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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

Primary FRCA MCQ June 2009


The following drugs cause hypokalaemia:
A) Pentazocine
B) Glucocorticoid
C) Salbutamol
D)Furosemide
E) Spirinolactone
In the liver:
A) Hepatic arterial blood flow is greater than portal
blood flow
B) the bile canaliculus is at the centre of the lobule
C) the portal vein supplies a third of the the total
hepatic blood flow
D) Portal venous pressure is normally greater than 20mmHg
E) The oxygen tension is lowest at the centre of the
lobule
pharmacology..
the following drugs may be used in the treatment of digoxin toxicity
a) phenytoin
b) lidnocaine
c) propanolol
d)potassium chloride
e)calcium chloride
Concerning competative antagonists..
a) show affinity for the agonist binding site
b) shift the dose-response curve to the right
c) prevent the agonist from attaining a maximal response
d) flumazenil is an example
Drugs which are renally excreted unchanged..
a)atenolol
b)ciprofloxacin
c) digoxin
d) morphine
e)..

In comparison to sodium nitroprusside, GTN shows..

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
a) greater propensity for venodilatation
b) improved myocardial contractility
c) cyanide toxicity

Regarding thiopental
a) has a pKa of 6.2
b) is metabolised to phenobarbitone
c) is protein boound to a greater extent than propofol
d) is more lipid soluble than propofol

REgarding sevoflurane
a)has a BP of 48.5
b) SVP of 21
c) is metabolised to a greater extent than desflurane
d) is more dense than ...

the onset of inhalational anaesthesia will increased by


a) increased alveolar ventilation
b) increased CO
c) adding CO2 to the inhaled mixture

the following drugs have active metabolites


a) vecuronium
b) morphine
c) pethidine
d) ketamine

The following frugs have a direct action on the contractility of the heart
a) digoxin
b) ephedrine
c)phenylephrine
Ropivacaine
a) is a pure enantiomer
b) is more lipid soluble than bupivicaine
c)
Drugs which increase lower oespohageal sphincter tone
Drugs which increase uterine tone

Acknowledgement: Thanks to the candidates of May 2009 Course2

University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

situations which delay gastric emptying


Physiology
Regarding the nutrition content of the following
a) 1L 5% dextrose contains 500 KCal (2100 KJ)
b) fructose contains more calories than glucose

The following will increase the level of aldosterone


a) ADH
b) renin
c)angiotensin
d) decreased salt load to JGA

baroreceptors

the anatomy of the liver


a) the bile canniculi are in the centre of each lobule
b) blood supply..
c) the centre of the lobule is more prone to ischaemia than the periphery

THe following will cause an increase in the A-a gradient


a) general anaesthesia
b) pneumonia
c) hypovolaemia
if a patient is anaesthetised in the left lateral position
a) the FRC will be in the uppermost area of the lung
b) a question about V/Q ratio in different areas of the lung
Closping capacity
a)is the same as closing volume
b) decreases with age
c) can be measured by helium dilution
d)something related to FRC
The following will increase net filtration in the glomerulus
a) efferent arterial pressure of 32
b) bowmans capsule oncotic pressure of....
c)glomerular hydrostatic pressure of..

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

Transmission of pain
a) fibres decussate in spinal cord
b) are A delta or C fibres
c) synapse twice befre reach cerebral cortex

physics and data interpretation


biological potentials
damping in invasive BP monitoring
specific heat definitions
A cylinder of entonox
a) should be filled to approx 140 bar
b) has equal measures of O2 and N2O by weight
c) can be stored horizontally
d) has a critical temperature of 5.5

FROM RCOA MCQ BOOKS


1. Arterial baroreceptors:
a. Are located only in the carotid sinus
b. Are stretch receptors
c. Increase their discharge rate in response to inc BP
d. Respond to changes in PaO2
e. Influence the secretion of thyroxine
2. Aldosterone secretion is stimulated by:
a. Volume expansion
b. Direct action of rennin
c. ADH
d. Direct action of Angiotensin
e. Reduction in serum sodium concentration
3. The following are true of the pressure/force relationship:
a. For a given force applied to syringe, doubling the diameter of the syringe will
reduce the pressure generated by a factor of four
b. Pressure required to open an expiratory valve at its minimum setting is approx
50 Pa
c. Pressure of a full oxygen cylinder is approximately 138 atmospheres
d. Entonox requires only a single stage reducing valve
e. Gauge pressure = measured value + atmospheric pressure

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

4. The following are true or follow Starlings law of the heart:


a. Increased end diastolic volume increases stroke volume
b. Increased ventricular fibre length increases force of contraction of ventricular
muscle
c. Increased atrial fibre length increases the force of contraction of atrial muscle
d. Duration of systole is decreased when the stroke volume increases
e. Law operates less efficiently in denervated or partially denervated heart
5. Concerning the cryoprobe:
a. Cooling is an adiabatic process
b. Rapid gas expansion from a capillary tube produces a fall in temperature
c. Cooling is due to internal energy change resulting from gas expansion
d. CO2 is a suitable gas for routine use
e. Tip temperatures as low as -90 deg C are required for efficient use
6. CVP measurement:
a. Must be carried out with the patient supine
b. Must be zeroed at 2nd intercostal space in mid-axillary line
c. Should normally show a pressure of +10 cm H2O
d. Requires a catheter placed in the right atrium
e. Can be accurately measured with an arterial pressure transducer
FROM MEMORY (hence not the complete set of answers for each question!!)
7. Sevoflurane
a. Has a BP of 48.5 deg C
b. Has an SVP of 89 mm Hg
c. Is metabolised more than desflurane
8. Muscle pains caused by administration of suxamethonium
a. Are more common in children and the elderly
b. Are diminished by co-administration of opioids
c. Are reduced by early ambulation
9. BIS
a. Can be measured in Hz
b. Is not affected by natural sleep
10. Data interpretation:

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

2 questions with a graph of a negatively skewed distribution, which was


marked with A,B,C which referred to mean, median and mode (these were
asked about in the questions)
2 questions on ABG of young woman with type 2 respiratory failure,
pneumonia and acidosis (HCO3 25, base excess -15). Ques re ?needs to be
intubated and ventilated immediately, ? respiratory or metabolic acidosis, ?
needs intravenous fluids,
2 questions on ECG on elderly man for elective inguinal hernia repair,
showing ST elevation V1-V3, II, III, aVF, LVH. Ques ?LVH, ?Left Axis
Deviation, ?Caliberation is 1cm = 1 mV, ? inferior infarct, ? op needs to be
cancelled

11. Following drugs are not safe to be given to patients on MAOIs


a. Ephedrine
b. Tramadol
c. Norad
d. Adrenaline
e. Morphine
12. Measurement systems
a. Critical damping is 0.8
b. Underdamped systems raise the measured diastolic pressure
c. MAP will always be accurate
d. Start of oscillations will relate to systolic BP
e. Cuff width should be 20% greater the diameter of arm
13. Glibenclamide
a. Is useful in Type 1 diabetes
b. Increases secretion of insulin
c. Increases sensitivity of insulin receptors to insulin
d. Can cause hypoglycaemic attacks
14. Digoxin toxicity can be treated with
a. Phenytoin
b. Amiodarone
c. Calcium chloride
15. Ropivacaine
a. Induces the cytochrome P450 system
b. Is more lipid soluble than bupivacaine
c. Is an ester

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank

16. In a soda lime canister in a circuit system


a. KOH is reformed
b. Ca(OH)2 is reformed
c. Water is essential for efficient functioning
pharmacology..
the following drugs may be used in the treatment of digoxin toxicity
a) phenytoin
b) lidnocaine
c) propanolol
d)potassium chloride
e)calcium chloride
Concerning competative antagonists..
a) show affinity for the agonist binding site
b) shift the dose-response curve to the right
c) prevent the agonist from attaining a maximal response
d) flumazenil is an example
Drugs which are renally excreted unchanged..
a)atenolol
b)ciprofloxacin
c) digoxin
d) morphine
e)..

In comparison to sodium nitroprusside, GTN shows..


a) greater propensity for venodilatation
b) improved myocardial contractility
c) cyanide toxicity

Regarding thiopental
a) has a pKa of 6.2
b) is metabolised to phenobarbitone
c) is protein boound to a greater extent than propofol
d) is more lipid soluble than propofol

REgarding sevoflurane
a)has a BP of 48.5
b) SVP of 21
c) is metabolised to a greater extent than desflurane
d) is more dense than ...

the onset of inhalational anaesthesia will increased by

Acknowledgement: Thanks to the candidates of May 2009 Course7

University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
a) increased alveolar ventilation
b) increased CO
c) adding CO2 to the inhaled mixture

the following drugs have active metabolites


a) vecuronium
b) morphine
c) pethidine
d) ketamine

The following frugs have a direct action on the contractility of the heart
a) digoxin
b) ephedrine
c)phenylephrine
Ropivacaine
a) is a pure enantiomer
b) is more lipid soluble than bupivicaine
c)
Drugs which increase lower oespohageal sphincter tone
Drugs which increase uterine tone
situations which delay gastric emptying
Physiology
Regarding the nutrition content of the following
a) 1L 5% dextrose contains 500 KCal (2100 KJ)
b) fructose contains more calories than glucose

The following will increase the level of aldosterone


a) ADH
b) renin
c)angiotensin
d) decreased salt load to JGA

baroreceptors

the anatomy of the liver


a) the bile canniculi are in the centre of each lobule
b) blood supply..
c) the centre of the lobule is more prone to ischaemia than the periphery

THe following will cause an increase in the A-a gradient

Acknowledgement: Thanks to the candidates of May 2009 Course8

University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
a) general anaesthesia
b) pneumonia
c) hypovolaemia
if a patient is anaesthetised in the left lateral position
a) the FRC will be in the uppermost area of the lung
b) a question about V/Q ratio in different areas of the lung
Closping capacity
a)is the same as closing volume
b) decreases with age
c) can be measured by helium dilution
d)something related to FRC
The following will increase net filtration in the glomerulus
a) efferent arterial pressure of 32
b) bowmans capsule oncotic pressure of....
c)glomerular hydrostatic pressure of..
Transmission of pain
a) fibres decussate in spinal cord
b) are A delta or C fibres
c) synapse twice befre reach cerebral cortex

physics and data interpretation


biological potentials
damping in invasive BP monitoring
specific heat definitions
A cylinder of entonox
a) should be filled to approx 140 bar
b) has equal measures of O2 and N2O by weight
c) can be stored horizontally
d) has a critical temperature of 5.5

Comparing ropivacaine with bupivacaine


cant remember stems.
Sevo;
SVP, boiling point
Na blocking drugs;
mexilitine
LA
etc
Drugs affecting folate met;
GTN
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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
N2O
Penicillin
Sulphonamides
Trimethroprim
A2 agonist;
cant remember stems
V/Q mismatch question with top/botom lung;
Comparing V/Q at top to bottom
PaCO2 higher at top or bottom
PaO2 higher at top of bottom
Stimulation of Aldosterone release;
renin
ADH
AII
Na levels
Question on doppler shift
cant remember stems
Question on BIS, BP monitoring (invasive and noninvasive)
Statistitcs; positive shift distributions;
markers for mean mode and median displayed but not
labelled, questions about which is which
Data interpretation;
ABG respiratory acidosis with metabolic compensation;
Be able to interpret BE level
ECG MI
Be able to interpret axis deviation, PR interval
Competitive antagonists:
a. Have an affinity to the agonist binding site on the receptor
b. Shift the log dose-response curve to the right
c. Do not depress the maximum obtainable response of the agonist
d. Include flumazenil
e. Increase the apparent affinity of the agonist for its receptor
In a patient taking a Mono-Amine Oxidase Inhibitor:
a) increased endogenous norepinephrine release
b) a hypertensive crisis may follow pethidine
administration
c) intravenous norepinephrine may be used safely
d) inhibition of microsomal liver enzymes
e) ephedrine should be avoided

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
Intravenous aminophylline:
a) increases norepinephrine release
b) decreases intracellular cyclic adenosine monophosphate
c) is an adenosine receptor antagonist
d) reduces intra-ocular pressure
e) crosses the blood brain barrier
One mole of a gas:
a) contains 6.022x10(23) molecules
b) occupies 2.24 litres at STP
c) that weighs 44g must be oxygen
d) is defined as the number of molecules contained in
0.012kg of carbon-12
e) is the SI unit of volume
Airway resistance:
a) is measured using body plethysmography
b) units are litres kPa(-1)
c) is independent of lung volume
d) is increased during forced expiration
e) is independent of flow
Skeletal muscle tone will be increased by:
a) transection of the anterior root spinal segments
b) hypokalaemia
c) destruction of the posterior spinal roots
d) gamma-efferent activity
e) voluntary hyperventilation
Closure of the foramen ovale in the neonate results from:
a) decreased pulmonary vascular resistance
b) reversal of the pressure gradient between right and
left atria
c) decreased blood volume immediately following delivery
d) hypoxaemia persisting after delivery
e) reduced production of prostaglandin E-1
PHARMACOLOGY

Glibenclamide
a) is renally excreted
b) can cause lactic acidosis
c) can cause hypoglycaemia
The following drugs should be reduced in dose in the presence of renal failure
a) metformin
b) cefuroxime
PHYSIOLOGY
Closing volume
a) is greater than closing capacity
b) can be measured by helium dilution

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
c) is increased with increasing age
PHYSICS
One mole
a) contains 6 x10 (23) atoms
b) of 44 grams has to be oxygen
c) occupies 2.24L at STP

1) Which of the following values are derived rather than


measured directly on a blood gas machine;
a- pH
b- pCO2
c-Base excess
d- Actual bicarbonate
e-Standard bicarbonate
2) Following block sodium channels
a- Mexilitine
b- Glucagon
c-Lidocaine
d-Phenytoin
e- ?propranolol
There were questions on.....
1. Which of the following rays are part of the
electromagnetic spectrum? options were
xray/doppler/radiotherapy/something that utislizes doppler
shift/??
2. Calorie content Fructose 30% solution/and comparing it
with glucose and fat emulsion
Concerning the cryoprobe:
a. cooling is an adiabatic process
b. rapid gas expansion from a capillary tube produces a fall in temperature
c. cooling is due ro internal energy change resulting from gas expansion
d. carbon dioxide is a suitable gas for routine use
e. tip temperatures as low as -90C are required for efficient use

Drugs that have their action at sodium channels


Milrinone
Lidocaine
Gtn
Phenytoin
And cannot remember the other
Comparison of gtn and na nitroprusside
Question about the mechanism of how competitive drug antagonists work
The data questions where
Abg on a girl with pneumonia, type 2 resp failure
Did she have type 2 failure because of shunt?
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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
Did she need intubating
Should she have 100 % o2
Another about a man with history angina for inguinal hernia repair
Ecg which showed ant septal and inf st elevation
Asked if he should have op cancelled
Rate
Lvh
If he had an inf mi
Physiology questions on
A - a gradient
Shunt
Muscle contraction
If you transect ant cord fibres
Post cord fibres
Non-parametric distribution with left skew, lines marked A, B and C
2 sets of 5 stems including:
a. this distribution is negatively skewed?
b/c. asked to identify mean, median, mode (2 stems)
d. would the mann-whitney u test be appropriate to analyse this population?
e. could the students t test be used?
1-Which drugs affect the Na channels
a phenytoin
b prilocaine
c mexilletine
some other drugs

2 which drugs are renally excreted


ciprofloxacin
Digxin
Atenolol
3 some definitions about heat
Specific capacity
heat capacity
4 Breathing system
a Lack is a Mapelson A system
b for spontaneous respiration requires FGF equal to minute volume
c it is dangerous if the inner tube is detached from the patient side
5 Sevoflurane
a boiling point
b Saturated vapour pressue

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
6 Mechanisms of secretion of ADH
7 mechanisms of secretion of Aldosteron
a Renin directly stimulates
b Angiotensin directly stimulate
c low serum serum Na
d Low serum potassium
Glibenclamide
a can cause hypoglycemic episodes
b stimulates insulin secretion
definition of absolute humidity
definition of relative humidity
definition of asobestic point in pulse oximetry
FRC redued in
Upright position
pregnancy
old age

suxamethonium muscle pain


ccan be reduced with diazepam premed
mostly affects children and old ages
early mobilisation post op will reduce the pain

BIS monitor
reduces the recall (awareness)
affected by normal sleep
value is shown in Hertz

Ropivacaine
a lipis solubility is more than lidocaine
is a racemic mixture
passes the placenta

some branches:
hair higrometer gets shorter if humidity goes up
Regnault hygrometer contains mercury
about damping
mean pressure will be under read with overdamoing
systolic pressure lower with underdamping
a bout cuff size for bp measurement
the size of cuff should be 20% more than the diameter of the arm

Acknowledgement: Thanks to the candidates of May 2009 Course14

University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
mechanisms increasing the speed of inhalational anaesthesi
a cardiac output
b increase alveolar ventilation
a question on which one is a Paramagnetic gass
Oxygen
Nitric oxide
CO2
Nitrous
Helium
one question about biological signals
ECG from 05 80Hz
EEG does not affect ECG
EMG affects ECG
which are direct inotropic
Adrenaline
Noreadrenalin
digoxin

which have hepatic metabolism


Vecuronium
furosemide
one question about the electricity leakage monitors in theatre

Concerning sevoflurane,
a)
b)
c)
d)
e)

Boiling point of 48 degrees


SVP at 20 degrees of 21kpa
More metabolised than desflurane
Respiratory stimulant at low concentration
Relaxes bronchial muscle

IV aminophylline,
a)
b)
c)
d)
e)

Increases norepinephrine levels


Reduces cAMP
Agonist at adenosine receptors
Reduce intraocular pressure
Crosses BBB

Treatment of digoxin-induced cardiac arrhythmia include


a) Phenytoin
b) Lidocaine
c) Propanolol

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
d) Potassium chloride
e) Calcium chloride

Which of these drugs increase myocardial contractility?


ephedrine
isoprenaline
phenylephrine
digoxin
quinidine

Metoclopramide causes:
Hypertension
Increased lower osephageal ?sphincter pressure
Prolactin release
Oculogyric crises
Hirtuism
NALOXONE:
A)Highly lipid soluble
B)High hepatic extraction
C)Peak Half life 1- 2hrs
Metoclopramide can cause:
A)hypertension
B)Hirsutism
C)Inceased oesophageal barrier pressur
D)Prolactinaemia
Skewed distribution graph:
A)This is a positive skewed graph
B)A is mode
C)B is median
D)C is mean
E)If all sqaured becomes a normal distribution graph
Coronary Circulation:
A)left and right coronary artery supply the left ventricle
B)Thesbian veins empty into left ventricle
C)coronary sinus empties into right atrium
D)Right coronary artery arises from post aortic sinus
Compared to intravascular compartment,interstitial compartment has more:
A)Chloride
B)Mg
C)HCO3
D)H+
E)K+

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University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
1- The following has a direct action on the cardiac
contrqactility:
a)Ephedrine
b)Phenylephrine
c)Isoprenaline
d)Digoxin
e)Quinidine
2- if the Cardiac output decreases and the O2 consumption
was unchanged, the following will increase:
a) Dead space to tidal volume ratio
b)The difference between the alveolar Po2 and arterial
PO2.
c)the arterial to mixed venous oxygen saturation
deifference
d)the arterial to alveolar PCO2 ratio
e)the blood Ph
3- The following affect the Na Channels:
a) Phenytoin
b)Theophylline
c) Prilocaine
d)Cyclizine
e)
1. Drugs excreted unchanged in urine are :
Atenolol
Digoxin
Vecuronium
Ketamine
Ciprofloxacin

GTN vs Sodium Nitroprusside (tachyphylaxis, CN toxicity, relative effect on capacitance


vessels, effect on contractility)
Aminophylline (mechanism of action in DETAIL)
Sevoflurane (boiling point, metabolism, respiratory stimulant at low concentrations?)
Cefotaxime (dose reduction in renal failure?)

Acknowledgement: Thanks to the candidates of May 2009 Course17

University Hopsitlas Coventry & Warwickshire S trust , Primary FRCA MCQ Bank
Ciprofloxacin (is it excreted unchanged?)
Carotid bodies question (verbatim from college book)
Total body water question (verbatim from college book)
Aldosterone secretion question (verbatim from college book)

Acknowledgement: Thanks to the candidates of May 2009 Course18