Title: Jamjar MCQ's / 2019

Q: Which haemodynamic changes are observed in Phase II of the Valsalva Manoeuvre?
1. Hypotension and increased venous return
2. Hypotension and tachycardia
3. Hypertension and bradycardia
4. Hypertension and reduced venous return
[...]
A: Hypotension and tachycardia

Q: Mechanism of Sodium Thiosulphate metabolism:
1. Oxidation (to pentobarbital)
2. Renal elimination unchanged
3. Reduction
4. Hydrolysis
[...]
A: Oxidation (to pentobarbital)

Q: Which additive of propofol retards bacterial growth?
1. Soyabean Oil (intralipid)
2. Sodium Hydroxide (brings pH > 7)
3. Edetate Disodium
4. Glycerol (isotonicity)
[...]
A: Edetate Disodium

Q: At which temperature are platelets best stored at?
1. 0-4 C
2. 2-6 C
3. 20-24C
4. < -25 C
[...]
A: 20-24C

Q: Which pathway describes the excretion and metabolism of rocuronium?
1. Hoffman elimination
2. Plasma cholinesterase
3. Non specific ester hydrolysis
4. Liver metabolism and excretion
[...]
A: Liver metabolism and excretion

Q: Which of these describes the pressures acting on the lung
1. Mouth Pressure – Alveolar Pressure
2. Alveolar Pressure – Pleural Pressure
3. Alveolar Pressure – Atmospheric Pressure
4. Alveolar Pressure – Abdominal Abdominal
[...]
A: Alveolar Pressure – Pleural Pressure

Q: Eccrine sweat glands:
1. Are innervated by parasympathetic fibers releasing acetylcholine from their post synaptic fibers
2. Are innervated by parasympathetic fibers releasing noradrenaline from their post synaptic fibers
3. Are innervated by sympathetic fibers releasing acetylcholine from their post synaptic fibers
4. Are innervated by sympathetic fibers releasing noradrenaline from their post synaptic fibers
[...]
A: Are innervated by sympathetic fibers releasing acetylcholine from their post synaptic fibers

Q: According to the oxygen cascade, which of the following has the lowest oxygen tension?
1. End expiratory gas
2. Mitochondria
3. Central venous blood
4. Venous admixture
[...]
A: Mitochondria

Q: Which cardiac reflex describes a rise in contractility in response to a raised heart rate?
1. Anrep effect
2. Bezold-Jarisch reflex
3. Bainbridge reflex
4. Treppe effect
[...]
A: Treppe effect (did not mention Bowditch) – frequency dependent inotropy

Q: Omeprazole acts by
1. Irreversibly binding H/Na/KATPase pump
2. Reversibly binding H/Na/KATPase pump
3. Irreversibly binding the H/K/ATPase pump
4. Reversible binding of H/K/ATPase pump
[...]
A: Irreversibly binding the H/K/ATPase pump

Q: Which of the following neuromuscular junction blocking drugs can induce a Phase II block?
1. Rocuronium
2. Suxamethonium
3. Vecuronium
4. Pancuronium
[...]
A: Suxamethonium

Q: Which of the following factors INCREASE cerebral blood flow?
1. Thiopentone
2. Temperature <35deg
3. PaCO2 <40mmHg
4. PaO2 <40mmHg
[...]
A: PaO2 <40mmHg

Q: According to the Stewart Physiochemical approach to acid base which of the following is a dependable variable:
1. HCO3
2. pCO2
3. Weak acid concentration
4. Strong Ion Difference
[...]
A: HCO3

Q: Which of the following stimulates bile secretion?
1. Secretin
2. Cholecystokinin
3. Somatostatin
4. Gastrin
[...]
A: Cholecystokinin

Q: Mechanism of action of amphotericin
1. Inhibition of cell wall synthesis
2. Inhibition of DNA synthesis
3. Formation of membrane pores
4. Inhibition of ergosterol synthesis
[...]
A: Formation of membrane pores (by binding to ergosterol)

Q: The pH of saliva
1. 6.8
2. 5.6
3. 1.5
4. 8.5
[...]
A: 6.8
Extra: The normal pH of saliva is 6.7 to 7.4

Q: The latent heat of vapourisation of water is:
1. 2260 J/g
2. 838 g/m^3
3. 213 J/g
4. 44g/m^3
[...]
A: 2260 J/g
Extra: For water at its normal boiling point of 100 ºC, the heat of vaporization is 2260 J g-1. This means that to convert 1 g of water at 100 ºC to 1 g of steam at 100 ºC, 2260 J of heat must be absorbed by the water.

Q: Which of the following most correctly describes the Bohr effect?
1. A decrease in PaCO2 will decrease the affinity of oxygen for haemoglobin
2. An increase in PaCO2 will promote oxygen offloading in the tissues
3. A decrease in pH will decrease the affinity of oxygen for haemoglobin
4. An increase in temperature will increase the affinity of oxygen for haemoglobin
[...]
A: An increase in PaCO2 will promote oxygen offloading in the tissues

Q: Which of these drugs has the SHORTEST context sensitive half time after a 12hr infusion?
1. Midazolam
2. Propofol
3. Morphine
4. Remifentanil
[...]
A: Remifentanil

Q: What is the action of inhaled nitric oxide?
1. Vasoconstriction with increased cGMP
2. Vasoconstriction with decreased cGMP
3. Vasodilation with increased cGMP
4. Vasodilation with decreased cGMP
[...]
A: Vasodilation with increased cGMP

Q: What is the respiratory quotient of fat?
1. 0.1
2. 0.3
3. 0.7
4. 1.0 CHO
[...]
A: 0.7

Q: Which of the following morphine metabolites has neuro-excitatory effects?
1. Morphine-1-glucuronide
2. Morphine-3-glucuronide
3. Morphine-6-glucuronide
4. Nor-morphine
[...]
A: Morphine-3-glucuronide

Q: Which is the MOST important mechanism of heat loss from the body of a naked person at a normal ICU room temperature of 21°C?
1. Conduction
2. Convection
3. Evaporation
4. Radiation
[...]
A: Radiation

Q: What best describes the functional residual capacity (FRC)?
1. The FRC is approximately 10 ml/kg in a normal healthy adult and varies with training
2. The FRC is composed of the inspiratory reserve volume and the closing capacity and varies with effort
3. The FRC is measured by spirometry or pneumotachography and varies with temperature
4. The FRC is the point of no flow at the end of a tidal breath
[...]
A: The FRC is the point of no flow at the end of a tidal breath

Q: Regarding bronchial muscle tone, which statement is correct?
1. Beta 2 adrenoreceptor stimulation and muscarinic cholinergic stimulation both decrease bronchial tone
2. Beta 2 adrenoreceptor stimulation and muscarinic cholinergic stimulation both increase bronchial tone
3. Beta 2 adrenoreceptor stimulation decreases tone and muscarinic cholinergic stimulation increases bronchial tone
4. Beta 2 adrenoreceptor stimulation increases tone and muscarinic cholinergic stimulation decreases bronchial tone
[...]
A: Beta 2 adrenoreceptor stimulation decreases tone and muscarinic cholinergic stimulation increases bronchial tone

Q: Which of the following body compartments CANNOT be directly measured?
1. Blood volume
2. Interstitial fluid volume
3. Plasma volume
4. Total body water
[...]
A: Interstitial fluid volume

Q: Which of the following stores the GREATEST amount of oxygen?
1. Oxygen combined with haemoglobin
2. Oxygen combined with myoglobin
3. Oxygen dissolved in the tissues
4. Oxygen stored within the functional residual capacity (FRC)
[...]
A: Oxygen combined with haemoglobin
Extra: Oxygen combined with haemoglobin 900ml of blood in HbO2 HbO2 = 18 ml Hb dissolved = 2-3ml

Q: The volume that best represents the Inspiratory capacity in a healthy adult is:
1. 7 ml/kg
2. 15 to 20 ml/kg
3. 30 ml/kg
4. 50 ml/kg
[...]
A: 50 ml/kg

Q: The mechanism of action of prostacyclin as a pulmonary vasodilator is:
1. Activation of adenyl cyclase Increasing Intracellular cAMP
2. Activation of guanylate cyclase Increasing cGMP
3. Inhibition of adenyl cyclase reducing cGMP
4. Inhibition of phosphodlesterase-5
[...]
A: Activation of adenyl cyclase Increasing Intracellular cAMP

Q: The pulmonary vessels contain approximately
1. 5% of blood volume
2. 10% of blood volume
3. 20% of blood volume
4. 25% of blood volume
[...]
A: 10% of blood volume

Q: Regarding cerebrospinal fluid (CSF):
1. About 150 ml Is produced per day
2. It has a lower chloride concentration compared to plasma
3. It has a lower pH compared to plasma
4. The normal volume Is about 500 ml
[...]
A: It has a lower pH compared to plasma
Extra: Note, CSF has a much higher Cl than plasma ?bc no plasma proteins

Q: Which of the following events occurs during swallowing?
1. Adduction of the vocal cords
2. Glossopharyngeal nerve Is simulated
3. Nasopharynx opens
4. Respiration Is increased
[...]
A: Adduction of the vocal cords
Extra: Adduction of the vocal cords Glossopharyngeal nerve is simulated

Q: Which of the following opiates has the HIGHEST lipid solubility?
1. Alfentanll
2. Fentanyl
3. Morphine
4. Remlfentanll
[...]
A: Fentanyl

Q: Which of the following Is a colligative property?
1. Freezing point depression
2. Humidity
3. Molecular weight
4. Temperature
[...]
A: Freezing point depression

Q: What is the MAXIMAL urine concentration that a healthy kidney can achieve?
1. 400 to 600 mOsm/L
2. 800 to 1000 mOsm/L
3. 1200 to 1400 mOsm/L
4. 1600 to 1800 mOsm/L
[...]
A: 1200 to 1400 mOsm/L

Q: Which of the following is IRRELEVANT when calculating a loading dose?
1. Body weight
2. Desired concentration
3. Renal function
4. Volume of distribution
[...]
A: Renal function

Q: Regarding its effect on neurotransmitter function, neostigmine:
1. Blocks catecholamine reuptake by nerve terminals
2. Inhibits acetylcholine release
3. Inhibits monoamine oxidase function
4. Inhibits the action of acetylcholinesterase
[...]
A: Inhibits the action of acetylcholinesterase

Q: What is the optimal temperature range for stored platelets?
1. ≦-25°C
2. 2 to 6°C
3. 10 to 15°C
4. 20 to 24°C
[...]
A: 20 to 24°C

Q: Which receptor does hyoscine act on?
1. 5-HT3
2. Dopamine D2
3. Muscarinic
4. Neurokinin 1
[...]
A: Muscarinic

Q: What is the mechanism of action of ondansetron?
1. Anticholinergic
2. Antihistamine
3. Dopamine (D2) antagonist
4. Serotonin (5-HT3) antagonist
[...]
A: Serotonin (5-HT3) antagonist

Q: What hormone do the D (delta) cells of the pancreas secrete?
1. Glucagon
2. Insulin
3. Pancreatic polypeptide
4. Somatostatin
[...]
A: Somatostatin

Q: Adrenaline is secreted by the:
1. Adrenal medulla
2. Zona fasciculata of the adrenal cortex
3. Zona glomerulosa of the adrenal cortex
4. Zona reticularis of the adrenal cortex
[...]
A: Adrenal medulla

Q: Type I hypersensitivity:
1. Involves production of IgG and IgM
2. Involves Th1 and CD8+ bearing cells
3. Is associated with increased vascular permeability and vasodilation
4. The prototype is autoimmune haemolytic anaemia
[...]
A: Is associated with increased vascular permeability and vasodilation

Q: Dobutamine:​
1. Decreases urine output
2. Has a half-life of 45 minutes
3. Increases atrioventricular nodal conduction velocity
4. Is a selective alpha agonist
[...]
A: Increases atrioventricular nodal conduction velocity

Q: With reference to benzodiazepines:
1. A single dose of midazolam has a quick offset of action due to rapid renal clearance
2. Diazepam undergoes hepatic metabolism to active desmethyldiazepam
3. Flumazenil is a non-competitive antagonist competitively inhibits
4. Lorazepam has a short duration of action
[...]
A: Diazepam undergoes hepatic metabolism to active desmethyldiazepam

Q: To which of the following side effects of opioid analgesics does tolerance MOST develop?
1. Bradycardia
2. Constipation
3. Miosis
4. Nausea and vomiting
[...]
A: Nausea and vomiting

Q: Renal blood flow:
1. Is about 600 ml/min per kidney
2. Is directly measured by infusing para-aminohippuric acid (PAH)
3. Is increased by sympathetic tone
4. Per gram of tissue, is the highest blood flow of any organ
[...]
A: Is about 600 ml/min per kidney

Q: Growth hormone:
1. Increases osteoblast activity
2. Is a steroid hormone
3. Is released evenly during a 24-hour period
4. Reduces fatty acid secretion
[...]
A: Increases osteoblast activity

Q: The following is an example of a prodrug:
1. Enalapril
2. Hydralazine
3. Metoprolol
4. Nifedipine
[...]
A: Enalapril

Q: Normal cerebral blood flow in mL/100g brain tissue/min is approximately:
1. 20
2. 50ml/100g
3. 85
4. 420
[...]
A: 50ml/100g

Q: Metabolic effects of Cortisol include:
1. Increased inflammatory mediator production
2. Increased protein synthesis
3. Inhibition of fatty acid oxidation
4. Stimulation of gluconeogenesis
[...]
A: Stimulation of gluconeogenesis

Q: Metabolic effects of adrenaline on the liver include the stimulation of:
1. Gluconeogenesis
2. Glycogenolysis
3. Protein synthesis
4. Triglyceride synthesis
[...]
A: Glycogenolysis
Extra: Glycogenolysis And Gluconeogenesis…

Q: What is the mechanism of action of vancomycin?
1. Inhibition of bacterial cell wall synthesis
2. Inhibition of bacterial DNA synthesis
3. Inhibition of bacterial ribosomes
4. Inhibition of beta-lactamase
[...]
A: Inhibition of bacterial cell wall synthesis

Q: Which of the following has the LEAST mineralocorticoid activity?
1. Aldosterone
2. Cortisol
3. Dexamethasone
4. Prednisone
[...]
A: Dexamethasone

Q: The measured peak end tidal CO2 (PETCO2) is normally:
1. At the end of phase II on a typical capnograph
2. Detected using side-stream or main-stream Doppler sensors
3. Higher than measured PaC02 when PEEP is applied during SIMV
4. Lower than PaC02 due to dead space
[...]
A: Lower than PaC02 due to dead space

Q: Lactate produced during strenuous exercise is predominantly:​
1. Converted to acetoacetate in muscle
2. Converted to glucose in the liver (Cori Cycle)
3. Converted to pyruvate in muscle
4. Converted to urea in the liver
[...]
A: Converted to glucose in the liver (Cori Cycle)

Q: During the cardiac cycle, aortic valve closure coincides with:
1. The beginning of isovolumetric relaxation
2. The ‘c wave’ of the central venous pressure trace
3. The first heart sound
4. The ‘T wave’ of the electrocardiograph (EGG)
[...]
A: The beginning of isovolumetric relaxation

Q: The arteriovenous oxygen concentration difference is GREATEST for the:
1. Brain
2. Heart
3. Liver
4. Lungs
[...]
A: Heart

Q: The sodium concentration in 0.9% (Normal) Saline is approximately:
1. 115 mmol/L
2. 128 mmol/L
3. 130 mmol/L
4. 150 mmol/L
[...]
A: 150 mmol/L

Q: What is the pKa of the phosphate buffer system?
1. pKa 6.1
2. pKa 6.8
3. pKa 7.4
4. pKa 8.1
[...]
A: pKa 6.8 Signifcant in ICF & urine

Q: Regarding the Haldane effect, which statement is correct?
1. Describes the rightward shift of the oxygen-haemoglobin dissociation curve in the tissues due to the effect of CO2 binding to haemoglobin
2. Describes the rightward shift of the oxygen-haemoglobin dissociation curve with an increase in temperature
3. Governs the respiratory exchange ratio for O2 uptake and CO2 production
4. The affinity of haemoglobin for CO2 is reduced by the binding of O2 in the lungs
[...]
A: The affinity of haemoglobin for CO2 is reduced by the binding of O2 in the lungs

Q: The MOST lateral anatomical structure is the:
1. Femoral artery
2. Femoral canal
3. Femoral nerve
4. Femoral vein
[...]
A: Femoral nerve

Q: The substance with the LOWEST intracellular ion concentration is:
1. Ca++
2. K+
3. Mg++
4. Na+
[...]
A: Ca++

Q: Propofol acts at the following site:
1. Inhibitory interneurons causing chloride efflux
2. NMDA receptors causing hyperpolarisation
3. Post-synaptic GABA A receptors causing hyperpolarisation
4. Pre-synaptic nerve terminals causing depolarisation
[...]
A: Post-synaptic GABA A receptors causing hyperpolarisation

Q: The proximal convoluted tubule of the kidney:
1. Is impermeable to urea – 50% reabs PCT
2. Is incapable of active transport
3. Is responsible for 20% of sodium reabsorption
4. Is responsible for 60% of sodium reabsorption
[...]
A: Is responsible for 60% of sodium reabsorption

Q: Angiotensin II:
1. Constricts renal arterioles
2. Is a steroid hormone
3. Is a vasodilator
4. Is produced mainly in the kidney
[...]
A: Constricts renal arterioles

Q: The following are acute phase proteins associated with inflammation except:
1. Albumin
2. Fibrinogen
3. Haptoglobin
4. Troponin I
[...]
A: Troponin I

Q: Which of the following agents inhibits factor Xa in-vivo?
1. Aprotinin
2. Epsilon aminocaproic acid
3. Rivaroxaban
4. Tranexamic acid
[...]
A: Rivaroxaban – free Xa & Xabound in complex inhibits
Extra: 1. Aprotinin – pancreatic trypsin inhibitor
2. Epsilon aminocaproic acid – synthetic inhibitor of the plasmin-plasminogen system
3. Rivaroxaban – free Xa & Xabound in complex inhibits
4. Tranexamic acid – binds lysine on plasminogen and presvents it being converted to plasmin

Q: Regarding the central venous pressure wave:
1. The “a wave” represents tricuspid valve closure
2. The “v wave” follows the “y descent”
3. The “y descent” occurs on the descent of the “a wave”
4. The “y descent” occurs on the descent of the “v wave”
[...]
A: The “y descent” occurs on the descent of the “v wave”

Q: Regarding clinical ultrasound, which statement is correct:
1. Attenuation of the signal can be reduced by high frequency (>20 MHz) transducers
2. Image resolution is improved at lower frequencies
3. Longer wavelengths result in greater tissue penetration
4. Penetration of tissues is directly proportional to the wave frequency
[...]
A: Longer wavelengths result in greater tissue penetration

Q: Which of the following statements is MOST true for West's zone 3 of the lung?
1. Alveolar pressure exceeds arterial pressure
2. Blood flow is determined by arterial pressure minus venous pressure
3. Venous pressure is lower than alveolar pressure
4. Venous pressure exceeds arterial pressure
[...]
A: Blood flow is determined by arterial pressure minus venous pressure

Q: Which of the following is a partial agonist at the mu (μ) opioid receptor?
1. Buprenorphine
2. Codeine
3. Fentanyl
4. Pethidine
[...]
A: Buprenorphine

Q: During turbulent flow:
1. Gas penetration to the airways is higher than laminar flow
2. The driving pressure is proportional to the density of the gas
3. The driving pressure is unrelated to the gas flow rate
4. The Reynolds number is low
[...]
A: The driving pressure is proportional to the density of the gas

Q: Regarding tranexamic acid:
1. Administration requires dose reduction in hepatic impairment – renally excreted 95% unchanged
2. It can only be given intravenously – topically in dentistry
3. It competes for lysine binding sites on plasmin and plasminogen, blocking their interaction with fibrin
4. It inhibits the fibrinolytic activity of plasminogen-streptokinase complex
[...]
A: It competes for lysine binding sites on plasmin and plasminogen, blocking their interaction with fibrin

Q: Of the following partial pressures at sea level (760 mmHg), which is the HIGHEST in expired air?
1. Carbon dioxide
2. Nitrogen
3. Oxygen
4. Water
[...]
A: Nitrogen

Q: In a normal 70 kg adult, the left ventricular volume immediately prior to opening of the aortic valve is:
1. 40 ml
2. 70 ml
3. 140 ml
4. 180 ml
[...]
A: EDV = 140 ml

Q: Which volume best approximates vital capacity in a healthy adult?
1. 2400 ml
2. 3500 ml
3. 4700 ml
4. 5900 ml
[...]
A: 4700 ml

Q: Sildenafil is used for:
1. Its dromotrophic action
2. Its inotropic action
3. Its natriuretic action
4. Its vasodilatory action
[...]
A: Its vasodilatory action

Q: Regarding the molecular configuration of Foetal haemoglobin (Hb F):
1. Contains beta chains with valine substituted for glutamic acid
2. Contains iron in the Ferric form
3. Contains two alpha and two delta polypeptide subunits
4. Contains two alpha and two gamma polypeptide subunits
[...]
A: Contains two alpha and two gamma polypeptide subunits
Extra: 1. Contains beta chains with valine substituted for glutamic acid (Sickle cell)
2. Contains iron in the Ferric form (metHb)
3. Contains two alpha and two delta polypeptide subunits (Variant of HbA, normal)
4. Contains two alpha and two gamma polypeptide subunits

Q: Which of the following has the HIGHEST osmolality?
1. 0.9% saline
2. 4% albumin
3. 5% dextrose
4. Hartmann’s solution
[...]
A: 0.9% saline
Extra: 1. 0.9% saline 300mOsm/kg
2. 4% albumin 250 mOsm/kg (higher tonicity)
3. 5% dextrose 278
4. Hartmann’s solution (Lactated Ringers) 274

Q: The normal pH of arterial blood is 7.4. This translates to a hydrogen ion concentration of:
1. 10 nmol/L
2. 40 nmol/L
3. 70 nmol/L 7.15
4. 100 nmol/L
[...]
A: 40 nmol/L

Q: Which of the following gastrointestinal secretions has the HIGHEST pH?
1. Bile 7-8
2. Gastric secretions 2.3-3.5
3. Pancreatic juice
4. Saliva
[...]
A: Pancreatic juice

Q: How much heparin is 1 mg of protamine able to inhibit?
1. 100iU
2. 200 iU
3. 300 IU
4. 400 IU
[...]
A: 100iU

Q: What percentage of renal blood flow is distributed to the medulla under normal physiological conditions?
1. 5 to 10%
2. 10 to 20%
3. 40 to 50%
4. 85 to 90%
[...]
A: 5 to 10%

Q: Thiopentone is MOSTLY associated with which of the following adverse effects?
1. Adrenocortical suppression
2. Bradycardia and metabolic acidosis
3. Exacerbation of acute intermittent porphyria
4. Raised intracranial pressure
[...]
A: Exacerbation of acute intermittent porphyria

Q: The total blood volume is distributed such that the majority is within the:
1. Arteries
2. Pulmonary circulation
3. Systemic capillaries
4. Veins
[...]
A: Veins
Extra: (Kam and Power also has some numbers on this)

Q: What is the mechanism of action of clopidogrel?
1. Adenosine diphosphate (ADR) receptor antagonist
2. Adenosine reuptake inhibitor
3. Cyclooxygenase (COX) inhibitor
4. Glycoprotein llb/llla receptor antagonist
[...]
A: Adenosine diphosphate (ADR) receptor antagonist

Q: What is the mechanism of action of metoclopramide?
1. Anticholinergic
2. Antihistamine
3. Antidopamine
4. Serotonin (5-HT2) antagonist
[...]
A: Antidopamine

Q: What is the mechanism of action of phentolamine?
1. Alpha adrenoreceptor antagonist
2. Centrally acting alpha 2 agonist
3. Direct vasodilator
4. Potassium channel activator
[...]
A: Alpha adrenoreceptor antagonist

Q: Digoxin toxicity is increased by:
1. Hypermagnesaemia
2. Hypocalcaemia
3. Hypokalaemia
4. Hyponatraemia
[...]
A: Hypokalaemia
Extra: In states of hypokalemia, or low potassium, digoxin toxicity is actually worsened because digoxin normally binds to the ATPase pump on the same site as potassium. When potassium levels are low, digoxin can more easily bind to the ATPase pump, exerting the inhibitory effects

Q: Adenosine is a naturally occurring nucleoside that:
1. Causes an increase in pulmonary vascular resistance
2. Has a negative inotropic effect
3. Has a plasma half-life of 2 minutes
4. Requires dose adjustment in end-stage renal failure
[...]
A: Has a negative inotropic effect
Extra: 1. Causes an increase in pulmonary vascular resistance – decreases PVR
2. Has a negative inotropic effect
3. Has a plasma half-life of 2 minutes – <10sec
4. Requires dose adjustment in end-stage renal failure – metabolized in RBC by phosphorelation

Q: Frusemide has the following effect:
1. Acutely increases serum urate concentration
2. Increases the production of cerebrospinal fluid
3. Produces a hypertonic urine
4. Pulmonary and systemic vasodilation
[...]
A: Pulmonary and systemic vasodilation

Q: A right shift of the oxygen-haemoglobin dissociation curve can be caused by:
1. A PaC02 of 55 mmHg
2. A decreased 2,3-diphosphoglycerate
3. A decreased hydrogen ion concentration
4. An increased proportion of Haemoglobin F
[...]
A: A PaC02 of 55 mmHg

Q: Phase 0 of depolarisation in a cardiac pacemaker cell occurs due to:
1. Equalisation of potassium efflux and calcium influx
2. Potassium efflux exceeding calcium influx
3. The onset of calcium influx
4. The opening of fast sodium channels
[...]
A: The onset of calcium influx

Q: The actions of vitamin D include:
1. Elimination of calcium from the gut
2. Enhanced absorption of phosphate from the gut
3. Excretion of phosphate from the kidney
4. Inhibition of osteoblast activity
[...]
A: Enhanced absorption of phosphate from the gut
Extra: 1. Elimination of calcium from the gut – increases
2. Enhanced absorption of phosphate from the gut
3. Excretion of phosphate from the kidney – increases phosphate reabsorption
4. Inhibition of osteoblast activity – increases blast activity

Q: Total body water is approximately equal to:
1. 0.07 L/kg
2. 0.21 L/kg
3. 0.60 L/kg
4. 1.00 L/kg
[...]
A: 0.60 L/kg
Extra: 0.6 x 70kh = 42L

Q: The resting membrane potential of a large peripheral nerve fiber is:
1. -40mV
2. -60mV
3. -70mV
4. -90mV
[...]
A: -70mV

Q: A characteristic of enantiomers is they:
1. Are linked by a double bond
2. Are superimposable
3. Exhibit tautomerism
4. Have a centre of chirality
[...]
A: Have a centre of chirality
Extra: 1. Are linked by a double bond
2. Are superimposable – they are mirror images of eachother
3. Exhibit tautomerism – structural isomerism – midazolam wh ionized at pH4 but at pH 7.4 changes into an unionized ring, lipid solb to cross BBB
4. Have a centre of chirality

Q: Which of the following organs has the HIGHEST total blood flow?
1. Brain 750ml/min
2. Heart 250ml/min
3. Kidneys 1200ml/min
4. Liver 1500ml/min
[...]
A: Liver 1500ml/min

Q: What type of receptors are opioid receptors?
1. G protein coupled receptors
2. Intracellular receptors
3. Ligand gated ion channels
4. Tyrosine kinase receptors
[...]
A: G protein coupled receptors

Q: Erythrocytes:
1. Are approximately 20 pm in diameter and 7 pm in thickness
2. Are flexible and easily deformed
3. Provide about 30% of the buffering power of whole blood
4. Survive in the circulation for an average of 160 days
[...]
A: Are flexible and easily deformed

Q: Which of the following adverse effects is associated with propofol?
1. Adrenocortical suppression
2. Bradycardia and metabolic acidosis
3. Exacerbation of acute intermittent porphyria
4. Raised intracranial pressure
[...]
A: Bradycardia and metabolic acidosis
Extra: - Bradycardia and metabolic acidosis
- Resets baroreceptor reflex
- Metabolic acidosis –PPF infusion syndrome

Q: Intracellular calcium ion concentration in a resting cell is most likely in the range of:
1. 0.0001 to 0.001 mmol/L
2. 0.001 to 0.01 mmol/L
3. 0.01 to 0.1 mmol/L
4. 0.1 to 1.0 mmol/L
[...]
A: 0.0001 to 0.001 mmol/L

Q: Central chemoreceptors:​
1. Are in the brainstem, in close proximity to the glossopharyngeal and vagus nerves
2. Are located outside of the blood brain barrier
3. Are sensitive to pO2
4. Respond to a change in pCO2 over several hours
[...]
A: Are in the brainstem, in close proximity to the glossopharyngeal and vagus nerves

Q: Noradrenaline:
1. Has a half-life of 20 minutes
2. Increases blood flow to the pregnant uterus
3. Is a derivative of tyrosine
4. Must be protected from light
[...]
A: Is a derivative of tyrosine

Q: The structure of aldosterone is best described as a:
1. Cholesterol derivative
2. Single chain polypeptide
3. Two chain polypeptide
4. Tyrosine derivative
[...]
A: Cholesterol derivative

Q: Effects of insulin include the stimulation of:
1. Beta oxidation of fatty acids
2. Glycogenolysis
3. Hormone sensitive lipase
4. Lipoprotein lipase
[...]
A: Lipoprotein lipase
Extra: Lipoprotein lipase (LPL, red) is synthesized primarily by skeletal muscle and adipose tissue. It is secreted into the interstitial fluid then diffuses to nearby capillaries. It becomes attached to large, branched proteins (haparan sulfate proteoglycans (HSPGs) bound to the inner capillary surface (not shown). Its function is to hydrolyze triglycerides (lavender) from lipoproteins into free fatty acids (FFA) and monoglycerides

Q: Regarding acyclovir, which of the following is MOST true?
1. It binds to cell membrane receptors leading to the induction of resistance of that cell to viral infection
2. It inhibits the release of viral particles from infected cells
3. It inhibits viral reverse transcriptase
4. It requires viral thymidine kinase for activation
[...]
A: It requires viral thymidine kinase for activation

Q: Which of the following local anaesthetics is the MOST cardiotoxic?
1. Bupivacaine
2. Lignocaine
3. Prilocaine
4. Ropivacaine
[...]
A: Bupivacaine
Extra: katzung, pp 426, brunton, pp 377)most local anesthetics can block na+ channels in cardiac muscle and thus they can depressautomaticity and conduction. at very high doses they can also depress contractility, likely byblocking ca++ channels. bupivacaine is more cardiotoxic than most other local anesthetics,apparently because the drug dissociates much more slowly than other local anesthetics duringdiastole, so a significant fraction of na+ channels at physiological heart rates remains blockedwith bupivacaine at the end of the diastole. bupivacaine induced cardiac toxicity is very difficult totreat and is enhanced by coexisting acidosis and hypoxemia)

Q: Coronary perfusion of the left ventricle is dependent on:
1. Diastolic pressure minus left ventricular end-systolic pressure
2. Diastolic pressure time index
3. Mean arterial pressure minus left ventricular end-systolic pressure
4. Systolic pressure time index
[...]
A: Diastolic pressure minus left ventricular end-systolic pressure

Q: Drugs that are eliminated by a first-order process exhibit the following kinetics:
1. A constant proportion of drug is eliminated per unit time
2. A constant quantity of drug is eliminated per unit time
3. The clearance is directly related to the time constant (Tau)
4. The elimination rate constant is directly related to the half-life
[...]
A: A constant proportion of drug is eliminated per unit time

Q: Which of the following exhibits the HIGHEST potency at the a1 adrenoreceptor?
1. Clonidine
2. Dopamine
3. Metaraminol
4. Noradrenaline
[...]
A: Noradrenaline
Extra: (Clonidine a2/a1 = 200:1)

Q: What is the mechanism of action of carbapenem antibiotics?
1. Inhibition of bacterial cell wall synthesis
2. Inhibition of bacterial DNA synthesis
3. Inhibition of bacterial ribosomes
4. Inhibition of folate metabolism
[...]
A: Inhibition of bacterial cell wall synthesis

Q: Ketamine has the following pharmacodynamic effect:
1. Antisialagogue
2. Bronchoconstriction
3. Decreased intracranial pressure
4. Direct myocardial depression
[...]
A: Direct myocardial depression

Q: Which of the following methods is used to measure plasma volume?
1. Chromium labelled red blood cells
2. Deuterium oxide – TBW
3. Inulin – ECF
4. Protein bound dyes (e.g. Evans blue)
[...]
A: Protein bound dyes (e.g. Evans blue)

Q: Which of the following neuromuscular junction blocking drugs can induce a Phase II Block?
1. Cisatracurium
2. Rocuronium
3. Suxamethonium
4. Vecuronium
[...]
A: Suxamethonium
Extra: Mechanism of Phase II Block. With increasing doses of succinylcholine (i.e., a large single dose, repeated doses, or a continuous infusion), a phase II block may occur. Continuous activation of acetylcholine receptors leads to ongoing shifts of sodium into the cell and potassium out of the cell.

Q: Metformin exerts its hypoglycaemic effect by:
1. Increasing insulin secretion by pancreatic beta cells
2. Inhibiting alpha-glucosidase enzymes
3. Inhibiting gluconeogenesis and delaying glucose absorption from the gastrointestinal tract
4. Stimulating pancreatic alpha cells to release insulin
[...]
A: Inhibiting gluconeogenesis and delaying glucose absorption from the gastrointestinal tract

Q: Oxytocin has the following effects in-vivo:
1. Gastric mucosal protection
2. Hyponatraemia
3. Systemic hypertension
4. Tocolysis
[...]
A: Hyponatraemia
Extra: Oxytocin is structurally similar to anti-diuretic hormone (ADH, vasopressin) and both are released from the posterior pituitary. Onset is ~1 min when given IV, and t1/2 is ~5 min.
- The most common side effect is hypotension
- Prolonged infusions can result in water retention and hyponatremia due to cross reactivity with the vasopressin receptor, giving rise to water intoxication.
Symptoms include AMS, headache, muscle cramps and nausea. Treatment is to stop the infusion and fluid restrict.

Q: Acetylsalicylic acid inhibits the cyclo-oxygenase enzyme resulting in:
1. Bronchodilation
2. Increased leukotriene synthesis
3. Increased prostaglandin synthesis
4. Reversible platelet inhibition
[...]
A: Increased leukotriene synthesis
Extra: - COX inhibitition
- Increases lipooxygenase pathway

Q: The end-systolic pressure volume relationship (ESPVR) of the cardiac pressure-volume diagram is a measure of:
1. Afterload
2. Contractility
3. Diastolic function
4. Preload
[...]
A: Contractility