ABSTRACT
Audit bleeding include: b. Adults c. Tonsillectomy performed for quinsy d. Use of diathermy e. Use of blunt dissection
67. Naloxone: a. Precipitates acute withdrawal symptoms in opiate addicts b. Is a competitive antagonist at m-opioid receptors only c. Is presented as a clear solution containing 0.4 mg/mL d. Alleviates the pruritus associated with spinal opioid use e. Undergoes extrahepatic conjugation
68. Features of sarcoidosis include: a. Caseating granulomas b. Bilateral hilar lymphadenopathy c. Lymphocytosis d. Hyperprolactinaemia e. Erythema marginatum
69. The Modified Day-Surgery Discharge Criteria include the following parameters for assessment: a. Nausea and vomiting b. Blood pressure c. Site of incision d. Surgical bleeding e. Cognitive dysfunction
70. Features of phaeochromocytoma include: a. 10% are benign tumours b. An association with neurofibromatosis c. Raised urinary 5-HIAA levels d. Dilated cardiomyopathy as a recognized complication e. Persistent hypertension as the most common presenting feature
71. Amide local anaesthetics include: a. Cocaine b. Tetracaine c. Prilocaine d. Etidocaine e. Bupivacaine
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for a appendicectomy includes: using thiopentone and suxametho-
nium with maintenance on propofol and remifentanil b. A spinal anaesthetic c. A modified rapid sequence induction with thiopentone and
rocuronium with maintenance on ether and remifentanil d. A modified rapid sequence induction with thiopentone and
rocuronium with maintenance on sevoflurane e. An induction with ketamine and rocuronium and maintenance
on propofol and remifentanil
73. The following statements are correct for WHO Clinical Staging of HIV/AIDS (2007): a. Persistent generalized lymphadenopathy occurs in Stage 1 b. .10% loss in measured body weight occurs in Stage 2 c. Applies to individuals aged 15 and over d. A CD4 count is required e. There are four stages
74. Application of positive end-expiratory pressure (PEEP): a. Improves left ventricular function in patients with congestive
heart failure b. Increases right ventricular afterload c. Is termed ‘best’ when producing maximal oxygen delivery d. Increases venous return to the right heart e. May compromise portal venous drainage
75. The Braden scale for predicting pressure ulcer risk includes the following parameters: a. Comorbidity b. Skin moisture c. Mobility d. Patient sensory perception e. Reason for admission
76. A patient who has been declared brainstem-dead is undergoing a beating-heart organ retrieval; intravenous administration of the following is appropriate: a. Growth hormone b. T3 c. T4 d. Insulin e. Desmopressin
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c. Atlantoaxial subluxation d. Hypertonicity e. Trisomy 18
78. Regarding acute pancreatitis: a. Diagnosis is preferably made by amylase estimation b. A Glasgow score of 3 indicates severe acute pancreatitis c. Enteral route is preferred for nutritional support d. The Balthazar severity index is used for biopsy staging e. Renal failure is a cause of increased amylase and lipase
79. Causes of thrombocytopenia include: a. Vitamin B12 deficiency b. Trimethoprim administration c. Hypersplenism d. Disseminated intravascular coagulation (DIC) e. Splenectomy
80. Intraosseous cannulation in children: a. Is contraindicated if proximal fractures exist b. Is contraindicated if osteomyelitis is present c. Can be performed in the femur d. Requires aspiration of blood for confirmation of placement e. Does not allow administration of bretylium
81. Intra-aortic balloon pump counter-pulsation: a. Describes inflation in early systole and deflation in diastole b. Is a Class I indication for cardiogenic shock c. Is contraindicated in aortic stenosis d. Uses N2 as the inflation gas e. Requires the tip of the balloon catheter to be distal to the origin
of the left subclavian artery
82. Regarding community-acquired pneumonia a. Haemophilus influenzae is the most frequent pathogen b. Pneumococcal antigen should only be performed in severe cases c. Severity is assessed using CURB-65 score d. Mortality rate for severe cases admitted to ICU is 33% e. Leukocytosis has a stronger association with mortality than
leukopenia
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neuropathy c. Romberg’s test d. Maddox wing test e. Postural blood pressure measurement
84. Features of hypopituitarism include: a. Hypoglycaemia b. Hyper-pigmentation c. Osteoporosis d. Morning cortisol level of 600 nmol/L e. Central obesity
85. Expected blood results for an infant with uncorrected pyloric stenosis would include: a. Hypochloraemia b. Hypokalaemia c. Hypernatraemia d. Metabolic acidosis e. Aciduria
86. The following are correct of adverse drug reactions (ADRs): a. Anaphylaxis is a Type A reaction b. Type B reactions are dose-related c. Only serious reactions should be reported on the Yellow
Card Scheme d. Only health-care professionals can report using the Yellow
Card Scheme e. The Yellow Card Scheme does not apply to herbal remedies
87. A 42-year-old inpatient has been suffering from intermittent generalized convulsions for 45 minutes without regaining consciousness; management should include: a. Diagnosing the type of epilepsy immediately b. Non-depolarizing muscle relaxant after general anaesthetic to
terminate seizure c. A bolus of glucose if the blood glucose level cannot be ascertained d. Administration of a phenytoin bolus 15-17 mg/kg over 1 minute e. Fosphenytoin administration as an alternative to phenytoin
88. Predisposing factors for dissecting aneurysms of the thoracic aorta include: a. Coarctation of the aorta b. Oriental race c. History of trauma d. Unicommisural aortic valve e. Syphilis
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c. Aortic regurgitation d. Foramen magnum stenosis e. Raynaud’s phenomenon
90. In a chronic smoker undergoing routine surgery, the following alterations in respiratory physiology would be expected: a. The oxyhaemoglobin dissociation curve is shifted to the right b. FEV1 declines at the rate of 110 mL/year c. Closing capacity is increased d. Normal pulse oximetry readings e. Carbon monoxide levels may be increased up to 5 times
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1a. False 1b. True 1c. False 1d. True 1e. False ATN is heralded by an acute decrease in glomerular filtration rate (GFR), followed by a rise in plasma urea and creatinine concentrations. There follows a maintenance phase usually lasting 1-2 weeks where GFR remains reduced, leading to further rises in urea and creatinine, and a final phase where tubular function recovers and large volumes of urine are often produced. Hyaline casts can occur under normal circumstances, but tubular epithelial casts indicate renal injury. The following indices are found in prerenal failure and acute renal failure caused by ATN:
Measurement Prerenal failure ATN
Urine osmolality (mOsm/kg) .500 ,300 Urine sodium concentration (mmol/L) ,20 .40 Fractional excretion sodium (%) ,1 .1 Urine : plasma creatinine ratio .40 ,10 Urine microscopy Normal Epithelial casts
2a. False 2b. True 2c. False 2d. True 2e. False Histamine acts on H2-receptors within the mycocardium and has positive chronotropic and inotropic effects. Amiodarone and adenosine are both negatively inotropic and chronotropic. Amiodarone reduces diastolic depolarization and depresses atrioventricular nodal automaticity and conduction. Adenosine reduces sinoatrial and atrioventricular nodal conduction, thus terminating paroxysmal supraventricular tachycardias; it has an extremely short plasma half-life of 10 s. Inhaled nitric oxide is a selective pulmonary vasodilator and therefore does not affect the myocardium. Finally, dantrolene may have antiarrhythmic properties in humans, but it does not affect force of contraction within the myocardium.
