28.

The following increase during pregnancy except:

a) plasma volume
b) fibrinogen
c) gastric emptying time
d) glucose tolerance
e) arterial PaCO2

29. Aldosterone causes except:

a) a decrease in urine sodium concentration
b) weight gain
c) decreased serum chloride level
d) increased extracellular fluid volume
e) increased K+ excretion

30. Atropine except:

a) may cause bradycardia
b) dilates the pupil in premedicant dose
c) has a shorter duration of action than glycopyrrolate
d) increases the physiological dead space
e) has both muscarinic and nicotinic effects

31. The respiratory centre in the brain stem receives input from all the following
except:

a) the aortic and carotid bodies

b) bronchiolar stretch receptors via vagal afferents
c) oxygen-sensitive chemoreceptors in the medulla
d) receptors which respond to the hydrogen ion concentration in the cerebrospinal
fluid
e) mechanoreceptors of the larynx

32. Asystole:

a) occurs in about 25% of hospital patients

b) is likely to follow bradycardia associated with mobitz type II AV block
c) only rarely follows ventricular fibrillation
d) when unresponsive to high dose adrenaline (5 mg) should be treated by external
pacing
e) may respond to precordial thump after basic life support

33. With a decrease in body temperature all are correct except:

a) P50 and PaCO2 are decreased
b) pH is increased
c) arrhythmias are increasingly common at temperatures below 30 degrees C
d) blood becomes more viscous
e) the EEG becomes isoelectric at about 20 degrees C

34. Regarding acid-base balance false answer is:

a) chronic obstructive airways disease patients have high serum bicarbonate levels
b) the normal anion gap is 20-25 mmol/L
c) mixed venous pH is always lower than arterial pH
d) the pKa for bicarbonate buffer is 6.1
e) kidneys cannot produce urine with a pH <4.4

35. Factors determining urinary sodium loss include the following except:

a) plasma sodium concentration

b) glomerular filtration rate
c) circulating renin levels
d) distal tubular fluid anion concentration
e) plasma hydrogen ion concentration

36. Pulmonary artery wedge pressure will be greater than left ventricular end
diastolic pressure in the following situations except:

a) presence of mitral valve prosthesis

b) positive end-expiratory pressure during mechanical ventilation
c) catheter tip in Zone I
d) non-compliant left ventricle
e) mitral stenosis

37. Adrenaline has tte following featuresexcept:

a) can be nebulised
b) is a bronchodilator
c) may elevate the blood sugar
d) has an almost equal effect on both alpha- and beta-adrenergic receptors
e) tracheal administration of adrenaline should be used even in presence of IV
access during cardiopulmonary resuscitation
38. Concerning absorption of carbon dioxide in breathing systems false statement is:

a) soda lime granules are sized 4-8 mesh

b) baralyme contains calcium hydroxide in addition to barium hydroxide
c) soda lime produces more compound A during low fresh gas flow
d) dry soda lime absorbs more carbon dioxide
e) carbon dioxide first reacts with sodium and potassium hydroxide of soda lime

39. An excitatory post-synaptic potential (EPSP) the false statement is:

a) is itself propagated by the post-synaptic cell

b) comprises depolarisation of the membrane to zero, transient reversal of potential
and then repolarisation
c) is related in amplitude to the concentration of the initiating transmitter at the
presynaptic membrane
d) may summate both temporally and spatially with other EPSPs
e) is reduced in amplitude by drugs which block the post-synaptic receptors for the
transmitter substance

40. Concerning the physiology of the stomach all are correct except:

a) acid secretion in response to hypoglycaemia is mediated by gastrin

b) gastric emptying is quickened by sympathetic stimulation
c) acid secretion is mediated by H2, M1 and gastrin receptors
d) gastric pH is normally around 2-3
e) acidity is reduced by proton pump inhibitors

14. A nulliparous woman in early labour with no other risk factors asks your advice
on the possible impact of epidural analgesia on maternal outcome. Your advice is
that the technique:

A. Has no adverse effect.

B. May prolong labour, but otherwise has no adverse effect.
C. May prolong labour and increase the instrumental delivery rate.
D. May prolong labour and increase the Caesarean section rate.
E. None of the above.

15. The most common early sign of amniotic fluid embolism (AFE) following a
normal vaginal delivery is:
A. Skin rash.
B. Hypertension.
C. Fitting.
D. Abnormal bleeding.
E. Cyanosis.

16. Infective endocarditis rarely occurs with:

A. Congenital bicuspid aortic valve
B. Atrial septal defect
C. Patent ductus arteriosus
D. Coarctation of the aorta
E. Mitral valve prolapse

17. Which is the most efficient breathing system during controlled ventilation?
A. Mapleson A.
B. Mapleson B.
C. Mapleson C.
D. Mapleson D.
E. Mapleson E.

18. The most accurate measure of LVEDP on a wedged pulmonary artery pressure
trace is:

A. The mean value of the PAOP at the end of expiration.

B. The peak of the 'A' wave at the end of expiration.
C. The peak of the 'V' wave at the end of expiration.
D. The peak of the 'A' wave at the end of inspiration.
E. The mean value of the PAOP at the end of inspiration.