MED2031 Mid Semester Practice Exam
MED2031 Mid Semester Practice Exam 2010
Respiratory Physiology1. Muscles used in passive expiration
includea. Diaphragmb. External intercostalsc. Internal
intercostalsd. No muscles are usede. Innermost intercostals
2. What is the residual volume in spirometry?a. Amount of air
remaining in lungs after maximum expirationb. Amount of air that is
exhaled when breathing with maximum forcec. Air inhaled or exhaled
when breathing at restd. Total volume of air that can be breathed
in and oute. Maximum amount of air that can be inhaled apart from
that which is breathed in at rest
3. What is vital capacity?a. Amount of air remaining in lungs
after maximum expirationb. Amount of air that is exhaled when
breathing with maximum forcec. Air inhaled or exhaled when
breathing at restd. Total volume of air that can be breathed in and
oute. Maximum amount of air that can be inhaled apart from that
which is breathed in at rest
4. What is inspiratory reserve volume?a. Amount of air remaining
in lungs after maximum expirationb. Amount of air that is exhaled
when breathing with maximum forcec. Air inhaled or exhaled when
breathing at restd. Total volume of air that can be breathed in and
oute. Maximum amount of air that can be inhaled apart from that
which is breathed in at rest
5. What is tidal volume?a. Amount of air remaining in lungs
after maximum expirationb. Amount of air that is exhaled when
breathing with maximum forcec. Air inhaled or exhaled when
breathing at restd. Total volume of air that can be breathed in and
oute. Maximum amount of air that can be inhaled apart from that
which is breathed in at rest
6. What is the anatomical dead space?a. About 2Lb. Volume in
non-functioning alveolic. Volume of conducting airways, nasal
cavity and pharynxd. Equal to physiological dead space if pathology
presente. Space in lungs to which air cannot penetrate
7. What is the physiological dead space?a. Sum of anatomical
dead space and volume in non-functioning alveolib. Volume in
non-functioning alveolic. Volume of conducting airways, nasal
cavity and pharynxd. Equal to anatomical dead space if pathology
presente. Space in lungs to which air cannot penetrate
8. Obstructive lung disease isa. Reduced pulmonary complianceb.
Reduced lung elasticityc. Can be caused by fibrosisd. Can be caused
by asthmae. Decreased airway resistance
9. What is the equation for minute volume?a. Respiratory rate x
tidal volumeb. Vital capacity x tidal volumec. Respiratory rate x
(tidal volume anatomical dead space)d. Tidal volume x respiratory
ratee. Respiratory rate x physiological dead space
10. What is the equation for alveolar ventilation?a. Respiratory
rate x tidal volumeb. Vital capacity x tidal volumec. Respiratory
rate x (tidal volume anatomical dead space)d. Tidal volume x
respiratory ratee. Respiratory rate x physiological dead
spaceVolume of air moved in alveoli in 1 minute
11. Factors affecting rate of gas diffusion include the
following excepta. Thickness of membraneb. Surface area of
membranec. Diffusion coefficient of gasd. Pressure difference
across membranee. Amount of viable alveoli
12. The diffusion coefficient of oxygen is higher than that of
carbon dioxidea. Trueb. False
13. The partial pressure of oxygen (PO2) in the alveolus is:a.
104mmHgb. 40mmHgc. 95mmHgd. 45mmHge. 23mmHg
14. The PO2 in the pulmonary veins isa. 104mmHgb. 40mmHgc.
95mmHgd. 45mmHge. 23mmHg
15. The PO2 in the blood leaving tissues is:a. 104mmHgb.
40mmHgc. 95mmHgd. 45mmHge. 23mmHg
16. The PCO2 in the alveoli isa. 104mmHgb. 40mmHgc. 95mmHgd.
45mmHge. 23mmHg
17. The PCO2 in the pulmonary veins isa. 104mmHgb. 40mmHgc.
95mmHgd. 45mmHge. 23mmHg
18. The PCO2 in the blood leaving tissues isa. 104mmHgb.
40mmHgc. 95mmHgd. 45mmHge. 23mmHg
19. Select the incorrect response. The Bohr effect a. Is a
property of haemoglobinb. States that an increase in carbon dioxide
decreases Hb saturation of oxygenc. Causes can increased amount of
oxygen unloaded to tissuesd. Causes an increased oxygen uptake in
alveolie. Is more pronounced when PO2 is higher
20. The utilisation coefficient of oxygen isa. About 25% and
decreases during exerciseb. About 50% and increases during
exercisec. About 25% and increases during exercised. About 50% and
decreases during exercisee. 100% and increases during exercise
21. Carbon dioxide is transported in the blood in the following
ways except:a. CO2b. HbCO2c. HCO3-d. O2.CO2e. D and A
22. Select the incorrect response. The Haldane effect:a. States
that binding of O2 to Hb displaces CO2 from bloodb. Increases
efficiency of movement of CO2 from blood to alveoli then external
airc. Is due to OxyHb binding CO2 less strongly than
dexoyhaemoglobind. Is due to increased acidity when OxyHb
increasese. Reduces the amount of carbon dioxide removed from
tissues
23. Which of the statements about ventilation is false?a.
Ventilation = (Vt- dead space) x respiratory rateb. Is equal to
perfusion in healthy peoplec. Is usually about 5L/mind. Is
increased near base of lunge. Ventilation: perfusion ratio is equal
in all areas of the lungs
24. Which of the following is false?a. In zone 1 the alveolar
air pressure is greater than pulmonary capillary pressureb. Zone 1
is pathologicalc. In zone 2 there is intermittent blood flow
through pulmonary capillaries during systoled. Zone 3 normally
occurs 10 cm above heart when standinge. In zone 3 the capillary
pressure is greater than the alveolar pressure
25. The alveoli at the apex contribute less to tidal volume than
alveoli at base due to:a. Smaller alveoli which can be expanded
more in the baseb. Gravityc. Increased perfusion near base of
lungd. Increased pressure near base of lungse. Decreased
ventilation: perfusion ratio at apex of lungs
26. Select the incorrect response. Hypoxic pulmonary
vasoconstrictiona. Lowers efficiency of gas exchangeb. Is the
opposite to what happens in tissuesc. Reduces blood flow to areas
with low ventilationd. Helps to match V:Q ratioe. Increases V:Q
ratio
27. Select the incorrect response. In emphysemaa. Lowered
ventilationb. Lowered perfusionc. Enlargement of alveolid. Overall
increase in V:Q ratioe. Manifests as pink puffers and blue
bloaters
28. The dorsal respiratory group:a. Is in the ponsb. Contains
inspiratory and expiratory neuronsc. Receives input from
glossopharyngeal and vagal nervesd. Used in heavy breathinge.
Regulates the shift from inspiration to expiration
29. Which of the following is false? The ventral respiratory
groupa. Contains inspiratory and expiratory neuronsb. Used in heavy
breathingc. Receives input from DRGd. Is activated when respiratory
drive is increasede. Regulates shift from inspiration to
expiration
30. Select the incorrect response. The pneumotaxic centrea. Is
in the ponsb. Occurs in the nucleus ambiguous and nucleus
retroambiguousc. Switches off inspiratory rampd. Controls duration
of expiratione. Has low output to slow the respiratory rateNucleus
parabrachialis is pneumotaxic centre.
31. Sensory receptors providing information to respiratory
centres include the following except:a. Central chemoreceptors
which response to pH changes in CSFb. Peripheral chemoreceptors
which are found in the carotid arteries and aortac. Baroreceptors
which respond to blood pressured. Stretch receptors are found in
the smooth muscle of bronchi and bronchioles and visceral pleurae.
Irritant receptors in the epithelial cells of airways
32. Carbon dioxide is the major factor controlling ventilation
in the short terma. Trueb. False
33. Ventilation increases with exercise because:a. Brain sends
collateral signals to respiratory centres at same time that it
signals to muscles to commence exercisingb. Decreased O2 in bloodc.
Increased CO2 in bloodd. Decreased pHe. Muscle and joint
proprioceptor response
34. Other factors that control ventilation include the following
except:a. Irritantsb. Drugsc. Brain damaged. J receptorse. Blood
pressure changes
35. Acid production in the body:a. Only occurs via glucose
breakdownb. Only occurs via amino acid breakdownc. Produces mainly
respiratory acidd. Produces mainly metabolic acide. Is a product of
renal outflow
36. A small change in pH equals a large change in [H+]a. Trueb.
False
37. The normal pH of arterial blood isa. 7.35b. 7.4c. 7.2d.
0.7e. 8.138. The normal pH of venous blood isa. 7.35b. 7.4c. 7.2d.
0.7e. 8.1
39. The mechanisms for maintaining pH include the following
except:a. Bufferingb. Diffusion c. Respirationd. Renal excretione.
B and D
40. Select the incorrect response. A buffera. Sequesters H+b.
Does not get rid of H+c. Works best if the pKa is equal to the pH
of the fluid it is bufferingd. Includes HCO3-, haemoglobin, plasma
proteins and phosphatee. Reduces pH
41. Normal CO2 pressure in arterial blood is:a. 40nmb. 40mmHgc.
45mmHgd. 24mMe. 7.4
42. Normal [H+]a. 40nMb. 40mmHgc. 45mmHgd. 24mMe. 7.4
43. Normal HCO3-a. 40nmb. 40mmHgc. 45mmHgd. 24mMe. 7.4
44. An increase in HCO3- will lead toa. Increased pHb. Decreased
pHc. Alkalosisd. Acidosise. A and C
45. An increase in CO2 or decrease in O2 in the blood leads to
the following excepta. Increase brain ECF [H+]b. Increase in
central chemoreceptor firingc. Increase in peripheral
chemoreceptors firingd. Increase in medullary inspiratory neurons
firinge. Decrease in ventilation
46. Respiratory acidosisa. Arises through low plasma CO2b.
pH> 7.45c. paCO2> 45mmHgd. increase in H+ or HCO3- not of
respiratory origine. may be a result of hyperventilation
47. Respiratory acidosis can occur in the following ways
except:a. Exaggerated V:Q ventopnoeab. Acute lung diseases like
pneumonia or asthmatic episodesc. Chronic lung diseases like COPD
or cystic fibrosisd. Alteration to central drive for respiration
like a head injurye. Neural linkage to respiratory muscles like
polio or MS
48. PAO2> PaO2a. Is normalb. Suggests pathologyc. Indicates
V:Q mismatchd. Indicates hypoxemia is due to ventilation and not
underlying lung disordere. B and C
49. Sleep is important for the following excepta. Memoryb.
Steroid productionc. Growthd. Immune functione. Protein
synthesis
50. Darkness decreases melatonin releasea. Trueb. False
51. Sleep deprivation can lead to the following excepta. Heart
failureb. Infection riskc. Decreased vascular reactivityd. Increase
sleep latencye. Hypotension
52. Sleep apnoea increases risk of the following excepta.
Arrhythmiasb. Hypotensionc. Neuropsychological damaged. Strokee.
Heart failure
53. Which of the following about sleep apnoea is false?a.
Obstructive sleep apnoea is due to upper airway dysfunctionb.
Obstructive sleep apnoea may be the cause of left ventricular
failurec. Central sleep apnoea is due to respiratory control
dysfunctiond. Central sleep apnoea may be the result of left
ventricular failuree. Central sleep apnoea is more likely to occur
in obese snorers
54. Treatment of sleep apnoea includes the following excepta.
Lifestyle factors like sleep hygiene, weight loss and reduced
alcohol intakeb. Upper airway surgery like UPPP or tonsil and
adenoid removalc. Bariatric surgeryd. Mouth splints to widen the
maxillae. Positive airway pressure
55. The pros of non-invasive ventilation like CPAP include the
following except:a. Avoidance of invasive procedures like tracheal
intubation which have complicationsb. Keeps upper airway intact
which is important in immune defence, swallowing and speechc. Less
sedationd. Increased patient comforte. Potential for abrupt
deterioration
56. Indications for NIVa. Tachypnoeab. Acidotic (pH< 7.35)c.
Hypercapnicd. Heart failuree. All of the above
57. Acclimatisation to lack of oxygen include the following
excepta. Hyperventilationb. Polycythemiac. Increased diffusing
capacity of lungsd. Pulmonary vasoconstrictione. Decreased tissue
capillarity
58. Symptoms of acute mountain sickness include the following
excepta. Headache/dizziness/nauseab. Cerebral oedemac. Peripheral
oedemad. Increased blood viscosity due to increased RBC mass and
haematocrite. Hypoxic pulmonary vasoconstriction
59. Effects of high partial pressures on body includea. Nitrogen
narcosisb. Oxygen toxicityc. Hypercapniad. Pulmonary fixatione. A
and B
60. To avoid decompression sickness, drop hyperbaric pressure
back to normal pressure immediatelya. Trueb. FalseRenal
physiology61. Without functioning kidneys, the following could
occur excepta. Hypotensionb. Anaemiac. Osteoporosisd. Metabolic
acidosise. Hyperkalemia
62. Functions of the kidneys include the following excepta.
Regulation of water and electrolyte volume/osmolarityb. Acid-base
regulationc. Excretion of metabolic wastesd. Secretion of
hormonese. Glycolysis
63. The percentage of total body water which is interstitial
fluid isa. 10%b. 40%c. 60%d. 30%e. 1%
64. The volume of which compartment is regulated?a. Plasmab.
Interstitial fluidc. Intracellular fluidd. Transcellular fluide.
Extracellular fluid
65. What receptor does not monitor changes in ECF volume and
composition?a. Low pressure baroreceptorsb. Osmoreceptors in
hypothalamusc. Renal baroreceptors which leads to renin released.
Adrenal cortexe. Mechanoreceptors
66. The composition of ICF and ECF is identical except fora. Ion
concentrationb. Protein contentc. Water concentrationd. Pressuree.
Osmolarity
67. What is Starlings Law?a. Fluid moves in direction of sum of
forces on each side of membraneb. Equivalent to net driving
pressurec. Takes into account colloid osmotic pressure and
hydrostatic pressured. A and Be. A, B and C
68. Blood flow to kidneys is what percentage of cardiac
output?a. 20-25%b. 10-20%c. 30-50%d. 60%e. 5%
69. Filtration fraction isa. Volume of plasma filtered per
minuteb. Glomerular filtration ratec. GFR/renal plasma flowd.
Amount of plasma filtered during single pass through kidneye. C and
D
70. Which of the following about nephrons is false?a. We are
born with the number of nephrons we will have for the rest of our
lifeb. Nephrons have a filtration component and a tubular
componentc. Nephrons are found in the pelvis of the kidneyd.
Nephrons can cross the medulla and cortex of the kidneye. Nephrons
are the functional unit of the kidney
71. The cortex contains the Bowmans capsule and convoluted
tubulesa. Trueb. False
72. The glomerulus isa. The drainage tubes of the kidneyb.
Interconnected specialised capillariesc. The filtration unit of the
kidneyd. Contain straight and convoluted tubulese. B and C
73. The tubular system contains the following excepta. Proximal
tubulesb. Loop of Henlec. Renal pelvisd. Collecting ducte. Distal
tubule
74. What are the steps in urine formation and where do they
occur?
75. Name the renal blood supply from the renal artery to the
peritubular capillary network
76. The epithelial layer of the glomerular capillaries are made
froma. Mesangial cellsb. Simple squamous cellsc. Cuboidal cellsd.
Podocytese. Connective tissue
77. The parietal layer of Bowmans capsule is made froma. Simple
squamous cellsb. Podocytesc. Capillariesd. Capillary endotheliume.
Mesangial cells
78. Fenestrae are found in __________ and are required for
___________a. Podocytes; particle movementb. Endothelial cells;
expansionc. Mesangial cells; structure maintenanced. Endothelial
cells; particle movemente. Podocytes; expansion
79. Mesangial cells are required for:a. Structure and support of
glomerulusb. Diffusion of particlesc. Changing surface area of
capillariesd. A and Ce. A and B
80. Nephrin is expressed bya. Podocytesb. Mesangial cellsc.
Endothelial cellsd. A and Be. A, B and C
81. Filtration slits exist between ___________ which are found
at the end of ____________ which are extensions from the cell body
of ____________a. Fenestrations; capillary extensions; endothelial
cellsb. Foot processes; pedicles; podocytesc. Fenestrations;
pedicles; endothelial cellsd. Foot processes; capillary extensions;
podocytese. Aquaporins; ADH; anti naturietic peptide
82. The glomerulus filtration barrier is composed of:a.
Endothelial fenestraeb. Glomerular basement membranec. Filtration
slit diaphragmsd. A and Be. A, B and C
83. Select the incorrect response. The juxtaglomerular
apparatus:a. Consists of a macula densa, juxtaglomerular cells,
extraglomerular mesangial cellsb. Monitor salt balancec. Produces
renin and thus regulates glomerular filtration and reabsorption of
Na+ and waterd. Is responsible for majority of water reabsorptione.
Is found at the vascular pole of a renal corpuscle84.
85. What are the forces controlling glomerular filtration
rate?a. Glomerular hydrostatic pressureb. Glomerular osmotic
pressurec. Bowmans space fluid pressured. All of the abovee. None
of the above
86. Glomerular filtration rate is given bya. (PGC PBS - GC ) x
Kfb. NFP x Kfc. Hydraulic conductivity x glomerular capillary
surface area x NFPd. A and Be. A, B and C
87. In liver diseasea. GFR decreasesb. GFR increasesc. Plasma
proteins decreasedd. Plasma proteins increasede. B and C
88. In dehydration, GFR decreasesa. Trueb. False
89. GFR is increased and renal blood flow is maintained bya.
Decreased afferent arteriolar pressure and decreased efferent
arteriolar pressureb. Increased afferent arteriolar pressure and
decreased efferent arteriolar pressurec. Decreased afferent
arteriolar pressure and increased efferent arteriolar pressured.
Increased afferent arteriolar pressure and increased efferent
arteriolar pressuree. All of the above
90. Select incorrect responsea. GFR must be kept relatively
constant or changes in reabsorption occurb. GFR is controlled via
autoregulationc. The myogenic mechanism of GFR control causes
vasoconstriction in efferent arterioles in response to increase
blood pressured. The juxtaglomerular apparatus responds to blood
pressure by changes in renin releasee. Autoregulation only occurs
between arterial pressure of 70-150mmHg
91. What is the definition of renal clearance?
92. The equation for clearance is given by:a. (V x Us)/Psb.
V/Psc. (V x Ps)/Usd. Us/Pse. Ps/( V x Us)
93. Which of the following is the most widely used clinically to
measure GFRa. Inulinb. Creatininec. Glucosed. Ureae.
Para-aminohippurate
94. Which of the following gives the most accurate measurement
for GFR?a. Inulinb. Creatininec. Glucosed. Ureae.
Para-aminohippurate
95. Which of the following is used to measure renal plasma
flow?a. Inulinb. Creatininec. Glucosed. Ureae.
Para-aminohippurate
96. How much sodium and how much water is reabsorbed usually?a.
99.5%, >99%b. 90%, 90%c. 99%, 99%d. >99.5%, >99%e. None of
the above
Pharmacology98. Rhinosinusitis:a. Is caused by bacteriab. Is
treated with antibioticsc. Is treated symptomaticallyd. Is commonly
diagnosed via blood culturese. All of the above
99. Pharyngitis and tonsillitisa. Can be caused by strep
pyogenesb. Can be caused by viruses like adenovirusc. Can be
complicated by peritonsillar abscessesd. Are treated
symptomatically and via antibioticse. All of the above
100. Select incorrect response. Otitis externaa. Is caused by
bacteria and fungib. Includes symptoms like discharge and
itchinessc. Is treated by dry aural toiletd. Is treated with
topical antibiotics and steroidse. Is prevented using prophylactic
antibiotics
101. Otitis mediaa. Is usually self limitingb. Is caused by
viruses or bacteriac. Can present with reddening of tympanic
membraned. Treatment is symptomatic usually or amoxycillin if
persistent and fever occurse. All of the above
102. Select incorrect response. Sinusitisa. Causes severe facial
painb. Causes tenderness over sinusesc. Treatment is valaciclovir
given intravenouslyd. Treatment is symptomatice. Usually caused by
viruses or allergies not bacteria
103. Croup is caused bya. Haemophilus influenzaeb. Parainfluenza
virusc. Rhinovirusd. Adenoviruse. RSV
104. Influenza is treated witha. Vaccinationb. Oseltamivirc.
Amoxycillind. Cefaclore. Doxycycline
105. Select incorrect response. Pertussis a. Caused by
Bordetella pertussisb. Includes symptoms such as paroxysmal
coughing, inspiratory whoop, post-tussive vomitingc. Treated with
antibiotics to prevent spreadd. Prevented with vaccinatione.
Secondarily caused by Haemophilus pertussis
106. Factors predisposing to fungal infections includea.
Moisture and warmthb. Diabetesc. Immunosuppressiond. Obesitye.
Broad spectrum antibiotics
107. Sites of action of fungal infection treatment include the
following excepta. Cell membrane synthesisb. Nucleic acid
synthesisc. Cell membrane integrityd. mRNA synthesise. Cell wall
synthesis
108. Clotrimazolea. Affects cell membrane integrityb. Is narrow
spectrumc. Is applied topicallyd. Inhibits fungal cell divisione.
Has no side effects
109. First line treatment for aspergillosis isa. Terbinafineb.
Amphotericinc. Ketoconazoled. Capsofungine. Griseofulvin
110. A major side effect of azoles isa. Renal toxicityb.
Allergenic reactionsc. Inhibition of P450 enzymesd. Conversion of
lanosterol to ergosterole. Immunosuppression
111. Asthma is caused bya. Inflammationb. Mucus secretionc.
Bronchoconstrictiond. All of the abovee. None of the above
112. Intrinsic asthma is caused bya. Hyper-responsive airwaysb.
NSAIDsc. Allergic responsed. Degranulation of mast cellse. Antibody
release
113. First line treatment for asthma area. Short-acting beta
agonistsb. Long-acting beta agonistsc. Steroidsd. Symptom
controllerse. Preventers
114. Terbutaline isa. Leukotriene antagonistb. Short-acting beta
agonistc. Long-acting beta agonistd. Steroide. Mast cell
stabiliser
115. Low dose inhaled corticosteroids or mast cell stabilisers
are used for asthmaa. As first line treatmentb. As second line
treatmentc. As third line treatmentd. As fourth line treatmente.
Are not used
116. Long acting beta agonists are used for asthmaa. As first
line treatmentb. As second line treatmentc. As third line
treatmentd. As fourth line treatmente. Are not used
117. The drugs classes used to treat angina includea. Nitratesb.
Calcium antagonistsc. Beta-antagonistsd. All of the abovee. None of
the above
118. Select the incorrect response. Glycerol trinitrate a. Is
also called nitroglycerineb. Is extremely volatilec. Lasts less
than 30mins if given sublinguallyd. Lasts less than 6 hours if
given transdermallye. Is used to cause vasodilation
119. Side effects of nitrates include the following excepta.
Hypotensionb. Reflex tachycardiac. Toleranced. Bradycardiae. None
of the above
120. Contraindications for nitrates area. Beta blockersb.
Calcium antagonistsc. Sildenafild. Amiodaronee. Diuretics
121. Which of the following calcium antagonists is most cardio
selective and thus most useful for supraventricular tachycardia?a.
Nifedipineb. Amlodopinec. Verapamild. Diltiazeme. Digoxin
122. In angina, beta blockers are used toa. Vasoconstrict
skeletal muscles vasculatureb. Vasodilate vasculature in skinc.
Decrease heart rated. Decrease paine. Increase water excretion
123. B1 antagonists includea. Atenololb. Metoprolol c.
Propranolold. A and Be. A, B and C
124. The drug classes used to treat arrhythmias includea.
Calcium channel blockersb. Potassium channel blockersc.
Beta-blockersd. Sodium channel blockerse. All of the above
125. An example of a sodium channel blocker isa. Amiodaroneb.
Bretyliumc. Sotalold. Flecainidee. Verapamil
126. Which of the following reduce pro-arrhythmic effects of
adrenaline and NAa. Metoprololb. Amiodaronec. Lignocained.
Diltiazeme. Digoxin
127. A common side effect of beta-blockers isa. Dry coughb.
Nauseac. Impotenced. Hypertensione. Immunosuppression
128. Contraindications for beta-blockers include the following
excepta. Asthmab. Bradycardiac. Calcium antagonistsd. Dry
coughinge. All of the above
129. Drug which prolongs the refractory period to stop
arrhythmias includesa. Amiodaroneb. Lignocainec. Dobutamined.
Carvedilole. Isoprenaline
130. The drug which converts an arrhythmic heart immediately to
sinus rhythm isa. Digoxinb. Adenosinec. Dobutamined. Nifedipinee.
Sotalol
131. Which of the following is not given for atrial
fibrillation?a. Digoxinb. Ca+ channel blockerc. Beta-blockerd.
Adenosinee. Warfarin
132. Which of the following is not given for bradycardia?a.
Isoprenalineb. Atropinec. Adrenalined. Metoprolol e. All of the
above are given
EMQa) Captoprilb) Losartanc) Carvedilold) Atenolole)
Propranololf) Indapamide g) Digoxinh) Dobutaminei)
Nitrovasodilators133. Angiotensin II receptor blocker
134. Limited IV use due to desensitisation and decreased beta 1
receptors
135. Used if ACE inhibitors, ARBs and diuretics
contraindicated
136. Contraindicated with digoxin
137. Common side effect of this drug is dry cough
138. Has long half life thus must be given with high loading
dose
139. Slows heart rateAnatomy140. Where do ribs fracture?a.
Anywhere according to traumab. At angle of ribc. Point of greatest
curvatured. Lateral border of erector spinaee. Clinical
paravertebral linef. All of the above
141. Where is an intercostal catheter usually inserted?a. 2nd
ICS paravertebral lineb. 5th ICS anywherec. 2nd ICS mid clavicular
lined. 5th ICS anterior to mid axillary linee. C and D
142. Select the incorrect response. Which site is used to insert
the intercostal catheter and why?a. Bottom of ICS to avoid
bleedingb. Mid clavicular line to avoid internal thoracic arteryc.
Mid axillary line for easier accessd. Paravertebral line as there
are no vessels here which can bleede. No incorrect response, all of
the above are used
143. Why does an intercostal nerve block have to be performed at
the lateral limit of erector spinae?a. No reason, just traditionb.
Easiest accessc. Dermatomal overlapd. To anaesthetise lateral
branche. No intercostal arteries or veins in this area so fewer
complications
144. The danger zones of the pleura include the following
excepta. Left costoxiphisternal angleb. Right costoxiphisternal
anglec. Above lung apicesd. Inferior to left 12th ribe. Inferior to
right 12th rib
145. Pleural aspiration is performeda. Usually around 9th/10th
ICSb. Anywhere according to clinical investigationc. Lateral border
of erector spinaed. A and Be. A, B and C
146. Why do foreign bodies lodge in the right main bronchus more
often than left?a. Left; more vertical, shorter, narrowerb. Right;
more vertical, shorter, widerc. Left; more horizontal, longer,
narrowerd. Right more horizontal, longer, widere. Right; more
vertical, longer, wider
147. Where does pneumonia from aspirated fluid most commonly
occur?a. Basal segment lower lobe left lungb. Basal segment upper
lobe right lungc. Apical segment lower lobe right lungd. Apical
segment upper lobe left lunge. Apical segment middle lobe right
lung
148. Which of the following about pneumothoraces is correct?a.
Pneumothorax is air filling the lungsb. Tension pneumothorax is
usually the most dangerous of pneumothoracesc. Spontaneous
pneumothoraces commonly occur in short, old womend. Iatrogenic
pneumothorax is of unknown origine. Pneumothoraces are treated
using pleural aspiration
149. The ligamentum arteriosum is a landmark used to find the
branch of the nerve which innervates what in the thoracic region?a.
Heartb. Intercostalsc. Pericardiumd. Parietal pleurae. None of the
above
150. Normal sites of oesophageal narrowing include the following
excepta. C6b. T4c. T5d. T6e. T12
151. This abnormal narrowing site is commonly caused bya. Right
ventricle hypertrophyb. Left ventricle hypertrophyc. Right atrium
hypertrophyd. Left atrium hypertrophye. None of the above
152. A clinical sign that may indicate lung carcinoma seen on an
x-ray isa. Enlarged subcarinal lymph nodesb. Widened carinac.
Diffuse fibrosisd. Fluid meniscuse. Consolidated lobe
153. Aortic coarctation may present clinically witha. Notching
of inferior border of ribsb. Radio-femoral delayc. Notable
pulsations in ICSd. A, Be. B, C
154. What complication of a pterion fracture shows up on a head
CT?a. Crescent shaped haemorrhageb. Lens shaped haemorrhagec.
Spidery, ventricle filling haemorrhaged. Temporal region
contusion
155. Scalp lacerations bleed heavily due to:a. Arteries pulled
apart by dense connective tissueb. Emissary veins being laceratedc.
Superficial veins in skind. Highly vascularised durae. Aponeurosis
resting tone pulling layers apart
156. Possible signs of cavernous sinus thrombosis include the
following excepta. Eye is fully abducted and depressedb. Ptosisc.
Reduced pupillary reflexd. Eye is fully adductede. Miosis
157. Why can subdural haemorrhages be more dangerous than
extradural haemorrhages?a. Easy to misdiagnoseb. Can cause coning
of brainstemc. Faster onset of symptomsd. Subdural haemorrhages are
arterial bleeds whereas extradural haemorrhages are venouse. Unable
to see subdural haemorrhages on head CT
158. An enlarged pituitary can causea. Loss of sight in one
eyeb. Complete blindness (loss of sight in both eyes)c. Binasal
hemianopiad. Bitemporal hemianopiae. ScotomaCranial regions and
brain physiology159. Which of the following about motor neurons is
incorrect?a. Upper motor neurons originate in cortex or brainstemb.
Upper motor neurons control voluntary movementc. Alpha motor
neurons directly innervate musclesd. Lower motor neurons subserve
both reflex and voluntary actionse. Lateral motor pathways control
posture and locomotion
160. Which of the following about the lateral corticospinal
tract is false?a. Originates from motor cortexb. Controls distal
muscles and fractionated movementsc. Decussates in medullary
pyramidsd. Controls facial musclese. Terminates in dorsolateral
region of ventral horns
161. Lesion of upper motor neurons in the brain leads to the
following except:a. Hyper-reflexiab. Hypertoniac. Partial
recoveryd. Impaired voluntary power in musclese. Contralateral
paresis/paralysis
162. Which of the following about areas of the cortex
controlling movement is false?a. The posterior parietal cortex
project to area 4 (primary motor cortex)b. The primary motor cortex
(area 4) generates the impulses which execute movementc. The PMA in
area 6 is responsible for sensory guidance of movement and
proximal/trunk muscle controld. The SMA in area 6 plans motor
actions guided from memorye. Pre-SMA lesions cause inability to
perform complex but not simple movements
163. The cerebellum:a. Refines/coordinating sequences of muscle
contractionsb. Evaluates disparities between intention and actionc.
Has inputs from spinal cord, motor cortex, somatosensory cortex and
visual cortexd. Has outputs to motor systems in cortex and brain
stem but not directly to alpha motor neuronse. All of the above
164. Which of the following about parts of the cerebellum is
false:a. Vestibulocerebellum contains the flocculonodular lobeb.
Spinocerebellum is made of vermis and intermediate parts of
hemispheresc. Vestibulocerebellum is responsible for balance and
receives input from vestibular/visual systemsd. Spinocerebellum
receives somatosensory information from limbs and controls distal
musclese. Cerebrocerebellum only receives input from
thalamusMicrobiology 165. Which of the following about infective
endocarditis is false?a. Infection of endocardium of heartb.
Usually bacterial but sometimes fungalc. Self-limitingd. Can enter
through oral cavity or breach in skine. Can occur due to
endocardial abnormalities like valve defects
166. Clinical features of infective endocarditis include the
following except:a. Feverb. Splinter haemorrhagesc. Petechiaed.
Oslers nodese. Spleen shrinkage
EMQa) Otitis externab) Acute bronchiolitisc) Influenzad)
Pneumoniae) SARSf) Tuberculosisg) Common coldh) Pharyngitis and
tonsillitis
167. Which disease occurs more commonly in children who have
viral infections, is mostly caused by strep pneumoniae but also
caused by Haemophilus influenzae?
168. Which disease is caused 75% of the time by RSV and often in
children under 2 years old?
169. Which disease is caused by the coronavirus, spread via
droplets and results in high fever?
170. Which disease is most commonly caused by the
rhinovirus?
171. Which diseases are commonly caused by adenoviruses but if
caused by strep pyogenes can lead to peritonsillar abscess?
172. Caused by pseudomonas aeruginosa, staph aureus, strep
pyogenes, Proteus and Klebsiella and in immunosuppressed patients
can cause base of skull osteomyelitis.
Pathology173. The roadway of injury includes the following
excepta. Cellular swellingb. Cytoplasmic swellingc. Nuclear
changesd. Crisis point tissue deathe. Loss of membrane
integrity
174. Limitations of the coronary arteries include the following
except:a. Coronary arteries only fill during diastoleb. Hypertrophy
of myocardium results in inadequate blood supply to extra musclec.
Small calibre of vessels means any narrowing leads to poor flowd.
Anatomical end arteries- no anastomoses to provide collateral
supply if occlusion occurse. None of the above- all are
limitations
175. AMIs commonly occur in/due to ischaemia in which region of
the heart?a. Right atriumb. Left atriumc. Right ventricled. Left
ventriclee. In all areas equally
176. Acute myocardial infarction can be diagnosed which of the
following:a. Troponinb. Creatine kinasec. ECG changesd. All of the
abovee. None of the above
177. The following are all consequences of infarction except:a.
Cardiac failureb. Pericarditisc. Thrombus formationd. Muscle
rupture 7-10 days after infarcte. Large scale growth of new
cardiomyocytes
178. Which of the following about AMI diagnostic protein markers
is false?a. Creatine kinase is found in 3 isoformsb. CKMB is most
common in the heartc. Troponin has 3 typesd. Tn T is most commonly
used as it is only manufactured by the hearte. Myoglobin is the
most specific and sensitive of all cardiac markersHealth
Promotion179. Name the 5 CM modalities and give an example of
each
180. Which of the following regarding CM and conventional
therapy is false?a. More out-of-pocket money is spent on CM than on
PBSb. Doctors who practice CM are expected to exhibit same level of
skills of any other practising doctorc. Lack of evidence for an
effect of treatment is not evidence for lack of effectd. 72% of
patients using both CM and conventional treatment do not tell their
doctor they are using CMe. The evidence supporting CM is equivalent
to the evidence supporting conventional medicine181. The Ottawa
Charter includes the following points except:a. Building health
public policyb. Creating hostile and competitive environmentsc.
Strengthening community actiond. Developing personal skillse.
Re-orientation of health care services towards disease
prevention
182. Which of the following about the HP cycle is true?a.
Implementation determines effectiveness of process or outcomeb.
Evaluation measures outcome against specific aims of interventionc.
Development may use the BASK modeld. Implementation makes use focus
groups and surveyse. Evaluation delivers an intervention
183. Which of the following is not a criterion for a screening
test?a. Condition should be common and contribute significantly to
burden of diseaseb. Test should detect condition earlier than
detection without screeningc. Test should have high sensitivity and
specificityd. Test should be able to detect more than one diseasee.
Test should have solid evidence base for efficacy
184. Listening to emo music is associated with youth suicide.
True or False?a. Trueb. False
Clinical skills185. The steps of looking at an ECG include the
following except:a. Rate and rhythmb. Calculating PR interval and
QRS complex durationsc. Analysing the cardiac axisd. Checking for
abnormalities in QRS complexes, ST segments and T wavese. Checking
for discrepancies between leadsThere will be discrepancies between
leads as they are measuring different areas of the heart
EMQ (q 191-196)a) 0.06-0.10sb) 0.12-0.20s c) 100/mind) 60/mine)
75/minf) 25/ming) Irregular rhythmh) Sinus rhythmi) 200msj) 300msk)
150msl) Left axis deviationm) Right axis deviationn) Normal axiso)
Left bundle branch blockp) Right bundle branch blockq) Ischaemiar)
Acute myocardial infarction
186. The normal length of the PR segment is?
187. The normal length of the QRS complex is?
188. The rate is?
189. The rhythm is?
190. The PR interval is?
191. The cardiac axis shows?
192. Which of the following is not a common symptom of CV
disease?a. Chest pain/anginab. Dyspnoea- paroxysmal, exertional,
orthopneac. Ankle or back oedemad. Palpitationse. Myocardial
infarction
193. Which of the following is not a risk factor for CV
disease?a. Family history of CV diseaseb. Past history of CV
diseasec. Hypotension d. Smokinge. Diabetes mellitus
194. Which of the following is not a common symptom in
respiratory disease?a. Coughb. Sputum productionc. Dyspnoead.
Syncopee. Post nasal dripRadha RamananPage 18