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Home | Pharmacology Viva Q

This is a collection of all the 'Introductory Viva Questions' listed in the ANZCA Examiner's Reports from 1994 onwards. This is the work of Nolan McDonnell (Palmerston North, NZ) who has kindly supplied the list for the use of others preparing for the Primary exams. 

A classified collection of the Pharmacology Viva Questions (by Elizabeth Holt) is also available: click on the link at the top.

1. Cellular Physiology & Metabolism
Active transport
Facilitated diffusion
Resting membrane potential
Transmembrane transport
ATP
Biologic oxidation
Basal Metabolic Rate / MRO₂
Citric acid cycle / Krebs cycle
Forces producing movement of substances across a semipermeable membrane
Glycolysis
Glycolysis-red cell versus muscle
Ketone bodies
Lactate production
Oxidative phosphorylation
Protein synthesis
Urea cycle / Formation of urea

2. Fluid and Electrolyte Physiology
Calcium: Functions and regulation
Colligative properties of solutions
Colloid osmotic pressure
Diffusion
Distribution of body water including compartments and content
Distribution of major ions
Donnan effect
Effects of an oral sodium load
Effect of 8.4% HCO3- infusion
Effect of one litre of Haemacel
Effects of drinking two litres of water
Effects of intravenous administration of 3% saline
Effects if transfusion of two litres of whole blood
Effect of sustained increase in sodium intake
Fate of one litre of 0.9% saline given intravenously
Lymph flow
Lymph functions
One third blood volume loss - effect of
Osmotic pressure
Magnesium-distribution/functions
Mole/Osmole/Osmolality measurement
Nernst equation
Osmosis
Peripheral oedema - formation
Potassium distribution in the body
Sodium intake and absorption
Starling’s law of the capillary / Starlings forces
What are the effects of reduced serum albumin on oxygen delivery to cells?
What is the circulating blood volume of a 70 kg adult?
What is the normal serum calcium concentration?
Water homeostasis

3. Acid-Base pHysiology
Arterial blood gases in pregnancy
Acid base changes and buffers
Blood gas interpretation
Carbonic anhydrase
Consequences of infusing one molar HCl intravenously
Henderson Hasselbalch equation
Neutral pH
pH homeostasis
Removal of H+ from the cell
Renal elimination of acid
Renal handling of an acid load
Renal handling of bicarbonate
Renal response to metabolic alkalosis
Respiratory acidosis/alkalosis
Titratable acidity
What is a buffer?

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4. Cardiovascular Physiology

Heart
Afterload
Cardiac function curves
Coronary artery blood flow
Coronary perfusion pressure
Draw sino-atrial action potential
CVP trace / waveform
Draw the cardiac cycle
ECG-origin of waveform
Ejection fraction
Factors affecting stroke volume
Frank-Starling mechanism
LV Compliance
LV pressure-time curves
LV pressure-volume loop
Myocardial action potential/ionic fluxes / Myocyte action potential
Myocardial cell metabolism
Myocardial contractility
Myocardial O₂ supply and demand
Normal electrocardiograph (ECG)
PCWP as an estimate of LV preload
Preload
Starlings law of the heart
Venous return curves
What is the effect of right atrial pressure on venous return?

Circulation
Aortic vs radial pressure traces
Definition of mean blood pressure
Differences between pulmonary and systemic circulations
Functions of vascular endothelium
Systemic vascular resistance / factors affecting
Zero reference point in the circulation
Compare and contrast muscle capillary with glomerular capillary

Control
Autoregulation
Cardiovascular effects of the Muller manoeuvre
Compensatory effects in chronic anaemia
Determinants of cardiac output
Determinants of central venous pressure
Determinants of blood pressure
Determinants of LVEDV
Role of baroreceptors
Sensing intravascular volume
What factors affect blood pressure in the long term?

Applied CVS Physiology
Effect of body immersion
Effects of cross clamping aorta
Effects of cross clamping the vena cava
Effect of lying supine from a standing position
Effect of steep Trendelenburg position
Effects of tourniquet release
Effects of Valsalva manoeuvre
How does a transplanted heart maintain cardiac output?
Physiology of exercise
Pressure waveforms during pulmonary catheter insertion
Temporal response to haemorrhage

5. Respiratory Physiology

Control of Breathing
Central chemoreceptors/peripheral
Control of ventilation

Gas Exchange/Transport
Alveolar air equation
Alveolar-arterial gradient for oxygen-causes etc
Causes of low PaO₂
Causes of hypercapnoea
Changes in gas exchange due to induction of intravenous anaesthesia
CO₂ carriage in blood
CO₂/ventilation curves
Cyanosis
2,3 DPG
Diffusion abnormalities in the lung
Effects of breathing 100% N2, 100% O2
Effects of hypercapnoea
Haemoglobin dissociation curve
Haemoglobin structure
Haldane effect
Hypoxia-defn, causes and effects
Indices of oxygenation and ventilation
Oxygen cascade-adult and foetal
Oxygen flux
Oxygen stores
Oxygen toxicity
P50
Respiratory quotient
V/Q mismatch
Venous admixture

Mechanics of Ventilation
Airways resistance and measurement
Alveolar pressure
Closing volume-measurement/importance
Closing capacity
Compliance
Dead space, types and measurement
Differences between static and dynamic compliance
Flow volume loops
Lung volumes
Mechanisms of airway trapping
Muscles of respiration
Functional residual capacity-role and measurement
Pulmonary compliance
Resistance to breathing
Respiratory dead space
Respiratory flow volume loops
Single breath nitrogen washout method
Spirometry
Surface tension
Surfactant
Work of breathing

Applied Respiratory Physiology
Altitude
Blood gas interpretation
Breath holding
Continuous positive airways pressure
Effects of age on lung function
Occluded left main bronchus
Occluded left pulmonary artery
Respiratory effects of morbid obesity
Respiratory changes with an open pneumothorax
What happens to a collection of air in the pleural space?

Other
Comparison of pulmonary and systemic vascular resistances
Functions of the nose
Non respiratory functions of the lung
PEFR
Pulmonary blood flow
Pulmonary vascular resistance
Respiratory acidosis/alkalosis
Shunt
Shunt equation
What cells are there in an alveolus?

6. Renal Physiology
Aldosterone
Angiotension II
Anti-diuretic hormone
Atrial natriuretic peptide
Autoregulation
Countercurrent exchange in the kidney
Endocrine functions of the kidney
Excretion of dilute and concentrated urine
Glomerular filtration rate
Glomerular tubular balance
Hormones produced by the kidney
Production of a concentrated urine
Proximal and distal tubular reabsorption
Regulation of potassium
Renal blood flow
Renal excretion of potassium
Renal handling of an acid load
Renal handling of sodium
Renal clearance
Renal concentrating ability
Renal response to metabolic alkalosis
Tubuloglomerular feedback
Urine composition
Water homeostasis

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7. Endocrine Physiology & Thermoregulation

Endocrine Physiology
Aldosterone
Angiotension II
Anti-diuretic hormone
Atrial natriuretic peptide
Control of blood glucose
Effects of bilateral adrenalectomy
Effects of insulin
Hormones: definition, classification and secretion
Insulin and insulin receptors
Thyroid hormone synthesis and action
What are the actions of thyroxine
What types of hormone receptors are there
Describe the metabolic adaptations to fasting
Respiratory quotient

Thermoregulation
Heat production/heat loss
Mechanisms of fever production
Temperature control under anaesthesia
Temperature regulation
Thermoneutral zone
What is the effect of unconsciousness on temperature control?

8. Physiology of Blood & the Immune System

Blood
Blood groups
Changes in stored blood
Coagulation
Contents of a red blood cell
Describe the metabolism of haem
Differences between plasma and serum
Haemoglobin structure
Haemostasis after finger laceration
Iron balance-how absorbed and control
Iron distribution in the body
Loading/unloading of haemoglobin (?supposed to be O₂)
Natural inhibitors of coagulation
Plasma Proteins-functions
Platelet contents and function
Red blood cell production, structure and metabolism
Response to acute anaemia
Von Willebrands factor
What happens to an old red blood cell?
What is in a unit of fresh frozen plasma?
What is the role of Vitamin K in the body?
What stops blood clotting?

Immunology
Anaphylaxis
Body-defence against infection
Complement cascade
Hypersensitivity
What are cytokines?
What is complement?

9. Gastrointestinal Physiology
Absorption of a carbohydrate load
Absorption of glucose through the gut wall
Bile and its loss/formation
Dietary fat handling
Effects of vomiting
Enterohepatic circulation
Functions of the liver
Functions of the pylorus
Functions of the stomach
Gastric acid production
Gastric emptying
Gastric secretions
GI hormones
Inducible enzyme systems
Iron balance-how absorbed and control
Liver blood flow
Liver blood flow-measurement
Lower oesophageal sphincter function / what is
Pancreatic secretions
Small bowel cutaneous fistula
Urea formation
Vomiting
What are the effects of a biliary fistula

10. Neurophysiology
Blood-brain barrier
Cerebral Blood flow
Cholinergic receptors
CSF composition and functions
CSF production and absorption
Describe the normal stages of sleep
How is pain transmitted in the spinal cord
Intracranial pressure
Mechanisms of pain
Mechanisms of windup
Neuromodulation of pain sensation
Reflexes
What is the role of the gamma motor neurone
What factors influence intraocular pressure

11. Physiology of Muscle & Neuromuscular Junction
Circulation to muscle
Describe excitation contraction coupling in skeletal muscle
Draw a muscle spindle
Golgi tendon organ
Smooth muscle
What factors cause smooth muscle contraction?
What is the RMP of resting skeletal muscle?
What types of muscle fibres are there?

12. Maternal, Foetal & Neonatal Physiology
Arterial blood gases in pregnancy
Blood volume changes in pregnancy
Circulatory changes at birth
Foetal circulation
Foetal haemoglobin
Functions of the placenta
Placental O₂ transfer / Factors affecting O₂ transport from mother to foetus
Pregnancy-cardiovascular changes
Pregnancy-respiratory changes

13. Measurement

Physics & Electrical Principles
Boiling point
Impedance & resistance - definition/difference
La Place’s law
Resistors
Resistance in fluid systems
SI units
Units of force, power and work
Venturi
Viscosity
What is capacitance?
What is the difference between gas and a vapour?
What is an exponential process?
What is the meaning of the term resistance?
What is meant by work?
Wheatstone bridge

Gas Analysis
Capnography
Carbon dioxide measurement (Severinghaus)
Gas analysis-infrared, paramagnetic, gas chrom, mass spectrometry
Mass spectrometer
Oxygen measurement
Pulse oximetry
Volatile agent monitoring
What does the term ‘partial pressure’ of a gas in a liquid mean

Flow & Volume Measurement
Airways resistance and measurement
Difference between laminar and turbulent flow
Fick principle
Flowmeters-types and principles
How can one calibrate a spirometer
How does a rotameter work
Measurement of gas flow
Measurement of cardiac output
Measurement of cerebral blood flow
PEFR
Pneumotachograph
Principles of thermodilution
Single breath nitrogen washout method
Spirometry

Pressure Measurement
Calibration of arterial lines
Damping
How can one measure intravascular pressure
How does a Dinamap work
How does one calibrate a pressure transducer
Measurement of blood pressure-invasive and non invasive
Strain gauge
Transducers

Temperature & Humidity
Heat and temperature
Humidity
Temperature measurement
What is a thermistor?

Measurement - Other
Measurement of intracellular water
Measurement of osmolality
Osmometer

Applied Physiology (collected from above sections)
What are the effects of:

How does a transplanted heart maintain cardiac output?
Blood gas interpretation
What happens to a collection of air in the pleural space?
Pressure waveforms during pulmonary catheter insertion

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