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MED2031 Mid Semester Practice Exam

Respiratory Physiology
1. Muscles used in passive expiration include
a. Diaphragm
b. External intercostals
c. Internal intercostals
d. No muscles are used
e. Innermost intercostals
2. What
a.
b.
c.
d.
e.

is the residual volume in spirometry?


Amount of air remaining in lungs after maximum expiration
Amount of air that is exhaled when breathing with maximum force
Air inhaled or exhaled when breathing at rest
Total volume of air that can be breathed in and out
Maximum amount of air that can be inhaled apart from that which is
breathed in at rest

3. What
a.
b.
c.
d.
e.

is vital capacity?
Amount of air remaining in lungs after maximum expiration
Amount of air that is exhaled when breathing with maximum force
Air inhaled or exhaled when breathing at rest
Total volume of air that can be breathed in and out
Maximum amount of air that can be inhaled apart from that which is
breathed in at rest

4. What
a.
b.
c.
d.
e.

is inspiratory reserve volume?


Amount of air remaining in lungs after maximum expiration
Amount of air that is exhaled when breathing with maximum force
Air inhaled or exhaled when breathing at rest
Total volume of air that can be breathed in and out
Maximum amount of air that can be inhaled apart from that which is
breathed in at rest

5. What
a.
b.
c.
d.
e.

is tidal volume?
Amount of air remaining in lungs after maximum expiration
Amount of air that is exhaled when breathing with maximum force
Air inhaled or exhaled when breathing at rest
Total volume of air that can be breathed in and out
Maximum amount of air that can be inhaled apart from that which is
breathed in at rest

6. What
a.
b.
c.
d.
e.

is the anatomical dead space?


About 2L
Volume in non-functioning alveoli
Volume of conducting airways, nasal cavity and pharynx
Equal to physiological dead space if pathology present
Space in lungs to which air cannot penetrate

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MED2031 Mid Semester Practice Exam


7. What
a.
b.
c.
d.
e.

is the physiological dead space?


Sum of anatomical dead space and volume in non-functioning alveoli
Volume in non-functioning alveoli
Volume of conducting airways, nasal cavity and pharynx
Equal to anatomical dead space if pathology present
Space in lungs to which air cannot penetrate

8. Obstructive lung disease is


a. Reduced pulmonary compliance
b. Reduced lung elasticity
c. Can be caused by fibrosis
d. Can be caused by asthma
e. Decreased airway resistance
9. What
a.
b.
c.
d.
e.

is the equation for minute volume?


Respiratory rate x tidal volume
Vital capacity x tidal volume
Respiratory rate x (tidal volume anatomical dead space)
Tidal volume x respiratory rate
Respiratory rate x physiological dead space

10.What is the equation for alveolar ventilation?


a. Respiratory rate x tidal volume
b. Vital capacity x tidal volume
c. Respiratory rate x (tidal volume anatomical dead space)
d. Tidal volume x respiratory rate
e. Respiratory rate x physiological dead space
Volume of air moved in alveoli in 1 minute
11.Factors affecting rate of gas diffusion include the following except
a. Thickness of membrane
b. Surface area of membrane
c. Diffusion coefficient of gas
d. Pressure difference across membrane
e. Amount of viable alveoli
12.The diffusion coefficient of oxygen is higher than that of carbon dioxide
a. True
b. False
13.The partial pressure of oxygen (PO2) in the alveolus is:
a. 104mmHg
b. 40mmHg
c. 95mmHg
d. 45mmHg
e. 23mmHg
14.The PO2 in the pulmonary veins is
a. 104mmHg
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b.
c.
d.
e.

40mmHg
95mmHg
45mmHg
23mmHg

15.The PO2 in the blood leaving tissues is:


a. 104mmHg
b. 40mmHg
c. 95mmHg
d. 45mmHg
e. 23mmHg
16.The PCO2 in the alveoli is
a. 104mmHg
b. 40mmHg
c. 95mmHg
d. 45mmHg
e. 23mmHg
17.The PCO2 in the pulmonary veins is
a. 104mmHg
b. 40mmHg
c. 95mmHg
d. 45mmHg
e. 23mmHg
18.The PCO2 in the blood leaving tissues is
a. 104mmHg
b. 40mmHg
c. 95mmHg
d. 45mmHg
e. 23mmHg
19.Select the incorrect response. The Bohr effect
a. Is a property of haemoglobin
b. States that an increase in carbon dioxide decreases Hb saturation of
oxygen
c. Causes can increased amount of oxygen unloaded to tissues
d. Causes an increased oxygen uptake in alveoli
e. Is more pronounced when PO2 is higher
20.The utilisation coefficient of oxygen is
a. About 25% and decreases during exercise
b. About 50% and increases during exercise
c. About 25% and increases during exercise
d. About 50% and decreases during exercise
e. 100% and increases during exercise
21.Carbon dioxide is transported in the blood in the following ways except:
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MED2031 Mid Semester Practice Exam


a.
b.
c.
d.
e.

CO2
HbCO2
HCO3O2.CO2
D and A

22.Select the incorrect response. The Haldane effect:


a. States that binding of O2 to Hb displaces CO2 from blood
b. Increases efficiency of movement of CO2 from blood to alveoli then
external air
c. Is due to OxyHb binding CO2 less strongly than dexoyhaemoglobin
d. Is due to increased acidity when OxyHb increases
e. Reduces the amount of carbon dioxide removed from tissues
23.Which of the statements about ventilation is false?
a. Ventilation = (Vt- dead space) x respiratory rate
b. Is equal to perfusion in healthy people
c. Is usually about 5L/min
d. Is increased near base of lung
e. Ventilation: perfusion ratio is equal in all areas of the lungs
24.Which of the following is false?
a. In zone 1 the alveolar air pressure is greater than pulmonary capillary
pressure
b. Zone 1 is pathological
c. In zone 2 there is intermittent blood flow through pulmonary capillaries
during systole
d. Zone 3 normally occurs 10 cm above heart when standing
e. In zone 3 the capillary pressure is greater than the alveolar pressure
25.The alveoli at the apex contribute less to tidal volume than alveoli at base
due to:
a. Smaller alveoli which can be expanded more in the base
b. Gravity
c. Increased perfusion near base of lung
d. Increased pressure near base of lungs
e. Decreased ventilation: perfusion ratio at apex of lungs
26.Select the incorrect response. Hypoxic pulmonary vasoconstriction
a. Lowers efficiency of gas exchange
b. Is the opposite to what happens in tissues
c. Reduces blood flow to areas with low ventilation
d. Helps to match V:Q ratio
e. Increases V:Q ratio
27.Select the incorrect response. In emphysema
a. Lowered ventilation
b. Lowered perfusion
c. Enlargement of alveoli
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d. Overall increase in V:Q ratio
e. Manifests as pink puffers and blue bloaters
28.The dorsal respiratory group:
a. Is in the pons
b. Contains inspiratory and expiratory neurons
c. Receives input from glossopharyngeal and vagal nerves
d. Used in heavy breathing
e. Regulates the shift from inspiration to expiration
29.Which of the following is false? The ventral respiratory group
a. Contains inspiratory and expiratory neurons
b. Used in heavy breathing
c. Receives input from DRG
d. Is activated when respiratory drive is increased
e. Regulates shift from inspiration to expiration
30.Select the incorrect response. The pneumotaxic centre
a. Is in the pons
b. Occurs in the nucleus ambiguous and nucleus retroambiguous
c. Switches off inspiratory ramp
d. Controls duration of expiration
e. Has low output to slow the respiratory rate
Nucleus parabrachialis is pneumotaxic centre.
31.Sensory receptors providing information to respiratory centres include the
following except:
a. Central chemoreceptors which response to pH changes in CSF
b. Peripheral chemoreceptors which are found in the carotid arteries and
aorta
c. Baroreceptors which respond to blood pressure
d. Stretch receptors are found in the smooth muscle of bronchi and
bronchioles and visceral pleura
e. Irritant receptors in the epithelial cells of airways
32.Carbon dioxide is the major factor controlling ventilation in the short term
a. True
b. False
33.Ventilation increases with exercise because:
a. Brain sends collateral signals to respiratory centres at same time that
it signals to muscles to commence exercising
b. Decreased O2 in blood
c. Increased CO2 in blood
d. Decreased pH
e. Muscle and joint proprioceptor response
34.Other factors that control ventilation include the following except:
a. Irritants
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b.
c.
d.
e.

Drugs
Brain damage
J receptors
Blood pressure changes

35.Acid production in the body:


a. Only occurs via glucose breakdown
b. Only occurs via amino acid breakdown
c. Produces mainly respiratory acid
d. Produces mainly metabolic acid
e. Is a product of renal outflow
36.A small change in pH equals a large change in [H+]
a. True
b. False
37.The normal pH of arterial blood is
a. 7.35
b. 7.4
c. 7.2
d. 0.7
e. 8.1
38.The normal pH of venous blood is
a. 7.35
b. 7.4
c. 7.2
d. 0.7
e. 8.1
39.The mechanisms for maintaining pH include the following except:
a. Buffering
b. Diffusion
c. Respiration
d. Renal excretion
e. B and D
40.Select the incorrect response. A buffer
a. Sequesters H+
b. Does not get rid of H+
c. Works best if the pKa is equal to the pH of the fluid it is buffering
d. Includes HCO3-, haemoglobin, plasma proteins and phosphate
e. Reduces pH
41.Normal CO2 pressure in arterial blood is:
a. 40nm
b. 40mmHg
c. 45mmHg
d. 24mM
e. 7.4
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MED2031 Mid Semester Practice Exam


42.Normal [H+]
a. 40nM
b. 40mmHg
c. 45mmHg
d. 24mM
e. 7.4
43.Normal HCO3a. 40nm
b. 40mmHg
c. 45mmHg
d. 24mM
e. 7.4
44.An increase in HCO3- will lead to
a. Increased pH
b. Decreased pH
c. Alkalosis
d. Acidosis
e. A and C
45.An increase in CO2 or decrease in O2 in the blood leads to the following
except
a. Increase brain ECF [H+]
b. Increase in central chemoreceptor firing
c. Increase in peripheral chemoreceptors firing
d. Increase in medullary inspiratory neurons firing
e. Decrease in ventilation
46.Respiratory acidosis
a. Arises through low plasma CO2
b. pH> 7.45
c. paCO2> 45mmHg
d. increase in H+ or HCO3- not of respiratory origin
e. may be a result of hyperventilation
47.Respiratory acidosis can occur in the following ways except:
a. Exaggerated V:Q ventopnoea
b. Acute lung diseases like pneumonia or asthmatic episodes
c. Chronic lung diseases like COPD or cystic fibrosis
d. Alteration to central drive for respiration like a head injury
e. Neural linkage to respiratory muscles like polio or MS
48.PAO2> PaO2
a. Is normal
b. Suggests pathology
c. Indicates V:Q mismatch
d. Indicates hypoxemia is due to ventilation and not underlying lung
disorder
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e. B and C
49.Sleep
a.
b.
c.
d.
e.

is important for the following except


Memory
Steroid production
Growth
Immune function
Protein synthesis

50.Darkness decreases melatonin release


a. True
b. False
51.Sleep
a.
b.
c.
d.
e.

deprivation can lead to the following except


Heart failure
Infection risk
Decreased vascular reactivity
Increase sleep latency
Hypotension

52.Sleep
a.
b.
c.
d.
e.

apnoea increases risk of the following except


Arrhythmias
Hypotension
Neuropsychological damage
Stroke
Heart failure

53.Which of the following about sleep apnoea is false?


a. Obstructive sleep apnoea is due to upper airway dysfunction
b. Obstructive sleep apnoea may be the cause of left ventricular failure
c. Central sleep apnoea is due to respiratory control dysfunction
d. Central sleep apnoea may be the result of left ventricular failure
e. Central sleep apnoea is more likely to occur in obese snorers
54.Treatment of sleep apnoea includes the following except
a. Lifestyle factors like sleep hygiene, weight loss and reduced alcohol
intake
b. Upper airway surgery like UPPP or tonsil and adenoid removal
c. Bariatric surgery
d. Mouth splints to widen the maxilla
e. Positive airway pressure
55.The pros of non-invasive ventilation like CPAP include the following except:
a. Avoidance of invasive procedures like tracheal intubation which have
complications
b. Keeps upper airway intact which is important in immune defence,
swallowing and speech
c. Less sedation
d. Increased patient comfort
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e. Potential for abrupt deterioration
56.Indications for NIV
a. Tachypnoea
b. Acidotic (pH< 7.35)
c. Hypercapnic
d. Heart failure
e. All of the above
57.Acclimatisation to lack of oxygen include the following except
a. Hyperventilation
b. Polycythemia
c. Increased diffusing capacity of lungs
d. Pulmonary vasoconstriction
e. Decreased tissue capillarity
58.Symptoms of acute mountain sickness include the following except
a. Headache/dizziness/nausea
b. Cerebral oedema
c. Peripheral oedema
d. Increased blood viscosity due to increased RBC mass and haematocrit
e. Hypoxic pulmonary vasoconstriction
59.Effects of high partial pressures on body include
a. Nitrogen narcosis
b. Oxygen toxicity
c. Hypercapnia
d. Pulmonary fixation
e. A and B
60.To avoid decompression sickness, drop hyperbaric pressure back to normal
pressure immediately
a. True
b. False
Renal physiology
61.Without functioning kidneys, the following could occur except
a. Hypotension
b. Anaemia
c. Osteoporosis
d. Metabolic acidosis
e. Hyperkalemia
62.Functions of the kidneys include the following except
a. Regulation of water and electrolyte volume/osmolarity
b. Acid-base regulation
c. Excretion of metabolic wastes
d. Secretion of hormones
e. Glycolysis
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MED2031 Mid Semester Practice Exam


63.The percentage of total body water which is interstitial fluid is
a. 10%
b. 40%
c. 60%
d. 30%
e. 1%
64.The volume of which compartment is regulated?
a. Plasma
b. Interstitial fluid
c. Intracellular fluid
d. Transcellular fluid
e. Extracellular fluid
65.What
a.
b.
c.
d.
e.

receptor does not monitor changes in ECF volume and composition?


Low pressure baroreceptors
Osmoreceptors in hypothalamus
Renal baroreceptors which leads to renin release
Adrenal cortex
Mechanoreceptors

66.The composition of ICF and ECF is identical except for


a. Ion concentration
b. Protein content
c. Water concentration
d. Pressure
e. Osmolarity
67.What
a.
b.
c.
d.
e.

is Starlings Law?
Fluid moves in direction of sum of forces on each side of membrane
Equivalent to net driving pressure
Takes into account colloid osmotic pressure and hydrostatic pressure
A and B
A, B and C

68.Blood
a.
b.
c.
d.
e.

flow to kidneys is what percentage of cardiac output?


20-25%
10-20%
30-50%
60%
5%

69.Filtration fraction is
a. Volume of plasma filtered per minute
b. Glomerular filtration rate
c. GFR/renal plasma flow
d. Amount of plasma filtered during single pass through kidney
e. C and D
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70.Which of the following about nephrons is false?
a. We are born with the number of nephrons we will have for the rest of
our life
b. Nephrons have a filtration component and a tubular component
c. Nephrons are found in the pelvis of the kidney
d. Nephrons can cross the medulla and cortex of the kidney
e. Nephrons are the functional unit of the kidney
71.The cortex contains the Bowmans capsule and convoluted tubules
a. True
b. False
72.The glomerulus is
a. The drainage tubes of the kidney
b. Interconnected specialised capillaries
c. The filtration unit of the kidney
d. Contain straight and convoluted tubules
e. B and C
73.The tubular system contains the following except
a. Proximal tubules
b. Loop of Henle
c. Renal pelvis
d. Collecting duct
e. Distal tubule
74.What are the steps in urine formation and where do they occur?

75.Name the renal blood supply from the renal artery to the peritubular capillary
network

76.The epithelial layer of the glomerular capillaries are made from


a. Mesangial cells
b. Simple squamous cells
c. Cuboidal cells
d. Podocytes
e. Connective tissue
77.The parietal layer of Bowmans capsule is made from
a. Simple squamous cells
b. Podocytes
c. Capillaries
d. Capillary endothelium
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e. Mesangial cells
78.Fenestrae are found in __________ and are required for ___________
a. Podocytes; particle movement
b. Endothelial cells; expansion
c. Mesangial cells; structure maintenance
d. Endothelial cells; particle movement
e. Podocytes; expansion
79.Mesangial cells are required for:
a. Structure and support of glomerulus
b. Diffusion of particles
c. Changing surface area of capillaries
d. A and C
e. A and B
80.Nephrin is expressed by
a. Podocytes
b. Mesangial cells
c. Endothelial cells
d. A and B
e. A, B and C
81.Filtration slits exist between ___________ which are found at the end of
____________ which are extensions from the cell body of ____________
a. Fenestrations; capillary extensions; endothelial cells
b. Foot processes; pedicles; podocytes
c. Fenestrations; pedicles; endothelial cells
d. Foot processes; capillary extensions; podocytes
e. Aquaporins; ADH; anti naturietic peptide
82.The glomerulus filtration barrier is composed of:
a. Endothelial fenestrae
b. Glomerular basement membrane
c. Filtration slit diaphragms
d. A and B
e. A, B and C
83.Select the incorrect response. The juxtaglomerular apparatus:
a. Consists of a macula densa, juxtaglomerular cells, extraglomerular
mesangial cells
b. Monitor salt balance
c. Produces renin and thus regulates glomerular filtration and
reabsorption of Na+ and water
d. Is responsible for majority of water reabsorption
e. Is found at the vascular pole of a renal corpuscle

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84.
85.What
a.
b.
c.
d.
e.

are the forces controlling glomerular filtration rate?


Glomerular hydrostatic pressure
Glomerular osmotic pressure
Bowmans space fluid pressure
All of the above
None of the above

86.Glomerular filtration rate is given by


a. (PGC PBS -

GC

) x Kf

b. NFP x Kf
c. Hydraulic conductivity x glomerular capillary surface area x NFP
d. A and B
e. A, B and C
87.In liver disease
a. GFR decreases
b. GFR increases
c. Plasma proteins decreased
d. Plasma proteins increased
e. B and C
88.In dehydration, GFR decreases
a. True
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b. False
89.GFR is increased and renal blood flow is maintained by
a. Decreased afferent arteriolar pressure and decreased efferent
arteriolar pressure
b. Increased afferent arteriolar pressure and decreased efferent arteriolar
pressure
c. Decreased afferent arteriolar pressure and increased efferent arteriolar
pressure
d. Increased afferent arteriolar pressure and increased efferent arteriolar
pressure
e. All of the above
90.Select incorrect response
a. GFR must be kept relatively constant or changes in reabsorption occur
b. GFR is controlled via autoregulation
c. The myogenic mechanism of GFR control causes vasoconstriction in
efferent arterioles in response to increase blood pressure
d. The juxtaglomerular apparatus responds to blood pressure by changes
in renin release
e. Autoregulation only occurs between arterial pressure of 70-150mmHg
91.What is the definition of renal clearance?

92.The equation for clearance is given by:


a. (V x Us)/Ps
b. V/Ps
c. (V x Ps)/Us
d. Us/Ps
e. Ps/( V x Us)
93.Which of the following is the most widely used clinically to measure GFR
a. Inulin
b. Creatinine
c. Glucose
d. Urea
e. Para-aminohippurate
94.Which of the following gives the most accurate measurement for GFR?
a. Inulin
b. Creatinine
c. Glucose
d. Urea
e. Para-aminohippurate
95.Which of the following is used to measure renal plasma flow?
a. Inulin
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b.
c.
d.
e.

Creatinine
Glucose
Urea
Para-aminohippurate

96.How much sodium and how much water is reabsorbed usually?


a. 99.5%, >99%
b. 90%, 90%
c. 99%, 99%
d. >99.5%, >99%
e. None of the above
Pharmacology
98.Rhinosinusitis:
a. Is caused by bacteria
b. Is treated with antibiotics
c. Is treated symptomatically
d. Is commonly diagnosed via blood cultures
e. All of the above
99.

Pharyngitis and tonsillitis


a. Can be caused by strep pyogenes
b. Can be caused by viruses like adenovirus
c. Can be complicated by peritonsillar abscesses
d. Are treated symptomatically and via antibiotics
e. All of the above

100.

Select incorrect response. Otitis externa


a. Is caused by bacteria and fungi
b. Includes symptoms like discharge and itchiness
c. Is treated by dry aural toilet
d. Is treated with topical antibiotics and steroids
e. Is prevented using prophylactic antibiotics

101.

Otitis
a.
b.
c.
d.

102.

Select incorrect response. Sinusitis


a. Causes severe facial pain
b. Causes tenderness over sinuses
c. Treatment is valaciclovir given intravenously
d. Treatment is symptomatic
e. Usually caused by viruses or allergies not bacteria

media
Is usually self limiting
Is caused by viruses or bacteria
Can present with reddening of tympanic membrane
Treatment is symptomatic usually or amoxycillin if persistent and fever
occurs
e. All of the above

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103.

Croup
a.
b.
c.
d.
e.

104.

Influenza is treated with


a. Vaccination
b. Oseltamivir
c. Amoxycillin
d. Cefaclor
e. Doxycycline

105.

Select incorrect response. Pertussis


a. Caused by Bordetella pertussis
b. Includes symptoms such as paroxysmal coughing, inspiratory whoop,
post-tussive vomiting
c. Treated with antibiotics to prevent spread
d. Prevented with vaccination
e. Secondarily caused by Haemophilus pertussis

106.

Factors predisposing to fungal infections include


a. Moisture and warmth
b. Diabetes
c. Immunosuppression
d. Obesity
e. Broad spectrum antibiotics

107.

Sites of action of fungal infection treatment include the following except


a. Cell membrane synthesis
b. Nucleic acid synthesis
c. Cell membrane integrity
d. mRNA synthesis
e. Cell wall synthesis

108.

Clotrimazole
a. Affects cell membrane integrity
b. Is narrow spectrum
c. Is applied topically
d. Inhibits fungal cell division
e. Has no side effects

109.
a.
b.
c.
d.

is caused by
Haemophilus influenzae
Parainfluenza virus
Rhinovirus
Adenovirus
RSV

First line treatment for aspergillosis is


Terbinafine
Amphotericin
Ketoconazole
Capsofungin

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e. Griseofulvin
110.
a.
b.
c.
d.
e.

A major side effect of azoles is


Renal toxicity
Allergenic reactions
Inhibition of P450 enzymes
Conversion of lanosterol to ergosterol
Immunosuppression

a.
b.
c.
d.
e.

Asthma is caused by
Inflammation
Mucus secretion
Bronchoconstriction
All of the above
None of the above

a.
b.
c.
d.
e.

Intrinsic asthma is caused by


Hyper-responsive airways
NSAIDs
Allergic response
Degranulation of mast cells
Antibody release

a.
b.
c.
d.
e.

First line treatment for asthma are


Short-acting beta agonists
Long-acting beta agonists
Steroids
Symptom controllers
Preventers

a.
b.
c.
d.
e.

Terbutaline is
Leukotriene antagonist
Short-acting beta agonist
Long-acting beta agonist
Steroid
Mast cell stabiliser

111.

112.

113.

114.

115.
Low dose inhaled corticosteroids or mast cell stabilisers are used for
asthma
a. As first line treatment
b. As second line treatment
c. As third line treatment
d. As fourth line treatment
e. Are not used
116.

Long acting beta agonists are used for asthma


a. As first line treatment
b. As second line treatment
c. As third line treatment

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d. As fourth line treatment
e. Are not used
117.
a.
b.
c.
d.
e.

The drugs classes used to treat angina include


Nitrates
Calcium antagonists
Beta-antagonists
All of the above
None of the above

a.
b.
c.
d.
e.

Select the incorrect response. Glycerol trinitrate


Is also called nitroglycerine
Is extremely volatile
Lasts less than 30mins if given sublingually
Lasts less than 6 hours if given transdermally
Is used to cause vasodilation

a.
b.
c.
d.
e.

Side effects of nitrates include the following except


Hypotension
Reflex tachycardia
Tolerance
Bradycardia
None of the above

a.
b.
c.
d.
e.

Contraindications for nitrates are


Beta blockers
Calcium antagonists
Sildenafil
Amiodarone
Diuretics

118.

119.

120.

121.
Which of the following calcium antagonists is most cardio selective and
thus most useful for supraventricular tachycardia?
a. Nifedipine
b. Amlodopine
c. Verapamil
d. Diltiazem
e. Digoxin
122.
a.
b.
c.
d.
e.
123.

In angina, beta blockers are used to


Vasoconstrict skeletal muscles vasculature
Vasodilate vasculature in skin
Decrease heart rate
Decrease pain
Increase water excretion

B1 antagonists include
a. Atenolol
b. Metoprolol

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c. Propranolol
d. A and B
e. A, B and C
124.
a.
b.
c.
d.
e.

The drug classes used to treat arrhythmias include


Calcium channel blockers
Potassium channel blockers
Beta-blockers
Sodium channel blockers
All of the above

a.
b.
c.
d.
e.

An example of a sodium channel blocker is


Amiodarone
Bretylium
Sotalol
Flecainide
Verapamil

125.

126.
NA

Which of the following reduce pro-arrhythmic effects of adrenaline and


a.
b.
c.
d.
e.

Metoprolol
Amiodarone
Lignocaine
Diltiazem
Digoxin

a.
b.
c.
d.
e.

A common side effect of beta-blockers is


Dry cough
Nausea
Impotence
Hypertension
Immunosuppression

a.
b.
c.
d.
e.

Contraindications for beta-blockers include the following except


Asthma
Bradycardia
Calcium antagonists
Dry coughing
All of the above

a.
b.
c.
d.
e.

Drug which prolongs the refractory period to stop arrhythmias includes


Amiodarone
Lignocaine
Dobutamine
Carvedilol
Isoprenaline

127.

128.

129.

130.
The drug which converts an arrhythmic heart immediately to sinus
rhythm is
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MED2031 Mid Semester Practice Exam


a.
b.
c.
d.
e.

Digoxin
Adenosine
Dobutamine
Nifedipine
Sotalol

a.
b.
c.
d.
e.

Which of the following is not given for atrial fibrillation?


Digoxin
Ca+ channel blocker
Beta-blocker
Adenosine
Warfarin

a.
b.
c.
d.
e.

Which of the following is not given for bradycardia?


Isoprenaline
Atropine
Adrenaline
Metoprolol
All of the above are given

131.

132.

EMQ
a)
b)
c)
d)
e)
f)
g)
h)
i)
133.

Captopril
Losartan
Carvedilol
Atenolol
Propranolol
Indapamide
Digoxin
Dobutamine
Nitrovasodilators
Angiotensin II receptor blocker

134.

Limited IV use due to desensitisation and decreased beta 1 receptors

135.

Used if ACE inhibitors, ARBs and diuretics contraindicated

136.

Contraindicated with digoxin

137.

Common side effect of this drug is dry cough

138.

Has long half life thus must be given with high loading dose

139.

Slows heart rate

Anatomy
140.

Where do ribs fracture?


a. Anywhere according to trauma
b. At angle of rib
c. Point of greatest curvature

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d. Lateral border of erector spinae
e. Clinical paravertebral line
f. All of the above
141.
a.
b.
c.
d.
e.

Where is an intercostal catheter usually inserted?


2nd ICS paravertebral line
5th ICS anywhere
2nd ICS mid clavicular line
5th ICS anterior to mid axillary line
C and D

142.
Select the incorrect response. Which site is used to insert the
intercostal catheter and why?
a. Bottom of ICS to avoid bleeding
b. Mid clavicular line to avoid internal thoracic artery
c. Mid axillary line for easier access
d. Paravertebral line as there are no vessels here which can bleed
e. No incorrect response, all of the above are used
143.
Why does an intercostal nerve block have to be performed at the
lateral limit of erector spinae?
a. No reason, just tradition
b. Easiest access
c. Dermatomal overlap
d. To anaesthetise lateral branch
e. No intercostal arteries or veins in this area so fewer complications
144.
a.
b.
c.
d.
e.

The danger zones of the pleura include the following except


Left costoxiphisternal angle
Right costoxiphisternal angle
Above lung apices
Inferior to left 12th rib
Inferior to right 12th rib

a.
b.
c.
d.
e.

Pleural aspiration is performed


Usually around 9th/10th ICS
Anywhere according to clinical investigation
Lateral border of erector spinae
A and B
A, B and C

145.

146.
Why do foreign bodies lodge in the right main bronchus more often
than left?
a. Left; more vertical, shorter, narrower
b. Right; more vertical, shorter, wider
c. Left; more horizontal, longer, narrower
d. Right more horizontal, longer, wider
e. Right; more vertical, longer, wider

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147.
a.
b.
c.
d.
e.
148.

Where does pneumonia from aspirated fluid most commonly occur?


Basal segment lower lobe left lung
Basal segment upper lobe right lung
Apical segment lower lobe right lung
Apical segment upper lobe left lung
Apical segment middle lobe right lung

Which of the following about pneumothoraces is correct?


a. Pneumothorax is air filling the lungs
b. Tension pneumothorax is usually the most dangerous of
pneumothoraces
c. Spontaneous pneumothoraces commonly occur in short, old women
d. Iatrogenic pneumothorax is of unknown origin
e. Pneumothoraces are treated using pleural aspiration

149.
The ligamentum arteriosum is a landmark used to find the branch of
the nerve which innervates what in the thoracic region?
a. Heart
b. Intercostals
c. Pericardium
d. Parietal pleura
e. None of the above
150.
a.
b.
c.
d.
e.

Normal sites of oesophageal narrowing include the following except


C6
T4
T5
T6
T12

a.
b.
c.
d.
e.

This abnormal narrowing site is commonly caused by


Right ventricle hypertrophy
Left ventricle hypertrophy
Right atrium hypertrophy
Left atrium hypertrophy
None of the above

a.
b.
c.
d.
e.

A clinical sign that may indicate lung carcinoma seen on an x-ray is


Enlarged subcarinal lymph nodes
Widened carina
Diffuse fibrosis
Fluid meniscus
Consolidated lobe

a.
b.
c.
d.

Aortic coarctation may present clinically with


Notching of inferior border of ribs
Radio-femoral delay
Notable pulsations in ICS
A, B

151.

152.

153.

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e. B, C
154.
a.
b.
c.
d.

What complication of a pterion fracture shows up on a head CT?


Crescent shaped haemorrhage
Lens shaped haemorrhage
Spidery, ventricle filling haemorrhage
Temporal region contusion

a.
b.
c.
d.
e.

Scalp lacerations bleed heavily due to:


Arteries pulled apart by dense connective tissue
Emissary veins being lacerated
Superficial veins in skin
Highly vascularised dura
Aponeurosis resting tone pulling layers apart

155.

156.
Possible signs of cavernous sinus thrombosis include the following
except
a. Eye is fully abducted and depressed
b. Ptosis
c. Reduced pupillary reflex
d. Eye is fully adducted
e. Miosis
157.
Why can subdural haemorrhages be more dangerous than extradural
haemorrhages?
a. Easy to misdiagnose
b. Can cause coning of brainstem
c. Faster onset of symptoms
d. Subdural haemorrhages are arterial bleeds whereas extradural
haemorrhages are venous
e. Unable to see subdural haemorrhages on head CT
158.
a.
b.
c.
d.
e.

An enlarged pituitary can cause


Loss of sight in one eye
Complete blindness (loss of sight in both eyes)
Binasal hemianopia
Bitemporal hemianopia
Scotoma

Cranial regions and brain physiology


159.

Which of the following about motor neurons is incorrect?


a. Upper motor neurons originate in cortex or brainstem
b. Upper motor neurons control voluntary movement
c. Alpha motor neurons directly innervate muscles
d. Lower motor neurons subserve both reflex and voluntary actions
e. Lateral motor pathways control posture and locomotion
160.

Which of the following about the lateral corticospinal tract is false?

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MED2031 Mid Semester Practice Exam


a.
b.
c.
d.
e.
161.

Originates from motor cortex


Controls distal muscles and fractionated movements
Decussates in medullary pyramids
Controls facial muscles
Terminates in dorsolateral region of ventral horns

Lesion of upper motor neurons in the brain leads to the following except:
a. Hyper-reflexia
b. Hypertonia
c. Partial recovery
d. Impaired voluntary power in muscles
e. Contralateral paresis/paralysis

162. Which of the following about areas of the cortex controlling movement is
false?
a. The posterior parietal cortex project to area 4 (primary motor cortex)
b. The primary motor cortex (area 4) generates the impulses which
execute movement
c. The PMA in area 6 is responsible for sensory guidance of movement
and proximal/trunk muscle control
d. The SMA in area 6 plans motor actions guided from memory
e. Pre-SMA lesions cause inability to perform complex but not simple
movements
163.

The cerebellum:
a. Refines/coordinating sequences of muscle contractions
b. Evaluates disparities between intention and action
c. Has inputs from spinal cord, motor cortex, somatosensory cortex and
visual cortex
d. Has outputs to motor systems in cortex and brain stem but not directly
to alpha motor neurons
e. All of the above

164.

Which of the following about parts of the cerebellum is false:


a. Vestibulocerebellum contains the flocculonodular lobe
b. Spinocerebellum is made of vermis and intermediate parts of
hemispheres
c. Vestibulocerebellum is responsible for balance and receives input from
vestibular/visual systems
d. Spinocerebellum receives somatosensory information from limbs and
controls distal muscles
e. Cerebrocerebellum only receives input from thalamus

Microbiology
165.

Which of the following about infective endocarditis is false?


a. Infection of endocardium of heart
b. Usually bacterial but sometimes fungal

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c. Self-limiting
d. Can enter through oral cavity or breach in skin
e. Can occur due to endocardial abnormalities like valve defects
166.

EMQ
a)
b)
c)
d)
e)
f)
g)
h)

Clinical features of infective endocarditis include the following except:


a. Fever
b. Splinter haemorrhages
c. Petechiae
d. Oslers nodes
e. Spleen shrinkage
Otitis externa
Acute bronchiolitis
Influenza
Pneumonia
SARS
Tuberculosis
Common cold
Pharyngitis and tonsillitis

167. Which disease occurs more commonly in children who have viral infections, is
mostly caused by strep pneumoniae but also caused by Haemophilus influenzae?
168. Which disease is caused 75% of the time by RSV and often in children under
2 years old?
169. Which disease is caused by the coronavirus, spread via droplets and results in
high fever?
170.

Which disease is most commonly caused by the rhinovirus?

171. Which diseases are commonly caused by adenoviruses but if caused by strep
pyogenes can lead to peritonsillar abscess?
172. Caused by pseudomonas aeruginosa, staph aureus, strep pyogenes, Proteus
and Klebsiella and in immunosuppressed patients can cause base of skull
osteomyelitis.
Pathology
173.

The roadway of injury includes the following except


a. Cellular swelling
b. Cytoplasmic swelling
c. Nuclear changes
d. Crisis point tissue death
e. Loss of membrane integrity

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174.

Limitations of the coronary arteries include the following except:


a. Coronary arteries only fill during diastole
b. Hypertrophy of myocardium results in inadequate blood supply to extra
muscle
c. Small calibre of vessels means any narrowing leads to poor flow
d. Anatomical end arteries- no anastomoses to provide collateral supply if
occlusion occurs
e. None of the above- all are limitations

175.

AMIs
a.
b.
c.
d.
e.

commonly occur in/due to ischaemia in which region of the heart?


Right atrium
Left atrium
Right ventricle
Left ventricle
In all areas equally

176.

Acute
a.
b.
c.
d.
e.

myocardial infarction can be diagnosed which of the following:


Troponin
Creatine kinase
ECG changes
All of the above
None of the above

177.

The following are all consequences of infarction except:


a. Cardiac failure
b. Pericarditis
c. Thrombus formation
d. Muscle rupture 7-10 days after infarct
e. Large scale growth of new cardiomyocytes

178.

Which of the following about AMI diagnostic protein markers is false?


a. Creatine kinase is found in 3 isoforms
b. CKMB is most common in the heart
c. Troponin has 3 types
d. Tn T is most commonly used as it is only manufactured by the heart
e. Myoglobin is the most specific and sensitive of all cardiac markers

Health Promotion
179.

Name the 5 CM modalities and give an example of each

180.

Which of the following regarding CM and conventional therapy is false?


a. More out-of-pocket money is spent on CM than on PBS
b. Doctors who practice CM are expected to exhibit same level of skills of
any other practising doctor
c. Lack of evidence for an effect of treatment is not evidence for lack of
effect

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181.

d. 72% of patients using both CM and conventional treatment do not tell


their doctor they are using CM
e. The evidence supporting CM is equivalent to the evidence supporting
conventional medicine
The Ottawa Charter includes the following points except:
a. Building health public policy
b. Creating hostile and competitive environments
c. Strengthening community action
d. Developing personal skills
e. Re-orientation of health care services towards disease prevention

182.

Which of the following about the HP cycle is true?


a. Implementation determines effectiveness of process or outcome
b. Evaluation measures outcome against specific aims of intervention
c. Development may use the BASK model
d. Implementation makes use focus groups and surveys
e. Evaluation delivers an intervention

183.

Which of the following is not a criterion for a screening test?


a. Condition should be common and contribute significantly to burden of
disease
b. Test should detect condition earlier than detection without screening
c. Test should have high sensitivity and specificity
d. Test should be able to detect more than one disease
e. Test should have solid evidence base for efficacy

184.

Listening to emo music is associated with youth suicide. True or False?


a. True
b. False

Clinical skills
185. The steps of looking at an ECG include the following except:
a. Rate and rhythm
b. Calculating PR interval and QRS complex durations
c. Analysing the cardiac axis
d. Checking for abnormalities in QRS complexes, ST segments and T
waves
e. Checking for discrepancies between leads
There will be discrepancies between leads as they are measuring
different areas of the heart
EMQ (q 191-196)
a) 0.06-0.10s
b) 0.12-0.20s
c) 100/min
d) 60/min
e) 75/min
f) 25/min
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g) Irregular rhythm
h) Sinus rhythm
i) 200ms
j) 300ms
k) 150ms
l) Left axis deviation
m) Right axis deviation
n) Normal axis
o) Left bundle branch block
p) Right bundle branch block
q) Ischaemia
r) Acute myocardial infarction
186.

The normal length of the PR segment is?

187.

The normal length of the QRS complex is?

188.

The rate is?

189.

The rhythm is?

190.

The PR interval is?

191.

The cardiac axis shows?

192.

Which of the following is not a common symptom of CV disease?


a. Chest pain/angina
b. Dyspnoea- paroxysmal, exertional, orthopnea

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c. Ankle or back oedema
d. Palpitations
e. Myocardial infarction
193.

Which of the following is not a risk factor for CV disease?


a. Family history of CV disease
b. Past history of CV disease
c. Hypotension
d. Smoking
e. Diabetes mellitus

194.

Which of the following is not a common symptom in respiratory disease?


a. Cough
b. Sputum production
c. Dyspnoea
d. Syncope
e. Post nasal drip

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