Anesthesia 5th Year Medicine -6th round- Feb 2026 – KOMU

محصلین عزیز،

قبل از شروع امتحان، لطفاً توجه داشته باشید که شما 90 دقیقه برای پاسخگویی به 50 سوال در اختیار دارید. برای هر سوال اضافه تر از ۱ دقیقه زمان در نظر گرفته شده است.

موفق باشید!

Anesthesia 5th Year Medicine -2nd Chance- March 2026

1 / 40

Malignant hyperthermia is triggered by:

A) A) Propofol

B) B) Nitrous oxide

C) C) Succinylcholine

D) D) Midazolam

2 / 40

Reversible causes of PEA include:

A) A) Hyperglycemia

B) B) Hypoxia

C) C) Hypertension

D) D) Hyperlipidemia

3 / 40

Normal ETCO₂ range:

A) A) 20–25 mmHg

B) B) 30–35 mmHg

C) C) 35–45 mmHg

D) D) 50–55 mmHg

4 / 40

Sudden drop in ETCO₂ suggests:

A) A) Hypoventilation

B) B) Pulmonary embolism

C) C) Rebreathing

D) D) Fever

5 / 40

The epidural space contains all EXCEPT:

A) A) Fat

B) B) Venous plexus

C) C) CSF

D) D) Spinal nerve roots

6 / 40

Initial biphasic shock dose:

A) A) 100 J

B) B) 150 J

C) C) 200 J

D) D) 360 J

7 / 40

Volume-controlled ventilation guarantees:

A) A) Constant pressure

B) B) Constant tidal volume

C) C) Constant oxygen saturation

D) D) Constant PEEP

8 / 40

First drug in severe hyperkalemia with ECG changes:

A) A) Insulin

B) B) Calcium gluconate

C) C) Furosemide

D) D) Sodium bicarbonate

9 / 40

Synchronized cardioversion is used in:

A) A) VF

B) B) Pulseless VT

C) C) Unstable atrial fibrillation

D) D) Asystole

10 / 40

Indication for intubation includes:

A) A) GCS 15

B) B) GCS ≤ 8

C) C) Mild cough

D) D) Stable oxygenation

11 / 40

Asystole management includes:

A) A) Immediate defibrillation

B) B) CPR and epinephrine

C) C) Amiodarone first

D) D) Cardioversion

12 / 40

Which factor increases MAC?

A) A) Advanced age

B) B) Hypothermia

C) C) Chronic alcohol use

D) D) Opioids

13 / 40

ETCO₂ during CPR reflects:

A) A) Renal perfusion

B) B) Cardiac output

C) C) Hemoglobin level

D) D) Sodium balance

14 / 40

Adult male ETT size:

A) A) 6.0–6.5

B) B) 7.0–7.5

C) C) 8.0–8.5

D) D) 9.0–9.5

15 / 40

Metabolic acidosis compensation involves:

A) A) Hypoventilation

B) B) Hyperventilation

C) C) Bradycardia

D) D) Hypoxia

16 / 40

Accidental dural puncture during epidural may cause:

A) A) Hypertension

B) B) Post-dural puncture headache

C) C) Bradycardia

D) D) Pulmonary edema

17 / 40

Target MAP in septic shock:

A) A) 55 mmHg

B) B) 60 mmHg

C) C) 65 mmHg

D) D) 75 mmHg

18 / 40

Test dose in epidural anesthesia is used to detect:

A) A) Liver failure

B) B) Intrathecal or intravascular injection

C) C) Hypoglycemia

D) D) Renal impairment

19 / 40

Colloids primarily increase:

A) A) Intracellular volume

B) B) Oncotic pressure

C) C) Interstitial fluid

D) D) Potassium level

20 / 40

PaO₂ primarily reflects:

A) A) Ventilation

B) B) Oxygenation

C) C) Metabolism

D) D) Cardiac rhythm

21 / 40

Epinephrine added to local anesthetic:

A) A) Increases systemic absorption

B) B) Shortens duration

C) C) Reduces bleeding and prolongs action

D) D) Causes alkalosis

22 / 40

Lipid emulsion therapy acts by:

A) A) Blocking sodium channels

B) B) Increasing renal excretion

C) C) Lipid sink mechanism

D) D) Increasing acetylcholine

23 / 40

Phase III of capnogram represents:

A) A) Dead space ventilation

B) B) Inspiration

C) C) Alveolar plateau

D) D) Equipment failure

24 / 40

The highest risk of total spinal anesthesia occurs when:

A) A) Dose is subtherapeutic

B) B) Drug is injected intramuscularly

C) C) Excessive cephalad spread occurs

D) D) Hypotonic solution is used

25 / 40

Respiratory acidosis ABG pattern:

A) A) ↓PaCO₂, ↑pH

B) B) ↑PaCO₂, ↓pH

C) C) ↓HCO₃⁻, ↑pH

D) D) ↑pH, ↑PaO₂

26 / 40

Laryngeal mask airway (LMA) is contraindicated in:

A) A) Elective surgery

B) B) Full stomach

C) C) Short procedure

D) D) Spontaneous breathing

27 / 40

First-line fluid in septic shock:

A) A) 5% Dextrose

B) B) Albumin

C) C) Isotonic crystalloid

D) D) Dextran

28 / 40

Hypotension after spinal anesthesia is mainly due to:

A) A) Myocardial depression

B) B) Sympathetic blockade

C) C) Histamine release

D) D) Vagal overactivity

29 / 40

Lidocaine belongs to which group?

A) A) Ester

B) B) Amide

C) C) Opioid

D) D) Benzodiazepine

30 / 40

Oxygen therapy is indicated when SpO₂ is below:

A) A) 98%

B) B) 95%

C) C) 94%

D) D) 90%

31 / 40

Lactate elevation in shock indicates:

A) A) Respiratory alkalosis

B) B) Tissue hypoperfusion

C) C) Hyperkalemia

D) D) Renal failure

32 / 40

The antidote for malignant hyperthermia is:

A) A) Naloxone

B) B) Atropine

C) C) Dantrolene

D) D) Calcium gluconate

33 / 40

MAC is defined as:

A) A) IV induction dose

B) B) Alveolar concentration preventing movement in 50%

C) C) Plasma protein binding level

D) D) Maximum tolerated dose

34 / 40

Hyperbaric bupivacaine spreads in the subarachnoid space according to:

A) A) Hepatic metabolism

B) B) CSF protein level

C) C) Patient position

D) D) Injection speed only

35 / 40

A key difference between epidural and spinal anesthesia is:

A) A) Epidural requires smaller doses

B) B) Epidural produces faster onset

C) C) Epidural produces segmental block

D) D) Epidural bypasses dura mater

36 / 40

Earliest ECG sign of hyperkalemia:

A) A) U wave

B) B) Peaked T wave

C) C) QT prolongation

D) D) ST elevation

37 / 40

Primary survey in trauma follows:

A) A) CAB

B) B) ABCDE

C) C) BLS

D) D) SOAP

38 / 40

Succinylcholine is:

A) A) Non-depolarizing blocker

B) B) Depolarizing blocker

C) C) Opioid

D) D) Sedative

39 / 40

LAST primarily affects:

A) A) Liver

B) B) CNS and cardiovascular system

C) C) Kidneys

D) D) Skin

40 / 40

The primary mechanism of spinal anesthesia is:

A) A) NMDA receptor inhibition

B) B) Voltage-gated sodium channel blockade

C) C) Potassium channel activation

D) D) Calcium channel blockade

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