General 8

Question 1

1. Angiotensin II has a role in maintenance of effective circulatory volume by the following mechanisms:

a) increasing thirst
b) increased antidiuretic hormone release from posterior pituitary
c) systemic vasoconstriction
d) increased aldosterone release
e) increased proximal tubular sodium reabsorption

Answer 1

ANSWERS

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Question 2

2. Adenosine triphosphate:

a) is synthesised when the skeletal muscle contracts
b) contains two energy rich phosphate bonds
c) is an integral part of the flavoprotein-cytochrome system
d) is only produced during the aerobic, not anaerobic, catabolism of glucose
e) is hydrolysed enzymically during the operation of the ‘sodium pump’

Answer 2

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Question 3

3. The blood-brain barrier:

a) anatomically, is at the arachnoid villi
b) is less permeable in the neonate
c) results in the total exclusion of many certain from the brain
d) results in very low catecholamine levels in the brain and spinal cord
e) is functionally similar to a cell membrane

Answer 3

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Question 4

4. Sodium reabsorption in the nephron is:

a) greater in the distal than in the proximal convoluted tubule
b) only achieved in exchange for potassium excretion
c) the only major energy consuming activity of the kidney
d) the main object of the countercurrent multiplier system
e) dependent on the glomerular filtration rate as well as aldosterone

Answer 4

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Question 5

5. The carotid body chemoreceptors:

a) are stimulated by a fall in arterial oxygen tension
b) are inhibited by a fall in arterial pH
c) produce reflex peripheral vasoconstriction
d) are responsible for increased ventilation in a patient with carbon monoxide poisoning
e) have a very high tissue blood flow

Answer 5

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Question 6

6. Concerning pain:

a) transmission occurs in the lateral spinothalamic tracts
b) it may be modulated at a spinal level by endorphinergic interneurones
c) it is modified at a spinal level by descending fibres from the periaqueductal grey matter of the mid-brain
d) fibres from the frontal cortex inhibit thalamic interpretation of pain
e) surgery of the cerebral cortex is not associated with pain

Answer 6

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Question 7

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

Answer 7

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Question 8

8. Concerning electrical safety:

a) when touching faulty apparatus with wet hands, skin impedance is increased and current flow greater than normal
b) electrical shock is not a risk with potential below 24 V AC or 50 V DC
c) the modern diathermy earthing plate is not connected directly with earth
d) microshock may lead to ventricular fibrillation via an intracardiac catheter with currents in excess of 150 microamps
e) leakage currents are induced voltages in other circuits resulting from an alternating mains current

Answer 8

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Question 9

9. Concerning flow:

a) if Reynold’s number exceeds 1000, turbulent flow is likely to be present
b) the critical velocity at which laminar flow changes to turbulent flow varies only with the gas involved
c) helium reduces the density of inspired gases and therefore the likelihood of turbulent flow within the respiratory system
d) turbulent flow within blood vessels is only detectable by invasive techniques
e) endotracheal tube adaptors (e.g. Magill) are specifically designed to avoid turbulent flow

Answer 9

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Question 10

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

Answer 10

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Question 11

11. Concerning the opioids used in the perioperative period:

a) the volume of distribution of fentanyl is greater than that of morphine
b) at physiological pH morphine is more ionised than alfentanil
c) morphine is more protein bound than fentanyl
d) fentanyl penetrates the blood-brain barrier more quickly than morphine
e) pethidine has a metabolite with epileptogenic potency

Answer 11

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Question 12

12. Tachyphylaxis occurs during treatment with:

a) ephedrine
b) trimetaphan
c) suxamethonium
d) noradrenaline
e) sodium nitroprusside

Answer 12

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Question 13

13. A plot of pressure against volume:

a) allows compliance to be measured
b) may show hysteresis
c) allows a direct measurement of airway resistance
d) is usually plotted on a semi-logarithmic paper
e) allows an estimate to be made of respiratory work

Answer 13

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Question 14

14. Concerning protamine:

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

Answer 14

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Question 15

15. Vasoconstrictor agents with little or no positive inotropic effect include:

a) adrenaline
b) methoxamine
c) isoprenaline
d) dobutamine
e) metaraminol

Answer 15

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Question 16

16. Opioid-induced bradycardia:

a) is not seen with pethidine
b) is due to stimulation of central vagal nuclei
c) is not seen in patients undergone bilateral vagotomy
d) is due to a direct effect of some of the opioids on the SA node
e) is more commonly seen when used with vecuronium in the intraoperative period

Answer 16

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Question 17

17. 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 availability

Answer 17

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Question 18

18. the oxyhaemogloin dissociation curve is:

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.

Answer 18

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Question 19

19. The weight of gas dissolved in a liquid at constant ambient pressure at equilibrium depends on:

a) temperature of the liquid
b) partial pressure of the gas
c) the diffusion coefficient
d) solubility of the gas in the liquid
e) critical temperature of the gas

Answer 19

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Question 20

20. Concerning opioid-induced muscle rigidity:

a) it is commonly seen with very high doses of opioids
b) it is more commonly seen with concomitant use of nitrous oxide
c) it is often seen in young patients
d) it can be reversed by naloxone
e) it is seen only in chest wall muscles

Answer 20

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Question 21

21. Concerning electromagnetic radiation:

a) it includes visible light
b) infrared radiation only occurs from objects that are hotter than the environment
c) Stefan’s law defines the heat radiated from a black body and includes a term of the fourth power of the absolute temperature of the body
d) obeys the inverse square law
e) includes ultrasound

Answer 21

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Question 22

22. Concerning the intracellular fluid:

a) it is approximately twice the volume of the extracellular fluid
b) the volume can be measured directly
c) it is freely interchangeable with other body fluid compartments
d) it contains approximately 150 mEq/L potassium
e) it is a fairly constant fraction of all tissues

Answer 22

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Question 23

23. Concerning hypersensitivity:

a) type I immediate hypersensitivity involves IgE
b) antigen excess in type III produces the Arthus reaction
c) delayed hypersensitivity is cell mediated
d) type II hypersensitivity binds complement
e) cell mediated hypersensitivity involves complement

Answer 23

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Question 24

24. The following are side-effects of suxamethonium:

a) anaphylaxis
b) masseter muscle rigidity
c) raised intraocular pressure
d) raised intragastric pressure
e) myoglobinuria

Answer 24

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Question 25

25. These are true in the SI system of measurement:

a) the basic unit of mass is the gram
b) pico is the prefix denoting 10-12
c) the Hertz is the derived unit of frequency
d) it is still allowable to use temperature on the Celsius scale
e) the unit of time in the metric and SI unit system are the same

Answer 25

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Question 26

26. With increasing altitude:

a) the concentration of oxygen in the atmosphere falls
b) the atmospheric pressure decreases exponentially
c) water will boil at a temperature of less than 100 degrees C
d) PaCO2 will decrease at first
e) acetazolamide can reduce the incidence of pulmonary oedema

Answer 26

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Question 27

27. The physiological dead space:

a) increases with induction of anaesthesia
b) decreases during controlled ventilation
c) increases with a short inspiration time
d) increases with the use of positive end-expiratory pressure

Answer 27

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Question 28

28. Warfarin:

a) competes with vitamin K
b) displaces phenylbutazone from plasma protein binding sites
c) blocks prothrombin synthesis
d) is contraindicated in malignant hypertension
e) prevents normal fibrinolysis

Answer 28

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Question 29

29. In man, atropine causes:

a) secretion of antidiuretic hormone
b) an initial bradycardia
c) relaxation of uterine muscle
d) relaxation of ureteric muscle
e) mydriasis

Answer 29

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Question 30

30. Concerning metabolism:

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

Answer 30

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