pastest

Question 1

how are NSAIDs categorised by risk of GI bleeding? give examples?

Answer 1

low risk - ibuprofen
intermediate - ketorolac, diclofenac, indomethacin
high - piroxicam , azopropazone

Question 2

which is the most ototoxic drug?

Answer 2

cisplatin - everyone gets a degree of hearing loss

Question 3

what is more ototoxic aminoglycosides or furosemide?

Answer 3

aminoglycoside abx - gentamicin

Question 4

what is the mechanism of clonidine and dexamedetomidine? what effects does this have?

Answer 4

alpha 2 agonist

hypotension
analgesia
sedation

Question 5

is tramadol safe in renal failure?

Answer 5

no,
active metabolite (O-desmethyltramadol) which is excreted renally

Question 6

what is the mechanism of cabergoline?
what is another example of drug in this group?

when are these used?

Answer 6

dopamine D2 receptor agonist

bromocriptine

hyperprolactinaemia - inhibits prolactin at anterior pituitary
acromegaly - inhibits GH release

Question 7

give an example of a somatostatin analogue ?

what is the indication?

Answer 7

octreotide

used for acromegaly as it inhibits GH release

Question 8

what is the bio-oral availabiltiy of paracetamol and aspirin and diclofenac?

Answer 8

paracetamol - 90%
aspirin - 70%
diclofenac - 50%

Question 9

what breaks down succinylcholine?

Answer 9

pseudo cholinesterase
aka as plasma esterases.

Question 10

which class I antiarrhythmic can be used in ALS?

Answer 10

lidocaine (1b)
when amiodarone is not available/contraindicated.

Question 11

which class of anti-arrhyhmic is lidocaine?

Answer 11

1b

Question 12

outline main mechanism of class I to IV anti-arrhythmics and their main effect on ECG…

Answer 12

class 1 = Na channel blocker
2 = B blocker
3 = K channel blocker
4 = Ca channel blocker

class 1 - widens QRS
class 2 - slows rate and widens PR
class 3 - prolongs QT
class 4 - slows rate and widens PR

Question 13

list the inducers of warfarin at CYP450

Answer 13

Abx - rifampicin

antiepileptic - phenytoin, carbemazepine, topiramate, barbiturates

other - Griseofulvin and st johns

PS CRAPT = phenytoin, st johns, carbemazepine, rifampicin, alcohol (indirect), phenobarbital (barbiturates) , topiramate

Question 14

which antiemetic is particularly useful for chemo induced N&V?

Answer 14

dexamethasone

Question 15

how do the class I anti-arrhythmics affect phase 0 of action potential, the refractory period and action potential duration?

Answer 15

phase 0
- class I a - moderate reduction
- class I b - small reduction
- class Ic - large reduction

action potential duration
- a - increased
b - reduced
c - no effect

refractory period
a - increased
b - reduced
c - no effect

Question 16

how do amiodarone and digoxin differ in effects on vision?

Answer 16

amiodarone - optic neuropathy
digoxin - red green colour vision change

Question 17

which anti-arrhythmic drug class does phenytoin belong to? what can it do to heart rhythm with IV administration?

Answer 17

clas Ib
complete heart block - increases PR

reduces refractory period

Question 18

what is the oil gas partition for sevoflurane?

Answer 18

80

Question 19

what is the molecular weight of sevo?

Answer 19

200Da

Question 20

which volatile has highest molecular weight?

Answer 20

SEVO

Question 21

what is the % of metabolism of the different volatiles?

Answer 21

0.02% desflurane
0.2% - isoflurane
2% - sevoflurane & enflurane
20% - halothane

Question 22

what is the SVP of halothane

Answer 22

32

Question 23

what is the SVP of isoflurane?

Answer 23

33

Question 24

what is the SVP of desflurane?

Answer 24

89

Question 25

what is the SVP of enflurane?

Answer 25

23.3

Question 26

what is the SVP of sevoflurane

Answer 26

22.7

Question 27

what is the MAC of halothane?

Answer 27

0.75

Question 28

what is the MAC of sevoflurane?

Answer 28

2.2

Question 29

what is the MAC of isoflurane? and enflurane?

Answer 29

isoflurane = 1.17 enflurane = 1.91

Question 30

what is the MAC of desflurane?

Answer 30

6

Question 31

what is the mac of nitrous oxide?

Answer 31

103

Question 32

what muscarinic receptor is found in heart and what type of receptor is this

Answer 32

M2 Gi

Question 33

where are M1 receptors located?

Answer 33

autonomic ganglia salivary glands gastric tissue Gq receptor

Question 34

where are M3 receptors located? what type of receptor is this?

Answer 34

smooth muscle - bronchoconstriction, GI movement also eyes - miosis Gq

Question 35

where are M4 and M5 receptors found and what type of receptors are these?

Answer 35

both in CNS M4 = Gi M5 = Gq

Question 36

what does phentolamine do to the nasal mucosa?

Answer 36

congestion increases risk of bleeeding Phentolamine = adrenoreceptor alpha antagonist

Question 37

which model is used for TCI propofol in kids?

Answer 37

2 options kataria paedfusor

Question 38

what is the Shuttler model?

Answer 38

TCI propofol model

Question 39

what is the domino model?

Answer 39

TCI for ketamine

Question 40

what class drug is pioglitazone?

Answer 40

TZD - Thiazolidinedione

Question 41

what class drug is sitagliptin?

Answer 41

gliptins DDP4 inhibitors diabetes

Question 42

which pain med is well suited for chronic pain/ chronic regional pain syndrome?

Answer 42

IV ketamine

Question 43

what are routes of administration for salbutamol?

Answer 43

IV oral inhaled sub cut

Question 44

what mixture does salbutamol consist of?

Answer 44

Racemix mixture of R and S enantiomers

Question 45

which anaesthetic induction agent has the highest clearance?

Answer 45

propofol 30-60ml/kg/min

Question 46

which anaesthetic induction agent has highest Vd?

Answer 46

propofol

Question 47

which anaesthetic induction agents have active metabolites?

Answer 47

thio ketamine

Question 48

which anaesthetic induction agent is least protein bound?

Answer 48

ketamine - 25%

Question 49

what anaesthetic drug is most likely to cause bronchospasm ?

Answer 49

atracurium (more so than desflurane)

Question 50

what is the delta ratio?

Answer 50

the ratio of change in the anion gap to the ratio of change in bicarbonate.. <0.4 = normal anion gap 0.4-0.8 = mixed normal and high gap 1-2 = high anion gap met acidosis >2 = met acidosis and alkalosis

Question 51

how can TRALI and TACO be differentiated by time frame?

Answer 51

TRALI - within 6 hours TACO - within 12 hours, up to 24

Question 52

what does a funnel plot in statistics do?

Answer 52

checks for risk of publication biased

Question 53

which type of study does a forest plot look at?

Answer 53

meta analysis

Question 54

what is the power of a study?

Answer 54

the sample size that is required to pick up a significant difference

Question 55

how do sulphonamide antibiotics work?

Answer 55

false substrate for folic acid synthesis pathway - prevent folic acid production and DNA synthesis

Question 56

how does chloramphenicol work?

Answer 56

binds 50s - inhibits protein synthesis

Question 57

how does fusidic acid work?

Answer 57

bacteriocidal inhibits protein synthesis

Question 58

what are the symptoms of a stellate ganglion block?

Answer 58

warm dry hand horners - constricted pupil, ptosis, enopthalmos, anhydrosis

Question 59

what is the reason for urinary retention with cauda equina?

Answer 59

reduced bladder sensation

Question 60

what are the different degrees of nerve injury?

Answer 60

neuropraxia - compression - local myelin damage only axonotmesis - crush - neuron damaged but surrounding e.g. epineureum, perinerum remain in tact neurotmesis - transection

Question 61

what are the nerve roots of the common peroneal nerve?

Answer 61

L4-S2

Question 62

how many values lie within 1, 2, 3 Standard deviations of the mean?

Answer 62

1= 67.7 % 2 = 95 3 = 99.7

Question 63

what is the most accurate info that can be obtained from an arterial line?

Answer 63

directly measured is systolic and diastolic pressures therefore this is most accurate indirectly calculated is stroke volume, contractility , SVR - less accurate

Question 64

which statistical test is used for parametric data comparing 2 groups?

Answer 64

student unpaired t test e.g. comparing group having a placebo and drug - unpaired because they are 2 separate groups or student paired t test e.g. comparing before and after results - paired because the each result needs to be paired for each patient.

Question 65

when is chi squared test used?

Answer 65

for categorical data

Question 66

which zone of the liver is for drug detox?

Answer 66

zone 3 - furtherest from portal triad, lowest perfusion

Question 67

which zone of the liver does bile production? what else occurs here?

Answer 67

zone 1 cholesterol production gluconeogenesis

Question 68

what do sodium levels do to MAC?

Answer 68

hyponatremia - lower MAC

Question 69

what is class I , II and III electrical equipment ?

Answer 69

class I - earthed case class 2 - double insulation of all parts class 3 - extra low voltage

Question 70

how is SVT treated?

Answer 70

adenosine if asthmatic - verapamil / diltiazam (CaCB)

Question 71

how does venturi effect and bernouli principle relate?

Answer 71

venturi effect is an APPLICATION of the bernoulli principle

Question 72

what is the formula for estimating weight of a child?

Answer 72

(age x 3) + 7

Question 73

how do different LMA sizes relate to weight?

Answer 73

0-5kg - size 1 5-10kg - size 1.5 10-20kg - size 2 20-30kg - size 2.5 >30kg - size 3

Question 74

how is amps of power of a circuit calculated?

Answer 74

watts/ volts

Question 75

what is the normal value for vital capacity?

Answer 75

around 4500ml ERV (1000) +IRV(3000)+ TV(500)

Question 76

when is liver damage at its max post paracetamol OD?

Answer 76

3-4 days

Question 77

when is IV acetylcysteine given before blood results are back?

Answer 77

if more than 150mg/kg 8-24 hours post ingestion

Question 78

which enatiomer of bupivacaine is less cardiotoxic?

Answer 78

S (not R)

Question 79

which metabolite of pancuronium is active and can cause prolonged muscle paralysis in renal failure?

Answer 79

3 - hydroxypancuronium (50% as potent)

Question 80

which anticoag has shortest half life?

Answer 80

unfractionated heparin

Question 81

what are the levels of evidence?

Answer 81

1a = systematic review 1b = well designed RCT 2a = well designed, controlled non randomised 2b - cohort 3 - case control 4 - expert opinions

Question 82

what are the recommendation grades in in statistics?

Answer 82

A - level 1 evidence = 1a and 1b B - level 2 evidence C- level 3 evidence D - level 4 evidence

Question 83

size of LMA ?

Answer 83

0-5 kg = 1 5-10kg = 1.5 10-20 = 2 20-30 = 2.5 30 -50 = 3 50-70=4 70+ = 5

Question 84

which statistical test looks at incidence?

Answer 84

chi squared

Question 85

what are more powerful, parametric or non-parametric tests?

Answer 85

parametric

Question 86

how does confidence interval vary with sample size?

Answer 86

larger sample size smaller confidence interval - i.e. narrower range of which 95% chance of true value lying between

Question 87

what type of data can median and SD be used?

Answer 87

Median and Standard Deviation are reserved for quantiative data that has a normal distribution.

Question 88

give examples of ordinal data

Answer 88

qualaitive but given a value e.g. ASA, frailty score can be compared by Chi squared

Question 89

if the P value is <0.05 what can we say?

Answer 89

statistically significant but cant say if clinically significant i.e. cant confirm one treatment is better than the other