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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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