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Self-Examination |
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| Answer to the questions with True(T) or False(F): |
| 1. Regarding two compartment
pharmacokinetics a) a drug is always removed from the peripheral compartment b) the central compartment is blood volume c) a drug with a high volume of distribution is likely lipophillic d) a drug can have a short duration of action while being eliminated very slowly e) most anaesthetic drugs are modelled well with a two-compartment model 2. Desflurane a) is a fluorinated methylisopropyl ether b) boils at 23C c) safe to use in patients with malignant hyperpyrexia d) stimulates sympathetic system when inspired concentration is suddenly increased e) prolongs the duration of muscle relaxants 3. Regarding the use of suxamethonium a) bradycardia is a complication b) phase II block occurs more commonly with neonates c) prolonged duration of action may be seen in around one patient in 40 (1:1500) d) can raise the serum potassium by 0.5 mMol. L-1 e) dose required is lower in small children 4. Concerning electroencephalography (EEG) a) voltages are in the range of 10-100 mvolts b) spontaneous EEG activity is lost when body temperature drops below 250C c) b waves are enhanced by sedatives d) d waves only occur in brain injury e) q waves occur at frequency of 4-7 Hz 5. Action potentials a) are all or none signals of about 100 mV in amplitude b) are generated by leakage of K+ down their concentration gradient c) are normally conducted antidromically d) summate at high frequencies e) depend on the size of the stimulus 6. Conduction velocity of a nerve impulse a) is greater in C fibres than in group A fibres b) is greater in large diameter nerve fibres c) is greater in unmyelinated nerve fibres because of saltatory conduction d) can be as fast as 120m/sec in human nerve fibres e) is decreased in hypothermia 7. Regarding drug metabolism by cytochrome P450 isoenzymes a) cytochrome P450 makes up 1% of total liver proteins b) most important enzyme is CYP3A4 c) the system is responsible for most of the reductive metabolism in humans d) volatile anaesthetics are metabolised by CYP2E1 e) some isoenzymes are inhibited strongly by erythromycin 8. Atropine a) may cause bradycardia b) dilates the pupil in premedicant dose c) has shorter duration action than glycopyrrolate d) increases the physiological dead space e) has both muscarinic and nicotinic effects 9. In pulmonary circulation a) capillary hydrostatic pressure is about 25 mm Hg b) 50% of the cardiac output goes to pulmonary circulation in foetus c) angiotensin is broken down d) bradykinin is inactivated e) hypoxia causes vasoconstriction 10. Regarding local anaesthetic agents (LA) a) potency of LAs is proportional to their lipid solubility b) duration of action is dependent on protein binding c) agents with low pKa have faster onset of action d) all local anaesthetics are vasodilators e) the depth of local anaesthetic block is increased by increasing the dose 11. Cisatracurium besylate a) is a mixture of three stereoisomers b) in equipotent doses has a similar duration of action to vecuronium c) is less potent than atracurium d) undergoes more Hoffmans degradation than atracurium e) in equipotent doses has a similar onset time to atracurium 12. If an electric current is fed through the body a) risk of injury is largely dependent upon the current flow b) antistatic shoes provide good protection due to their high resistance c) high frequencies are more dangerous than low frequencies d) ventricular fibrillation occurs at a lower current in patients with dysrhythmias e) tingling sensation is felt at a current strength of 1mA 13. The countercurrent concentrating mechanism in kidney a) depends on active transport of sodium & chloride out of ascending loop of Henle b) allows an osmolality of 1200 mosmoles/kg in distal tubules c) occurs predominantly in the cortical nephrons d) relies on the free movement of water and electrolytes across the walls of vasa recta e) depends on a low concentration of urea in the medullary interstitium 14. The adverse effects of NSAIDs on the kidney a) are reversible in normal kidneys b) are not dose related c) are mediated by inhibition of PGI2 synthesis d) may cause acute interstitial nephritis e) are counteracted by the use of ACE inhibitors 15. The following trigger the secretion of ADH from posterior hypothalamus a) a reduction in ECF by 5% b) chronic renal failure c) anxiety d) supine position e) head injury 16. Concerning the measurement of oxygen a) an oxygen electrode should be calibrated at zero and in room air b) oxygen tension in a liquid can be measured with a Clark electrode c) a polarographic electrode can be used in vivo d) oxygen measurement in a gas mixture makes use of the magnetic property of oxygen e) a fuel cell has a rapid response to change in oxygen concentration 17. Drug clearance a) is the amount of drug removed from plasma in unit time b) is proportional to half-life c) is low in lipid soluble drugs d) occurs only in the liver and kidney e) is calculated by dividing the dose of drug given by area under plasma conc-time curve 18. Volume of distribution of a drug a) is low if the drug is highly protein bound b) can be calculated by multiplying half-life by natural logarithm of 2 c) is relatively low for muscle relaxants d) is proportional to half life e) is dependent on the elimination rate constant 19. Concerning composition of body fluids a) plasma constitutes a quarter of ECF volume b) ECF volume may be grossly depleted in intestinal obstruction c) protein content of interstitial fluid is higher compared to intracellular fluid and plasma d) ratio of ECF/ICF volume is smaller in infants and children e) normal osmolality of plasma is 280 mosmoles/kg 20. Aldosterone causes a) a decrease in urine sodium concentration b) weight gain c) decreased serum chloride level d) increased ECF volume e) increased K+ excretion 21. The following antibiotics have good activity against anaerobic bacteria a) vancomycin b) aztreonam c) metronidazole d) imipenem e) trimethoprim 22. Flumazenil a) may induce panic attacks in susceptible patients b) has anticonvulsant activity in patients with epilepsy c) has a long duration of action d) may cause nausea and vomiting e) has inverse agonist action at benzodiazepine receptors 23. Concerning the blood brain barrier (BBB) a) is virtually impermeable to ions and proteins b) breaks down around the brain infarcts c) rise in serum albumin by 20g/l will draw more H2O across BBB than rise in serum Na+ by 5 mmol/l d) when damaged cytotoxic brain oedema results e) mannitol coresses the BBB easily 24. Osmolality a) is number of osmotically active particles per litre of solvent b) of urine is similar to that of plasma in chronic renal failure c) may be estimated by formula 2X(Na+K) + Blood sug + BUN d) is measured by amount of depression of the freezing point e) is a part of colloid oncotic pressure 25. ABO compatibility is essential for transfusion of a) SAGM blood b) haemoglobin solutions c) cryprecipitates d) FFP e) platelets 26. The following increase during pregnancy a) plasma volume b) fibrinogen c) gastric emptying time d) glucose tolerance e) arterial PaCO2 27. Carbon monoxide a) relaxes the smooth muscle b) inhibits platelet aggregation c) acts as a neural messenger in the brain d) expired concentration is increased in airway inflammatory diseases e) concentration in circle is increased during desflurane anaesthesia 28. Resting potential across the nerve membrane a) depends largely on the ratio of K+ inside and outside the cell b) is positive inside with respect to outside c) is of order of 0.06 volt d) decreases in magnitude during prolonged hypoxia e) is greater the larger the diameter of the nerve fibre 29. Activation of NMDA receptors a) is important in learning and memory b) can result in neuronal damage c) is involved in the development of opioid tolerance d) causes opening of the chloride channel e) may increase the intensity of pain 30. Bacteria develop resistance to antibiotics a) by changing permeability of porin channels in cellwall b) by producing enzymes to inactivate antibiotics c) by altering target sites (DNA gyrase and topoisomerase) for antibiotics d) by active extrusion of antibiotic once it enter the cell e) easily in presence of necrotic tissue |
| Designed by: Gholamreza Ghamatzadeh |