, TEST YOURSELF
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Henry GW Paw is Consultant in Anaesthesia and Intensive Care at York Hospital, and
Clinical Senior Lecturer at the Hull York Medical School, UK.
Vijayanand Nadella is a Specialty Registrar in West Yorkshire rotation, UK.
Questions
1 Pharmacokinetic variation B Carbon monoxide shifts the oxyhaemoglobin dissocia-
Which of the following variations in pharmacokinetics tion curve to the left
are seen in obesity? C Closing volume is decreased
A Gastrointestinal absorption of drugs is not affected D Bone marrow activity is decreased
by obesity E There is evidence that there is increased risk of deep
B The proportion of total body water to the body mass vein thrombosis in smokers
is increased
C Plasma protein binding remains unchanged 5 Patient selection for day case surgery
D Hepatic blood flow is decreased Which of the following are true about the principles of day
E Renal excretion of drugs is increased case surgery?
A Ex-premature babies of less than 60 post-conceptual
2 Pharmacokinetic variation weeks can safely be considered for day surgery
Which of the following drugs induce the cytochrome B The incidence of postoperative cognitive dysfunction is
P450 enzyme system? reduced by day surgery in the elderly
A Griseofulvin C Myocardial infarction or revascularization within
B Rifampicin the last 3 months is a contraindication for day
C Erythromycin surgery
D Fluconazole D There are insufficient data to recommend a fasting
blood glucose or HbA1C above which day surgery
E Etomidate
should not proceed
3 Intravenous anaesthetic agents E Patients with obstructive sleep apnoea are not consid-
Which of the following are true regarding the pharma- ered for day case surgery
cological actions of magnesium (Mg2D)?
A Reduces the minimum alveolar concentration of 6 Principles of artificial ventilation
volatile anaesthetics Which of the following are true about the ventilation strat-
B It acts as a natural calcium agonist egies used in acute respiratory distress syndrome (ARDS)?
C Increases acetylcholine release from the motor nerve A Gas is preferentially delivered to less compliant lung
terminals units with volume-controlled ventilation
D Acts as an antagonist at N-methyl-D aspartate B A higher mean airway pressure for a given peak airway
(NMDA) receptors pressure can be achieved with pressure-controlled
ventilation
E Has been used in the treatment of ventricular
arrhythmias associated with digitalis C The benefits of prone ventilation are essentially from
improved ventilation and perfusion matching
4 Effects of smoking on health and anaesthesia D In ARDS associated with pneumonia high positive end-
Which of the following are true about the effects of expiratory pressure levels may be highly beneficial
smoking relevant to anaesthesia? E High-frequency oscillation ventilation improves
A Nicotine increases the myocardial oxygen demand outcome when compared to conventional ventilation
Correct answers: 1 (A, C, E) 2 (A, B) 3 (A, D, E) 4 (A, B) 5 (B, C, D) 6 (B, C)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 14:3 132
, TEST YOURSELF
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Vijayanand Nadella MBBS DA FCAI is a Consultant in Anaesthesia and Intensive Care at
Calderdale & Huddersfield NHS Trust, UK.
Questions
1 Physical principles of defibrillators A Notching of the P wave is seen in right atrial
Which of the following are true regarding the biphasic hypertrophy
defibrillators? B The presence of a U wave is classical of hyperkalaemia
A The energy levels for effective defibrillation are C T-wave inversion can be seen with myocarditis
higher than that required with the monophasic D WolffeParkinsoneWhite syndrome may cause a pro-
B The current initially flows in one direction and then longation of the QRS interval
reverses E Right bundle branch block can occur in an atrial septal
C Increases the incidence of post-resuscitation defect
myocardial dysfunction
D The impedance is low with the biphasic truncated 5 Drugs acting on the heart: heart failure and
exponential waveform coronary insufficiency
E The rectilinear biphasic waveform was developed Which of the following conditions are contra-indications to
specifically for implantable cardiac devices angiotensin-converting enzyme inhibitors (ACEI) therapy?
2 Drugs acting on the heart: antihypertensive A History of angioedema
drugs B Symptomatic heart failure
Which of the following b-blockers are cardioselective? C Unilateral renal artery stenosis
A Atenolol D Severe aortic stenosis
B Metoprolol E Hyperkalaemia
C Bisoprolol
D Labetalol 6 Electromechanical coupling and regulation of
E Carvedilol force of cardiac contraction
Which of the following are true regarding the structure
3 Drugs acting on the heart: anti-arrhythmics and mechanisms involved in cardiac muscle contraction?
Which of the following are true regarding the pharma- A The cardiac muscle fibre has a well-defined transverse
cology of adenosine? tubule system
A Adenosine is a naturally-occurring purine nucleoside B The ryanodine receptors are located in the membrane
B Acts via G protein coupled receptor mechanism of the sarcoplasmic reticulum
C Adenosine has a half life of 10 minutes C Tropomyosin binds at the C site on the troponin
D May be used in the treatment of WolffeParkinson molecule
eWhite syndrome D The uptake of calcium by the sarcoplasmic reticulum
E Bronchospasm is a recognised side effect at the end of the cardiac action potential is a passive
process
4 Electrocardiogram and arrhythmias E The activation of L type calcium channels triggering
Which of the following are true regarding the variations the contractile process is mediated by G protein
in ECG? coupled receptors
Correct answers: 1 (B, D), 2 (A, B, C), 3 (A, B, E), 4 (C, D, E), 5 (A, D, E), 6 (A, B, E)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 16:5 246 .
, TEST YOURSELF
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Henry GW Paw is Consultant in Anaesthesia and Intensive Care at York Hospital, and
Clinical Senior Lecturer at the Hull York Medical School, UK.
Vijayanand Nadella is a Specialty Registrar in West Yorkshire rotation, UK.
Questions
1 Drugs affecting coagulation 4 Pharmacological modulation of cardiac function
Which of the following are true about the glycoprotein and blood vessel calibre
(GP) IIb/IIIa receptors and their antagonists? Which of the following are true about the mechanism of
A GP IIb/IIIa receptors consist of three subunits action of various cardio vascular drugs?
B Platelet transfusion will be ineffective in reducing A Enoximone is a specific phosphodiesterase III inhibitor
the anti-platelet effect of receptor antagonists B Digoxin inhibits the sodiumepotassium adenosine
C Dose needs to be adjusted for patients with renal triphosphatase pump
impairment C Dobutamine is a potent dopamine receptor agonist
D Eptifibatide has a very high affinity to the GP IIb/IIIa D Verapamil is a T type calcium channel antagonist
receptor E Nicorandil is a potential nitric oxide donor
E Abciximab has a plasma half-life greater than 24
hours 5 Central venous cannulation: ultrasound
techniques
2 Drugs affecting coagulation Which of the following are true about the physics and uses
Which of the following are true regarding the pharma- of ultrasound for internal jugular (IJ) cannulation?
cology of ticlopidine? A A low frequency probe is useful for IJ cannulation
A Is a thienopyridine derivative B The complication rate is less than 1% with the use of
B Reversible antagonist of the adenosine diphosphate ultrasound for IJ cannulation
receptor on platelets C Ultrasound reduces the time for successful cannulation
C Onset of action is within 48 hours D It is mandatory to use ultrasound for IJ cannulation
D The inhibition of platelet aggregation is concentra- E Chest X-ray is not needed to confirm position when
tion dependent ultrasound has been used for venous cannulation
E Aplastic anaemia is a serious complication
6 Cardiopulmonary resuscitation (CPR) and post-
3 Sedation and delirium in the intensive care resuscitation care
unit Which of the following are true regarding chest compres-
Which of the following are true regarding delirium in sions and drugs used during resuscitation?
the intensive care unit? A At best, chest compressions achieve up to 25% of
A The incidence of delirium in intensive care patients normal coronary perfusion
is around 5% B Waveform capnography provides a measure of CPR
B It is associated with significantly higher mortality quality
C Physical restraints are advised in the management of C Adrenaline is recommended via the tracheal route if
delirium venous access is difficult
D Haloperidol reduces the risk of delirium D Mild hypothermia reduces the problems associated
E Delirium is associated with disturbance of with reperfusion injury
consciousness E CPR is a contraindication to thrombolysis
Correct answers: 1 (C), 2 (A, D, E), 3 (B, E), 4 (A, B, E), 5 (C), 6 (A, B, D)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 14:1 42
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Henry GW Paw is Consultant in Anaesthesia and Intensive Care at York Hospital, and
Clinical Senior Lecturer at the Hull York Medical School, UK.
Vijayanand Nadella is a Specialty Registrar in West Yorkshire rotation, UK.
Questions
1 Pharmacokinetic variation B Carbon monoxide shifts the oxyhaemoglobin dissocia-
Which of the following variations in pharmacokinetics tion curve to the left
are seen in obesity? C Closing volume is decreased
A Gastrointestinal absorption of drugs is not affected D Bone marrow activity is decreased
by obesity E There is evidence that there is increased risk of deep
B The proportion of total body water to the body mass vein thrombosis in smokers
is increased
C Plasma protein binding remains unchanged 5 Patient selection for day case surgery
D Hepatic blood flow is decreased Which of the following are true about the principles of day
E Renal excretion of drugs is increased case surgery?
A Ex-premature babies of less than 60 post-conceptual
2 Pharmacokinetic variation weeks can safely be considered for day surgery
Which of the following drugs induce the cytochrome B The incidence of postoperative cognitive dysfunction is
P450 enzyme system? reduced by day surgery in the elderly
A Griseofulvin C Myocardial infarction or revascularization within
B Rifampicin the last 3 months is a contraindication for day
C Erythromycin surgery
D Fluconazole D There are insufficient data to recommend a fasting
blood glucose or HbA1C above which day surgery
E Etomidate
should not proceed
3 Intravenous anaesthetic agents E Patients with obstructive sleep apnoea are not consid-
Which of the following are true regarding the pharma- ered for day case surgery
cological actions of magnesium (Mg2D)?
A Reduces the minimum alveolar concentration of 6 Principles of artificial ventilation
volatile anaesthetics Which of the following are true about the ventilation strat-
B It acts as a natural calcium agonist egies used in acute respiratory distress syndrome (ARDS)?
C Increases acetylcholine release from the motor nerve A Gas is preferentially delivered to less compliant lung
terminals units with volume-controlled ventilation
D Acts as an antagonist at N-methyl-D aspartate B A higher mean airway pressure for a given peak airway
(NMDA) receptors pressure can be achieved with pressure-controlled
ventilation
E Has been used in the treatment of ventricular
arrhythmias associated with digitalis C The benefits of prone ventilation are essentially from
improved ventilation and perfusion matching
4 Effects of smoking on health and anaesthesia D In ARDS associated with pneumonia high positive end-
Which of the following are true about the effects of expiratory pressure levels may be highly beneficial
smoking relevant to anaesthesia? E High-frequency oscillation ventilation improves
A Nicotine increases the myocardial oxygen demand outcome when compared to conventional ventilation
Correct answers: 1 (A, C, E) 2 (A, B) 3 (A, D, E) 4 (A, B) 5 (B, C, D) 6 (B, C)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 14:3 132
, TEST YOURSELF
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Vijayanand Nadella MBBS DA FCAI is a Consultant in Anaesthesia and Intensive Care at
Calderdale & Huddersfield NHS Trust, UK.
Questions
1 Physical principles of defibrillators A Notching of the P wave is seen in right atrial
Which of the following are true regarding the biphasic hypertrophy
defibrillators? B The presence of a U wave is classical of hyperkalaemia
A The energy levels for effective defibrillation are C T-wave inversion can be seen with myocarditis
higher than that required with the monophasic D WolffeParkinsoneWhite syndrome may cause a pro-
B The current initially flows in one direction and then longation of the QRS interval
reverses E Right bundle branch block can occur in an atrial septal
C Increases the incidence of post-resuscitation defect
myocardial dysfunction
D The impedance is low with the biphasic truncated 5 Drugs acting on the heart: heart failure and
exponential waveform coronary insufficiency
E The rectilinear biphasic waveform was developed Which of the following conditions are contra-indications to
specifically for implantable cardiac devices angiotensin-converting enzyme inhibitors (ACEI) therapy?
2 Drugs acting on the heart: antihypertensive A History of angioedema
drugs B Symptomatic heart failure
Which of the following b-blockers are cardioselective? C Unilateral renal artery stenosis
A Atenolol D Severe aortic stenosis
B Metoprolol E Hyperkalaemia
C Bisoprolol
D Labetalol 6 Electromechanical coupling and regulation of
E Carvedilol force of cardiac contraction
Which of the following are true regarding the structure
3 Drugs acting on the heart: anti-arrhythmics and mechanisms involved in cardiac muscle contraction?
Which of the following are true regarding the pharma- A The cardiac muscle fibre has a well-defined transverse
cology of adenosine? tubule system
A Adenosine is a naturally-occurring purine nucleoside B The ryanodine receptors are located in the membrane
B Acts via G protein coupled receptor mechanism of the sarcoplasmic reticulum
C Adenosine has a half life of 10 minutes C Tropomyosin binds at the C site on the troponin
D May be used in the treatment of WolffeParkinson molecule
eWhite syndrome D The uptake of calcium by the sarcoplasmic reticulum
E Bronchospasm is a recognised side effect at the end of the cardiac action potential is a passive
process
4 Electrocardiogram and arrhythmias E The activation of L type calcium channels triggering
Which of the following are true regarding the variations the contractile process is mediated by G protein
in ECG? coupled receptors
Correct answers: 1 (B, D), 2 (A, B, C), 3 (A, B, E), 4 (C, D, E), 5 (A, D, E), 6 (A, B, E)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 16:5 246 .
, TEST YOURSELF
MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to test
your knowledge of selected topics in this issue of the journal. The correct answers
are given at the foot of the page.
Henry GW Paw is Consultant in Anaesthesia and Intensive Care at York Hospital, and
Clinical Senior Lecturer at the Hull York Medical School, UK.
Vijayanand Nadella is a Specialty Registrar in West Yorkshire rotation, UK.
Questions
1 Drugs affecting coagulation 4 Pharmacological modulation of cardiac function
Which of the following are true about the glycoprotein and blood vessel calibre
(GP) IIb/IIIa receptors and their antagonists? Which of the following are true about the mechanism of
A GP IIb/IIIa receptors consist of three subunits action of various cardio vascular drugs?
B Platelet transfusion will be ineffective in reducing A Enoximone is a specific phosphodiesterase III inhibitor
the anti-platelet effect of receptor antagonists B Digoxin inhibits the sodiumepotassium adenosine
C Dose needs to be adjusted for patients with renal triphosphatase pump
impairment C Dobutamine is a potent dopamine receptor agonist
D Eptifibatide has a very high affinity to the GP IIb/IIIa D Verapamil is a T type calcium channel antagonist
receptor E Nicorandil is a potential nitric oxide donor
E Abciximab has a plasma half-life greater than 24
hours 5 Central venous cannulation: ultrasound
techniques
2 Drugs affecting coagulation Which of the following are true about the physics and uses
Which of the following are true regarding the pharma- of ultrasound for internal jugular (IJ) cannulation?
cology of ticlopidine? A A low frequency probe is useful for IJ cannulation
A Is a thienopyridine derivative B The complication rate is less than 1% with the use of
B Reversible antagonist of the adenosine diphosphate ultrasound for IJ cannulation
receptor on platelets C Ultrasound reduces the time for successful cannulation
C Onset of action is within 48 hours D It is mandatory to use ultrasound for IJ cannulation
D The inhibition of platelet aggregation is concentra- E Chest X-ray is not needed to confirm position when
tion dependent ultrasound has been used for venous cannulation
E Aplastic anaemia is a serious complication
6 Cardiopulmonary resuscitation (CPR) and post-
3 Sedation and delirium in the intensive care resuscitation care
unit Which of the following are true regarding chest compres-
Which of the following are true regarding delirium in sions and drugs used during resuscitation?
the intensive care unit? A At best, chest compressions achieve up to 25% of
A The incidence of delirium in intensive care patients normal coronary perfusion
is around 5% B Waveform capnography provides a measure of CPR
B It is associated with significantly higher mortality quality
C Physical restraints are advised in the management of C Adrenaline is recommended via the tracheal route if
delirium venous access is difficult
D Haloperidol reduces the risk of delirium D Mild hypothermia reduces the problems associated
E Delirium is associated with disturbance of with reperfusion injury
consciousness E CPR is a contraindication to thrombolysis
Correct answers: 1 (C), 2 (A, D, E), 3 (B, E), 4 (A, B, E), 5 (C), 6 (A, B, D)
ANAESTHESIA AND INTENSIVE CARE MEDICINE 14:1 42
