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General Primary MCQ 9

1. Ideal volatile agent should have:

a) analgesic properties
b) high oil:gas partition coefficient
c) low blood:gas partition coefficient
d) boiling point less than 20 degrees C
e) low molecular weight

2. Regarding intracranial pressure (ICP) monitoring:

a) ventricular catheter is the gold standard for monitoring of ICP

b) in infants, ICP can be monitored by placing a transducer over anterior fontanelle
c) the normal ICP waveform is like a miniature CVP waveform
d) cerebral blood flow is zero when mean arterial blood pressure is same as ICP
e) ventricular catheter does not allow compliance testing

3. Regarding temperature monitoring:

a) infrared thermometers use the frequency of electromagnetic radiation of the emitting object
b) thermistors measure temperature-sensitive electrical resisitance
c) liquid crystal is used for measurement of skin surface temperature
d) skin surface temperature corresponds to core temperature following induction of anaesthesia
e) core-peripheral temperature gradient is a measure of tissue perfusion

4. PaCO2 - PEtCO2 difference is smaller in:

a) ventilation with large tidal volumes

b) third trimester of pregnancy
c) exercise
d) chronic obstructive airways disease patients ventilated with low respiratory rate compared with
ventilation with a high rate
e) infants and neonates without known lung disease

5. Regarding control of breathing:

a) cerebrospinal fluid has a very poor buffering capacity for a given change in pH compared with blood
b) carotid and aortic bodies start firing non-linearly when PaO2 falls below 13 kPa
c) stretch receptors in airways are an integral part of Hering-Breuer’s reflex
d) epithelial receptors in the larynx can precipitate laryngospasm
e) J receptors are activated by pulmonary capillary engorgement

6. Dopamine:

a) does not cross the blood-brain barrier

b) causes renal vasodilatation via DA1 receptors
c) inhibits prolactin release
d) may cause nausea and vomiting via DA2 receptors
e) increases atrioventricular conduction

7. Glyceryl trinitrate:

a) dilates both resistance and capacitance vessels

b) is a nitric oxide donor
c) may cause cyanide toxicity
d) can cause reflex tachycardia
e) in combination with adrenaline can be used in low cardiac output conditions

8. Sodium nitroprusside:

a) reduces both preload and afterload

b) can decompose if the infusion bag is not wrapped by aluminium foil
c) molecule has five cyanide groups
d) combines with haemoglobin to produce cyanmethaemoglobin
e) toxicity can be associated with increase in mixed venous oxygen saturation

9. Concerning allergic reactions:

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a) released histamine has a half-life of 2.5 minutes

b) plasma tryptase level is increased during the reaction
c) tryptase is a marker of drug-induced allergic reaction
d) methylhistamine level is decreased in urine during an allergic reaction
e) a skin-prick test to identify the suspected agent brings the sensitised lymphocytes to the skin surface

10. The following statements are correct:

a) SI unit of pressure is mmHg

b) atmospheric pressure at sea level is about 100 kPa
c) a central venous pressure of 7.5 mmHg is equivalent to 10 cm H 2O
d) laminar flow in a blood vessel has the greatest flow rate at the centre of the blood vessel
e) flow is proportional to the square root of the pressure difference in turbulent flow

11. Verapamil:

a) prolongs A-V nodal refractoriness

b) undergoes extensive first-pass hepatic extraction on oral administration
c) is a useful antiarrhythmic agent in cases of recent myocardial infarction
d) is contraindicated in Wolff-Parkinson-White syndrome
e) is also useful for ventricular arrhythmias

12. The electrolyte and acid-base imbalance seen in end-stage renal failure includes:

a) metabolic alkalosis
b) a fall in serum magnesium
c) a rise in serum phosphate
d) a rise in serum calcium
e) a fall in serum potassium

13. Nitrous oxide:

a) is stored as a liquid
b) is a gas above a temperature of 36 degrees C
c) cylinders should have a filling ratio of 0.65-0.75
d) content in a cylinder is always reflected from its pressure gauge
e) cylinder when full has a pressure of about 50 atmospheres

14. Closing volume:

a) is larger than functional reserve capacity

b) may be determined by single breath N 2 curve following a deep breath of oxygen
c) is high in young children and decreases progressively with advancing age
d) if high, may be responsible for arterial hypoxaemia
e) is unaffected by bronchomotor tone

15. Regarding haemodynamic changes seen following the Valsalva manoeuvre:

a) the rise in mean arterial blood pressure (MAP) in phase I is due to the rise in intrathoracic pressure
b) in phase II, decreased venous return is responsible for the drop in MAP
c) MAP increases in phase III due to the rise in heart rate and vasoconstriction
d) MAP returns to normal in phase IV
e) these changes are present even in autonomic dysfunction

16. Propofol:

a) has a pH of 7.0-8.5
b) is insoluble in water
c) is twice as potent as thiopentone
d) can be given as an infusion because its terminal half-life is less than 30 minutes
e) may change the colour of urine due to propofol glucuronide

17. Hypophysectomy will result in:

a) depressed thyroid function

b) osteoporosis and generalised wasting
c) the secretion of adrenal glucocorticoid and sex hormones to a low level
d) diabetes insipidus
e) normal aldosterone secretion

18. Pneumotachograph:

a) lumen is broken up to a large number of smaller tubes

b) has a sensitive differential pressure transducer across the resistor
c) output is affected by the gas viscosity
d) may give an erroneous reading in the presence of condensed water vapour
e) works on the principle of Poiseuille's Law

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19. Sympathetic stimulation affects carbohydrate metabolism because:

a) adrenaline increases liver glycogenolysis

b) sympathetic nerves to the pancreas regulate insulin release
c) peripheral tissues require adrenaline to take up glucose
d) insulin cannot act on the liver in the absence of adrenaline
e) none of the above

20. Regarding work of breathing:

a) inspiring a low tidal volume at a higher rate reduces the elastic component of work of breathing
b) work of breathing is increased at high inspiratory flow
c) the viscous component of work of breathing is increased in the presence of stiff lungs
d) low respiratory rate reduces the viscous component of work of breathing
e) patients naturally adopt a respiratory pattern which ensures the lowest work of breathing

21. Gastric emptying:

a) can be measured by using radioactive substances

b) may be measured by repeated X-rays after a barium meal
c) can be measured by naso-gastric aspiration of the residues
d) is commonly measured by paracetamol uptake
e) time is delayed by intravenous erythromycin

22. One or more prostaglandins:

a) are peptides found in prostatic secretions

b) dilate the bronchial smooth muscles
c) dilate the afferent arterioles in the glomeruli
d) raise the intracranial pressure
e) affect platelet function

23. Regarding endorphins:

a) they are short chain peptides

b) there is a homogenous population of receptors for them
c) they are present in the brain but not the spinal cord
d) concentrations are decreased by exercise
e) may be antagonised by naloxone

24. Both bradykinin and histamine:

a) are direct vasodilators

b) increase capillary permeability
c) stimulate the secretion of gastric acid
d) cause pain when applied to a blister base
e) cause vasodilatation in the axon reflex

25. Prostaglandins are:

a) not naturally occurring substances

b) used to induce abortion and labour
c) metabolised in the pulmonary circulation
d) modulators of histamine and bradykinin action in pain
e) involved in protecting the gastric mucosa from hydrochloric acid

26. Normal values in the newborn include:

a) blood volume of 110 ml/kg

b) arterial blood pressure of 80/60 mmHg
c) resting heart rate of 160-180 bpm
d) PaO2 of 6 kPa
e) HbF of 40%

27. Regarding thyroid hormones:

a) they sensitise the myocardium to catecholamines

b) they lower the plasma cholesterol
c) they increase the formation of messenger RNAs
d) reverse T3 may be active in some cells
e) iodine is absorbed from the gastrointestinal tract in ionised form

28. Regarding antiarrhythmic drugs:

a) amiodarone enhances repolarisation

b) flecainide has no effect on repolarisation
c) magnesium is not useful in AF and torsades de pointes
d) adenosine can differentiate supraventricular from ventricular arrhythmias

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e) beta-blockers increase K+ permeability and decrease the rate of firing in the SA node

29. Regarding the passage of glomerular filtrate through the renal tubules:

a) the thick ascending limb of the loop of Henle dilutes the filtrate by its powerful sodium pumps
b) the osmolality of the filtrate at the tip of loop of Henle is about 1200 mosm/L
c) the distal tubule is normally impermeable to water
d) glucose is absent in the filtrate in the loop of Henle
e) sodium concentration in the descending limb of the loop of Henle is the same as that in the proximal
convoluted tubule

ANSWERS

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14.FTFTF
15.TTTTF
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19.TFFFF (alpha 2 inhibits insulin release, beta 2 increases insulin release)
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25.FTTTT
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27.TTTFT
28.FTFTF (amiodarone slows repolarisation).
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