Paper 2 MCQs Flashcards
Donor blood in the UK is routinely screened for evidence of infection by?
- HIV
- Hepatitis B
- Hepatitis C
Peripheral nerve injury is a recognised complication of which bones?
- fracture of the upper fibula
- dislocated shoulder
- fracture shaft of humerus
What is etomidate?
An imidazole derivative
Does etomidate contain an ester group?
Yes
Is etomidate associated with adrenal medullary suppression or high incidence of allergy?
No
What is the pain of angina like?
- is not stabbing in nature
- is aggravated by cold weather conditions
- occurs centrally
- is not relieved by rest within 2 or 3 seconds of stopping exercise
- is associated with nausea
Which of these drugs can be used via tracheal tube?
a) atropine
b) sodium bicarbonate
c) adrenaline
d) lidocaine
e) calcium carbonate
- atropine
- adrenaline
- lidocaine
What are possible causes of postop jaundice?
- as a consequence of biliary surgery
- after perioperative blood transfusion
- due to incidental viral hepatitis
- NOT associated following the use of nitrous oxide for a prolonged surgical procedure or following premed with papaverum
In the Venturi, does delivered concentration fall when the flow is decreased from 5 to 2L/min?
No
Is rebreathing likely in a venturi mask?
No
In the venturi, should total flow be >20 L?
Yes
In the venturi, how would you increase oxygen concentration?
Increasing the diameter of the constriction increases the oxygen concentration
In the venturi, does covering the holes in the side of the mask decrease the O2 concentration?
No
What are the features of a depolarising block?
- fasciculations
- short duration of action
- no fade
- not antagonised by anticholinesterases
- a rise in intraocular pressure
Should a complication occurring with an incidence of at least 1% should be explained to a patient preoperatively?
Yes
What is soda lime mainly made of?
Calcium hydroxide
Does soda lime require water for the absorption process?
Yes
In a patient with rheumatoid arthritis, expected problems include?
- anaemia
- difficulty with intubation
- poor venous access
Which of the following would cause you to postpone an elective operation?
a) a haemoglobin concentration of 10.8 g/dl
b) acute intermittent porphyria
c) a white cell count of 8 x 109/L
d) unexpected glycosuria
e) a potassium concentration of 5.0 mmol/L
- unexpected glycoruria only
Gallstones are associated with:
a) intestinal obstruction
b) peritonitis
c) pancreatitis
d) carcinoma of the gall bladder
e) cholangitis
All of them
Does cardiac output vary with oxygen consumption?
No
Does cardiac output…
- increases with a rise in left ventricular end-diastolic volume
- increases with a rise in afterload
- increases with a rise in myocardial contractility
Yes
No
Yes
Induction with ketamine is contraindicated:
a) in an asthmatic patient
b) for caesarean section
c) in a patient with facial burns
d) in a hypertensive patient
e) in a shocked patient
- asthma - no
- C-section - no
- burns - no
- hypertensive - yes
- shocked pt - no
Where is the oesophagus?
Posterior mediastinum, beginning at C6, and is about 25cm long
What is the epithelium of the oesophagus?
Stratified squamous epithelium without keratin
What is the motor innervation of the oesophagus?
The vagus
The following drugs can be used to treat bronchospasm occurring during anaesthesia:
a) aminophylline
b) halothane
c) salbutamol
d) sodium dicromoglycate
e) propranolol
- aminophylline
- halothane
- salbutamol
The partial pressure of carbon dioxide in arterial blood:
a) rises during sleep
b) rises when acclimatised at an altitude of 5000 metres
c) is halved when the minute ventilation is doubled (with constant production of CO2)
d) differs from that of mixed venous blood by about 0.8 kPa (6 mmHg)
e) normally rises at about 0.8 kPa (6 mmHg) per minute during apnoea
- rises during sleep
- does not rise at altitude
- is halved if minute ventilation is doubled
- differs from mixed venous blood by about 0.8 kPa
- doesn’t rise at a rate of 0.8 kPa/min during apnoea
In the treatment of established malignant hyperthermia,what drugs are part of the treatment?
- dantrolene
- sodium bicarbonate
- glucose + insulin
What are the constituents of raw opium?
- morphine
- papaverine
- codeine
Which of the following are recognised features of Fallot’s tetralogy:
a) squatting
b) pulmonary oligaemia
c) cyanosis occurring only with exercise
d) a loud systolic murmur due to a ventricular septal defect
e) syncope
- squatting
- pulmonary oligaemia
- loud systolic murmur due to VSD
The risk of passive regurgitation can be increased by:
a) the presence of a nasogastric tube
b) neostigmine
c) metoclopramide
d) a non-depolarising muscle relaxant
e) placing a patient in the lithotomy position
- NG tube in situ
- placing a patient in lithotomy
Regarding the innervation of the eye:
a) the sensory supply is via the facial nerve
b) the motor supply to orbicularis oculi is via the oculomotor nerve
c) the sympathetic supply is via the superior cervical ganglion
d) the ciliary ganglion lies within the extraocular muscle cone
e) parasympathetic stimulation produces mydriasis
- the optic nerve is the sensory nerve for vision
- motor supply to obicularis oculi is facial nerve
- sympathetic supply is via superior cervical ganglion
- ciliary ganglion lies within extraocular muscle cone
- parasympathetic stimulation produces miosis
The following are produced in the anterior pituitary:
a) somatotrophin
b) oxytocin
c) aldosterone
d) thyrotrophin (TSH)
e) prolactin
- somatotrophin
- TSH
- prolactin
(plus GH, LH, FSH ACTH)
Stridor following thyroidectomy may be caused by:
a) recurrent laryngeal nerve damage
b) wound haematoma
c) thyroid storm
d) hypocalcaemia
e) tracheomalacia
All except thyroid storm
What are the features of acute intracranial extradural haematoma?
a) after a lucid interval
b) in association with contralateral pupillary dilatation
c) in the elderly
d) in association with a skull fracture
e) as a result of arterial bleeding
- occurs after a lucid interval
- associated with ipsilateral pupillary dilatation (oculomotor nerve compression)
- associated with skull # (75%)
- are commoner in young males (trauma)
- middle meningeal artery is involved in 75% of EDH
A size E cylinder of nitrous oxide:
a) contains the equivalent of 1800 litres of gas (at STP) when full
b) has a pressure of 137 Bar at 20 degrees C when full
c) may develop frost on the outside during normal use
d) is coloured blue, with blue and white quartered shoulders
e) contains more liquid than gas when full
- contains 1800L N2O at STP when full
- pressure of 51 bar
- can be frosty outside when in use
- is blue body with blue shoulders
- contains more liquid than gas when full
When using a circle system with absorber and a vaporiser outside the circle:
a) a fresh gas flow of at least 2/3 of the minute volume is required
b) the actual inspired vapour concentration during maintenance may be higher than the vaporiser setting
c) the actual inspired oxygen concentration may be lower than that of the fresh gas at low fresh gas flows
d) sevoflurane is a suitable agent to use
e) the system can only be used for patients breathing spontaneously
- F
- F
- T
- F
- F
What is normal intraocular pressure?
Normal eye pressure ranges from 12-22 mm Hg
Can intra-ocular pressure be normal in closed-angle glaucoma?
Yes
Tachycardia may be expected following administration of:
a) pancuronium
b) ketamine
c) edrophonium
d) gallamine
e) d-tubocurarine
- T - pancuronium
- T - ketamine
- F
- T -gallamine
- F
Digoxin toxicity:
a) is potentiated by hypokalaemia
b) is an idiosyncracy of the drug
c) produces atrioventricular block
d) is less likely to occur in the elderly
e) is associated with vomiting
- T
- F
- T
- F
- T
The following drugs are readily soluble in water:
a) propofol
b) midazolam
c) diazepam
d) ketamine
e) etomidate
- midazolam
- ketamine
P waves are absent in:
a) atrial fibrillation
b) ventricular tachycardia
c) massive pulmonary embolism
d) first degree heart block
e) nodal rhythm
- only AF
The pupil is dilated by the following being put into the conjunctival sac:
a) ephedrine
b) timolol
c) homatropine
d) cocaine
e) chloramphenicol
- ephedrine
- homatropine
- cocaine
/Which has a lower MAC- halothane or isoflurane?
Halothane
Which is metabolised in the liver more - halothane or isoflurane?
Halothane
What is halothane?
A halogenated hydrocarbon
What effect does halothane have on the myocardium?
Sensitises the myocardium to the arrhythmogenic action of adrenaline, even at a concentration of 1 MAC
Reduced central venous pressure may be due to:
a) intermittent positive pressure ventilation
b) constrictive pericarditis
c) increased venous capacitance
d) tricuspid incompetence
e) reduced myocardial contractility
Increased venous capacitance
A tall R wave in lead V1 is typically present with:
a) left bundle branch block
b) right ventricular hypertrophy
c) inferior myocardial infarction
d) mitral stenosis
e) hyperkalaemia
- RVH
Lymph:
a) contains no cells
b) contains less protein than plasma
c) circulates at a rate of 1 litre per day
d) clots on standing
e) carries important enzymes
- does contain cells
- contains less protein than plasma
- clots on standing
- carries important enzmes
