Académique Documents
Professionnel Documents
Culture Documents
2. Desflurane:
a) is a fluorinated methylisopropyl ether
b) boils at 23 degrees C
c) is safe to use in patients with malignant hyperpyrexia
d) stimulates the sympathetic system when inspired concentration is suddenly increased
e) prolongs the duration of muscle relaxants
5. Action potentials:
a) are all or none signals of about 100 mV in amplitude
b) are generated by leakage of K+ down their concentration gradient
c) are normally conducted antidromically
d) summate at high frequencies
e) depend on the size of the stimulus
8. Atropine:
a) may cause bradycardia
b) dilates the pupil in premedicant dose
c) has a shorter duration of action than glycopyrrolate
d) increases the physiological dead space
e) has both muscarinic and nicotinic effects
21. The following antibiotics have good activity against anaerobic bacteria:
a) vancomycin
b) aztreonam
c) metronidazole
d) imipenem
e) trimethoprim
22. Flumazenil:
a) may induce panic attacks in susceptible patients
b) has anticonvulsant activity in patients with epilepsy
c) has a long duration of action
d) may cause nausea and vomiting
e) has inverse agonist action at benzodiazepine receptors
24. Osmolality:
a) is the number of osmotically active particles per litre of solvent
b) of urine is similar to that of plasma in chronic renal failure
c) may be estimated by formula 2X(Na+K) + Blood sug + BUN
d) is measured by amount of depression of the freezing point
e) is a part of colloid oncotic pressure
ANSWERS
1.FFTTT
2.FTFTT
3.TFFTF
4.FFTFT
5.TFFFF
6.FTFTT
7.TTFTT
8.TTTTF
9.FFTTT
10.TTTFT
11.FTFTF
12.TTFTT
13.TFFTF
14.TFTTF
15.FFTFT
16.FTTTF
17.FFFFT
18.TFTTF
19.TTFFT
20.TTFTT
21.FFTTF
22.TFFTF
23.TTFFF
24.FTFTF
25.TFTTF
26.TTTTF
27.FTFFT
28.TFTTF
29.TTFFT
30.TTTFT
1. P50:
a) is normally 5.5 kPa
b) is increased at high altitude
c) is an indicator of the position of the oxygen dissociation curve
d) is increased in foetal blood
e) is increased in banked red blood cells
4. Lung compliance:
a) opioid m receptor
b) muscarinic cholinoceptors
c) nicotinic cholinoceptors
d) GABA A receptor
e) GABA B receptor
a) most lasers use light of wavelengths in the visible and infrared spectrum
b) the CO2 laser is strongly absorbed by water, blood and tissues
c) the Nd-Yag laser is absorbed mostly by pigments
d) nitrous oxide should be avoided during the use of a laser near the airway
e) endotracheal tube cuffs should be inflated with saline or water
a) chronic obstructive airways disease patients have high serum bicarbonate levels
b) the normal anion gap is 20-25 mmol/L
c) mixed venous pH is always lower than arterial pH
d) the pKa for bicarbonate buffer is 6.1
e) kidneys cannot produce urine with a pH <4.4
24. Baroreceptors:
26. Asystole:
ANSWERS
1.FTTFF (decreased 2-3DPG in banked RBC‟s causes a LEFT shift of curve and therefore DECREASED
P50)
2.TTFFT
3.TTFTF
4.TTTTT
5.FTFTT
6.TTFTF
7.TTFTT
8.FTTT
9.TTTFT (Lung compliance increases in emphysema because of the less elastic lung tissue)
10.TTTTT
11.TFTTT
12.TFTFF (2nd gas effect SPEEDS UP the rate of rise of alveolar pp of the inhalational agent)
13.TTTFF
14.TFTTT
15.FFTTT
16.TFTTT
17.FFTTF
18.FFFFT (most do in fact cross the BBB and act directly on the Vomiting Centre but the CTZ is
outside the BBB and DA and 5HT3 blockers antgonise these NT‟s peripherally)
19.TTFFT
20.TTTTT
21.TTFFT
22.TTTFT
23.TFTTT
24.FTTTF
25.FTFFT
26.FTFFF
27.TTTTT
28.FTTF
29.TFTFF
30.FFFFF
1. Hyponatraemia:
2. Adrenaline:
a) can be nebulised
b) is a bronchodilator
c) may elevate the blood sugar
d) has an almost equal effect on both alpha- and beta-adrenergic receptors
e) tracheal administration of adrenaline should be used even in presence of
IV access during cardiopulmonary resuscitation
3. Heparin:
4. Glycopyrrolate:
5. Isoprenaline:
7. Regarding nitrates:
8. Ephedrine:
a) shows tachyphylaxis due to downregulation of beta receptors
b) readily crosses the blood-brain barrier
c) releases noradrenaline at sympathetic nerve endings
d) has both alpha and beta effects
e) reduces placental blood flow
12. Methaemoglobinaemia:
16. Haemaccel:
a) is a derivative of starch
b) has an average molecular weight of 35,000 daltons
c) is equally distributed throughout the extracellular fluid
d) has a half life of 8 hours
e) is hypotonic
18. The haemoglobin oxygen dissociation curve is moved to the left by:
19. Amiodarone:
21. Pulmonary artery wedge pressure will be greater than left ventricular end diastolic
pressure in the following situations:
a) a greater osmolarity
b) a higher protein concentration
c) a lower chloride ion concentration
d) a lower hydrogen ion concentration
e) a lower potassium ion concentration
a) the most rapidly conducting fibres in the heart are the Purkinje fibres
b) the last part of the ventricle to be activated is the apex
c) the duration of an action potential in a ventricular muscle fibre is about the same as in a skeletal
muscle fibre
d) the T wave of the ECG occurs at the beginning of the absolute refractory period of the ventricle
e) left axis deviation leads to abnormally large R wave in Standard Limb Lead I
a) Conn‟s syndrome
b) prolonged unconsciousness
c) analgesic-induced nephropathy
d) diabetes insipidus
e) acutely decreased renal blood flow
ANSWERS
1.TTTFT a)see p.680, Kumar and Clark: fall in ECF osmolality causes H2O to move into cells.
2.TTTTF
3.FTTTT a) most texts quote max MW of 40,000 d) in high doses, PT is prolonged.
4.FTTFT c) hence use with caution in glaucoma.
5.TTFTF
6.TTTT
7.TTFTT
8.FTTTF
9.FTTTT
10.TTTFF
11.TTTTT
12.TTTTF
13.FTTTF
14.FFTTT
15.TTFTF
16.FTFFF
17.FTFTF
18.FTTTF
19.TTTTT
20.TFFTT
21.TTTFT
22.TTTTF
23.FFFTT
24.TFFFF
25.TTTTT
26.TFTFF
27.FFTFF
28.TTTTF
29.FTTTF
30.TTTTT
5. Rocuronium:
a) is an aminosteroid
b) is stable in aqueous solution
c) undergoes principally hepatic elimination
d) can provide intubating conditions within 60 seconds
e) does not release histamine
6. Propofol:
a) is insoluble in water
b) is bound to albumin up to 97-98%
c) reduces sodium channel opening times in neuronal membranes
d) is isotonic
e) does not cause tachycardia
10. The effects of moving from sea level to an altitude of 5000 m include:
a) hyperventilation
b) kidneys slowly lose bicarbonate
c) increased serum level of erythropoietin
d) increased number of mitochondria
e) heart rate remains elevated
16. Morphine:
a) 10-30% of oral morphine reaches the systemic circulation
b) has a terminal half-life of approximately 3 hours
c) has morphine-3-glucoronide as principal metabolite
d) morphine-6-glucoronide has no analgesic effect
e) increases the secretion of antidiuretic hormone
17. Amiodarone:
a) are designed to distend enormously when subjected to pressures above 50-60 mmHg
b) are of optimal size that fits neatly in one hand
c) prevent wastage of fresh gas flow during expiratory pause
d) provide a rough visual assessment of volume of ventilation
e) act as a reservoir because anaesthetic machine can not provide the peak inspiratory flow
required in normal respiration
a) Magill system is most efficient for spontaneously breathing patients even at a fresh gas flow
(FGF) of 70% of minute ventilation
b) D, E and F systems are all T pieces
c) Bain system requires a FGF of 50-60 ml/kg during spontaneous breathing
d) the rate of change of vapour concentration in circle system depends on circle system volume, the
FGF rate and net gas uptake
e) Magill system is inefficient during controlled ventilation because much of the gases are vented via
pop-off valve
29. Insulin:
ANSWERS
1.TTTFT
2.TTTFF
3.TTFTF
4.TTTTT
5.TTTTT
6.TTTTT
7.TTTTT
8.TFTTT
9.FTFTT
10.FFTFF
11.FTTTT
12.TTTTT
13.TTTTT
14.TFTT
15.TTTTF
16.TTTFT
17.TTTTT
18.FTTT
19.FFTTT
20.TTFTF
21.FTTTF
22.TFTFF
23.FTTFT
24.FTTTT
25.FTTF
26.TTFFF
27.TTTTF
28.FTTFF
29.FTTFT
30.TTTFT
2. Adrenaline:
a) epoprostenol
b) calcium heparin
c) hydroxyethyl starch
d) dipyridamole
e) remifentanil
a) standard bicarbonate is lower than actual bicarbonate in a chronic obstructive airways disease
(COAD) patient
b) metabolic alkalosis is seen with prolonged use of loop diuretics
c) standard bicarbonate is low in metabolic acidosis
d) about 70% of carbon dioxide is transported in plasma as bicarbonate
e) the ratio of HCO3/CO2 may be normal in a stable COAD patient
a) normal variation in barometric pressure at sea level is unlikely to influence end-tidal CO2
b) rebreathing can raise end-tidal CO2 if the minute ventilation remains unchanged
c) a decrease in cardiac output decreases the end-tidal CO2
d) discontinuation of N2O at the end of anaesthesia may transiently reduce the end-tidal CO2
e) shunt has less of an impact on end-tidal CO2 in contrast to O2
17. In a normal resting man, a fall in heart rate would be expected to occur following:
a) increased carotid sinus pressure
b) increased right atrial pressure
c) application of pressure to the eyeball
d) the release of a Valsalva manoeuvre
e) inspiration
a) the [H+] electrode relies for its action on the hydrogen ion sensitivity of a glass electrode
b) A CO2 electrode is, in principle, a modified [H+] electrode
c) The [H+] electrode requires no temperature compensation
d) CO2 may be measured by an infrared absorption spectrometer
e) N2O may be measured by an infrared absorption spectrometer
a) when the pulse is absent, the first thing to do is to go and telephone for help
b) the recovery position should be adopted when patient is unconscious and breathing through a
clear airway
c) ventricular fibrillation is the commonest primary cause of cardiac arrest
d) early defibrillation is the most important determinant of success in ventricular fibrillation
e) the peripheral venous route is preferred because CPR can continue and cannulation is rapid
24. Adenosine:
a) is composed of adenine and d-ribose
b) causes depression of cardiac contractility by binding to adenosine A1 receptors
c) mediates vasodilatation by binding to low affinity adenosine A2 receptors
d) is used in diagnosis of supraventricular arrhythmias
e) blocks re-entry circuits for its antiarrhythmic effects
a) H+ excreted into the tubular fluid reacts with HCO3- in the tubular fluid
b) H+ excreted into tubular fluid combines with HPO42- when HCO3- is consumed
c) H+ excreted into the tubular fluid reacts with NH3 when HPO42- is consumed
d) the phosphate and ammonia buffers are more utilised than HCO3 in metabolic acidosis
e) an increased amount of HCO3- is added to blood in respiratory acidosis
26. Total body oxygen consumption can be measured by the following methods:
ANSWERS
1.FTTTF
2.TFTTT
3.TTTFT
4.TTTTF
5.TFFTF
6.TTTTT
7.TTTTT
8.TTTTT
9.TFTTF
10 FTTTT
11.TTTTT
12.TTTTT
13.TTTTT
14.FFTFT
15.FFTFF
16.TTTTT
17.TTTTF
18.TTFTT
19.FTTTT
20.TFTTT
21.TTFFF
22.TTTTT
23.FTTTT
24.TTTTT
25.TTTTT
26.TTTTF
27.TTTTT
28.TFTTT
29.FTTTT (A: is false, range quoted is 25-125 dyn.sec/cm5 in A-Z, Fundamentals and Oxford
Handbook of critical care).
2. Halothane:
a) has a marked arrhythmogenic potential compared with other currently used volatiles
b) is a racemic mixture of optical isomers
c) has a minimal alveolar concentration of 0.29 in 70% of nitrous oxide
d) is metabolised to the greatest extent amongst currently available agents
e) sensitises the myocardium to endogenous or exogenous catecholamines
4. Enflurane:
5. Ketamine:
9. Concerning buffers:
14. When a patient is using a monoamine oxidase inhibitor, the following drugs should be
avoided:
a) halothane
b) pethidine
c) adrenaline
d) dopexamine
e) phenylephrine
a) anticholinergic drugs
b) histamine
c) vagal stimulation
d) gastrin
e) sucralfate
21. A more rapid induction of anaesthesia will occur using an inhalational agent if:
a) pKa
b) pH
c) molecular weight
d) binding site availability
e) lipid solubility
a) the rate of excretion is proportional to the concentration of the drug present in the body at any
time
b) the plasma level decay is exponential
c) excretion must be purely renal
d) excretion must not be affected by administration of another drug
e) 95% of the drug is eliminated in about three time constants
25. The following drugs have greater than 50% bioavailability after oral administration:
a) warfarin
b) propranolol
c) atenolol
d) lidocaine
e) morphine
a) opiates
b) metoclopramide
c) atropine
d) gastrin
e) dopamine
28. Lidocaine:
29. The factors affecting the rate of transport of a drug across the placenta are:
ANSWERS
1.TTTTT
2.TTTTT
3.FFTTT
4.TTFTF
5.TFTTT
6.TTFFF d)[H+] 36-46 nm/L [Na+] 135-145 mmol/l. Body concerned more with [H+] than [Na+]
7.TTTFF
8.TTFTT
9.FTFFT
10.TTFFT
11.FTTTF
12.TFTTF d)See West pg 53
13.TTFFT
14.FTTTT
15.FTFTF
16.FTTTF
17.FTTTT
18.TFTTT
19.FFTFF
20.TFFFF
21.FFTTF
22.TFFTF e) This is voltage mediated and no energy per se is needed – the ions flow because the
membrane is depolarised.
23.FTFTT d) competition for binding sites is competitive and can alter unbound fraction of each”
(Peck+Williams)
24.TTFTT
25.TFFFF c) 45% bioavailability in Calvey+Williams, QBASE, Peck+W BUT 50% in Fundamentals of
Anaesthesia e) only 25% reaches systemic circulation
26.TFTFT
27.TFFT
28.TFTFT
29.TTTTT e) all the above are true and are listed in Fundamentals pg 533 (old edition)
a) they are absorbed more rapidly after intercostal block than after caudal administration
b) in the foetus they are able to cross the placenta as readily as from the mother
c) they are weak acids
d) those which are esters are rapidly metabolised by liver enzymes
e) pKa is the pH at which more than half of a local anaesthetic exists in non-ionised form
8. With reference to the mechanical events in the cardiac cycle in a normal adult human:
a) the left ventricle ejects more blood per beat than the right ventricle
b) the mitral valve opens when the left atrial pressure exceeds the left ventricular pressure
c) during strenuous work, the left ventricular end-diastolic volume may be double that at rest
d) the pulmonary valve opens when the right ventricular pressure reaches 20-25 mmHg
e) during diastole, the left ventricular pressure is about 70 mmHg
a) an increase in muscle blood flow begins after the first half minute of exercise
b) cerebral blood flow rises if the exercise causes systolic arterial blood pressure to rise
c) body temperature may rise measurably
d) lymph flow from the exercising muscle increases
e) visceral blood flow decreases
a) all the foetal blood returning from the placenta flows directly into the inferior vena cava
b) foetal blood carries more oxygen than maternal blood at a low PO2
c) umbilical venous blood has a PO2 of 4-5 kPa
d) blood on the right side of the foetal heart is slightly better oxygenated than that on the left side
e) pulmonary vascular resistance is higher than after birth
14. If about 500 ml of isotonic saline were to be infused into a healthy adult,
the consequences would include:
a) is the degree of inotropic state of heart independent of preload, afterload or heart rate
b) determines the rate of development of ventricular pressure (dp/dt)
c) can be estimated by ventricular pressure-volume loops
d) is reduced by hypocalcaemia
e) accounts for approximately 90% of total myocardial oxygen consumption
a) fasciculation
b) sustained response to tetanic stimulation
c) presence of post-tetanic potentiation
d) small rapidly moving muscles are blocked first
e) more than 90% of the receptors must be blocked by the relaxant for optimal relaxation
21. Midazolam:
a) is an anticonvulsant
b) is lipid soluble at physiological pH
c) has no active metabolites
d) has an elimination half-life of 2-4 hours
e) can be administered as nasal drops for premedication
a) midazolam
b) remifentnil
c) propofol
d) sevoflurane
e) ropivacaine
24. Bioavailability:
27. Elderly patients show increased response to standard drug dosage and an increased
incidence of adverse drug reactions because they have:
30. Phenytoin:
ANSWERS
2. Adenosine triphosphate:
6. Concerning pain:
7. Gas chromatography:
a) depends on the partition of a substance between two phases, one stationary and one moving
b) the stationary phase is an inert solid material that packs the column
c) a specific detector is needed at the end of the column
d) a particular gas can be identified by its specific profile
e) the amount of a particular gas is calibrated against accurately known samples
9. Concerning flow:
10. The effects of opioids at a desired CNS receptor site depend on:
a) route of administration
b) volume of distribution
c) ionisation and protein binding
d) cerebral blood flow
e) permeability of blood-brain barrier
a) ephedrine
b) trimetaphan
c) suxamethonium
d) noradrenaline
e) sodium nitroprusside
a) it is a basic protein
b) 1 mg antagonises 100 mg heparin
c) it is a myocardial stimulant
d) it is contraindicated in hepatic failure
e) it is 60% protein bound
15. Vasoconstrictor agents with little or no positive inotropic effect include:
a) adrenaline
b) methoxamine
c) isoprenaline
d) dobutamine
e) metaraminol
a) a curve relating quantity of oxygen combining with haemoglobin to the partial pressure of oxygen
in the gas with which the blood is equilibrated
b) the dissociation constant of oxygen
c) a reflection of the efficiency of oxygen transport
d) the same shape and position for haemoglobin A and myoglobin
e) only of sigmoid shape in vivo.
19. The weight of gas dissolved in a liquid at constant ambient pressure at equilibrium
depends on:
a) anaphylaxis
b) masseter muscle rigidity
c) raised intraocular pressure
d) raised intragastric pressure
e) myoglobinuria
28. Warfarin:
a) skeletal muscles at rest utilise free fatty acids (FFA) as the energy source
b) the mechanical efficiency of skeletal muscles is greater during isotonic contraction than isometric
contraction
c) the amount of ATP generated from FFA varies with their size
d) th deamination of amino acids results in urea synthesis by the liver
e) phosphoryl creatine is an energy store for skeletal muscles for ATP synthesis
ANSWERS
1.TTTTT
2.FFFFT
3.FFTFT
4.FFFFT
5.TFTFT
6.TTTTT
7.TFTFT
8.FTTTT
9.FFTFF
10.TTTTT
11.TTFTT
12.TTTTT
13.TTFFT
14.TFFFF
15.FTFFT
16.TTTTT
17.TTTFF
18.TFTFF
19.TTFTF
20.TFFFF
21.TFTTF
22.TFFTF
23.TFTTF
24.TTTTT
25.FTTTT
26.FTTTT
27.TFTT
28.TTTTF
29.FTFTT
30.TTTTT
a) analgesic properties
b) high oil:gas partition coefficient
c) low blood:gas partition coefficient
d) boiling point less than 20 degrees C
e) low molecular weight
a) infrared thermometers use the frequency of electromagnetic radiation of the emitting object
b) thermistors measure temperature-sensitive electrical resisitance
c) liquid crystal is used for measurement of skin surface temperature
d) skin surface temperature corresponds to core temperature following induction of anaesthesia
e) core-peripheral temperature gradient is a measure of tissue perfusion
a) cerebrospinal fluid has a very poor buffering capacity for a given change in pH compared with
blood
b) carotid and aortic bodies start firing non-linearly when PaO2 falls below 13 kPa
c) stretch receptors in airways are an integral part of Hering-Breuer‟s reflex
d) epithelial receptors in the larynx can precipitate laryngospasm
e) J receptors are activated by pulmonary capillary engorgement
6. Dopamine:
7. Glyceryl trinitrate:
8. Sodium nitroprusside:
11. Verapamil:
12. The electrolyte and acid-base imbalance seen in end-stage renal failure includes:
a) metabolic alkalosis
b) a fall in serum magnesium
c) a rise in serum phosphate
d) a rise in serum calcium
e) a fall in serum potassium
a) is stored as a liquid
b) is a gas above a temperature of 36 degrees C
c) cylinders should have a filling ratio of 0.65-0.75
d) content in a cylinder is always reflected from its pressure gauge
e) cylinder when full has a pressure of about 50 atmospheres
a) the rise in mean arterial blood pressure (MAP) in phase I is due to the rise in intrathoracic
pressure
b) in phase II, decreased venous return is responsible for the drop in MAP
c) MAP increases in phase III due to the rise in heart rate and vasoconstriction
d) MAP returns to normal in phase IV
e) these changes are present even in autonomic dysfunction
16. Propofol:
a) has a pH of 7.0-8.5
b) is insoluble in water
c) is twice as potent as thiopentone
d) can be given as an infusion because its terminal half-life is less than 30 minutes
e) may change the colour of urine due to propofol glucuronide
18. Pneumotachograph:
a) inspiring a low tidal volume at a higher rate reduces the elastic component of work of breathing
b) work of breathing is increased at high inspiratory flow
c) the viscous component of work of breathing is increased in the presence of stiff lungs
d) low respiratory rate reduces the viscous component of work of breathing
e) patients naturally adopt a respiratory pattern which ensures the lowest work of breathing
29. Regarding the passage of glomerular filtrate through the renal tubules:
a) the thick ascending limb of the loop of Henle dilutes the filtrate by its powerful sodium pumps
b) the osmolality of the filtrate at the tip of loop of Henle is about 1200 mosm/L
c) the distal tubule is normally impermeable to water
d) glucose is absent in the filtrate in the loop of Henle
e) sodium concentration in the descending limb of the loop of Henle is the same as that in the
proximal convoluted tubule
ANSWERS
1.TTTFF
2.TTFTF
3.TTTTF
4.TTTTT
5.TTTTT
6.TTTTT
7.TTFTT
8.TTTTT
9.TTTFT
10.FTTTT
11.TTFTF
12.FFTFF
13.TTTFT
14.FTFTF
15.TTTTF
16.TTTFT
17.TFTTT
18.TTTTT
19.TFFFF (alpha 2 inhibits insulin release, beta 2 increases insulin release)
20.TTFTT
21.TTTTF
22.FTTFT
23.FFFFT
24.TTFTF
25.FTTTT
26.FTTFF
27.TTTFT
28.FTFTF (amiodarone slows repolarisation).
29.TTFTT
5. First-order processes:
7. 5-HT:
11. Adenosine:
a) is an endogenous nucleoside and a metabolite of high energy phosphates
b) has a half-life of 8-10 seconds
c) has a negative inotropic effect
d) can cause severe bradycardia
e) has cellular protective effects during hypoxia or ischaemia
a) 0.4% isoflurane at 3 atmospheres will produce a similar depth of anaesthesia to that produced by
1.2% isoflurane at sea level
b) rotameters may read falsely high due to an increase in gas density
c) air can be used to elicit a loss of resistance of epidural space
d) endotracheal tube cuffs should be inflated with saline
e) the risk of oxygen toxicity is higher with high FIO2
14. The natural frequency of direct pressure measuring systems (desirable > 30 Hz)
would be higher in presence of:
a) vagal blockade
b) mechanical obstruction
c) stimulation of splanchnic nerves
d) blockade of ventral roots near subarachnoid space below level of T4
e) neostigmine
21. Pulmonary arterial occlusion pressure will be greater than left ventricular end-
diastolic pressure in the presence of:
a) cardiac output
b) alveolar ventilation
c) transfer factor
d) carbon dioxide production
e) activity of medullary chemoreceptors
25. Central venous pressure is greater than pulmonary arterial occlusion pressure in:
a) right ventricular failure
b) pulmonary embolism
c) chronic lung disease
d) pulmonary hypertension
e) acute pulmonary regurgitation
26. The following statements are true regarding these new drugs:
a) when the glomerular filtration rate is reduced by 75%, serum creatinine begins to rise
b) urine osmolality reflects the tubular function
c) urinary sodium <20 mmol/L indicates hypovolaemia
d) fractional excretion of sodium is greater than normal in acute tubular necrosis
30. Blood urea nitrogen is an unreliable measure of renal dysfunction as it is increased in:
a) gastrintestinal haemorrhage
b) dehydration
c) excessive protein intake
d) end-stage liver disease
e) omission of essential amino acids from diet
ANSWERS
1.TFTFF
2.TFFTT
3.FTTTF
4.TTFFT
5.TTFTT
6.FTFTT (Cl= k. Vd)
7.FTTTT
8.TTFTT
9.TTTTT
10.TTTTT
11.TTTTT
12.TFFFF
13.TTFTT
14.TFTTF
15.TTTTT
16.TTTTF
17.TTFFT
18.TFFTF
19.TTTTT
20.FTFFT
21.TFTFF (see A-Z, with PEEP, LVEDP>PAWP)
22.FTTFF
23.TTTTF
24.TTTTT
25.TTTTT
26.TTTTT
27.TTTTT
28.TTTT
29.TTTFT
30.TTTFT
a) dose administered
b) volume of distribution
c) hepatic clearance
d) rate of injection
e) cardiac output
a) lidocaine
b) morphine
c) propofol
d) levo-bupivacaine
e) vecuronium
a) t1/2 = k/0.693
b) CL= k.Vd
c) CL = 0.693 x Vd / t1/2
d) pH = pKa + log [base/acid]
e) I x Css = CL
where I = infusion rate, Css = plasma concentration at steady state, CL = clearance
5. Ketamine:
a) is an imidazole derivative
b) has also antanalgesic effect
c) is contraindicated rectally
d) has no active metabolites
e) probably has no effect on intracranial pressure
6. The following statements are true regarding the opioids used in the perioperative
period:
a) bioavailabilty of most of the opioids given by the oral route is about 75-85%
b) highly water soluble opioids have a rapid onset of action
c) the duration of action of opioids is related to their terminal half-lives
d) they have flow-dependent hepatic clearance
e) morphine has a terminal half-life similar to fentanyl
8. Methohexitone:
a) is an oxybarbiturate
b) may cause pain on injection
c) is a methylated hexobarbitone
d) is safer in asthma than thiopentone
e) has a shorter half life than propofol
a) bronchospasm
b) increased uterine tone
c) hypoglycaemia
d) decreased peripheral blood flow
e) urinary retention
11. The following influence the rate of absorption of a drug given intramuscularly:
a) pka
b) pH
c) blood flow to the muscle
d) site of injection
e) pharmaceutical formulation
12. Clonidine:
a) is an alpha-1 adrenoceptor agonist
b) reduces catecholamine release in the body
c) is a commonly used antihypertensive agent
d) is contraindicated via the epidural route
e) does not alter the minimal alveolar concentration of volatile agents
15. Naloxone:
a) is a pure antagonist
b) does not produce antanalgesic effects in naive subjects
c) has a terminal half-life of 2.5 hours
d) can be used orally
e) completely reverses the side effects of buprenorphine
16. Enoximone:
17. In a patient with a low cardiac output, the following are true of inhalational
anaesthetic agents:
18. The rate of induction using an inhalational technique is directly related to:
a) the rate at which alveolar approaches the inspired fractional anaesthetic concentration
b) the blood-gas solubility coefficient
c) the inspired fractional anaesthetic concentration
d) the alveolar ventilation
e) right or left shunt
a) dexamethasone
b) isoflurane
c) glyceryl trinitrate
d) ketamine
e) nitrous oxide
a) age
b) increased extracellular fluid volume
c) pregnancy
d) renal failure
e) cardiac failure
ANSWERS
1.TFFTT
2.FFFFF
3.TTFFF (Parbrook, flow is directly proportional to the square root of pressure in turbulent flow)
4.FTTTF
5.FFFFF
6TFTFT
7.FFFTT
8.TTTFF
9.TTTFF
10.TTTTF
11.FFTTT
12.FTFFF
13.FTTTT
14.FTFTF
15.TFTFF
16.TFFTF
17.FFTFT
18.TTTTF
19.FFFTT
20.TFTFF
21.TFFTF
22.FTTTT
23.FFTFT
24.FFFFF
25.TTFFF
26.TTFTF
27.FFFTT
28.FFFFF
29.TTTTT
30.FFFFF
Art1. Albumin:
a) has a molecular weight of 69,000, with a strong negative charge on its surface
b) is synthesised by hepatocytes at a rate of 9-12 g/day in a healthy adult
c) generates oncotic pressure because of its high molecular weight
d) has a degradation half-life of 18 days
e) can be present in the urine in individuals on prolonged standing
a) when the rate of flow through tubule increases, the glomerular filtration rate (GFR) in the same
nephron decreases
b) when GFR increases, the solute reabsorption in the tubule also increases
c) for each H+ secreted in the renal tubule, one Na+ and one HCO3- enter the interstitial fluid
d) more H+ is secreted in the proximal tubule than in the distal tubule
e) urine becomes more acidic in presence of low plasma HCO3-
4. Regarding diuretics:
7. Esmolol:
a) when acid production is increased after a meal, urine may be less acidic
b) parietal cells have H+,K+-ATPase proton pumps
c) activity of the proton pump is determined by the level of cAMP in parietal cells
d) parietal cells have H2, M1 and gastrin receptors
e) prostaglandins inhibit the activity of proton pumps
14. Naloxone:
a) is a derivative of oxymorphone
b) has a reverse agonist effect
c) can cause pulmonary oedema
d) has a duration of effective antagonism of 30-45 minutes
e) has an antanalgesic effect in individuals not given opioids
a) bradykinin
b) histamine
c) 5-hydroxytryptamine
d) substance-P
e) calcitonin gene-related peptide (CGRP)
18. Pancuronium:
a) is a synthetic steroid
b) releases a large amount of histamine
c) causes noradrenaline release at nerve endings
d) can cause ganglion blockade
e) has a duration of action of 45-60 minutes
23. Glucagon:
24. Midazolam:
25. Ketamine:
a) nalbuphine
b) nalorphine
c) naloxone
d) buprenorphine
e) meptazinol
27. Enflurane:
a) is a halogenated hydrocarbon with an oil:gas partition coefficient of 98
b) when metabolised is converted to form inorganic flouride ions
c) at high concentration can cause seizures when associated with low PaCO2
d) depresses hypoxic pulmonary vasoconstriction
e) depresses uterine tone and contractility
a) flow is laminar in tubes that are very long compared with their diameter
b) flow is turbulent when Reynold‟s number is < 2000
c) flow through an orifice is influenced by the fluid or gas density
d) velocity is higher and pressure is lower at the point of constriction in a tube
e) at low haematocrit, blood flow is better in blood vessels
a) the mass of a gas that dissolves in a liquid is proportional to its partial pressure
b) a tube whose radius exceeds its length is called an orifice
c) bipolar cautery does not need a dispersive ground plate electrode
d) in unipolar cautery, if the dispersive pad is not in proper contact with the skin, burn can occur
around the ECG electrode
e) gases do not obey Boyle‟s law at temperatures at which they approach their point of liquefaction
BONUS QUESTION
ANSWERS
1.TTFTT
2.FFTTT
3.TTTTT
4.TTTTT
5.TTTTT
6.TTTTT
7.TTFTT
8.TTTTT
9.TTTTT
10.TTTFT
11.TTTTT
12.TTTTF
13.TTTTT
14.TFTTT
15.TTTTF
16.TTTTT
17.TTTTF
18.TFTFT
19.TTTTT
20.TTTTF
21.FTTTT
22.TTTTT
23.TTTTT
24.TTTTT
25.TTTFT
26.TTFTT
27.FTTTT (enflurane is a halogenated methylether)
28.TTTTF
29.TFTTT
30.TTTTT
BONUS QUESTION.TTTTT
6. If oxygen is added to inspired air to increase its partial pressure from 20 kPa (150
mmHg) to 60 kPa (450 mmHg):
a) serotonin
b) hypocarbia
c) hypoxia
d) a fall in pH
e) adrenaline
9. The fall in urine output associated with major trauma may be caused by:
a) haemorrhage
b) a rise in antidiuretic hormone activity
c) a fall in aldosterone activity
d) an increase in the level of circulating catecholamines
e) a rise in corticosteroid output
a) the PO2 is higher in the ductus venosus than in the ductus arteriosus
b) blood can go from the right atrium to the aorta without passing through the left atrium and
ventricle
c) the PO2 in the aortic arch is higher than in the descending aorta
d) blood flowing through the foramen ovale comes principally from the superior vena cava
e) blood passes through the ductus arteriosus because of the high pulmonary vascular resistance
a) hyperglycaemia
b) peripheral vasodilatation
c) suppression of uterine contractility
d) pupillary dilatation
e) a reduction in cardiac output
a) motor paralysis
b) loss of sensation
c) loss of reflexes
d) loss of sympathetic and sudomotor tone
e) hypotonia
a) plasma
b) red blood cells
c) renal tubular cells
d) gastric parietal cells
e) cardiac muscle cells
ANSWERS
1. FFTFF
2. TFTTF
3. TTTFF
4. TFTFT
5. TFTTT
6. TFFTF
7. TFTTF
8. FTFTF
9. TTFTT
10. TTTFT
11. FFTFT
12. TTFFT
13 FFFFT
14. FTTFF
15. TTFFF
16. FFTTT
17. FTFFT
18. FTTTF
19. FFTFF
20. FTTTT
a) stroke volume
b) left ventricular end-diastolic volume
c) arterial partial pressure of oxygen
d) systemic vascular resistance
e) blood viscosity
ANSWERS
1.TTTTT
2.TTFFF
3.TFTTF
4.FFTTT
5.TTTFF
a) catecholamines
b) an increase in heart rate
c) an increase in fibre length
d) an increase in parasympathetic nervous system activity
e) calcium ions
ANSWERS
6.TFFTT
7.FTTFF
8.TTTTT
9.TTTFT
10.TTFFT
11. The following cause a decrease in the arterial partial pressure of oxygen:
a) anaemia
b) carbon monoxide
c) hyperventilation
d) a rise in physiological dead-space
e) old age
ANSWERS
11.FFFFT
12.FTFTF
13.TFTTF
14.TFTFF
15.TTTTT
a) 3% carboxyhaemoglobin
b) 5% methaemoglobin
c) 70% oxyhaemoglobin
d) 2% free haemoglobin
e) 2% fetal haemoglobin
a) bradykinin
b) adrenaline
c) calcium
d) vasopressin
c) histamine
a) a decreased haematocrit
b) a decreased total blood volume
c) a decreased serum sodium concentration
d) an abnormal glucose tolerance test
e) a reduced metabolic rate
ANSWERS
16.TFTFF
17.FFTFF
18.TTFTT
19.TFFFT
20.FTFTF
3. In thermoregulation:
4. Adrenaline:
5. Glucagon:
a) is a positive inotrope
b) is produced by the beta cells of the pancreas
c) stimulates production of free fatty acids in the blood
d) release is increased in starvation
e) stimulates glycogen synthesis
ANSWERS
1.TFTFT
2.FFTTT
3.TTFFT (fundamentals of anaesthesia, 2nd edition page 446)
4.FTTTF
5.TFTTF
r6. Surfactant:
a) is a mucopolypeptide
b) causes a decrease in surface tension
c) results in the same surface tension for different sized alveoli
d) causes an increase in compliance
e) production is reduced after a prolonged reduction in pulmonary blood flow
7. Sinus arrhythmia:
a) produces a lengthening of the P-R interval
b) produces a lengthening of the R-R interval
c) is maximal with breath holding
d) is more marked during exercise
e) is more marked in 70 year olds than in 20 year olds
ANSWERS
6.FTFTT
7.FTFFF
8.TFFTF
9.FTFFT
10.TFFTF
a) sweat glands
b) the adrenal medulla
c) the parotid gland
d) parasympathetic ganglia
e) the neuromuscular junction
15. Insulin:
ANSWERS
11.FTTFT
12.TTTFF
13.FFTFF
14.TTTTT
15.FFTTT
19. Oxytocin:
a) stimulates production of milk
b) stimulates ejection of milk
c) release is stimulated by dilatation of the cervix
d) is synthesized in the anterior pituitary
e) produces more powerful uterine contraction in the presence of progesterone
20. Aldosterone:
ANSWERS
16.TFTTF
17.FTTTF
18.TFFFT
19.FTTFF
20.FFFTT
1. Adrenaline
4. Vital capacity:
ANSWERS
1.FTTFF
2.FTTTF
3.TTFTF
4.TFTFT
5.TFFFF
a) results in certain molecules in the blood taking longer to equilibrate with tissue fluid in the brain
than with tissue fluid elsewhere
b) permits CO2 to pass freely
c) is more permeable to water-soluble substances than fat-soluble substances
d) is more permeable in neonates than in adults
e) is readily crossed by dopamine
7. A reflex action:
8. Platelets:
9. The pressure:
a) drop across the major veins is similar to that across the major arteries
b) drop across the hepatic portal bed is similar to that across the splenic vascular bed
c) in the hepatic portal vein is higher than that in the inferior vena cava
d) drop across the vascular bed in the foot is greater when standing than when lying down
e) drop across the pulmonary circulation is the same as across the systemic circulation
6.TTFTF
7.TFFTT
8.TTFTT
9.FFTFF
10.FFFTT
a) the oxygen saturation when the arterial partial pressure of oxygen is 50 mmHg
b) the arterial oxygen tension when haemoglobin is 50% saturated
c) an indicator of the position of the oxygen dissociation curve
d) raised in foetal blood
e) lowered in chronic anaemia
5. Renin:
ANSWERS
1.FFFFT
2.FTTTF
3.FTTFF
4.TTTFT
5.TTFFT
a) testosterone
b) aldosterone
c) angiotensin
d) noradrenaline
e) deoxycorticosterone
2. Aldosterone:
3. Cerebrospinal fluid:
5. Bile:
ANSWERS
1.FTFFT
2.TFTFT
3.TFFFT
4.TTTFT
5.TFFFF
a) anaemia
b) acclimatisation to altitude
c) stored blood
d) trained athletes
e) cyanotic heart disease
ANSWERS
1.TTFFF
2.TFTTF
3.TTFTF
4.TTFFT
5.TTFFT
ANSWERS
1.TFTFF
2.TTFFF
3.TTTTT
4.TFFTT
5.TTFFF
ArticleDate:20060518
Si1. On ascending to an altitude of 6000m, changes include:
2. Transferrin is:
a) retrosternal pain
b) dizziness
c) auditory disturbances
d) convulsions
e) atelectasis
Donor Recipient
a) B O
b) AB A
c) B AB
d) O AB
e) AB O
a) have a higher rate of oxygen consumption per gram than brain tissue
b) respond to changes in oxygen tension and not content
c) respond to changes in pH
d) conduct afferent information via the glossopharyngeal and vagus nerves
e) are found in the carotid sinus
ANSWERS
1.TTTTF
2.FFTTT
3.TFFFT
4.TTFFT
5.FTTTF
1. In the healthy heart, an increase in stroke volume is seen with an increase in:
a) dP/dT
b) aortic systolic pressure
c) left ventricular end-diastolic volume
d) left ventricular end-systolic pressure
e) heart rate
a) parasympathetic block
b) sympathetic block
c) facial nerve block
d) trigeminal nerve block
e) oculomotor nerve block
a) tyrosine
b) phenylalanine
c) noradrenaline
d) dopamine
e) isoprenaline
ANSWERS
1.TFTFF
2.TTFFF
3.TTTFF
4.FTTFT
5.TTTTF
a) glucagon
b) adrenaline
c) growth hormone
d) starvation
e) major trauma
2. Adenyl cyclase:
3. Surfactant:
a) contains phospholipids
b) prevents oedema formation in the alveolar wall
c) reduces surface tension by approximately 30%
d) produces a monomolecular layer
e) stabilises the size of an alveolus
ANSWERS
1.TFTFT
2.TTFFF
3.TTFFT
4.FFFTT
5.FFTFT
a) the PR interval should be less than 0.2 s and greater than 0.12 s
b) the QRS complex should last less than 0.02 s
c) the T wave is normally greater than 1 mV
d) there will be an interval of 0.75 s between the end of one complex and the beginning of the next
e) the T wave is ventricular repolarisation
3. Atropine:
a) the maximum quantity of oxygen that will combine with 100 ml of whole blood
b) the ratio between oxygen uptake and oxygen usage
c) independent of the haemoglobin concentration
d) the oxygen physically dissolved in blood
c) normally of the order of 15 ml per 100 ml whole blood
10. Captropril:
a) if the cuff is too small for the arm, the pressure will tend to read high
b) accuracy is increased by leaving the cuff slightly inflated between readings
c) the slower the deflation, the more accurate the reading
d) a mercury column has a low frequency response
e) diastolic pressure agrees more accurately with direct measurement than will systolic pressure
a) amphetamine
b) atropine
c) propranalol
d) dobutamine
e) nifedipine
a) thermodilution
b) electromagnetic flow meter
c) Doppler ultrasound
d) limb plethysmography
e) ballistocardiography
ANSWERS
1.TFFFT
2.TTTFF
3.TTTFT
4.TFFFT
5.TTFFF
6.TFTTT
7.TFFFF
8.TFTFT
9.TFFFF
10.FTTFF
11.TTTTT
12.TFFTF
13.TTTFF
14.TFTFF
15.FTTTF
16.FFTFF
17.TFFTT
18.TTTFT
19.FFFFF
20.FTTFT
1. Cimetidine:
a) is exacerbated by digoxin
b) is precipitated by sulphonamides
c) is precipitated by ethyl alcohol
d) is treated by parenteral lidocaine
e) contraindicates the use of thiopentone
a) headache
b) nausea
c) abdominal pain
d) convulsions
e) coupled beats
a) tinnitus
b) metabolic acidosis
c) a reduction in the platelet count
d) haemolysis
e) hyperventilation
8. Pethidine:
a) digoxin
b) amiodarone
c) mexiletine
d) verapamil
e) bretylium
10. The following act directly on vascular smooth muscle by altering calcium transport:
a) nicardipine
b) sodium nitroprusside
c) hydralazine
d) bendrofluazide
c) dantrolene
11. Metoclopramide:
a) has an action on gastric emptying opposed by atropine
b) causes prolactin release
c) is a phenothiazine
d) lowers the blood glucose
e) is a dopamine antagonist
a) ethacrynic acid
b) gentamicin
c) frusemide
d) cefuroxime
e) streptomycin
14. Phenobarbitone:
a) androgenic
b) diabetogenic
c) progestogenic
d) anabolic
e) carcinogenic
16. Buprenorphine:
a) cimetidine
b) propranolol
c) clonidine
d) amiodarone
e) digoxin
18. Sulphonylureas:
a) are used in maturity-onset diabetes
b) can cause hypoglycaemia
c) are suitable for the treatment of ketoacidosis
d) are an effective treatment for hyperglycaemia following total pancreatectomy
e) can cause lactic acidosis
19. Hyoscine:
a) causes tachycardia
b) causes sedation
c) causes mydriasis
d) is an antiemetic
e) has a weaker antisialagogue effect than atropine
a) tremor
b) an increase in uterine contractility
c) a worsening of intermittent claudication
d) hypokalaemia
e) tachycardia
ANSWERS
1. FFFTT
2. FTTFT
3. TTTTT
4. TTTFT
5. TTFFT
6. FFTFT
7. TTFFF
8. FTFTT
9. FTTFT
10. TTTFF
11. TTFFT
12. TTTFT
13. TFTFF
14. TTTFF
15. TTFTT
16. FFTTF
17. FTTFF
18. TTFFF
19. TTTTF
20. TFFTT
1. Dopamine:
a) halothane
b) adrenaline
c) diltiazem
d) nifedipine
e) trimetaphan
3. The following can be used safely in a patient on a monoamine oxidase inhibitor:
a) morphine
b) pethidine
c) noradrenaline
d) amphetamine
e) adrenaline
a) antiemesis
b) somnolence
c) pupillary dilatation
d) tachycardia followed by bradycardia
e) extrapyramidal symptoms
5. Clonidine:
ANSWERS
1.TTFTT
2.FTFFF
3.TFTFT
4.TTTTF
5.TFFTT
6. Hydralazine:
a) is metabolised by acetylation
b) is destroyed by plasma cholinesterase
c) can cause a lupus-like syndrome
d) stimulates the baroreceptor reflex
e) is contraindicated in pregnancy
a) suxamethonium
b) diamorphine
c) captopril
d) paracetamol
e) enalapril
a) physostigmine
b) dopamine
c) propranolol
d) glycopyrrolate
e) noradrenaline
9. Naloxone:
a) tyrosine
b) phenylalanine
c) dopamine
d) isoprenaline
e) noradrenaline
ANSWERS
6.TFTTF
7.FTFFT
8.TFTFF
9.FTTTT
10.TTTFT
a) diamorphine
b) diazepam,
c) metoclopramide
d) cisapride
e) omeprazole
12. Chlorpromazine:
13. Alfentanil:
a) nitrous oxide
b) sodium nitroprusside
c) sulphonamides
d) penicillin
e) trimethoprim
ANSWERS
11.TFTTF
12.TTTFT
13.TFFFF
14.TFTFT
15.FTTFF
17. Dopexamine:
ANSWERS
16.FTFTF
17.FTTTT
18.TTFFT
19.TFFTF
20.TFTTF
a) trimetaphan
b) hexamethonium
c) ouabain
d) benzhexol
e) physostigmine
2. Esmolol:
3. Enflurane:
4. Morphine:
a) increased by ketamine
b) decreased by halothane
c) increased by beta-2 antagonists
d) unaffected by suxamethonium
e) decreased by nifedipine
ANSWERS
1.TTFTF
2.TTTTT
3.TFFFT
4.TFTTT
5.TTTTT
a) thrombocytopenia
b) coma
c) metabolic acidosis
d) jaundice
e) pulmonary oedema
a) lithium
b) diazepam
c) trimetaphan
d) magnesium
e) suxamethonium
8. Atropine:
a) diethyl ether
b) chloroform
c) cyclopropane
d) enflurane
e) halothane
ANSWERS
a) propranolol
b) lidocaine
c) phenytoin
d) calcium
e) potassium
12. Dobutamine:
14. The following factors encourage passage of a substance across the cell membrane:
a) cardiac arrhythmias
b) hypotension
c) restlessness
d) metabolic acidosis
e) jaundice
ANSWERS
11.TTTFT
12.TTFTF
13.TTTT
14.TFFFF
15.TTTTF
17. Sulphonylureas:
a) tachycardia
b) impotence
c) constipation
d) systemic lupus erythematosus
e) bronchoconstriction
a) mean
b) standard error of the mean
c) standard deviation
d) range
e) p of less than 0.5
ANSWERS
16.FFTTT
17.TFFFT
18.TFFTF
19.FTTTF
20.FFFTF
a1. Nifedipine:
a) causes tachycardia
b) causes tremor
c) causes hypoglycaemia
d) can be given sublingually
e) dilates skeletal muscle arterioles
2. Tetracycline:
3. Neostigmine:
a) atracurium
b) lidocaine
c) bupivacaine
d) neostigmine
e) propranolol
a) etomidate
b) ketamine
c) midazolam
d) pethidine
e) cotrimoxazole
ANSWERS
1.TTFTT
2.TTTTT
3.FFTT
4.FTFFT
5.FFTTF
Arti6. The following drugs are mainly eliminated from the body by hepatic metabolism:
a) isoflurane
b) morphine
c) atracurium
d) suxamethonium
e) dopamine
a) diazepam
b) midazolam
c) methadone
d) gelofusine
e) hydroxyethyl starch
8. Phenytoin:
a) shows first-order elimination kinetics
b) induces enzymes
c) causes hypotension
d) causes vitamin B2 deficiency
e) has a half-life of about 4 hours
9. L-dopa:
a) painful joints
b) pulmonary oedema
c) acute tubular necrosis
d) convulsions
e) bradycardia
ANSWERS
6.FTFFF
7.TFTFT
8.TTTFF
9.TTTTF
1
11. Atropine:
12. Beclomethasone:
a) salbutamol
b) propranolol
c) noradrenaline
d) acetylcholine
e) dopamine
ANSWERS
11.FTFTT
12.TTFFT
13.FTFTT
14.FTTFT
15.TFFFF
ArticleDate:20040629
SiteSection: Article
0.FTFTF
a) sevoflurane
b) halothane
c) desflurane
d) trichlorethylene
e) enflurane
19. Warfarin:
20. Salbutamol:
ANSWERS
16.TTFTF
17.FFFTF
18.TFTFT
19.FFFTT
20.FFFTT
cleDate:20060214 te:20051021
ArticleDate:20051021
ArticleDate:20051101
SiteSection: Article
icleDate:20050220