MCQ Paper from August 2015

MCQs Primary Exam - August 2015

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What is this MCQ collection?

This paper has been RECONSTRUCTURED from MCQs remembered by those sitting the Aug 2015 ANZCA Anaesthetic Primary exam in Australia and New Zealand. Not all questions and not all options have been remembered, and mostly the wording is not entirely correct. As this is a remembered list, there will be some errors, so the MCQs here could have 0, 1, or even 2 correct options in the versions here. More details about past MCQs are available on the Black Bank Wiki (Password details on are the home page)

Instructions on Actual Paper

Each MCQ has a question stem followed by 5 options labelled A. through to E.
For each question: 'Select the single best answer'
( NB: Some options are missing here as this paper has been reconstructured from remembered MCQs. Letters for missing options are mostly left out.)

1. Hb is a good buffer because:

      A. Large concentration in blood

      B. It contains 38 imidazole groups on histidine residues

      C. Plasma protein pKa is near pH of blood

      D. ?Deoxy haemoglobin is more acidic than oxyhaemoglobin

2. Which ONE of the following is classified as a "strong ion"?

      A. phosphate

      B. chloride

      C. albumin

      D. ?

3. Bicarbonate buffer is the most important extracellular buffer system because:

      A. CO2 and HCO are present in large concentrations

      B. Of carbonic anahydrase

      C. CO2 is delt with by the lung and HCO3 by the kidneys

      D. Of the Henderson Hasselbach equation

4. Pure water at pH 7 has hydrogen ion concentration of:

      A. 0 nanomol/L

      B. 40 nanomol/L

      C. 70 nanomol/L

      D. 100 nanomol/L

      E. 1000 nanomol/L

5. Which ONE of these increases vasopressin (ADH) secretion?

      A. Increase in arterial BP

      B. Moving to erect position

      C. Increased pressure veno­atria junction

      D. Reduced effective oncotic pressure plasma

      E. Increase ECF volume

6. Hartmann's solution contains:

      A. 154 mmol/L Na+

      B. 2 mmol/L Ca++

      C. 2 mmol/L K+

      D. 154 mmol/L Cl­

      E. 3 mmol/L Mg++

7. Cardiogenic shock is the result of:

      A. decreased arterial pressure

      B. cardiac arrhythmia

      C. decreased stroke volume

      D. decreased venous return

      E. increased venous pressure

8. Administration of a large volume of Normal Saline (0.9%) is likely to produce:

      A. no change in acid base status

      B. hyperchloraemic metabolic acidosis

      C. hypochloraemic metabolic acidosis

      D. hyperchloraemic metabolic alkalosis

      E. hypochloraemic metabolic alkalosis

9. Torsades de Pointes:

      A. results from supraventricular tachycardia

      B. more likely in bradycardia in susceptible pts

      C. treated with 150mg of amiodarone over 30 minutes

      D. results from HYPERmagnesaemia

10. Carotid sinus massage is used in supraventricular tachycardia to:

      A. Decrease sympathetic stimulation of SA node

      B. Increase vagal outflow to SA node

      C. Decrease sympathetic stimulation to AV node

      D. Increase vagal outflow to AV node

      E. Decrease conductivity

11. Peripheral vascular resistance:

      A. can be calculated from mean arterial pressure, pulmonary wedge pressure

      B. units are dynes·s·cm-5

      C. equals driving pressure MULTIPLIED by Cardiac output

12. When a healthy young person loses 20% of their blood volume:

      A. diastolic pressure decreases

      B. ADH secretion increases

      C. cerebral blood flow decreases

      D. urinary sodium excretion increases

13. What is the INITIAL response on moving from supine to erect position?

      A. Increased SV

      B. Increased CO

      C. Increased TPR

      D. Increased MAP

      E. Increased CVP

14. Which ONE of the following would cause a decrease in fluid movement from a capillary to the interstitium?

      A. Closure of pre-capillary sphincters

      B. Increased plasma oncotic pressure

      C. Decreased MAP

      D. Decreased venous pressure

      E. Sympathetically­ mediated increased arteriolar tone

15. What is the main component of surfactant?

      A. dipalmitoyl phosphatidylcholine

      B. ??

      C. ?

16. These drugs are safe in porphyria EXCEPT for:

      A. propofol

      B. atropine

      C. suxamethponium

      D. droperidol

      E. diazepam

17: Normal CVS physiology in the elderly:

      A. Increased arterial elasticity

      B. Increased DBP

      C. Increased pulse pressure

      D. Increased ventricular compliance

      E. Faster diastolic filling time

18: Ankle venous pressure in adult in standing position is: (in mmHg)

      A. 4.5

      B. 9

      C. 45

      D. 90

      E. 150

19. The lowest percentage of shunt where a pO2 of 100mmHg CANNOT be achieved with increasing FiO2 is:

      A. 15%

      B. 25%

      C. 35%

      D. 45%

      E. 55%

20. Regarding the cell membrane Na+-K+ ATPase pump

      A. ?ADP ?ATP production ...

      B. is electrogenic

      C. 3K+ out, 2Na+ in

21. Which ONE has the LOWEST intracellular concentration

      A. Na+

      B. HCO3­

      C. Cl­

      D. Mg++

      E. Ca++

22. Sugammadex provides effective reversal of:

      A. Rocuronium

      B. Vecuronium

      C. Rocuronium and vecuronium

      D. Rocuronium, vecuronium and pancuronium

23. A pulmonary capillary pressure trace has:

      A. a waves, but not c or v waves

      B. c waves, but not a or v waves

      C. v waves, but not a or c waves

      D. a and v waves, but not c

      E. a, c, and v waves

24. Overestimation of SaO2 occurs with:

      A. Carboxyhaemoglobin

      B. Fluorescein

      C. Hyperbilirubinaemia

      D. HbF

      E. HbS

25. Which ONE of the following CANNOT be measured with spectrophotometry?

      A. N2

      B. volatiles

      C. C02

      D. N20

26. What inhibits insulin?

      A. Glucagon

      B. Alpha-2 Agonists

27. In the foetal circulation ...

      A. Blood from the SVC flows into the LA via the foramen ovale

      B. Blood in the umbilical vein is 40% saturated with oxygen

      C. Blood from the IVC flows to the head vessels via the ductus arteriosus

      D. Ductus venosus drains directly into the IVC

      D. All haemoglobin is foetal haemoglobin

28. the first two hours of fasting...

      A. Glucagon is increased

      B. Proteolysis is the main source for glucose

      C. Insulin is increased

      D. Hormone sensitive lipase is activated

29. Isotonic contraction of a skeletal muscle fibre is NOT associated with a change in distance between:

      A. Sarcomere length

      B. A bands

      C. I bands

      D. Z lines move closer together

      E. M lines move closer together

30. Haemoglobin (Hb) structure is

      A. 2 porphyrin rings with 2 Fe3+ ions

      B. 4 porphyrin rings with 4 Fe3+ ions

      C. 2 porphyrin rings qith 2 Fe2+ ions

      D. 4 porphyrin rings with 4 Fe3+ ions

      E. 4 porphyrin rings with 4 Fe 2+ ions

31. Which ONE of the following is TRUE about tissue macrophages:

      A. half life <24 hours (or other incorrect stem)

      B. derived from circulating lymphocytes

      C. In the liver they are called histiocytes

      D. not found in the brain

      E. are important in the first line defence against bacteria

32. The liver produces all of the following EXCEPT:

      A. von Willebrand factor

      B. Albumin

      C. Antithrombin III

      D. Fibrin

      E. Cholesterol

33. In pregnancy, the increase in ventilation:

      A. Occurs in 2nd trimester of pregnancy onwards

      B. Is primarily due to an increase in oestrogen

      C. Is primarily due to an increase in progesterone

      D. Represents a 10% increase in ventilation

      E. Is mainly due to an increase in respiratory rate

34. The most immediate source of energy in muscle is

      A. ATP in all muscle cell types

      B. Creatine phosphate in skeletal muscle, ATP in cardiac and smooth muscle

      C. Creatine phosphate in skeletal and cardiac muscle, ATP in smooth muscle

      D. Creatine phosphate in cardiac muscle, ATP in skeletal and smooth muscle

      E. Creatine phosphate in all muscle cell types

35. Similarities between cardiac and skeletal muscle EXCEPT:

      A. Resting membrane potentials

      B. Striations

      C. Nuclei

      D. ?

36. Regarding REM sleep:

      A. Easily rousable state

      B. Always comes after NREM

      C. becomes more frequent toward end of sleep cycle

37. Increased sympathetic activity causes

      A. Increased gastrointestinal peristalsis

      B. Pulmonary vasodilation

      C. Splanchnic vasodilatation

      D. Miosis

      E. Piloerection

38. Regarding parasympathetic autonomic innervation:

      A. Post ganglionic fibres are on the walls of viscera

      B. Post ganglionic fibres are relatively long

      C. Pre ganglionic neurotransmitters are acetylcholine and noradrenaline

      D. Commonly affected by spinal block

      E. Causes constriction of detrusor muscle and urinary sphincter

39. Which ONE of the following is NOT a mechanoreceptor:

      A. Golgi tendon organ

      B. Pacinian corpuscles

      C. Meissner’s corpuscles

      D. Merkel’s discs

      E. Ruffini endings

      ?F. Krause Bulbs

40. Cerebral blood flow regulation is MOST affected by

      A. pCO2

      B. pO2

      C. pH

      D. ?

      E. ?

41. With respect to calcium absorption:

      A. Inhibited by Protein/lactose

      B. Less than 10% ingested is absorbed

      C. Facilitated by phosphate

      D. Requires calcium-binding mucosal protein

      E. Occurs due to facilitated diffusion in the upper small bowel

42. With respect to vitamin B12 deficiency:

      A. B12 is absorbed in terminal ileum

      B. Due to a lack of ingested intrinsic factor

      C. B12 is destroyed by gastric acid

      D. Due to increased erythropoesis

      E. Due to a lack of vitamin B12 intake for a few weeks

43. Which ONE is NOT a derived SI unit:

      A. Joule

      B. Litre

      C. Pascal

      D. Ampere

      E. Newton

44. All of the following can be used to measure the concentration of a volatile agent EXCEPT:

      A. Paramagnetic analysis

      B. Raman spectroscopy

      C. Mass spectrometry

      D. Infrared analysis

45. No details

46. The effects of IPPV on the renal system:

      A. decreased renal peritubular pressure secondary to decreased venous pressure

      B. decresed sodium reabsorbtion

      C. increased ANP secretion

      D. decreased aldosterone secretion

      E. increased SNS activity

47. Atrial natriuretic peptide (ANP):

      A. Decreases Na+ reabsorption in proximal tubule

      B. Increases Na+ reabsorption somewhere

      C. Decreases Na+ reabsorption proximal tubules and distal tubules

      D. Decreases reabsorption in ascending loop of henle

      E. Relaxes afferent arteriole

48: Regarding the sympathetic nervous system:

      A. Increases Na+ reabsorption in the proximal tubule

      B. Increases efferent arteriole tone to decrease GFR

      C. Decreases renin release

      D. ...?collecting ducts ...

49. The macula densa is an example of a:

      A. Baroreceptor

      B. Osmoreceptor

50. I?n the presence of ADH, the highest proportion of water reabsorption occurs in the:

      A. proximal convoluted tubule

      B. loop of Henle

      C. distal convoluted tubule

      D. cortical collecting duct

      E. medullary collecting duct

51. Increased tubular reabsorption in response to increased glomerular filtration is called:

      A. Tubuloglomerular feedback

      B. Autoregulation

      C. Tubuloglomerular balance

      D. Pressure diuresis

      E. Pressure naturesis

52. In order to excrete an osmotic load of 600 mOsm/day, the minimum daily urine output is:

      A. 10 mls

      B. 100 mls

      C. 500 mls

      D. 1000 mls

      E. 1200 mls

53. Role of ADH:

      A. Inserts aquaporin channels into basolateral membrane of collecting ducts

      B. Acts on vascular V1a receptors

      C. Reabsorbs Na+ and H2O

54. Regarding dose-response curve:

      A. Line from 20 to 80% is straight

      B. ?

55. Regarding PGF2alpha

      A. Pulmonary hypertension

      B. ?

56. Gas flow is less likely to be turbulent with

      A. Decreased viscosity

      B. Increased temperature

      C. Increasing the density

      D. Increasing the radius bifurcation

57. Pulmonary Vascular resistance

      A. Same as Systemic vascular resistance as both sides of the heart receive the same cardiac output

      B. Influenced only by alveolar oxygen tension

      C. Increased by increasing airway pressures

      D. decreased with increasing lung volumes

      E. Calculated by multiplying pressure drop x blood flow

58. An increase in venous admixture has most effect by an increase in

      A. Alveolar dead space

      B. West's zone 3

      C. A­a gradient

      D. PaCO2

      E. Mixed venous PO2

59. Regarding muscles of respiration

      A. Diaphragm moves 1 cm in normal breathing

      B. Diaphragm can be an accessory muscle of expiration

      C. Internal intercostal muscles are inspiratory

      D. 50% of normal breathing is due to intercostals

      E. Sternocleidomastoid is an accessory muscle of inspiration that acts by raising the 1st rib

60. The effect of severe hypercapnia includes:

      A. Increased levels circulating catecholamines in plasma

      B. Increased urine output

      C. No effect on myocardial contractility

      D. Shift of OHDC to the LEFT

      E. Reduce systemic blood pressure

61. Regarding Hypoxic Pulmonary Vasoconstriction:

      A. Solely mediated by alveolar PO2

      B. Biphasic with INCREASE at 40mins following prolonged hypoxia

      C. Requires intact neural connections

      D. Mediated by pulmonary vein smooth muscle contraction

      E. Unaffected by inhaled nitric oxide & prostacyclin

62. Which is the most anterior (? in a paravertebral block?)

      A. anterior surface of lamina

      B. supraspinous ligament

      C. interspinous ligament

63. Which ONE of the following devices is most commonly used in breath-to-breath analysis of oxygen in anaesthetic breathing circuits?

      A. Paramagnetic oxygen analyser

      B. Clarke electrode

      C. Fuel cell

      D. Gas chromatography

      E. Mass spectroscopy

64. What is the lowest PERCENT of shunt needed NOT to be able to achieve paO2 100?

      A. 15%

      B. 25%

      C. 35%

      D. 45%

      E. 50%

65. Neonatal tidal volume (mls per kg) is:

      A. 3mls

      B. 7mls

      C. 15mls

      D. 20mls

66. Where is endothelin-1 made?

      A. Endothelium

      B. Liver

      C. ?

      D. ?

67. Which ONE is true in neonates??

      A. TBW is 85%

      B. ?

68. No details

69. In chronic obstructive airways disease

      A. Increased total lung capacity

      B. increased slope of effort dependent portion

      C. increased vital capacity

      D. reduced compliance

70. Brown fat :

      A. Metabolism is autonomically mediated

      B. Mediates its effects by insulation of neck vessels

      C. ?

      D. Produces heat by uncoupling of oxidative phosphorylation outside of the mitochondria

      E. Results in the production of large amounts of ATP and heat

71. Inability for anaesthetised patients to generate heat due to

      A. Insufficient brown fat

      B. skeletal muscle relaxation

      C. Dilated peripheral vessels

72. Adenosine and amiodarone are both

      A. Class three anti­arrhythmics

      B. Half life 10secs and 10 mins respectively

      C. Can be used for SVT and VT

      D. Prolong AV node conduction and PR interval

      E. Blocks Na channels

73. Signs of digoxin overdose

      A. Visual disturbance

      B. PR prolongation

      C. QT lengthening

      D. Constipation

74. Esmolol:

      A. Non selective

      B. More lipid soluble than propanolol

      C. Intrinsic sympatho mimetic

      D. Broken down by pseudocholinesterase

      E. Peak haemodynamic effects in 5 minutes

75. Phenoxybenzamine acts at its receptor via:

      A. Competitive antagonism

      B. Alpha-1 selective

      C. Acts via an intermediate

      D. ncreased intracellular calcium

76. Which agent is MOST effective in the treatment of motion sickness

      A. D2 blockers

      B. 5HT-3 blockers

      C. Antihistamines

      D. Cannabinoids

      E. Butyrophenones

77. Which antihypertensive is contraindicated in pregnancy

      A. Clonidine

      B. Ramipril

      C. Methyldopa

      D. Hydralazine

78. The chemoreceptor trigger zone (CTZ) has:

      A. 5HT-3 and D2 receptors

      B. ACh and H1 receptors

      C. ?

      D. ?

79. When used for myocardial ischaemia, intravenous nitroglycerine (GTN):

      A. Dilates coronary arterioles

      B. Reduces myocardial oxygen demand by reducing LVEDP and reducing mean arterial pressure

      C. Is ineffective when used in doses <5 mcg/kg/min

      D. Is associated with methaemoglobinaemia when infused for prolonged periods

      E. ?

80. Milrinone:

      A. Decreases pulmonary vascular resistance

      B. Acts by reducing cyclic AMP levels via phosphodiesterase III inhibition

      C. Is ineffective when given orally

      D. Is associated with thrombocytopenia in chronic use

      E. Increases systemic vascular resistance

81. All of the below act via increasing cAMP EXCEPT:

      A. Digoxin

      B. Glucagon

      C. Adrenaline

82. No details

83. Which of the following is MOST likely to cause anti-cholinergic syndrome?

      A. Scopolamine

      B. Hyoscine

      C. Atropine

      D. Glycopyrrolate

84. What is the mechanism of action of tranexamic acid?

      A. Inhibits inactivation of plasminogen

      B. ?

85. Dabigatran :

      A. Has oral bioavailability of 80%

      B. Has a half life of 8-12 hours

      C. Requires a 75% dose reduction in renal failure

      D. ? .

86. Frusemide :

      A. Has 30% (?or 35%) protein binding

      B. Has an elimination half-life less than 1 hour

      C. 90% excreted in bile

      D. Increases rate of secretion in the renal tubules

87. ... Q about glucagon pharmacology - no further details...

88. No details

89. How long after commencing a propofol infusion must it be used by:

      A. 6 hrs

      B. 12 hrs

      C. 18 hrs

      D. 24 hrs

      E. 30 hrs

90. Which of the following is NOT correct:

      A. The pka of an agent is inversely proportional to the pH of the solution

      B. The closer the pka to the pH, the bigger the change in ionised portion per given change in pH

      C. Thiopentone will have an increase in the unionised portion in acidosis

      D. Opioids (or Morphine) will have a decrease in ionised portion in alkalosis

      E. The excretion of salicylates is increased by acetazolamide

91. No details

92. Which ONE of the following will readily cross the blood brain barrier ?

      A. Suxamethonium

      B. Dopamine

      C. Propanolol

      D. Edrophonium

      E. Glycopyrrolate

93. No details

94. No details

95. No details

96. Propofol TCI using Marsh model (in 'Diprifusor') is affected by which of the following parameters:

      A. Weight

      B. Height

      C. Age

      D. Weight and age

      E. Weight and height

97. Regarding drugs with high hepatic clearance:

      A. Clearance is decreased with low hepatic blood flow

      B. Clearance does not change with high hepatic blood flow

98. Regarding rectal administration of drugs

      A. Rectal indomethacin does not cause gastric symptoms

      B. Rectal administration is predictable and effective.

      C. Superior haemorrhoidal vein absorption results in hepatic first pass metabolism

      D. Paracetamol cannot be given rectally

99. No details

100. No details

101. No details

102. No details

103. Which ONE of the following about inhalational agents is true?

      A. Sevoflurane has chlorine and fluorine atoms

      B. Sevoflurane has a lower oil gas solubility than desflurane

      C. Sevoflurane has a higher blood gas solubility than desflurane

104. No details

105. An effect of isoflurane at 1 MAC during spontaneous ventilation:

      A. Decreased RR

      B. Decreased TV

      C. Normal response to PO2 Increased PVR

      D. Increased airway resistance

106. Regarding toxic effects of inhalational anaesthetics:

      A. Sevoflurane metabolism produces TFA?

      B. Directly related to fluoride ion concentration causing nephrotoxicity

      C. Compound A is toxic in rats but not in humans.

107. A factor which does NOT affect rate of rise of the FA/FI ratio:

      A. Age

      B. MAC

      C. Cardiac output

      D. Solubility

108. A side effect 8.4% NaHCO3 administration is:

      A. Intracellular acidosis

      B. Rebound metabolic acidosis

      C. ... ?

109. No detail

110. No detail

111. Regarding thiopentone which ONE of these is INCORRECT:

      A. Decreases CMRO2 by up to 55%

      B. Lacks depression of airway reflexes and can cause cough

      C. ?

      D. ?

      E. Aspirin increases its free concentration

112. Ketamine is:

      A. A non competitive NMDA receptor antagonist


113 Which ONE of the following is NOT said to be safe in porphyria?

      A. Atropine

      B. Diazepam

      C. Propofol

      D. Droperidol

      E. Suxamethonium

114 Which ONE of the following is TRUE?

      A. Hartmann’s solution contains 150 mmol/L Na+

      B. Osmolality of Normal Saline is 308 mosm/L

      C. The pH of Normal Saline is 7.35­7.45

      D. Osmolality of Hartmann’s solution is 308 mosm/L

      E. Rapid infusion of Hartmann’s solution can cause lactic acidosis

115. Lignocaine:

      A. Over 50% unionised at pH 7.4

      B. Metabolism is dependent on liver blood flow

      C. ...

116. Ropivacaine:

      A. Is a pure R isomer

      B. Is an isomer of bupivacaine

      C. Provides more motor block than bupivacaine

      D. Has more toxicity than bupivacaine

      E. Has similar physico­chemical properties to bupivacaine

117. Which ONE is NOT a feature of local anaesthetic activity?

      A. Decreased in alkaline environment

      B. Dependent on uncharged molecules crossing the cell membrane

      C. Relies on action potential inhibition via sodium channel blockade

      D. Deeper block with increasing action potential frequency

      E. Small nerve fibres are more readily blocked than large fibres

118. Twenty mls of 0.5% Bupivacaine is inadvertently injected into an epidural vein over 30 seconds. The patient is 30 years old, pregnant and weighs 60kg. The most likely outcome would be:

      A. Tinnitus and sinus tachycardia

      B. Confusion and atrial ectopics

      C. Grand mal seizure and hypotension

      D. Focal seizure and torsades de pointes

      E. Muscle twitching and heart block

119. Which combination is CORRECT with regards to chemotherapeuthic agents and their side effects?

      A. Doxorubicin ­ pulmonary fibrosis

      B. Bleomycin ­ cardiomyopathy

      C. Cisplatin ­ pseudocholinesterase deficiency

      D. Cyclophosphamide ­ monoamine oxidase inhibition

      E. Vincristine ­ peripheral neuropathy

120. Regarding atracurium metabolism:

      A. Has an active metabolite.

      B. Ester metabolism is a minor pathway of elimination

      C. Metabolism is by Hofmann elimination which is pH dependent (‘Did not include temperature’)

121. Regarding plasma cholinesterase (pseudocholinesterase) enzyme:

      A. Inhibited 80% by dibucaine

      B. Concentration is increased in the third trimester of pregnancy

      C. Concentration is increased in the neonate

      D. Metabolises lidocaine

      E. Metabolises atracurium

122. Mivacurium:

      A. Is a steroidal muscle relaxant

      B. Offset occurs within 10 minutes after an ED95 dose

      C. Often requires reversal with an anticholinesterase

      D. Action may be prolonged by an anticholinesterase

123. No details

124. No details

125. Midazolam:

      A. Less lipid soluble than lorazepam

      B. Ampoule pH alkaline

      C. Metabolism by demethylation

      D. Significant first pass metabolism

      E. Water soluble at physiological pH

126. Phenytoin:

      A. Low protein binding

      B. Increases sodium conductance

      C. Can not be used as an antiarrhythmic

      D. Nystagmus sign of toxicity

127. Concerning midazolam, which ONE is NOT correct:

      A. It has a half­life of 3 hours

      B. It has no active metabolite

      C. Its oral bioavailability is 40 to 60%

      D. ... ? lipid solubility...

128: Characteristics of serotonin syndrome :

      A. Hypothermia

      B. Encephalopathy

      C. Muscle flaccidity

      D. Hypocalcaemia

129. Histamine:

      A. Sequestration in body and bound to platelets

      B. Bronchodilation via H1 receptors

      C. Augments nociception via action in central and peripheral nociceptors

      D. Potent inhibitor of gastric acid secretion

      E. Severe bradycardia with IV infusion of histamine

130. An axillary nerve block is performed. On incision, the patient complains of pain anterolateral forearm. Which nerve has been missed?

      A. Median n

      B. Ulnar n

      C. Axillary n

      D. Musculocutaneous n

      E. Radial n

131. A patient is in the lithotomy position for laparoscopy. What is NOT a risk factor for compartment syndrome in the lower leg?

      A. Obesity

      B. Male gender

      C. Lithotomy stirrups

      D. ?Past history of hypertension

      E. ?

132. No details

133. The context-sensitive half-time for alfentanil TIVA of 4 hours duration is?

      A. 30 mins

      B. 60 mins

      C. 90 mins

      D. 120 mins

      E. 260 mins

134. Regarding Fresh Frozen Plasma (FFP)

      A. Contains high sodium load

      B. Has no factor 5 or 8

      C. Had no albumin

      D. Needs to be cross matched before use

135. Regarding Morphine and Tramadol, which statement is true?

      A. Morphine is less potent than tramadol

      B. Tramadol is less efficacious than morphine

      C. Tramadol exhibits NMDA receptor antagonism

      D. Pruritus is a common side effect of tramadol

      E. Tramadol is a synthetic codeine derivative

136. One mg of alfentanil is administered to a pregnant woman at term for induction of anaesthesia prior to a caesarean section. What percentage of unionised drug (of alfentanil) will be present in the fetal blood?

      A. 1%

      B. 10%

      C. 50%

      D. 90%

      E. 99%

137. No details

138. No details

139. What one of these is NOT a catecholamine? (or not an inotrope?)

      A. Isoprenaline

      B. Dobutamine

      C. Dopamine

      D. Phenylephrine

      E. ?

140. ...something about what happens when BSL low?...

      A. Beta-1 stimulation of hepatic cells

      B. Beta-2 stimulation of hepatic cells

      C. Beta-2 stimulation of glucagon suppressing insulin

      D. Beta-2 stimulation inhibiting insulin

      E. Beta-2 stimulation causing insulin release

141. Potential side effects of high dose inhaled steroids include all of the following EXCEPT:

      A. Oral candidiasis

      B. HPA axis inhibition

      C. Osteopenia / osteoporosis

      D. Alopecia

      E. Dysphonia

142. What forms the posterior boundary of the epidural space?

      A. Anterior longitudinal ligament

      B. Anterior aspect of the laminae

      C. Supraspinous ligament

      D. Posterior aspect of the laminae

      E. Interspinous ligament

143. The LEFT recurrent laryngeal nerve:

      A. Motor nerve root from accessory nerve

      B. Hook around aorta anterior to arteriosus ligamentum

      C. Supply cricothyroid muscle

      D. Sensory supply to left pharyngeal mucosa

144. Cephalic vein, what is NOT correct

      A. Receive tributary from ulnar forearm

      B. Lateral to biceps tendon

      C. Pierces the clavipectoral fascia

      D. Valve at junction of cephalic and axillary vein

      E. travel between pectoralis major and deltoid muscle

145. A patient is anaesthetised with 50% oxygen, 50% nitrous oxide and 1% sevoflurane for a tracheostomy. When the surgeon cut into the trachea with diathermy, the ETT catches fire. In this case the nitrous oxide is acting as :

      A. fuel

      B. oxidising agent

      C. ?smoldering agent

      D. secondary ignition source by increasing conductivity of the gas mixture

      E. Smothering agent by increasing the distance between oxygen molecules

146. What type of Mapleson circuit is an Ayre's T­piece?

      A. D

      B. B

      C. A

      D. E

      E. F

147. What is the LOWEST value of microshock required to cause VF?

      A. 1 microAmp

      B. 10 microAmp

      C. 100 microAmp

      D. 1 mA

      E. 10 mA

148. Mobile phones are classified as what type of electrical appliance ?

      A. class I

      B. class II

      C. class III

      D. type BF

      E. type CF

149 A substance above its critical temperature:

      A. May exist in either its liquid or solid state

      B. May exist in either liquid or gas state

      C. may exist in either liquid or vapour state

      D. has a latent heat of vaporisation of zero

      E. the pressure within a container is not dependent on the volume of the container

150 Regarding disinfection:

      A. removal of micro­organisms and unwanted matter from contaminated materials

      B. prevention of microbial contamination

      C. complete destruction of all microorganisms including spores

      D. inactivation of non­sporing organisms using thermal or chemical means

      E. Occurs before decontamination and sterilisation