SBA Mock 4 Topics

Question 1

Deciding tube diameter for RSI?

Answer 1

Age/4 + 4

And - 0.5mm if using cuff, which you should for RSI

Question 2

borders of epidural space

Answer 2

post: ligamentam flavum
ant: posterior longitudinal ligament
sup: fusion of 3 spinal and periosteal layers of dura mater at foramen magnum
inferior: sacrococcygeal membrane
lateral: pedicles and intervertebral foramina

Question 3

how does nitrous oxide affect the brain?

Answer 3

raise ICP, CBF, cerebral O2 consumption

impairs autoregulation

Question 4

which anaesthetic agents can trigger histamine release, and action of mast cells confined to the skin?

Answer 4

atracurium
mivacurium
morphine
pethidine

Question 5

warfarin metabolised by which enzyme?

Answer 5

CYP1A2

“warfarin-12”

Question 6

volatile agents metabolised by which enzyme?

Answer 6

CYP2E1

“volatile-21”

Question 7

codeine metabolised to morphine by which enzyme?

What level of inter individual variation is there in this enzyme?

Answer 7

CYP 2D6

defective/ slow in:
10% uk population
30% chinese population

“codeine-26”

Question 8

paracetamol is metabolised by?

Answer 8

CYP 3A4

“paracetamol-34”

Question 9

What is the advantage of using S-ketamine?

Answer 9

1. more cardiostable
2. doesn’t cause ischaemic preconditioning of the heart
3. significantly LESS INTENSE emergence phenomena, but same frequency (more frequent in psych conditions)

Question 10

what type of inheritance is malignant hyperthermia?

Answer 10

autosomal dominant

Question 11

managing new onset AF < 24 hours?

Answer 11

no adverse features

1. Heparin - attempt chemical or electrical cardioversion
2. > 48 hours DC cardiovert

Question 12

sulfanylureas action and risk

Answer 12

Ie. glibenclamide
stimulates B-cells to secrete more insulin in T2DM
Mostly likely to cause hypoglycaemia in non-insulin dependent diabetics

Question 13

Acetazolamide:

1. target
2. location
3. effect

Answer 13

1. carbonic anhydrase inhibitor
2. PCT
3. reduces pH,
   increases Cl

Question 14

Bumetanide/ furosemide:

1. target
2. location
3. effect

Answer 14

1. Inhibit Na/Cl reabsorbtion
2. Ascending loop Henle
3. Reduce Na, K, Cl, Mg
   - increase pH

Question 15

Bendroflumathiazide
Metalazone:

1. target
2. location
3. effect

Answer 15

1. Inhibit Na, Cl reabsorbtion
2. DCT
3. Reduce Na, K, Cl
   Increase Ca, pH

Question 16

Amiloride:

1. target
2. location
3. effect

Answer 16

1. Inhibits Na/K exchanger
2. DCT
3. increases K

Question 17

Spironolactone:

1. target
2. location
3. effect

Answer 17

1. Aldosterone antagonist
2. DCT/ CD
3. increase K, reduce Na

Question 18

Mannitol:

1. target
2. location
3. effect

Answer 18

1. Osmotic diuretic
2. Ascending loop henle
3. Reduces Na, K

Question 19

ST elevation in lead II, II aVF indicates?

Answer 19

Right coronary artery

inferior MI

Question 20

ST elevation: leads V2, V3, V4?

Answer 20

LAD - left anterior descending artery

anterior MI

Question 21

ST elevation: I, aVL, V5, V6?

Answer 21

Circumflex artery

lateral MI

Question 22

highest risk events of very high pCO2?

Answer 22

arrhythmias
myocardial depression
increased PVR
etc.

Question 23

anterior spinal artery syndrome presents as?

Answer 23

ischaemia anterior 2/3 spine
therefore paralysis below level of ischaemia

Preserved proprioception, vibration sense and touch