mrcp 2014 Flashcards
1
Q
- In pure respiratory acidosis, the kidney augments plasma bicarbonate (HCO3-) by
A. Combining C02 and H20 to form HC03’
B. producing greater amounts of titratable alkalinity.
C. secreting H2PO4 into the tubule in exchange for HCO3-.
D. increasing plasma aldosterone.
E. reabsorbing all the filtered HCO3
-.
A
a
2
Q
- A 25-year-old female presents with significant haemorrhage secondary to a ruptured ectopic
pregnancy. Which blood component transfusion practice is MOST LIKELY to cause harm?
A. Transfusion of A +ve packed red cells to an AB –ve recipient
B. Transfusion of A –ve packed red cells to an AB +ve recipient
C. Transfusion of AB +ve fresh frozen plasma to AB –ve recipient
D. Transfusion of B +ve cryoprecipitate to an O –ve recipient
E. Transfusion of AB –ve platelets to an O +ve recipient
A
a
3
Q
4. Which of the following is filtered at a higher rate than it is excreted yet is more concentrated in the urine than in the filtrate? A. inulin. B. glucose. C. para-amino hippurate. D. urea. E. water.
A
d
4
Q
- Regarding normal physiological changes in a healthy pregnancy, which one of the following
changes would NOT be consistent with expected changes?
A. 10% increase in heart rate by 12 weeks gestation
B. 20% increase in stroke volume by 12 weeks gestation
C. 20% increase in red cell volume by 28 weeks gestation
D. 20% increase in anatomical dead space by 28 weeks gestation
E. 50% increase in glomerular filtration rate by 12 weeks gestation
A
d
5
Q
- Regarding normal coronary artery blood flow, the following statements are true
EXCEPT which one?
A. Total left coronary artery flow is initially decreased by tachycardia
B. At rest, right coronary artery blood flow is greater than left coronary artery blood flow at the
beginning of systole
C. Flow in the left coronary artery at rest may be as high as 100 mL/min
D. Right coronary flow is at its lowest at the beginning of diastole
E. At rest, peak left coronary artery flow may be six times higher than peak right coronary artery
flow
A
d
6
Q
- Regarding peri-operative fluid management, which one of the following statements is MOST
CORRECT?
A. In patients with acute kidney injury, potassium-containing balanced electrolyte solutions should
be avoided
B. High molecular weight hydroxy-ethyl starch solutions should be avoided in severe sepsis
C. For patients with acute kidney injury, if free water is required 5% dextrose solution should be
avoided
D. In patients without gastric emptying disorders, oral water is acceptable pre- operatively except
in the last hour prior to induction of anaesthesia
E. Elderly patients are more likely to benefit from 4% dextrose/0.18% saline fluid as maintenance
A
b
7
Q
- At rest and during light, moderate or heavy exercise the distribution of cardiac output through
specific vascular beds varies. For a typical 70 kg male, the following statements are true EXCEPT?
A. During heavy exercise, the cerebral blood flow is around 750 mL/min
B. At rest, renal blood flow is 450 mL/min per 100 g of tissue
C. At rest, skeletal muscle receives 20% of total cardiac output
D. During heavy exercise, coronary blood flow increases ten-fold
E. During heavy exercise, splanchnic blood flow falls to around 1 % of total cardiac output
A
d
8
Q
- At rest and during light, moderate or heavy exercise the distribution of cardiac output through
specific vascular beds varies. For a typical 70 kg male, the following statements are true EXCEPT?
A. During heavy exercise, the cerebral blood flow is around 750 mL/min
B. At rest, renal blood flow is 450 mL/min per 100 g of tissue
C. At rest, skeletal muscle receives 20% of total cardiac output
D. During heavy exercise, coronary blood flow increases ten-fold
E. During heavy exercise, splanchnic blood flow falls to around 1 % of total cardiac output
A
d
9
Q
- Regarding the physics of ultrasound, which one of the following statements is CORRECT?
A. Application of a direct current causes piezoelectric materials to vibrate
B. The speed of sound conduction through the human body is 940 m/s
C. Differences in acoustic impedence of different tissues causing refraction of the incident beam is
the basis of ultrasound imaging in the body
D. For most applications in anaesthesia, e.g. vessel cannulation and regional anaesthesia, Amode
display format is employed
E. Anisotropy is an example of an ultrasound artifact where the echoic amplitude of a structure
varies with the angle of insonation
A
e
10
Q
- Regarding neonatal physiology, which one of the following statements is TRUE?
A. A neonate has low levels of endorphins compared to adults
B. A neonate has mature neuromuscular junctions by two weeks of age
C. A neonate has 50% greater oxygen consumption than an adult
D. A neonate has blunted parasympathetic reflexes
E. A neonate has poor sympathetic response to bleeding
A
e
11
Q
- Regarding the operation of a hydrogen electrode in order to measure pH, which one of the
following statements is CORRECT?
A. A special membrane is selectively permeable to H+ ions
B. A calomel reference electrode describes a silver electrode in direct contact with silver chloride
C. The ‘salt-bridge’ is potassium chloride
D. A highly sensitive ammeter is required
E. A unit difference in pH will produce a voltage of 6V
A
c
12
Q
Switzerland in the summer. You would expect all of the following changes to occur with this
endurance training, EXCEPT which one?
A. Significant increase in the resting stroke volume as well as maximal exercise stroke volume
B. Increased resting oxygen uptake, from 0.3 L/min to 0.5 L/min
C. Increased maximum oxygen uptake, from 2.8 L/min to 5.2 L/min
D. Hypertrophy of the heart, which is similar to the effects of hypertension
E. Delayed exercise-related rise in lactate
A
b
13
Q
- Regarding capnography, which of following is the LEAST correct?
A. Capnography is based on the principle that gases with two or more different atoms in the
molecule will absorb infrared radiation
B. The particular frequency of infrared radiation is selected by first passing it through a crystal
window
C. A reference cell increases accuracy of the system
D. The use of infrared radiation with a wavelength of 4.28 μm for the analysis of carbon dioxide
should reduce interference from the presence of nitrous oxide
E. In the sidestream capnograph, a sample is drawn at about 150 mL/min
A
b
14
Q
- A farmer slips and falls in a remote field during a hot summer. He has nothing to eat and his
only drink is whisky from a hip flask. He is not found for 3 days. On admission to hospital he is
peripherally cold, with a heart rate of 110 beats/min and a blood pressure of 85/40mmHg. Which of
the following is the most potent stimulus for antidiuretic hormone release in this patient?
A. Ingestion of alcohol
B. Stimulation of central osmoreceptors
C. Stimulation of aortic arch baroreceptors
D. Pain
E. Stress
A
c
15
Q
- Which of the following statements are correct regarding tests of coagulation?
A. Heparin therapy doesn’t affect prothrombin time (PT)
B. A prolonged activated partial thromboplastin time (aPTT) may be due to hypofibrinogenaemia
C. Haemophilia prolongs both PT and aPTT
D. Thrombin time tests the conversion of prothrombin to thrombin
E. Von Willebrand’s disease affects the PT but not the aPTT
A
b
16
Q
- Which one of the following statements regarding anticoagulant agents is correct?
A. Low molecular weight heparins have a greater ability to inhibit thrombin than to inhibit
Factor Xa
B. Fondaparinux is contraindicated for thromboprophylaxis in major joint replacement surgery
C. Unfractionated heparin inhibits platelet activation by fibrin and also binds reversibly to
antithrombin III
D. Neuraxial blockade is acceptable 12 hours after ceasing an infusion of abciximab (ReoPro®)
E. In heparin-induced thrombocytopenia, danaparoid (a heparinoid) should be avoided as an
alternative agent
A
c
17
Q
- Regarding colloid preparations for intravenous infusion, which one of the following statements
is CORRECT?
A. Gelofusine® consists of urea-linked gelatin component molecules
B. Regarding penta-starches, the ‘pent’ refers to 50% esterification with succinyl groups
C. Dextran 70 and 110 interfere with platelet aggregation and have an anticoagulant action,
whereas Dextran 40 does not
D. Gelatin used for medical colloids is derived from exposing collagen from sheep bones to a
strong alkali then boiling water
E. Heta-starch contains molecules with mean molecular weight of 450 kDa
A
e