RCOA prep paper 2 Flashcards
Question 1
Possible indications for use of ‘ancillary’ tests in diagnosis of death following cessation of
brain - stem function include
A. Severe respiratory disease with chronic carbon dioxide retention
B. High cervical spine injury
C. Recent thiopentone therapy with blood level > 5 mg l
-1
D. Extensive facio-maxillary injuries
E. Guillain-Barré syndrome
D
Question 2
Antibiotic prophylaxis is currently recommended for patients with structural cardiac
defects undergoing
A. Dental procedures
B. Upper gastrointestinal endoscopy
C. Bronchoscopy
D. Body Piercing
E. Tatooing
B
Question 3
Myasthenia gravis:
A. Is a disease of the presynaptic terminal of the neuromuscular junction
B. Is usually associated with anti - acetylcholine receptor antibodies
C. Commonly presents with sensory symptoms
D. Patients are sensitive to depolarising neuromuscular blocking agents
E. Plasma exchange is a useful long
-term treatment
B
Question 4
In Sepsis:
A. Tumour Necrosis Factor (TNF) is a
pivotal cytokine and high levels are
associated with a poor outcome.
B. Low levels of circulating TNF receptors are associated with a poor outcome
C. High mobility group protein (HMG-B1) is an important cytokine produced early in sepsis
D. Disseminated intravascular coagulation (DIC) is associated with high levels of protein
C,
antithrombin III and high platelet counts.
E. The inflammatory response can be easily controlled and manipulated in clinical practice
A
Question 5
In neonatal circulation:
A. The foramen ovale and ductus arteriosus usually close within 48 hours of birth
B. The haemoglobin concentration is often more than 16 g/dl
C. The circulating volume is 70 ml/kg
D. The total body water is less as a percentage of weight than in an adult
E. GFR is relatively high
B
Qu estion 6
The following statements about ventilator induced lung injury are true
A. Broncho-alveolar lavage specimens show increased interleukin 6 levels
B. It can be distinguished from ARDS by chest X-ray
C. It can be reduced by the use of lower tidal volu
mes
D. More than half of deaths are due to hypoxaemia
E. Human studies show that high PEEP levels reduce mortality
C
Question 7
You have anaesthetised a 17 year old Jehovah’s patient. During surgery there is massive
haemorrhage and a lifesaving blood transfusion is needed. Which of the following is the
correct course of action
A. Contact your medical defence union before giving blood
B. Administer blood immediately
C. Parental consent is required before blood transfusion
D. Respect this patient’s refusal and
do not administer blood
E. The Trust Legal Team must be contacted before giving blood
D
Question 8
After brain injury:
A. Hypotension should not be treated unless the mean arterial blood pressure is < 60
mmHg for more than one hour;
B. Arterial PaO2 should be maintained > 13.0 kPa;
C. Serum glucose should be tightly controlled between 4.0 –
6.0 mmol/l;
D. An external ventricular drain is the safest way to monitor intracranial pressure;
E. Jugular venous oximetry is a sensitive monitor of regional cerebral ischaemia.
B
Question 9
Ventilatory failure is commonly associated with
A. A decrease in functional residual capacity
B. Increased lung and total thoracic compliance
C. Increased lung water
D. Chest wall abnormalities
E. An adequate arterial oxygen content
D
E
Question 10
Which of the following are indications for artificial ventilation in an adult at rest
A. A vital capacity of 10 ml/kg
B. A respiratory rate of >35 bpm
C. An oxygen saturation of 88%
D. An A - a oxygen gradient >300mmHg
E. An FEV1 <75% vital capacity
E
Question 11 The extradural space can contain
A. Fat
B. Spinal nerve roots
C. Lymphatics
D. Batson`s plexus
E. Connective tissue
all
