirable characteristics of a blood substitute include:
(a)Long shelf-life.
(b)Binding of nitric oxide.
(c)High oxygen affinity.
(d)Maintenance of buffering capacity.
(e)Maintains blood viscosity at 4 cP.

30. N-acetyl cysteine:
(a)Can be effective when given more than 36 h after paracetamol overdose.
(b)Has no role in non-paracetamol-induced liver failure.
(c)Should be discontinued after 72 h.
(d)May improve the microcirculation.
(e)Should only be given when results of paracetamol concentrations are available.

31. In acute liver failure:
(a)More than 30% of early deaths are caused by raised intracranial pressure.
(b)Deterioration of hepatic encephalopathy can be rapid and unpredictable.
(c)Haemodynamic changes are very similar to those in systemic sepsis.
(d)Cerebral blood flow autoregulation is lost.
(e)Hepatectomy may improve haemodynamic stability.

32. In the initial management of a patient with acute liver failure:
(a)Respiratory function is the most important consideration.
(b)Metabolic acidosis is an important prognostic indicator.
(c)The amount of sodium-containing fluids should be limited during resuscitation.
(d)The rate of progression of the syndrome can be easily predicted.
(e)Ventilation for transfer to a liver unit is rarely necessary.

33. Thoracic epidural analgesia:
(a)Is superior to patient-controlled analgesia for postoperative dynamic analgesia.
(b)Can be inserted safely in an anticoagulated patient.
(c)Provides optimal analgesia with opioid alone.
(d)Has a high incidence of associated respiratory depression when opioids are given.
(e)Can improve postoperative pulmonary function.

34. Postoperative pain:
(a)Is a contributory factor in postoperative myocardial ischaemia.
(b)Is adequately assessed using a verbal rating scale at rest.
(c)Can lead to chronic pain problems.
(d)Is actively managed mainly for humanitarian reasons.
(e)Is one of the major fears of surgical patients.

35. The stress response to surgery:
(a)Occurs mainly during operation.
(b)May be obtunded by high-dose opioids.
(c)Is completely eliminated by effective thoracic epidural analgesia.
(d)Is beneficial for postoperative recovery.
(e)Promotes postoperative catabolism.

36. Regarding vertebral canal haematoma:
(a)Neurological recovery is poor unless surgical evacuation is carried out within 8 h.
(b)Most cases are associated with spinal or epidural anaesthesia.
(c)Altered clotting status is found in most cases.
(d)Epidural catheter use is more risky than single-shot spinal techniques.
(e)It is best diagnosed with CT (computed tomography) scanning.

37. Regarding low-molecular-weight heparin:
(a)It must not be given if a patient has an epidural catheter in place.
(b)It has a longer half-life than unfractionated heparin.
(c)Most authorities would suggest at least 12 h should elapse after dosing before attempting central neuraxial block.
(d)It can be given 2 h after uneventful spinal or epidural block.
(e)It must be given before surgery to provide effective thromboprophylaxis.

38. Central neuraxial block:
(a)Is safe in patients on aspirin alone.
(b)Is contraindicated in fully anticoagulated patients.
(c)Should ideally be performed only when the INR (international normalized ratio) is less than 1.5 in patients on warfarin.
(d)Should ideally be avoided within 4 h of a dose of subcutaneous unfractionated heparin.
(e)Provides significant thromboprophylaxis.

39. The following are prognostic indicators of outcome after traumatic brain injury:
(a)Intracranial pressure.
(b)Glasgow Coma Score.
(c)Absence of cerebral autoregulation.
(d)End-tidal carbon dioxide partial pressure.
(e)Virginia prediction tree.

40. Basic head-injury management should always include the following:
(a)Core temperature maintenance at 34°C.
(b)Haemoglobin greater than 12 g dl-1.
(c)Blood glucose 4–8 mmol litre-1.
(d)Norepinephrine to maintain a mean arterial pressure of at least 90 mm Hg.
(e)Arterial carbon dioxide partial pressure of 3–3.5 kPa.
41. Methods available to control increased intracranial pressure include:
(a)Lumbar drainage of cerebrospinal fluid.
(b)Administration of mannitol.
(c)Bifrontal lobotomy.
(d)Thiopental administration.
(e)Nursing at 30° head up.

42. Concerning transfer of the patient with an isolated severe head injury:
(a)All devices around the neck should be removed to enhance cerebral venous drainage.
(b)All patients should have arterial and central venous lines sited prior to leaving the base hospital.
(c)Any anaesthetist could transfer a head-injured patient safely.
(d)All patients with a Glasgow Coma Score of less than 8 should have the airway secured with a tracheal tube before transfer.
(e)All transfers should be completed within 4 h of the initial referral.

43. A patient presenting with a Glasgow Coma Score of 3 may have the following findings on the CT scan:
(a)Small point contusion in the brain stem.
(b)Epidural haematoma.
(c)Intracerebral haemorrhage.
(d)Diffuse axonal injury.
(e)Open basal cisterns.

44. In a patient with burns, the amount of acute pain experienced:
(a)Is related but not directly proportional to the area of the burn.
(b)Is none or slight in burns in which a high percentage are full thickness.
(c)Can be reduced by cooling the burn with tap water.
(d)Is best treated with intramuscular opioids.
(e)May be influenced by psychological factors such as fear.

45. Burns dressings:
(a)Always require general anaesthesia.
(b)Can take 1–2 h in a major burn.
(c)Can be managed using intravenous sedation with midazolam alone.
(d)Are amenable to the use of ketamine, especially in children.
(e)May contribute to secondary hyperalgesia.

46. Rare, non-burn causes of pain in the burned patient may include:
(a)Colonic pseudo-obstruction.
(b)Heterotopic bone deposition.
(c)Compartment syndrome in a limb.
(d)Associated skeletal trauma.
(e)Donor site pain.

47. Carotid artery surgery:
(a)Is performed less frequently since the availability of improved angioplasty techniques.
(b)Is considered in all patients with symptoms.
(c)Is considered in all patients with >70% stenosis.
(d)Has a similar risk of perioperative stroke for all patients.
(e)Is frequently associated with significant blood loss.

48. Local anaesthesia for carotid surgery:
(a)Is preferred by the patient.
(b)Leads to a shorter hospital stay.
(c)Is associated with improved outcome.
(d)Does not require the presence of an anaesthetist.
(e)Reduces shunt insertion rate.

49. Deep cervical plexus block:
(a)May cause respiratory distress.
(b)Is inherently safer than other local anaesthetic techniques.
(c)Is more cardiovascularly stable than epidural techniques.
(d)Is never used in combination with other local blocks.
(e)Always produces a temporary facial nerve block.

50. The regulation of blood pressure:
a. Principally involves the arterial baroreceptors on a minute-to-minute basis.
b. Involves the renin–angiotensin–aldosterone but not the atrial natriuretic peptide system.
c. Includes the regulation of renin solely by the concentration of sodium in the distal tubule.
d. Is modulated by nitric oxide, a modulation that is impaired in hypertensive patients.
e. Involves sodium balance in the long term.

51. The pathophysiology of hypertension:
a. Necessarily includes an increase in both cardiac output and systemic vascular resistance.
b. Most of the time includes a degree of vascular remodelling.
c. Consistently includes a narrowing of the pulse pressure resulting from vascular remodelling.
d. Is contributed to by increased autonomic activity and resetting of baroreflexes.
e. Is not contributed to by changes in myoplasmic calcium in vascular smooth muscle.

52. The consequences of hypertension include:
a. Marked left ventricular dilatation.
b. Preserved systolic function until cardiac failure develops.
c. Impaired diastolic function.
d. Renal functional impairment as the most prominent complication.
e. Death attributable to coronary heart disease.

53. The long-term treatment of hypertension:
a. Is not indicated where only systolic pressure is elevated.
b. Reduces the risk on coronary but not cerebrovascular events.
c. Should include ACE inhibitors in diabetic patients.
d. Is much more effective with modern agents than with diuretics and [beta]-blockers.
e. Is not beneficial if blood pressure does not exceed 160/100 mm Hg.

54. Left ventricular hypertrophy as an ECG finding in the hypertensive patient:
a. Is always associated with increased perioperative risk.
b. Should be treated only with [beta]-adrenoceptor blockers preoperatively.
c. May be accompanied by evidence of left ventricular failure.
d. Is a strong indicator for the use of epidural rather than general anaesthesia.
e. Must involve exclusion of causes other than hypertension such as severe aortic regurgitation.

55. Propofol:
a. Has a faster onset-time for hypnosis than thiopental.
b. Has a longer context-sensitive half-time than fentanyl after a 1 h infusion.
c. Has a higher clearance than alfentanil.
d. Is suitable for infusions of long duration because it has a large volume of distribution at steady state.
e. Has a clearance that is greater than hepatic plasma flow.

56. Alfentanil:
a. Reaches steady-state more rapidly than fentanyl using a constant infusion rate.
b. Is less lipid soluble than fentanyl.
c. Has a faster onset-time than propofol because it has a lower pKa.
d. Has the same context-sensitive half-time after an infusion of 2 h as after an infusion of 6 h.
e. Administration can be through a commercially available target-controlled delivery device.

57. Concerning context-sensitive half-time:
a. It depends on the concentration of drug in plasma when the infusion is stopped.
b. It is the inverse of the rate constant for excretion times.
c. After two context-sensitive half-times the plasma concentration will be one quarter of its value at the end of infusion.
d. The context-sensitive half-time for alfentanil is always shorter than that for propofol.
e. It will increase linearly in proportion to the duration of infusion.

58. Regarding occlusion of an infusion:
a. The time from occlusion to the pump alarm sounding is always the same.
b. Pressure in the administration set should be reduced before releasing the occlusion.
c. An occlusion alarm will sound if the infusion has extravasated.
d. Maximum limits for occlusion alarm pressures should not be varied between patient groups.
e. Pumps may automatically reduce any post-occlusion bolus.

59. Before connecting an infusion device to a patient:
a. Syringe drivers with the syringe in place should always be purged.
b. The roller clamp on a volumetric pump infusion line should be fully opened after insertion into the device.
c. An infusion line with an anti-reflux valve will always be needed.
d. It is important to check whether a back-off facility precludes an anti-siphon valve.
e. The pump can be positioned up to 100 cm above the patient.

60. Regarding infusion devices:
a. Pumps in therapy category A are appropriate for neonates.
b. Several types of device should be available in each clinical area.
c. The majority of infusion errors is attributable to equipment faults.
d. Rates should always be set as ml h-1.
e. Drugs with a short half-life should be infused by therapy category B pumps.

61. Pathophysiological changes likely after brainstem death include:
a. Hypoglycaemia.
b. Pulmonary oedema.
c. Hyperkalaemia.
d. Hypothermia.
e. Elevation in circulating thyroid hormones.

62. Concerning the intensive care management of the potential organ donor:
a. The use of a pulmonary artery flotation catheter is contraindicated in cardiac donation.
b. Bronchoscopy should be avoided if lung donation is considered.
c. Clotting factor transfusion may be necessary.
d. Norepinephrine is the preferred ‘first line’ inotrope.
e. The FIO2 should be maintained at >=60%. The use of vasopressin as first line inotrope may reduce the need for norepinephrine

63. Hormone ‘resuscitation’ of the potential organ donor includes:
a. Intravenous T3.
b. Vasopressin.
c. ACTH.
d. Insulin.
e. Fludrocortisone.

64. Concerning the diagnosis of brainstem death in the UK:
a. The first case was described in 1959.
b. It is only necessary in the potential organ donor.
c. Time of death is declared after the second set of brainstem death tests.
d. Relatives are usually approached for organ donation after the second set of tests.
e. The organ donor register should be checked only if the relatives are considering donation.

65. The presence of the following conditions in a potential organ donor are absolute contraindications to donation:
a. Hepatic cirrhosis.
b. Hepatitis C.
c. Drug abuse.
d. Sepsis.
e. Cerebral glioma.

66. Concerning abdominal aortic aneurysms (AAA):
a. They are discovered during the investigation of other conditions in two-thirds of patients.
b. They are infrarenal in 90% of cases.
c. The incidence of rupture increases with aneurysm size.
d. They should be repaired when the maximum diameter exceeds 40 mm.
e. Most are suitable for endovascular repair.

67. Endovascular aneurysm repair (EVAR):
a. Can be performed when there is major ileodistal arterial disease.
b. Requires at least 10 mm of straight aorta above the aneurysm sac.
c. Results in fewer systemic complications compared with open repair.
d. Causes significant cardiovascular instability.
e. Can only be performed as an elective procedure.

68. The advantages of EVAR compared with open surgical repair include:
a. Shorter duration of operation.
b. Decreased length of hospital stay.
c. Decreased metabolic stress.
d. Less postoperative pain.
e. Less expensive.

69. The following physiological changes occur in normal pregnancy:
a. Progesterone increases the sensitivity of the respiratory centre to carbon dioxide.
b. Systemic vascular resistance is increased in trimesters I and II.
c. Central venous pressure increases.
d. Gastric emptying is delayed.
e. FRC decreases to 80% of pre-pregnancy values.

70. Concerning the Confidential Enquiry into Maternal Deaths 1997–1999:
a. Thrombosis and thromboembolism were the major direct causes of maternal death.
b. Anaesthesia accounted for 3% of direct maternal death.
c. All women undergoing caesarean section should receive prophylaxis against venous thromboembolism.
d. Deaths from amniotic fluid embolism have increased.
e. The rate of maternal deaths from sepsis is slowly decreasing.

71. In pregnant women with cardiac disease:
a. Chest x-ray is contraindicated.
b. Endocarditis accounts for 10% of cardiac deaths.
c. Pregnancy is absolutely contraindicated in primary pulmonary hypertension.
d. The foetus of the mother with congenital heart disease (CHD) has an increased risk of CHD.
e. Oxytocin increases systemic vascular resistance.

72. Concerning the sterilization of anaesthetic equipment:
a. Boiling in water for 15 min at atmospheric pressure kills bacteria and spores.
b. An autoclave pressure of 1 bar at a temperature of 120°C for 15 min will kill all living organisms.
c. Gluteraldehyde 2% has no sporicidal activity.
d. Ethylene oxide takes <1 h to be completely effective.
e. Gas plasma is a form of high-level disinfection.

73. With regard to decontamination procedures:
a. Cleaning of equipment after use is of little importance if the item is to be autoclaved.
b. High-level disinfectants have no sporicidal activity.
c. Manual methods are much more reliable than automatic methods.
d. Chemical indicators are used in sterile packs to confirm that the contents are sterile.
e. Biological indicators are used to help distinguish processed items from unprocessed packages.

74. Regarding the decontamination of flexible endoscopes:
a. Chlorine-releasing compounds are commonly used for disinfection.
b. Endoscopes are pressure tested before disinfection.
c. Ethylene oxide can be used to sterilize endoscopes.
d. Low-level disinfectants are acceptable.
e. They are stored vertically after use.

75. The following statements are correct:
a. Clonidine is an [alpha]-2 antagonist.
b. Fentanyl and sufentanil are equipotent.
c. Morphine is highly lipid soluble.
d. Intrathecal fentanyl may cause fetal bradycardia.
e. Intrathecal morphine can cause respiratory depression.

76. Concerning local anaesthetics:
a. They reduce impulse transmission by blocking extracellular sodium channels.
b. Levobupivacaine is an isomer of bupivacaine.
c. Ropivacaine is less cardiotoxic than bupivacaine.
d. Ropivacaine 0.2% and bupivacaine 0.1% are equipotent.
e. Bupivacaine is a single enantiomer.

77. Combined spinal–epidurals:
a. Are offered by 25% of obstetric units in the UK for labour analgesia.
b. Have been associated with case reports of meningitis.
c. May reduce accidental dural puncture rate when compared with conventional epidurals.
d. Produce less motor block compared with low dose infusion techniques.
e. May be associated with a longer learning curve when the needle-through-needle technique is used.

78. Epidural analgesia in labour is associated with:
a. Increased length of labour.
b. Decreased duration of second stage of labour.
c. Maternal pyrexia.
d. Early onset postpartum back pain.
e. Improved neonatal APGAR scores.

79. Concerning epidural analgesia in labour:
a. PCEA reduces the total local anaesthetic dose administered.
b. Mobile epidurals are associated with less motor block.
c. Low dose infusions decrease anaesthetic workload when compared with midwife epidural top-ups.
d. PCEA provides high maternal satisfaction rates.
e. The Bromage score can be used to assess motor block

80. Recognized features of hypovolaemic shock include:
a. Polyuria.
b. Tachycardia.
c. Warm peripheries.
d. Metabolic acidosis.
e. Hypertension.

81. Concerning CVP:
a. CVP can be used to assess volume status.
b. Fluid challenge in a hypovolaemic patient may result in a decrease in CVP.
c. Fluid challenge in a normovolaemic patient will result in a slight increase in CVP.
d. The measurement of CVP can be misleading in patients with normal hearts.
e. Central venous catheter insertion to measure CVP can be associated with significant complications.

82. Causes of extracellular volume depletion include:
a. Severe burns.
b. Capillary leak.
c. Glycine infusion.
d. Diarrhoea.
e. Leaking aortic aneurysm.

83. Concerning a fluid challenge:
a. There will be an increase in stroke volume in all patients responsive to fluid.
b. Crystalloid can be used instead of colloid by giving a larger volume.
c. The lower the blood volume the greater the CVP increase expected with a 200 ml bolus of colloid.
d. A fluid challenge is contraindicated in a patient with a CVP of 20 mm Hg.
e. A decrease in CVP in response to a 200 ml bolus of colloid should be followed by further colloid infusion.

84. A pneumoperitoneum of 10–20 mm Hg:
a. Reduces cardiac output.
b. Markedly reduces urine output.
c. Has no effect on functional residual capacity.
d. Decreases airway resistance.
e. Increases intracranial pressure.

85. Concerning the use of carbon dioxide for pneumoperitoneum:
a. It is used because its blood solubility is greater than air.
b. Capnography is a good measure of PaCO2 in all patients.
c. Nitrous oxide can be used instead of carbon dioxide for laparoscopic cholecystectomies to decrease peritoneal irritation.
d. Bradycardias occur because of direct effects of carbon dioxide.
e. Venous embolism requires insertion of a central line.

86. Concerning anaesthesia for laparoscopic sterilization:
a. It necessitates endotracheal intubation in all cases.
b. Nitrous oxide anaesthesia has no significant side-effects.
c. It requires long-acting opioids.
d. An epidural avoids shoulder-tip pain caused by peritoneal irritation.
e. There is a risk of endobronchial intubation.

87. Regarding oxygen kinetics:
a. [Latin capital letter D with dot above]O2 is the product of cadiac output and CaO2.
b. [Latin capital letter D with dot above]O2 can be measured directly from analysis of respiratory gases.
c. The normal O2ER is 0.2–0.3.
d. The normal O2ER for the heart is 0.6.
e. All forms of tissue hypoxia respond to increasing DO2.

88. Regarding the Hb concentration:
a. In vivo the oxygen combining capacity of Hb is 1.39 ml g-1.
b. The critical Hb concentration is that below which tissue hypoxia occurs.
c. The critical Hb concentration is ~50 g litre-1 in humans.
d. Current guidelines state that blood transfusion is not indicated above an Hb concentration of 70 g litre-1 for any patients.
e. The principal physiological response to anaemia is an increase in cardiac output, which is attributable to an increase in heart rate.

89. In the critically ill patient:
a. Hypoxia is defined as a PaO2 < 8 kPa.
b. Hyperlactataemia and acidaemia are specific indicators of tissue hypoxia.
c. Hypoxia is extremely unlikely if DO2 is normal.
d. Goal-directed therapy, aiming for a supra-normal DO2, is advocated in patients with multi-organ failure.
e. Oxygen supply dependency is almost always pathological.

90. Airway obstruction or apnoea is rare with the following sedation techniques:
a. Calming an infant with intranasal midazolam.
b. Nitrous oxide used for dentistry.
c. Rectal thiopental for painless imaging.
d. Low-dose propofol for painless imaging.
e. Intramuscular ketamine for wound care.

91. Children differ from adults as follows:
a. Cooperation is unusual.
b. Respiratory depression is more common.
c. Recovery is more predictable.
d. Sedation can persuade adults to cooperate.
e. Sleep is more easily achieved for non-painful procedures.

92. The following are contraindications to sedation in children by non-anaesthetists:
a. Cyanotic heart disease.
b. Tracheostomy.
c. High intracranial pressure.
d. A Grand Mal convulsion with 24 h.
e. A runny nose.

93. The following have a high success rate:
a. Behavioural techniques for dental extractions.
b. Chloral hydrate for lumbar puncture.
c. Oral midazolam for MRI scanning.
d. Intramuscular ketamine for wound care.
e. Nitrous oxide for lumbar puncture.

94. Common complications of sedation include:
a. Vomiting with triclofos.
b. Paradoxical reactions with midazolam.
c. Hallucinations with ketamine.
d. Severe respiratory depression with choral hydrate.
e. Airway obstruction during ‘deep’ sedation for oesophagogastroscopy.

95. An anaphylactic reaction:
a. Is a predictable adverse drug reaction.
b. Is a Type I hypersensitivity reaction.
c. Involves the production of IgG antibodies after exposure to the antigen.
d. Can be clinically identical to an anaphylactoid reaction.
e. Affects females more than males.

96. Concerning anaphylaxis:
a. Undiluted epinephrine (adrenaline) 0.5–1 mg should be given i.v. as part of immediate management.
b. Desaturation is the commonest first clinical feature.
c. The most common drugs to cause it are the induction agents.
d. The anaphylactic reaction often begins 30–60 min after the start of the anaesthetic.
e. The estimated mortality is 25%.

97. When investigating the reaction:
a. The anaesthetist should perform skin prick tests once the reaction has stabilized.
b. Specific IgE antibodies for succinylcholine can be assayed.
c. The anaesthetist who administered the drug is responsible for reporting the reaction on a ‘Yellow Card’.
d. Previous history of drug exposure does not seem necessary especially with neuromuscular blocking drugs.
e. Screening for anaphylaxis is of use clinically.

98. Tryptase:
a. Concentrations increase after both anaphylactic and anaphylactoid reactions.
b. Blood samples can be stored at 4°C for up to 48 h.
c. Maximum concentrations in the blood occur within 20 min of a reaction.
d. A serum concentration of 10 ng ml-1 implies that no reaction occurred.
e. Is stored equally in mast cells, red cells and white cells.

99. Hypertension in surgical patients:
a. Is associated with cardiovascular instability for both pressure and heart rate.
b. Increases the risk of hypertensive crises in response to stimuli.
c. May contribute to increased postoperative cardiac morbidity, but not mortality.
d. Can be ignored if it is purely systolic.
e. Should be treated preoperatively if >180/110 mm Hg on more than two occasions.

100. The anaesthetic management of hypertensive patients should:
a. Be decided exclusively on the blood pressure.
b. Include a thorough investigations of target organ involvement.
c. Disregard ‘white coat’ hypertension as irrelevant.
d. Include measurement of more than one blood pressure before the patient presents for surgery.
e. Involve the use of balanced anaesthesia.

101. The preoperative evaluation should include:
a. The search for evidence of secondary hypertension.
b. The rapid, i.v. correction of hypokalaemia where present.
c. A detailed examination of the patients on-going medication with a view to replacing diuretics and [beta]-blockers by ACE inhibitors.
d. The introduction of rapidly active antihypertensive agents with a view to proceeding with elective surgery on the next day.
e. Consideration of extended monitoring in case of left ventricular hypertrophy and strain.

102. The haemodynamic responses of hypertensive patients to anaesthesia and surgery are characterized by:
a. Exaggerated hypo- and hypertension in response to vasoactive drugs.
b. Hypertension after laryngoscopy that is suppressed by local anaesthesia.
c. Bradycardia in response to laryngoscopy and intubation.
d. Excessive hypotension in patients chronically treated with [beta]-blockers.
e. Greater stability if the antihypertensive medication is continued.

103. Hypertensive crises during anaesthesia, surgery, and recovery:
a. Are never associated with myocardial damage.
b. Can always be controlled by sublingual nifedipine.
c. Require treatment based on associated clinical features such as tachycardia and myocardial ischaemia.
d. Can cause an haemorrhagic but not ischaemic stroke.
e. Only occur in patients with diastolic hypertension.

104. There is increased secretion of the following hormone in response to major surgery:
a. Arginine vasopressin.
b. Norepinephrine.
c. Thyroxine.
d. Testosterone.
e. Renin.

105. Protein catabolism is promoted by:
a. Cortisol.
b. Growth hormone.
c. Insulin-like growth factor-I.
d. Insulin.
e. Glutamine.

106. The acute phase response includes:
a. Hypothermia.
b. Decreased plasma albumin.
c. Hepatic sequestration of copper.
d. Increased C-reactive protein.
e. Neutrophil leucocytosis.

107. The increased risk of local anaesthetic toxicity in neonates:
a. Applies to amethocaine gel.
b. Is partly attributable to reduced hepatic clearance of amide local anaesthetic agents.
c. Is further increased in the presence of a left-to-right intra-cardiac shunt.
d. Is due to increased protein binding capacity in neonates.
e. Is ameliorated by concurrent general anaesthesia.

108. Concerning local anaesthetic techniques in infants:
a. The neonatal spinal cord terminates at the level S3/4.
b. An 18G epidural needle is an appropriate size for a 5 kg baby.
c. Awake subarachnoid block is useful for long operations.
d. Injecting local anaesthetic slowly has no advantages.
e. A test dose of local anaesthetic is useful.

109. Peripheral nerve block in infants:
a. Is safer than central block.
b. Is less efficacious than central block.
c. Needs a higher dose of local anaesthetic.
d. Does not produce motor block.
e. Does not require the use of a nerve stimulator.

110. Concerning epidural anaesthesia in infants:
a. The younger the child, the lower should be the approach to accessing the epidural space.
b. Epidural catheter techniques can be used in the septic infant.
c. Thoracic epidural blocks need a lower dose of local anaesthetic.
d. Additives such as clonidine are unsafe in neonates.
e. The commonest serious adverse effect is site infection.

111. Concerning subarachnoid block in infants:
a. It can safely be performed in the conscious neonate.
b. Is contraindicated in the presence of severe respiratory disease.
c. A relatively large volume of local anaesthetic per kg is needed when compared with an adult.
d. Causes hypotension in neonates.
e. Has a more rapid onset and shorter duration of anaesthesia than a caudal epidural block.

112. Concerning hypnotic agents in obese patients:
a. Propofol accumulates more in obese patients owing to its lipophilic properties.
b. In a TCI system using Marsh kinetics, TBW has to be used.
c. Induction dose of propofol is better calculated on IBW rather then on TBW.
d. Maintenance dose of propofol can be calculated on TBW.
e. Midazolam initial and continuous dosage can be safely calculated from TBW.

113. Concerning neuromuscular blocking agents in obese patients:
a. Rapid sequence induction is still considered standard.
b. Succinylcholine should be calculated on LBM.
c. When avoiding the use of succinylcholine, rocuronium 0.9 mg kg-1 TBW is a good alternative.
d. Mivacurium can be calculated on TBW.
e. Rocuronium should be avoided because of reports of anaphylactic reactions.

114. Concerning volatile agents in obese patients:
a. MAC values have to be adjusted according to age, body temperature and body weight in obese patients.
b. Sevoflurane will give rise to higher fluoride concentrations in morbidly obese patients and should be avoided.
c. Patients with the metabolic syndrome should not receive desflurane because of the risk of hepatitis.
d. Isoflurane has less organ toxicity compared with halothane and enflurane and is a better choice in morbidly obese patients.
e. Because of its lack of metabolism and a low fat solubility, nitrous oxide is useful in obese patients.

115. When resuscitating severely head-injured patients:
a. Securing the airway is important because >60% of spontaneously breathing patients may hypoxaemic.
b. The combination of hypoxaemia and hypotension doubles mortality.
c. GCS <12 and an unstable cervical spine fracture are indications for endotracheal intubation.
d. A CT scan must be performed immediately to diagnose and evacuate haematomas.
e. Fluid restriction of 2 litre is mandatory in order to minimize cerebral oedema.

116. When treating long bone fractures in patients who have sustained a severe head injury:
a. Early fixation may be associated with improved outcome.
b. Early fixation of fractures may be detrimental if associated with large blood loss and prolonged resuscitation.
c. For delayed fixation, most suitable time for surgery is within 48 h after the injury.
d. Secondary brain insults are less frequent when lower limb tourniquets are used.
e. In those patients with significant brain lesions, intracranial pressure monitoring may reduce the incidence of cerebral hypoperfusion.

117. In patients who have suffered multiple injuries:
a. Outcome is significantly worse when the injuries are associated with a head injury.
b. Intracranial lesions must be excluded when there is persistent hypotension despite fluid resuscitation.
c. Succinylcholine is best avoided because of its effect on intracranial pressure.
d. Fluid resuscitation with glucose-containing solutions may produce hypothermia, which should not be treated as it is beneficial for cerebral protection.
e. Urine output is a poor indicator of fluid status and cardiac output because the patients may have received mannitol.

118. The following physiological changes occur when a patient is placed in the prone position:
a. Reduction of intracranial pressure.
b. Minimal effect on intraocular pressure if head position is optimal.
c. Improved oxygenation in all patients.
d. Increase in functional residual capacity.
e. Reduced stroke volume.

119. Perioperative ulnar neuropathy:
a. Is more common in women.
b. Is often associated with an associated contralateral clinical neuropathy.
c. Will usually present within 24 h.
d. In >50% of patients the cause is found to be excess external pressure.
e. Was associated with the use of trichloroethylene.

120. The Trendelenburg position:
a. Always improves cardiovascular parameters in hypovolaemia patients.
b. Results in a net increase in central blood volume of >20%.
c. Was first described by Willy Meher in 1881.
d. Classically requires a 45° head down tilt.
e. May result in brachial plexus injuries.

121. The following factors are associated with an increased risk of eye injury under anaesthesia:
a. Duration of anaesthesia >4 h.
b. Male.
c. ASA III–IV.
d. Operations performed on a Monday.
e. Lateral position.

122. Compartment syndrome in the lithotomy position:
a. Is not present if a pedal pulse is present.
b. Is present if the difference between diastolic pressure and compartment pressure is <30 mm Hg.
c. Occurs in ~1 in 8500 anaesthetics.
d. Is associated with the use of intermittent calf compression stockings.
e. Is associated with prolonged anaesthetics.

123. Neostigmine:
a. Exerts a direct action on the neuromuscular junction causing skeletal muscle contraction.
b. Causes mydriasis.
c. Causes bronchodilatation and an increase in physiological dead space.
d. Causes a decrease in cardiac output.
e. Crosses the blood–brain barrier easily.

124. Concerning the anticholinergic agents:
a. Atropine and glycopyrronium have no effect on nicotinic receptors.
b. They block the muscarinic receptors competitively.
c. Central anticholinergic syndrome can be antagonized using neostigmine.
d. They can precipitate urinary retention.
e. They enhance gastric emptying and increase lower oesophageal sphincter tone.

125. The following statements are true:
a. Acetylcholinesterase is found in erythrocytes.
b. Remifentanil is mainly metabolized by butyrylcholinesterase.
c. Neostigmine binds to the esteratic site of acetylcholinesterase.
d. Butyrylcholinesterase metabolizes diamorphine.
e. Acetylcholine is hydrolysed by acetylcholinesterase, releasing acetic acid and choline.

126. Edrophonium:
a. Is more potent than neostigmine.
b. Has a brief duration of action compared with neostigmine.
c. Is the treatment of choice in a cholinergic crisis in myasthenia gravis.
d. Inhibits plasma cholinesterase in addition to acetylcholinesterase.
e. Has a more rapid onset of action than neostigmine.

127. Concerning poisoning by nerve agents in chemical warfare:
a. Pyridostigmine is used as preventive treatment.
b. The initial cholinergic phase lasts 24–48 h.
c. Non-depolarizing neuromuscular blocking agents may have a protective effect on the nicotinic receptors at the neuromuscular junction.
d. Magnesium may be used as it increases presynaptic acetylcholine release.
e. Pralidoxime can cause laryngospasm and muscle rigidity.

128. Glycoprotein IIb/IIIa inhibitors:
I. Reduce platelet aggregation.
II. Improve outcome with thrombolysis.
III. Reduce the risk of non-fatal MI in NSTEMI patients undergoing coronary angioplasty.
IV. Can only be administered on a single occasion to any patient.
V. Need to be reversed before major surgery.

129. The troponins:
I. Have a greater sensitivity than CK-MB in diagnosis of MI.
II. May be detected in serum 5 days after infarction.
III. When detected in serum invariably reflect irreparable myocardial damage.
IV. Will be significantly elevated in serum within 1 h of MI.
V. Have a prognostic role in critical illness.

130. Regarding reperfusion therapy:
I. rt-PA is invariably superior to streptokinase.
II. Thrombolysis is indicated within 24 h of presentation.
III. PTCA is only indicated in STEMI.
IV. PTCA is a superior treatment to thrombolysis in STEMI.
V. PTCA is contraindicated in cardiogenic shock.

131. The following are currently recommended therapies in the treatment of unstable angina:
I. Aspirin.
II. Atenolol.
III. Low molecular weight heparin.
IV. Streptokinase.
V. CABG.

132. In the diagnosis of MI:
I. Echocardiography has a role.
II. New left bundle branch block on the ECG confirms acute infarction.
III. A typical history of ischaemic pain is required.
IV. The ECG must show ST-segment elevation.
V. The size of the infarction can be judged from the cumulative enzyme release.

133. G-protein-coupled receptors:
I. Are located in the nucleus.
II. Are composed of three subunits: [alpha], [beta] and [gamma].
III. Can modulate ion channel activity.
IV. Are involved in cardiac contraction.
V. Show a high degree of homology to ligand-gated ion channels.

134. Naloxone:
I. Is a non-competitive opioid antagonist.
II. Could theoretically produce a pain response.
III. Displays mixed agonist–antagonist pharmacology.
IV. Shifts the dose response curve to morphine parallel to the right with no change in maximum.
V. Can reverse the effects of opioid partial agonists.

135. Concerning agonists and antagonists:
I. KD is a measure of agonist efficacy.
II. Efficacy is the dose range over which a response is produced.
III. EC50 is a measure of agonist potency.
IV. Potency is the strength or size of a response produced.
V. A partial agonist can be described as having negative efficacy.

136. During high intensity exercise, predominant sources of ATP in the first minute of exercise are:
I. Phosphocreatine.
II. Lactate.
III. Glycogen.
IV. Fatty acids.
V. Amino acids.

137. Type II muscle fibres are associated with:
I. Rapid speed of contraction.
II. Rich blood supply.
III. High levels of myoglobin.
IV. White colouration.
V. Low levels of oxidative enzymes.

138. During very strenuous exercise:
I. Oxygen consumption increases about 100 times above resting oxygen consumption.
II. Increase in ventilation is attributable to changes in arterial concentrations of oxygen and carbon dioxide.
III. Heart rate is a limiting factor in the delivery of oxygen.
IV. Stroke volume is a limiting factor in the delivery of oxygen.
V. Blood flow to muscle is 500–1000 ml•100 g muscle-1 min-1.

139. The following are indications for awake craniotomy:
I. Posterior fossa lesions.
II. Stereotactic biopsy.
III. Tumours involving eloquent areas of brain.
IV. Tumours with significant dural involvement.
V. Confused or disorientated patient.

140. During awake craniotomy:
I. Sedative premedication should be prescribed to alleviate anxiety.
II. The patient should use ear plugs to shield them from unwanted noise.
III. Placement of a urinary catheter is contraindicated.
IV. Anticonvulsant drugs should be stopped preoperatively in patients undergoing awake epilepsy surgery.
V. Patients should be allowed to position themselves on the operating table.

141. In relation to local anaesthetic techniques during awake craniotomy:
I. Local anaesthesia is optional during mini-craniotomy or stereotactic biopsy.
II. Cutaneous nerves arising from the trigeminal nerve innervates all outer layers of the skull.
III. Drilling the skull is the most painful part of the procedure.
IV. Epinephrine containing local anaesthetics can be safely used throughout the procedure.
V. The dura can be adequately anaesthetized by local anaesthesia placed around the middle meningeal artery.

142. In relation to the provision of sedation during awake craniotomy:
I. [alpha]2-Adrenoreceptor agonists are a useful adjunct.
II. Patient-controlled sedation with propofol produces less respiratory depression than other techniques.
III. Propofol and remifentanil infusion is the sedative regimen of choice.
IV. Airway control is not problematic if low dose sedation is employed.
V. BIS monitoring is widely used to improve safety.

143. Complications of awake craniotomy include:
I. Frequent need to convert to general anaesthesia because of intolerance of the awake procedure.
II. Intraoperative seizures.
III. Hypoxaemia.
IV. Brain swelling.
V. Diabetes insipidus.

144. TURP syndrome:
I. Is more likely if 2000 ml of the irrigation fluid is absorbed.
II. Is not related to the duration of surgery.
III. Is often recognizable by the onset of confusion.
IV. May be reduced by blood pressure within normal values.
V. Is safely treated with hypertonic saline.
145. Concerning cataract surgery:
I. It is increasing because of the ‘ageing’ population.
II. It is associated with marked postoperative pain.
III. It can be performed under general anaesthesia in 20% of cases.
IV. Regional anaesthesia is with needle techniques in most instances.
V. Cognitive dysfunction is a relative contraindication to a regional technique.

146. Concerning regional anaesthesia in the elderly:
I. Ephedrine is effective in treating hypotension.
II. Volume loading up to 8 ml kg-1 is useful in preventing hypotension.
III. It conveys long-term advantages compared with general anaesthesia.
IV. The elderly have a reduced incidence of post-dural puncture headache allowing larger spinal needles to be used.
V. The use of sedation may negate the benefits of regional anaesthesia on postoperative cognitive dysfunction.

147. Concerning anaesthetic drugs and the elderly:
I. Reduced doses of neuromuscular drugs are required owing to reduced muscle mass.
II. MAC values of inhalational drugs are reduced by 20–40%.
III. The uptake of sevoflurane in the elderly is similar to younger adults owing to its low blood-gas solubility.
IV. Atropine is likely to produce a greater increase in heart rate compared with younger patients.
V. Lipophilic drugs such as opioids and i.v. agents exhibit a prolonged duration of action owing to an increase in the t1/2[beta] elimination half-life.

148. In the elderly:
I. Serum urea and creatinine concentrations within normal limits rule out renal dysfunction.
II. Shivering may be ineffective at restoring body temperature owing to reduced muscle mass.
III. The oxygen demand created by shivering is unlikely to cause cardiorespiratory complications owing to insufficient muscle bulk.
IV. Regurgitation of stomach contents is more likely owing to autonomic dysfunction.
V. [beta]-Receptor sensitivity is reduced, resulting in a reduction in response to exogenous [beta]-agonists.

149. Controlled conventional ventilation using peak inspiratory pressures of 14 cm H2O and a PEEP of 4 cm H2O in the anaesthetized normovolaemic patient with pre-existing normal lungs induces the following pulmonary changes:
I. Activation of the inflammatory cascade.
II. A reduction in cardiac output.
III. Volutrauma.
IV. Shear force barotrauma damage.
V. A decrease in oxidative stress.

150. Safe ventilatory practice in homogeneous lungs:
I. Does not take normal alveoli beyond their elastic limit.
II. Requires PEEP to be at or below the lower inflection point.
III. Limits tidal volume.
IV. Promotes cyclical derecruitment.
V. Maximizes the opening of recruitable alveoli.

151. High frequency oscillatory ventilation:
I. Uses an oscillatory wave to generate tidal movement above dead-space.
II. May create stable inflation of alveoli.
III. Is less useful in homogeneous pathologies than conventional ventilation.
IV. Is best used as a rescue therapy.
V. Always requires heavy sedation or neuromuscular blockade.

152. Antioxidants:
I. Are depleted in critical illness.
II. Are a component of surfactant.
III. Prevent free radical damage.
IV. Promote oxidative stress.
V. Are not normally found in the lungs.

153. Nitric oxide:
I. Relaxes vascular and smooth muscle by stimulating production of cAMP.
II. Has marked selective pulmonary vascular effects.
III. May increase SaO2 in the absence of pulmonary hypertension.
IV. Rarely improves oxygenation in neonates with severe neonatal pulmonary hypertension.
V. Rarely induces tolerance to its effects.

154. Post-traumatic stress disorder:
I. Is associated with fatigue 6 months after ICU discharge.
II. Is an abnormal reaction to severe stress.
III. Is seen in ~30% of patients during ICU follow-up.
IV. Is more common in those patients with factual memories of their ICU stay.
V. Can lead to a chronic anxiety state.

155. The following drugs may lead to erectile dysfunction:
I. Atenolol.
II. Amiodarone.
III. Haloperidol.
IV. Silendafil.
V. Amitriptyline.

156. Concerning patients treated in ICU:
I. Tracheal stenosis is a relatively common complication following tracheostomy.
II. Tracheal stenosis can be diagnosed on lung function testing.
III. Surgical correction of poor cosmetic appearance of the tracheostomy scar can be performed under local anaesthetic.
IV. Most patients have some structured memory of their ICU stay.
V. The use of gelatin based fluid resuscitation on the ICU may lead to a delayed severe pruritus.

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