McqMate
Chapters
| 101. |
Regarding local anaesthetics (LA) |
| A. | Lignocaine is metabolised in the liver faster than any of the other amide LA |
| B. | Allergies to amide Las are more common than with the ester Las |
| C. | Prilocaine is the most cardiotoxic LA |
| D. | Cocaine is an amide LA which is often used as a drug of abuse |
| E. | The +1/2 of lignocaine may be increased 3-4 fold in a patient with severe liver disease |
| Answer» E. The +1/2 of lignocaine may be increased 3-4 fold in a patient with severe liver disease | |
| 102. |
Regarding nondepolarising muscle relaxants |
| A. | Jaw and eye muscles are paralysed before the limb and trunk muscles |
| B. | Rocuronium is the most potent nondepolarising skeletal muscle relaxant |
| C. | Atracurium is a steroid derivative |
| D. | Vecuronium blocks cardiac muscarinic receptors, thus inducing moderate increase in heart rate |
| E. | The nondepolarising agents produce a non-surmountable blockade |
| Answer» A. Jaw and eye muscles are paralysed before the limb and trunk muscles | |
| 103. |
The skeletal muscle relaxant with the longest duration of action is |
| A. | Suxamethonium |
| B. | Mivacurium |
| C. | Pancuronium |
| D. | Rocuronium |
| E. | Vecuronium |
| Answer» C. Pancuronium | |
| 104. |
Which of the following DOES NOT increase the susceptibility of a nerve fibre to conduction blockade by a local anaesthetic |
| A. | Small diameter |
| B. | Myelination |
| C. | Location in the periphery of a nerve |
| D. | High firing rate |
| E. | Short action potential duration |
| Answer» E. Short action potential duration | |
| 105. |
Diuretics |
| A. | Work to lower BP initially by decreasing peripheral vascular resistance |
| B. | Thiazide diuretics are potassium sparing |
| C. | Are effective in lowering Bp by 20 – 25 mmHg in most patients |
| D. | BP response to thiazides continues to increase at doses greater than usual therapeutic dose. |
| E. | Diuretics may impair glucose tolerance |
| Answer» E. Diuretics may impair glucose tolerance | |
| 106. |
Methyl dopa |
| A. | Lowers the heart rate and cardiac output more than clonidine does |
| B. | Causes reduction in renal vascular resistance |
| C. | Has minimal CNS side effects |
| D. | Has 80% bioavailability |
| E. | Usual therapeutic dose is about 1 – 2 mg/day |
| Answer» B. Causes reduction in renal vascular resistance | |
| 107. |
Propranolol |
| A. | Is a B1 specific blocker |
| B. | Causes prominent postural hypotension |
| C. | Inhibits the stimulation of renin production by catecholamines |
| D. | Has a half life of 12 hours |
| E. | Has no effect on plasma lipids |
| Answer» C. Inhibits the stimulation of renin production by catecholamines | |
| 108. |
Hydralazine |
| A. | Dilates veins but not arterioles |
| B. | Is contraindicated in the treatment of preeclampsia |
| C. | Can cause an SLE type syndrome in up to 10 – 20% of patients |
| D. | Causes orthostatic hypotension in many cases |
| E. | Is extremely useful as a single agent in treatment of hypertension |
| Answer» C. Can cause an SLE type syndrome in up to 10 – 20% of patients | |
| 109. |
Which of the following drug’s metabolism characteristics are bimodally distributed in the population? |
| A. | Sodium nitroprusside |
| B. | Clonidine |
| C. | Minoxidil |
| D. | Hydralazine |
| E. | Phentolamine |
| Answer» D. Hydralazine | |
| 110. |
The ACE inhibitors |
| A. | Inhibit peptidyl dipeptidase thus preventing the inactivation of bradykinin |
| B. | Captopril is a prodrug |
| C. | Are to be used with caution in patients with IHD as reflex sympathetic activation occurs secondary to the hypotensive effects of the ACE inhibitors |
| D. | Have no role in treating the normotensive diabetic patients |
| E. | Are useful antihypertensive agents in late pregnancy |
| Answer» A. Inhibit peptidyl dipeptidase thus preventing the inactivation of bradykinin | |
| 111. |
The following drugs when combined with ACE inhibitors may produce troublesome problems EXCEPT |
| A. | Diclofenac |
| B. | Potassium supplements |
| C. | Spironolactone |
| D. | Lithium |
| E. | Theophylline |
| Answer» E. Theophylline | |
| 112. |
The nitrates |
| A. | Have an antianginal effect via vasodilation of arterioles only |
| B. | Serve to increase preload |
| C. | Have a direct effect on cardiac muscle to cause a decrease in anginal symptoms |
| D. | All have high oral bioavailability |
| E. | Are contraindicated in the presence of increased intracranial pressure |
| Answer» E. Are contraindicated in the presence of increased intracranial pressure | |
| 113. |
Regarding Calcium channel blockers |
| A. | Calcium channel blockers are not bound to plasma proteins |
| B. | Nifedipine has less vascular potency than verapamil |
| C. | Felodipine has been shown to inhibit insulin release in humans |
| D. | Diltiazem has a plasma half life of 3 – 4 hours |
| E. | Verapamil has high affinity for cerebral blood vessels thus decreasing vasospasm post subarachnoid haemorrhage |
| Answer» D. Diltiazem has a plasma half life of 3 – 4 hours | |
| 114. |
Which of the following calcium channel blockers is excreted predominantly in the faeces? |
| A. | Nifedipine |
| B. | Felodipine |
| C. | Diltiazem |
| D. | Nimodipine |
| E. | Verapamil |
| Answer» C. Diltiazem | |
| 115. |
Which of the following calcium channel blockers has the longest plasma half life? |
| A. | Felodipine |
| B. | Diltiazem |
| C. | Amlodipine |
| D. | Nimodipine |
| E. | Verapamil |
| Answer» C. Amlodipine | |
| 116. |
The following include major actions of digoxin on cardiac electrical functions EXCEPT |
| A. | Decreased PR interval on ECG |
| B. | Decreased conduction velocity at the AV node |
| C. | Increased automaticity of the atrial muscle |
| D. | Decreased effective refractory period in purkinje system/ventricles |
| E. | Bigeminy can be induced by digoxin |
| Answer» A. Decreased PR interval on ECG | |
| 117. |
Which of the following increases the risk of digoxin induced arrhythmias? |
| A. | Hyperkalaemia |
| B. | Hypercalcaemia |
| C. | Hypermagnesaemia |
| D. | Hyperuricaemia |
| E. | Hypernatraemia |
| Answer» B. Hypercalcaemia | |
| 118. |
Digoxin |
| A. | Is poorly lipid soluble |
| B. | Is extensively metabolized |
| C. | Has a half life in the body of 40 hours |
| D. | Has minimal GI toxicity |
| E. | Is 80% bound to plasma proteins |
| Answer» C. Has a half life in the body of 40 hours | |
| 119. |
Drugs which may increase digoxin effect include all of the following EXCEPT |
| A. | Amiodarone |
| B. | Diltiazem |
| C. | Frusemide |
| D. | Quinidine |
| E. | Antacids |
| Answer» E. Antacids | |
| 120. |
Which of the following drugs has the smallest volume of distribution? |
| A. | Chloroquine |
| B. | Verapamil |
| C. | Imipramine |
| D. | Warfarin |
| E. | Digoxin |
| Answer» D. Warfarin | |
| 121. |
Which is the most common organism causing community acquired pneumonia? |
| A. | pneumococcus |
| B. | hemophilus influenzi |
| C. | viral |
| D. | gm negatives |
| E. | mycoplasma |
| Answer» A. pneumococcus | |
| 122. |
which organism causing pneumonia has an increased association with COPD |
| A. | pneumococcus |
| B. | hemophilus influenzi |
| C. | viral |
| D. | gm negatives |
| E. | mycoplasma |
| Answer» B. hemophilus influenzi | |
| 123. |
Which organism causing pneumonia has an increased incidence in IV drug users and those post-influenza? |
| A. | pneumococcus |
| B. | staph aureus |
| C. | viral |
| D. | gm negatives |
| E. | mycoplasma |
| Answer» B. staph aureus | |
| 124. |
Which drug/s should be used in adult mild-mod. Community acquired pneumonia? |
| A. | amoxycillin |
| B. | doxycycline |
| C. | rulide |
| D. | any of the above as a single drug |
| E. | amoxycillin and rulide |
| Answer» D. any of the above as a single drug | |
| 125. |
Which drug regimen is suggested for severe community acquired pneumonia initially? |
| A. | benzyl penicillin and gentamicin and erythromycin |
| B. | benzyl penicillin and gentamicin |
| C. | ceftriaxone and gentamicin |
| D. | gentamicin and erythromycin |
| E. | flucloxacillin and gentamicin |
| Answer» A. benzyl penicillin and gentamicin and erythromycin | |
| 126. |
Which bug makes up 50% of hospital acquired pneumonia? |
| A. | pneumococcus |
| B. | staph aureus |
| C. | gm –ve bacilli |
| D. | legionella |
| E. | chlamydia psittici |
| Answer» C. gm –ve bacilli | |
| 127. |
What is the largest size spontaneous primary pneumothorax that can be managaed without aspiration or thoracostomy? |
| A. | 10% |
| B. | 15% |
| C. | 20% |
| D. | 30% |
| E. | 35% |
| Answer» C. 20% | |
| 128. |
In which sort of pneumoathorax is aspiration likely to be most successful? |
| A. | traumatic |
| B. | secondary |
| C. | primary |
| D. | iatrogenic |
| E. | equally effective in all of the above |
| Answer» C. primary | |
| 129. |
What if the role of aspiration in traumatic pneumothoraces? |
| A. | there is no role |
| B. | first line management in small pneumathoraces only |
| C. | it should be tried in all pneumathoraces as long as there is no respiratory compromise |
| D. | it can be repeated twice before thoracostomy tube is considered |
| E. | none of the above |
| Answer» A. there is no role | |
| 130. |
Whatis the recurrence rate of primary spontaneous pneumathoraces? |
| A. | 10% |
| B. | 20% |
| C. | 30% |
| D. | 40% |
| E. | 50% |
| Answer» E. 50% | |
| 131. |
Which is not a biochemical feature of transudative pleural effusions? |
| A. | protein<30g/l |
| B. | pleural protein:serum protein <0.5 |
| C. | pleural LDH : seurm LDH < 0.6 |
| D. | pleural glucose< serum glucose |
| E. | none of the above are biochemical features |
| Answer» D. pleural glucose< serum glucose | |
| 132. |
Which of the list below is not the cause of an exudative pleural effusion? |
| A. | viral pneumonia |
| B. | pancreatitis |
| C. | TB |
| D. | Malignancy |
| E. | Nephrotic syndrome |
| Answer» E. Nephrotic syndrome | |
| 133. |
Which of the list below is not a cause of a transudative pleural effusion? |
| A. | CCF |
| B. | PE |
| C. | SLE/RA |
| D. | Cirrhosis |
| E. | Nephritic syndrome |
| Answer» C. SLE/RA | |
| 134. |
Which is not a possible cause of haemoptysis? |
| A. | PE |
| B. | Mitral stenosis |
| C. | Pneumonia |
| D. | Aortic stenosis |
| E. | Neoplasm |
| Answer» D. Aortic stenosis | |
| 135. |
Which statement is false about haemoptysis? |
| A. | massive haemoptysis is greater than 600ml in 24 hours |
| B. | a CXR is normal in about 25 % of cases |
| C. | in any four cases, one is likely to be due to nonteuberculous infection, one due to neoplasia, one due to rarer causes and one idiopathic |
| D. | in massive hemoptysis the pt should be nursed bleeding lung up |
| E. | if possible a double lumen tube should be reserved for post brochoscopy as a rigid bronchoscope cannot be passed down it |
| Answer» D. in massive hemoptysis the pt should be nursed bleeding lung up | |
| 136. |
Which drug/intervention is of no proven benefit in management of acute severe asthma in adults? |
| A. | steroids |
| B. | magnesium |
| C. | steroids |
| D. | CPAP |
| E. | Aminophylline |
| Answer» E. Aminophylline | |
| 137. |
As a generalization, at what PEFR should someone be admitted? |
| A. | PEFR<25% pretreatment and <40% posttreatment |
| B. | PEFR<10% pretreatment and <20% posttreatment |
| C. | PEFR<40% pretreatment and <60% posttreatment |
| D. | PEFR<50% pretreatment and <70% posttreatment |
| E. | PEFR is of no value in this decision |
| Answer» A. PEFR<25% pretreatment and <40% posttreatment | |
| 138. |
Which statement is false? |
| A. | Ipratropium is of definite proven benefit in asthma when used with B agonists |
| B. | Ketamine is the intubation agent of choise but in ongoing therapy in acute asthma no benefit has yet been proven in the few studies done |
| C. | Oral steroids are as effective as parenteral steroids |
| D. | Aminophylline may have a role in acute treatment in children but not in adults |
| E. | No studies have been done to see whether adrenaine is better than parenteral salbutamol |
| Answer» A. Ipratropium is of definite proven benefit in asthma when used with B agonists | |
| 139. |
Which is FALSE regarding CPAP in acute asthma? |
| A. | it decreases the work of breathing |
| B. | it causes bronchodilation and decreases airway resistance |
| C. | it improves gas exchange if used alone in severe asthma |
| D. | it may be an effective alternative to ETT when maximal pharmacotherapy is used |
| E. | it reduces the cardiovascular impact of changes in pressures caused by asthma |
| Answer» C. it improves gas exchange if used alone in severe asthma | |
| 140. |
Which drug/intervention is rarely used acutely in the acute setting of exacerbation of COAD? |
| A. | salbutamol |
| B. | CPAP |
| C. | Aminophylline |
| D. | Steroids |
| E. | Ipratropium |
| Answer» C. Aminophylline | |
| 141. |
Which statement is incorrect regarding the acute management of exacerbation of COAD? |
| A. | support for the widespread use of steroids is limited |
| B. | support for the use of salbutamol combined with ipratropium is limited |
| C. | B agonists are widely used assuming the possiblility of a small reversible component to the airflow obstruction |
| D. | Support for the widespread use of CPAP and BiPAP is minimal |
| E. | Theophylline is rarely used acutely |
| Answer» D. Support for the widespread use of CPAP and BiPAP is minimal | |
| 142. |
Regarding pulmonary emboli, which statement is correct? |
| A. | a normal Aa gradient excludes a PE |
| B. | a paO2>80 excludes a PE |
| C. | a normal CXR excludes a PE |
| D. | anticoagulation reduces mortality from PE from 30% to 10% |
| E. | all of the above are correct |
| Answer» D. anticoagulation reduces mortality from PE from 30% to 10% | |
| 143. |
With regards to PE which statement is CORRECT? |
| A. | embolectomy has a better outcome than thrombolysis in massive PE |
| B. | streptokinase is more effective with lower side effects than tPA in massive PE |
| C. | LMWH is probably as effective as unfractionated heparin |
| D. | TOE is sensitive for peripheral emboli |
| E. | Spiral CT angiography is better at detecting peripheral clots than central |
| Answer» C. LMWH is probably as effective as unfractionated heparin | |
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