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Chapter 6 ยท MCQ Read Mode

Biomedical Instrumentation- II

ABME06ยท78 Total MCQs
Question 1 of 78Cardiac Pacemakers and Defibrillators

Defibrillation terminates ventricular fibrillation by:

ACooling the myocardium
BStimulating the sino-atrial node directly with a small current
CDepolarising a critical mass of myocardium simultaneously so that organised activity can resume
DRestarting a heart that has stopped completely
Answer is hidden
Question 2 of 78Cardiac Pacemakers and Defibrillators

Which of the following rhythms should NOT be treated with a defibrillator shock?

ACoarse ventricular fibrillation
BPulseless ventricular tachycardia
CVentricular fibrillation
DAsystole
Answer is hidden
Question 3 of 78Cardiac Pacemakers and Defibrillators

Compared with a monophasic waveform, a biphasic defibrillator waveform:

AIs used only for internal paddles
BRequires more energy but is safer
CCannot be synchronised
DAchieves defibrillation at lower energy with less myocardial injury
Answer is hidden
Question 4 of 78Cardiac Pacemakers and Defibrillators

The essential difference between defibrillation and synchronised cardioversion is that cardioversion:

AUses alternating current
BRequires no sedation
CUses higher energy
DDelivers the shock timed to the R wave
Answer is hidden
Question 5 of 78Cardiac Pacemakers and Defibrillators

Energy stored in the capacitor of a DC defibrillator is given by:

ACurrent times resistance squared
BVoltage divided by capacitance
COne half times capacitance times voltage squared
DCapacitance times voltage
Answer is hidden
Question 6 of 78Cardiac Pacemakers and Defibrillators

Conductive gel is applied to defibrillator paddles principally to:

APrevent the capacitor from overcharging
BReduce transthoracic impedance so that more current reaches the heart
CImprove adhesion of the pads only
DCool the skin
Answer is hidden
Question 7 of 78Cardiac Pacemakers and Defibrillators

Internal paddles applied directly to the heart during cardiac surgery require an energy of about:

A10 to 50 J
B500 J
C200 to 360 J
D1 J
Answer is hidden
Question 8 of 78Cardiac Pacemakers and Defibrillators

Asynchronous (fixed-rate) pacing is potentially dangerous because a stimulus may:

ADamage the pacemaker lead
BFall on the T wave and provoke ventricular fibrillation
CCause asystole
DDischarge the battery instantly
Answer is hidden
Question 9 of 78Cardiac Pacemakers and Defibrillators

A pacemaker that fails to inhibit when an intrinsic beat occurs is showing:

AUndersensing
BBattery depletion only
CFailure to capture
DOversensing
Answer is hidden
Question 10 of 78Cardiac Pacemakers and Defibrillators

Transcutaneous external pacing has the principal disadvantage that it is:

ASlow to establish
BPainful and usually requires sedation
CUnable to be used in an emergency
DOnly usable during cardiac surgery
Answer is hidden
Question 11 of 78Cardiac Pacemakers and Defibrillators

The tiered therapy of an implantable cardioverter-defibrillator begins for slower ventricular tachycardia with:

AAsynchronous pacing at 100 per minute
BAnti-tachycardia pacing
CWithholding all therapy
DA maximum energy shock
Answer is hidden
Question 12 of 78Cardiac Pacemakers and Defibrillators

The commonest cause of an inappropriate shock from an implantable cardioverter-defibrillator is:

AExercise at normal heart rates
BCorrect detection of ventricular fibrillation
CBattery depletion
DAtrial fibrillation with a rapid ventricular response or another supraventricular tachycardia
Answer is hidden
Question 13 of 78Cardiac Pacemakers and Defibrillators

A patient with a permanent pacemaker requires surgery. Which precaution is most important regarding surgical diathermy?

ARemove the pacemaker before surgery
BUse bipolar diathermy where possible and keep the current path away from the device
CTurn off the ECG monitor
DUse higher diathermy power to overcome interference
Answer is hidden
Question 14 of 78Instruments for Surgery

Surgical diathermy uses frequencies above about 300 kHz because at such frequencies the current:

APenetrates more deeply into tissue
BRequires no return electrode
CProduces no heat at all
DProduces heat without stimulating nerve or muscle
Answer is hidden
Question 15 of 78Instruments for Surgery

In monopolar electrosurgery, the purpose of the large patient return plate is to:

AProvide a low current density so that no heating occurs where the current leaves the patient
BIncrease the power delivered at the tip
CMonitor the ECG
DEarth the patient for safety
Answer is hidden
Question 16 of 78Instruments for Surgery

The waveform used for pure cutting in electrosurgery is:

AInterrupted and of high voltage with a low duty cycle
BDirect current
CMains frequency alternating current
DContinuous and of relatively low voltage with high current
Answer is hidden
Question 17 of 78Instruments for Surgery

Bipolar diathermy is preferred to monopolar diathermy in a patient with a permanent pacemaker because:

AThe current path is confined between the two forceps tips
BIt requires no generator
CIt delivers much higher power
DIt produces no smoke
Answer is hidden
Question 18 of 78Instruments for Surgery

An unseen bowel burn during laparoscopic monopolar diathermy is most characteristically caused by:

ALow generator power
BExcessive gel on the return plate
CCapacitive coupling or insulation failure of the instrument shaft
DUse of bipolar current
Answer is hidden
Question 19 of 78Instruments for Surgery

A surgeon repeatedly asks for the diathermy power to be increased. The most important action is to:

ASwitch to a different generator
BCheck the return plate contact and the whole circuit before increasing power
CAsk the anaesthetist to lower the oxygen
DIncrease the power as requested immediately
Answer is hidden
Question 20 of 78Instruments for Surgery

The process by which an excited atom struck by a photon emits a second identical photon is:

ASpontaneous emission
BAbsorption
CStimulated emission
DFluorescence
Answer is hidden
Question 21 of 78Instruments for Surgery

A population inversion in a laser medium means that:

AThe beam travels backwards
BThe wavelength is inverted
CThe mirrors are reversed
DMore atoms are in the excited state than in the ground state
Answer is hidden
Question 22 of 78Instruments for Surgery

The carbon dioxide laser is described as a precise cutting laser because its 10,600 nm radiation is:

AReflected by all tissues
BAbsorbed only by melanin
CPoorly absorbed, so it penetrates several millimetres
DVery strongly absorbed by water, depositing energy within about 0.1 mm
Answer is hidden
Question 23 of 78Instruments for Surgery

Which laser penetrates most deeply into tissue and is therefore used for coagulating large vessels and debulking tumours endoscopically?

AExcimer at 193 nm
BEr-YAG at 2,940 nm
CCO2 at 10,600 nm
DNd-YAG at 1,064 nm
Answer is hidden
Question 24 of 78Instruments for Surgery

The helium-neon laser is most commonly used in surgical systems as:

AA retinal photocoagulator
BA lithotripsy source
CThe main cutting beam
DA visible aiming beam for an invisible infrared laser
Answer is hidden
Question 25 of 78Instruments for Surgery

Retinal injury is a particular hazard with lasers operating in the wavelength range:

ABelow 300 nm
BAbove 3,000 nm
CExactly 10,600 nm
D400 to 1,400 nm
Answer is hidden
Question 26 of 78Instruments for Surgery

Protective eyewear worn during laser surgery must be:

AAny dark sunglasses
BClear plastic safety spectacles
CWorn only by the surgeon
DSpecific to the wavelength in use and of adequate optical density
Answer is hidden
Question 27 of 78Physiotherapy and Electrotherapy Equipment

Short-wave diathermy operates at the internationally allocated frequency of:

A1 MHz
B50 Hz
C27.12 MHz
D2,450 MHz
Answer is hidden
Question 28 of 78Physiotherapy and Electrotherapy Equipment

The capacitive (condenser field) method of short-wave diathermy heats which tissue preferentially?

ABone marrow
BBlood only
CSubcutaneous fat
DMuscle
Answer is hidden
Question 29 of 78Physiotherapy and Electrotherapy Equipment

Microwave diathermy is particularly hazardous to the eye because the lens:

AIs protected only by the cornea
BContains melanin
CAbsorbs no microwave energy at all
DIs avascular and cannot dissipate the heat, so cataract may result
Answer is hidden
Question 30 of 78Physiotherapy and Electrotherapy Equipment

Therapeutic ultrasound at 3 MHz rather than 1 MHz is chosen when the target tissue is:

ABone marrow
BSuperficial
CDeep, several centimetres below the surface
DThe abdominal viscera
Answer is hidden
Question 31 of 78Physiotherapy and Electrotherapy Equipment

The applicator of a therapeutic ultrasound unit must be kept constantly moving in order to:

AMaintain the coupling gel temperature
BAllow the timer to run
CAvoid hot spots and standing waves
DPrevent the crystal from overheating
Answer is hidden
Question 32 of 78Physiotherapy and Electrotherapy Equipment

A high beam non-uniformity ratio in a therapeutic ultrasound head indicates:

AGood beam quality
BMarked peaks of intensity within the beam, risking tissue damage
CA large effective radiating area
DLow output power
Answer is hidden
Question 33 of 78Physiotherapy and Electrotherapy Equipment

Chronaxie is defined as the pulse duration required to excite a muscle at an intensity of:

AThe rheobase itself
BTen times the rheobase
CHalf the rheobase
DTwice the rheobase
Answer is hidden
Question 34 of 78Physiotherapy and Electrotherapy Equipment

In interferential therapy, two medium-frequency currents are used because they:

AProduce heat rather than stimulation
BCross the skin with low impedance and beat to give a low-frequency current deep in the tissue
CCannot stimulate nerve
DRequire no electrodes
Answer is hidden
Question 35 of 78Physiotherapy and Electrotherapy Equipment

Conventional high-frequency TENS relieves pain principally by:

AHeating the tissue
BStimulating large A-beta fibres and closing the gate in the dorsal horn
CReleasing endogenous opioids
DBlocking the neuromuscular junction
Answer is hidden
Question 36 of 78Physiotherapy and Electrotherapy Equipment

Pain relief produced by acupuncture-like low-frequency TENS can be reversed by naloxone, which indicates that it is mediated by:

AGate control in the dorsal horn
BDirect nerve block
CEndogenous opioid release
DLocal vasodilatation
Answer is hidden
Question 37 of 78Physiotherapy and Electrotherapy Equipment

TENS electrodes must not be placed over the anterior neck because stimulation of the carotid sinus may cause:

AMuscle hypertrophy
BSkin burns only
CCataract formation
DHypotension and laryngospasm
Answer is hidden
Question 38 of 78Physiotherapy and Electrotherapy Equipment

Deep heating modalities are contraindicated in a patient with a metal implant because metal:

AConcentrates the current and may cause a local burn
BAbsorbs no energy
CReflects all the energy harmlessly
DPrevents the machine from tuning
Answer is hidden
Question 39 of 78Physiotherapy and Electrotherapy Equipment

Pulsed short-wave diathermy differs from continuous short-wave diathermy in that it:

AUses a different frequency
BHeats only fat
CRequires no electrodes
DProduces a negligible mean temperature rise while delivering the same peak energy
Answer is hidden
Question 40 of 78Haemodialysis Machines and Lithotripters

In haemodialysis, the removal of urea from the blood occurs principally by:

AActive transport across the membrane
BUltrafiltration under transmembrane pressure
COsmosis into the blood
DDiffusion down its concentration gradient
Answer is hidden
Question 41 of 78Haemodialysis Machines and Lithotripters

Blood and dialysate flow in opposite directions through a dialyser in order to:

AAllow the use of a smaller membrane area
BPrevent clotting of the fibres
CReduce the blood pump speed required
DMaintain the concentration gradient along the whole length of the dialyser
Answer is hidden
Question 42 of 78Haemodialysis Machines and Lithotripters

The blood pump of a haemodialysis machine is a peristaltic roller pump because:

AIt measures blood flow directly
BIt can generate very high pressures
CIt requires no electricity
DThe pump mechanism never contacts the blood, which remains inside the tubing
Answer is hidden
Question 43 of 78Haemodialysis Machines and Lithotripters

A conductivity alarm on a dialysis machine protects the patient against:

AExcessive heparin
BMembrane rupture
CAir embolism
DIncorrect dialysate composition, which could cause haemolysis or osmotic disturbance
Answer is hidden
Question 44 of 78Haemodialysis Machines and Lithotripters

The air detector in the venous line of a dialysis circuit is critical because it prevents:

AClotting of the dialyser
BAir embolism
CBlood leak into the dialysate
DHypothermia
Answer is hidden
Question 45 of 78Haemodialysis Machines and Lithotripters

Cellulosic dialysis membranes were largely replaced by synthetic membranes because cellulosic membranes:

AAre mechanically too strong
BStrongly activate complement, causing first-use reactions
CCannot remove urea
DAre impermeable to water
Answer is hidden
Question 46 of 78Haemodialysis Machines and Lithotripters

Disequilibrium syndrome during early dialysis sessions is caused by:

AExcessive heparin administration
BToo rapid removal of urea, producing cerebral oedema
CHypothermic dialysate
DMembrane rupture
Answer is hidden
Question 47 of 78Haemodialysis Machines and Lithotripters

Chloramine must be removed from dialysis water by activated carbon because it causes:

AHaemolysis
BAluminium encephalopathy
CHypercalcaemia
DAir embolism
Answer is hidden
Question 48 of 78Haemodialysis Machines and Lithotripters

Extracorporeal shock waves fragment a urinary stone while sparing soft tissue because:

ASoft tissue and water have similar acoustic impedance, but the stone presents a large mismatch
BThe wave is focused only inside the stone
CStones absorb ultraviolet light
DSoft tissue reflects the wave completely
Answer is hidden
Question 49 of 78Haemodialysis Machines and Lithotripters

In an electrohydraulic lithotripter using an ellipsoidal reflector, the stone is positioned at:

AOutside the reflector entirely
BThe second focus, F2
CThe centre of the reflector surface
DThe first focus, F1
Answer is hidden
Question 50 of 78Haemodialysis Machines and Lithotripters

Shock wave delivery in modern lithotripters is often synchronised to the ECG in order to:

AIncrease the energy of each shock
BImprove stone localisation
CAvoid inducing cardiac arrhythmia by firing during the refractory period
DReduce the number of shocks needed
Answer is hidden
Question 51 of 78Haemodialysis Machines and Lithotripters

Which is an absolute contraindication to extracorporeal shock wave lithotripsy?

AMild hypertension
BPregnancy
CStone of 1 cm in the renal pelvis
DPrevious ureteroscopy
Answer is hidden
Question 52 of 78Haemodialysis Machines and Lithotripters

Extracorporeal shock wave therapy applied to plantar fasciitis differs from lithotripsy in that it aims to:

ADestroy the fascia completely
BStimulate a biological healing response rather than fragment a target
CRequire general anaesthesia always
DUse much higher energy
Answer is hidden
Question 53 of 78Anaesthesia Machines, Ventilators and Infusion Systems

On an anaesthesia machine, oxygen is placed last (most downstream) in the flowmeter manifold so that:

ANitrous oxide can be delivered alone
BOxygen flows more smoothly
CA leak in another flowmeter tube cannot dilute the oxygen supply
DThe oxygen flowmeter is easier to read
Answer is hidden
Question 54 of 78Anaesthesia Machines, Ventilators and Infusion Systems

The hypoxic guard on an anaesthesia machine ensures that:

AThe delivered mixture always contains at least about 25 per cent oxygen
BNitrous oxide is never used
CThe vaporiser cannot be overfilled
DThe oxygen cylinder cannot be removed
Answer is hidden
Question 55 of 78Anaesthesia Machines, Ventilators and Infusion Systems

Which monitor provides the definitive confirmation that a tracheal tube is correctly placed in the trachea?

APulse oximetry
BChest auscultation alone
CCapnography
DAirway pressure measurement
Answer is hidden
Question 56 of 78Anaesthesia Machines, Ventilators and Infusion Systems

A negative pressure ventilator such as the iron lung works by:

ACooling the chest to reduce metabolic demand
BApplying subatmospheric pressure around the chest so air is drawn in through the natural airway
CForcing gas into the lungs through a tracheal tube
DOscillating the chest wall at high frequency
Answer is hidden
Question 57 of 78Anaesthesia Machines, Ventilators and Infusion Systems

In a pressure-cycled ventilator, a fall in lung compliance will result in:

AA constant tidal volume with higher pressure
BA reduced tidal volume
CAn increased tidal volume
DNo change in either pressure or volume
Answer is hidden
Question 58 of 78Anaesthesia Machines, Ventilators and Infusion Systems

Pressure support ventilation is described as flow-cycled, meaning that inspiration ends when:

AInspiratory flow falls to a set fraction of its peak value
BA set time has elapsed
CA set volume has been delivered
DThe patient's effort ceases entirely
Answer is hidden
Question 59 of 78Anaesthesia Machines, Ventilators and Infusion Systems

Positive end-expiratory pressure is applied principally to:

AReduce the inspired oxygen requirement to zero
BShorten the inspiratory time
CPrevent alveolar collapse and improve oxygenation
DIncrease the tidal volume
Answer is hidden
Question 60 of 78Anaesthesia Machines, Ventilators and Infusion Systems

In lung-protective ventilation for ARDS, the tidal volume is set at approximately:

A6 mL/kg of predicted body weight
B3 mL/kg of actual body weight
C15 mL/kg of predicted body weight
D12 mL/kg of actual body weight
Answer is hidden
Question 61 of 78Anaesthesia Machines, Ventilators and Infusion Systems

The commonest and most immediately lethal hazard associated with mechanical ventilation is:

AOxygen toxicity
BCircuit disconnection
CAlarm battery depletion
DHumidification failure
Answer is hidden
Question 62 of 78Anaesthesia Machines, Ventilators and Infusion Systems

A syringe pump is preferred to a volumetric peristaltic pump when:

AParenteral nutrition is required
BNo power supply is available
CSmall volumes of a potent drug must be delivered accurately at a low rate
DSeveral litres of crystalloid must be given rapidly
Answer is hidden
Question 63 of 78Anaesthesia Machines, Ventilators and Infusion Systems

A characteristic problem of syringe pumps delivering vasoactive drugs is:

AInability to deliver rates above 1 mL/h
BComplete absence of alarms
CStart-up delay and a bolus when an occlusion is released
DFree flow whenever the door is opened
Answer is hidden
Question 64 of 78Anaesthesia Machines, Ventilators and Infusion Systems

An infusion system in which the pump rate is automatically adjusted from a continuously measured blood glucose value is an example of:

APatient-controlled analgesia
BTarget-controlled infusion
COpen-loop control
DClosed-loop control
Answer is hidden
Question 65 of 78Anaesthesia Machines, Ventilators and Infusion Systems

Free flow of intravenous fluid when a giving set is removed from a volumetric pump is prevented by:

AThe occlusion alarm
BThe drug library
CAn anti-free-flow clamp on the administration set
DThe air-in-line detector
Answer is hidden
Question 66 of 78Patient Safety

The physiological effect of an electric shock is determined principally by the:

AMagnitude and path of the current and the duration of contact
BColour of the insulation
CVoltage alone
DPower rating of the equipment
Answer is hidden
Question 67 of 78Patient Safety

The 'let-go' current at mains frequency, above which a person can no longer release a conductor, is approximately:

A10 to 20 mA
B1 mA
C1 A
D100 mA
Answer is hidden
Question 68 of 78Patient Safety

Microshock differs from macroshock in that microshock:

AAffects only the skin
BRequires a much higher voltage
CDelivers the whole current directly to the myocardium through an intracardiac pathway
DOccurs only with direct current
Answer is hidden
Question 69 of 78Patient Safety

A patient with a saline-filled intracardiac pressure line is described as electrically susceptible and must be connected only to equipment of class:

AType CF
BClass II only
CType BF
DType B
Answer is hidden
Question 70 of 78Patient Safety

Leakage current in a piece of medical equipment:

AIs present even when the equipment is functioning perfectly
BOccurs only when there is a fault
CIncreases with the frequency of the ECG signal
DIs always zero in Class I equipment
Answer is hidden
Question 71 of 78Patient Safety

Current flowing between two ECG electrodes through the patient during normal operation is called:

APatient leakage current
BPatient auxiliary current
CEarth leakage current
DEnclosure leakage current
Answer is hidden
Question 72 of 78Patient Safety

Leakage current limits in the standards are specified both in normal condition and in single fault condition because:

ANo single failure should be allowed to create a hazard
BSingle fault condition is safer
CNormal condition cannot be measured
DEquipment is normally used in a faulty state
Answer is hidden
Question 73 of 78Patient Safety

Equipotential bonding in a critical care area protects the patient by ensuring that:

AAll equipment is double insulated
BThe mains supply is switched off automatically
CLeakage currents are eliminated entirely
DNo potential difference exists between metal items that may be touched simultaneously
Answer is hidden
Question 74 of 78Patient Safety

A residual current device set to trip at 30 mA:

AProtects against both macroshock and microshock
BProtects only against fire
CProtects against macroshock but not against microshock
DReplaces the need for protective earth
Answer is hidden
Question 75 of 78Patient Safety

In an electrical safety test, the protective earth continuity resistance of a Class I device should typically not exceed:

A1 megohm
B10 ohms
CAbout 0.2 ohms
D100 ohms
Answer is hidden
Question 76 of 78Patient Safety

Insulation resistance in an electrical safety test is measured by applying:

AMains voltage at 50 Hz
B500 V DC between the mains parts and earth or applied parts
C10 A at low voltage
DA 9 V battery
Answer is hidden
Question 77 of 78Patient Safety

The measuring device network built into an electrical safety analyser is designed to:

AMimic the frequency-dependent response of the human body to current
BConvert direct current to alternating current
CIncrease the measured current for safety margin
DFilter out the ECG signal
Answer is hidden
Question 78 of 78Patient Safety

Electrical safety testing of a medical device should be performed:

AOnce in the lifetime of the device
BAt commissioning, after any repair, and at defined regular intervals
COnly by the manufacturer at the factory
DOnly when the device fails in use
Answer is hidden
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