ABSTRACT
T2-L1 c. Supplies the cervical sympathetic ganglia with white rami
originating from the thoracic levels only d. Causes vasoconstriction of the vertebral artery and its branches
via the inferior cervical ganglion e. Is potentiated by digoxin in high doses
22. Base SI units include: a. Kelvin b. Ampere c. Watt d. Joule e. Kilogram
23. Physiological changes in pregnancy include: a. Reduction in plasma cholinesterase b. Reduction in minimum alveolar concentration (MAC) values at
sea level c. Microcytic anaemia d. Reduction in antithrombin II levels e. Significant reduction in gastric emptying
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c. Bioavailability is 90% following subcutaneous injection d. Is strongly basic e. Is active against factor Xa and factor IIa
25. Predictors for mortality without transplantation in a patient with hepatic encephalopathy are: a. Prothrombin time (PT) .100 s b. Serum bilirubin .225 mmol/L c. Age ,40 years d. Hepatitis B e. Paracetamol toxicity associated with blood pH ,7.3
26. A patient on ICU, admitted for respiratory failure, develops severe sepsis; contraindications to the administration of recombinant human activated protein C (rhAPC) include: a. Epidural catheter in situ b. Haemorrhagic stroke 6 months ago c. Platelet count ,100 109/L d. Intracranial neoplasm e. Multi-organ failure
27. A patient is admitted with an Addisonian crisis; the following features are expected: a. Hypertension b. Hypokalaemia c. Hypernatraemia d. Hyperglycaemia e. Pyrexia
28. Beck’s triad consists of: a. Tachycardia b. Hypotension c. Retrosternal pain d. Narrowed pulse pressure e. Muffled heart sounds
29. The following factors increase the risk of electrocution in the operating theatre: a. Current of high rather than low frequency b. Earthed patient contact c. Capacitative coupling d. Line isolation monitor e. High humidity
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c. Increases sinoatrial node automaticity d. Is contraindicated in aortic stenosis e. Is metabolized by monoamine oxidase (MAO)
31. Concerning measurement of body fluid volumes: a. Plasma volume can be measured with radiolabelled albumin b. Intracellular volume can be measured directly with deuterium
oxide c. Extracellular fluid volume can be measured using mannitol d. Extracellular fluid volume is most accurately measured with
inulin e. Intersititial fluid volume cannot be measured directly
32. Concerning body weight: a. Ideal body weight can be calculated using Broca’s index b. Lean body weight is the weight of all the soft tissue organs,
excluding bone and fat c. Suxamethonium should be dosed according to ideal body weight d. The Devine formula for ideal body weight takes age into account e. Body surface area can be calculated from the Mosteller formula
33. A mountain climber ascends to an altitude of 3500 m in 12 hours; the following would be expected: a. Lower percentage of inspired oxygen than at sea level b. Hypoxic pulmonary vasoconstriction c. High-altitude pulmonary oedema d. Alkaline urine e. Cheyne-Stokes breathing pattern during sleep
34. The following is correct of renal replacement therapy (RRT): a. Synthetic haemofilters are associated with superior outcomes b. For veno-venous catheters the ‘arterial’ port removes blood from
holes on the side c. Patients with a platelet count ,80 109/L should receive
prostacyclin d. Haemofiltration is based on the principle of diffusion e. Improvement in outcome has been demonstrated in septic shock
35. Recognized risk factors for post-extubation stridor (PES) in ICU include: a. Obesity b. Large endotracheal tubes c. Presence of a nasogastric tube d. Myasthenia gravis e. Intubation for more than 36 hours
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b. Prolonged labour c. Polyhydramnios d. Previous PPH e. Protein C deficiency
37. A 65-year-old man presents for emergency surgery; on examination he has a slow-rising pulse and a loud ejection-systolic murmur; haemodynamic management for general anaesthesia includes: a. Normal to high pulse rate b. Isoprenaline administration for persistent hypotension c. High to normal systemic vascular resistance (SVR) d. Low preload e. Atropine administration for heart rates ,60/min
38. The following statements regarding the measurement of lung volumes are correct: a. A Vitalograph only measures expiratory volumes and flows b. Clinical measurements are performed at STP c. Functional residual capacity ¼ residual volume þ inspiratory
reserve volume d. A Benedict-Roth is a ‘wet’-type spirometer e. A Wright respirometer is inaccurate for continuous flow
39. Doxapram: a. Is contraindicated in thyrotoxicosis b. Causes an increase in cardiac output c. Can be given orally d. Is used as an adjunct for intubation e. Increases cerebral blood flow
40. In evidence-based medicine: a. Level Ib is based on at least one randomized controlled trial b. Level III is based on case reports c. Level IV is based on clinical experience of respected authorities d. Grade C recommendations are based on level III evidence e. Grade of recommendation does not reflect clinical importance of
recommendation
41. The following lead to an increase in pulmonary artery occlusion pressure (PAOP): a. Mitral stenosis b. Acute respiratory distress syndrome (ARDS) c. Pulmonary fibrosis d. Left ventricular failure e. Use of positive end-expiratory pressure (PEEP)
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and atlas is normally 5 mm
b. Intervertebral joints are synovial c. The anterior longitudinal ligament connects C1 to the sacrum d. Ligamentum flavum connects the laminae of adjacent vertebrae e. The vertebral artery does not pass through the foramen
transversarium of C7
43. A 74-year-old man is admitted to the ICU following return of spontaneous circulation (ROSC) after a prolonged in-hospital asystolic cardiac arrest. He is comatose and normothermic; reliable predictors of outcome include: a. Absent motor responses on day 1 post-arrest b. Burst suppression on electroencephalography c. His age d. Absent corneal reflexes on day 1 post-arrest e. The circumstances surrounding his cardiac arrest
44. National Institute of Health and Clinical Excellence (NICE) Guidelines recommend immediate CT scanning in head-injured adult patients with the following criteria: a. .1 episode of vomiting b. Amnesia for all events following impact c. GCS ,13 on immediate examination d. Battle’s sign e. GCS ,14 on assessment in A&E 1 hour following injury
45. Duchenne’s muscular dystrophy: a. Is a sex-linked recessive condition b. Typically presents at the age of 7 years c. Is associated with normal plasma creatine kinase (CK) levels d. Is associated with severe kyphoscoliosis e. Is commonly associated with autonomic dysfunction
46. Heart failure during pregnancy can be safely treated with: a. Digoxin b. Diuretics c. ACE inhibitors d. Nitrates e. Hydralazine
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of radiation by a given
concentration is the same as that of twice the thickness of solution of half the concentration
b. Lambert’s law states that each layer of equal thickness absorbs an equal fraction of radiation that passes through it
c. The isobestic point depends on haemoglobin concentration and temperature
d. Oxygen is a paramagnetic gas e. Clark’s electrode consists of an Ag/AgCl anode and a gold mesh
cathode
48. With regard to a sub-Tenon’s block: a. Tenon’s capsule fuses posteriorly with the dura of the optic nerve b. Warfarin therapy constitutes an absolute contraindication c. Globe perforation is not a risk d. Akinesia is volume-dependent of local anaesthetic e. It is ineffective anaesthesia for vitreoretinal surgery
49. Injury of the ulnar nerve at the elbow results in: a. A claw hand deformity worse than ulnar lesions at the wrist b. Paralysis of the medial half of the flexor digitorum profundus c. Inability to flex the wrist joint d. Inability to abduct the thumb e. Paralysis of the 3rd and 4th lumbricals causing hyperextension of
the metacarpophalangeal joints
50. Ketamine: a. Is a pentazocine derivative b. Is contraindicated in porphyria c. Acts by competitive antagonism of NMDA receptors d. Does not affect postoperative nausea and vomiting e. Increases circulating catecholamine levels
51. The following are boundaries of the femoral triangle: a. Fascia iliaca forms the roof b. The inguinal ligament forms the superomedial border c. The lateral border is the medial border of sartorius d. The femoral vein lies outside the femoral sheath e. The psoas muscle forms part of the floor
52. American College of Cardiology/American Heart Association guidelines (2003) state that the following are Category I indications for echocardiography in the critically ill patient: a. Suspected myocardial contusion b. Haemodynamic instability c. Suspected aortic dissection d. Suspected pericardial tamponade e. Follow-up investigation in major trauma
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(SAH): should be treated with surgical
clipping c. Risk factors include smoking d. WFNS Grade 4-5 patients should be intubated and ventilated e. The highest risk of re-bleeding is at days 3-7 following
haemorrhage
54. Regarding a child with patent ductus arteriosus (PDA): a. Treatment consists of indometacin b. True persistence is recognized after 1 month c. Accounts for 30% of congenital heart disease d. Thoracotomy, when performed, is usually right-sided e. Cyanosis is an early sign
55. Necrotizing fasciitis: a. Is polymicrobial in type I infections b. Is most commonly caused by group B streptococci c. Speed of spread is directly proportional to the thickness of the
subcutaneous layer d. Is an absolute indication for surgery e. Leads to tissue destruction due to release of exotoxins
56. The Wright respirometer: a. Is used for measuring forced expiratory volumes b. Consists of a vane moved by gas flow c. Has a vane that rotates in both directions d. Measures continuous flow accurately e. Produces an electrical output for analysis
57. Clonidine can be used for: a. Intravenous regional anaesthesia (IVRA) b. Menopausal flushing c. Control of high intracranial pressure d. Seizure control e. Migraine
58. Regarding heat loss during anaesthesia: a. The linear phase precedes the redistribution phase b. Patients with autonomic neuropathy do not exhibit the plateau
phase c. Both general and regional anaesthesia are causes d. Specific heat capacity of blood is 1.2 kJ kg21 8C21
e. Convection is the primary method under anaesthesia
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plexus: nerves have the same origins c. The lateral cutaneous nerve of the thigh is formed from L3-4 d. The genitofemoral nerve receives a contribution from T12 e. The ilioinguinal and iliohypogastric nerves receive contributions
from T12 and L1
60. Sodium: a. Is the principal extracellular anion b. Is mainly reabsorbed in the distal convoluted tubule c. Antidiuretic hormone (ADH) is released in response to serum
osmolality of 280 mOsm/kg d. Correction can cause central pontine myelinolysis, which is
diagnosed by CT e. Daily requirements are 0.1 mmol kg21 day21 in an adult
61. Fondaparinux: a. Is derived from heparin b. Has antithrombin activity c. Causes heparin-induced thrombocytopenia (HIT) d. Is safe in renal failure e. Is not reversed by protamine
62. A young man is brought to A&E following a motorcycle accident. He is very pale, hypotensive and tachycardic and complaining of difficulty breathing, with left-sided chest pain. The following is correct: a. Stony dullness is a likely finding on left chest examination b. Hyperresonance is a likely finding on left chest examination c. Definite absence of tracheal deviation excludes tension
pneumothorax d. Spinal shock is likely e. A mediastinum .8 cm width at the aortic arch on chest X-ray is
abnormal
63. Regarding Nissen’s fundoplication: a. It is an effective treatment for a primary oesophageal carcinoma b. Mortality rate is less than 1% c. Dumping syndrome is a recognized postoperative risk d. Achalasia is effectively treated e. Patients who require fundoplication are at increased risk of
bronchiectasis
64. Proximal muscle weakness is classically a feature of: a. Polymyositis b. Guillain-Barre´ syndrome c. Polymyalgia rheumatica d. Hypothyroidism e.
