PD CCM 2013(prabuddhaka@yahoo.

com)
01)Regarding Trachea
Tracheal bifurcation at the level of T4- T5
Left lobar bronchus is more in line with rachea
The angle between the 2 main bronchi is 60 -70 degrees
Thyroid is the most common external cause of tracheal compression
02)Aldesterone
Secretion is increased by rennin
Vasoconstrictor
Antogonised by spironolactone
02)Bactericidal
Chorhexidine
Vancomicin
Neomycin
Erythromycin
Fusidic acid
03)Jugular veonous bulb oxygen saturation
Measurement is decrased in status epilepticus
Can be increased following use of thiopental
Hypercarbia
04)Oxygen flux
Indepndent of oxygen flow at the tissue level
05)Chlorothiazide
Decreases Na and Cl reabsorption of glomerular filtrate
Can cause hyperkalemia
Results hyperglycemia
Can cause metabolic acidosis
06)Following drugs can be used as transdermally active patch
Fentanyl
GTN
Diazepam
Morphine
Pethidine
07) Regarding Intracranial pressure
Increases when lie down from supine

More than central venous pressure

Frusemide affects more than mannitol
Steroids is effective in increased ICP when associated with tumors
08)During the immediate post surgical period
Increased K+ excreation
Increased Na+ absorption
Hyperglycemia
Decreased Na+excretion
09) regarding the compliance of the lung
Depends on the air flow
decreased with surfactant
10)Damage to left cervical sympathetic trunk
Results in loss of taste sensation in anterior 1/3 of the tongue
Decreased salivation
Decreased sweating from the left side of he face
Partial ptosis of the left side
Miosis of the the left eye
11) ABG
Trapped air bubble causes decrease in PCO2
Excess heparin can cause increase PH
Kept in room temperature can cause dcrease in PH
Neeeds to apply correction for oxygen when kept in low temperature
12)Pulse oxymetry
Use ambient light to do the measurement
Flow must pulsatile to do the measurement
Measures are increased with carboxy hemoglobin
Use isobastic point in the measurement

13)Regarding the larynx

Extends from the C4-C6
Inlet is closed by the posterior cricoareytenoid muscle
Innervated by recurrent laryngeal nerve up to vestibular fold
Thyroid ishmus is anterior relation

!4)recurrent laryngeal nerve can be damaged in severe Mitral stenosis

15)Pulmonary capillary wedge pressure

Equals to the left atrial pressure
Equals to the right atrial pressure
Measures Mean pulmonary artery pressure
Measure Aortic pressure after valve closure
16)following are true regarding 70kg man
Daily energy requirement with moderate activity is 3500kcal
GFR is 1200ml/min
Minimal Daily requirement is 450ml to prevent negative balance
17)In pregnancy
GFR increases
Increases clotting factors
Increases the cardiac output
Increases the total lung volume
18)Unfractinated Heparin
Crosses placenta
Facilitate formation of inactive thrombin antithrombin complex
In high concentrations can inhibit aggregation of platelets
In high concentrations inbit factor Xii, Xi
19)Warfarin
Highly protein bound
Decrease production of prothrombin
Oral bioavailability is high
20) Full term neonate
Cardiac output is increased by increased HR
Ductus arteriosus is anatomically closed
Foramen ovale is functionally closed in 2-3 days
Pulmonary vascular resistance is decreased with the first breath
In some congenital heart diseases patent ductus arteriosus is needed
21)Na+ counter transport in kidney is coupled with
ClCa+
Glucose
Amino acid
H+
23)In ECG

No P wave is seen in nodal rhythem

QRS complex is 0.8sec
PR interval is 0.1 sec
PR interval is prolonged in hypocalcemia
24) Cardiac muscle action potential
Due to Na+influx
Depends on the Ca+
Absolute refractory period is similar to the action potential duration
25)Brachial plexus
Roots are posterior to the Serratus Anterior
Formed by the ventral rami or C5-T1
Cords related to the axillary artery
Posterior cord is formed by the all roots
26)Internal Jugular vein
Is a continuation of transverse sinus
Cervical sympathetic trunk is anterior to it
27)increased muscle growth
Growth hormone
Insulin
Steroids
Glucagon

28)Increase gastric acid secretion

Acetylcholine
Histamine
Vagal stimulation
Somatostatin
Increased sympathetic activity
29)immediate management of anaphylactic shock
Epinephrine
Piriton
Hydrocortizoe
30)Adrenosympathetic response to shock
Increased cardiac contractility
Decreased peripheral resistance

31)Beclomethazone
Is a fludrocortizone
Causes candidiasis
Increases circulatory catecholamines
Aersol form is available
32)Atropine
Decreases bronchial secretions
Causes mydriasis
Decreases muscle strength
Causes ganglion blockade
33)Acute phase proteins
Alpha 1 antitrypsin
Cholesterol
CRP
34)Acute pancreatitis
Persistant Diabetes mellitus is a complication
Causes hypercalcaemia
Hypocalcemia is a known cause
Hypertryglyceredimia
35)Regarding antibiotics
Imipenum causes seizures
Beta lactum antibiotics causes needs no dose adjustment in renal failure
Aminoglycosides once daily regimen can decrease the renal impairment

37)Obstructive jaundice
Causes increased urobilinogen
Increases fat content of faeces
Causes increased ALP
May leads to coagulopathy
38)functions of the liver
Detoxification of drugs

Stores vit B12

Synthesizes albumin
Secrete digestive enzymes
Produces erythropoietin
39)regarding platelet transfusion
Need filtration
Needs crossmatcthing
effective after 2/52of storage
40)Incompatible blood transfusion
Cause agglutination of donor red cells
Tissue hypoxia
Renal impairment
41)following are increased in the extracellular fluid when compared with the
intracellular fluid
K+
Po4H+
42)Accidental contact of health care worker with blood/blood stained fluid
Hep B immunoglobulin irrespective of patients immune status
Patients blood for Hb s antibodies
After Hep B vaccines is given regular booster doses are given
If HIV antibodies positive patient antiretroviral Ig should be given to the worker
43) T/F
CT uses xrays
USS uses sound waves
Digital x ray no radiation hazard
MRI uses magnetic field
Contrast solutions used are water soluble
44)At the temperature of 30*c
Oxygen consumption is decreased
GFR is decreased
Increased solubility of the CO2
45) In elderly
Pulse pressure is increased
IIncreased Functional residual capacity
Decreased level of Intracranial pressure
Increased heart rate to the exersice

46)Regarding the osmolality of the body fluids

47) in hypocalcaemia
Chosvteks sign is positive
Troissures sign is positive
48)Regarding the osmolality of the body fluid
Ca+ is the most abundant
Total osmolality of Intracellular fluid and Extracellular fluid is equal
49)Following are approximately correct
Plasma osmolality is 300mosm/l
50)Regarding the blood pressure measurement
Standard cuff in an obese patient causes decreased BP measurement
Should cover 2/3 of the upper arm
Standard width of the cuff is 15cm
Small cuff give falsely high reading
Large cuff gives falsely low reading
51) regarding the successful resuscitation following basic life support
Pco2 value should be 2%
Po2 value should be 16%
Mixed venous oxygen saturation should be 75%
52) increased Risk of DVT
Pregnancy
OCP
Malignancy
Lupus anticoagulant
53) polycythemia causes
Increased blood viscosity
54) increased Intraabdominal pressure
Increased ICP
Ventilation perfusion mismatch
Decrease liver blood flow
Decrease GFR
55)In JVP
C wave is not clinically significant

A wave is due to atrial systole

V wave due to ventricular filling
Y descent is steep in dehydration
Constrictive pericarditis
56)following are Nephrotoxic
ACE inhibitors
Radiocontrast
NSAIDS
PCM
57)Oxytocin during the pregnancy
Transient hypotension
Intestinal colic
Nausea vomiting
Peripheral vasoconstriction

By Dr NH