ANESTHESIA MARCH' 08

FCPS I - 26th MARCH' 08
ANESTHESIA

1. If a drug is taken orally. How will u assess the drug?
a. plasma drug conc
b. blood drug conc
c. urine drug conc

2. Regarding Nitroglycerine, all are true except
a. extensive 1st pass effect
b. venodilator
c. dec venous return
d. dec HR
e. t1/2 is 3-5 min

3. Warfarin, effect inc by
a. Cimetidine

4. Why the dose of theophylline in infant is smaller than in adults
a. dec metabolism
b. dec plasma protein binding

5. Enzyme induction occurs in:
a. liver
b. kidney
c. heart
d. adrenals

6. Digoxin toxicity
a. Inc K*
b. Inc Mg*
c. dec Ca**
d. dec Na*
e. alkalosis

7. Secondary active transport occurs thru
a. glucose
b. Na*
c. K*
d. Urea

8. 2 liters of 2 different gases of diff mol wt contain
a. equal no. of molecules
b. equal no. of atoms

9. Capillary permeability is inc by
a. hypertension
b. plasma colloid osmotic pressure
c. intersitial hydrostatic press
d. altered permeability

10. PG in inflammation dec by:
a. aspirin
b. corticosteroids
c. phosphodiesterase inhibitors

11. Which is true.
a. all parasymp are cholinergic
b. all sympathetic are adrenergic
c. all post-gang parasymp are cholinergic

12. Gastric motility is inc by:
a. inc gastrin
b. ACh
c. Secterin
d. Somatostatin

13. Gastric acid is inc by
a. Gastrin
b. ACh
c. Secterin
d. Somatostatin

14. Basal level of bile

15. alpha recptors effects ?
a. inc HR
b. lipogenesis
c. midriasis
d. piloerector contraction
e. bronchodilator

16. Beta effect ?
a. Inc HR and force of contraction

17. ACh effect?
a. Inc salivation
b. inc sweating
c. constipation

18. Thirst is dec by:
a. ADH
b. aldosterone
c. Ag II
d. baroreceptor efferent
e. inc Hematocrit

19. promotes each others actions
a. atropine and reserpine
b. amytriptyline and reserpine
c. atropine and amitryptyline

20. After induction of anesthesia by 10 mg/kg thiopentone, pt is hypotonic. Cause ?
a. hypersensitivity
b. dec HR
c. dec contractility

21.In hypertonic obs cardiomyopathy, which Ca** channel blocker is used:
a. Nifedipine
b. Nicardipine

22. Loop diuretics + thiazides enhance each others effect ( Dec NaCl abs) at:
a. descending loop of Henle
b. ascending loop of Henle
c. proximal convoluted tubule
d. distal convoluted tubule
e. collecting duct

23. Pt with mild CCF. Treatment started. 1 week later pt complains of severe pain at Rt big toe. Cause:
a. thiazide
b. furosemide
c. ACEi
d. amiodarone

24. Metastatic pleural effusion. Drug to be given:
a. streptomycin
b. clindamycin
c. corticosteroids
d. bleomycin

25. Monotherapy for mild CCF:
a. digoxin
b. captopril
c. nifedipine
d. propranolol

26.Pacemaker for complete heart block. Terminals shd be in:
a. SA node
b. AV node
c. Rt atrium
d. purkinje
e. Rt ventricle ..............(correct)

27. Infant with renal abnormality (renal artery stenosis). Drug responsible:
a. ACEi
b. Ca** channel blocker
c. amiodarone

28.Lungs inactivate Bradykinin by:
a. enz involved in converting kallikrein to plasma protein

29.After loss of 1 litre of blood in 5 min:
a. diastolic press dec
b. systolic press dec
c. aldosterone inc
d. no change

30. CO = VR. Large hump on left of cardiac pacing mentions:
a. inc contractility
b. inc HR
c. inc end-diastolic vol

31. Amiodarone.........> MOA

32. Lidocaine. MOA?
a. dec abnormal tissue conduction and no effect on normal tissue
b. inc PR interval
c. dec atrial contraction
d. dec AV conduction
e. inc QRS
f. inc QT

33. Class IA antiarrythmic drugs
a. Lidocaine
b. quinidine
c. procainide
d. amiodarone

34. Lidocaine as antiarrrythmic:
a. blocks Na* channels
b. Beta blocker
c. K* channel blocker

35.Verapamil ..... as antiarrythmic ?

36.Drug that inc extracellular K* (moves K* out of the cell):
a. Angiotensin
b. H2CO3
c. Carbonic anhydrase
d. pH
e. exercise

37. Sec K* in renal cells
a. metabolic alkalosis
b. carbonic anhydrase

38. Consistent finding in hypoKalemia
a. prolong vomiting
b. diarrhea
c. ureters attached to colon

39. Metabolic alkalosis
a. renal failure

40. ARF- most effect.
a. PCT
b. DCT
c. LOH
d. CD

41. Hb 8.0, HCO3- inc (35), pH Inc, Ca++ dec. Cause
a. ARF
b. Vit D def
c. folic acid deficiency
d. PTH

42. Anesthetics differ from anelgesics in:
a. only alter A delta and C fibers
b. Anesthetics effect at cerebral level and analgesics at spinal cord level
c. affects only pain and temp and no other sensory modalities

43. High output cardiac failure
a. Thiamine
b. B2
c. B6
d. Folic acid

44. 90 yrs old lady with purplish large patch on Rt hand and arm. No itching or pain. No comorbids, Otherwise Normal. Reason?
a. Capillary abn
b. Prothrombin
c. Vit K dependent clotting factors

45. 10 yrs old girl from Baluchistan c/o fatiguw, lethargy, mild jaundice, discoloration of skin, enlarged spleen. Hb 8.0, MCV 58, S. Ferritin 1000. Appropriate treatment?
a. deferroxamine
b. blood transfusion
c. iron transfusion

46. Death d/t embolism after accident
a. Fat
b. tumor cells
c. air
d. thromboembolism

47. Warfarin, effects on:
a. Factor VIII
b. factor III
c. Prothrombin

48. Ibpratopium bromide given by nebulization:
a. dec ACh release in bronchi
b. vasodil
c. inc secretion

49. Mast cell stabilizer.
a. Na chromoglycate

50. T1/2 of desmethyl diazepam, an inactive metabolite of diazepam is:
a. 20-50 hrs
b. 50-100 hrs
c. 100-200 hrs
d. 36-200 hrs ................... (correct)

51. Post menopausal women with brease ca. DOC
a. Tamoxifen

52. Sec released from thyroid gland entering circulation is:
a. Thyroxine
b. Free T3
c. free T4
d. TSH
e. TRH

53. Cushing's triad:
a. Inc ICP, HTN, Bradycardia
b. Inc ICP, hypoTN, bradycardia
c. inc ICP, hypoTN, tachycardia
d. inc ICP, HTN. tachycardia
e. dec ICP, HTN, tachycardia

54. CSF
a. total 150 ml
b. production rate 20 ml/hr
c. produced by ependymal cells of choroid plexus
d. drained by lymphatics

55. CSF:
a. Inc K* than plasma
b. dec glucose
c. dec specific gravity

56. PTH
a. inc PO4 abs from renal tubules
b. inc Ca resorption from bones
c. CRF
d. Anemia

57. Imp buffer in interstitial fluid
a. H2CO3
b. Hb
c. plasma pr.
d. PO4

58. Cell wall synthesis inhib
a. Penicillin

59. Sulphonamides inhibit
a. tetrahydrofolate in bacteria

60. Dark urine after starting ATT.
a. Rifampin

61. 1 week after starting of ATT, pt c/o pain in big toe. Reason
a. INH
b. Rifampin
c. Ethambutol
d. PZA

62. Needle inserted at paramedian vertebral canal pierces:
a. ant spinal lig
b. post spinal lig
c. supraspinal lig
d. interspinal log
e. ligamentum flavum

63. Pseudomembrane colitis linked to:
a. clindamycin
b. penicillin
c. cephalosporins
d. erythromycin

64. Regarding chemotherapy all are true, except:
a. often multi therapy is not curative
b. req daily dosing of multiple drugs for long time

65. Flumazenil
a. onset of action 30-60 min
b. all unconscious pts must be screened by this drug
c. paradoxical tachycardia
d. max safe dose 1 mg/day

66. Isoflurane
a. MAC 1.9
b. req special vaporizer
c. dec HR

66. Sevoflurane
a. dec HR
b. req use of normal vaporizer

67. MAC of Sevoflurane with 60% NO
a. 0.66-0.68

67. Ether causes
a. autonomic stimulation

68. Enflurane
a. EEG typical of seizures
b. not concerned to dose / conc adm
c. inc ICP
d. nonevident facial spasm

69. More pungent.
a. Isoflurane
b. enflurane
c. desflurane at MAC <1

70. Halothane

71. Metabolism of halides to release fluroide levels in descending order:
a. desfurane < isoflurane < enflurane < sevoflurane < halothane < methoxyflurane
0.02 0.2 2.5 3 - 5 20

72. Blood flow regulation
a. cerebrum > cerebellum > sp. cord
b. sp. cord > cerebellum > cerebrum
c. cerebrum > sp. cord > cerebellum

73. N2O shd not be used in elderly with intestinal obs d/t:
a. risk of inc distension

74. Cylinder half filled with liquid N2O. Pressure in the cylinder?

75. Pressre of N2O cylinder is 750 psi. Pressure in the cylinder till the last drop evaporates?

76. T1/2 N2O ?
a. does not undergo metab and is exc unchanged

77. Myocardial toxicity to a L/A?
a. Bupivacaine

78. cardiovascular collapse
a. bupivacaine

79. MetHbemia
a. Prilocaine

80. Fracture 5, 6th rib. longest acting L/A to be given
a. Bupivacaine

81. MAC related to:
a. Bl / gas solubility
b. oil / gas solubility
c. alveolar air conc.

82. Hyperoxia. All true except 1.
a. retrolental fibroplasia
b. atelectasis
c. dec surfactant prod
d. CV depression
e. anemia

83. PG released in inflammation are inhibited by:
a. aspirin
b. corticosteroids
c. serotonin

84. Muscle relaxant that can be given to an asthmatic pt
a. atracurium
b. tubocurare
c. cisatracurium
d. suxa

85. Muscle relaxant, renally exc, long duration of action
a. tubocurare
b. vancuronium
c. pancuroniun
d. gellamine

86. For disinfection hands shd be washed with
a. phenol
b. alcohol with chlorhexidine
c. formaldehyde

87. The operating room shd b cleaned with the following drug, following surgery of HIV pt:
a. 10% gluteraldehyde
b. 1% phosphoenol
c. 2% gluteraldehyde
d. H2O2

88. Following is true regarding sterilization:
a. repeated heating denatures polyvenyl tubings
b. autoclaving is heating objects at 121 degC at 15 psi for 3 min
c. radiation (UV light)
d. dry heat
e. formaldehyd

89. Reason for heat generation when CO2 is passed thru soda lime
a. formation of CaCO3
b. CaO formation
c. friction b/w soda and CO2

90. Flowmeter stops working when
a. flow of N2O > O2
b. flow of O2 > N2O
c. breakage / disruption of control valve.

91. Laminar flow (MURAD QS)
a. flow directly prop pressure
b. resistance independent

92. When Rynolds no. exceeds 3000
a. viscosity dec
b. density dec
c. velocity dec

93. Flow meter
a. used towards expiration
b. kept vertical to keep the dial needle at zero
c. not affected by humidity
d. cannot be attached to the ventilator

94. Regarding transducer all are true except
a. changes signal from 1 form of energy to another
b. capacitanc transducer can be used on body

95. Movement of molecules from high conc they layer/ surface:
a. diffusion
b. osmosis
c. doppler effect

96. Critical temp is:
a. the temp at which gas must be cooled to become liquid

97. Latent heat of vaporization:
a. temp at which liquid converts to vapour / gas without the utilization of external heat
b. becomes zero with gain of energy

98. Relation of vol of a subs to its weight is:
a. density
b. viscosity
c. conc

99. To convert Celcius scale to Farenheit scale:
a. 9/5 *F- 32
b. 5/9 *F x 32
c. 5/9 *F + 32
d. Subract 32 and multiply by 5/9
e. add 32 and multiply by 9/5

100. Pt lying uncovered in operating room. Max heat is lost by:
a. Conduction
b. convection
c. radiation
d. evaporation

101. Pt with ETT tube. Heat is lost by:
a. Conduction
b. convection
c. radiation
d. evaporation

102. As the gas flows thru the vaporizer
a. gas is heated
b. outside of the container is cooled
c. surface vapour with highest energy is evaporated

103. Humidity is measured by:
a. hygrometer
b. thermometer

104. Apart frm measuring end tidal CO2 conc., capnograph can also measure
a. CO2 saturation
b. PO2
c. reduced Hb
d. oxyHb

105. Regarding Capnograph
a. rise of baseline indicate failure of valve
b. rise of height indicate valve failure

106. O2 is measured by all techniques except ......................(MURAD QS)
a. mass spectrometry

107. alpha waves with eyes closed
a. convert to beta when eyes open
b. convert to delta in REM
c. followed by slow frequency, high altitude wave

108. During diathermy when neutral plate is disturbed: ( Burn inc as current density inc, but independent of freq )
a. pt may get a burn even at ECG electrodes ( Burn can occur at all frequencies )
b. depends it is operating at cutting or coagulation mode
c. depends on current frequency

109. Strong magnetic instruments may not be used in a remote village d/t side effects. Instrument that can be used is:
a. CT scan
b. MRI
c. Angioplasty

110. Resistance in series:
a. inc as the wire is stretched
b. known as strain gauge used as pressure transducer
c. proportional to current flow

111. Wheatstone bridge
a. measures changes of resistsnce
b. no current flows when bridge is balanced

112. Pulse oxymetery
a. signals occur at 0.5 sec
b. light emitted by filtered light source

113. Variance is related to:
a. variability
b. square root of std deviation
c. range

114. Which measure of central tendency is used most frequently in clinical practise
a. mean
b. mode
c. median
d. 50th percentile
e. Wilcoxon rank sum test

115. t-test
a. shows relation of 2 paired means

116. Surgeon treats 200 pts of heamorrhoids. He randomly divides the pts into surgically treated and pharmacologically treated groups. After 1 yr he reasses the pts and finds that surgically treated pts have better outcome. This is called:
a. case - control study
b. cohort study
c. prospective cohort
d. randomized control trials

117. Treatment of strep pneumonia by sulphonamide and penicilline by random selection is called:
a. single blind
b. double blind
c. tripple blind

118. O2 carried most in fetal circ.
a. Umblical artery
b. Umblical vein
c. Superior vena cava
d. Aorta

119. Esophagus histology
a. covered by squamous ep
b. has str. sq in upper 1/3
c. has str. sq. in lower 1/3
d. has 3 layers of muscles
e. esophageal opening acting as anatomical sphincter

120. Length of larynx.
a. 15 cm average
b. cricoid to T2 cartilage

121. Esophageal opening
a. at left crus of diaphragm
b. Left phrenic nerve also passes thru this opening
c. at level of T12 vert
d. acts as anatomic sphincter to the stomach

122. Pt complains of chest pain for more than 30 min . ECG shows changes in V1- V4. It denotes:
a. anterior wall MI
b. anterolateral MI
c. Inferior wall MI
d. Lateral wall MI
e. Inferior wall MI

123. Groove for subclavian artery at
a. clavicle
b. 1st rib
c. 2nd rib
d. 6th rib

124. Structures entering thorasic inlet
a. accessory nerve
b. aorta
c. superior vena cava
d. azygous vein
e. Left recurrent laryngeal nerve

125. Diaphragm is directly not attached to:
a. T10 vertebral body
b. L1 vertebral body
c. xiphisternum
d. 10th rib

126. Fibrous pericardium and parietal layer of serous pericardium is supplied by
ä. phrenic nerve
b. cardiac plexus
c. esophageal plexus
d. intercostal nerves

127. Needle inserted at 5th intercostal space on the left of the sternum pierces:
a. internal intercostal muscle
b. internal membrane
c. left atrium
d. left ventricle
e. right ventricle

128. Which is untrue. 1st branch of ascending aorta is:
a. RCA from anterior aortic sinus
b. LCA from arch of aorta
c. left subclavian

129. 2nd heart sound is produced d/t :
a. closure of aortic and pulmonary valves

130. S2 splitting occurs d/t
a. delayed closure of pulmonic valve

131. Spinal cord ends at the level of lower border of:
a. L2 vertebra
b. L3 vertebra
c. L4 vertebra
d. L5 vertebra
e. S1 vertebra

132. Which is a branch of posterior division of sacral plexus
a. pudendal nerve
b. posterior cutaneous nerve of thigh
c. common peroneal nerve
d. nerve to quadratus femoris
e. perforating cutaneous nerve

133. Aortic pressure tracing is highest at which phase of cardiac cycle:
a. isovolumetric relaxation
b. rapid ejection phase
c. slow ejection phase
d. isovolumetric contraction

134. Muscle of quiet inspiration
a. diaphragm

135. Damage to pneumotaxic centre leads to:
a. apneusis
b. deep inspiration
c. short expiratory phase
d. irregular breathing
e. apnea

136. Thich filaments:
a. actin
b. myocin
c. tropomyocin
d. actin and myocin
e. troponin

137. Example of carrier mediated counter transport:
a. Na- glucose transport

138. Depolarization of cell is maintained by:
a. Na influx

139. Inhaled foreign body lodges in which part of lung
a. Rt apical bronchus

140. At the end of expiration:
a. intra-alveolar pressure is subatmospheric
b. intra-pleural pressure is subatmospheric

141. Action potential thru large nerve fiber:
a. 300 ms
b. 30 ms
c. 3 ms
d. 0.3 ms
e. 0.03 ms

142. Blow to the lateral surface of knee joint damages:
a. medial meniscus, medial collateral lig and anterior cruciate lig.

143. Knee joint is supplied by:
a. L3-L4

144. Vagus forms the efferent pathway of:
a. Hering- Breur reflex
b. J- receptors of pulmonary capillaries
c. Bain Bridge reflex

145. Leftwatd shift of oxy-Hb curve is called:
a. Bohr effect
b. Haldane effect
c. Chloride shift

146. Ventilation perfusion mismatch in which Ventilation > Perfusion is called as:
a. shunt
b. dead space

147. Most important buffer is interstitial fluid
a. Hb
b. H2CO3
c. H2PO4
d. Proteins

148. Damage to what part of brain will result in central cease of respiration
a. medulla

149. Pacinian corpuscles related to
a. touch
b. vibration
c. pressure
d. rapidly adapting pain
e. slowly adapting pain

150. Medullary respiratory group of neurons part of ascending reticular system
a. True
b. false

151. Anion gap increases in:
a. Uncontrolled DM

152. Bile from liver is different from that from GB in:
a. has more HCO3-
b. has more mucous and pigments
c. has more anions

153. Dry mouth increases all except
a. thrist
b. ADH
c. Ag II
d. Plsma osmolarity
e. Plasma vol

154. H* sec from nephron is inc by
a. acidosis
b. alkalosis

155. Coronary blood flow is maintained by:
a. autoregulation

156. Increased filtration thru capillary is fascilitated by:
a. Inc plasma colloid osmotic pressure
b. inc hydrostatic pressure of cap
c. inc hydrostatic pressure of ISF
d. inc oncotic pressure of ISF

157. General anesthesia influences
a. motor is affected 1st
b. pain neurons blocked 1st
c. sensory neurons blocked 1st
d. autonomic neurons blocked 1st

158. Middle cerebral artery supplies
a. leg foot area of motor and sensory cortex.......... true / false

159. Stretch reflex afferent 1a fibers .................... true/false

160. Mediators of inflammation
a. C3a
b. C5a
c. IL1
d. TNF alpha

161. Largest total cross-sectional and surface area is of:
a. artery
b. arterioles
c. capillaries
d. venules
e. veins

162. Blood flow regulation is mediated by:
a. arterioles
b. precepillary sphincter
c. capillaries
d. venules

163. If heart rate is 80 beats/min
a. duration of PR interval wld be b/w 0.12 - 0.16 sec

164. Lung function that cannot be measured by spirometry:
a. Residual vol

165. FRC = ?
a. ERV + RV

166. Hypoglycemia increases
a. SSK
b. Somatostatin
c. Gastrin
d. VIP
e. Secretin

167. Gastric acid is stimulated by:
a. Gastrin
b. CCK
c. Secterin
d. GIP
e. VIP

168. Somatostatin dec sec of which hormone
a. ADH
b. Insulin
c. Oxytocin
d. Prolactin
e. Thyroid hormone

169. A postmenopausal women suffered fracture d/t osteoporosis. Her Ca** is Inc, PO4 is dec. Reason?
a. Estrogen
b. Cortison
c. PTH
d. CRF
e. Calcitonin

170. Physics... Capacitance