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Basic Sciences: Anatomy

1. What is the distance between the Carina and the Left Upper Lobe?
A. 1 cm
B. 3 cm
C. 5 cm
D. 7 cm
E. 10 cm

2. The musculocutaneous nerve is responsible for:
A. Forearm pronation
B. Wrist flexion
C. Thumb abduction
D. Forearm flexion.

3. At the confluence of the posterior, middle and anterior mediastinum, which
structure is not obstructed by tumor?
A. right atrium
B. SVC
C. Carina
D. IVC
E. Pulmonary artery

4. All are true of spinal cord perfusion EXCEPT
A. anterior spinal artery arises from vertebral artert
B. there are 2 posterior spinal arteries
C. posterior arteries supply 2/3 of spinal cord
D. art. of Adamkiewitz commonly arises from the high
E. thoracic aorta

5. The Internal Mammary artery arises from :
A. Costocervical trunk
B. Vertebral artery
C. Subclavian artery
D. Brachiocephalic artery
E. Transverse Cervical artery

6. Sensory innervation above cords:
1. internal branch of superior laryngeal nerve
2. external branch of superior laryngeal nerve
3. recurrent laryngeal nerve
4. lingual n.
5. glossopharyngeal n.

7. Dorsal nerve of the penis:
1. Runs in Buck’s fascia
2. ?
3. ?
4. ?
5. ?


Basic Sciences: Pharmacology & Therapeutics

1. Regarding transdermal drug absorption
A. Is due to passive absorption through the skin
B. It is deposited subcutaneously as a depo
C. Can not achieve stable blood levels
D. Iontophoresis ionizes lipophilic drugs and enhances absorption
E. Liposolubility decreases absorption

2. Why in a neonate does the FA/FI increase faster
A. Relative low FRC
B. Decreased volume in the pediatric circuit
C. Higher CO

3. Faster induction in neonates than adults, all EXCEPT
1. decreased MAC
2. increased VE.
3. increased blood flow to vessel rich areas
4. increased blood / gas solubility
5. increased relative tidal volume compared to adult

4. FA/FI will increase faster with all of the following, EXCEPT
A. Increased CO
B. ?

5. Regarding Midazolam
a) In the elderly, the volume of distribution is decreased
b) The imidazol ring is responsible for its lipophilicity
c) the duration is shorter in the elderly
d) It is affected by renal failure
e) It has high protein binding

6. Magnesium is useful for which postop. CABG arrhythmia
a) PVCs
b) A. Fib.
c) A. Flutter.
d) Junctional Rhythm.
e) PAT.

7. What medication is indicated in an asthmatic patient who presents uterine atony
a) Oxytocin
b) PgE1
c) PgF2
d) Ergonovine

8. To decrease ICP
a) Furosemide acts by decreasing ICP
b) Mannitol works better than Lasix

9. Which of the following is true of Low Molecular Weight Heparin?
a. PTT is a poor predictor of its activity
b. Undergoes significant hepatic metabolism
c. Has same effect on factor XI and Fibrinogen

10. Which of the following is true of Heparin?
a. Protein binding is clinically unimportant
b. Has an equal effect on factor XI an on Fibrinogen
c. Has hepatic elimination that is dose independent
d. Works by inhibiting ATIII

11. A patient is homozygous for atypical pseudocholinesterase. What would you expect?
a. Non enzymatic metabolism of sux
b. High dibucaine number

12. What is true for Remifentanyl?
a. Low levels of pseudocholinesterase will prolong its effect
b. Hepatic metabolism is important
c. Renal dysfunction will prolong its effect
d. Duration of infusion will not affect context sensitive halftime

13. Intrathecal Morphine
a. T1/2 is the same as for IV morphine (2-4 hrs)
b. Spinal vascular uptake is an important route of its metabolism

14. All are true for Esmolol except:
a. Liver metabolism is important
b. Is not a membrane stabilizer
c. T1/2 is 9 minutes
d. Metabolized by red cell esterases

15. Which will increase cerebrovascular resistance?
a. Pentothal
b. Isoflurane
c. Furosemide
d. Mannitol

16. Which will increase CBF directly?
a. Ketamine
b. Propofol
c. Pentothal
d. Lidocaine
e. Fentanyl

17. All are true about Ca channel blockers except:
a. Cause direct cerebral vasoconstriction
b. Decrease HR
c. Decrease inotropy
d. Decrease AV conduction
e. Cause coronary vasodilation

18. What is true for Protamine?
a. No negative inotropic effect
b. No effect on coagulation without heparin

19. Increased sensitivity to muscle relaxants in patients receiving Magnesium therapy is
caused by which of the following?
a. Decreased presynaptic acetylcholine release
b. Increased sensitivity to succinylcholine.

20. Drug to give in anaphylaxis
A histamine
B epinephrine
C neosynephrine
D steroid

21. Ropivacaine vs. Bupivacaine
A higher pKa
B lower cardiotoxicity and preferable for IV block
C something about elimination

22. Lidocaine vs. Bupivacaine
A CNS toxicity is the same
B worst with hypocarbia
C pregnant not more susceptible
D lidocaine more AV-blockthan bupivacaine.

23. Demerol
A neg. inotrope
B bradycardia (dose dependent)
C no histamine release
D normeperidine is inactive
E inhibits SA-node

24. Endocarditis prophylaxis for patient with prosthetic valve for bowel surgery ( no allergy)
A ampicillin+ genta
B vanco+ Genta
C cefoxim+ gentamycine
D clindamycine + ampicilline

25. Opioid least ionized at physiologic pH
A morphine
B alfentanyl
C sufentanyl
D fentanyl
E meperidine

26. Halothane 19.7 gr is vaporized in 224L of O2 What is the final concentration? (molec.
Weight =197)
A 10%
B 5%
C 2.5%
D 1%
E not enough information

27. Cyclosporin
A nephrotoxicity

28.. Phenol with glycine
A agent of choice for celiac plexus block
B hypobaric
C does not give meningeal irritation
D lasts 8-10 years

29. Addition of bicarbonate to local anaesthetics:
1. no precipitate
2. inc. Pco2
3. slower onset , lower duration
4. ?
5. ?

30. Which one does not give pulmonary toxicity
A adriamycine
B Bleomycine
C Busulfan

31. Desflurane versus Sevoflurane
A. Sevo makes more carbon dioxide
B. Des makes more compound A
C. Sevo is more biodegradable.

32. Which is true about metoprolol?
A. more liposoluble than propanolol
B. 20% renaly excreted
C. less than 50% available after oral ingestion
D. ?

33. Which is true of halothane at 0.1 MAC?
A. decrease of pCO2 by 4.5 mmHg on incision
B. increased tidal volume
C. hypercapnic and hypoxic effects additive
D. ?

34. Which does not result in lung toxicity
A. bleomycin
B. adriomycin
C. methotrexate
D. mitomycin
E. ?

36. Which of the foll has the least hemodynamic effect with Clonidine 5mcg/kg?
A. Alcohol withdrawal
B. Aortic stenosis
C. Hypovolemia
D. Pericarditis
E. ?

37. Benzodiazepines act on which receptors?
A. GABA
B. Serotonin
C. Dopamine
D. ?

38. Why is fentanyl shorter acting than morphine?
A. redistribution away from the CNS
B. smaller volume of distribution
C. shorter T1/2 beta
D. ?

39. Regarding cocaine intoxication which is false?
A. blocks reuptake of norepi post synaptically
B. hypertension can result in cerebral and pulmonary edema
C. decreased levels of plasma cholinesterase results in increased toxicity
D. inhalation and IV injection give same severity of disease
E. hyperthermia is life threatening

40. What determines the time to peak effect with a loading dose
A. Volume of distribution of central compartment
B. Volume of distribution at time of peak effect
C. Steady state plasma concentration
D. Rate of elimination
E.  ?

41. Hyperthyroid patient treated with propranolol. How does propranolol work ?
A. Decreases peripheral manifestations of increased sympathetic tone
B. Decreases T4 to normal
C. Decreases C.O. to normal levels.

42. Desflurane used over a dry CO2 absorbent :
A. Increased compound A production
B. Decreased onset of anaesthesia
C. Produces carbon monoxide

43. Epidural fentanyl, EXCEPT :
A. Peak effect in 20 minutes
B. Effect by increase in substance P
C. Effect increased by alpha agonist
D. ?
E. ?

44. IV PGE1 causes all EXCEPT :
A. Decreased SVR
B. Decreased PVR
C. Apnea
D. Hyperthermia
E. CNS depression.

45. What drug affects the denervated heart the most ? (NB: norepineph. was not in the list)
A. Atropine
B. Digoxin
C. Edrophonium
D. Adenosine
E. Pancuronium

46. Which β -blocker has the longest t1/2 ?
A. Pindolol
B. Nadolol
C. Acebutolol
D. Esmolol
E..

47. All inhibit HPV, EXCEPT :
A. Ibuprofen
B. Resp alk
C. Met alk
D. Halothane
E. ?

48. LA binds to what other protein besides albumin?
A. Cholinesterase
B. Alpha-1 acid glycoprotein
C. ˜various other distractors
D. ?
E. ?

49. Which increases CBF the most ?
A. Sevo
B. Des
C. Halo
D. Iso
E. Enfl

50. Which will increase or decrease seizure activity by its own or its metabolite (question was
worded exactly like this) EXCEPT:
A. Propofol
B. Methohexital
C. Enflurane
D. Atracurium
E. Morphine

51. Why is Fluoride lower with Sevo than Enfl ?
A. Lower blood:gas coefficient
B. Increased renal excretion
C. Increased MAC
D. More halogens in Sevo
E. More degraded in the soda lime

52. Spread of local anaesthetics is most affected by:
1. Baricity
2. height
3. direction of bevel
4. injection technique
5. ?

53. High dose opioids:
1. inhibit vomiting centers.
2. ?

54. 0.75% ISOFL. W/ 50% N2O
1. inc. bleeding
2. dec. maternal awareness
3.?
4. ?
5. ?

55. Ondansetron acts on which receptor?
1. GABA
2. dopamine
3. alpha adrenergic
4. beta adrenergic
5. serotonin

56. ALFENTA VS. Fentanyl
1. less protein binding
2. less clearance
3. greater vol. of dist.
4. Greater liposolubility

57. Which respiratory parameter increases uptake of a more soluble volatile?
1. inc. minute ventilation
2. dec. frc
3. inc. Aa gradient
4. diffusion capacity
5. dec. mac

58. Droperidol:
1. does not reduce cbf
2. .3 mg/kg dec. vent. response to co2
3. .5 mg/kg causes respiratory depression
4. does not interfere with eeg monitoring
5.

59. Persistent PSVT, BP 80/50 already received 6mg adenosine with no effect. Next step:
1. adenosine 12 mg
2. lidocaine
3. beryllium
4. procainamide
5. verapamil

60. Drug of choice in PSVT?
1. beryllium
2. adenosine
3. verapamil
4. esmolol
5. procainamide

61. Ondansetron, all EXCEPT
1. prolongs recovery room time
2. inc. liver function tests
3. sedation
4. no extrapyramidal effects
5. headache.

62. Dantrolene (acutely) EXCEPT:
1. hepatitis
2. nausea
3. diarrhea
4. ?
5. ?

63. Glycine 1.5% during TURP:
1. confusion
2. convulsions
3. pulmonary edema
4. abdominal pain

64. Regarding nitrous oxide:
1. formula is NO
2. mac is 105%
3. boiling point is 47 deg.
4. Vapor pressure ????
5.

65. Drug of choice in WPW syndrome:
1. verapamil
2. diltiazam
3. digoxin
4. propranolol
5. lidocaine

66. Which will support fire?
1. halothane
2. n20
3. n2
4. ISO.


Basic Sciences: Physiology

1. Where do you find Muscarinic receptors
A. parasympathetic ganglia
B. Sympathetic ganglia
C. Postsynaptic adrenal medulla
D. Presynaptic sympathetic myocardial terminals
E. Postsynaptic neuromuscular junction

2. Regarding the R/Q coefficient
A. equals 1 with carbohydrate diet
B. > 1 if respiratory failure
C. increases to 2 if starvation
D. equals O2 consumption/CO2 production
E. is the same as metabolic rate.

3. A pregnant patient desaturates faster because all EXCEPT
A. Increased CO
B. Decreased FRC
C. Increased Oxygen consumption
D. Decreased carrying capacity
E. Increased Aa gradient

4. Hemoglobin F
A. Is present in high concentrations in Thalasemia major
B. > 90% of Hb in the newborn is HbF
C. The Oxygen dissociation curve for HbF is shifted to the right in comparison with adult hemoglobin
D. HgF gives up oxygen more freely at the tissue level than does adult Hemoglobin
E. 2-3 DPG binds HbF more avidly than adult hemoglobin.

5. What does not increase the ETCO2
A. Decreased CO
B. CO2 insuflation into the peritoneal cavity for laparoscopy
C. Release of limb tourniquet
D. Onset of MH

6. Regarding Anatomic dead space
A. It is calculated by the Bohr equation
B. Increases with intubation
C. In a healthy subject is practically the same as the physiologic dead space

7. Regarding Renal function in the neonate
A. Increased renal blood flow
B. Increased glomerular filtration
C. Distal Sodium reabsorption is impaired
D. Increased glomerular permeability.

8. What is the approximate blood volume in a 3.5 kg neonate?
A. 100 cc
B. 200cc
C. 300 cc
D. 500 cc

9. Which is the most important determinant of pulmonary mechanics at 90% TLC?
A. Lung parenchyma
B. Rib cage
C. Bronchi
D. Pleural pressure

10. Which variable is LEAST effort dependant on PFT’s?
A. MEF 25-75%
B. FEV1
C. FVC
D. FEV1/FVC.

11. A difference of 5 mmHg between EtCO2 and PaCO2:
A. Is normal in a healthy patient under GA
B. Is due to the Thebesian and Bronchial veins

12. What will NOT decrease the EtCO2?
A. Increased cardiac output
B. Hyperventilation
C. Endobronchial intubation
D. Pulmonary embolus

13. What is true for Antithrombin III?
A. Natural Serine protease
B. Inhibits selective coagulation factors
C. Depletion of AT III will increase effect of heparin
D. ?

14. What is the final destination of a neural stimulus originating in L arm
A. R postcentral gyrus
B. R thalamus
C. L precentral gyrus
D. L periaqueductal grey matter

15. Myocytes use normally what as substrate in presence of O2
A. FFA
B. Glucose
C. Amino acids
D. Ketones
E. Lactate

16 Release of tourniquet
A increased ETCO2
B increased BP
C decreased HR

17 Osmolarity of HCO3 8.4%
A 1000 mosm/L
B 2000 mosm/L
C 84mmol/L
D 84 mosm/L
E 0.5mosm/L

18. Umbilical venous PO2 before first breath
A 50
B 40
C 30
D 20
E 10

19 Renal physiology
A Cl reabsorption in ascending limb Henle
B. ?

20. Placental transfer : EXCEPT
A. High pKa
B. ?

21. Placental transfer
A conc not between mother and fetus.
B. ?

22. Closing volume : EXCEPT
A CV= phase 4
B CV=CC-RV
C CV normal =20% of VC
D CV increases with age
E CV= absolute of beginning phase 4

23. Osmolality of NaCl 0.9%
A 308
B 273
C 258

24. R coronary flow least affected by
A maximal systolic pressure of R ventricle
B time of systole
C adenosine
D resistance of epicardial vessels
E diastolic

25. Which is a component of the descending pain pathway?
A. Locus ceruleus
B. Spino-reticular tract
C. Lamina I and V
D. Dorsolateral funiculus.

26. Unilateral transection of the dorsal nerve roots of C5-T2 results in
A. loss of wrist reflexes
B. loss of shoulder abduction
C. loss of sensation over acromion
D. sympathetic paralysis
E. ?

27. Osmolalty of NaCl
A. 308
B. ?

28. All are true of hypomagnesemia EXCEPT
A. Nodal tachycardia
B. Ventricular tachycardia
C. Paroxysmal atrial tachycardia
D. 2 nd degree AV block
E. potentiates digoxin toxicity

29. ANF, all EXCEPT?
A. peripheral vasodilation
B. positive inotropy
C. ?
D. ?
E. ?

30. All are needed to calculate oxygen delivery EXCEPT
A. P50
B. O2 saturation
C. Hemoglobin
D. PO2
E. Oxygen solubility

31. According to studies in the newborn lamb, what is true?
A. Immaturity of the sympathetic system predisposes to bradycardia
B. Cardiac index is 2 times that of adult
C. Decreased afterload after birth

32. % total body water in neonate
A. 90
B. 75
C. 60
D. 50
E. 40

33. Regarding cardiac depolarisation:
a. Threshold potential = -90mV
b. K efflux during depolarization
c. Na influx during phase I
d. Ca maintains isoelectric gradient during depolarization.

34. You will have to calcuate PVR from a table of values of CVP, MAP, PCWP, etc.
A. The answer is 64!!

35. With prolonged FiO2 >0.6, all EXCEPT:
A. Absorption atelectasis
b. Tracheitis + substernal chest pain
c. Sloughing of Type II alveolar cells
d. Pulmonary edema
e. Pulmonary fibrosis

36. pH = 7.35, pCO2=34, pO2=75, sat=98%. Which state is this compatible with ?
A. Neonatal
b. Sleep
c. Pregnancy
d. Chronic altitude
e. Elderly

37. Factors affecting RV coronary flow, EXCEPT :
a. RCA autoregulation
b. Adenosine levels
c. Peak RV systolic pressure
d. Diastolic time
e. Epicardial coronary flow

38. Leftward shift of the Hb oxygen dissociation curve:
1. Hgb F
2. Inc. 2,3 DPG
3. Inc. Pco2
4. ?

39. Maternal P50:
1. 18 mmHg
2. 27
3. 30
4. 33
5. 35

40. What is the HA/A ? pH 1.4 pKa 4.4
1. 1/100
2. 3
3. 1/3
4. 10
5. 100

41. Respiratory changes in the elderly:
1. dec. cc
2. dec. cv
3. inc. elastic recoil
4. inc. v/q mismatch

42. Renal response to hypovolaemia:
1. efferent arteriole vasoconstriction and large alpha activation
2. medullary vasodilatation accompanied by angiotensin release
3. medullary vasoconstriction with anf release
4. vasodilatation at level of ascending loop of henle

43. CVP tracing with normal sinus rhythm:
1. a is during ventricular contraction
2. x is the start of ventricular contraction
3. c is tricuspid valve closure
4. v occurs during diastole
5. y wrong.

44. Percent fat is highest in:
1. premature
2. neonate
3. 6 months
4. 1 year
5. adults

45. Minute ventilation for spont breathing man, resting, to keep normocarbia
A 6300 ml/min
B 4200 ml/min
C 8400 ml/min
D 3000 ml/min


Basic Sciences: Statistics

1. How is the 95% Confidence Interval calculated?
A. Need the standard deviation
B. It means you can accept the Null hypothesis
C. Need the Bonferoni correction
D. Gives you the variability about the mean

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