Critical Care Medicine 2016

Selection ex amination for post- graduate diploma in Critical Care Medicine-
2015
1- CSF differ from plasma as CSF contain;

a) High PaCO2 content
b) High Mg2+ content
c) High HCO3- content
d) High sug ar content
e) High Pr- content
2- CO2 electrode;
a) Use glass electrodes sensitive to PH
b) Directly measure HCO3-
c) NaHCO3 solution
3- Pace maker action potential;

a) Repolarize due to long lasting Ca2+ channels opening
b) In parasympathetic stimulation hyperpolarization is due to K + channels
c) RMP -70mV
d) Depolarization is due to Na+ channels
4- ACE
a) Increase bradykinin
b) Blocked by Enalapril
c) React with renin to produce A2
d) Present in endothelium
5- Hyperkalemia
a) PR prolongation
b) Narrow QRS
c) QT prolong ation
d) Causes digoxin toxicity
e) Heart stops at systole
6- Dig oxin
a) Wide therapeutic index
b) Toxicity is common among elderly
c) Teratogenic
d) Toxicity is produced by impaired renal functions
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e) Toxicity causes bradycardia
7- R OTEM can be used to detect
a) Hb concentration
b) Fibrinolysis
c) Fibrinogen content
d) ?PLT
e) ?VWF
8- PT can be used to asses;

a) Heparin
b) LMWH
c) Warfarin
d) VW disease
e) PLT function
9- Aspirin
a) Reversibly inhibit COX-2
b) Action last for 10days
c) Subling ual route has faster onset than oral route
10-Which of the following drugs have significant anti-PLT activity

a) High dose aspirin
b) Clopidogrel
c) Low dose ibuprofen
11- Endog enous substances acting on opioid receptors;

a) Morphine
b) Endo-morphine
c) Leu-encephalin
12- Pro-drugs;
a) Midazolam
b) ?nalophrene/naloxone
c) Promethazine
13- Antibiotics
a) Cephalosporins should be avoided in patients with history of allergy to penicillin
b) Penicillin need no dose adjustment in renal failure
c) Nitrofurontoin can be given to treat acute pyelonephritis
d) Metronidazole can be used to treat Clostredium difficile
e) MRSA needed broad spectrum antibiotics
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14- Neurog enic thoracic outlet syndrome;
a) Caused by pressure on lower trunk of brachial plexus
b) Causes pain in shoulder and arm
c) May need to excise ?1st / cervical rib
15- Increase Na excretion

a) Increased atrial pressure
b) Cushing ’s Xd
c) Thiazide treatment
d) Aldosterone
e) Arterial vasodilatation
16- Hyponatreamia;
a) SIADH
b) Diabetes insipidus
c) Ampotericine B
d) Liver failure
17- Area under the curves of following gives COP;

a) Capnog raphy
b) ECG- QR S complex
c) ?arterial wave
d) ?Venous pulse wave
18- T lymphocytes;
a) Transformed in to B lymphocytes
b) Mature at thymus
c) Deficient in AIDS
d) Consist of cytotoxic cells
19- HCO- buffer system;

a) The main intracellular buffer system
b) Is important because its abundance
c) Is important because of the presence of CA enzyme
d) Is important because HCO3- and CO2 easily removed by kidneys and lungs
20- Anion-gap acidosis

a) Lactaemia
b) Ketosis
c) Vomiting
d) Diarrhea
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e) End stag e renal disease
21- Direct determinants of mixed venous O2content;

a) CO2 production
b) Cytochrome enzyme system
c) Blood flow
22- Hypothermia
a) Hypercoagulability
b) Reduced ICP
c) Reduced immunity
d) Increase blood pressure
e) Reduced ETCO2
23- Following symptoms can be seen in patients with loss of >2Lof blood;
a) GCS 10/15
b) HR> 100
c) BP 80/60
d) ?PP decline <10%
24- R egarding CXR

a) L hilum is hig her than R
b) Trachea bifurcation angle 100o in adult
c) Dome of right diaphragm is 5cm hig her than left
d) Pulmonary arteries are visible more clearly than veins
25- Imaging in lung diseases;

a) MRI- gives excellent information on lungs
b) HRCT gives g ood information on interstitial lung disease
c) Bronchogram is the best option to visualize bronchial tree
d) PE- CT
26- LO Sphincter
a) Tone increase by atropine
b) Metoclopramide cause increase tone
c) Consist of striated muscles
d) Supplied by vagus
e) Sympathetic causes increase tone
27- Pulmonary plethora in CXR;

a) PE
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b) Pulmonary HT
c) HF
d) L-R shunt
e) Pulmonary venous congestion
28- Diastolic dysfunction of heart;

a) Increased LVEDP
b) Normal SV
c) Causes pul.HT
d) Reduced diastolic filling
e) Reduced compliance
29- Aortic balloon catheter is significant, because it causes

a) Increase SBP
b) Increase DB P
c) Reduction in O2 consumption
30- Nitrates
a) Reduce preload
b) Arteriolar vasodilatation
c) Reduce HR
d) May cause PPH
31- Foetal Hb;

a) Consist of 2 alpha & 2beta chains
b) Convert to adult HbA @ 6 months
c) Affinity more for 2,3DPG than adult Hb
d) Causes reduce sickling of HbS
32- Hazardous effects of imag ing ;

a) USS causes foetal anomalies
b) Ionizing radiation caused by CXR
c) B arium causes anaphylactoid reactions
d) IV contrast –nephropathy
e) MR I- effect galeniv??
33- Following are categorized as features of dysplasia

a)Loss of polarity
b) R educe mitotic fig ures
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c)Tissue atrophy
d)R educe nuclear cytoplasmic ratio
e)Tissue atypia?
34- Microangiopathic haemolytic anaemia caused by;

a) March haemog lobinaemia
b) DIC
c) TTP
35- Delirium caused by;

a) Alcohol withdrawal
b) Schizophrenia
c) Anti-convulsant intoxication
d) Hypoglycemia
e) Thiamine deficiency
36- Radiology
a) MR I cannot be used to diagnose prostate CA
37- CO2;
a) R educed temperature- increased solubility
b) 200 times soluble than O2
c) Carries in blood mainly via dissolution form
d) PaCO2 affected by dissolved CO2??
38- Regarding temperature of a liquid;

a) B oiling point is when temp>room tem.
b) Depends on satur.vapour pressure
39- Pulse oximetry is incorrect in the presence of;

a) Hyperoxia
b) AV fistula
c) Severe T R
d) Carboxy Hb
e) Anaemia?
40- Wreig hter’

s respirometer;
a) Is a flow meter
b) Can be used to asses VC
c) Depends on effort
d) Unidirectional
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e) FEV1can be assessed?
41- Dead space;

a) Can be calculated by single breath N2 wash out method
b) Increased by IPPV
c) Hypovolaemia causes increase DS
42- Alpha adrenergic receptors;

a) Present in lung alveoli
b) Activation causes increase Camp
c) Ca2+ ??
d) Ligand gated??
43- Renal failure caused by;

a) Protamine
44-Heparin;
a) Main action is by activating protease inhibitor anti-thrombin 111
b) LMWH----
45- Warfarin
a) Causes inactivation of fac.x
46- Opioid receptors;

a) Are Gs pr- coupled receptors
b) Activation will causes increase c-AMP
47-Dexmedetomidate ;
a) Is alpha 2 analog ue
b) Antanalgesic
c)Causes respiratory failure
48- Regarding influenza epidemic;

a) OPD doctors should wear masks
b) Hand washing with alcohol based hand rub
c)Good out-come in patients started anti-viral therapy after 48 hours of hospitalization
49- Disease transmission;
50- Post-operative infections can be avoided by;

a) Using prophylactic antibiotics before contaminated Sx
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b) Using AB for clean Sx
c)Prolong use of AB in post-op period
d) Regular standardization of sterilizing equipment
e) Maintaining directional ventilation in theater
51- p value;
a) p>0.5 means no significant difference between …..
b) p>0.05 means no significant difference between …..
52- Null hypothesis;

a) Incorrect means there is a significant difference between sample and population
b) Type 1error- False (+ )
c)Type 2 error- can be prevented by ……
d) Type 2 error…….
e)
53- Information collection system in ICU;
a) ?? future assessment
54- Modalities of pain;

a) Trans-cutaneous nerve stimulation causes………….
b) Stimulation of alpha-1fibers by tense
Stem wise;
· K etamine gives its analgesic effect via GAB A

· Tramadol causes its action via,……
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Critical Care Medicine 2016

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Selection ex amination for post- graduate diploma in Critical Care Medicine-

1- CSF differ from plasma as CSF contain;

3- Pace maker action potential;

8- PT can be used to asses;

10-Which of the following drugs have significant anti-PLT activity

11- Endog enous substances acting on opioid receptors;

15- Increase Na excretion

17- Area under the curves of following gives COP;

19- HCO- buffer system;

20- Anion-gap acidosis

21- Direct determinants of mixed venous O2content;

24- R egarding CXR

25- Imaging in lung diseases;

27- Pulmonary plethora in CXR;

28- Diastolic dysfunction of heart;

29- Aortic balloon catheter is significant, because it causes

31- Foetal Hb;

32- Hazardous effects of imag ing ;

33- Following are categorized as features of dysplasia

34- Microangiopathic haemolytic anaemia caused by;

35- Delirium caused by;

38- Regarding temperature of a liquid;

39- Pulse oximetry is incorrect in the presence of;

40- Wreig hter’

41- Dead space;

42- Alpha adrenergic receptors;

43- Renal failure caused by;

46- Opioid receptors;

48- Regarding influenza epidemic;

49- Disease transmission;

50- Post-operative infections can be avoided by;

52- Null hypothesis;

54- Modalities of pain;

· K etamine gives its analgesic effect via GAB A

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