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Physiology MCQs > Last minute facts > Flashcards

Last minute facts Flashcards

1
Q

Reflex arc

A

Thermoreceptors, Aδ fibre afferent neurone (conduction velocity 10-30 m/s), dorsal horn, interneurone, Aα fibre efferent neurone (conduction velocity (60-120 m/s) and effector

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2
Q

most ATP from the metabolism of glucose?

A

Electron transport phosphorylation produces the most ATP from the metabolism of glucose

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3
Q

Valsalva phases

A

Phase I - An initial increase in venous return from intrathoracic vessels causes a transient decrease in HR and increase in BP.

Phase II - As the high intrathoracic pressure in maintained there is a decrease in the venous return which is sensed by baroreceptors. This causes an increase in HR and decrease in BP. The BP tends to return to normal by the end of phase II.
Phase III - Sudden release of forced expiration and/or glottal opening results in a return of the intrathoracic pressure to normal. This causes pooling of blood into intrathoracic vessels resulting in a decrease in BP, whilst the HR remains elevated.
Phase IV - During phase IV the intrathoracic pressure remains normal and the continued increase return of systemic venous blood produces a reflex bradycardia associated with an increase in BP to normal.

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4
Q

1 litre of 5% dextrose (d-glucose) is intravenously infused into a normally fit and well 54-year-old female over a period of 10 minutes.

Which one of the following physiological responses is most likely to influence a change in the urine output in this patient?

A

Inhibition of arginine vasopressin (AVP) secretion / ADH

The threshold of the volume receptors is 7-10% blood volume change. The osmoreceptors are sensitive to a 1-2% change in osmolality. 


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5
Q

PaO2

A

PAO2 = PiO2 − PaCO2/R

The PiO2 can be calculated by subtracting the partial pressure exerted by water vapour at body temperature:

PiO2 = 0.21 × (100 kPa − 6.3 kPa)
PiO2 = 19.8
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6
Q

Interstitial oncotic pressure lung

A

Interstitial oncotic pressure = 17 mmHg

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7
Q

ACVXY pathology

A

In atrial fibrillation no “a” wave is seen
In tricuspid stenosis the “a” wave is enlarged
In tricuspid regurgitation the “v” wave is enlarged.

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8
Q

Which one of the following actions of PTH is most likely to lead to the release of calcium from bone?

A

Osteoclasts are cells which promote bone resorption. They are stimulated indirectly by PTH

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9
Q

Stuff about Beta blockers

A 
Uses
Angina
HTN
CCF
Arrhythmia
Hyperthyroid
anxiety
migrane prop
second prevent - Mi

Beta - hypertensive reponse laryngoscpy
hypotensive anaes
Htn/ arrhythmia

Antag @ beta adrenergic

Non select 
B1
B2
timolol
sotlaol

Selctive - b 1
Atenolol
meotp

some membrane stab - sotalol

Neg inotropy & chronotropy - red work & bp

PO
Some IV - atenolol esmolol

S e - brady
worse ccf
worsen WORSEN pVD
Cold extrem

Bspams - asthmatic

Tireness
nightmare sleep dist

Diabetes - reduce glycogenolsyis
insluin relase -
blunt hypogly response

not use w/ Calcium chan antag -> neg ino - verap diltiazem - prof hypoenti brady conduction

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10
Q

CSF path

A

Ependymal cell chroid - late vent

Choroid plexus

Foramen monro

Aqeuduct sylvius

foramen magendia

Arach vili

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11
Q

Neostigmine is an

A

Neostigmine is an acetylcholinesterase inhibitor used to increase the concentration of acetylcholine at the neuromuscular junction and promotes muscarinic effects:

Bradycardia
Increased gastrointestinal motility and intraluminal pressure
Increased bladder contractility
Sweating
Miosis
Bronchospasm.
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12
Q

1 litre of 0.9% N. saline

A

1 litre of 0.9% N. saline will therefore in this time-frame increase plasma volume by about 250 mL, potentially the threshold for activation of the volume receptors in the atria which would release atrial natriuretic peptide (ANP).

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13
Q

ph h io conc

  1. 3
  2. 35
A

7 100

  1. 3 50
  2. 35 - 40
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14
Q

Liver

A

Although the liver constitutes 2.5% of total body weight it receives almost 25% of the cardiac output.

The liver has a dual blood supply:

Hepatic artery 500 ml/min (100 mmHg), 95% oxygen saturation
Portal vein 1000 ml/min (7 mmHg), 70% oxygen saturation.
The coronary, renal and cerebral circulations are capable of autoregulation.

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15
Q

Increase A-a gradient

A

V/Q mm
R-L shunt
diffusion defects

eg
hypovol, decrease co, anaesthesia, pneumonia

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16
Q

Thermocouple Relies on

A

Seebeck effect is
temperature between two dissimilar electrical conductors or semiconductors produces a voltage difference between the two metals.

temp increase - flow increase

A thermocouple is a device that can be used to measure temperature. It uses a thermoelectric principle (Seebeck effect) as the basis of operation.

he bimetallic strip has a junction potential proportional to temperature

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17
Q

Measureing compartments

A
  • Total body water: isotopic water
  • ECF: Mannitol and inulin
  • Blood: isotopic red cells
  • Plasma: tracer-labelled albumin and Evan’s blue dye
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18
Q

NNT

A

NNT = 1 / Absolute risk reduction

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19
Q

Correct regarding blood

A

Serum is a product of coagulated blood.

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20
Q

Circle effeciency

A

B. The CO2 absorber should be placed downstream of the reservoir bag

FGF enters downstream and is not
wasted via the APL.

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21
Q

Vaughan williams

A

The sodium channel blockers

which prolong the action potential are quinidine and procainamide (Class IA).

Lignocaine, mexiletine and phenytoin are Class IB drugs and shorten action
potential,

while flecainide (Class IC) has no effect on the action potential.
Beta blockers are Class II drugs.
Sotalol (Class III) is a potassium channel blocker, while verapramil and
diltiazem block calcium channels and are Class IV drugs.
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22
Q

ProThrombotic inheritied

A

Factor V Leiden and protein C or S deficiencies are inherited thrombophilia and result in a prothrombotic state.

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23
Q

LAST immed rx

A

Give an initial intravenous bolus injection of 20% lipid emulsion 100 mL over 1 min

+

Start an intravenous infusion of 20% lipid emulsion at 1000 mL.h–1

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24
Q

Electrical wire

A

A thinner metal wire has higher resistance than a thicker one.

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25
Q

1volt

A

One volt (V) is defined as the potential difference across a segment of wire
necessary to allow the flow of one ampere of current while there is dissipation of
one watt of power.

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26
Q

Amp

A 
The ampere (A) is a measure of current and is defined as the movement of one
coulomb of charge (equivalent to 6.24 × 1018 electrons) past a point in one second.
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27
Q

hot wire anemometry

A

It is very sensitive and has a very fast response time

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28
Q

Cao2

A

= (Hb g/dL × 10 × saturations × 1.34 [Huffner constant]) +

PaO2[kPa] × 10 × 0.0225mL O2 dissolved per 100 mL plasma per kPa

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29
Q

tec 6

A

TEC 6 desflurane vaporizer is a measured flow vaporizer and does not require
temperature compensatory mechanisms

Desflurane requires a specially designed measured-flow vaporizer.
The chamber of the vaporizer is heated to a temperature of 39°C, which results in
a desflurane vapour pressure of 200 kPa

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30
Q

Haldane

A

The Haldane effect refers to the ability of haemoglobin to carry more CO2 in its
deoxygenated state.

.

31
Q

Bohr

A

The Bohr effect refers to the behaviour of the oxygen dissociation curve (right
shift and increased O2 off-loading) when exposed to conditions of a high PaCO2,
increased H+ and high temperatures

32
Q

Rec activated

A

• Ion channel opening and closing: action of norepinephrine on K+ channels in
the heart and NM junction
• mRNA transcription: thyroid hormones and steroid hormones
• Activation of phospholipase C: angiotensin II and alpha 2 receptor
• Tyrosine kinase in cytoplasm: insulin
• Activation of adenylate cyclase: B1 recepto

33
Q

liver o2 supply

A

The arterial blood, being 98% saturated, contributes around 30–40% of
the oxygen requirements of the liver, with the portal vein (having drained the
stomach, gallbladder, intestines, spleen and pancreas) having saturations around
85% and contributing the rest

B. 30% from hepatic artery and 70% from portal vein

34
Q

first-order kinetic

A

first-order kinetics whereby rate of elimination is proportional to the amount
of drug remaining in the bbody

35
Q

b2 outside vessels

A

β-2 receptors in the liver, when stimulated, aid in glycogenolysis.

36
Q

Clearance (mL/min)

A

Clearance (mL/min) =
urine concentration of substance urine (mg/mL)
× urine flow (mL/min)
/ concentration of substance in the plasma (mg/mL)

37
Q

Vd

VD ex

A

If Vd = blood volume, then the drug is restricted to the plasma.
If Vd = total body water volume, then the drug is equally distributed
throughout the body.
If Vd > total body water, then the drug is concentrated in the tissues

Examples of a Vd are as follows: digoxin: 500 L; insulin: 50 L; lignocaine: 120 L;
propranolol: 250 L; aspirin: 12 L; and warfarin: 9 L.

38
Q

An exaggerated response to depolarizing muscle relaxants in paralysed

A

B. Extra-junctional acetylcholine receptors

denervation injuries and in burns patients a

massive efflux of potassium will ensue from the muscle cell – enough
to precipitate a cardiac arrest.

39
Q

Coag optimal

A

Coagulation is optimal when a pulsed sine wave pattern-alternating current is
used.

applied to dry, clean and hairless skin to allow adequate surface area to disperse the current.

Cutting is achieved
using a sine wave pattern of alternating current

40
Q

Cylinders

A

For oxygen cylinders at 137 Barr:
Size C contains 170 L;
Size D contains 340 L; and
Size E contains 680 L.

B. Composite cylinders are frequently found in the hospital setting

41
Q

Zidovudine

A

D. Thymidine kinase is essential for zidovudine to act.

protect the baby from vertical transmission

42
Q

Stress respose affet on sugar

A
  1. Decreased insulin secretion – alpha adrenergic effect;
  2. Increased growth hormone secretion – this inhibits glucose uptake; and
  3. Increased gluconeogenesis (and possibly glycogenolysis) mediated by cortisol
    and circulating catecholamines
43
Q

Sulphonylurea

A

A. They displace insulin from B-cells in the islets of Langerhans

Sulphonylureas bind to the ATP K+ channel on the B-cell membrane and
depolarize the cell to secrete insulin.

44
Q

Steroids -

A

• Minor surgery: IV hydrocortisone 25 mg at induction only.
• Moderate surgery: IV hydrocortisone 25 mg on induction + 100 mg
hydrocortisone over 24 hours post-operatively.
• Major surgery: IV hydrocortisone 25 mg on induction + 100 mg hydrocortisone
per day for 72 hours post-operatively

<10mg - Normal HPA

45
Q

BMR

A

B. Rate of heat production in an individual who is at mental and physical rest, in a
thermoneutral environment, 12–14 hours after a meal

46
Q

gate control theory

rubbing somewhere sore

A

The gate control theory of pain and closure of the ‘gate’ from A beta fibre stimulation

47
Q

All of the following are safety features of modern anaesthetic machine

A

An emergency oxygen flush provides flow rates in excess of 35 L/min.
B. Oxygen is fed downstream of other gases
A pressure-relieving valve is set at 30 kPa to prevent damage to the machine.
E. An oxygen failure device will trigger if the oxygen pressure drops below
200 kPa.

48
Q

Response to metabolic acidosis

A

Aortic and carotid body chemoreceptors travelling via the vagus and
glossophryngeal nerves, respectively, and the central medullary chemoreceptors

49
Q

Bernoulli

A

Bernoulli Effect. The pressure drop may be of sufficient magnitude to entrain
fluid or gas from a port just distal to the constriction. This is the Venturi Principle

uction apparatus, scavenging
equipment and Venturi valves

50
Q

antiemitics

A

Dopamine antagonists: chlorpromazine, prochlorperazine, droperidol,
domperidone and metoclopramide.
• Anticholinergics: hyoscine, atropine and glycopyrrolate.
• 5HT3 antagonists: ondansetron, tropisetron and granisetron.
• Antihistaminics: cyclizine and promethazine.
• Amitriptyline is not an anti-emetic. Steroids (dexamethasone), acupuncture (P6
point) and cannabinoids have anti-emetic properties.
• NK1 receptor antagonists are used as anti-emetics in cancer chemotherapy such
as aprepitant.

51
Q

Safety

A

Class I: any conductive part of such equipment which may contact the user are
earthed (i.e. grounded). A fuse is incorporated such that the fuse disintegrates if
the user becomes part of the circuit.
• Class II: The user is protected from making contact with live elements through
the uses of double insulation. These types of equipment are not earthed.
• Class III: These incorporate internal power sources and hence pose less threat to
operators.

52
Q

awareness monitoring

A

B. Auditory evoked potentials are more sensitive than somatosensory evoked
potentials
Entropy decreses

53
Q

Toe amputation

A

C. Superficial and deep peroneal nerve and posterior tibial nerve

54
Q

rugs have anticholinergic properties, including:

A

Many different classes of drugs have anticholinergic properties, including:

Tricyclic antidepressants
Phenothiazines and
Some antihistamines, for example, chlorpheniramine and promethazine.

55
Q

ankle block

A

nkle block, five nerves need to be anaesthetised.

They are

The saphenous nerve (the terminal branch of the femoral nerve) and
Four nerves derived from the sciatic nerve:
The tibial
Sural
Superficial peroneal and
Deep peroneal nerves (not common peroneal nerve).

56
Q

pH

A

pH = - log10 [H+], rearranging the equation:

[H+] = 10-pH or substituting pH, [H+] = 10-7

One nanomol = 1 x 10-9 or 0.000000001

10-7 = 1x 0.0000001 or 10 x 0.00000001 or 100 x 0.000000001

100 nanomol

57
Q

V = I X R

A

Potential difference (V) = current (I) x resistance (Ω).

Rearranging the equation:

I = V/R1 + R2

where:

V    = 12
R1 = 4
R2 = 2
58
Q

Crit damping

A

ritical damping provides the quickest approach to zero amplitude (damping factor = 1).

With overdamping the approach to zero is slower (damping factor >1). Neither sine wave overshoots the zero point.

59
Q

thermocouple

A

The thermojunction voltage generated by dissimilar metals varies linearly with temperature (Seebeck effect).

60
Q

FEV1 FVC

A

The severity of a reduction in %FVC (restrictive defect) or %FEV1/FVC (obstructive defect) predicted can be classified as follows:

Mild 70-80%
Moderate 60-69%
Moderately severe 50-59%
Severe 35-49%
Very severe <35%

This patient has a mixed deficit with a severe obstructive deficit as %FEV1/FVC predicted is 46.9% and a moderate restrictive deficit as %FVC of predicted is 61.3

If the FEV1/FVC ratio is less than 80% of predicted value and VC < 80% = mixed picture.

If the FEV1/FVC ratio is less than 80% predicted value and VC > 80% = obstructive picture.

If the FEV1/FVC ratio is greater than 80% of predicted value and VC > 80% = normal picture.

If the FEV1/FVC ratio is greater than 80% of predicted value and VC < 80% predicted= restrictive picture.

61
Q

more specific to bipolar compared with unipolar diathermy?

A

Has a power output of up to 140 joules per second This is the correct answer

62
Q

Soda lime is routinely used as part of a modern circle system with a vaporiser outside the circuit (VOC).

A

Carbon monoxide formation This is the correct answer

63
Q

λ = v/f

A

λ = v/f

64
Q

gas density at atitude

A

The density of a gas decreases with altitude and viscosity unaltered

65
Q

Force

pressure

energy

power

volt

A

Force: m.kg.s-2

Pressure: m-1.kg.s-2

Energy or work: m2.kg.s-2

Power: m2.kg.s-3

Volt: m2.kg.s-3.A-1

66
Q

RAD

LAD

A

QRS complex is net negative in lead I, net positive in lead aVF.

Lead I +ve, lead II −ve and aVF −ve

67
Q

time constant

A

However, the crux of this question is to remember that the time constant (τ) is the inverse of the rate constant (k)

k = 0.02 s−1

Tau (τ) = 1/k = 1/0.02 = 50 s

Therefore 1 time constant has elapsed and the plasma concentration has fallen by 63% (37% remains) .

68
Q

Frictional losses

A

Frictional losses mean that kinetic energy recovered is always less than the original potential energy This is the correct answer

69
Q

Carrier GF

A

VO (vaporiser output) mL =
Carrier gas flow (mL/minute) × SVP of agent (kPa)
_____________________________________
Ambient pressure (kPa) − SVP of agent (kPa)

70
Q

A sevoflurane vaporiser is set at 2% and is operating at an ambient pressure of 200 kPa.

Which of the following options best represents vaporiser output at this pressure?

A

(Please select 1 option)

The output is 1% because the saturated pressure of sevoflurane is unaffected by ambient pressure
71
Q

ecg freq

A

Bandwidth 0.05-150 Hz, voltage 100-4000 microvolts

72
Q

Thermistor fall

A

thermistor consists of a little bead of metal oxide semiconductor, the resistance of which falls exponentially (not linearly) as the temperature rises.

73
Q

Force
capac
kinetic

A

Force = mass × acceleration
Capacitance (farad) = charge / voltage
Kinetic energy = ½ × mass × (velocity)²

Physiology MCQs (17 decks)

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