id
stringlengths
36
36
question
stringlengths
8
990
A
stringlengths
1
284
B
stringlengths
1
250
C
stringlengths
1
278
D
stringlengths
1
297
choice_num
int64
2
9
target
stringclasses
6 values
category
int64
1
3
E
stringlengths
1
604
F
stringclasses
14 values
G
stringclasses
3 values
H
stringclasses
3 values
I
stringclasses
1 value
0a9092c4-cc37-5fdd-b315-594dff5c5a46
Which of the following causes an increase in the ionized calcium concentration?
Increased serum albumin
Alkalosis
Transfusion of fresh frozen plasma
Acidosis
4
D
1
null
null
null
null
null
52342534-652b-5339-990b-8b89e2316044
Which of the following statements is true regarding the preoperative preparation for a patient with pheochromocytoma?
Selective α1 -blockers have a longer duration of action compared with phenoxybenzamine.
β-Blockade should be initiated before α-blockade.
Calcium channel blockers are contraindicated in patients with pheochromocytoma.
The primary side effect of phenoxybenzamine is orthostatic hypotension.
4
D
1
null
null
null
null
null
1b5ebcb5-efa9-5727-ab41-899046f7d0fb
Which of the following steroids lacks mineralocorticoid activity?
Hydrocortisone
Dexamethasone
Methylprednisolone
Prednisone
4
B
1
null
null
null
null
null
423f2d0d-10b9-5550-b416-2050b7df9030
19. In which of the following patients is stress dose steroid administration
A 67-year-old man on prednisone 10 mg daily for 5 days for chronic obstructive pulmonary disease exacerbation presenting for laparoscopic cholecystectomy
A 40-year-old woman on prednisone 2.5 mg daily for 6 years for systemic lupus erythematosus presenting for total knee arthroplasty
A 23-year-old man on prednisone 20 mg daily for ulcerative colitis presenting for subtotal colectomy
A 56-year-old woman on prednisone 40 mg daily for rheumatoid arthritis presenting for superficial lymph node biopsy
4
C
2
null
null
null
null
null
c1283ad7-42cd-55da-ab63-1adf7cdf3a78
Which of the following correctly describes a physiologic effect of glucocorticoids?
Increase in eosinophils and basophils
Decreased protein catabolism
Sensitization to insulin
Promotion of gluconeogenesis
4
D
1
null
null
null
null
null
27f4d8a9-d0d4-5e5e-a5f3-cc08fd1a6248
Which of the following characteristics is most consistent with nonketotic hyperosmolar coma?
Metabolic acidosis
Hypokalemia
Skeletal muscle weakness
Profound hyperglycemia >600 mg/dL
4
D
1
null
null
null
null
null
65b1d2cd-e0e6-53f2-a9f3-190a5a4852f0
Long-term type 1 diabetes is associated with which of the following anesthetic complications?
Malignant hyperthermia
Difficult airway
Pseudocholinesterase deficiency
Anaphylaxis to local anesthetics
4
B
1
null
null
null
null
null
66052a1c-f3fe-5c08-bede-5a36c94008f3
Which of the following statements is true of glucose metabolism in the perioperative period?
Glucagon levels are decreased.
Blood glucose levels in nondiabetic patients may rise as much as 60 mg/dL.
Catecholamines inhibit gluconeogenesis.
ACTH levels are decreased.
4
B
1
null
null
null
null
null
32574c1c-4ccb-5b4f-b438-c38efefc3d07
In which of the following scenarios is it acceptable to administer metformin therapy?
The night before elective surgery
In the presence of NYHA class II heart failure
The morning a patient will undergo CT scan with IV contrast
In a patient with pyelonephritis who remains normotensive
4
A
1
null
null
null
null
null
97552047-84fc-58a6-9eec-987f550e94b4
Which of the following statements is true regarding the cardiac risk in patients with diabetes mellitus?
Diabetic patients reliably present with classic angina symptoms in the setting of acute myocardial infarction.
Aspirin therapy is recommended for diabetic patients in the absence of known coronary disease.
Routine stress testing is indicated for all diabetic patients to identify silent ischemia.
ACE inhibitors should be avoided in diabetes because they are at risk of diabetic nephropathy.
4
B
1
null
null
null
null
null
557a70cc-1b04-5e62-bafd-a55444698b05
The process of glycolysis converts glucose into what molecule?
NADPH
Acetyl-CoA
Pyruvate
Lactate
4
C
1
null
null
null
null
null
4bd79704-403b-5c05-a7ac-77885f031c2e
27. Which molecule is common to carbohydrate, lipid, and amino acid metabolism and does directly enter the Krebs cycle for further metabolism?
Acetyl-CoA
Pyruvate
Citrate
Succinyl-CoA
4
A
1
null
null
null
null
null
3fb44b19-d1f1-554b-bdb6-1d08ac1988d5
Which of the following molecules accelerates the Krebs cycle via activation of pyruvate dehydrogenase phosphatase?
Citrate
ATP
NADH
Calcium
4
D
1
null
null
null
null
null
3d82c877-f973-5c93-8c17-521d663e2eb2
Which of the following is the final acceptor of electrons in the electron transport chain?
NADH
NAD+
Oxygen
FADH+
4
C
1
null
null
null
null
null
97cf3577-fecc-502d-b53c-758b27b77616
Which of the following organs is/are responsible for gluconeogenesis?
Liver only
Kidney only
Brain
Liver and kidney
4
D
1
null
null
null
null
null
9454e8ce-f874-52fe-833a-13e5ed9f6658
Which of the following is the mechanism of action of simvastatin in lowering lipid levels?
Prevention of intestinal absorption of triacylglycerides (TAGs)
HMG-CoA reductase inhibition
PCSK9 inhibition
Upregulation of β-oxidation of fatty acids
4
B
1
null
null
null
null
null
5280a74b-c7d3-5e69-b08a-6a202ee89b2c
Which of the following is true of lipid digestion?
Cholecystokinin speeds gastric motility.
TAGs are absorbed unchanged in the small intestine.
Emulsification of lipids occurs primarily in the small intestine.
Lipids diffuse into enterocytes unchanged because of their water solubility.
4
C
1
null
null
null
null
null
08ab5d85-c1b3-54da-8e0b-7a967dcf1db2
Patients with pancreatic exocrine insufficiency are at risk for which vitamin deficiency?
Thiamine
Pyridoxine
Vitamin B12
Vitamin D
4
D
1
null
null
null
null
null
bfbc5d3d-9d6e-53d2-a0e0-1bbf5c40884f
Which of the following statements is true with regard to lipid metabolism in the liver?
The liver may package TAGs into very-low-density lipoproteins for transport to other tissues.
The liver can extract energy from ketones via ketoacyl-CoA transferase.
Insulin activates β-oxidation of fatty acids in the liver.
When there is a deficiency in glycogen, the liver converts glucose to TAGs for storage.
4
A
1
null
null
null
null
null
438c91a2-4cc8-5e9d-ae32-bec01b44c50b
35. Which organ is unable to utilize fatty acid oxidation in times of starvation and thus relies primarily on ketone metabolism?
Heart
Liver
Brain
Muscle
4
C
1
null
null
null
null
null
8cd5aa45-10fd-5749-800e-b594d0667cd3
Which of the following statements is true regarding cholesterol metabolism?
Bile salts are recirculated through enterohepatic circulation several times a day.
Cholesterol is converted into bile salts in the gall bladder.
Bile salts are excreted into the colon.
Cholesterols are hydrophilic molecules.
4
A
1
null
null
null
null
null
fb56bf4b-7c88-5009-bc69-bec39627fd79
Which of the following is the mechanism of action of ezetimibe in lowering lipid levels?
Prevention of intestinal absorption of TAGs
HMG-CoA reductase inhibition
PCSK9 inhibition
Upregulating β-oxidation of fatty acids
4
A
1
null
null
null
null
null
326875f7-9eb9-51b8-a1ec-019f1adf6050
Inhaled nitric oxide (NO) produces pulmonary vasodilation via increased concentration of which of the following substances?
Calcium
Atrial natriuretic peptide
Cyclic adenosine monophosphate (cAMP)
Cyclic guanosine monophosphate (cGMP)
4
D
1
null
null
null
null
null
77fc4e14-504c-5e92-aa58-495d1fca6b65
Phosphodiesterase-5 inhibitors, such as sildenafil, will have which of the following effects?
Increase the intracellular level of cAMP
Increase the intracellular level of cGMP
Decrease the intracellular level of cAMP
Decrease the intracellular level of cGMP
4
B
1
null
null
null
null
null
f4882c75-f69b-5ec5-8a79-ff7f104c3d53
Activation of the β1 -adrenergic receptor will increase the concentration of which of the following secondary messengers?
Cyclic guanosine monophosphate
Cyclic adenosine monophosphate
Ca 2+
Inositol triphosphate (IP3 )
4
B
1
null
null
null
null
null
d108d930-1daa-5af1-a350-2f67c2a42d04
Acetylcholine (Ach) binds to which subunit of the nicotinic acetylcholine receptor (nAchR) on the skeletal muscle?
α
β
γ
δ
4
A
1
null
null
null
null
null
26147abf-0ab1-5b4b-b5bf-a9f0b4621856
Which of the following is the correct sequence of signals, leading to skeletal muscle contraction?
Release of Ach → ligand-gated Na + channels → motor nerve depolarization → voltage-gated Ca ++ channels → muscle depolarization
Motor nerve depolarization → voltage-gated Ca ++ channels → release of Ach → ligand-gated Na + channels → muscle depolarization
Motor nerve depolarization → ligand-gated Na + channels → release of Ach → voltage-gated Ca ++ channels → muscle depolarization
Ligand-gated Na + channels → voltage-gated Ca ++ channels → release of Ach → motor nerve depolarization → muscle depolarization
4
B
1
null
null
null
null
null
12b13e09-a62e-5aab-85f5-a76ca888fea3
All of the following conditions may increase extrajunctional acetylcholine receptors (AchRs), EXCEPT which one?
Severe burn
Prolonged ICU stay
Stroke
Renal failure
4
D
1
null
null
null
null
null
de45b5ba-54f6-5294-8195-34c3258a59e2
The effect of Ach at the neuromuscular junction (NMJ) is terminated by which of the following mechanisms?
Break down by acetylcholinesterase
Break down by pseudocholinesterase
Degradation by tissue esterase
Reuptake into the nerve terminal
4
A
1
null
null
null
null
null
0d3d9164-6e47-553b-bcd3-4026111d407c
5. How many Ach molecules must bind to each postsynaptic receptor on muscle cells to induce conformational change?
1
2
3
4
4
B
1
null
null
null
null
null
6042e6a4-ad35-5994-a0e2-45b36a16d151
All of the following drugs inhibit nAchRs EXCEPT which one?
α-Bungarotoxin
Curare
Pancuronium
Atropine
4
D
1
null
null
null
null
null
180544e1-cd65-5d0f-a468-2dd742a6b106
Ca +2 binding to which component of the NMJ induces muscle contraction?
Actin
Thin filaments
Troponin
Nicotinic acetylcholine receptor
4
C
1
null
null
null
null
null
d3883a5f-9946-5fd7-a142-d7862136c82c
Which of the following structures of the skeletal muscle does not change in length as the muscle contracts?
A band
I band
H zone
Z line
4
A
1
null
null
null
null
null
53abfdd5-a5ab-5709-a190-b771b1a9a8eb
Which subunit of the nAchR is present in receptors located at the endplate
β
γ
δ
ε
4
D
1
null
null
null
null
null
6a50e318-18ac-562c-ae52-a75978a23ec0
Which of the following is the resting potential of the skeletal muscle cell?
−90 mV
−70 mV
−50 mV
0 mV
4
A
1
null
null
null
null
null
d0b646aa-a0cf-577a-adba-aa26d8a6eaa5
Which of the following agents leads to an increase of Ach release from motor neuron terminals?
Calcium channel blockers
Magnesium
Tetanus toxin
Botulinum toxin
4
C
1
null
null
null
null
null
20e6a087-b407-5a78-b42f-15ce68ef46b6
Synthesis of Ach is facilitated by which enzyme?
Acetylcholinesterase
Choline acetyltransferase
Choline kinase
Choline transporter
4
B
1
null
null
null
null
null
84207d85-73ae-5d2e-b7f6-d567129086e4
13. Which of the following is the correct configuration of voltage-gated sodium channels in the repolarization phase immediately after the peak of an action potential?
Activation and inactivation gates both open
Activation gate open, inactivation gate closed
Activation gate closed, inactivation gate open
Activation and inactivation gates both closed
4
B
1
null
null
null
null
null
dcf08f50-2b5c-5015-9e7c-52537651e43d
Tetanic fade following administration of nondepolarizing neuromuscular blockers (NMBs) indicates the inhibition of which group of receptors?
Presynaptic nAchR
Postsynaptic nAchR
Presynaptic calcium channels
Postsynaptic calcium channels
4
A
1
null
null
null
null
null
535013b0-01a0-5c1b-8b85-f1cbf168b3c1
Potential adverse effects of succinylcholine include all of the following
Myalgia
Aspiration
Increased intraocular pressure
Anaphylaxis
4
B
1
null
null
null
null
null
b00a3661-34d8-5811-80e6-decf62f79ab7
Which of the following statements provides the most accurate explanation behind the "faster onset" of rocuronium as compared with cisatracurium?
Rocuronium is less potent.
Rocuronium is more potent.
Rocuronium is ultrashort acting.
Rocuronium is long acting.
4
A
1
null
null
null
null
null
54cd671a-a918-5966-8fd9-9e18141dfdaf
Which of the following agents belongs to the group of benzylisoquinolinium NMBs?
Rocuronium
Cisatracurium
Vecuronium
Succinylcholine
4
B
1
null
null
null
null
null
45ac23e4-707d-56b0-8201-2b05c045855c
Compared with its precursor atracurium, what is the main advantage of cisatracurium?
Rapid, organ-independent degradation
Faster onset
Longer duration because of active metabolites
Decreased histamine release
4
D
1
null
null
null
null
null
1dde24f4-41ab-55a6-94f8-ce1e221ca57e
When a long-duration depolarizing NMB (eg, pancuronium) is added at the end of an intermediate-duration NMB (eg, rocuronium) block, how will the recovery pattern change?
Recovery will be similar to rocuronium.
Recovery will be similar to pancuronium.
Recovery will be synergistically prolonged, significantly longer than pancuronium.
Recovery will be antagonistically shortened, significantly shorter than rocuronium.
4
A
2
null
null
null
null
null
d44dfadd-73d3-552c-ab86-1d12904f6223
Compared with the phase I block elicited by succinylcholine, the phase II block has which of the following characteristics?
Same twitch strength with repetitive stimulation
Posttetanic potentiation
Similarity with depolarizing block
Posttetanic depression
4
B
1
null
null
null
null
null
2f1ba421-ae99-558c-be7e-566bf0016105
21. Which statement regarding the phase II block that can be associated with succinylcholine administration is true?
Phase II block occurs only after prolonged exposure to succinylcholine.
Receptor desensitization is a mechanism responsible for phase II block.
Inhalation anesthetics delay the onset of phase II block.
Phase II block results in train-of-four (TOF) fade but not tetanic fade.
4
B
1
null
null
null
null
null
cf9d4ddd-5e1b-5db8-8650-52ba83021002
A patient was maintained on a succinylcholine infusion for 8 hours during surgery and does not regain spontaneous ventilation 30 minutes after the infusion was discontinued. TOF yields 1 twitch. Which of the following is the best course of action?
Give neostigmine.
Send pseudocholinesterase activity test.
Give naloxone.
Wait for spontaneous recovery.
4
D
3
null
null
null
null
null
c526c925-cd8f-5c88-bca3-39165f2825a0
Which mechanism best explains the fasciculations often seen preceding a phase I block by succinylcholine?
Activation of presynaptic nAchR
Activation of postsynaptic nAchR
Prolonged muscle depolarization
Prolonged muscle repolarization
4
A
1
null
null
null
null
null
d96f3a35-db60-5a4d-9888-75438d0b1847
A patient on succinylcholine infusion has a TOF ratio of 0.3. What does this tell about the patient's degree of paralysis?
Patient is in phase I block.
Patient is in phase II block.
Patient is recovering from block.
Cannot tell from given information.
4
B
2
null
null
null
null
null
14f86c97-64ee-527f-b8d1-115f76c54b69
Monitoring the TOF to assess the quality of a neuromuscular blockade offers what advantage over single twitch monitoring?
TOF offers objective assessment of fade.
TOF ratio correlates with the amount of stimulating current applied.
TOF does not require baseline measurement.
TOF is best at detecting the onset of neuromuscular blockade.
4
C
1
null
null
null
null
null
6132e1c3-39d2-5cbc-ae92-4343884d22dd
When the TOF ratio is 0.7, what portion of the AchRs is still blocked?
25%
50%
75%
95%
4
C
1
null
null
null
null
null
4ff0e835-3552-5798-99d3-716a87b78538
A TOF yields 0 twitch. Repeated 1 Hz stimulation following a 5-second 50 Hz tetanus produces 1 twitch. Assuming the patient was given an intermediateacting NMB, how much time is expected until recovery to TOF twitch count of 1?
1-2 minutes
5-10 minutes
20-30 minutes
>1 hour
4
C
2
null
null
null
null
null
49ff5b5c-0de7-5f5e-a462-9eca8330aee3
28. Compared with TOF, what is an advantage of double-burst stimulation (DBS) for monitoring of neuromuscular blockade?
Easier to detect fade
Does not use tetanic stimuli
Ability to immediately apply a repeat stimulus
Smaller current
4
A
1
null
null
null
null
null
384a4cb1-5c58-557a-9154-efac08b712a4
Side effects of neostigmine include all of the following EXCEPT which one?
Salivation
Tachycardia
Nausea/vomiting
Bowel motility
4
B
1
null
null
null
null
null
c5685d82-1108-5503-827d-4dc7e5bafc47
How long would a patient with a dibucaine number of 20 be expected to remain paralyzed after an intubating dose of succinylcholine?
4 minutes
40 minutes
4 hours
4 days
4
C
1
null
null
null
null
null
5fff6467-2f2a-5947-987f-ded6fcd05c8f
What differentiates Lambert-Eaton myasthenic syndrome (LEMS) from myasthenia gravis?
Patients with LEMS often have autonomic dysfunction.
LEMS results from autoantibodies to the postsynaptic AchRs.
Patients with LEMS feel more proximal than distal weakness.
Patients with LEMS get progressively fatigued with repetitive use of muscles.
4
A
1
null
null
null
null
null
a0ebfcaf-6d6b-5f94-8aa2-fc2d600700f5
In patients with myasthenia gravis, which factor best predicts the risk of requiring prolonged intubation and mechanical ventilator support?
Age of illness onset
Involvement of muscle groups
Dosage of acetylcholinesterase inhibitor at home
Circulating autoantibody level
4
C
2
null
null
null
null
null
a0a13a0b-de7e-519b-bf6a-da9578152d3f
How do patients with myasthenia gravis react to depolarizing NMBs and nondepolarizing NMBs?
Sensitive to depolarizing, but insensitive to nondepolarizing NMBs
Insensitive to depolarizing, but sensitive to nondepolarizing NMBs
Sensitive to both depolarizing and nondepolarizing NMBs
Insensitive to both depolarizing and nondepolarizing NMBs
4
B
1
null
null
null
null
null
d66fb32e-6a02-565c-bbc9-1957c367b663
A patient with myasthenia gravis presents with muscle weakness and respiratory failure. What is the best way to differentiate a myasthenia crisis from a cholinergic crisis?
Presence or absence of GI symptoms
Pupillary exam
Tensilon test
Excessive sweating
4
C
1
null
null
null
null
null
7e29109e-a782-5049-af07-c3951d77a47d
What is the inheritance pattern of Duchenne muscular dystrophy (DMD)?
Autosomal dominant
Autosomal recessive
X-linked dominant
X-linked recessive
4
D
1
null
null
null
null
null
804c4185-0303-5e8e-9415-715cd5536446
36. For patients with myotonic dystrophy, prolonged muscle contraction (myotonia) can be triggered by exposure to all of the following agents EXCEPT which one?
Succinylcholine
Rocuronium
Potassium
Neostigmine
4
B
2
null
null
null
null
null
60aaaed5-4bbe-591d-8ee2-c6e42f405391
Which intravenous anesthetic agent should be avoided in patients with mitochondrial myopathy?
Propofol
Etomidate
Ketamine
Dexmedetomidine
4
A
1
null
null
null
null
null
72019bfe-9bec-5f04-9966-4d254d122ea7
Malignant hyperthermia is a known risk for patients with the following conditions EXCEPT which one?
King Denborough syndrome
Multiminicore disease
Central core disease
Central cord syndrome
4
D
1
null
null
null
null
null
15d89010-3b34-536b-985a-ec5ab970c575
Which intravenous fluid should be avoided in patients with mitochondrial disorder?
Normal saline
Lactated Ringer (LR)
Dextrose
Albumin
4
B
2
null
null
null
null
null
219b7490-11e7-52ad-9ed2-fddf2a75ef8c
Psuedocholinesterase activity is increased in which of the following conditions?
Pregnancy
Liver failure
Obesity
Malignancy
4
C
1
null
null
null
null
null
6865a162-81ed-58a8-86e5-0b0e240f17a5
A researcher designs a study examining the relationship between the gender of patients and the development of phantom limb pain. In this example, "gender" is best described as which of the following types of variables?
Continuous
Dichotomous
Ordinal and dichotomous
Nominal and dichotomous
4
D
1
null
null
null
null
null
3ba83abb-5b8d-5fca-aba7-4518ddc2267e
A researcher designs a study with the purpose of investigating postoperative analgesic and blood pressure effects when acetaminophen was administered preoperatively. One hundred patients are randomized to receive either acetaminophen or a placebo pill. Systolic blood pressure measurements are recorded in each group, both before their operative procedure and postoperatively. What type of statistical test would be best utilized to analyze data for this study?
Paired t-test
Unpaired (Student) t-test
Chi-squared
ANOVA
4
A
2
null
null
null
null
null
181a188e-7098-51b1-8b8e-2392099efa38
A researcher designs a study that examines the relationship between red hair and postoperative nausea and vomiting. Which of the following statistical tests
Paired t-test
Unpaired (Student) t-test
Chi-squared
ANOVA
4
C
2
null
null
null
null
null
493bf095-37ca-5cb0-826e-236fa96be54c
A researcher performs a study comparing the average heart rate of 4 groups of patients receiving different doses of a new β-blocker. Which of the following statistical tests is most appropriate to analyze the data from this study?
Paired t-test
Unpaired (Student) t-test
Chi-squared
ANOVA
4
D
2
null
null
null
null
null
43e9629d-7887-5cd7-a593-c7dc10db4fce
5. The probability of a newborn baby developing respiratory distress with a mother who is a smoker is 0.2 What are the odds of a newborn baby developing respiratory distress with a mother who is a smoker ?
0.1
0.25
1
4
4
B
2
null
null
null
null
null
b6164e9e-c81d-5274-9ac6-dc0a43b8de55
A highly sensitive test is defined as which of the following?
A test that correctly classifies those with the disease
A test that correctly excludes those without the disease
A test that if negative indicates the true absence of the disease
A test that if positive indicates the true presence of the disease
4
A
1
null
null
null
null
null
57daf25f-78bd-53fa-ab9e-f2f26ceabdb1
A highly specific test is defined as which of the following?
A test that correctly classifies those with the disease
A test that correctly excludes those without the disease
A test that if negative indicates the true absence of the disease
A test that if positive indicates the true presence of the disease
4
B
1
null
null
null
null
null
94fc812f-25f7-58be-944f-f046b91db848
A test with a high positive predictive value (PPV) is defined as which of the following?
A test that correctly classifies those with the disease
A test that correctly excludes those without the disease
A test that if negative indicates the true absence of the disease
A test that if positive indicates the true presence of the disease
4
D
1
null
null
null
null
null
657083d9-acc2-5152-89ac-ade610bbdf8a
A test with a high negative predictive value is best described as which of the following?
A test that correctly classifies those with the disease
A test that correctly excludes those without the disease
A test that if negative indicates the true absence of the disease
A test that if positive indicates the true presence of the disease
4
C
1
null
null
null
null
null
4ffab09c-edf4-5368-ad56-9db9b8e799dd
In which type of observational study are subjects chosen and followed over a period to observe the outcome of interest?
Cohort
Case-control studies
Cross-sectional studies
Case series
4
A
1
null
null
null
null
null
2d85a6e9-3a47-512f-bc13-af62a46e200b
A survey is devised with the intent to compare patient satisfaction and anesthetic type (general or regional anesthesia). This inquiry is best described as which type of study design?
Cohort
Case-control
Cross-sectional
Randomized trial
4
C
1
null
null
null
null
null
6f50d02f-773e-55fd-8692-2cca1a8e1f13
13. A type I error is defined as which of the following?
Incorrectly rejecting the null hypothesis
Correctly rejecting the null hypothesis
Incorrectly accepting the null hypothesis
Incorrectly rejecting the alternative hypothesis
4
A
1
null
null
null
null
null
7f3ada42-e493-56a2-adde-f739e200155e
A study is being designed to examine the impact of a new analgesic on postoperative pain. Patients will be randomized to receive either the new analgesic or placebo, and average postoperative pain scores will be compared in the 2 patient groups. An increase in sample size will be required if which of the following factors is increased?
Standard deviation
α
β
Effect size
4
A
2
null
null
null
null
null
919dfe3f-395a-5869-9f76-6d1dd2de4395
The number needed to treat (NNT) is defined as which of the following?
The risk of the outcome in the experimental group
The difference in risk in the treatment and control groups
The number of patients who need to be treated to decrease the adverse outcome by 10%
The number of patients who need to be treated to prevent 1 adverse outcome
4
D
1
null
null
null
null
null
bf9d10f6-d0b0-5910-b08b-50d8f8cabe71
An investigator is interested in comparing the differences in survival over time for patients who receive general anesthesia versus regional anesthesia for prostatectomies. Which of the following statistics would be most appropriate to analyze these data?
Relative risk
Hazard ratio (HR)
Odds ratio
Rate ratio
4
B
2
null
null
null
null
null
74938152-3c98-56a5-8058-818e5e3b316b
In a randomized control trial, the term "crossover" refers to which of the following?
Patients who drop out of the trial
Patients who do not receive treatment during the course of the trial
Patients who receive a sequence of different treatments during the trial
Patients who do not end up receiving an assigned treatment and instead are enrolled in another randomized control trial
4
C
1
null
null
null
null
null
a9f0e0eb-75b2-5474-9228-eea3d0abe091
In a single-blinded randomized control trial, the individuals being blinded to receiving treatment are which of the following?
Subjects only
Investigators only
Statistician only
Subjects and investigators
4
A
1
null
null
null
null
null
b47851e4-ca76-5490-8f40-990b97328344
20. In statistical tests the P-value is defined as which of the following?
The probability of rejecting the null hypothesis
The probability of obtaining a test statistic value equal to or more extreme than the actual test statistics given the null hypothesis is true
The probability of accepting the null hypothesis
The probability of obtaining a test statistic value less extreme than the test statistics given the null hypothesis is true
4
B
1
null
null
null
null
null
3de2842f-5ac4-5fe7-bcc4-5f8304c7d626
You perform thromboelastography for your hemorrhaging patient who has sustained massive abdominal trauma and it reveals a prolonged R time. Which of the following is an appropriate initial therapy to manage the patient's suspected coagulopathy?
Platelets
Fresh frozen plasma
Tranexamic acid
Cryoprecipitate
5
B
2
Packed red blood cells
null
null
null
null
11fa4608-471d-56ec-adbd-49a7be88dbcd
A 26-year-old patient with autoimmune thrombocytopenic purpura and a platelet count of 51 000 per microliter is scheduled for urgent appendectomy. Which thromboelastographic parameter do you expect to be altered in this patient?
Reaction (R) time
Kinetic (K) time
α angle
Maximum amplitude (MA)
5
D
2
Fibrinolysis (F)
null
null
null
null
965eb423-d717-5a3f-91c1-867a7a438ed2
4. TEG is performed and reveals an increased R time and decreased MA. These abnormalities are most suggestive of which of the following coagulation deficits?
Decreased platelets
Decreased clotting factors
Decreased fibrinogen
Increased fibrinolysis
5
E
2
Both decreased platelets and decreased clotting factors
null
null
null
null
0555dcfb-033b-5416-9bcd-24184aec7bdc
A patient is receiving blood product transfusions after undergoing aortic valve replacement. Despite the transfusions, the surgeons still note that their field is very "oozy." TEG is performed, which reveals a decreased α angle. Which blood product should be administered next?
Platelets
Fresh frozen plasma
Tranexamic acid
Cryoprecipitate
5
D
3
Packed red blood cells
null
null
null
null
2624a1d4-49ee-5f04-b0ff-645760f589c9
The complication rate (vascular complications and nerve injuries) associated with insertion of arterial lines closest to which of the following?
3-18 per 10 patients
3-18 per 100 patients
3-18 per 1000 patients
3-18 per 10 000 patients
5
D
1
3-18 per 100 000 patients
null
null
null
null
16c7afba-a36c-5819-8ac1-baa73775e6b7
Which nerve is at greatest risk of suffering an injury during arterial catheter insertion into the brachial artery?
Median nerve
Radial nerve
Ulnar nerve
Musculocutaneous nerve
5
A
1
Axillary nerve
null
null
null
null
1fb3db44-d115-5ca7-9577-e5f3f9612bf5
A "flush test" is performed to assess damping of an arterial line pressuremonitoring system. A system with an appropriate dynamic response will have which of the following responses to rapid flushing?
One large oscillation before a return to baseline
One large and 1 small oscillation before a return to baseline
One large and 3 small oscillations before a return to baseline
Several large and several small oscillations before a return to baseline
5
B
1
A square wave
null
null
null
null
2f4afaab-46a5-50c2-bcf9-b9f8f003e942
Which of the following is most likely to produce underdamping in an arterial pressure monitoring system?
Excessive tubing length
Bubbles in the tubing system
Kink in the arterial catheter
Thrombus at the tip of the arterial catheter
4
A
1
null
null
null
null
null
81a96f64-4cb6-5100-9460-690ca5c1eab3
10. How does the systolic pressure measured in the dorsalis pedis artery differ from that measured in the aorta?
5 mm Hg lower than the aorta
5 mm Hg higher than the aorta
20 mm Hg higher than the aorta
20 mm Hg lower than the aorta
5
C
1
The same systolic pressure as the aorta
null
null
null
null
849f9a29-8bc5-5ee2-8488-05fe97e4c009
Which component of a central venous pressure (CVP) waveform is most likely to be absent in a patient with a junctional rhythm?
a-wave
x-descent
c-wave
Diastole descent
5
A
2
v-wave
null
null
null
null
2e6a9c77-7105-5cef-8b1c-900293a231cf
A patient with severe tricuspid regurgitation would be expected to have which of the following CVP tracing abnormalities?
Cannon a-wave
Tall c-v wave, diastole
Exaggerated x-descent
Exaggerated y-descent
4
B
1
null
null
null
null
null
cd453c90-5e98-5387-ba45-c4a2835c893d
Where is the right internal jugular vein typically located in relation to the right carotid artery in the lower neck?
Posterior and medial
Anterior and medial
Posterior and lateral
Anterior and lateral
4
D
1
null
null
null
null
null
ad58e752-361a-5439-83a3-bf2136e6964b
For insertion of a peripherally inserted central catheter, which vein is preferred, matched with its anatomical location?
Cephalic vein, lateral
Cephalic vein, medial
Basilic vein, lateral
Basilic vein, medial
4
D
1
null
null
null
null
null
9afc5c67-415c-598c-8e8e-4aed27c060cb
Which of the following is the most common cause of death associated with iatrogenic pulmonary artery rupture (PAR)?
Anoxia
Hemorrhagic shock
Cardiac tamponade
Myocardial infarction
4
A
1
null
null
null
null
null
96139dc6-342c-5a5b-bbc0-f4840d343ab8
17. A 65-kg patient is receiving volume-controlled ventilation with a tidal volume of 400 mL and frequency of 14 breaths per minute. The measured peak airway pressure is 18 cm H2O, with a plateau pressure of 12 cm H2O, and the PEEP is 2 cm H2O. What is the static compliance of the patient's lung compliance?
40 mL/cm H2O
67 mL/cm H2O
25 mL/cm H2O
25 cm H2O/L
6
A
2
15 cm H2O/L
40 cm H2O/L
null
null
null
31e53e79-ac63-5544-92f0-5f2ce511382c
For a euvolemic patient with normal lung compliance and cardiac function, delivery of positive pressure ventilation (PPV) would be most likely to have which of the following hemodynamic effects?
Decreased preload, decreased afterload, and increased cardiac output
Decreased preload, increased afterload, and decreased cardiac output
Decreased preload, increased afterload, and increased cardiac output
Increased preload, decreased afterload, and decreased cardiac output
6
A
3
Increased preload, decreased afterload, and increased cardiac output
Increased preload, increased afterload, and decreased cardiac output
null
null
null
2b38ad39-1833-5b4c-8814-79704fafd75b
21. A patient is breathing steadily at a minute ventilation of 10 L/min while receiving supplemental oxygen via nasal cannula at a rate of 6 L/min. What is the approximate FiO2 delivered to the patient during inspiration?
0.15-0.21
0.21-0.28
0.28-0.38
0.38-0.46
5
D
2
0.46-0.52
null
null
null
null