General 12

Question 1

1. 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

Answer 1

1.TTFTT

Question 2

2. The following statements are correct:
   a) thromboxane A2 is principally produced by the endothelial cells
   b) prostacyclin is produced in large amounts by the platelets
   c) aspirin irreversibly inhibits cyclooxygenase both in platelets and endothelial cells
   d) nitric oxide activates soluble guanylyl cyclase in smooth muscle
   e) endothelins are polypeptides with half-lives of less than a minute

Answer 2

2.FFTTT

Question 3

3. Regarding renal physiology:
   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-

Answer 3

3.TTTTT

Question 4

4. Regarding diuretics:
   a) ethanol inhibits antidiuretic hormone secretion
   b) theophylline increases the sodium content of urine
   c) acetozolamide increases the sodium content of urine
   d) spironolactone can cause hyponatraemia
   e) frusemide leads to increased K+ secretion in the distal tubule

Answer 4

4.TTTTT

Question 5

5. Pulmonary vascular resistance is:
   a) increased by low alveolar PO2
   b) decreased by prostacyclin
   c) decreased by isoprenaline
   d) increased by adrenaline
   e) increased by metabolic and respiratory acidosis

Answer 5

5.TTTTT

Question 6

6. Regarding the drugs acting on the autonomic nervous system:
   a) methyldopa forms false transmitters
   b) bretylium prevents norepinephrine release
   c) yohimbine blocks alpha-2 adrenergic receptors
   d) mivazerol is an alpha-2 agonist
   e) clonidine has analgesic action

Answer 6

6.TTTTT

Question 7

7. Esmolol:
   a) is a beta-1 selective blocker
   b) has an elimination half-life of 9 minutes
   c) is metabolised by plasma pseudocholinesterase
   d) may cause hypotension
   e) is useful in the management of supraventricular arrhythmias

Answer 7

7.TTFTT

Question 8

8. Regarding gastric acid secretion:
   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

Answer 8

8.TTTTT

Question 9

9. Regarding the measurement of body temperature:
   a) electrical resistance of platinum increases with rises in temperature
   b) thermistor is a metal oxide whose resistance drops with rises in temperature
   c) copper and constanton are used for the Seeback effect in thermocouple
   d) infrared thermometer is increasingly used for measuring tympanic membrane temperature
   e) the triple point of water is at 273.160 Kelvin

Answer 9

9.TTTTT

Question 10

10. In the pulmonary circulation:
    a) serotonin is almost completely removed by a single pass
    b) bradykinin is degraded by angiotensin-converting enzyme
    c) histamine is unaffected during its passage
    d) resistance is decreased by hypoxia
    e) oxygen saturation is higher in pulmonary veins than bronchial veins

Answer 10

10.TTTFT

Question 11

11. At high altitude (e.g. 6000 m):
    a) barometric pressure is about half atmospheric
    b) FIO2 is 0.21
    c) the saturated vapour pressure of water is 6.3 kPa at 37 degrees C
    d) the boiling point of water would be low
    e) hypoxia predominates the ventilatory drive

Answer 11

11.TTTTT

Question 12

12. Regarding the opioids used in the perioperative period:
    a) papaveretum has a morphine content up to 70%
    b) codeine has a higher oral bioavaibility than morphine
    c) pethidine crosses the blood-brain barrier more rapidly than morphine
    d) sufentanil is 5-10 times as potent as fentanyl
    e) the metabolism of remifentanil is affected by concomitant administration of anticholinesterases

Answer 12

12.TTTTF

Question 13

13. The output of a variable bypass vaporiser can be influenced by:
    a) rate of fresh gas flow
    b) temperature inside the vaporiser
    c) back pressure during intermittent positive pressure ventilation
    d) composition of carrier gases
    e) filling halothane vaporiser with enflurane

Answer 13

13.TTTTT

Question 14

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

Answer 14

14.TFTTT

Question 15

15. Functional residual capacity:
    a) increases in obstructive airways disease
    b) decreases in term pregnancy
    c) is increased by application of positive end-expiratory pressure
    d) is lower in morbidly obese patients
    e) is not altered after induction of anaesthesia with sevoflurane

Answer 15

15.TTTTF

Question 16

16. The following are analgesic substances:
    a) bradykinin
    b) histamine
    c) 5-hydroxytryptamine
    d) substance-P
    e) calcitonin gene-related peptide (CGRP)

Answer 16

16.TTTTT

Question 17

17. Pulse pressure:
    a) depends on left ventricular stroke volume
    b) increases with increase in the velocity of blood flow
    c) depends on the compliance of the arterial tree
    d) is higher in peripheral arteries than that in the aorta
    e) is low in high cardiac output states

Answer 17

17.TTTTF

Question 18

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

Answer 18

18.TFTFT

Question 19

19. Regarding anaesthetic gases:
    a) nitrous oxide can be liquified at 50 atmospheres at room temperature
    b) nitrogen can cause surgical anaesthesia at 12 atmospheres
    c) a half empty oxygen cylinder has a pressure of about 68 atmospheres
    d) oxygen is stored for hospital supply in liquid form at -150 degrees C
    e) Boyle’s Law does not apply to anaesthetic gases due to van der Waals attraction between the molecules

Answer 19

19.TTTTT

Question 20

20. Regarding the neuromuscular junction:
    a) the junctional cleft is about 50-60 nm across
    b) the postjunctional membrane is thrown into folds
    c) the acetylcholine receptor has five protein subunits
    d) two alpha subunits of the acetylcholine receptor have to be activated for the channel to open
    e) acetylcholine is synthesised from choline and acetic acid

Answer 20

20.TTTTF

Question 21

21. Packed red blood cells:
    a) one bag contains 220 ml of red cells and 80 ml of plasma
    b) has a packed cell volume of 0.65-0.75
    c) cause fewer febrile transfusion reactions
    d) contain a negligible amount of platelets and white cells
    e) can have saline, adenine, glucose and mannitol (SAGM) added as an additive solution

Answer 21

21.FTTTT

Question 22

22. Regarding cerebral blood flow:
    a) the brain receives 15% of cardiac output
    b) cerebral blood flow rises by 4% for each mm rise in PaCO2
    c) volatile anaesthetics increase cerebral blood flow
    d) volatile anaesthetics can impair the autoregulation of cerebral blood flow
    e) cerebral blood flow is relatively constant for cerebral perfusion pressures between 50-150 mmHg

Answer 22

22.TTTTT

Question 23

23. Glucagon:
    a) plasma level is increased in cirrhosis of the liver
    b) is an inotrope
    c) causes glycogenolysis in liver but not in muscle
    d) secretion is inhibited by propanolol
    e) can cause hyperkalaemia

Answer 23

23.TTTTT

Question 24

24. Midazolam:
    a) has a half-life of less than 2 hours
    b) is water soluble at a pH 4
    c) has an active metabolite
    d) can have a prolonged effect if given with erythromycin
    e) can be given by the intranasal route

Answer 24

24.TTTTT

Question 25

25. Ketamine:
    a) raises the plasma noradrenaline level
    b) can cause unpleasant side-effects in adults for 24 hours after administration
    c) is a depressant to denervated cardiac muscle
    d) produces a loss of consciousness in one arm-brain circulation time
    e) is a bronchdilator

Answer 25

25.TTTFT

Question 26

26. Which of the following are partial agonists at opioid receptors:
    a) nalbuphine
    b) nalorphine
    c) naloxone
    d) buprenorphine
    e) meptazinol

Answer 26

26.TTFTT

Question 27

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

Answer 27

27.FTTTT (enflurane is a halogenated methylether)

Question 28

28. Regarding gas or liquid flow:
    a) in laminar flow, flow is determined by the pressure gradient divided by resistance
    b) in laminar flow system, resistance is constant and independent of flow
    c) resistance increases with flow in turbulent flow
    d) Poiseuille’s law does not apply in turbulent flow
    e) flow through an orifice is always turbulent

Answer 28

28.TTTTF

Question 29

29. Regarding fluid flow:
    a) flow is laminar in tubes that are very long compared with their diameter
    b) flow is turbulent when Reynold’s number is

Answer 29

29.TFTTT

Question 30

30. Regarding physics applied to anaesthesia:
    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

Answer 30

30.TTTTT

Question 31

Regarding pain transmission:

a) ad fibres are myelinated while C fibres are unmyelinated
b) visceral pain is carried by unmyelinated sympathetic fibres
c) sharp pain is transmitted by Ad fibres while dull aching pain is transmitted by C fibres
d) lamina II of the dorsal horn has inhibitory interneurones which modulate pain transmission
e) besides pain, Ad- and C fibres also carry touch and temperature sensation

Answer 31

BONUS QUESTION.TTTTT