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(1)

Primary Exa

m 2014.

2

n Pape

r Questio

Short Answe

r

1. Describ

e th

e vascula

r anatom

y o

f th

e antecubita

l foss

a (arteria

l an

d venous)

.

2. Describ

e th

e washou

t o

f desfluran

e fro

m a

patient followin

g si

x hour

s o

f genera

l

anaesthesia. Yo

u ma

y wis

h t

o us

e a

graph t

o illustrat

e th

e description

.

3. Briefl

y outlin

e th

e acut

e managemen

t o

f malignan

t hyperthermi

a (durin

g a

relaxant genera

l anaesthetic)

. Describ

e th

e importan

t aspect

s o

f dantrolen

e

pharmacology relevan

t t

o treatin

g malignan

t hyperthermia

.

4. Describ

e a

n activ

e anaestheti

c ga

s scavengin

g system

.

5. Describ

e th

e physiolog

y o

f th

e pai

n pathway

s an

d ho

w drug

s ma

y modulat

e th

e

perception o

f pain

.

6. 20ml

s o

f 0.5

% bupivacain

e i

s inadvertentl

y administere

d intravenousl

y ove

r 1

5

seconds t

o a

60 yea

r old

, 60k

g woman

. Describ

e th

e potentia

l complication

s an

d

mechanisms o

f these

.

7. A

new

test calle

d th

e "intubatio

n score

" ha

s a

reported 90

% sensitivit

y an

d 70

%

specificity whe

n use

d t

o predic

t difficul

t intubation

. Describ

e ho

w thi

s

information an

d othe

r statistic

s relate

d t

o thi

s tes

t ca

n b

e use

d i

n predictin

g

difficult intubation

. Ho

w wil

l th

e incidenc

e o

f difficul

t intubatio

n affec

t th

e

performance o

f thi

s test

?

(2)

Primary Exa

m 2014.

2

Short Answe

r Questio

n Pape

r

8. Outlin

e th

e importan

t pharmacologica

l consideration

s whe

n stoppin

g warfari

n

and commencin

g prophylacti

c (lo

w dose

) lo

w molecula

r weigh

t hepari

n (LMWH

)

in th

e peri-operativ

e period

.

9. Wha

t lowe

r limi

t o

f Sp0

2 woul

d yo

u accep

t i

n a

n ASA

l youn

g mal

e unde

r genera

l

anaesthesia? Explai

n you

r reason

s fo

r choosin

g thi

s value

.

10. Ho

w i

s rena

l bloo

d flo

w regulated

? Wha

t ar

e th

e physiologica

l effect

s o

f

angiotensin II

?

11. Describ

e th

e cardiovascula

r change

s tha

t occu

r wit

h morbi

d obesity

.

12. Explai

n th

e Boh

r an

d Haldan

e effect

s in

trans-placental ga

s exchange

.

13. Briefl

y explai

n th

e change

s tha

t occu

r i

n store

d whol

e blood

.

14. Outlin

e th

e effect

s o

f intravenousl

y administerin

g 50

0 m

l o

f 20

% mannitol

.

Outline th

e potentia

l problem

s associate

d wit

h it

s use

.

15. Writ

e brie

f note

s o

n th

e physiologica

l change

s associate

d wit

h sleep

.

Page 3 of 3

(3)

1> What are the potential side effects of propofol and its formulations?

2. Draw and explain the characteristics of a log dose-response curve that describes the

major clinical effect of rocuronium. Describe how factors encountered in clinical

practice may alter this curve.

3. Outline the safety features of currently used plenum vaporisers.

4. Describe the physiological basis of methods used to prevent hypoxaemia prior to

intubation in a rapid sequence induction. Include any adverse effects of these

methods.

5. Explain the effects of intermittent positive pressure ventilation on cardiac output.

6. Outline the pharmacological management of bronchoconstriction in acute severe

asthma. Include mechanisms of action and potential adverse effects.

7. Describe the local anatomy relevant to the performance of a lumbar epidural block.

8. Describe the princtpies of surgical diathermy.

9. Describe the washout of sevoflurane from a patient following two hours of general

anaesthesia. You may wish to use a graph to illustrate the description.

10. List the pharmacodynamic differences between tramadol and morphine.

11. Compare and contrast the management of an overdose of aspirin with that of an

overdose of paracetamol.

12. Describe the alterations to the physiology of the nervous system in the older patient

and outline the consequent effects on pain perception,

13. Compare and contrast the pharmacology of Normal Saline and 4% Albumin.

14. Compare and contrast the physiological effects of a six hour fast of fluids and food

with a twenty four hour fast in a healthy adult

15. Indicate the sequence of the physiological changes to the fetal circulation at birth

and briefly describe the mechanisms that account for these changes.

(4)

Primaiy Exam 2013.2

1, Explain the effects of intermittent positive pressure ventilation on cardiac output.

2, Describe tiie physiological basis of methods used to prevent hypoxaemia prior to

Intubation in a rapid sequence Induction. Include any adverse effects of these

methods.

3, Outline the safety features of currently used plenum vaporisers,

4, Discuss t h e physlologica} significance of the hlood-brain barrier.

5, Outline t h e role of t h e kidneys in the regulation of body Vv^ater

6, Briefly describe t h e breakdown of haemoglobin after red cell lysis,

7, Describe the phystologlcat effects of endogenous glucocorticoids,

S, Describe the effects of resonance and damping on an invasive arterial blood

pressure tracing.

9, Using cephazoiln as an example in joint replacement surgery, outline the principles

of antibiotic chemoprophytaxls for surgical site infections.

10. List the classes of drugs that may be used to manage an intra-operative

hypertensive crisis and briefly outline the mechanisms of action.

11. Describe how non steroidal anti-inflammatory drugs exert their clinical effects.

Outline the advantages and disadvantages in using COX-2 selective agents.

12, Explain how differences in the pharmacokinetics of alfentanil and fentanyl can

influence the way they are administered intravenously.

13. Draw and explain the characteristics of a log dose-response curve that describes

the major clinical effect of rocuronium. Describe how factors encountered in

clinical practice may alter this curve,

14. List the drugs that affect uterine tone, and outline the adverse effects of these

agents.

(5)

1. What are the major classes of oral hypoglycaemic agents? Outline their mechanisms of

action and possible side effects.

2. What are the advantages and disadvantages of xenon as an anaesthetic agent?

3. Classify isomers. Briefly write an account of their significance in drugs used in anaesthesia.

4. Describe how suxamethonium and non-depolarising neuromuscular blocking agents

produce their adverse cardiovascular effects.

5. Discuss the concept of volume of distribution. How may it be used in the calculation of a

loading dose? What assumptions are made in this calculation?

6. Sevoflurane and fentanyl are a common anaesthetic drug combination. Discuss

pharmacological reasons why it is useful to use them together.

7. Describe the pharmacology of midazolam.

8. Discuss the metabolism of morphine, codeine and pethidine.

9. Describe the cough reflex.

10. Write brief notes on innate and acquired immunity.

10. Compare and contrast lung function in the neonate with that in an adult.

12. Briefly explain the cardiovascular responses to central neuraxial blockade.

13. How does a fall in temperature influence blood gas solubility and acid base values?

14. Briefly describe the structure of mitochondria. Outline the metabolic processes that occur

in mitochondria.

15. Describe the peripheral and central nervous system pathways that lead to the

perception of pain following a laceration to the thumb.

16. Explain how oxygen supply of organs is maintained during isovolaemic haemodilution.

Q17

Q11

(6)

JULY / SEPTEMBER 2012

1. How does warfarin exert Its anti-coagulant effect? What methods can be used to reverse the

effects of warfarin prior to surgery?

2. Compare and contrast propofol and sevoflurane for maintenance of anaesthesia with

respect to kinetics, cardiovascular and central nervous system effects.

2. Define the terms "tolerance" and "tachyphylaxis". Discuss the different mechanisms by which

tolerance can develop, giving examples where appropriate.

3. Outline the acute adverse effects of opioid receptor agonists. Describe the mechanisms of the

acute adverse effects of opioid receptor agonists.

5. Discuss the pharmacology of drugs that Inhibit the activity of the renin-angiotensin system.

What particular problems can occur in the anaesthetised patient taking these drugs?

6. List agents that can reduce bronchiolar tone and explain the mechanisms of action with

examples.

7. Some sets of information, for example the visual analogue scale used in pain assessment, can be

treated as parametric or non-parametric data. What are the advantages and disadvantages of

using each method? In each case, which tests can be used to analyse the data?

8. Classify the toxic effects of local anaesthetic drugs. Detail the potential for, and mechanisms of,

toxicity of prilocaine.

9. Describe the waveforms and pressures that are seen in each anatomical location during

insertion of a pulmonary arterial catheter. What factors may increase these pressures?

10. Outline the mechanisms by which the kidney maintains potassium homeostasis.

11. Outline the important features of the lymphatic circulation.

12. Discuss the physiological causes of early post-operative hypoxaemia,

13. Using an example of exponential decay, define and outline the important features of an

exponential function.

14. Detail the protective and regulatory roles of the liver.

15. Describe the fuel sources used during early and sustained fasting in humans.

16. Briefly outline the differences between the pulmonary circulation and the systemic

circulation.

(7)

1. Outline the pharmacology of agents used in the management of pregnancy

induced hypertension.

2. In relation to the pharmacokinetics of nitrous oxide, describe the significance of partition

coefficients, increasing inspired concentration, the second gas effect and diffusion

hypoxia.

2. Classify the drugs which are useful for reducing the volume and acidity of gastric

contents, giving an outline of the mechanism of effect for each group.

4. Discuss factors influencing the recovery and reversal of neuromuscular blockade induced

by rocuronium.

5. Using opioids as examples describe and illustrate with graphs what you understand by the

terms "potency", "efficacy", "partial agonist", "competitive antagonist", and "therapeutic

index".

6. List the side effects of non-steroidal anti-inflammatory drugs. Briefly explain the

mechanisms responsible for each of these side effects.

7. Discuss the suitability of ketamine as an intravenous anaesthetic agent.

8. Discuss the statistical methods which can be used for analysis of groups of categorical data.

9. Describe the role of baroreceptors in the control of systemic arterial pressure

10. Outline the principles of a pneumotachograph. What factors affect the accuracy of this

device?

11. Outline the physiology of blood groupings that allows O negative packed cells to be

safely transfused to most patients.

12. Describe the main mechanisms by which chemical neurotransmitters exert their

effects, using examples from the autonomic nervous system

13. Describe the factors affecting the diffusion of gas at the placenta, including the Bohr

and Haldane effects

14. Outline the components of parenteral nutrition and explain the rationale for the use of

each component.

15. Describe the role of the kidneys in excretion of acid.

16. Describe the factors involved in the balance between left ventricular myocardial

oxygen supply and demand

(8)

A U G U S T / S E P T E M B E R 2011

1. Compare and contrast the clinically significant cardiovascular and central nervous

system effects of desflurane and sevoflurane.

2. W h a t is meant b y the term "two compartment model" i n pharmokinetics? Use

P R O P O F O L as an example i n explanation.

3. W h a t is the mechanism of action of p -adrenoreceptor antagonists? Outline the

therapeutic uses and side effects of these drugs.

4. Describe the pathogenesis and management of paracetamol

toxicity.

5. Describe the mechanism of action of protamine w h e n u s e d to reverse effects of

heparin. Outline the side-effects of protamine.

6. D i s c u s s the relative advantages and disadvantages of u s i n g morphine and fentanyl

for post-operative Patient Controlled Analgesia (PCA).

7. Briefly outline the acute management of malignant hyperthermia (during a relaxant

general anaesthetic). Describe the important aspects of dantrolene pharmacology

relevant to treating malignant hyperthermia.

8. Describe the terms train-of-four stimulation and double burst stimulation w i t h

respect to the peripheral nerve stimulator. Describe their advantages and

disadvantages w h e n used to evaluate non-depolarising neuromuscular blockade.

9. Outline the physiological roles of prostaglandins i n the body.

10. Describe the effects of resonance and damping on an invasive arterial blood

pressure tracing,

11. Describe the ionic basis of automaticity of cardiac pacemaker cells.

12. Outline the similarities and differences between myoglobin and adult

haemoglobin, explaining the physiological relevance of the differences.

13. Outline the physiological role of cerebro spinal f l u i d , including a description of its

production and fate,

14. Describe the changes i n respiratory function tests that occur w i t h long term

increases i n small airways resistance,

15. Outline the physiological changes that may explain w h y a n otherwise w e l l patient

may have a reduced urinary output intraoperatively

(9)

Q l . Describe the factors which increase the risk of systemic toxicity with amide local anaesthetic

agents.

Q 2._Classify non-opioid drugs used for the treatment of neuropathic pain and indicate proposed

mechanisms of analgesic action and potential adverse effects.

Q S.Outline the effects of liver failure on drug kinetics and dynamics.

Q 4..Describe the ideal properties of agents used for sedation using two examples.

Q 5. List the classes of drugs that may be used to manage hypertensive crisis and briefly outline the

mechanism of action.

Q 6. Write a brief outline on the pharmacology of remifentanil.

Q 7. Describe the advantages and disadvantages of using nitrous oxide as part of a general

anaesthetic.

Q 8 How may drugs potentiate the action of non-depolarizing muscle relaxants at the

neuromuscular junction?

Q 9. Describe the ways in which CO2 is carried in the blood

Q10: Describe the factors that oppose left ventricular ejection.

11. Describe the functions of the loop of Henle, including the physiological mechanisms Involved.

Q12. Compare and contrast a single twitch and a tetanic contraction in a skeletal muscle fibre.

Q13. Describe the determinants of work of breathing in an adult human at rest.

Q14. Describe the physiological effects of general anaesthesia on temperature regulation

Q15. Describe the functions of the gastric secretions.

Q 16. Explain the difference between viscosity and density. Outline the effects of changes in

viscosity and density on the flow of gases and liquids.

(10)

t/J^RCHItAAY201Q

QUESTION 1 Describe how the chemical structure of local anaesthetic drugs determines their

efficacy and safety.

QUESTION 2 Describe the methods of determining depth of neuromuscular block and list the

advantages and limitations of each.

QUESTION 3 Discuss the adverse effects that may occur with the administration of

desflurane.

QUESTION 4 Describe the time course between an intravenous injection of a general

anaesthetic agent to loss of consdousness. Explain the delay using

pharmacokinetic prindples.

QUESTION 5 Describe how Non Steroidal Anti-Inflammatory Drugs exert their clinical

effects. Outline the advantages and disadvantages in using COX-2 selective

agents.

QUESTION 6 List the main drug groups used in the treatment of diabetes mellitus. For each

group explain the mechanism of action and give examples.

QUESTION 7 Briefly describe the pharmalogical role of the nicotinic cholinergic receptor.

QUESTION 8 Classify drugs used in the treatment of depression. Outline the interactions

between antidepressant drugs and drugs that are commonly used during the

peri-operative period.

QUESTION 9 Explain the physiological factors that may lead to a decrease in mixed venous

blood oxygen saturation.

QUESTION 10 Describe how white blood cells defend the body against infection.

QUESTION 11 Describe the changes that occur in the urine and the plasma with renal

dysfunction.

QUESTION 12 Briefly explain the changes that occur in stored whole blood.

QUESTION 13 Describe the autonomic innervation of the heart and the effects of autonomic

stimulation on cardiac function.

QUESTION 14 Describe the factors that affect static respiratory system compliance.

QUESTION 15 Explain how cardiac output is measured using a thermodilution technique.

QUESTION 16 Describe the processes whereby substances may cross cell membranes, giving

(11)

Question 1 : Compare and contrast the pharmacokinetics of orally and intravenously

administered morphine and oxycodone.

Question 2 : Describe the composition of 4% albumin and Normal Saline. Compare and

contrast the pharmacology of each.

Question 3: Describe the mechanism of action, pharmacokinetics and major side

effects of intravenously administered amiodarone.

Question 4 : Briefly outline the effects of sevoflurane on skeletal, smooth and cardiac

muscle tissues. Include how these effects are mediated and their clinical

significance.

Question 5 : Describe the pharmacodynamic effects and clinical uses

of anticholinesterase drugs.

Question 6 : Describe the principles of how a computer-controlled infusion device

targets and maintains a constant effect site concentration of propofol.

Question 7 : List the physical properties of oxygen. Discuss the potential adverse

effects associated with oxygen administration.

Question 8 : Discuss the statistical methods which can be used for analysis of groups

of categorical data.

Question 9 : Describe the factors that affect respiratory system compliance.

Question 10 : Discuss the factors that influence coronary blood flow.

Question 11 : Explain the physical principles of ultrasound imaging.

Question 12 : Describe the function of the muscles involved in ventilation.

Question 13 : Describe the cardiovascular changes in the neonate that occur at birth.

Question 14 : Discuss the effects on intracranial pressure when a person is placed in

a head down tilt.

Question 15 : Explain the role of haemoglobin as a buffer.

(12)

MOJSIBAY, 2 I V I A R C H 2009

QUESTION 1 Explain the concept of Minimal Alveolar Concentration (/AAC) and its clinical utility.

LIST the patient factors which: a) Increase MAC

fa) Decrease /AAC

c) Are known to have no effect on MAC

QUESTION 2 Describe the factors which increase the risk of systemic toxicity with amide local anaesthetic agents.

QUESTION 3 Outline the factors that determine the rate of recovery from non-depolarising neuromuscular block?

QUESTION 4 Compare and contrast atropine and glycopyrrolate. Discuss the clinical implications of these differences.

QUESTION 5 Outline the effects of an opioid injected into the spinal intrathecal space.

QUESTION 6 Describe t h e mechanism of action a n d pharmacokinetics of phenytoin,

QUESTION 7 Outline the subtypes of serotonin (5-hydroxytryptamine) receptors. Discuss pharmacological agents that act at these sites.

QUESTION 8 What is meant by the term "95% confidence interval"? Explain the practical applications of confidence intervals and indicate why they may be preferred to p-values.

QUESTION 9 Discuss the physiological factors that determine intracranial pressure (ICP), and describe how changes in posture affect ICP.

QUESTION 10 Describe the physiological effects of t h e glucocorticoids.

QUESTION 11 Outline the determinants and regulation of extracellular fluid volume.

QUESTION 12 Outline the factors contributing to the generation and maintenance of the resting membrane potential.

QUESTION 13 What is the Frank-Starling mechanism and describe its relationship to excitation contraction coupling

QUESTION 14 Describe the physiological processes that influence the rate of gastric emptying.

QUESTION 15 Describe the formation, f a t e and role of lactate i n energy production,

QUESTION 16 Outline the effects of acute exposure to air at an altitude where barometric pressure is 347mmHg. What compensatory mechanisms occur with gradual exposure to increasing altitude?

(13)

QUESTION 1 Sevoflurane and fentanyl are a common anaesthetic drug combination. Discuss

pharmacological reasons v/hy it is useful to use them together.

QUESTION 2 What are the potential side effects of propofol and its formulations?

QUESTION 3 Discuss classes of drugs that influence Post-Operative Nausea and Vomiting

(PONV) including mechanisms where known.

QUESTION 4 Describe the effect of obesity on pharmacokinetics and the potential clinical

implications, providing relevant examples.

QUESTION 5 Describe the factors that may decrease the clinical response to nondepolarising

neuromuscular blocking agents.

QUESTION 6 Discuss the pharmacodynamics of drugs that affect uterine tone.

QUESTION 7 Outline the pharmacological management of ventricular fibrillation in an adult

with reference to: drugs, dose, mechanisms of action, and potential adverse

effects.

QUESTION 8 Mean arterial blood pressure has been measured in two groups of patients one

hour after the administration of either a placebo or an antihypertensive drug.

Explain how these data could be analysed.

QUESTION 9 Classify the causes of hypotension in the early post-operative period, giving

relevant examples.

QUESTION 10 Compare and contrast the neonatal respiratory system vrith the adult.

QUESTION 11 Describe the role of insulin in fat metabolism

QUESTION 12 Discuss the production and function of red blood cells

QUESTION 13 Explain the physiological processes that cause oliguria in response to

hypovolaemic shock

QUESTION 14 Outline the central nervous system effects on an awake person breathing air

containing carbon dioxide.

QUESTION 15 Describe the complement system.

QUESTION 16 List the gastric cell types and their secretions and the functions of these

secretions.

(14)

FEBRUARY/APRIL 2008

QUESTION 1 An 80 year otd woman is undergoing major emergency surgery. Describe the maintenance inhaled concentration of sevoflurane you would choose and the factors that might influence this.

QUESTION 2 List the classes of drugs that are useful in indudng diuresis clinically. Outline their mechanism of action.

QUESTION 3 Describe the ideal pharmacokinetic and pharmacodynamic properties of agents used for sedation. Outline the pharmacology of midazolam and propofol with reference to these Ideal properties.

QUESTION 4 Outline the pharmacologic management if bronchoconstriction in acute severe asthma. Include mechanisms of action and potential adverse effects.

QUESTION 5 Classify drugs that alter activity at serotonin receptors with examples. Describe their mechanisms of action and clinical indications.

QUESTION 6 A surgeon wishes to use topical anaesthetic In the nose before surgery in a 30 year old 70 kg man. He normally uses topical cocaine 5% plus

lignocaine 2% with adrenaline 1:100,000 Injection. What volumes of cocaine 5% and (fgnocaine can be used safety? What are the potential toxic effects of cocaine and how do lignocaine and adrenaline affect this?

QUESTION 7 Describe the terms tratn-of-four stimulation and double burst stimulation with respect to the peripheral nerve stimulator. Describe their advantages and disadvantages when used to evaluate non-depolarising neuromuscular blockade,

QUESTION 8 Define the mechanisms of action and adverse effects of metoprolol, glyceryl trinitrate and dlltiazem when used to manage myocardial ischaemia.

QUESTION 9 The skin, the kidneys, and the carotid bodies are examples of where specific organ blood flow is far in excess of that organ's metabolic requirements. For each example, explain what the physiological role of the high organ blood flow is, why this high flow is an advantage to the person and a brief description of the mechanisms Involved.

QUESTION 10

QUESTION 11

QUESTION 12

QUESTION 13

QUESTION 14

Define "thermoneutral z o n e " . Briefly explain how the body regulates temperature when the ambient temperature exceeds the thermoneutral zone.

Outline the physiological c o n s e q u e n c e s of diabetic keto acidosis.

Describe the physiological changes that occur In respiratory function during pregnancy.

Describe the production of cerebrospinal fluid, its role and its fate.

Describe the pathways w h e r e b y myocardial i s c h a e m i a may be e x p e r i e n c e d as pain in the throat or arm regions.

QUESTION 15 Describe how the kidney establishes t h e medullary concentrating gradient.

(15)

QUESTION 1 Outline the potential beneficial and a d v e r s e effects of isoflurane on the cardiovascular system (include mechanisms of effect) in patients with ischaemic heart disease.

QUESTION 2 Describe the pharmacokinetic principles of total intravenous anaesthesia using propofol.

QUESTION 3 List the anaesthetic related uses of clonidine. What are the effects of

clonidine on the cardiovascular and central nervous system and how are these effects mediated?

QUESTION 4 Briefly outline the pharmacology of ketamine with reference to its use as an analgesic agent in the post-operative period.

QUESTION 5

QUESTION 6

QUESTION 7

Outline how the pharmacokinetics of morphine, bupivacaine a n d suxamethonium differ in t h e neonate compared to t h e adult. Briefly describe t h e clinical implications of these differences.

Outline the ideal properties of a colloid intravenous fluid. Give examples of colloids and briefly describe the features of each.

List the agents used therapeutically to reduce platelet function. Outline their mechanisms of action, adverse effects, mode of elimination and duration of action.

QUESTION 8 What is meant by the term Randomised Controlled Trial (RCT)? What are the strengths and weaknesses of randomized control trial design?

QUESTION 9 What is humidity and how c a n it be measured?

QUESTION 10 Describe sepsis and describe the metabolic c o n s e q u e n c e s of sepsis.

QUESTION

11

Write brief notes on the physiological changes associated

with

sleep. QUESTION 12 Detail the protective and regulatory roles of t h e liver.

QUESTION 13

QUESTION 14

QUESTION 15

Explain the c o n c e p t of time constants and relate these to " f a s t " and " s l o w " alveoli

Explain in physiologic terms the effect of severe aortic stenosis on myocardial supply and demand.

Describe the changes that occur with ageing that can affect oxygen delivery to the tissues during moderate exercise.

(16)

JULY/AUGUST 2007

QUESTION 1 Describe the adverse effects that may occur with the admim'stration of

desflurane.

QUESTION 2 Outline the important pharmacological considerations when stopping

warfarin and commendng prophylactic (low dose) low molecular weight

heparin (LMWH) in the peri-operative period.

QUESTION 3 Outline the important pharmacological considerations concerning choice of opioid

and dosage when converting from intravenous morphine to oral opioid

analgesia in the post-operative period.

QUESTION 4 A new test called the "intubation score" has a repori:ed 90% sensitivity

and 70% spedfidty when used to predict difficult intubation. Describe

how this information and other statistics related to this test can be used in

predicting difficult intubation. How will the inddence of difficult

intubation affect the performance of this test?

QUESTION 5 Describe the factors which increase the risk of systemic toxidty with

amide local anaesthetic agents.

QUESTION 6 Describe how suxamethonium produces neuromuscular blockade. What is

the mechanism of recovery of neuromuscular function and what

mechanisms may be involved in Phase 11 block?

QUESTION 7 Outline the mechanisms of action and potential adverse effects of the oral

hypoglycaemic agents.

QUESTION 8 Write short notes on anti-hypertensive drugs that exert their action via

blocking the effects of angiotensin.

QUESTION 9 Briefly explain the cardiovascular responses to central neural blockade.

QUESTION 10 Briefly describe the factors that affect the partial pressure of carbon dioxide

in mixed venous blood.

QUESTION 11 Explain the physical principles of ultrasound imaging.

QUESTION 12 Outline the mechanisms by which the kidney maintains potassium homeostasis.

QUESTION 13 Outline the physiology of blood groupings that allows 0 negative blood to be

safely transfused to most patients.

QUESTION 14 Describe the cardiovascular changes in the neonate that occur at birth.

QUESTION 15 Outline the clinical laboratory assessment of liver function.

QUESTION 16 Draw and label a lead II electrocardiogram (ECG) tradng for one cardiac cycle,

indicating normal values. What is the PR interval and what factors

influence it?

(17)

Q U E S T I O N 2 After epidural injection in a health term pregnant woman, discuss the factors influencing the distribution of hupivacaine to (a) the maternal C S F and spinal cord; (b) the maternal circulation; (c) the foetus.

Q U E S T I O N 3 Discuss factors contributing to inter-individual variability in the therapeutic response to opioid analgesic medications.

Q U E S T I O N 4 Discuss the suitability of ketamine as a total intravenous anaesthetic agent in comparison with propofol.

Q U E S T I O N 5 Classify non-opioid drugs used for the treatment of neuropathic pain and indicate proposed mechanisms of analgesic action and potential adverse effects.

Q U E S T I O N 6 Briefly outline the acute management of malignant hyperthermia (during a relaxant general anaesthetic). Describe the important aspects of dantrolene pharmacology relevant to treating malignant hyperthermia.

Q U E S T I O N 7 Describe the pharmacology of midazolam including its mechanism of action.

Q U E S T I O N 8 List the classes of drugs used clinically to treat chronic left ventricidar failure. Outlme their mechanisms of action.

Q U E S T I O N 9 Define "Venous Admixture". Briefly explain how venous admixture influences arterial oxygen tension and how an increase in inspired oxygen concentration may effect this.

Q U E S T I O N 10 Explain the mechanisms that prevent blood clotting in intact blood vessels (do not draw the clotting cascade).

Q U E S T I O N 11 Discuss how the body handles a metabohc acidosis.

Q U E S T I O N 12 Explain the physiological principles underlyuig the use of peritoneal dialysis in a patient with chronic renal failure with this dialysate solution.

N a 1 3 2 m E q / L Mg 0.5 m E q / L K 0 m E q / L Lactate 40 m E q / L C I 96 m E q / L glucose 2.5 g % C a 3.5 m E q / L

Q U E S T I O N 13 Describe the determinants of Venous Return and the effect general anaesthesia woxdd have on these.

Q U E S T I O N 14 Explain the mechanisms whereby oxygen transfer is facilitated at the placenta.

Q U E S T I O N 15 Describe the effects of resonance and damping on an invasive arterial blood pressure tracing.

Q U E S T I O N 16 Briefly outline the components of parenteral nutrition, explaining the rationale for the use of each component.

(18)

FEBRUARY/APBIL 2006

QUESTION 1 Outlme the pharmacologic management of bronchoconstriction in acute severe asthma. Include mechanisms of action and potential adverse effects.

QUESTION 2 What is an isomer? Briefly write an account of the types of isomers and their significance in drugs used in anaesthesia.

QUESTION 3 List the non-ideal features of nitrous oxide.

QUESTION 4 Describe the pharmacodynamic properties of propofol and how this influences its clinical usage. QUESTION 5 Write short notes on factors affecting the speed of onset and duration of effect of local

anaesthetics when used to produce peripheral nerve block.

QUESTION 6 Explain the possible mechanisms for prolonged neuromuscular blockade after a four hour procedure using a non-depolarising muscle relaxant.

QUESTION 7 Briefly outline the pharmacology of naloxone.

QUESTION 8 I n a clinical trial, why is adequate power important? What factors affect the determination of an adequate sample size?

QUESTION 9 Outline the systemic cardiovascular response to exercise.

QUESTION 10 List the physiological factors which increase respiratory rate and include a brief explanation of the mechanism by which each achieves this increase.

QUESTION 11 Briefly outline the role of platelets i n haemostasis.

QUESTION 12 Classiiy and describe the main cellular and molecular mechanisms by which chemical neurotransmitters exert their effects. Use examples from cholinergic and adrenergic neurotransmission to illustrate the answer.

QUESTION 13 Describe the factors that influence metabolic rate.

QUESTION 14 Explain the physiological processes which cause oliguria in response to hypovolaemic shock. QUESTION 15 Briefly describe the measurement of p H in a blood sample using a p H electrode.

QUESTION 16 Describe the physiological factors that contribute to the competence and tone of the lower oesophageal sphincter.

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QUESTION 1 Describe the use of different sympathomimetics to treat hypotension occurring as a result of subarachnoid block. Outline the advantages and disadvantages of these agents.

QUESTION 2 Compare and contrast the clinically significant respiratory, cardiovascular and central nervous system effects of desflurane and isoflurane.

QUESTION 3 Describe the factors which contribute to the inter-individual variability in drug response seen with intravenous anaesthetic induction agents.

QUESTION 4 Describe the advantages and disadvantages of rocuronium for rapid sequence induction.

QUESTION 5 Briefly explain the mechanisms responsible for non-steroidal anti-inflammatory drug (NSAID) - induced side effects. Outline the advantages and disadvantages of selective cyclooxygenase (COX 2) inhibitors.

QUESTION 6 A new clinical test called the "intubation score" has a reported 90% sensitivity and 70% specificity when used to predict difficult intubation. Describe how the accuracy, predictive value and clinical utility of this test can be evaluated. How will the incidence of difficult intubation affect the performance of this test?

QUESTION 7 Outline the drug and non-drug treatment of ventricular fibrillation in an adult. Briefly describe their mechanisms of action. (Do not discuss basic life support, airway therapies and oxygen)

QUESTION 8 Describe the pathogenesis and management of paracetamol toxicity.

QUESTION 9 Describe the factors that oppose left ventricular ejection.

QUESTION 10 Describe the determinants of work of breathing in an adult human at rest.

QUESTION 11 List the hormones that regulate tubular reabsorption and describe their action and site of action.

QUESTION 12 Explain the difference between viscosity and density. Outline the effects of changes in viscosity and density on the flow of gases and liquids.

QUESTION 13 Briefly describe the structure of a mammalian skeletal muscle fibre and explain how its structure is related to its contractile function. DO NOT describe excitation-contraction coupling.

QUESTION 14 Compare and contrast the physiological effects of a six hour fast of fluids and food with a twenty four hour fast in a healthy adult.

QUESTION 15 Explain how a metabolic acidosis develops in hypovolaemic shock. Describe the consequences of this metabolic acidosis for the body.

(20)

MARCH/APRIL 2005

QUESTION 1 Classify anti-emetic drugs. Give examples and describe side effects of each class.

QUESTION 2 Outline the acute adverse effects of opioid receptor agonists. Describe the mechanisms of the acute adverse effects of opioid receptor agonists.

QUESTION 3 What factors might explain the inter-individual variability in drug response seen with intravenous anaesthetic induction agents?

QUESTION 4 Outline the mechanisms of action of drugs that inhibit cholinergic transmission at the neuromuscular junction giving examples.

QUESTION 5 List the antiplatelet agents and outline their mechanisms of action, adverse effects, mode of elimination and duration of action.

QUESTION 6 Briefly outline pharmacological methods of reducing gastric acidity. Indicate the mechanisms of action and the advantages and disadvantages of each method.

QUESTION 7 Outline the main biochemical events involved i n noradrenergic transmission. Outline how these may be altered by the use of M A O (mono amine oxidase) inhibitors.

QUESTION 8 Outline the pathology of acute anaphylactic reactions with reference to the mediators released and their effects. Outline the role of epinephrine and its mechanisms of action i n treating anaphylaxis.

QUESTION 9 Describe the control of gastric emptying.

QUESTION 10 Write brief notes on the physiological changes associated with sleep. QUESTION 11 Describe how the body detects and responds to a water deficit

QUESTION 12 Describe the physiological factors influencing the carbon dioxide tension in arterial blood. QUESTION 13 Describe the non-respiratory functions of the lung.

QUESTION 14 Describe the compensatory mechanisms i n a fit person moving from the supine to the standing position.

QUESTION 15 Discuss how the body handles a metabolic acidosis.

(21)

metabolism of isoflurane is so low.

QUESTION 2 Using opioids as examples describe and illustrate with graphs what you understand by the terms "potency", "efficacy", "partial agonist", "competitive antagonist", and "therapeutic index".

QUESTION 3 Write brief notes on the physico-chemical properties of lidocaine (lignocaine).

QUESTION 4 Define die term 'context -sensitive half time'. How does it differ from the half life typically quoted for a drug? Illustrate this concept by comparing thiopentone vs. propofol and fentanyl vs. remifentanil.

QUESTION 5 Outline the advanced life support management of ventricular fibrillation in an adult including the mechanisms of action and potential adverse effects of these therapies. (Do not discuss basic life support, airway therapies and oxygen).

QUESTION 6 Describe the therapeutic and unwanted effects of dexamethasone.

QUESTION 7 Briefly outline the pharmacology of droperidol, emphasising its mechanism of action, perioperative use and side effects.

QUESTION 8 Describe the adverse effects of beta adrenoreceptor antagonists.

QUESTION 9 Describe the gravity dependent processes which affect pulmonary blood flow. What changes take place when the pressure increases in the pulmonary vessels?

QUESTION 10 Describe the forces acting across the glomerular capillary membrane. Explain how afferent and efferent arteriolar tone affect glomerular filtration rate.

QUESTION 11 Outline the principles of compatibility testing of blood for transfusion. QUESTION 12 Briefly discuss the physiological roles of plasma proteins.

QUESTION 13 Explain how cardiac output is measured using a thermodilution technique. QUESTION 14 Describe the processes of excitation and contraction within smooth muscle cells.

QUESTION 15 Describe the autonomic innervation of the heart and the direct effect of autonomic stimulation on cardiac function.

QUESTION 16 Explain the changes on Functional Residual Capacity (FRC) that take place with administration of anaesthesia.

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FEBRUARY/MARCH 2004

QUESTION 1 Describe the effects of isoflurane on intracranial metabolism, intracranial haemodynamics, intracranial pressure and the EEG.

QUESTION 2 Outline factors determining speed of onset of neuromuscular blocking agents.

QUESTION 3 Briefly describe the factors that determine skin penetration by local anaesthetics. Briefly describe the formulation and pharmacology of E M L A cream.

QUESTION 4 Outline the effects of an opioid injected into the spinal intrathecal space. QUESTION 5 Outline the effects of liver failure on drug kinetics and dynamics. QUESTION 6 Outline the circulatory effects of glyceryl trinitrate.

QUESTION 7 Describe the mechanisms of action of inotropes and provide examples. QUESTION 8 Describe briefly the side effects and complications of heparin therapy.

QUESTION 9 Briefly outline the differences between the pulmonary circulation and the systemic circulation. QUESTION 10 Describe the vasoactive substances released by the endothelium. Explain the role they play in

regulating blood flow through the peripheral circulation.

QUESTION 11 What is 2,3 DPG? How is i t produced in the red blood cells and how does it mteract with haemoglobin? What is its relevance in altitude exposure, anaemia, and stored blood? QUESTION 12 What are the physiological consequences of decreasing functional residual capacity by one litre

in an adult?

QUESTION 13 Describe the concept of renal clearance and its use to estimate glomerular filtration rate. QUESTION 14 Briefly describe the difference between laminar and turbulent flow. List the factors that

increase the probability of turbulent flow.

QUESTION 15 List the physiological factors that determine intracranial pressure. Explain briefly how intracranial pressure is regulated.

QUESTION 16 Explain how the kidney handles glucose. Describe the physiological consequences of glycosuria.

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QUESTION 1 Briefly describe how drugs produce their pharmacological effects. Illustrate each mechanism with examples.

QUESTION 2 Write a brief description of the pharmacology of ropivacaine.

QUESTION 3 List the effects of histamine. Write a brief outline on the pharmacology of the H j blocking drugs.

QUESTION 4 Write short notes on tramadol. QUESTION 5 statistics

QUESTION 6 Compare and contrast neostigmine and the organophosphorus compounds. QUESTION 7 Outline the factors which influence the elimination half-life of propofol.

QUESTION 8 List the classes of drugs used clinically to treat chronic left ventricular failure. Outline their mechanisms of action.

QUESTION 9 Describe how carbon dioxide is produced in the body. How does it move from the site of production to the pulmonary capUlary?

QUESTION 10 List the physiological factors which affect left atrial pressure and explain their effects.

QUESTION 11 Briefly explain how oximetry can be used to estimate the partial pressure of oxygen in a blood sample.

QUESTION 12 Briefly describe the secretion and functions of renin and angiotensin. QUESTION 13 Describe the functions of the gastric secretions.

QUESTION 14 Briefly describe the difference between a single twitch and a tetanic contraction in a skeletal muscle fibre. Include in your answer the physiological basis for the development of a tetanic contraction.

QUESTION 15 Describe the mechanism of action of G-proteins in the cell.

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MARCH/APRIL 2003

QUESTION 1 Briefly outline the effects of isoflurane on skeletal, smooth and cardiac muscle tissues. Indicate how these effects are mediated and their clinical significance.

QUESTION 2 Outline the neuropharmacology of thiopentone, covering only its site of action, EEG changes, effects on cerebral blood flow and intracranial pressure.

QUESTION 3 Explain how lignocaine prevents the conduction of a nerve action potential. QUESTION 4 Outline the potential problems associated with additives used to make medicines suitable for

intravenous injection.

QUESTION 5 Outline the important statistical issues in designing a study to compare the duration of analgesia of two drugs given for post-operative pain relief.

QUESTION 6 Explain how differences in the pharmacokinetics of alfentanil and fentanyl can influence the way they are administered intravenously.

QUESTION 7 Classify diuretics, briefly explaining their mode of action.

QUESTION 8 Describe the onset and offset of neuromuscular block at the diaphragm, larynx and adductor poUicis after administration of 2.5 x ED95 dose of vecuronium. Comment on the differences observed. What are the clinical implications of these differences?

QUESTION 9 Explain the role of haemoglobin as a buffer.

QUESTION 10 Describe the factors influencing hepatic blood flow.

QUESTION 11 Define the "thermoneutral zone". Briefly explain how the body regulates temperature when the ambient temperature exceeds thermoneutral zone.

QUESTION 12 Explain the mechanisms that maintain cerebral blood flow on moving from a supine to a standing position.

QUESTION 13 Briefly describe the principles and sources of error in the measurement of systemic arterial blood pressure using an automated oscillometric non-invasive monitor.

QUESTION 14 Describe the factors that affect lung compliance. QUESTION 15 Describe the physiological actions of thyroid hormones.

QUESTION 16 Describe the functions of the loop of Henle, including the physiological mechanisms involved.

(25)

QUESTION 1 Draw and label, on the same X - Y axis, FA/FI curves for the following halothane concentrations in oxygen, showing a 30 minute period from starting administration.

(a) Halothane 1 % , subject breathing spontaneously. (b) Halothane 6%, subject breathing spontaneously. (c) Halothane 6%, subject paralysed and ventilated.

W i t h reference to the major factors determining the shape of FA/FI curves explain the differences between A and B, and A and C.

QUESTION 2 Describe the potential interactions of sevoflurane, desflurane and isoflurane with carbon dioxide absorbents.

QUESTION 3 Outline GABA's role as a neuro transmitter and indicate how its actions may be modified by pharmacological agents.

QUESTION 4 Describe how a computer-controlled infusion device targets and maintains constant blood concentrations of propofol.

QUESTION 5 Describe the pharmacological effects of paracetamol. Oufline its toxicity and management. QUESTION 6 List the potential clinical uses of an alpha-2 adrenoceptor agonist and outline the limitations of

clonidine for each.

QUESTION 7 Write short notes on factors affecting the speed of onset and duration of effect of local anaesthetics when used to produce peripheral nerve block.

QUESTION 8 Outline the pharmacological differences between neonates and adults with reference to sevoflurane, vecuronium and morphine.

QUESTION 9 Describe the effects of tachycardia on myocardial oxygen supply and demand in a normal heart QUESTION 10 Describe the role of baroreceptors in the control of systemic arterial pressure.

QUESTION 11 Briefly describe the potential causes of a difference between measured end-tidal and arterial partial pressure of carbon dioxide.

QUESTION 12 Explain the difference between perfusion limitation and diffusion limitation in the transfer of gas between alveolus and pulmonary capillary. Outline the factors that determine whether gas transfer is perfusion or diffusion limited.

QUESTION 13 Describe the factors that affect airways resistance.

QUESTION 14 Oufline the role of the kidney in the regulation of body water.

QUESTION 15 Briefly describe the N M D A (N-methyl d-aspartate) receptor and its physiological role in the central nervous system.

QUESTION 16 Outline the mechanism of secretion of hydrochloric acid by the stomach. Briefly describe how secretion of hydrochloric acid by the stomach is controlled.

(26)

MARCH/APRIL 2002

QUESTION 1 Explain how oxygen supply of organs is maintained during isovolaemic haemodilution.

QUESTION 2 Draw a labelled diagram of a cardiac muscle action potential highlighting the sequence of changes in ionic conductances. Explain the terms "threshold", "excitability", and "irritabOity" with the aid of the diagram.

QUESTION 3 Define "Venous Admixture". Briefly explain how venous admisture influences arterial oxygen tension and how an increase in inspired oxygen concentration may affect this.

QUESTION 4 Outline the physiological factors that influence pulmonary vascular resistance.

QUESTION 5 Outline the factors contributing to the generation and maintenance of the resting membrane potential.

QUESTION 6 Explain the physiological processes which cause oliguria in response to hypovolaemic shock QUESTION 7 Outline the principles of a pneumotachograph. What factors affect the accuracy of this device? QUESTION 8 Describe the physiological factors that contribute to the competence and tone of the lower

oesophageal sphincter.

QUESTION 9 Outline the toxicity of local anaesthetics.

QUESTION 10 Outline the factors that determine recovery (offset of action) after ceasing a drug infusion. QUESTION 11 Briefly outline the effects of thiopentone and ketamine not mediated via the central nervous

system.

QUESTION 12 Outline the mechanism of action of non-steroidal anti-inflammatory drugs and their potential adverse effects.

QUESTION 13 What are the side effects of amiodarone and what problems may develop during concurrent anaesthesia.

QUESTION 14 Briefly oufline pharmacological methods of reducing gastric acidity. Indicate the mechanisms of action and the advantages and disadvantages of each method.

QUESTION 15 Describe the mechanism of the anticoagulant effect of coumarin derivatives and what determines the onset and offset of effect

(27)

QUESTION 1 Outline the influences of pregnancy on pharmacokinetics.

QUESTION 2 Briefly describe the factors affecting the uptake of orally administered medicines.

QUESTION 3 Draw a graph comparing the ratio of inspired to alveolar concentrations during the first half hour of administration for nitrous oxide, isoflurane, and halothane. Outline reasons for observed differences between the agents and indicate the effects of increases in alveolar ventilation and cardiac output

QUESTION 4 Briefly outline the potential interactions between volatile agents and carbon dioxide absorbents.

QUESTION 5 Oufline the possible reasons for prolongation of paralysis induced by an intravenous dose of 1 mg.kg"^ of suxamethonium. Briefly indicate the consequences of such a prolonged block.

QUESTION 6 Write brief notes on tolerance and dependence in relation to opioid analgesics. QUESTION 7 Outline the potential pharmacological advantages and disadvantages of intra-operative

beta-blockade.

QUESTION 8 Outline the pharmacological effects of vasopressin.

QUESTION 9 Draw a pressure volume loop for the left ventricle in a normal adult. Outline the information that can be obtained from such a loop.

QUESTION 10 List the physiological factors which increase respiratory rate. Include a brief explanation of the mechanism by which each achieves this increase.

QUESTION 11 Outline the factors that determine coronary vascular resistance. QUESTION 12 Briefly explain the changes that occur in stored whole blood. QUESTION 13 Briefly describe the functions of renin and angiotensin. QUESTION 14 Explain the physical principles of ultrasound imaging.

QUESTION 15 Give a brief account of the mechanisms which regulate gastric secretion. QUESTION 16 Explain the Bohr and Haldane effects in trans-placental gas exchange.

(28)

AUGUST/SEPTEMBER 2001

QUESTION 1 Explain the effects of intermittent positive pressure ventilation on left ventricular output QUESTION 2 Describe the determinants of work of breathing in an adult human at rest

QUESTION 3 Describe the fuel sources used during early and sustained fasting in man. QUESTION 4 Describe the physiological changes that occur in respiratory function during pregnancy. QUESTION 5 Describe the structure and function of voltage gated ion channels.

QUESTION 6 Explain how the kidney handles glucose. Describe the physiological consequences of glycosuria.

QUESTION 7 Explain the main difference between the intrinsic and extrinsic pathways of coagulation. QUESTION 8 Explain the physiological processes involved in the development of interstitial oedema. QUESTION 9 What do you understand by the term "clearance". Using propofol as an example, explain

briefly the importance of clearance.

QUESTION 10 Briefly describe the adverse effects of nitrous oxide.

QUESTION 11 Describe the required pharmacological characteristics of local anaesthetic formulations intended for topical use.

QUESTION 12 Outline the effects of an opioid injected into the spinal intrathecal space. QUESTION 13 Compare and contrast neostigmine and the organophosphorus compounds.

QUESTION 14 Outline the direct effects of endogenously released histamine.

QUESTION 15 Oufline the potential benefits and disadvantages of peri-operative beta-blockade.

QUESTION 16 Briefly describe correlation and simple linear regression, and explain their differences. What assumptions are common to both?

(29)

QUESTION 1 Outlme the determinants and regulation of extracellular fluid volume. QUESTION 2 Briefly describe the effect of resting muscle length and load conditions on the tension

generated by a skeletal muscle. How do these factors affect the velocity of shortening?

QUESTION 3 Briefly describe the measurement of p H in a blood sample using a p H electrode QUESTION 4 Indicate the sequence of the physiological changes to the fetal circulation at birth and briefly

describe the mechanisms which account for these changes.

QUESTION 5 Explain briefly the role of the skin in maintaining a normal body temperature.

QUESTION 6 Describe the substances released by the endothelium. Explain the role they play in regulating blood flow through the peripheral circulation.

QUESTION 7 Describe how the body detects and responds to water deficit.

QUESTION 8 What are the physiological consequences of decreasing functional residual capacity by one litre in an adult?

QUESTION 9 Briefly describe how drugs may produce their pharmacological effects. Illustrate each mechanism with examples.

QUESTION 10 Outline GABA's role as a neurotransmitter and indicate how its actions may be modified by pharmacological agents.

QUESTION 11 Define the term "context -sensitive half time". How does this differ from the elimination half life? Illustrate your answer by comparing thiopentone vs. propofol and fentanyl vs. remifentanil.

QUESTION 12 Briefly describe the respiratory effects of the volatile agents.

QUESTION 13 Outline the NON-ideal features as an intravenous induction agent of the current formulations of propofol.

QUESTION 14 Give examples of drugs that enhance the action of the non-depolarising neuromuscular blocking agents at the neuromuscular junction. Briefly describe the mechanism of these interactions.

QUESTION 15 Compare and contrast the pharmacology of esmolol and propranolol QUESTION 16 Describe the use of the null hypothesis and the P-value in a drug trial.

(30)

JULY/AUGUST 2000

QUESTION 1 Describe the role of baroreceptors in the control of arterial pressure.

QUESTION 2 Briefly describe the principles and sources of error in the measurement of arterial blood pressure using an automated oscillometric non-invasive monitor.

QUESTION 3 Draw an expiratory flow volume curve for a forced expiration from total lung capacity. Describe its characteristics in people with normal lungs, as well as those with obstructive and restrictive lung disease.

QUESTION 4 Outline the principles of compatibility testing of allogeneic (homologous) blood for transfusions. QUESTION 5 Briefly discuss the relationship between structure and function in skeletal muscle.

QUESTION 6 Briefly oufline the physiological control of intraocular pressure. QUESTION 7 Outline the actions of insulin that affect fat metabolism.

QUESTION 8 Describe the factors governing glomerular filtration rate.

QUESTION 9 What is an isomer? Briefly write an account of the types of isomers and significance in drugs used in anaesthesia.

QUESTION 10 Qassify diuretics giving examples and briefly explaining their action. QUESTION 11 Describe the structure and function of G proteins.

QUESTION 12 Explain how differences in the pharmacokinetics of alfentanil and fentanyl can influence the way they are administered intravenously.

QUESTION 13 Write short notes on factors affecting the speed of onset and duration of local anaesthetics when used to produce peripheral nerve block.

QUESTION 14 Write short notes contrasting the cardiovascular effects of propofol and ketamine seen clinically.

QUESTION 15 Write brief notes on latex aUergy.

(31)

QUESTION 1 Explain how cardiac output is measured using a thermodilution technique?

QUESTION 2 Briefly describe the factors that influence the partial pressure of oxygen in mixed venous blood?

QUESTION 3 What is a normal value for pulmonary vascular resistance? Oufline physiological factors that influence pulmonary resistance.

QUESTION 4 Briefly describe the difference between a single twitch and tetanic contraction in a skeletal muscle fibre. Include in your answer the physiological basis for the development of a tetanic contraction.

QUESTION 5 Describe the important determinants of work of breathing in an adult human at rest. Explain how to minimise work of breathing.

QUESTION 6 Describe the control of gastric emptying.

QUESTION 7 List the hormones that regulate renal tubxilar reabsorption and describe their action and site of action.

QUESTION 8 Briefly describe the breakdown of haemoglobin after red cell lysis. QUESTION 9 Compare and contrast the effects of halothane and isoflurane on the heart.

QUESTION 10 Briefly describe the pharmacological effects of paracetamol. Outline the mechanisms of its toxicity.

QUESTION 11 Oufline the main biochemical events involved in noradrenergic transmission, and how these may be altered by the use of M A O (mono amine oxidase) inhibitors ?

QUESTION 12 Outline the pharmacology of oxytocin.

QUESTION 13 Briefly describe correlation and simple linear regression, and explain their differences. What assumptions are common to both?

QUESTION 14 Discuss the roles of plasma esterases on drugs used in anaesthesia. QUESTION 15 Describe the effects of opioids on the respiratory system.

QUESTION 16 Briefly describe the factors that determine skin penetration by local anaesthetics. What is an eutectic mixture? Briefly describe the formulation and pharmacology of EMLA® cream.

(32)

JULY/AUGUST 1999

QUESTION 1 How does a fall in temperature influence blood gas solubility and acid base values?

QUESTION 2 What physiological factors contribute to the competence and tone of the lower oesophageal sphincter?

QUESTION 3 Describe the factors that affect airway resistance.

QUESTION 4 Outline the role of the kidneys in the regulation of body water. QUESTION 5 Describe the ways in which C O 2 is carried in the blood.

QUESTION 6 Explain the mechanisms that maintain cerebral blood flow on moving from a supine to a standing position.

QUESTION 7 Describe how the partial pressure of oxygen in a blood sample is measured using a Clark electrode.

QUESTION 8 Draw both aortic root and a radial artery pressure wave forms on the same axes. Explain the differences between them.

QUESTION 9 What is meant by "95% confidence interval"? Explain the practical applications of confidence intervals and indicate why they may be preferred to P-values? QUESTION 10 Outline factors determining speed of onset of neuromuscular blocking agents. QUESTION 11 Outline the toxicity of local anaesthetics.

QUESTION 12 Briefly describe the mechanism and treatment of the toxicity of sodium nitroprusside. QUESTION 13 Using opioids as an example describe and illustrate with graphs what you understand by the

terms "potency", "efficacy", "partial agonist", "competitive antagonist", and "therapeutic index".

QUESTION 14 Briefly outline the effects of intravenous induction agents not mediated via the central nervous system.

QUESTION 15 Briefly describe the preparation of oxygen for medical use. List the physical properties of oxygen. Outline the potential adverse effects associated with its medical use. QUESTION 16 Outline the factors that determine recovery (offset of action) after ceasing a drug

(33)

QUESTION 1 Explain the Bohr and Haldane effects in trans-placental gas exchange. QUESTION 2 Explain the mechanisms that prevent blood clotting in intact blood vessels (do not draw

the clotting cascade).

QUESTION 3 Describe the factors that affect the transport of oxygen and carbon dioxide from the alveolus to blood.

QUESTION 4 Explain how the kidney handles glucose. Describe the physiological consequences of glycosuria.

QUESTION 5 Differentiate between the terms "heat" and "temperature". Explain briefly the principles of a mercury thermometer, indicating its advantages and disadvantages. QUESTION 6 Describe the factors influencing hepatic blood flow.

QUESTION 7 Describe the autonomic innervation of the heart, and the direct effect of autonomic stimulation on cardiac function.

QUESTION 8 Explain the significance of plasma oncotic pressure in capillary fluid dynamics.

QUESTION 9 I n a clinical trial, why is adequate power important? What factors affect the determination of an adequate sample size?

QUESTION 10 Write a brief oufline on the pharmacology of remifentanil.

QUESTION 11 Briefly compare and contrast the clinical pharmacology of atropine, hyoscine (scopolamine) and glycopyrrolate.

QUESTION 12 Explain the phenomena known as fade and post tetanic facilitation associated with the use of neuromuscular blocking agents.

QUESTION 13 Describe the neuropharmacology of thiopentone covering its site of action, EEG changes, effects on cerebral blood flow and intracranial pressure.

QUESTION 14 Briefly oufline the pharmacological effects of the volatile anaesthetic agents on the kidneys.

QUESTION 15 List the drugs used clinically as anticoagulants and antithrombotics. Write short notes on their mechanisms of actions.

References

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