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Created: 15/2/2005
1. The following agents may cause pulmonary fibrosis:

a) bleomycin
b) cortisone hemisuccinate
c) beryllium
d) paraquat
e) organophosphate compounds

2. In comparison with an older child, a newborn infant increases pulmonary ventilation by breathing more often rather than more deeply. This is related to:

a) total respiratory compliance
b) the horizontal disposition of the rib cage
c) immature respiratory chemoreceptors
d) non-respiratory acidosis found in neonates
e) coordination of respiratory effort with sucking movement

3. The most common site of laryngeal granuloma after short-term intubation is:

a) the piriform fossa
b) the epiglottis
c) the anterior 1/3 of the vocal cords
d) the posterior 1/3 of the vocal cords
e) the trachea

4. Regarding measurement of anaesthetic gases:

a) infra-red analysers are specific for agents
b) mass spectrometry may not be specific for agents
c) infra-red analysers pick up isopropyl alcohol
d) acoustic techniques may be used to measure gas concentrations
e) nitrous oxide interferes with paramagnetic analysers

5. Regarding myasthenia gravis:

a) IgE antibodies are found in 85% of patients
b) muscle weakness improves with exercise
c) muscle weakness is worsened by gentamicin
d) plasma exchange produces rapid remission
e) thymectomy is the treatment of choice in patients over 50 years

6. A raised reticulocyte count is found in:

a) untreated pernicious anaemia
b) aplastic anaemia
c) untreated iron deficiency anaemia
d) chronic granlocytic leukaemia
e) congenital spherocytic haemolytic anaemia

7. Measurement of prothrombin time is helpful in:

a) haemophilia
b) von Willebrand’s disease
c) scurvy
d) jaundice
e) idiopathic thrombocytopenic purpura

8. Propofol:

a) is suspended in an emulsion of soya bean oil and egg phosphatide
b) can produce green urine
c) has little effect on the cardiovascular system
d) impairs ventilatory response to CO2
e) has no effect on intraocular pressure

9. Essential criteria for the diagnosis of brain stem death are:

a) equal pupils
b) absent doll’s head response
c) absent limb movements
d) patient’s temperature must exceed 34 degrees C
e) PaCO2 must exceed 6.5 kPa at completion of apnoea testing

10. Malignant hypertension is associated with:

a) increased risk of pulmonary oedema
b) right bundle branch block
c) reduced creatinine clearance
d) proteinuria
e) pulmonary hypertension

11. Coarctation of the aorta:

a) is a congenital condition
b) produces upper limb hypertension
c) may be associated with a displaced apex beat
d) produces a diastolic murmur over the precordium
e) produces skeletal abnormalities on a plain chest X-ray

12 Routine laboratory investigation of a 42-year-old man reveals an elevated creatinine phosphokinase. This finding may indicate:

a) abnormal metabolism of haemoglobin
b) the patient is at increased risk of malignant hyperpyrexia under anaesthesia
c) hepatocellular dysfunction
d) recent exercise
e) recent myocardial infarction
f) Duchenne muscular dystrophy
g) hypothyroidism

13. Febrile collapse following a colectomy may be due to:

a) pulmonary embolus
b) breakdown of the anastomosis
c) haemorrhage
d) sepsis

14. pH 7.5, PCO2 7kPa, PO2 12 kPa, B.E. +9.5
These arterial blood gas values could represent:

a) pyloric stenosis for several days
b) the administration of 50 mmol of bicarbonate following cardiac arrest
c) excessive deadspace ventilation
d) a severe asthmatic on steroids
e) chronic obstructive airways disease

15. A young man admitted to casualty following a road traffic accident is found to have central dislocation of the hip and is shocked. Likely causes are:

a) ruptured bladder
b) ruptured urethra
c) blood loss
d) neurogenic shock
e) fat embolism

16. A patient with vomiting, respiratory distress, cyanosis, epigastric tenderness and subcutaneous emphysema in the neck may be suffering from:

a) ruptured oesophagus
b) ruptured diaphragm
c) ruptured trachea
d) spontaneous pneumothorax
e) pulmonary embolus

17. The following are features of malignant hyperpyrexia:

a) hypoxia
b) hypocapnia
c) hyperkalaemia
d) prolonged neuromuscular blockade

18. In patients with porphyria:

a) griseofulvin may precipitate an acute attack
b) glycine should not be used during transurethral resection of the prostate
c) dysautonomia may occur
d) preoperative fluid restriction is beneficial
e) fentanyl may safely be used

19. In carcinoid syndrome:

a) urine turns pink on standing
b) aortic valve lesions frequently occur
c) there is an association with obstinate constipation
d) diarrhoea and bronchospasm may occur
e) severe flushing occurs
f) ketanserin, octreotide and aprotonin should be given

20. Regarding anaphylactoid reactions:

a) they are clinically indistinguishable from anaphylaxis
b) widespread erythema occurs
c) adrenaline is the treatment of choice
d) they are not commonly caused by etomidate

21. For a patient suffering from Parkinson’s disease on L-dopa, the following agents should not be used:

a) enflurane
b) droperidol
c) nitrous oxide
d) morphine
e) fentanyl

22. During cardiopulmonary resuscitation:

a) lidocaine should be used before adrenaline in ventricular fibrillation
b) calcium is appropriate in patients undergoing haemodialysis
c) cardioversion at 50 J is indicated for ventricular tachycardia
d) adrenaline 0.5 mg is an appropriate dose for administration via an endotracheal tube
e) bicarbonate should be administered every 10 minutes

23. The risk of electrocution may be reduced by:

a) conductive flooring
b) the use of isolating transformers
c) a separate earth for each socket
d) the use of fuses
e) battery powered equipment

24. Ventricular arrhythmias are more common in the presence of:

a) hypokalaemia
b) hypoxia
c) thyrotoxicosis
d) cardiopulmonary bypass and digoxin treatment
e) essential hypertension

25. Hypoglycaemic coma:

a) occurs with hypothermia
b) may cause coma in adrenal failure
c) is a recognised complication of untreated thyrotoxicosis
d) occurs in normal people after 48 hours of fasting

26. In arterial blood gases:

a) heparin in significant amounts will cause an elevated pH
b) there is an increase in dissolved oxygen with hypothermia
c) when the FiO2 is 1 the alveolar-arterial pressure difference exceeds 15 kPa

27. An adult breathing 100% oxygen at sea level may suffer from:

a) retrosternal chest pain
b) convulsions
c) dizziness
d) atelectasis
e) permanent visual damage

28. In the measurement of cardiac output using a thermistor:

a) the temperature measurement is accurate to 0.1 degree C
b) the thermistor is proximal to the balloon
c) results are inaccurate after the catheter has been in use for more than 48 hours
d) the thermistor measures the true core temperature

29. The following are associated with ulcerative colitis:

a) iritis
b) cirrhosis
c) cholangitis
d) arthropathy
e) finger clubbing

30. Features of ankylosing spondylitis include:

a) it is more common over the age of 40 and in males rather than females
b) low grade pyrexia
c) sciatica
d) hip arthropathy
e) iritis

31. In L5-S1 disc prolapse with sciatica in the right leg:

a) loss of the knee jerk on the right occurs
b) loss of sensation in the medial right calf occurs
c) incontinence requires further surgical investigation
d) plaster of Paris cast is the preferred early treatment
e) it is commonly associated with scoliosis

32. Cauda equine syndrome is more common in:

a) old age
b) use of epidural adrenaline
c) lithotomy position
d) cases where barbotage is used
e) face down position

33. Suitable anaesthetic techniques for patients with raised intracranial pressure are:

a) nitrous oxide, oxygen and fentanyl; controlled ventilation
b) nitrous oxide, oxygen, thiopentone and atracurium
c) ketamine
d) halothane, nitrous oxide and oxygen; spontaneous respiration
e) pre-medication with morphine

34. Epidural opiates may cause:

a) nausea and vomiting
b) motor block
c) urinary retention
d) hypotension
e) respiratory depression

35. An elevated left hemidiaphragm may be caused by:

a) left pneumothorax
b) left pleural effusion
c) situs inversus
d) left phrenic nerve paralysis
e) left lower lobe collapse

36. In formulating total parenteral nutrition for a 30-year-old, 70 kg man recovering from major trauma:

a) insulin is not needed if less than ? of glucose per day is used
b) 6000 kcal per day would be appropriate
c) there is a risk of sepsis
d) 0.5 mmol of phosphate is needed daily

37. In patients with permanent pacemakers:

a) suxamethonium should be avoided if possible
b) prophylactic antibiotics should not be used
c) diathermy should preferably not be used
d) electrolytes should be corrected prior to anaesthesia
e) anaesthesia can lead to profound hypotension

38. Cricoid pressure:

a) is effective in the presence of a nasogastric tube
b) requires a complete cricoid cartilage to be effective
c) should be performed with the neck extended
d) should be performed after 5 minutes' pre-oxygenation
e) compresses the oesophagus against the cervical vertebrae

39. Regarding EMLA cream:

a) it contains 5% prilocaine and lidocaine
b) it contains adrenaline
c) the melting point of the agents is decreased
d) it can be made with carbonated salts
e) it can be made from any local anaesthetics

40. Regarding caudal anaesthesia:

a) the posterior superior iliac crest can be used as a landmark
b) absorption of local anaesthetic is greater than from lumbar epidurals
c) the dura ends at the level of the posterior superior iliac spine
d) subcutaneous injection can be detected using air
e) negative pressure can be used to detect the space

41. The first rib:

a) is crossed by the subclavian artery
b) is crossed by the vagus nerve
c) is crossed by the supratentorial fascia
d) lies above the stellate ganglion
e) is a landmark for supraclavicular brachial plexus block

42. Regarding the femoral nerve:

a) it arises from the L2, -3 and -4 spinal segments
b) it lies lateral to the femoral artery at the inguinal ligament
c) it supplies the lateral aspect of the thigh
d) total block allows arthroscopy of the knee to be performed
e) block relieves pain from a fractured femur

43. Isoflurane:

a) causes a dose-related decrease in systematic vascular resistance
b) causes respiratory depression
c) is metabolised to inorganic fluoride
d) can cause a tachycardia

44. Regarding intravenous guanethidine:

a) it blocks parasympathetic nerves
b) it cannot be repeated
c) the tourniquet must remain inflated for at least 1 hour
d) it is used as a treatment for sympathetic dystrophy
e) both postural hypotension and diarrhoea are common
f) it causes hypotension

45. The following are true of alfentanil:

a) it is more potent than sufentanil
b) the volume of distribution is greater than that for fentanyl
c) it is more protein bound than fentanyl
d) it has a shorter elimination half-life than fentanyl
e) it is more ionised than fentanyl

46. Pethidine is used in obstetrics because:

a) it is 75% excreted unchanged
b) it does not cross the placenta
c) it causes less respiratory depression than an equipotent dose of morphine
d) it can be used without medical supervision
e) it does not affect uterine contractility

47. In the management of uterine haemorrhage, the following are used:

a) IV fibrinogen
b) IV ergometrine
c) aortic compression
d) uterine packing
e) bimanual compression

48. Ritodrine causes:

a) heart block
b) bradycardia
c) pulmonary oedema
d) peripheral vasoconstriction
e) increased uterine contractility

49. Concerning arterial pressure transducers:

a) mean pressure is not affected by damping
b) critical damping of 0.8
c) an intraflow square wave measures damping
d) optimum damping occurs at 5x the resonant frequency
e) they are best used with long, narrow catheters

50. Causes of respiratory distress in the neonate include:

a) unilateral choanal atresia
b) TDF
c) diaphragmatic hernia
d) necrotising enterocolitis
e) myelomeningocoele

51. Neonates compared with adults have:

a) decreased oxygen consumption
b) decreased ability to shiver
c) increased Vd/Vt
d) increased body surface area/weight ratio
e) increased airway resistance

52. Concerning the use of thiopentone in lower segment caesarean section (LSCS):

a) there is a greater concentration in foetal liver compared with maternal liver
b) the greatest fetal concentration occurs within 2 minutes of maternal administration
c) less crosses the placenta if given at the beginning of a contraction
d) neonatal depression is proportional to peak maternal concentration
e) thiopentone crosses the fetal blood-brain barrier more readily

53. The following are causes of APGAR (<5) following LSCS:

a) maternal hypoxia
b) uterine incision-delivery time greater than 90 s
c) placental transfer of muscle relaxant
d) reduced uterine contractility
e) reduced placental blood flow

54. Suxamethonium does not cross the placenta because of:

a) placental cholinesterase
b) high protein binding
c) elongated molecule
d) high degree of ionisation
e) insufficient maternal concentration

55 Postoperative vomiting is:

a) more common in males than in females
b) reduced with preoperative administration of anticholinergics
c) increased if pain is managed with opiates
d) worse if nitrous oxide is used
e) more common in operations on the abdomen than of the lower limbs

56. Cerebral ischaemia during hypotensive anaesthesia:

a) is worse in a steep head-up position
b) occurs with isoflurane
c) is common when the blood pressure cuff is inflated frequently
d) can be detected with EEG monitoring
e) is avoided if normocarbia is maintained

57. In paracetamol overdose:

a) respiratory alkalosis occurs
b) the patient is hypothermic
c) methionine is used in the treatment
d) acetyl cysteine is an antidote
e) coagulopathy is an early complication

58. Alveolar hypoventilation is associated with:

a) metabolic acidosis
b) asthma
c) upper airway obstruction
d) raised intracranial pressure
e) marked ascites




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