SAQ - Primary Examination : Pharmacology
Listing of ANZCA Primary Exam Short Answer Questions - PHARMACOLOGY SAQs
This listing was originally compiled by Mark Waddington (NZ)
Worried about the Statistics question on the paper?
You probably
shouldn't be. A glance at the Statistics list shows that there are only 4
questions that have been asked (& asked repeatedly) since 1995 so
unless they think up a new one these four are the ones to have prepared
answers ready to go.
Note added: Since the above advice was written, one
of this set of 4 questions was repeated yet again on the March 2001 paper.
Fortunately, many people have noticed the pattern (or read about it here)
so the pass rate was a whopping 89% on this question. A quick glance
suggests this is the highest pass rate ever achieved on a single question,
and on a Statistics one at that !!! So the advice is still the same: have
prepared & practised answers to these 4 questions.
However, a new Q about statistics & study design appeared in 2003.
When were the SAQs introduced? In the Mar-Apr 1995 paper,
with 10 questions in each area. From the Mar-Apr 1996 exam, this changed
to the current format of 8 questions in each area. The questions in
this listing prior to 1995 are not really SAQs but the previous
Essay-style questions - nevertheless, you may find them useful so these
are included here.
What was the pass rate for each question? I have started to add this information in the right-most column. It is not yet complete. It is interesting to note what happens to the pass rate when a question is repeated at a subsequent exam.
Pharmacology
Questions
|
General Pharmacology |
||
|
Pharmacodynamics |
||
| 03B3 |
Outline GABA's role as a neurotransmitter and indicate how its actions may be modified by pharmacological agents. |
63% |
| 01A10 | Outline GABA's role as a neurotransmitter and indicate how its actions may be modified by pharmacological agents | 53% |
| 01A9 | Briefly describe how drugs produce their pharmacological effects. Illustrate each mechanism with examples. | 75% |
| 00B11 | Describe the structure and function of G proteins | 50% |
| 1999 | Using opioids as examples describe and illustrate with graphs what you understand by the terms 'potency', 'efficacy', 'partial agonist', 'competitive antagonist' and 'therapeutic index'. | 77% |
| 97A9 | Briefly describe the pharmacological role of the nicotinic cholinergic receptor | 62% |
| 1997 | What do you understand by the term 'clearance'? Using propofol as an example, explain briefly the importance of clearance | |
| 1997 | Briefly describe the drug factors that may predispose to thrombophlebitis | |
| 96B12 | Briefly
describe how drugs may produce their pharmacological effects. Illustrate each mechanism with examples. |
30% |
| 96A16 | Define therapeutic index and briefly outline its significance. Describe briefly also the therapeutic ratio and the use of the of the cardiac/cns toxicity ratio (cns = central nervous system) | 79% |
| 1994 | Briefly explain non-competitive antagonism at receptor sites and give two examples | |
| 1994 | Briefly describe the possible mechanism of action of general anaesthetics | |
| 1993 | Briefly outline the chemistry of soda lime and the potential interactions with anaesthetic agents | |
| 93A2 | Define potency, affinity and efficacy illustrating your answer by reference to opioids in clinical use [See also 95B9] | 84% |
| 1991 | Write short notes on log dose effect curves | |
|
Pharmacokinetics |
||
| 02B1 | Outline the influences of pregnancy on pharmacokinetics | 39% |
| 02B2 | Briefly describe the factors affecting the uptake of orally administered medicines | 67% |
| 02A10 | Outline the factors that determine recovery (offset of action) after ceasing a drug infusion. | 43% |
| 01A11 | Define the term 'context-sensitive half time'. How does this differ from the elimination half life? Illustrate your answer by comparing thiopentone vs. propofol, and fentanyl vs. remifentanil | 64% |
| 00A14 | Discuss the roles of the plasma esterases on drugs used in anaesthesia | 67% |
| 99B16 | Outline the factors that determine recovery (offset of action) after ceasing a drug infusion. | 55% |
| 98A13 | Outline the factors that determine recovery (offset of action) after ceasing a drug infusion | 37% |
| 96A13 | Describe briefly the factors determining transdermal uptake of
drugs and give some examples of drugs that can be administered by the
transdermal route. Briefly outline the advantages and disadvantages of transdermal administration of drugs. |
79% |
| 1995 | Describe the clearance of drugs by the kidney | |
| 1995 | Give a brief account of drug protein binding and outline its significance | |
| 95B8 | Outline the
factors that determine recovery (offset of effect) after ceasing a drug
infusion. Explain the relevance of a drug’s elimination half time. |
6% |
| 95A3 | Define Phase I and Phase II reactions in drug metabolism. Provide examples with drugs used in anaesthesia. | 70% |
| 95A2 | Define a 'steady state' in pharmacology. List the advantages and disadvantages of a steady state and outline the characteristics of drugs which make them suitable for steady state pharmacology | 65% |
| 95A4 | Briefly describe the factors affecting the uptake of orally administered medicines | 76% |
| 1994 | Discuss the ways in which the consequences of liver disease may influence drug disposition. | |
| 1992 | Write short notes on binding of drugs to plasma proteins | |
| 1992 | Write short notes on measurement of whole body drug clearance | |
| 1992 | Write short notes on zero order kinetics | |
| 1992 | Write short notes on Hepatic extraction ratios | |
| 1991 | Write short notes on the clearance of drugs | |
| 1991 | Write short notes on estimation of apparent volume of distribution of a drug | |
| 1991 | Write short notes on binding of drugs to plasma proteins | |
| 1990 | Define bio-availability. Discuss the factors which determine the bio-availability of a drug. | |
|
Other General Pharmacology |
||
| 03A4 |
Outline the potential problems associated with additives used to make medicines suitable for intravenous injection. |
43% |
| 00B15 | Write brief notes on latex allergy | 44% |
| 00B9 | What is an isomer? Briefly write an account of the types of isomers and their significance in drugs used in anaesthesia | 67% |
| 99B15 | Briefly
describe the preparation of oxygen for medical use. List the physical
properties of oxygen. Outline the potential adverse effects associated with its medical use. |
50% |
| 98B16 | Write brief notes on latex allergy | 30% |
| 95A5 | What is an
isomer? Briefly write an account of the types of isomers and their
significance in drugs used in anaesthesia |
55% |
| 1992 | Write short notes on chemical additives to anaesthetic solutions | |
| 1991 | Discuss the factors which influence the administration and dosage of drugs in the elderly. | |
|
Inhalational Anaesthetic Agents |
||
| 03B8 |
Outline the pharmacological differences between neonates and adults with reference to sevoflurane, vecuronium and morphine. |
42% |
| 03B2 |
Describe the potential interactions of sevoflurane, desflurane and isoflurane with carbon dioxide absorbents. |
60% |
| 03B1 |
Draw and label, on the same X - Y axis, FA/FI curves for the following halothane concentrations in oxygen, showing a 30 minute period from starting administration. a. Halothane 1%, subject breathing spontaneously. b. Halothane 6%, subject breathing spontaneously. c. Halothane 6%, subject paralysed and ventilated. With reference to the major factors determining the shape of FA/FI curves explain the differences between (a) and (b), and (a) and (c). |
29% |
| 03A1 |
Briefly outline the effects of isoflurane on skeletal, smooth and cardiac muscle tissues. Indicate how these effects are mediated and their clinical significance. |
74% |
| 02B4 | Briefly outline the potential interactions between volatile agents and carbon dioxide absorbents | 52% |
| 02B3 | Draw a graph comparing the ratio of inspired to alveolar concentrations during the first half hour of administration for nitrous oxide, isoflurane, and halothane. Outline reasons for observed differences between the agents and indicate the effects of increases in alveolar ventilation and cardiac output. | 73% |
| 01B10 | Briefly describe the adverse effects of nitrous oxide. | 76% |
| 01A12 | Briefly describe the respiratory effects of the volatile agents | 58% |
| 00A9 | Compare and contrast the effects of halothane and isoflurane on the heart | 65% |
| 99A14 | Briefly outline the pharmacological effects of the volatile anaesthetic agents on the kidneys. | 64% |
| 98A16 | Outline the potential for methoxyflurane and sevoflurane to produce toxic effects on the kidney | 75% |
| 1997 | Compare and contrast the effects on the heart of halothane and isoflurane | 46% |
| 1997 | Discuss the possible effect of volatile inhalational agents on the liver | |
| 96B11 | Briefly outline the effects of volatile Inhalational agents on the muscle tissues, indicating postulated mechanisms and clinical significance. | 43% |
| 96A9 | Describe briefly the central nervous system effects of isoflurane | |
| 96A12 | Define MAC and outline the factors which influence it. Briefly explain MAC-hour, MAC-awake, MAC-bar and the applications of these terms | 76% |
| 95B10 | Draw a graph
comparing the ratio of inspired to alveolar concentrations during the
first half hour of administration for nitrous oxide, isoflurane and
halothane. Outline the reasons for the observed differences between the agents and indicate the effects of non-concurrent increases in alveolar ventilation and cardiac output. |
52% |
| 95A7 | Explain briefly the potential advantages and disadvantages of SEVOFLURANE | 82% |
| 95B5 | Briefly outline the effects of the volatile agents on muscle tissues. Include a description of how these effects are mediated and their clinical significance. | 55% |
| 1993 | Briefly outline the chemistry of soda lime and the potential interactions with anaesthetic agents | |
| 1993 | Describe the direct effects of isoflurane on the cardiovascular system | |
| 1993 | Explain how nitrous oxide may contribute to adverse anaesthetic outcome | |
|
Intravenous Anaesthetic Drugs & Antagonists |
||
| 03B4 | Describe how a computer-controlled infusion device targets and maintains constant blood concentrations of propofol. | 33% |
| 03A2 |
Outline the neuropharmacology of thiopentone, covering only its site of action, EEG changes, effects on cerebral blood flow and intracranial pressure. |
80% |
| 02A16 | Briefly outline the pharmacology of flumazenil | 45% |
| 02A11 | Briefly outline the effects of thiopentone and ketamine not mediated via the central nervous system. | 77% |
| 01B9 | What do you understand by the term "clearance". Using propofol as an example, explain briefly the importance of clearance. | 77% |
| 01A13 | Outline the NON-ideal features as an intravenous induction agent of the current formulations of propofol | 55% |
| 00B14 | Write short notes contrasting the cardiovascular effects of propofol and ketamine seen clinically | 46% |
| 99B14 | Briefly outline the actions of intravenous induction agents not mediated via the central nervous system. | 24% |
| 99A13 | Describe the neuropharmacology of thiopentone covering its site of action, EEG changes, effects on cerebral blood flow and intracranial pressure. | 78% |
| 98B9 | Write short notes contrasting the cardiovascular effects of propofol and ketamine seen clinically. | 63% |
| 98A10 | Outline the NON-ideal features as an intravenous induction agent of the current preparation of propofol. | 67% |
| 1997 | List the properties of an ideal intravenous anaesthetic. To what extent does methohexitone conform to this ideal. | 76% |
| 95A9 | Briefly outline the effects of intravenous induction agents not mediated via the central nervous system, as well as their side effects. Include a brief account of the mechanisms by which these side effects are exerted | 17% |
| 1994 | Describe the ideal intravenous anaesthetic agent. Describe in detail the extent to which propofol approaches this ideal. | |
| 1993 | Briefly explain how knowledge of the pharmacokinetic properties of propofol would enable it to be used for the induction and maintenance of anaesthesia by continuous infusion. | |
| 1992 | Write short notes on Methohexitone | |
| 1991 | Write short notes on Methohexitone | |
| 1990 | Write short notes on the pharmacokinetics of midazolam | |
|
Muscle Relaxants & Antagonists |
||
| 03A8 |
Describe the onset and offset of neuromuscular block at the diaphragm, larynx and adductor pollicis after administration of 2.5 x ED95 dose of vecuronium. Comment on the differences observed. What are the clinical implications of these differences? |
50% |
| 02B5 | Outline the possible reasons for prolongation of paralysis induced by an intravenous dose of 1 mg.kg-1 of suxamethonium. Briefly indicate the consequences of such a prolonged block. | 60% |
| 01B13 | Compare and contrast neostigmine and the organophosphorus compounds. | 64% |
| 01A14 | Give examples of drugs that enhance the action of the non-depolarising neuromuscular blocking agents at the neuromuscular junction. Briefly describe the mechanisms of these interactions. | |
| 00B16 | Compare and contrast the pharmacology of atracurium and cis-atracurium | 26% |
| 99B10 | Outline factors determining speed of onset of neuromuscular blocking agents | 58% |
| 99A12 | Explain the phenomena known as fade and post tetanic facilitation associated with the use of neuromuscular blocking agents. | 43% |
| 98B13 | Draw and explain the characteristics of a log dose-response curve that describes the major clinical effect of vecuronium. List factors encountered in clinical practice that may alter this curve | 46% |
| 98A15 | Compare the metabolism of suxamethonium to that of atracurium. | 83% |
| 1997 | Briefly describe the pharmacological actions of the anti-cholinesterases with reference to edrophonium, neostigmine and the organophosphorus compounds. Indicate the similarities and differences with the 3 drugs | |
| 1997 | Give examples of drugs that enhance the action of the non-depolarising neuromuscular blocking agents at the neuromuscular junction. Briefly describe the mechanisms of their actions. | 41% |
| 96B16 | Outline briefly the possible reasons for prolongation of paralysis induced by an intravenous dose of 1mg/kg of suxamethonium. Briefly indicate the consequences of such a prolonged block. | 58% |
| 1994 | Explain the use of the peripheral nerve stimulator in monitoring muscle relaxants and their offset. | |
| 1993 | What factors may alter plasma cholinesterase activity and how can this activity be measured | |
| 1993 | Briefly discuss the side effects of atracurium | |
| 1992 | Write short notes on atracurium | |
| 1990 | Write short notes on post tetanic facilitation | |
| 1990 | Write short notes on dibucaine number | |
|
Local Anaesthetics |
||
| 03B7 |
Write short notes on factors affecting the speed of onset and duration of effect of local anaesthetics when used to produce peripheral nerve block. |
46% |
| 03A3 |
Explain how lignocaine prevents the conduction of a nerve action potential. |
37% |
| 02A9 | Outline the toxicity of local anaesthetics | 57% |
| 01B11 | Describe the required pharmacological characteristics of local anaesthetic formulations intended for topical use. | 41% |
| 00B13 | Write short notes on factors affecting the speed of onset and duration of local anaesthetics when used to produce peripheral nerve block | 54% |
| 00A16 | Briefly describe the factors that determine skin penetration by local anaesthetics. What is a eutectic mixture? Briefly describe the formulation and pharmacology of EMLA® cream? | 73% |
| 1999 | Outline the toxicity of local anaesthetics | 36% |
| 98B15 | Describe the pharmacology of ropivacaine and explain why it may be considered a safer agent than bupivacaine. | 42% |
| 1997 | List the physico-chemical characteristics of bupivacaine. Explain how they influence its pharmaco-dynamic effects at the site of administration | |
| 1997 | Describe the ideal pharmacological characteristics of local anaesthetic agents and formulation intended for topical use, including their clinical applications. | 22% |
| 96B13 | Outline briefly the pharmacokinetics and pharmacodynamics of lignocaine. | 54% |
| 1995 | Outline factors that determine latency (speed of onset) of local anaesthetic drugs | |
| 1994 | Compare and contrast ropivacaine and bupivacaine | |
| 1993 | Outline the factors which would make a local anaesthetic agent suitable for use in obstetric practice | |
| 1993 | Explain with the example of three local anaesthetic agents of your choice, how their physico-chemical properties influence their pharmacological effects | |
| 1992 | Write short notes on the cardiovascular toxicity of bupivacaine | |
| 1991 | Write short notes on transdermally administered local anaesthetic agents | |
| 1991 | Write short notes on the cardiovascular toxicity of bupivacaine | |
|
Autonomic & Cardiovascular Drugs |
||
|
Autonomic Pharmacology |
||
|
|
||
| 00A11 | Outline the main biochemical event involved in noradrenergic transmission, and how these may be altered by the use of MAO (mono amine oxidase) inhibitors | 57% |
| 99A11 | Briefly compare and contrast the clinical pharmacology of atropine, hyoscine and glycopyrrolate. | 42% |
| 98A14 | Discuss the use of different vasoconstrictors to treat hypotension occurring as a result of subarachnoid block | 60% |
| 1997 | Outline the main biochemical event involved in noradrenergic transmission, and how these may be altered by the use of MAO (mono amine oxidase) inhibitors | |
| 1994 | Give a brief account of the actions of the alpha-adrenergic agonists and their potential applications in anaesthesia | |
| 1990 | Write short notes on pyridostigmine | |
|
Adrenoreceptor Drugs |
||
| 03B6 | List the potential clinical uses of an alpha-2 adrenoceptor agonist and outline the limitations of clonidine for each. | 60% |
| 02B7 | Outline the potential pharmacological advantages and disadvantages of intra-operative beta-blockade. | 76% |
| 01B15 | Outline the potential benefits and disadvantages of peri-operative beta-blockade | 47% |
| 01A15 | Compare and contrast the pharmacology of esmolol and propranolol | |
| 99A16 | Describe the effects of the alpha 2 adrenoceptor agonists relevant to anaesthesia | 63% |
| 1991 | Write short notes on Atenolol | |
|
Antihypertensives (incl Diuretics) |
||
| 03A7 |
 Classify
diuretics, briefly explaining their mode of action. |
88% |
| 00B10 | Classify diuretics giving examples and briefly explaining their action | 79% |
| 1999 | Briefly describe the mechanism and treatment of the toxicity of sodium nitroprusside. | 48% |
| 1994 | Write about the pharmacology of Captopril | |
| 1994 | Give a brief account of the pharmacological actions and toxicity of nitric oxide | |
| 1994 | Write about the pharmacology of Nifedipine | |
| 1993 | Compare and contrast nitroprusside and nitroglycerin | |
| 1993 | What is meant by the term “calcium channel”? What are the effects of calcium channel blocking agents? | |
| 1991 | Discuss the mechanisms of action of drugs which may be employed to lower blood pressure during anaesthesia. | |
|
Anti-arrhythmic Drugs |
||
| 02A13 | What are the side-effects of amiodarone and what problems may develop during concurrent anaesthesia? | 44% |
| 96A15 | Describe briefly the pharmacology of adenosine and its potential uses in anaesthesia. | 65% |
| 1993 | What are the effects of calcium channel blocking agents | |
| 1990 | Write short notes on calcium channel blocking agents | |
|
Miscellaneous Pharmacology |
||
|
Anti-emetic Drugs |
||
| 98B10 | Describe the sites of action of antiemetic agents used for postoperative nausea and vomiting | 77% |
| 1997 | Describe the location and function of dopamine receptors Give some examples of agonist and antagonist drugs. |
73% |
| 1994 | Write about the pharmacology of Droperidol | |
| 1991 | What are the properties of the ideal antiemetic? How might such a drug be evaluated clinically? | |
|
Drugs affecting Coagulation |
||
| 02A15 | Describe the mechanism of the anticoagulant effect of coumarin derivatives and what determines the onset and offset of action. | 45% |
| 99A15 | List the drugs used clinically as anti-coagulants and anti-thrombotics. Write short notes on the mechanisms of their actions. | 65% |
| 95B4 | Outline the chemistry of heparin. Describe the mechanism of action and list its toxic effects. | 58% |
| 95A8 | Describe the mechanism of action of protamine when used to reverse effects of heparin. Outline the side-effects of protamine | 43% |
| 95A10 | Outline the importance of vitamin K and the factors determining its uptake | 68% |
| 1993 | Discuss the pharmacology of drugs used in the control of blood coagulation. | |
| 1990 | Discuss the pharmacology of drugs used therapeutically to alter coagulation | |
|
Obstetric Pharmacology |
||
| 00A12 | Outline the pharmacology of oxytocin | 77% |
| 96B14 | Outline briefly the pharmacology of oxytocin | 54% |
| 95B6 | Outline the influence of pregnancy on pharmacokinetics | 64% |
| 1994 | Give a brief account of the pharmacological actions and side effects of prostaglandins used in obstetrics | |
| 1992 | Write short notes on placental transfer of drugs | |
|
Gastrointestinal Pharmacology |
||
| 02A14 | Briefly
outline pharmacological methods of reducing gastric acidity. Indicate the mechanisms of action and their advantages and disadvantages of each method |
59% |
| 98A12 | Classify the drugs which are useful for reducing the volume and acidity of gastric contents, giving an outline of the mechanism of effect for each group. | 46% |
| 96B15 | Briefly give
an account of the pharmacological methods for reducing gastric acidity. Indicate the mechanisms and their advantages and disadvantages. |
51% |
|
NSAIDs / Paracetamol |
||
| 03B5 |
Describe the pharmacological effects of paracetamol. Outline its toxicity and management. |
86% |
| 02A12 | Outline the mechanism of action of non-steroidal anti-inflammatory drugs and their potential adverse effects | 72% |
| 00A10 | Briefly describe the pharmacological effects of paracetamol. Outline the mechanisms for its toxicity. | 70% |
| 1997 | Outline the mechanism of action of non-steroidal anti-inflammatory drugs and their potential adverse effects | 65% |
| 1995 | Briefly describe the pharmacological effects of paracetamol. List its clinical indications and outline the mechanisms for its toxicity. | |
| 1993 | Write about the pharmacology of ketorolac | |
|
Unclassified Drugs |
||
| 02B8 | Outline the pharmacological effects of vasopressin | 79% |
| 01B14 | Outline the direct effects of endogenously released histamine. | 49% |
| 98A11 | Briefly describe the pharmacological implications of the administration of a single dose of gentamycin during anaesthesia. | 75% |
| 98A9 | List the effects of histamine. Write a brief outline on the pharmacology of the H1 blocking drugs. | 62% |
| 96A10 | Describe briefly the mechanism of action of dantrolene. List it adverse effects and outline its uses in anaesthesia. | 64% |
| 1994 | Compare the advantages and disadvantages of synthetic colloids and stable plasma protein solution in volume replacement. | |
|
Statistics |
||
| 03A5 |
Outline the important statistical issues in designing a study to compare the duration of analgesia of two drugs given for post-operative pain relief. |
38% |
| 01B16 |
Briefly describe correlation and simple linear regression, and explain their differences. What assumptions are common to both? |
82% |
| 01A16 | Describe the use of the null hypothesis and P-value in a drug trial | 89% |
| 00A13 | Briefly
describe correlation and simple linear regression, and explain their
differences. What assumptions are common to both? |
70% |
| 99B9 | What is meant by '95% confidence interval'? Explain the practical applications of confidence intervals and indicate why they may be preferred to P-values. | 48% |
| 99A9 | In a clinical trial why is adequate power important? What factors affect the determination of an adequate sample size? | 58% |
| 98B12 | Briefly
describe the terms correlation and simple linear regression, and explain
their differences. What assumptions are common to both? |
34% |
| 97A14 | What is meant by '95% confidence interval'? Explain the practical applications of confidence intervals and indicate why they may be preferred to P-values. | 30% |
| 1997 | In a clinical trial why is adequate power important? What factors affect the determination of an adequate sample size? | 35% |
| 96B10 | Describe briefly the use of the NULL HYPOTHESIS in a drug trial and how the P-value is relevant | 62% |
| 96A14 | Explain briefly the differences between simple linear regression and correlation and indicate the assumptions common to both. | |
| 95B7 | What is meant by '95% confidence interval'? Explain the practical applications of confidence intervals and indicate why they may be preferred to P-values. | 33% |
| 95A6 | Describe the NULL HYPOTHESIS in a drug trial and how the P-value is relevant | 53% |
| 1994 | Define Standard Deviation. Explain its application to the use of drugs in clinical anaesthetic practice. | |
| 1992 | Write short notes on Student’s “t” test | |
| 1991 | Write short notes on bias in drug trials and how its influence may be reduced. | |
| 1991 | Write short notes on non parametric statistical tests. | |
| 1990 | Write short notes on probability | |
