Primary Exam SAQ

Question 1

<p>Discuss the pharmacology of ketamine in acute pain management. Include in your answer the advantages and disadvantages of different routes of administration.</p>

Answer 1

<p>A</p>

Question 2

<p>List the components of soda lime, used for the absorption of carbon dioxide. Outline the hazards associated with the use of soda lime within a circle circuit and how the risks can be minimised.</p>

Answer 2

<p>A</p>

Question 3

<p>What affect does placing a patient in the right lateral position have on lung ventilation and perfusion?</p>

Answer 3

<p>A</p>

Question 4

<p>Discuss the concepts of half life and context sensitive half-time with examples from anaesthetic pharmacology.</p>

Answer 4

<p>A</p>

Question 5

<p>Describe how morbid obesity affects time to awakening after inhalation anaesthesia.</p>

Answer 5

<p>A</p>

Question 6

<p>Describe the sites of action of antiemetic agents used for post operative nausea and vomiting.</p>

Answer 6

<p>A</p>

Question 7

<p>Discuss the potential adverse effects of NON depolarising muscle relaxants.</p>

Answer 7

<p>A</p>

Question 8

<p>Outline the physiological changes that may explain why an otherwise well patient may have a reduced urinary output intra-operatively.</p>

Answer 8

<p>A</p>

Question 9

<p>Briefly outline the differences between the pulmonary circulation and the systemic circulation.</p>

Answer 9

<p>A</p>

Question 10

<p>Outline how hyperventilation may reduce intracranial pressure.</p>

Answer 10

<p>A</p>

Question 11

<p>Explain the mechanisms whereby oxygen transfer is facilitated at the placenta.</p>

Answer 11

<p>A</p>

Question 12

<p>Describe the physiological factors that contribute to the competence and tone of the lower oesophageal sphincter.</p>

Answer 12

<p>A</p>

Question 13

<p>Describe the fuel cell and the paramagnetic oxygen analyser. Discuss their use in anaesthetic practice.</p>

Answer 13

<p>A</p>

Question 14

<p>Compare and contrast the pharmacology of neostigmine and sugammadex.</p>

Answer 14

<p>A</p>

Question 15

<p>Discuss the prevention of electrical shock in the operating theatre.</p>

Answer 15

<p>A</p>

Question 16

<p>Discuss the physical principles and equipment used for measurement of exhaled carbon dioxide by infrared analysis using side stream sampling. Outline the potential sources of error.</p>

Answer 16

<p>A</p>

Question 17

<p>Draw and label a circle breathing system. Explain its advantages and disadvantages.</p>

Answer 17

<p>A</p>

Question 18

<p>Describe the anatomy of the neonatal airway, and what implications this has for airway management.</p>

Answer 18

<p>A</p>

Question 19

<p>Discuss the potential adverse effects of NON depolarising muscle relaxants.</p>

Answer 19

<p>A</p>

Question 20

<p>Discuss the relative advantages and disadvantages of using morphine and fentanyl for post-operative Patient Controlled Analgesia (PCA).</p>

Answer 20

<p>A</p>

Question 21

<p>Discuss the factors influencing the speed of onset of blockade, of a major peripheral nerve, with local anaesthetic.</p>

Answer 21

<p>A</p>

Question 22

<p>Describe the pharmacodynamic properties of propofol EXCLUDING its effects on the central nervous system. Describe how these influence clinical use.</p>

Answer 22

<p>A</p>

Question 23

<p>Outline the pharmacology of agents used in the acute management of hypertension in pregnancy.</p>

Answer 23

<p>A</p>

Question 24

<p>Describe the mechanism of action, pharmacokinetics and major side effects of amiodarone.</p>

Answer 24

<p>A</p>

Question 25

<p>Describe the cardiovascular changes that occur with ageing.</p>

Answer 25

<p>A</p>

Question 26

<p>Describe the respiratory effects of adding positive end expiratory pressure (PEEP) to intermittent positive pressure ventilation (PPV).</p>

Answer 26

<p>A</p>

Question 27

<p>Describe the autonomic innervation of the heart and the effects of autonomic stimulation on cardiac function.</p>

Answer 27

<p>A</p>

Question 28

<p>Outline the physiological mechanisms of progression from acute to chronic pain and how drugs may alter this progression.</p>

Answer 28

<p>A</p>

Question 29

<p>Describe the physiological role of prostaglandins on smooth muscle throughout the body.</p>

Answer 29

<p>A</p>

Question 30

<p>Describe the physiological effects of sleep on the brain and the respiratory system.</p>

Answer 30

<p>A</p>

Question 31

<p>Compare and contrast oxygen delivery via nasal cannulae (nasal prongs/specs), simple face mask (eg Hudson or CIG mask) and Venturi mask.</p>

Answer 31

<p>A</p>

Question 32

<p>Propofol and remifentanil TCI are often given together as a total intravenous anaesthesia technique. Discuss pharmacological reasons why this is a useful combination</p>

Answer 32

<p>A</p>

Question 33

<p>Outline the genetic variations on the cytochrome P450 2D6 enzyme and discuss the clinical relevance for drugs used in the perioperative period</p>

Answer 33

<p>A</p>

Question 34

<p>Describe the advantages and disadvantages of using nitrous oxide as part of a general anaesthetic</p>

Answer 34

<p>A</p>

Question 35

<p>Discuss the potential adverse effects of suxamethonium</p>

Answer 35

<p>A</p>

Question 36

<p>Discuss the factors affecting the duration of action of a local anaesthetic block to a major peripheral nerve</p>

Answer 36

<p>A</p>

Question 37

<p>Compare and contrast LMWH and unfractionated heparin</p>

Answer 37

<p>A</p>

Question 38

<p>A new test called the "intubation score" has a reported 90% sensitivity and 70% specificity when used to predict difficult intubation. Describe how this information and other statistics related to this test can be used in predicting difficult intubation. How will the incidence of difficult intubation affect the performance of this test?</p>

Answer 38

<p>A</p>

Question 39

<p>Draw both aortic root and a radial artery pressure wave forms on the same axes. Explain the differences between them</p>

Answer 39

<p>A</p>

Question 40

<p>Draw an expiratory flow-volume curve obtained from a maximal expiratory effort after a vital capacity breath, for a person with:
<br></br>normal lungs
<br></br>restrictive lung disease
<br></br>obstructive lung disease
<br></br>(10 marks)
<br></br>Explain how and why these curves (and the derived parameters) are different in each disease state (15 marks)</p>

Answer 40

<p>A</p>

Question 41

<p>Discuss the physiological consequences of total spinal anaesthesia caused by intrathecal administration of 20 ml of 2% lignocaine at the L3/4 level. (Do not include management)</p>

Answer 41

<p>A</p>

Question 42

<p>Describe how the large daily volume of glomerular filtrate is altered by the kidney to form a relatively low volume of concentrated urine</p>

Answer 42

<p>A</p>

Question 43

<p>Outline the physiological effects of the adrenal hormones aldosterone and cortisol. (Do NOT describe synthesis or metabolism)</p>

Answer 43

<p>A</p>

Question 44

<p>Outline the clinical laboratory assessment of liver function</p>

Answer 44

<p>A</p>

Question 45

<p>Describe the respiratory effects of adding positive end expiratory pressure (PEEP) to intermittent positive pressure ventilation (IPPV).</p>

Answer 45

<p>A</p>

Question 46

<p>Compare and contrast the action potentials from the sino-atrial node and a ventricular myocyte.</p>

Answer 46

<p>A</p>

Question 47

<p>Explain the physiological processes that cause oliguria in response to hypovolaemic shock.</p>

Answer 47

<p>A</p>

Question 48

<p>Outline the physiology of blood groupings that allows O negative packed cells to be safely transfused to most patients.</p>

Answer 48

<p>A</p>

Question 49

<p>Describe the cardiovascular changes that occur with morbid obesity.</p>

Answer 49

<p>A</p>

Question 50

<p>Discuss the determinants and control of spinal cord perfusion.</p>

Answer 50

<p>A</p>

Question 51

<p>Explain the reasons why a pulse oximeter may give incorrect readings.</p>

Answer 51

<p>A</p>

Question 52

<p>Describe how the oxygen Vacuum Insulated Evaporator works.</p>

Answer 52

<p>A</p>

Question 53

<p>Describe the anatomy and relations of the right internal jugular vein relevant to performing central venous cannulation.</p>

Answer 53

<p>A</p>

Question 54

<p>Describe the effects of giving an unopposed dose of neostigmine.</p>

Answer 54

<p>A</p>

Question 55

<p>a) Briefly describe the bactericidal activity of gentamicin. Explain why it is usually administered as a single daily dose.
<br></br>b) Describe the potential toxic effects of gentamicin.</p>

Answer 55

<p>A</p>

Question 56

<p>Explain the mechanisms by which intravenous morphine produces analgesia. Your answer should focus on the location and function of mu opioid receptors.</p>

Answer 56

<p>A</p>

Question 57

<p>Describe the effect of a pregnancy, at term, on wash-in of volatile anaesthetic agents.</p>

Answer 57

<p>A</p>

Question 58

<p>Describe the principles of how a computer-controlled infusion device targets and maintains a constant effect-site concentration of propofol.</p>

Answer 58

<p>A</p>

Question 59

<p>Briefly describe the pharmacodynamics of agents used in the treatment of post-operative nausea and vomiting (PONV), with particular reference to their site of action and side effects.</p>

Answer 59

<p>A</p>

Question 60

<p>Write a brief description of the pharmacology of ropivacaine.</p>

Answer 60

<p>A</p>

Question 61

<p>Describe the mechanism of action of protamine when used to reverse effects of heparin. Outline the side-effects of protamine.</p>

Answer 61

<p>A</p>

Question 62

<p>Describe the compensatory mechanisms in a fit person moving from the supine to the standing position.</p>

Answer 62

<p>A</p>

Question 63

<p>Compare and contrast warfarin and dabigatran with particular emphasis on the patient that presents for surgery.</p>

Answer 63

<p>A</p>

Question 64

<p>Describe the visceral and somatic pain of labour with particular reference to the anatomy of the pain pathways</p>

Answer 64

<p>A</p>

Question 65

<p>Using a labelled diagram, describe how a mechanical (non-cassette) variable bypass vaporiser achieves the concentration set on the dial. Describe the mechanisms that compensate for temperature and downstream pressure changes.</p>

Answer 65

<p>A</p>

Question 66

<p>A) Describe the immediate cardiovascular responses to the sudden loss of 30% of the blood volume in healthy awake person.
<br></br>B) How are these responses different if the patient is undergoing anaesthesia with sevoflurane?</p>

Answer 66

<p>A</p>

Question 67

<p>(a) Describe the generation and features of a normal awake EEG
<br></br>(b) Briefly discuss the processing performed by quantitative EEG monitors (such as BIS or Entropy) to produce a single number from the EEG.</p>

Answer 67

<p>A</p>

Question 68

<p>Outline the factors which influence the time taken for loss of consciousness during an inhalational induction of anaesthesia</p>

Answer 68

<p>A</p>

Question 69

<p>Describe the effects of morbid obesity on the respiratory system.</p>

Answer 69

<p>A</p>

Question 70

<p>Compare and contrast the pharmacology of ephedrine and norepinephrine (noradrenaline).</p>

Answer 70

<p>A</p>

Question 71

<p>Discuss the factors affecting duration of action of a local anaesthetic block to a major peripheral nerve.</p>

Answer 71

<p>A</p>

Question 72

<p>Draw and explain the characteristics of a quantal dose-response curve that describes the major clinical effect of rocuronium. Outline medications and medical conditions that may cause the curve to shift to the left or right.</p>

Answer 72

<p>A</p>

Question 73

<p>Describe the physiological processes that influence the rate of gastric emptying.</p>

Answer 73

<p>A</p>

Question 74

<p>Describe the immunology, mediators and pathophysiology of anaphylaxis. Do not discuss management.</p>

Answer 74

<p>A</p>

Question 75

<p>Describe the clinical effects of non-steroidal anti-inflammatory drugs including the mechanism(s) through which they exert these effects.</p>

Answer 75

<p>A</p>

Question 76

<p>Describe the determinants of left ventricular myocardial oxygen supply and demand.</p>

Answer 76

<p>A</p>

Question 77

<p>Describe the pharmacodynamic properties of propofol EXCLUDING its effects on the central nervous system. Describe how these influence clinical use.</p>

Answer 77

<p>A</p>

Question 78

<p>Write brief notes on the pharmacology of tramadol.</p>

Answer 78

<p>A</p>

Question 79

<p>Describe the cardiovascular changes that occur with morbid obesity.</p>

Answer 79

<p>A</p>

Question 80

<p>Outline the theories, both current and discredited, as to how volatile anaesthetic agents cause loss of consciousness.</p>

Answer 80

<p>A</p>

Question 81

<p>Outline the hazards associated with the use of CO2 absorbents within a circle breathing system and how the risks can be minimised.</p>

Answer 81

<p>A</p>

Question 82

<p>List the desired and adverse effects of opioids and the corresponding anatomical location of the receptors being activated.</p>

Answer 82

<p>A</p>

Question 83

<p>Describe the washout of sevoflurane from a patient following two hours of general anaesthesia. You may wish to use a graph to illustrate the description.</p>

Answer 83

<p>A</p>

Question 84

<p>Justify the dose of propofol you would expect to use to induce anaesthesia in the following scenarios, using pharmacokinetic and pharmacodynamic principles.
<br></br>(a) 4 year old child weighing 15kg (25%)
<br></br>(b) 75 year old man weighing 70kg (25%)
<br></br>(c) 40 year old man weighing 70kg with severe hypovolaemic shock (50%)</p>

Answer 84

<p>A</p>

Question 85

<p>Outline the pharmacology of intravenous metoprolol.</p>

Answer 85

<p>A</p>

Question 86

<p>Discuss the determinants of renal blood flow.</p>

Answer 86

<p>A</p>

Question 87

<p>Describe the determinants of left ventricular myocardial oxygen supply and demand.</p>

Answer 87

<p>A</p>

Question 88

<p>Describe the respiratory response to hypoxaemia in both the awake and anaesthetised patient.</p>

Answer 88

<p>A</p>

Question 89

<p>Compare and contrast the pharmacology of neostigmine and sugammadex.</p>

Answer 89

<p>A</p>

Question 90

<p>Define and describe LUNG compliance. Discuss the difference between static and dynamic compliance.</p>

Answer 90

<p>A</p>

Question 91

<p>(a) Describe the mechanisms by which heat is transferred between the body and its environment (30%)
<br></br>(b) Describe methods by which body heat may be conserved under anaesthesia (70%)</p>

Answer 91

<p>A</p>

Question 92

<p>Describe platelets and their role in haemostasis.</p>

Answer 92

<p>A</p>

Question 93

<p>Classify drugs used in the treatment of depression. Outline the interactions between antidepressant drugs and drugs that are commonly used during the peri-operative period.</p>

Answer 93

<p>A</p>

Question 94

<p>Briefly describe the principles (50%) and sources of error (50%) in the measurement of arterial blood pressure using an automated oscillometric non-invasive monitor.</p>

Answer 94

<p>A</p>

Question 95

<p>Discuss the factors that affect oxygen transport from the alveoli to the tissues.</p>

Answer 95

<p>A</p>

Question 96

<p>Describe the effects of sevoflurane on the respiratory system.</p>

Answer 96

<p>A</p>

Question 97

<p>Compare and contrast the pharmacology of suxamethonium and rocuronium.</p>

Answer 97

<p>A</p>

Question 98

<p>Describe the maternal cardiovascular changes that occur during pregnancy.</p>

Answer 98

<p>A</p>

Question 99

<p>Outline the adverse effects which could occur following the rapid transfusion of ten (10) units of packed red cells.</p>

Answer 99

<p>A</p>

Question 100

<p>Using opioids as examples, describe and illustrate with graphs, what you understand by the terms “potency”, “efficacy”, “partial agonist”, “competitive antagonist” and “therapeutic index”.</p>

Answer 100

<p>A</p>

Question 101

<p>Briefly outline the functions of the kidney.</p>

Answer 101

<p>A</p>

Question 102

<p>Describe the autonomic innervation of the heart (60%), and the effects of autonomic stimulation on cardiac function (40%).</p>

Answer 102

<p>A</p>

Question 103

<p>Outline the mechanisms of action of the drugs, with examples, which increase myocardial contractility.</p>

Answer 103

<p>A</p>

Question 104

<p>Describe the pharmacology of midazolam.</p>

Answer 104

<p>A</p>

Question 105

<p>Outline the normal physiological control of blood glucose in a nondiabetic adult.</p>

Answer 105

<p>A</p>

Question 106

<p>List the drugs which affect uterine tone and outline the adverse effects of these agents.</p>

Answer 106

<p>A</p>

Question 107

<p>Describe the factors determining transdermal uptake of drugs (50%). Briefly outline the advantages and disadvantages of transdermal administration of drugs (50%).</p>

Answer 107

<p>A</p>

Question 108

<p>Describe the physiological role of prostaglandins on smooth muscle throughout the body.</p>

Answer 108

<p>A</p>

Question 109

<p>Explain the effects of intermittent positive pressure ventilation on cardiac output.</p>

Answer 109

<p>A</p>

Question 110

<p>Describe the cardiovascular changes that occur with ageing.</p>

Answer 110

<p>A</p>

Question 111

<p>Discuss the effects of pregnancy on the respiratory system that are relevant to the practice of anaesthesia. Include in your answer how these effects influence the conduct of anaesthesia.</p>

Answer 111

<p>A</p>

Question 112

<p>Describe the ways in which carbon dioxide is carried in the blood.</p>

Answer 112

<p>A</p>

Question 113

<p>Discuss the cerebral effects of prolonged anaesthesia in steep head down position.</p>

Answer 113

<p>A</p>

Question 114

<p>Outline the clinical laboratory effects of renal function. What are the limitations of each test?</p>

Answer 114

<p>A</p>

Question 115

<p>Explain how a metabolic acidosis develops in hypovolaemic shock. Describe the consequences of this metabolic acidosis for the body.</p>

Answer 115

<p>A</p>

Question 116

<p>20mls of 1% ropivacaine is inadvertently administered intravenously over 15 seconds to a 60yo, 60kg woman. Describe the potential complications and mechanisms of this. Do not discuss treatment.</p>

Answer 116

<p>A</p>

Question 117

<p>Draw on a single graph wash in curves for the first half hour administration of 70% nitrous oxide, 6% desflurane and 2% sevoflurane. Explain why the curves are different for each agent (80%). Describe and explain the effect on these curves with a) A doubling of alveolar ventilation and b) A doubling of cardiac output. (20%)</p>

Answer 117

<p>A</p>

Question 118

<p>Describe the effect of sevoflurane on the following regional circulations: Cerebral, coronary, pulmonary, hepatic and uteroplacental. Do not discuss specific organ effects.</p>

Answer 118

<p>A</p>

Question 119

<p>Describe the principles of how a computer controlled infusion device targets and maintains a constant effect site concentration of propofol.</p>

Answer 119

<p>A</p>

Question 120

<p>Outline the factors that determine the rate of recovery from non-depolarising neuromuscular block.</p>

Answer 120

<p>A</p>

Question 121

<p>Outline the principles of antibiotic prophylaxis for surgical site infections using cefazolin in knee joint replacement surgery as an example.</p>

Answer 121

<p>A</p>

Question 122

<p>Describe the metabolism and excretion of tramadol, including the implications for clinical practice.</p>

Answer 122

<p>A</p>

Question 123

<p>Explain the reasons why a pulse oximeter may give incorrect readings.</p>

Answer 123

<p>A</p>

Question 124

<p>Explain how cardiac output is measured using a thermodilution technique.</p>

Answer 124

<p>A</p>

Question 125

<p>Draw a pressure volume loop for the left ventricle in a normal adult. Outline the information that can be obtained from such a loop.</p>

Answer 125

<p>A</p>

Question 126

<p>Discuss the potential adverse effects of suxamethonium.</p>

Answer 126

<p>A</p>

Question 127

<p>Describe the normal regulation of cerebral blood flow and outline physiological factors which may alter it. DO NOT discuss the effect of medications or pathology.</p>

Answer 127

<p>A</p>

Question 128

<p>Draw and label a lead II electrocardiogram (ECG) tracing for one cardiac cycle, indicating normal values. What is the PR interval and what factors influence it?</p>

Answer 128

<p>A</p>

Question 129

<p>Outline the theories, both current and discredited, as to how inhalational anaesthetic agents cause loss of consciousness.</p>

Answer 129

<p>A</p>

Question 130

<p>Outline the safety features of currently used mechanical variable bypass vaporisers.</p>

Answer 130

<p>A</p>

Question 131

<p>Propofol and remifentanil target controlled infusions are often given together as a total intravenous anaesthesia technique. Discuss pharmacological reasons why this is a useful combination.</p>

Answer 131

<p>A</p>

Question 132

<p>Describe how morbid obesity might affect washout after inhalation anaesthesia</p>

Answer 132

<p>A</p>

Question 133

<p>Briefly explain the cardiovascular effects of central neuraxial blockade.</p>

Answer 133

<p>A</p>

Question 134

<p>Using ropivacaine and lignocaine as examples, explain the pharmacokinetic principles that affect speed of onset and duration of action of local anaesthetics.</p>

Answer 134

<p>A</p>

Question 135

<p>Discuss the physiological responses to administration of 2 litres of Hartmann's solution intravenously over 1 hour to a conscious, healthy, euvolaemic 70kg adult.</p>

Answer 135

<p>A</p>

Question 136

<p>Describe the respiratory and cardiovascular changes associated with a carbon dioxide pneumoperitoneum for laparoscopic surgery.</p>

Answer 136

<p>A</p>

Question 137

<p>Draw the oxygen-haemoglobin and carbon dioxide-haemoglobin dissociation curves on the same axis (partial pressure vs. content). Compare and contrast these two curves.</p>

Answer 137

<p>A</p>

Question 138

<p>Briefly outline the roles of the hypothalamus.</p>

Answer 138

<p>A</p>

Question 139

<p>Discuss the role of paracetamol in multi-modal analgesia(50%). Explain paracetamol metabolism and the mechanism of toxicity (50%). Do not discuss management of toxicity.</p>

Answer 139

<p>A</p>

Question 140

<p>Describe the anatomy and relations of the right internal jugular vein as relevant to performing central venous cannulation</p>

Answer 140

<p>A</p>

Question 141

<p>Outline the possible reasons for prolonged paralysis induced by an intravenous dose of 1 mg/kg of suxamethonium.</p>

Answer 141

<p>A</p>

Question 142

<p>Compare and contrast povidone iodine and alcoholic chlorhexidine as skin antiseptic agents.</p>

Answer 142

<p>A</p>

Question 143

<p>Discuss possible causes for the PaCO2 differing from the ETCO2 in an anaesthetised, intubated patient on IPPV.</p>

Answer 143

<p>A</p>

Question 144

<p>Compare and contrast the effects of sevoflurane and nitrous oxide on the cardiovascular system.</p>

Answer 144

<p>A</p>

Question 145

<p>Describe the mechanisms that facilitate oxygen and carbon dioxide exchange in the placenta.</p>

Answer 145

<p>A</p>

Question 146

<p>Describe how the effects of warfarin can be reversed when URGENT surgery is indicated (40%). For each option discuss the advantages and disadvantages (60%).</p>

Answer 146

<p>A</p>

Question 147

<p>Describe the washout of desflurane from a patient following six hours of general anaesthesia. Draw a graph to illustrate the description.</p>

Answer 147

<p>A</p>

Question 148

<p>Describe the process by which increased tissue demand for oxygen leads to an increase in cardiac output.</p>

Answer 148

<p>A</p>

Question 149

<p>Outline the effects of opioids injected into the spinal intrathecal space using both fentanyl and morphine to illustrate your answer.</p>

Answer 149

<p>A</p>

Question 150

<p>Describe the ionic basis of automaticity in the pacemaker cells of the sino- atrial node.</p>

Answer 150

<p>A</p>

Question 151

<p>An infusion of 50mls of 50% dextrose is given to a healthy 70kg adult. Describe the possible metabolic pathways for the dextrose.</p>

Answer 151

<p>A</p>

Question 152

<p>Using a labelled diagram, describe how a self-inflating bag-valve-mask resuscitation device works.</p>

Answer 152

<p>A</p>

Question 153

<p>Describe the time course between an intravenous injection of a general anaesthetic agent to loss of consciousness. Explain the delay using pharmacokinetic principles.</p>

Answer 153

<p>A</p>

Question 154

<p>Describe the adverse effects of neostigmine.</p>

Answer 154

<p>A</p>

Question 155

<p>Discuss the effects of ageing on the respiratory system.</p>

Answer 155

<p>A</p>

Question 156

<p>Briefly explain the principles of Doppler ultrasound used to measure cardiac output</p>

Answer 156

<p>A</p>

Question 157

<p>Describe the alterations to the physiology of the nervous system in the older patient and outline the consequent effects on pain perception</p>

Answer 157

<p>A</p>

Question 158

<p>Describe the mechanism of action of G-proteins</p>

Answer 158

<p>A</p>

Question 159

<p>Outline the mechanism of secretion of hydrochloric acid by the stomach. Briefly describe how secretion of hydrochloric acid by the stomach is controlled.</p>

Answer 159

<p>A</p>

Question 160

<p>a) Describe the immediate cardiovascular responses to the sudden loss of 30% of the blood volume in a healthy awake person. b) How are these responses different if the patient is undergoing anaesthesia with sevoflurane?</p>

Answer 160

<p>A</p>

Question 161

<p>Draw and label a lead II electrocardiogram (ECG) tracing for one cardiac cycle, indicating normal intervals and values. What is the PR interval and what factors influence it?</p>

Answer 161

<p>A</p>

Question 162

<p>Discuss respiratory system compliance and outline factors that affect it.</p>

Answer 162

<p>A</p>

Question 163

<p>Describe the physiological mechanisms by which the renal collecting duct is able to produce both dilute and concentrated urine.</p>

Answer 163

<p>A</p>

Question 164

<p>Describe the determinants of left ventricular myocardial oxygen supply and demand.</p>

Answer 164

<p>A</p>

Question 165

<p>Draw and label a normal capnograph to show the phases of the respiratory cycle. (30%) List and briefly describe what information can be obtained from the capnograph. (70%)</p>

Answer 165

<p>A</p>

Question 166

<p>Describe the effect of pregnancy, at term, on wash-in of volatile anaesthetic agents</p>

Answer 166

<p>A</p>

Question 167

<p>Discuss the adverse environmental effects of anaesthetic agents in current use</p>

Answer 167

<p>A</p>

Question 168

<p>Discuss factors that influence the toxicity of local anaesthetics when used for topical anaesthesia of skin and mucosa.</p>

Answer 168

<p>A</p>

Question 169

<p>Discuss the structure and function of the NMDA receptor and briefly describe the interaction of ketamine with this receptor</p>

Answer 169

<p>A</p>

Question 170

<p>Using opioids as examples describe and illustrate with graphs what you understand by the terms "potency", "efficacy", "partial agonist", "competitive antagonist", and "therapeutic index".</p>

Answer 170

<p>A</p>

Question 171

<p>500ml of 20% mannitol is administered intravenously to a neurosurgical patient. Outline the cerebral, circulatory and renal effects including potential problems associated with its use.</p>

Answer 171

<p>A</p>

Question 172

<p>Describe the principles (50%) and sources of error (50%) in the measurement of arterial blood pressure using an invasive arterial line and transducer</p>

Answer 172

<p>A</p>

Question 173

<p>Mallampati score is a diagnostic test for difficult intubation with a sensitivity of 30% and specificity of 90%. Describe how this information and other statistics related to this test can be used in predicting difficult intubation. How does the prevalence of difficult intubation affect the performance of the test?</p>

Answer 173

<p>A</p>

Question 174

<p>Discuss the pharmacokinetic implications of severe chronic kidney disease, using examples of drugs used in anaesthesia to illustrate your answer.</p>

Answer 174

<p>A</p>

Question 175

<p>Describe the advantages and disadvantages of using nitrous oxide as part of a general anaesthetic</p>

Answer 175

<p>A</p>

Question 176

<p>Describe the individual effects of propofol and sevoflurane on the cerebral metabolic rate of oxygen consumption (CMRO2) and cerebral blood flow (CBF).</p>

Answer 176

<p>A</p>

Question 177

<p>Outline the physiology of blood groups that allows O negative packed cells to be safely transfused to most patients.</p>

Answer 177

<p>A</p>

Question 178

<p>Describe the factors that affect afterload for each of the right and the left ventricles.</p>

Answer 178

<p>A</p>

Question 179

<p>Describe the peripheral and central nervous system pathways that lead to the perception of pain following a laceration to the thumb.</p>

Answer 179

<p>A</p>

Question 180

<p>Compare and contrast the pharmacology of metaraminol and adrenaline (epinephrine).</p>

Answer 180

<p>A</p>

Question 181

<p>Describe the anatomy of the neonatal airway, and what implications this has for airway management.</p>

Answer 181

<p>A</p>

Question 182

<p>Describe the V/Q ratio at the apex and base of the upright lung. How does this affect regional gas exchange?</p>

Answer 182

<p>A</p>

Question 183

<p>Explain the onset and offset of neuromuscular block at the diaphragm, larynx, and adductor pollicis, after an intubating dose of vecuronium. What are the clinical implications of these differences?</p>

Answer 183

<p>A</p>

Question 184

<p>Describe how Non-Steroidal Anti-Inflammatory Drugs exert their therapeutic and adverse effects (70%). Outline the advantages and disadvantages of using COX-2 selective agents (30%).</p>

Answer 184

<p>A</p>

Question 185

<p>Explain how a pulse oximeter works. Do NOT discuss the potential sources of error.</p>

Answer 185

<p>A</p>

Question 186

<p>Define the terms “tolerance” and “tachyphylaxis” (30%). Discuss the mechanisms by which these can develop, giving relevant examples (70%).</p>

Answer 186

<p>A</p>

Question 187

<p>List the major classes of oral hypoglycaemic drugs and provide an example for each class. Briefly outline their mechanism of action and major side effects.</p>

Answer 187

<p>A</p>

Question 188

<p>Discuss how the body handles a metabolic acidosis.</p>

Answer 188

<p>A</p>

Question 189

<p>Describe the respiratory responses to hypoxaemia in both the awake and anaesthetised patient.</p>

Answer 189

<p>A</p>

Question 190

<p>Describe closing capacity and its relationship to airway closure. Explain its clinical significance and measurement.</p>

Answer 190

<p>A</p>

Question 191

<p>Outline the pharmacology of cancer chemotherapeutic agents with reference to problems caused during the perioperative period.</p>

Answer 191

<p>A</p>

Question 192

<p>Write short notes contrasting the cardiovascular effects of propofol and ketamine seen clinically.</p>

Answer 192

<p>A</p>

Question 193

<p>Describe the pathogenesis and management of paracetamol toxicity.</p>

Answer 193

<p>A</p>

Question 194

<p>Explain the effects of intermittent positive pressure ventilation on cardiac output.</p>

Answer 194

<p>A</p>

Question 195

<p>Briefly outline the mechanisms by which ACE inhibitors and angiotensin receptor blockers produce a) their therapeutic effects b) potential adverse effects</p>

Answer 195

<p>A</p>

Question 196

<p>a) Define "volume of distribution". What factors influence the size of the volume of distribution? b) How may it be used in the calculation of a loading dose? What assumptions are made in this calculation?</p>

Answer 196

<p>A</p>

Question 197

<p>Describe the pharmacology of dexmedetomidine.</p>

Answer 197

<p>A</p>

Question 198

<p>Draw, label and describe the waveforms and pressures that are seen in each anatomical location during insertion of a pulmonary artery catheter.</p>

Answer 198

<p>A</p>

Question 199

<p>Explain how local anaesthetics prevent the conduction of action potentials within a major peripheral nerve.</p>

Answer 199

<p>A</p>

Question 200

<p>Describe the normal regulation of cerebral blood flow and outline physiological factors which may alter it. DO NOT discuss the effect of medications or pathology.</p>

Answer 200

<p>A</p>

Question 201

<p>Describe the effects of sevoflurane on the respiratory system.</p>

Answer 201

<p>A</p>

Question 202

<p>Discuss the relative advantages and disadvantages of using morphine and fentanyl for post- operative Patient Controlled Analgesia (PCA).</p>

Answer 202

<p>A</p>

Question 203

<p>Discuss possible causes for the PaCO2 differing from the ETCO2 in an anaesthetised, intubated patient on IPPV.</p>

Answer 203

<p>A</p>

Question 204

<p>Explain the physiological effects of acute hypercapnia, caused by hypoventilation.</p>

Answer 204

<p>A</p>

Question 205

<p>Describe the effects of perioperative hypothermia. DO NOT discuss mechanisms of heat loss.</p>

Answer 205

<p>A</p>

Question 206

<p>For each of the following, describe the features that ensure the safe delivery of oxygen during anaesthesia a) cylinders b) pipeline supply c) anaesthesia machines</p>

Answer 206

<p>A</p>

Question 207

<p>Briefly outline the potential immunological effects of transfusing packed red cells.</p>

Answer 207

<p>A</p>

Question 208

<p>Discuss factors that determine the time to awakening after cessation of a propofol target controlled infusion (TCI).</p>

Answer 208

<p>A</p>

Question 209

<p>Classify anti-emetic drugs according to their mechanism of action. Give examples and describe side effects of each class.</p>

Answer 209

<p>A</p>

Question 210

<p>Describe the factors determining transdermal uptake of drugs. Using examples, outline the advantages and disadvantages of transdermal administration of drugs.</p>

Answer 210

<p>A</p>

Question 211

<p>Compare and contrast the effects of the right lateral position (right side down) on lung ventilation and perfusion in a healthy 70 kg patient who is a) Awake, breathing spontaneously b) Anaesthetised, paralysed, with IPPV</p>

Answer 211

<p>A</p>

Question 212

<p>Draw and label a graph of a normal basic viscoelastic test of clotting function. What information about the physiology of clotting is depicted in this graph? How will the graph be altered by hyperfibrinolysis?</p>

Answer 212

<p>A</p>

Question 213

<p>On the same axes, draw wash-in curves for the first 30 minutes administration of: • 70% nitrous oxide • 6% desflurane • 2% sevoflurane. Explain why the curves are different for each agent.</p>

Answer 213

<p>A</p>

Question 214

<p>Using a labelled diagram, describe how a self-inflating bag-valve-mask resuscitation device works.</p>

Answer 214

<p>A</p>

Question 215

<p>Discuss the potential adverse effects of suxamethonium.</p>

Answer 215

<p>A</p>

Question 216

<p>Compare and contrast the pharmacology of ephedrine and norepinephrine (noradrenaline).</p>

Answer 216

<p>A</p>

Question 217

<p>Discuss the physiological effects of infusing 2 litres of Hartmann's solution over 1 hour in a conscious, healthy, euvolaemic 70kg adult.</p>

Answer 217

<p>A</p>

Question 218

<p>Describe the pharmacology of midazolam relevant to its use for pre-medication.</p>

Answer 218

<p>A</p>

Question 219

<p>Briefly outline the structure and function of the blood brain barrier.</p>

Answer 219

<p>A</p>

Question 220

<p>Define cardiac preload, and describe its determinants</p>

Answer 220

<p>A</p>

Question 221

<p>Discuss how the responses to opioid medications are altered in the elderly. Explain using pharmacokinetic and pharmacodynamic principles.</p>

Answer 221

<p>A</p>

Question 222

<p>On the same axes, draw the oxy-haemoglobin dissociation curve for both foetal and adult haemoglobin. Explain why these curves are different, and the physiological advantages of these differences.</p>

Answer 222

<p>A</p>

Question 223

<p>Briefly outline the physiology of the hormones produced within, or activated by, the kidney. DO NOT discuss autocrine or paracrine substances.</p>

Answer 223

<p>A</p>

Question 224

<p>Discuss the factors that influence coronary blood flow.</p>

Answer 224

<p>A</p>

Question 225

<p>Discuss the pharmacology of dantrolene relevant to its use in the treatment of malignant hyperthermia.</p>

Answer 225

<p>A</p>

Question 226

<p>Name the cartilages of the larynx (20%). Discuss the anatomy of the airway relevant to performing an awake bronchoscopic intubation via the nasal route (80%).</p>

Answer 226

<p>A</p>

Question 227

<p>Outline the effects of liver failure on drug kinetics and dynamics (2011A03).</p>

Answer 227

<p>A</p>

Question 228

<p>Discuss the physiological factors that determine intracranial pressure (ICP) and describe how changes in posture affect ICP (2004A15)</p>

Answer 228

<p>A</p>

Question 229

<p>Describe the cardiovascular response to a sustained valsalva maneouvre. What can be learnt about a patient’s cardiovascular function from observing this response?</p>

Answer 229

<p>A</p>

Question 230

<p>Compare and contrast the clinically significant cardiovascular and central nervous system effects of desflurane and sevoflurane (2011b01).</p>

Answer 230

<p>A</p>

Question 231

<p>Describe the effects of alpha 2 adrenoreceptor agonists relevant to anaesthesia</p>

Answer 231

<p>A</p>

Question 232

<p>Outline the pathology of acute anaphylactic reactions with reference to the mediators released and their effects. Outline the role of adrenaline and its mechanisms of action in treating anaphylaxis</p>

Answer 232

<p>A</p>

Question 233

<p>Outline the systemic cardiovascular response to exercise</p>

Answer 233

<p>A</p>

Question 234

<p>Explain the concept of time constants and relate these to “fast” and “slow ” alveoli</p>

Answer 234

<p>A</p>

Question 235

<p>Explain how the kidney handles glucose. Describe the physiological consequences of glycosuria.</p>

Answer 235

<p>A</p>

Question 236

<p>Define “Venous Admixture”. Briefly explain how venous admixture influences arterial oxygen tension and how an increase in inspired oxygen concentration may effect this.</p>

Answer 236

<p>A</p>

Question 237

<p>Describe the important determinants of work of breathing in an adult human at rest. Explain how to minimise work of breathing.</p>

Answer 237

<p>A</p>

Question 238

<p>Describe the factors that affect airways resistance.</p>

Answer 238

<p>A</p>

Question 239

<p>What are the major classes of oral hypoglycaemic agents? Outline their mechanisms of action and possible side effects.</p>

Answer 239

<p>A</p>

Question 240

<p>What are the advantages and disadvantages of xenon as an anaesthetic agent?</p>

Answer 240

<p>A</p>

Question 241

<p>Classify isomers. Briefly write an account of their significance in drugs used in anaesthesia.</p>

Answer 241

<p>A</p>

Question 242

<p>Describe how suxamethonium and non-depolarising neuromuscular blocking agents produce their adverse cardiovascular effects.</p>

Answer 242

<p>A</p>

Question 243

<p>Discuss the concept of volume of distribution. How may it be used in the calculation of a loading dose? What assumptions are made in this calculation?</p>

Answer 243

<p>A</p>

Question 244

<p>Sevoflurane and fentanyl are a common anaesthetic drug combination. Discuss pharmacological reasons why it is useful to use them together.</p>

Answer 244

<p>A</p>

Question 245

<p>Describe the pharmacology of midazolam.</p>

Answer 245

<p>A</p>

Question 246

<p>Draw a diagram of the larynx, as it would be seen at direct laryngoscopy. Label the important anatomical structures.</p>

Answer 246

<p>A</p>

Question 247

<p>Describe the cough reflex.</p>

Answer 247

<p>A</p>

Question 248

<p>Write brief notes on innate and acquired immunity.</p>

Answer 248

<p>A</p>

Question 249

<p>Compare and contrast lung function in the neonate with that in an adult.</p>

Answer 249

<p>A</p>

Question 250

<p>Briefly explain the cardiovascular responses to central neuraxial blockade.</p>

Answer 250

<p>A</p>

Question 251

<p>How does a fall in temperature influence blood gas solubility and acid base values?</p>

Answer 251

<p>A</p>

Question 252

<p>Briefly describe the structure of mitochondria. Outline the metabolic processes that occur in mitochondria.</p>

Answer 252

<p>A</p>

Question 253

<p>Explain how oxygen supply of organs is maintained during isovolaemic haemodilution.</p>

Answer 253

<p>A</p>

Question 254

<p>How does warfarin exert its anti-coagulant effect? What methods can be used to reverse the effects of warfarin prior to surgery?</p>

Answer 254

<p>A</p>

Question 255

<p>Compare and contrast propofol and sevoflurane for maintenance of anaesthesia with respect to kinetics, cardiovascular and central nervous system effects.</p>

Answer 255

<p>A</p>

Question 256

<p>Define the terms “tolerance” and “tachyphylaxis”. Discuss the different mechanisms by which tolerance can develop, giving examples where appropriate.</p>

Answer 256

<p>A</p>

Question 257

<p>Outline the acute adverse effects of opioid receptor agonists. Describe the mechanisms of the acute adverse effects of opioid receptor agonists.</p>

Answer 257

<p>A</p>

Question 258

<p>Discuss the pharmacology of drugs that inhibit the activity of the renin-angiotensin system. What particular problems can occur in the anaesthetised patient taking these drugs?</p>

Answer 258

<p>A</p>

Question 259

<p>List agents that can reduce bronchiolar tone and explain the mechanisms of action with examples.</p>

Answer 259

<p>A</p>

Question 260

<p>Classify the toxic effects of local anaesthetic drugs. Detail the potential for, and mechanisms of, toxicity of prilocaine.</p>

Answer 260

<p>A</p>

Question 261

<p>Describe the waveforms and pressures that are seen in each anatomical location during insertion of a pulmonary arterial catheter. What factors may increase these pressures?</p>

Answer 261

<p>A</p>

Question 262

<p>Outline the mechanisms by which the kidney maintains potassium homeostasis.</p>

Answer 262

<p>A</p>

Question 263

<p>Outline the important features of the lymphatic circulation.</p>

Answer 263

<p>A</p>

Question 264

<p>Discuss the physiological causes of early post-operative hypoxaemia.</p>

Answer 264

<p>A</p>

Question 265

<p>Using an example of exponential decay, define and outline the important features of an exponential function.</p>

Answer 265

<p>A</p>

Question 266

<p>Detail the protective and regulatory roles of the liver.</p>

Answer 266

<p>A</p>

Question 267

<p>Describe the fuel sources used during early and sustained fasting in humans.</p>

Answer 267

<p>A</p>

Question 268

<p>Briefly outline the differences between the pulmonary circulation and the systemic circulation.</p>

Answer 268

<p>A</p>

Question 269

<p>Outline the pharmacology and clinical uses of methadone.</p>

Answer 269

<p>A</p>

Question 270

<p>Discuss the factors that influence metabolic rate</p>

Answer 270

<p>A</p>

Question 271

<p>Give a brief account of the physiological consequences of hypothermia.</p>

Answer 271

<p>A</p>

Question 272

<p>Discuss the physiological basis of vomiting. List the medications that can be used for rescue of post-operative vomiting in the recovery room, and their mechanism of action</p>

Answer 272

<p>A</p>

Question 273

<p>What are the physiological effects of performing a laparoscopic procedure requiring pneumoperitoneum in the steep head-down trendelenberg position?</p>

Answer 273

<p>A</p>

Question 274

<p>Describe the action of unfractionated heparin (30%). What is the definition of 1 unit of heparin? (10%). Discuss the adverse effects of heparin. (60%)</p>

Answer 274

<p>A</p>

Question 275

<p>How is carbon dioxide absorbed from a circle circuit? What are the hazards associated with this absorption?</p>

Answer 275

<p>A</p>

Question 276

<p>Discuss the mechanism of action of paracetamol and its clinical effects (50%). Describe paracetamol toxicity (25%) and its management (25%).</p>

Answer 276

<p>A</p>

Question 277

<p>List and briefly describe the ways that cardiac output can be measured (50%). Describe in detail ONE method commonly used during cardiac surgery (50%).</p>

Answer 277

<p>A</p>

Question 278

<p>Define local anaesthetic toxicity (20%). What are the potential clinical adverse effects (30%)? How should this patient be managed? (50%)</p>

Answer 278

<p>A</p>

Question 279

What are the potential side effects of propofol and its formulations?

Answer 279

A

Question 280

Draw and explain the characteristics of a log dose-response curve that describes the major clinical effect of rocuronium. Describe how factors encountered in clinical practice may alter this curve.

Answer 280

A

Question 281

Outline the safety features of currently used plenum vaporisers.

Answer 281

A

Question 282

Describe the physiological basis of methods used to prevent hypoxaemia prior to intubation in a rapid sequence induction. Include any adverse effects of these methods.

Answer 282

A

Question 283

Explain the effects of intermittent positive pressure ventilation on cardiac output.

Answer 283

A

Question 284

Outline the pharmacological management of bronchoconstriction in acute severe asthma. Include mechanisms of action and potential adverse effects.

Answer 284

A

Question 285

Describe the local anatomy relevant to the performance of a lumbar epidural block.

Answer 285

A

Question 286

Describe the principles of surgical diathermy.

Answer 286

A

Question 287

Describe the washout of sevoflurane from a patient following two hours of general anaesthesia. You may wish to use a graph to illustrate the description.

Answer 287

A

Question 288

List the pharmacodynamic differences between tramadol and morphine.

Answer 288

A

Question 289

Compare and contrast the management of an overdose of aspirin with that of an overdose of paracetamol.

Answer 289

A

Question 290

Describe the alterations to the physiology of the nervous system in the older patient and outline the consequent effects on pain perception.

Answer 290

A

Question 291

Compare and contrast the pharmacology of Normal Saline and 4% Albumin.

Answer 291

A

Question 292

Compare and contrast the physiological effects of a six hour fast of fluids and food with a twenty four hour fast in a healthy adult

Answer 292

A

Question 293

Indicate the sequence of the physiological changes to the fetal circulation at birth and briefly describe the mechanisms that account for these changes.

Answer 293

A

Question 294

Explain the effects of intermittent positive pressure ventilation on cardiac output.

Answer 294

A

Question 295

Describe the physiological basis of methods used to prevent hypoxaemia prior to intubation in a rapid sequence induction. Include any adverse effects of these methods.

Answer 295

A

Question 296

Outline the safety features of currently used plenum vaporisers.

Answer 296

A

Question 297

Discuss the physiological significance of the blood-brain barrier.

Answer 297

A

Question 298

Outline the role of the kidneys in the regulation of body water.

Answer 298

A

Question 299

Briefly describe the breakdown of haemoglobin after red cell lysis.

Answer 299

A

Question 300

Describe the physiological effects of endogenous glucocorticoids.

Answer 300

A

Question 301

Describe the effects of resonance and damping on an invasive arterial blood pressure tracing.

Answer 301

A

Question 302

Using cephazolin as an example in joint replacement surgery, outline the principles of antibiotic chemoprophylaxis for surgical site infections.

Answer 302

A

Question 303

List the classes of drugs that may be used to manage an intra-operative hypertensive crisis and briefly outline the mechanisms of action.

Answer 303

A

Question 304

Describe how non steroidal anti-inflammatory drugs exert their clinical effects. Outline the advantages and disadvantages in using COX-2 selective agents.

Answer 304

A

Question 305

Explain how differences in the pharmacokinetics of alfentanil and fentanyl can influence the way they are administered intravenously.

Answer 305

A

Question 306

Draw and explain the characteristics of a log dose-response curve that describes the major clinical effect of rocuronium. Describe how factors encountered in clinical practice may alter this curve.

Answer 306

A

Question 307

List the drugs that affect uterine tone, and outline the adverse effects of these agents.

Answer 307

A

Question 308

What are the potential side effects of propofol and its formulations?

Answer 308

A

Question 309

Classify and discuss the pharmacology of anti-platelet drugs

Answer 309

A

Question 310

List and discuss the methods of measuring temperature

Answer 310

A

Question 311

Discuss the anatomy of the right femoral triangle with respect to venous cannulation. List the structures potentially damaged during the procedure.

Answer 311

A

Question 312

Describe the circle breathing system.

Answer 312

A

Question 313

Outline the role of carbon dioxide in the maintenance of ventilation.

Answer 313

A

Question 314

Outline the protective and regulatory functions of the liver.

Answer 314

A

Question 315

A surgeon wishes to use topical local anaesthetic in the nose before surgery in a 30 year old 70 kg man. He normally uses topical cocaine 5% plus lignocaine 2% with adrenaline 1:100,000 injection. What volumes of these drugs can be used safely? What are the potential toxic effects of cocaine and how does lignocaine and adrenaline affect these?

Answer 315

A

Question 316

Sevoflurane and fentanyl are a common anaesthetic drug combination. Discuss pharmacological reasons why it is useful to use them together.

Answer 316

A

Question 317

Describe the role of baroreceptors in the control of systemic arterial pressure.

Answer 317

A

Question 318

Briefly outline the effects of sevoflurane on skeletal, smooth and cardiac muscle tissues. Include how these effects are mediated and their clinical significance

Answer 318

A

Question 319

List the classes of drugs that may be used to manage an intra-operative hypertensive crisis and briefly outline the mechanisms of action.

Answer 319

A

Question 320

What are the physiological consequences of decreasing functional residual capacity by one litre in an adult?

Answer 320

A

Question 321

Outline the physiological changes that may explain why an otherwise well patient may have a reduced urinary output intraoperatively.

Answer 321

A

Question 322

Discuss the relative advantages and disadvantages of using morphine versus fentanyl for post-operative Patient Controlled Analgesia (PCA).

Answer 322

A

Question 323

Describe the time course between an intravenous injection of a general anaesthetic agent to loss of consciousness. Explain the delay using pharmacokinetic principles.

Answer 323

A

Question 324

Discuss factors influencing the recovery and reversal of neuromuscular blockade induced by rocuronium.

Answer 324

A

Question 325

Describe the determinants of venous return and the effect general anaesthesia would have on these.

Answer 325

A

Question 326

Compare and contrast the effects of general and neuraxial anaesthesia on thermoregulation.

Answer 326

A

Question 327

Describe the vascular anatomy of the antecubital fossa (arterial and venous).

Answer 327

A

Question 328

Describe the washout of desflurane from a patient following six hours of general anaesthesia. You may wish to use a graph to illustrate the description.

Answer 328

A

Question 329

Briefly outline the acute management of malignant hyperthermia (during a relaxant general anaesthetic). Describe the important aspects of dantrolene pharmacology relevant to treating malignant hyperthermia.

Answer 329

A

Question 330

Describe an active anaesthetic gas scavenging system.

Answer 330

A

Question 331

Describe the physiology of the pain pathways and how drugs may modulate the perception of pain.

Answer 331

A

Question 332

20mls of 0.5% bupivacaine is inadvertently administered intravenously over 15 seconds to a 60 year old, 60kg woman. Describe the potential complications and mechanisms of these.

Answer 332

A

Question 333

A new test called the “intubation score” has a reported 90% sensitivity and 70% specificity when used to predict difficult intubation. Describe how this information and other statistics related to this test can be used in predicting difficult intubation

Answer 333

A

Question 334

Outline the important pharmacological considerations when stopping warfarin and commencing prophylactic (low dose) low molecular weight heparin (LMWH) in the peri-operative period.

Answer 334

A

Question 335

What lower limit of SpO2 would you accept in an ASA1 young male under general anaesthesia? Explain your reasons for choosing this value.

Answer 335

A

Question 336

How is renal blood flow regulated? What are the physiological effects of angiotensin II?

Answer 336

A

Question 337

Describe the cardiovascular changes that occur with morbid obesity.

Answer 337

A

Question 338

Explain the Bohr and Haldane effects in trans-placental gas exchange.

Answer 338

A

Question 339

Briefly explain the changes that occur in stored whole blood.

Answer 339

A

Question 340

Outline the effects of intravenously administering 500 ml of 20% mannitol. Outline the potential problems associated with its use.

Answer 340

A

Question 341

Write brief notes on the physiological changes associated with sleep.

Answer 341

A

Question 342

Explain the difference between perfusion limitation and diffusion limitations in the transfer of gas between alveolus and pulmonary capillary. Outline the factors that determine whether gas transfer is perfusion or diffusion limited.

Answer 342

A

Question 343

Describe the properties of surfactant and relate these to its role in influencing respiratory mechanics.

Answer 343

A

Question 344

Describe the effect of obesity on pharmacokinetics and the potential clinical implications, providing relevant examples.

Answer 344

A

Question 345

Explain the changes in Functional Residual Capacity (FRC) that take place with administration of anaesthesia.

Answer 345

A