Arterial supply of the spinal cord

Regarding the arterial supply of the spinal cord, the following statements are true

EXCEPT which one?

a) There are two posterior spinal arteries and one anterior spinal artery, all derived

from the vertebral arteries

b) The great anterior radicular artery (spinal artery of Adamkiewicz) most often arises

at T10 on the left

c) Some radicular arteries derive their supply from intercostal arteries

d) The pia mater does not cover the spinal vasculature

e) The anterior inferior spinal cord is more vulnerable to ischaemia than the posterior

cord

Methylene blue

Regarding methylene blue, the following statements are true EXCEPT which one?

a) It has been used in cases of anaphylaxis previously unresponsive to standard

treatment

b) It has been used in combination with light to treat psoriasis

c) It has been used to treat arsenic poisoning

d) It has been used to treat methaemoglobinaemia

e) It has been used to treat malaria

Paediatric advanced life support

A 15 kg two-year-old boy is being anaesthetised, spontaneously breathing on a laryngeal

mask airway, for exploration and repair of a small umbilical hernia. The child is

otherwise fit and well. Thirty minutes into the procedure, for no apparent reason, the

child develops a bradycardia of 30bpm and end-tidal CO2 falls to zero. With regard to

the choice of uncuffed endotracheal tube (internal diameter in mm) for initial intubation

attempt, the bolus dose of intravenous adrenaline, and setting for the manual

monophasic defibrillator, which of the following options describes the BEST practice?

a) 4.0 endotracheal tube, 300 mcg adrenaline, defibrillator set to 30 joules

b) 4.5 endotracheal tube, 150 mcg adrenaline, defibrillator set to 60 joules

c) 4.0 endotracheal tube, 150 mcg adrenaline, defibrillator set to 60 joules

d) 4.5 endotracheal tube, 150 mcg adrenaline, defibrillator set to 30 joules

e) 4.0 endotracheal tube, 300 mcg adrenaline, defibrillator set to 60 joules

Soda lime

Regarding the soda lime in a circle system, the following statements are true EXCEPT

which one?

a) The granule diameter is 3 to 4mm

b) If it contains Titan Yellow, the colour change will be from deep pink when fresh to

off-white when exhausted

c) It will contain water even in an unopened packet prior to use

d) It will always contain calcium hydroxide

e) As it is used there will be a steady decline in the amount of sodium hydroxide

present

Myasthenic syndromes

Which one of the following clinical features is MOST LIKELY to distinguish myasthenia

gravis from Lambert–Eaton myasthenic syndrome?

a) Aged 55 at onset of symptoms

b) An improvement of strength with the administration of intravenous edrophonium

c) Involvement of facial muscles

d) Finding of immunoglobulin G antibodies to the nicotinic acetylcholine receptor

e) Presence of deep tendon reflexes

Non-invasive ventilators

According to the British Thoracic Society guidelines on non-invasive ventilation (2002),

essential features of a non-invasive ventilator include the following EXCEPT which one?

a) A disconnection alarm

b) Internal battery with power for at least one hour

c) Sensitive flow triggers

d) Rate capability of at least 40 breaths/min

e) Pressure control

Throat pack insertion

The National Patient Safety Agency (NPSA) recommends a number of methods to

reduce the risk of a throat pack (TP) being inadvertently left in situ. As part of these

recommendations they suggest that one of two methods be used in all cases. Which of

the following options contains BOTH of these suggested methods?

 

a) Placing a visible label on the patient stating a TP is in situ and removing it when

the TP is removed, or placing a label on the airway device (LMA or endotracheal

tube) stating a TP is in situ.

b) Tying one end of the TP to the airway device, or recording insertion and removal of

the TP as part of the formal swab count

c) Recording insertion and removal of the TP as part of the formal swab count, or

performing a formalised two-person check of the insertion and removal of the TP

d) Leaving part of the TP protruding externally, or putting a visible label or mark on

the patient stating a throat pack is in situ

e) Recording insertion and removal of the TP as part of the formal swab count, or

attaching the TP securely to the artificial airway device