Thursday, 28 August 2014
Wednesday, 27 August 2014
MCQs Q.74 To Q.103
Q.74 Regarding two compartment pharmacokinetics:
a) a drug is always removed from the peripheral compartment
b) the central compartment is blood volume
c) a drug with a high volume of distribution is likely to be lipophillic
d) a drug can have a short duration of action while being eliminated very slowly
e) most anaesthetic drugs are modelled well with a two-compartment model
Q.75 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
Q.76 Regarding the use of suxamethonium:
a) bradycardia is a complication
b) phase II block occurs more commonly with neonates
c) prolonged duration of action may be seen in around one patient in 40
d) can raise the serum potassium by 0.5 mmol/ L
e) dose required is lower in small children
Q.77 Concerning electroencephalography (EEG):
a) voltages are in the range of 10-100 millivolts
b) spontaneous EEG activity is lost when the body temperature drops below 25 degrees C
c) b waves are enhanced by sedatives
d) d waves only occur in brain injury
e) q waves occur at a frequency of 4-7 Hz
Q.78 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
Q.79 Conduction velocity of a nerve impulse:
a) is greater in C fibres than in group A fibres
b) is greater in large diameter nerve fibres
c) is greater in unmyelinated nerve fibres because of saltatory conduction
d) can be as fast as 120 m/s in human nerve fibres
e) is decreased in hypothermia
Q.80 Regarding drug metabolism by cytochrome P450 isoenzymes:
a) cytochrome P450 makes up 1% of total liver proteins
b) the most important enzyme is CYP3A4
c) the system is responsible for most of the reductive metabolism in humans
d) volatile anaesthetics are metabolised by CYP2E1
e) some isoenzymes are inhibited strongly by erythromycin
Q.81. 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
Q.82. In the pulmonary circulation:
a) capillary hydrostatic pressure is about 25 mmHg
b) 50% of the cardiac output goes to the pulmonary circulation in the foetus
c) angiotensin is broken down
d) bradykinin is inactivated
e) hypoxia causes vasoconstriction
Q.83 Regarding local anaesthetic agents (LA):
a) the potency of LAs is proportional to their lipid solubility
b) the duration of action is dependent on protein binding
c) agents with low pKa have a faster onset of action
d) all local anaesthetics are vasodilators
e) the depth of local anaesthetic block is increased by increasing the dose
Q.84. Cisatracurium besylate:
a) is a mixture of three stereoisomers
b) in equipotent doses has a similar duration of action to vecuronium
c) is less potent than atracurium
d) undergoes more Hoffmans degradation than atracurium
e) in equipotent doses has a similar onset time to atracurium
Q.85. If an electric current is fed through the body:
a) risk of injury is largely dependent upon the current flow
b) antistatic shoes provide good protection due to their high resistance
c) high frequencies are more dangerous than low frequencies
d) ventricular fibrillation occurs at a lower current in patients with dysrhythmias
e) a tingling sensation is felt at a current strength of 1 mA
Q.86. The countercurrent concentrating mechanism in the kidney:
a) depends on active transport of sodium and chloride out of the ascending loop of Henle
b) allows an osmolality of 1200 mosmoles/kg in distal tubules
c) occurs predominantly in the cortical nephrons
d) relies on the free movement of water and electrolytes across the walls of the vasa recta
e) depends on a low concentration of urea in the medullary interstitium
Q.87 The adverse effects of NSAIDs on the kidney:
a) are reversible in normal kidneys
b) are not dose related
c) are mediated by inhibition of PGI2 synthesis
d) may cause acute interstitial nephritis
e) are counteracted by the use of ACE inhibitors
Q.88 The following trigger the secretion of antidiuretic hormone from the posterior hypothalamus:
a) a 5% reduction in extracellular fluid
b) chronic renal failure
c) anxiety
d) supine position
e) head injury
Q.89. Concerning the measurement of oxygen:
a) an oxygen electrode should be calibrated at zero and in room air
b) oxygen tension in a liquid can be measured with a Clark electrode
c) a polarographic electrode can be used in vivo
d) oxygen measurement in a gas mixture makes use of the magnetic property of oxygen
e) a fuel cell has a rapid response to change in oxygen concentration
Q.90 Drug clearance:
a) is the amount of drug removed from plasma in unit time
b) is proportional to half-life
c) is low in lipid-soluble drugs
d) occurs only in the liver and kidney
e) is calculated by dividing the dose of drug given by area under plasma concentration-time curve
Q.91 The volume of distribution of a drug:
a) is low if the drug is highly protein bound
b) can be calculated by multiplying half-life by natural logarithm of 2
c) is relatively low for muscle relaxants
d) is proportional to half life
e) is dependent on the elimination rate constant
Q.92 Concerning composition of body fluids:
a) plasma constitutes a quarter of extracellular fluid (ECF) volume
b) ECF volume may be grossly depleted in intestinal obstruction
c) the protein content of interstitial fluid is higher compared with intracellular fluid (ICF) and plasma
d) the ratio of ECF/ICF volume is smaller in infants and children
e) the normal osmolality of plasma is 280 mosmoles/kg
Q.93 Aldosterone causes:
a) a decrease in urine sodium concentration
b) weight gain
c) decreased serum chloride level
d) increased extracellular fluid volume
e) increased K+ excretion
Q.94 The following antibiotics have good activity against anaerobic bacteria:
a) vancomycin
b) aztreonam
c) metronidazole
d) imipenem
e) trimethoprim
Q.95 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
Q.96 Concerning the blood brain barrier (BBB):
a) it is virtually impermeable to ions and proteins
b) it breaks down around brain infarcts
c) a rise in serum albumin by 20 g/L will draw more H2O across the BBB than a rise in serum Na+ by 5 mmol/L
d) when damaged, cytotoxic brain oedema results
e) mannitol crosses the BBB easily
Q.97 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
Q.98. ABO compatibility is essential for transfusion of:
a) SAGM blood
b) haemoglobin solutions
c) cryoprecipitates
d) FFP
e) platelets
Q.99 The following increase during pregnancy:
a) plasma volume
b) fibrinogen
c) gastric emptying time
d) glucose tolerance
e) arterial PaCO2
Q.100. Carbon monoxide:
a) binds to haemoglobin with 100 times the affinity of oxygen
b) results in the oxyhaemoglobin curve shifting to the left
c) poisoning can be reliably detected by pulse oximetry
d) levels in normal non-smokers is 10-15%
e) concentration in circle is increased during desflurane anaesthesia
Q.101. Resting potential across the nerve membrane:
a) depends largely on the ratio of K+ inside and outside the cell
b) is positive inside with respect to outside
c) is of the order of 0.06 volt
d) decreases in magnitude during prolonged hypoxia
e) is greater the larger the diameter of the nerve fibre
Q.102 Activation of NMDA receptors:
a) is important in learning and memory
b) can result in neuronal damage
c) is involved in the development of opioid tolerance
d) causes opening of the chloride channel
e) may increase the intensity of pain
Q.103. Bacteria develop resistance to antibiotics:
a) by changing permeability of porin channels in cell wall
b) by producing enzymes to inactivate antibiotics
c) by altering target sites (DNA gyrase and topoisomerase) for antibiotics
d) by active extrusion of antibiotic once it enter the cell
e) easily in presence of necrotic tissue
a) a drug is always removed from the peripheral compartment
b) the central compartment is blood volume
c) a drug with a high volume of distribution is likely to be lipophillic
d) a drug can have a short duration of action while being eliminated very slowly
e) most anaesthetic drugs are modelled well with a two-compartment model
Q.75 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
Q.76 Regarding the use of suxamethonium:
a) bradycardia is a complication
b) phase II block occurs more commonly with neonates
c) prolonged duration of action may be seen in around one patient in 40
d) can raise the serum potassium by 0.5 mmol/ L
e) dose required is lower in small children
Q.77 Concerning electroencephalography (EEG):
a) voltages are in the range of 10-100 millivolts
b) spontaneous EEG activity is lost when the body temperature drops below 25 degrees C
c) b waves are enhanced by sedatives
d) d waves only occur in brain injury
e) q waves occur at a frequency of 4-7 Hz
Q.78 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
Q.79 Conduction velocity of a nerve impulse:
a) is greater in C fibres than in group A fibres
b) is greater in large diameter nerve fibres
c) is greater in unmyelinated nerve fibres because of saltatory conduction
d) can be as fast as 120 m/s in human nerve fibres
e) is decreased in hypothermia
Q.80 Regarding drug metabolism by cytochrome P450 isoenzymes:
a) cytochrome P450 makes up 1% of total liver proteins
b) the most important enzyme is CYP3A4
c) the system is responsible for most of the reductive metabolism in humans
d) volatile anaesthetics are metabolised by CYP2E1
e) some isoenzymes are inhibited strongly by erythromycin
Q.81. 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
Q.82. In the pulmonary circulation:
a) capillary hydrostatic pressure is about 25 mmHg
b) 50% of the cardiac output goes to the pulmonary circulation in the foetus
c) angiotensin is broken down
d) bradykinin is inactivated
e) hypoxia causes vasoconstriction
Q.83 Regarding local anaesthetic agents (LA):
a) the potency of LAs is proportional to their lipid solubility
b) the duration of action is dependent on protein binding
c) agents with low pKa have a faster onset of action
d) all local anaesthetics are vasodilators
e) the depth of local anaesthetic block is increased by increasing the dose
Q.84. Cisatracurium besylate:
a) is a mixture of three stereoisomers
b) in equipotent doses has a similar duration of action to vecuronium
c) is less potent than atracurium
d) undergoes more Hoffmans degradation than atracurium
e) in equipotent doses has a similar onset time to atracurium
Q.85. If an electric current is fed through the body:
a) risk of injury is largely dependent upon the current flow
b) antistatic shoes provide good protection due to their high resistance
c) high frequencies are more dangerous than low frequencies
d) ventricular fibrillation occurs at a lower current in patients with dysrhythmias
e) a tingling sensation is felt at a current strength of 1 mA
Q.86. The countercurrent concentrating mechanism in the kidney:
a) depends on active transport of sodium and chloride out of the ascending loop of Henle
b) allows an osmolality of 1200 mosmoles/kg in distal tubules
c) occurs predominantly in the cortical nephrons
d) relies on the free movement of water and electrolytes across the walls of the vasa recta
e) depends on a low concentration of urea in the medullary interstitium
Q.87 The adverse effects of NSAIDs on the kidney:
a) are reversible in normal kidneys
b) are not dose related
c) are mediated by inhibition of PGI2 synthesis
d) may cause acute interstitial nephritis
e) are counteracted by the use of ACE inhibitors
Q.88 The following trigger the secretion of antidiuretic hormone from the posterior hypothalamus:
a) a 5% reduction in extracellular fluid
b) chronic renal failure
c) anxiety
d) supine position
e) head injury
Q.89. Concerning the measurement of oxygen:
a) an oxygen electrode should be calibrated at zero and in room air
b) oxygen tension in a liquid can be measured with a Clark electrode
c) a polarographic electrode can be used in vivo
d) oxygen measurement in a gas mixture makes use of the magnetic property of oxygen
e) a fuel cell has a rapid response to change in oxygen concentration
Q.90 Drug clearance:
a) is the amount of drug removed from plasma in unit time
b) is proportional to half-life
c) is low in lipid-soluble drugs
d) occurs only in the liver and kidney
e) is calculated by dividing the dose of drug given by area under plasma concentration-time curve
Q.91 The volume of distribution of a drug:
a) is low if the drug is highly protein bound
b) can be calculated by multiplying half-life by natural logarithm of 2
c) is relatively low for muscle relaxants
d) is proportional to half life
e) is dependent on the elimination rate constant
Q.92 Concerning composition of body fluids:
a) plasma constitutes a quarter of extracellular fluid (ECF) volume
b) ECF volume may be grossly depleted in intestinal obstruction
c) the protein content of interstitial fluid is higher compared with intracellular fluid (ICF) and plasma
d) the ratio of ECF/ICF volume is smaller in infants and children
e) the normal osmolality of plasma is 280 mosmoles/kg
Q.93 Aldosterone causes:
a) a decrease in urine sodium concentration
b) weight gain
c) decreased serum chloride level
d) increased extracellular fluid volume
e) increased K+ excretion
Q.94 The following antibiotics have good activity against anaerobic bacteria:
a) vancomycin
b) aztreonam
c) metronidazole
d) imipenem
e) trimethoprim
Q.95 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
Q.96 Concerning the blood brain barrier (BBB):
a) it is virtually impermeable to ions and proteins
b) it breaks down around brain infarcts
c) a rise in serum albumin by 20 g/L will draw more H2O across the BBB than a rise in serum Na+ by 5 mmol/L
d) when damaged, cytotoxic brain oedema results
e) mannitol crosses the BBB easily
Q.97 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
Q.98. ABO compatibility is essential for transfusion of:
a) SAGM blood
b) haemoglobin solutions
c) cryoprecipitates
d) FFP
e) platelets
Q.99 The following increase during pregnancy:
a) plasma volume
b) fibrinogen
c) gastric emptying time
d) glucose tolerance
e) arterial PaCO2
Q.100. Carbon monoxide:
a) binds to haemoglobin with 100 times the affinity of oxygen
b) results in the oxyhaemoglobin curve shifting to the left
c) poisoning can be reliably detected by pulse oximetry
d) levels in normal non-smokers is 10-15%
e) concentration in circle is increased during desflurane anaesthesia
Q.101. Resting potential across the nerve membrane:
a) depends largely on the ratio of K+ inside and outside the cell
b) is positive inside with respect to outside
c) is of the order of 0.06 volt
d) decreases in magnitude during prolonged hypoxia
e) is greater the larger the diameter of the nerve fibre
Q.102 Activation of NMDA receptors:
a) is important in learning and memory
b) can result in neuronal damage
c) is involved in the development of opioid tolerance
d) causes opening of the chloride channel
e) may increase the intensity of pain
Q.103. Bacteria develop resistance to antibiotics:
a) by changing permeability of porin channels in cell wall
b) by producing enzymes to inactivate antibiotics
c) by altering target sites (DNA gyrase and topoisomerase) for antibiotics
d) by active extrusion of antibiotic once it enter the cell
e) easily in presence of necrotic tissue
MCQs Q.1 To Q.73
Q.1 In sickle cell disease
a) At least 50 per cent of the red cell haemoglobin is in the fetal form of HgB (Hb F)
b) Dactylitis is an early sign in infancy
c) Splenomegaly is a characteristic finding in adults
d) Iron therapy is valuable if the patient is anaemic
e) Travel in an un-pressurised aircraft can precipitate a sickling crisis
Q.2 In cautious use of oxygen in high concentrations in patients with chronic bronchitis is liable to
a) Cause cataract formation
b) Lead to a rise in intracranial pressure
c) Be associated with a coarse flapping tremor
d) Reduce alveolar ventilation
e) Cause low molecular weight proteinuria
Q.3 A plasma bicarbonate level of 32 mEq/1 is consistent with
a) Hypokalaemia
b) Persistent vomiting due to pyloric stenosis
c) Diabetic ketoacidosis
d) Chronic cor pulmonale
e) Chronic renal failure
Q.4 Accidental hypothermia with a core temperature below 30 C may cause
a) Metabolic acidosis
b) J waves in the electrocardiogram
c) Ventricular fibrillation
d) A rise in serum amylase
e) Hyperglycaemia
Q.5 Acutely reducing the inspired oxygen concentration to 10% at sea level can cause
a) Decreased urinary pH
b) Increased cardiac output
c) Decreased binding capacity of Hb for oxygen
d) A respiratory alkalosis
e) Increased erythropoietin secretion
Q.6 Administration of oxygen in hypovolaemic shock
a) Increases the PaO2
b) Decreases the physiological shunt
c) Decreases alveolar dead space
d) Increases pulmonary vascular resistance
e) Increases the dissolved oxygen content of blood
a) At least 50 per cent of the red cell haemoglobin is in the fetal form of HgB (Hb F)
b) Dactylitis is an early sign in infancy
c) Splenomegaly is a characteristic finding in adults
d) Iron therapy is valuable if the patient is anaemic
e) Travel in an un-pressurised aircraft can precipitate a sickling crisis
Q.2 In cautious use of oxygen in high concentrations in patients with chronic bronchitis is liable to
a) Cause cataract formation
b) Lead to a rise in intracranial pressure
c) Be associated with a coarse flapping tremor
d) Reduce alveolar ventilation
e) Cause low molecular weight proteinuria
Q.3 A plasma bicarbonate level of 32 mEq/1 is consistent with
a) Hypokalaemia
b) Persistent vomiting due to pyloric stenosis
c) Diabetic ketoacidosis
d) Chronic cor pulmonale
e) Chronic renal failure
Q.4 Accidental hypothermia with a core temperature below 30 C may cause
a) Metabolic acidosis
b) J waves in the electrocardiogram
c) Ventricular fibrillation
d) A rise in serum amylase
e) Hyperglycaemia
Q.5 Acutely reducing the inspired oxygen concentration to 10% at sea level can cause
a) Decreased urinary pH
b) Increased cardiac output
c) Decreased binding capacity of Hb for oxygen
d) A respiratory alkalosis
e) Increased erythropoietin secretion
Q.6 Administration of oxygen in hypovolaemic shock
a) Increases the PaO2
b) Decreases the physiological shunt
c) Decreases alveolar dead space
d) Increases pulmonary vascular resistance
e) Increases the dissolved oxygen content of blood
Q.7 The following decrease uterine muscle tone
a) A.D.Hb) Salbutamol
c) Halothane
d) PGF2-alpha
e) Amyl nitrite
Q.8 Factors speeding induction with an inhalational agent include;-
a) An opiate premedication
b) Decreased cardiac output
c) Increased alveolar ventilation
d) Substitution of an agent with higher blood gas solubility
e) Increased inspired carbon dioxide concentration
Q.9 Ketamine induced hallucinations and delirium
a) Can be decreased by a benzodiazepine premedication
b) Are less common in children
c) Are less common after short surgical procedures
d) Are less following IM administration
e) Are caused only by its metabolites
Q.10 Prilocaine
a) Is 70% protein bound
b) Is an amide
c) Is used in eutectic mixtures
d) Is metabolised by plasma cholinesterase
e) Is more toxic than lignocaine at the same dose
Q.11 D-tubocurare
a) Is monoquaternary
b) Is a ganglion blocker
c) Is excreted into bile
d) Causes histamine release
e) Blocks the cardioinhibitory nerve supply to the heart.
Q.12 Alphs I Acid Glycoprotein
a) Is increased in burns, trauma, malignancy and post MI.
b) Is decreased in neonates, pregnancy and with the oral contraceptive.
c) Is synthesised in the liver.
d) Binds Atenolol.
e) Significantly modifies the free fraction of propranolol
Q.13 Causes of the anticoagulant effect of a massive blood transfusion includes:-
b) Is an amide
c) Is used in eutectic mixtures
d) Is metabolised by plasma cholinesterase
e) Is more toxic than lignocaine at the same dose
Q.11 D-tubocurare
a) Is monoquaternary
b) Is a ganglion blocker
c) Is excreted into bile
d) Causes histamine release
e) Blocks the cardioinhibitory nerve supply to the heart.
Q.12 Alphs I Acid Glycoprotein
a) Is increased in burns, trauma, malignancy and post MI.
b) Is decreased in neonates, pregnancy and with the oral contraceptive.
c) Is synthesised in the liver.
d) Binds Atenolol.
e) Significantly modifies the free fraction of propranolol
Q.13 Causes of the anticoagulant effect of a massive blood transfusion includes:-
a) Deficient factor V and VIII
b) Inactive platelets
c) Microaggregates
d) Cold
e) Vitamin K antagonism
Q.14 The following are recognised causes of a raised fasting serum triglyceride concentration:
a) High ethanol intake
b) Treatment with propranolol
c) Treatment with nifedipine
d) Chronic renal failure without proteinuria
e) Treatment with cholestyramine
Q.15 The radial artery
a) Is the main artery forming the deep palmar arch.
b) Is medial to the radial nerve at the wrist
c) Supplies al the digits
d) Is superficial to extensor pollicis longus tendon.
e) Enters the palm between the heads of the first dorsal interosseous muscle.
Q.16 The following are the main buffers of hydrogen ions in the blood:
a) Haemoglobin
b) Ammonium ions
c) Phosphate
d) Bicarbonate
e) Plasma proteins
Q.17 Hyponatraemia may be seen with the following:
a) Addison’s disease
b) Renal disease
c) Congestive cardiac failure
d) Use of diuretics such as frusemide
e) Carcinoma of the lung
Q.18 The left recurrent laryngeal nerve;
a) Hooks round the arch of the aorta
b) Hooks round the subclavian artery
c) Is related intimately to the superior thyroid artery
d) Runs between the oesophagus and trachea
e) Section causes abduction of the cords
Q.19 The following conditions are likely to causes serious complications during pregnancy:
a) Mitral stenosis
b) Secundum atrial septal defect
c) Ventricular septal defect with normal pulmonary artery pressure
d) Primary pulmonary hypertension
Q.20 The heart rate is increased by;-
a) Raised intracranial pressure
b) Inspiration
c) Moving ot the upright position from lying down
d) Adrenaline
e) Stimulation of the pain fibres of the trigeminal nerve.
Q.21 Reduced urine output during major surgery is due to
a) Catecholamine release
b) Rennin-aldosterone system
c) Supine posture
d) Hypotension
e) ADH
Q.22 Halothane
a) Forms bromide
b) Has 4 fluoride atoms
c) Has MAC of 1.5 vol % at one atmosphere
d) Is a coronary vasodilator
e) Is a suitable agent for single breath induction
Q.23 Isoflurane
a) Is inflammable at high (oxygen)
b) Slows AV conduction at clinical concentration
c) Is a methyl-ethyl ether
d) Is more potent than enflurane
e) Is a coronary vasodilator
Q.24 Alfentanil
a) Produces analgesia without sedation
b) Induces convulsions
c) Is more protein bound than morphine
d) Has a lower Vd than fentanyl
e) Is more potent than fentanyl
Q.25 A total body potassium deficit due to gastro-intestinal loss may be consistent with:-
a) A normal serum K_
b) Normal adrenals and kidneys
c) And acid urine
d) Increased bicarbonate
Q.26 Ptosis may be caused by damage to:-
a) The occulomotor nerve
b) The trigeminal nerve
c) The cervical sympathetic ganglion
d) The abducens nerve
e) The parasympathetic system
Q.27 Paroxysmal ventricular tachycardia can be arrested by:-
a) Disopyramide
b) Lignocaine
c) Digoxin
d) Phenoperidine
e) Magnesium
Q.28 Regarding innervations of uterus and birth canal
a) Analgesia/anaesthesia of the birth canal can be effected by a pudendal block
b) The sensory innervation of the uterus is carried via sympathetic efferents to L2
c) Increase in gamma efferent activity will increase uterus tone.
d) Nitrites influence uterine tone by there effect on parasympathetic system
e) Lignocaine with adrenaline is safe in pudendal nerve block
Q.29 Tendon jerks of the lower limb
a) Are increased with ventral horn lesions
b) Are increased with a lesion in the contralateral motor-cortex
c) Are increased with a lesion in the ipsilateral spinothalamic tract
d) Are increased with lesions of upper motor neurones
e) Are uninfluenced by lesions in the extra-pyramidal system
Q.30 In patient with severe hypovolaemia
a) The physiological dead space is increased
b) Arterio-venous oxygen difference is decreased
c) Renal blood flow is diminished
d) Ventilation is usually depressed
e) Carbon dioxide retention occurs
Q.31 The serum potassium concentration:-
a) In a normal subject is increased suxmethonium
b) Is increased by thiopentone
c) Influences the toxicity of digoxin
d) Is lowered in extensive burns
e) Is increased by hyperventilation
Q.32 In a patient with oedema due to cardiac failure there is:-
a) Increased sympathetic nervous activity.
b) Increased plasma rennin activity
c) Reduced sodium reabsorption by the renal tubules.
d) Increase serum sodium
e) An interstitial fluid volume of about 10L
Q.33 The following increase the speed of induction with an inhalational agent:-
a) Opiate pre-medication
b) Increased alveolar ventilation
c) Increased cardiac output
d) Replacing it with an agent that has a blood / gas solubility twice that of the one in use
e) The second gas effect
Q.34 Lignocaine
a) Decreases nitrous oxide requirements
b) Is metabolised by liver esterases
c) Its clearance is reduced by constant IV infusion for 24 hours
d) Causes a decrease in the resting membrane potential
e) Affects potassium ion flux during the action potential.
Q.35 Alveolar uptake of anaesthetic gas is dependent on
a) Blood solubility of the agent
b) Potency of the agent
c) Alveolar ventilation inspired concentration of the agent
d) Venous concentration of the agent
e) Fresh gas flow
Q.36 The following are positive ionotropes:-
b) Inactive platelets
c) Microaggregates
d) Cold
e) Vitamin K antagonism
Q.14 The following are recognised causes of a raised fasting serum triglyceride concentration:
a) High ethanol intake
b) Treatment with propranolol
c) Treatment with nifedipine
d) Chronic renal failure without proteinuria
e) Treatment with cholestyramine
Q.15 The radial artery
a) Is the main artery forming the deep palmar arch.
b) Is medial to the radial nerve at the wrist
c) Supplies al the digits
d) Is superficial to extensor pollicis longus tendon.
e) Enters the palm between the heads of the first dorsal interosseous muscle.
Q.16 The following are the main buffers of hydrogen ions in the blood:
a) Haemoglobin
b) Ammonium ions
c) Phosphate
d) Bicarbonate
e) Plasma proteins
Q.17 Hyponatraemia may be seen with the following:
a) Addison’s disease
b) Renal disease
c) Congestive cardiac failure
d) Use of diuretics such as frusemide
e) Carcinoma of the lung
Q.18 The left recurrent laryngeal nerve;
a) Hooks round the arch of the aorta
b) Hooks round the subclavian artery
c) Is related intimately to the superior thyroid artery
d) Runs between the oesophagus and trachea
e) Section causes abduction of the cords
Q.19 The following conditions are likely to causes serious complications during pregnancy:
a) Mitral stenosis
b) Secundum atrial septal defect
c) Ventricular septal defect with normal pulmonary artery pressure
d) Primary pulmonary hypertension
Q.20 The heart rate is increased by;-
a) Raised intracranial pressure
b) Inspiration
c) Moving ot the upright position from lying down
d) Adrenaline
e) Stimulation of the pain fibres of the trigeminal nerve.
Q.21 Reduced urine output during major surgery is due to
a) Catecholamine release
b) Rennin-aldosterone system
c) Supine posture
d) Hypotension
e) ADH
Q.22 Halothane
a) Forms bromide
b) Has 4 fluoride atoms
c) Has MAC of 1.5 vol % at one atmosphere
d) Is a coronary vasodilator
e) Is a suitable agent for single breath induction
Q.23 Isoflurane
a) Is inflammable at high (oxygen)
b) Slows AV conduction at clinical concentration
c) Is a methyl-ethyl ether
d) Is more potent than enflurane
e) Is a coronary vasodilator
Q.24 Alfentanil
a) Produces analgesia without sedation
b) Induces convulsions
c) Is more protein bound than morphine
d) Has a lower Vd than fentanyl
e) Is more potent than fentanyl
Q.25 A total body potassium deficit due to gastro-intestinal loss may be consistent with:-
a) A normal serum K_
b) Normal adrenals and kidneys
c) And acid urine
d) Increased bicarbonate
Q.26 Ptosis may be caused by damage to:-
a) The occulomotor nerve
b) The trigeminal nerve
c) The cervical sympathetic ganglion
d) The abducens nerve
e) The parasympathetic system
Q.27 Paroxysmal ventricular tachycardia can be arrested by:-
a) Disopyramide
b) Lignocaine
c) Digoxin
d) Phenoperidine
e) Magnesium
Q.28 Regarding innervations of uterus and birth canal
a) Analgesia/anaesthesia of the birth canal can be effected by a pudendal block
b) The sensory innervation of the uterus is carried via sympathetic efferents to L2
c) Increase in gamma efferent activity will increase uterus tone.
d) Nitrites influence uterine tone by there effect on parasympathetic system
e) Lignocaine with adrenaline is safe in pudendal nerve block
Q.29 Tendon jerks of the lower limb
a) Are increased with ventral horn lesions
b) Are increased with a lesion in the contralateral motor-cortex
c) Are increased with a lesion in the ipsilateral spinothalamic tract
d) Are increased with lesions of upper motor neurones
e) Are uninfluenced by lesions in the extra-pyramidal system
Q.30 In patient with severe hypovolaemia
a) The physiological dead space is increased
b) Arterio-venous oxygen difference is decreased
c) Renal blood flow is diminished
d) Ventilation is usually depressed
e) Carbon dioxide retention occurs
Q.31 The serum potassium concentration:-
a) In a normal subject is increased suxmethonium
b) Is increased by thiopentone
c) Influences the toxicity of digoxin
d) Is lowered in extensive burns
e) Is increased by hyperventilation
Q.32 In a patient with oedema due to cardiac failure there is:-
a) Increased sympathetic nervous activity.
b) Increased plasma rennin activity
c) Reduced sodium reabsorption by the renal tubules.
d) Increase serum sodium
e) An interstitial fluid volume of about 10L
Q.33 The following increase the speed of induction with an inhalational agent:-
a) Opiate pre-medication
b) Increased alveolar ventilation
c) Increased cardiac output
d) Replacing it with an agent that has a blood / gas solubility twice that of the one in use
e) The second gas effect
Q.34 Lignocaine
a) Decreases nitrous oxide requirements
b) Is metabolised by liver esterases
c) Its clearance is reduced by constant IV infusion for 24 hours
d) Causes a decrease in the resting membrane potential
e) Affects potassium ion flux during the action potential.
Q.35 Alveolar uptake of anaesthetic gas is dependent on
a) Blood solubility of the agent
b) Potency of the agent
c) Alveolar ventilation inspired concentration of the agent
d) Venous concentration of the agent
e) Fresh gas flow
Q.36 The following are positive ionotropes:-
a) Verapamil
b) Potassium
c) Propranolol
d) Elucagon
e) Theophylline
b) Potassium
c) Propranolol
d) Elucagon
e) Theophylline
Q.37 The following have a blood/ gas solubility less than 2
a) Cyclopropaneb) Nirous oxide
c) Halothane
d) Isoflurane
e) Trilene
Q.38 Isoflurane is:-
a) A fluorinated hudrocarbon
b) Has a MAC of 0.5 in 70% N20
c) Causes less respiratory depression than halothane
d) Should not be used with sodalime
e) Has a greater oil/gas solubility than halothane
Q.39 Concerning intravenous regional anaesthesia:-
a) Up to 30 mls of 1% lignocaine may be used
b) Systemic side effects may occur despite an effective tourniquet
c) Prilocaine 1% is contraindicated
d) May be used on the lower limb.
e) Works as long as tourniquet is in place
Q.40 The following are true concerning ABO blood
a) In an individual three allelic genes determine blood groups
b) Genotype is determined by serological tests
c) Blood group may change during bone marrow transplantation
d) Subgroup incompatibility may cause severe transfusion reactions
e) Antibodies to blood group substances A and B occur naturally
Q.41 The following occur as a response to major surgery:-
a) Natriuresis
b) Hypocalcaemia
c) Reduced Lipolysis
d) Increased peritoneal uptake.
e) Potassium retention.
Q.42 The following increase in normal pregnancy:-
a) Plasma albumin
b) Blood urea
c) ESR
d) Serum thyromine
e) Serum uric acid.
Q.43 The following drugs should be avoided in renal failure:-
a) Gentamicin
b) Doxycycline
c) Aluminium hydroxide
d) Frusemide
e) Nirtofurantoin.
Q.44 In tardive dyskinesia:-
a) The condition can be caused by metoclopramide
b) Symptoms can be exacerbated by emotional stress
c) Is due to hypersensitivity of dopamine receptors
d) Anticholinergic drugs are a useful therapy.
e) The lesion is in the cerebellum.
Q.45 Anaphylactic and anaphylactoid reactions.
a) Anaphylactoid reactions commoner than anaphylactic
b) Bronchospasm is a common feature of anaphylaxis
c) Hydrocortisone is a first line drug
d) Muscle relaxants are commonest triggering agents during anaesthesia
e) Thiopentone more likely to cause anaphylactic type reaction
Q.46 Post-op nausea and vomiting.
a) Five times commoner in females
b) Increases with increasing age
c) Commoner with Propofol than thiopentone
d) Isoflourane least emetogenic of the inhalational agents
e) Ondansetron clearance significantly reduced in renal failure
Q.47 Massive transfusion of filtered blood may lead to:-
a) Hypothermia
b) Increased plasma ionised calcium
c) Hypokalaemia
d) Right shift of oxyhaemoglobin dissociation curve
e) Metabolic acidosis
Q.48 Congenital diaphragmatic hernia
a) Presents usually bilateral
b) Presents usually in the first day or two of life
c) Is not a contraindication for use of N20.
d) May usually be diagnosed by CXR
e) has a better prognosis than Traceho-oesophgeal Fistula
Q.49 Characteristic features of the re-feeding syndrome include:-
a) Acute hypophosphataemia.
b) Glycosuria
c) Decreased red cell survival.
d) Reduced S.V.R
e) Parasthesia
Q.50 Features of acute post-infective polyneuropathy includes:
a) Frontal balding
b) Sympathetic neurone involvement
c) Weakness of upper motor neuron type.
d) Invariable progression of ventilation
e) Normal CSF protein.
Q.51 Regarding Reflex sympathetic dystrophy.
a) Osteoporosis common
b) Dysaesthesia a feature
c) Cryoablation is useful
d) Trophic changes occur rarely
e) May follow trivial injury.
Q.52 Trigeminal Neuralgia
a) Radiofrequency lesioning via foramen rotundum is effective
b) Typically produces altered sensation
c) Commoner in females
d) Mandibular branch of trigeminal nerve most commonly involved
e) Carbamazepine more efficacious than phenytoin
Q.53 Stellate ganglion block produces:-
a) Miosis
b) Enopthalmos
c) Hyperhidrosis
d) Ipsilateral nasal congestion
e) Facial flushing
Q.54 Brachial Plexus
a) Radial nerve formed by superior, middle and inferior trunks
b) Cords are formed proximal to first rib
c) Interscalene approach has lowest success rate for plamar surgery
d) Subclavian approach most appropriate for surgery on medial arm
e) Axillary approach best for radial nerve blockade.
Q.55 Loss of weight with a normal or increased appetite is found in:-
a) Carcinoma of the stomach
b) Thyrotoxicosis
c) Diabetes mellitus
d) Addison’s disease
e) Prostatic Cancer
Q.56 The following are features of chronic renal failure:-
a) Bleeding tendency
b) Macrocytic anaemia
c) Hypertension
d) Splenomegaly
e) Tetany
Q.57 Pracetamol poising may cause:-
a) Loss of consciousness at an early stage:-
b) Metabolic acidosis
c) Hypoprothrombinaemia
d) Hyperprothrombinaemia
e) Hyperfibrinoginaemia
b) Glycosuria
c) Decreased red cell survival.
d) Reduced S.V.R
e) Parasthesia
Q.50 Features of acute post-infective polyneuropathy includes:
a) Frontal balding
b) Sympathetic neurone involvement
c) Weakness of upper motor neuron type.
d) Invariable progression of ventilation
e) Normal CSF protein.
Q.51 Regarding Reflex sympathetic dystrophy.
a) Osteoporosis common
b) Dysaesthesia a feature
c) Cryoablation is useful
d) Trophic changes occur rarely
e) May follow trivial injury.
Q.52 Trigeminal Neuralgia
a) Radiofrequency lesioning via foramen rotundum is effective
b) Typically produces altered sensation
c) Commoner in females
d) Mandibular branch of trigeminal nerve most commonly involved
e) Carbamazepine more efficacious than phenytoin
Q.53 Stellate ganglion block produces:-
a) Miosis
b) Enopthalmos
c) Hyperhidrosis
d) Ipsilateral nasal congestion
e) Facial flushing
Q.54 Brachial Plexus
a) Radial nerve formed by superior, middle and inferior trunks
b) Cords are formed proximal to first rib
c) Interscalene approach has lowest success rate for plamar surgery
d) Subclavian approach most appropriate for surgery on medial arm
e) Axillary approach best for radial nerve blockade.
Q.55 Loss of weight with a normal or increased appetite is found in:-
a) Carcinoma of the stomach
b) Thyrotoxicosis
c) Diabetes mellitus
d) Addison’s disease
e) Prostatic Cancer
Q.56 The following are features of chronic renal failure:-
a) Bleeding tendency
b) Macrocytic anaemia
c) Hypertension
d) Splenomegaly
e) Tetany
Q.57 Pracetamol poising may cause:-
a) Loss of consciousness at an early stage:-
b) Metabolic acidosis
c) Hypoprothrombinaemia
d) Hyperprothrombinaemia
e) Hyperfibrinoginaemia
Q.58 A patient is receiving intravenous antibiotic therapy for S.B.E she gradually becomes more dyspnoeic, b.p. 130/50, CVP 18 cm H2O, diastolic and systolic murmurs are heard at the L.stemal edge. The most likely diagnosis (es) are:-
a) Ruptured aneurysm of the ascending aortab) penicillin sensitivity
c) Cardiac failure
d) Ruptured valve cusp
e) Myocardial infarction
Q.59 In severe salicylate poisoning you may find:-
a) Coma
b) Metabolic acidosis
c) Hypoprothrombinaemia
d) Hyperprothrombinaemia
e) Hyperfibrinoginaemia
Q.60 Recognized causes of persistent or recurrent painless nausea and vomiting include:-
a) Hiatus hernia
b) Chronic cholecystitis
c) Hypercalcaemia
d) Diabetes mellitus
e) Vertebro-basilar insufficiency
Q.61 Recognised early manifestations of methanol poisoning include:-
a) Dilated pupils
b) Hyperventilation
c) Respiratory alkalosis
d) Episodes of apnoea
e) Raised serum amylase
Q.62 Pain in the back:-
a) Due to secondary carcinoma of the vertebrae is worst at night
b) Due to ankylosing spondylitis is improved by rest
c) Due to degenerative disease is accompanied by limitation of flexion and extension but not of lateral flexion
d) Due to ankylosing spondylitis is accompanied by bilateral limitation of lateral flexion
e) If accompanied by flattening of the lumbar lordosis is probably due to inflammatory disease.
Q.63 Myoedema may present with:-
a) Coma
b) Bradycardia
c) Flat T-waves on E.C.G
d) Carpel tunnel syndrome
e) Macrocytic anaemia
c) Hypercalcaemia
d) Diabetes mellitus
e) Vertebro-basilar insufficiency
Q.61 Recognised early manifestations of methanol poisoning include:-
a) Dilated pupils
b) Hyperventilation
c) Respiratory alkalosis
d) Episodes of apnoea
e) Raised serum amylase
Q.62 Pain in the back:-
a) Due to secondary carcinoma of the vertebrae is worst at night
b) Due to ankylosing spondylitis is improved by rest
c) Due to degenerative disease is accompanied by limitation of flexion and extension but not of lateral flexion
d) Due to ankylosing spondylitis is accompanied by bilateral limitation of lateral flexion
e) If accompanied by flattening of the lumbar lordosis is probably due to inflammatory disease.
Q.63 Myoedema may present with:-
a) Coma
b) Bradycardia
c) Flat T-waves on E.C.G
d) Carpel tunnel syndrome
e) Macrocytic anaemia
a) Give homatropine eye drops to visualise the discs better
b) Give morphine 10 mgs I.M.
c) Do a lumbar puncture
d) Give Mannitol 25 ml of 20% I.V.
e) Give a G.A for reduction of his colles fracture.
Q.65 A 60 years old man is brought in by ambulance unconscious breathing O2 at 6L/min from a face mask. He is sweating; twitching his limbs and has bilateral papilloedema. His blood gases are:-
PO2 70 mmHg., PO2 70 mmHg, PH 7.16
You should:-
a) Give phenytoin 100 mgs I.M. to prevent epileptic fits
b) Do a lumbar puncture
c) Arrange for an E.E.G.
d) Give Na bicarbonate I.V to raise the arterial pH.
e) Intubate and ventilate him
Q.66 Acute pancreatitis may cause:-
a) Retro peritoneal abscess
b) Pancreatic abscess
c) Pancreatic pseudocyst
d) Hyperglycaemia
e) Tetany.
Q.67 In a 20 years old fit young adult with a history of vomiting for 3 weeks with no other symptoms, you would expect to find:-
a) Raised blood urea
b) Potassium 3 mEq/L
c) HCO3↑
d) Na↑
e) Na↓
Q.68 In a patient with a vocal cord palsy due to bronchial carcinoma:
a) It is often bilateral
b) The R. is more often affected than th left
c) The L. is more often affected than the right
d) It is usually due to metastases
e) It is usually do to radiotherapy.
Q.69 A 30 years old female patient wit increasing dyspnoea has the following results on cardiac catheterisation :-
R.A. 5, R.V. (normal), P.A. mean 50, Wedge 9, L.A. (normal), L.V. 110/8, Aorta 110/70, The diagnosis(es) are:-
a) Mitral stenosis
b) Mitral incompetence
c) Idiopathic pulmonary hypertension
d) Aortic incompetence
e) Aortic stenosis
Q.70 Dystrophia myotonica is characterised by:-
a) Testicular atropy
b) Ptosis
c) Frontal baldness
d) Diabetes mellitus
e) Optic atropy.
Q.71 Post dural puncture headache
a) Reduced incidence using paramedian approach
b) Incidence reduced following bed rest versus early mobilization
c) Is associated with visual and auditory disturbances
d) Features identical of those seen in cervical myofascial pain syndrome
e) ACTH is useful adjunct in tratment
Q.72 Nerve block at ankle
a) Superficial peroneal never innervates first interdigital cleft
b) Sural nerve blocked at superior border for lateral malleolus
c) Tibial nerve innervates sole of foot.
d) Deep peroneal nerve blocked at medial aspect of medial malleolus
e) Saphenous nerve is sensory extension of femoral nerve
Q.73 Balloon-tipped pulmonary artery flotation catheters.
a) Provide direct measurement of left atrial pressure
b) Transducer should be zeroed at level of sternal angle
c) Pressures should be measured at end expiration
d) P.E.E.P should be involved during P.C.W.P measurement
e) Catheter tip should be sited in lung zone III
b) Ptosis
c) Frontal baldness
d) Diabetes mellitus
e) Optic atropy.
Q.71 Post dural puncture headache
a) Reduced incidence using paramedian approach
b) Incidence reduced following bed rest versus early mobilization
c) Is associated with visual and auditory disturbances
d) Features identical of those seen in cervical myofascial pain syndrome
e) ACTH is useful adjunct in tratment
Q.72 Nerve block at ankle
a) Superficial peroneal never innervates first interdigital cleft
b) Sural nerve blocked at superior border for lateral malleolus
c) Tibial nerve innervates sole of foot.
d) Deep peroneal nerve blocked at medial aspect of medial malleolus
e) Saphenous nerve is sensory extension of femoral nerve
Q.73 Balloon-tipped pulmonary artery flotation catheters.
a) Provide direct measurement of left atrial pressure
b) Transducer should be zeroed at level of sternal angle
c) Pressures should be measured at end expiration
d) P.E.E.P should be involved during P.C.W.P measurement
e) Catheter tip should be sited in lung zone III
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