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You are in Home >> Exams >> Primary FRCA >> Primary MCQ 2

Paper 1

Created: 16/6/2004

1. The following are largely metabolised in the body prior to elimination:

a) midazolam
b) atracurium
c) halothane
d) isoflurane
e) gallamine

2. Calcium channel blockers include:

a) verapamil
b) beta-blockers
c) nifedipine
d) captopril
e) hydralazine

3. Regarding the Magill breathing system:

a) fresh gas flow should always be greater than 8 litres/minute
b) it always contains an expiratory valve
c) it has the same physical properties as a Bain system
d) it is equivalent to the Mapleson C classification
e) it is more efficient for spontaneous respiration than intermittent positive pressure ventilation

4. The MAC value of:

a) enflurane is greater than that of isoflurane
b) halothane is greater than that of cyclopropane
c) nitrous oxide is greater than 1 atmosphere
d) methoxyflurane is greater than that of isoflurane
e) halothane is greater than that of enflurane

5. In the first 3 days following major surgery, urinary excretion of the following will be reduced:

a) sodium
b) chloride
c) water
d) potassium
e) nitrogen

6. Boundaries of the epidural space include the:

a) interspinous ligament
b) posterior surface of the lamina
c) anterior longitudinal ligament
d) posterior longitudinal ligament
e) sacro-coccygeal membrane

7. Morphine administered epidurally may cause:

a) nausea and vomiting
b) respiratory depression
c) itching
d) muscle weakness
e) a fall in blood pressure

8. The following values are correct for a normal adult heart:

a) left atrial pressure - 20 mmHg
b) pulmonary artery pressure - 45/30 mmHg
c) left ventricular pressure -120/3 mmHg
d) right atrial pressure - 3-5 mmHg
e) cardiac index - 3 L/min/m2

9. The presence of a slow junctional rhythm in a fit 50 year old man receiving halothane:

a) requires immediate treatment
b) suggests hypoxia
c) suggests the patient is light
d) should be treated with beta-blockers
e) may be treated with glycopyrrolate

10. There is an increased incidence of gallstones in:

a) haemolytic anaemia
b) hypercalcaemia
c) oral contraceptive pill users
d) hypoparathyroidism
e) conditions with an increased production of bile salts

11. Methaemoglobinaemia can be:

a) caused by prilocaine
b) caused by blood transfusion
c) caused by carbon monoxide poisoning
d) treated by methylene blue
e) treated by ascorbic acid

12. Human plasma albumin:

a) is the greatest contributor to plasma oncotic pressure
b) is produced in the liver
c) carries carbon dioxide in the blood
d) is an anion at pH 7.5
e) is actively filtered by the glomerulus

13. The following are anticholinesterases:

a) organophosphates
b) neostigmine
c) prilocaine
d) ranitidine
e) atropine

14. Dopamine antagonists cause:

a) renal artery vasodilatation
b) extrapyramidal effects
c) antiemetic effects
d) a rise in heart rate
e) a rise in the apnoeic threshold for CO2

15. Oxygen:

a) is prepared by fractional distillation
b) has a critical temperature of 36.5 degrees C
c) in the presence of oil can lead to explosion
d) under hyperbaric conditions can produce convulsions
e) therapy can lead to bone marrow depression with prolonged exposure

16. Headache after spinal anaesthesia:

a) is less likely with a 26G than with a 22G needle
b) is due to an increase in cerebrospinal fluid pressure
c) is unlikely to develop after 24 hours
d) may be accompanied by a 6th cranial nerve palsy
e) is more frequent in the elderly

17. The following ions have a higher intracellular than extracellular concentration:

a) sodium
b) calcium
c) potassium
d) chloride
e) bicarbonate

18. Pressure:

a) is force per unit area
b) can be expressed as the height of fluid in a column
c) is force multiplied by distance
d) is work per unit time
e) has potential difference as its electrical analogue

19. The sympathetic nervous system:

a) has cholinergic post-ganglionic fibres
b) has fibres in the vagus
c) causes miosis
d) has acetylcholine as the ganglionic neurotransmitter
e) has its outflow from the spinal cord from T1 to L2

20. Methohexitone:

a) is more potent than thiopentone
b) commonly causes pain on injection
c) is a thiobarbiturate
d) causes involuntary movements
e) is prepared in a solution of pH 7.4

21. A respirometer can be used to measure:

a) functional residual capacity
b) residual volume
c) vital capacity
d) inspiratory reserve volume
e) closing volume

22. The following can influence the height of a spinal block:

a) strength of local anaesthetic solution
b) volume of local anaesthetic solution
c) baricity of local anaesthetic solution
d) the interspace used
e) addition of adrenaline to the local anaesthetic solution

23. Features of Mendelson’s syndrome include:

a) urticarial rash
b) bronchospasm
c) hypoxia
d) hypotension
e) aspiration of at least 100 ml of gastric contents

24. 21 day old stored blood:

a) is a good source of platelets
b) is a good source of clotting factors
c) may have a serum potassium concentration of 10 mmol/L
d) may have a pH of 7.0
e) is likely to have an excess of 2,3-diphosphoglycerate

25. Tracheal deviation to the right can be caused by:

a) a large left pleural effusion
b) right upper lobe fibrosis
c) a right pneumothorax
d) a retrosternal goitre
e) a previous left pneumonectomy

26. The following should decrease the risk of severe barotrauma:

a) a compliant reservoir bag
b) a pressure relief valve set at 70 cm H20
c) non-interchangeable connections in a circle system
d) draw-over anaesthesia
e) use of cylinders rather than piped gas supplies

27. When administering oxygen:

a) a Ventimask delivers a fixed oxygen percentage independent of fresh gas flow
b) nasal cannulae are less efficient than an MC mask
c) a constant oxygen percentage is delivered by an MC mask
d) significant rebreathing is likely with an MC mask
e) chronic bronchitic patients should never receive more than 28% oxygen

28. Signs of a Horner’s syndrome include:

a) dry forehead
b) conjuctival injection
c) ptosis
d) exophthalmos
e) miosis

29. In a patient who fails to breathe 1 hour after administration of 80 mg suxamethonium:

a) the pseudocholinesterase gene is likely to be homozygous atypical
b) a serum potassium of 2 5 mmol/L is a possible cause
c) 2.5 mg neostigmine should be given
d) the metabolism of lidocaine may well be impaired
e) the same response would be expected in all siblings

30. Regarding anticholinergic agents:

a) atropine is a stronger antisialogogue than hyoscine
b) hyoscine produces more tachycardia than atropine
c) glycopyrrolate produces marked mydriasis
d) glycopyrrolate crosses the blood-brain barrier
e) hyoscine-induced confusion in the elderly is reversed by procyclidine

31. The cerebral blood flow of a normal person is increased:

a) when the arterial PCO2 increases from 5.3 to 8.0 kPa
b) when placed in the head-down position
c) if the mean arterial blood pressure rises from 90 to 110 mmHg
d) if the intracranial pressure is increased
e) during physiological sleep

32. Features of aortic regurgitation include:

a) right ventricular hypertrophy
b) wide pulse pressure
c) a mid-diastolic murmur at the apex
d) pulsus paradoxus
e) cardiac failure

33. With regard to kidney function:

a) sodium is mainly reabsorbed from the proximal tubule
b) urinary potassium content is regulated by the distal tubule
c) glucose is completely reabsorbed if the blood concentration is normal
d) a rise in blood volume results in an increase in antidiuretic hormone secretion
e) acidosis results in an increased excretion of ammonium chloride

34. Concerning nitrous oxide cylinders:

a) they are colour-coded blue with white shoulders
b) the cylinder pressure is directly proportional to the quantity of N20 it contains
c) rapid emptying of a cylinder will cause its temperature to fall
d) pressure regulators must be used to reduce the pressure of the gas supplied from the cylinder before it enters the patient circuit
e) the pressure in a full cylinder at 20 degrees C is approximately 137100 kPa

35. The Mapleson A breathing system:

a) is a non-rebreathing system
b) must have the expiratory valve close to the patient
c) requires a fresh gas flow equal to the dead space ventilation
d) requires a higher fresh gas flow than a Mapleson D system in manual ventilation
e) was modified by Magill from Mapleson’s original design

36. Activated charcoal, as used in the Cardiff Aldasorber:

a) does not absorb nitrous oxide
b) is effective in absorbing isoflurane
c) increases expiratory resistance significantly
d) can be reactivated by heating to remove the absorbed agents
e) produces toxic substances if used with trichlorethylene

37. The oxygen-haemoglobin dissociation curve is moved to the right by:

a) acidosis
b) raised body temperature
c) passage through the pulmonary capillaries
d) ageing
e) anaemia

38. At the neuromuscular junction:

a) the resting potential is -45 mV
b) single twitch height is reduced if 60% of receptors are occupied by a non-depolarising muscle relaxant (NDMR)
c) acetylcholine reduces the permeability of the post-junctional membrane to sodium
d) neostigmine directly displaces NDMR from the motor end plate
e) hypokalaemia increases sensitivity to an NDMR

39. The following act on peripheral alpha-adrenergic receptors:

a) clonidine
b) phenoxybenzamine
c) trimetaphan
d) droperidol
e) phentolamine

40. Isoflurane:

a) is not metabolised
b) can be used with accuracy in halothane vaporisers
c) is less respiratory depressant than halothane
d) has a calcium antagonist action
e) causes a fall in heart rate in elderly subjects



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