2
Short Answer Question Paper
Describe the washout of desflurane from a patient following six hours of general
2.
Describe the vascular anatomy of the antecubital fossa (arterial and venous).
1.
3.
Describe the physiology of the pain pathways and how drugs may modulate the
5.
4.
perception of pain.
6.
7.
A new test called the "intubation score" has a reported 90% sensitivity and 70%
specificity when used to predict difficult intubation.
information and other statistics related to this test can be used in predicting
difficult intubation.
Page 2 of 3
8.
9.
What lower limit of Sp02 would you accept in an ASAl young male under general
anaesthesia?
10.
How is renal blood flow regulated? What are the physiological effects of
angiotensin II?
14.
13.
12.
11.
15.
Page 3 of 3
FEBRUARY/APRIl 2014
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.
2,
3,
4,
5,
6,
7,
S,
9,
10.
11.
Describe how non steroidal anti-inflammatory drugs exert their clinical effects.
Outline the advantages and disadvantages in using COX-2 selective agents.
12,
13.
14.
List the drugs t h a t affect uterine tone, and outline the adverse effects of these
agents.
15.
What are the potential side effects of propofol and its formulations?
What are the major classes of oral hypoglycaemic agents? Outline their mechanisms of
action and possible side effects.
2.
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.
Q11 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
1.
A U G U S T / S E P T E M B E R 2011
Compare a n d contrast the clinically significant cardiovascular a n d central nervous
system effects of desflurane a n d sevoflurane.
2.
3.
4.
Describe
the
pathogenesis
and
management
of
paracetamol
toxicity.
5.
6.
7.
8.
9.
adult
FEBRUARY/APRIL 2011
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.
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
QUESTION 16 Describe the processes whereby substances may cross cell membranes, giving
examples.
JULY/SEPTEMBER 2010
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.
Question 16 : Outline the clinical laboratory assessment of liver function.
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
QUESTION 5
Outline the effects of an opioid injected into the spinal intrathecal space.
QUESTION 6
D e s c r i b e t h e m e c h a n i s m of a c t i o n a n d p h a r m a c o k i n e t i c s of p h e n y t o i n ,
QUESTION 7
QUESTION 8
What is meant by the term " 9 5 % 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
QUESTION 11
QUESTION 12
QUESTION 13
QUESTION 14
QUESTION 15
QUESTION 16
JULY/SEPTEMBER 2009
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
QUESTION 16 List the gastric cell types and their secretions and the functions of these
secretions.
FEBRUARY/APRIL 2008
QUESTION 1
QUESTION 2
QUESTION 3
QUESTION 4
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
QUESTION 9
QUESTION 10
QUESTION 11
QUESTION 12
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.
Define "thermoneutral z o n e " . Briefly explain how the body regulates
temperature when the ambient temperature exceeds the thermoneutral
zone.
Outline t h e physiological c o n s e q u e n c e s of d i a b e t i c keto acidosis.
QUESTION 13
QUESTION 14
D e s c r i b e t h e p a t h w a y s w h e r e b y m y o c a r d i a l 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 t h e t h r o a t or a r m regions.
QUESTION 15
QUESTION 16
JULY/SEPTEMBER 2008
QUESTION 1
QUESTION 2
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
QUESTION 5
QUESTION 6
QUESTION 7
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 a n d h o w c a n it b e m e a s u r e d ?
QUESTION 10
D e s c r i b e sepsis a n d d e s c r i b e t h e metabolic c o n s e q u e n c e s of s e p s i s .
QUESTION
11
QUESTION 12
QUESTION
13
QUESTION 14
with
sleep.
QUESTION 15
Describe the changes that occur with ageing that can affect oxygen delivery
to t h e tissues during moderate e x e r c i s e .
QUESTION 16
QUESTION 1
desflurane.
QUESTION 2
JULY/AUGUST 2007
Describe the adverse effects that may occur with the admim'stration of
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
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
QUESTION 10 Briefly describe the factors that affect the partial pressure of carbon dioxide
in mixed venous blood.
QUESTION 11
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
QUESTION 15
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?
FEBRUARY/APRIL
2007
Q U E S T I O N 1 Describe the potential adverse effects of administering neostigmine post operatively.
Q U E S T I O N 2 After epidural injection i n 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.
anaesthetic).
Describe
the
important
aspects
of
dantrolene
132mEq/L
Mg
0.5 m E q / L
0 mEq/L
Lactate
40 m E q / L
CI
96 m E q / L
glucose
2.5 g %
Ca
3.5 m E q / L
Q U E S T I O N 13 Describe the determinants of Venous R e t u r n 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.
FEBRUARY/APBIL
2006
QUESTION 1 Outlme the pharmacologic management of bronchoconstriction i n 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 i n
drugs used i n anaesthesia.
QUESTION 3
QUESTION 4 Describe the pharmacodynamic properties of propofol and how this influences its clinical usage.
QUESTION 5 W r i t e 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
QUESTION 8 I n a clinical trial, why is adequate power important? What factors affect the determination of an
adequate sample size?
QUESTION 9
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
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
QUESTION 14 Explain the physiological processes which cause oliguria i n response to hypovolaemic shock.
QUESTION 15 Briefly describe the measurement of p H i n 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.
JULY/SEPTEMBER 2006
QUESTION 1
QUESTION 2 Compare and contrast the clinically significant respiratory, cardiovascular and
central nervous system effects of desflurane and isoflurane.
QUESTION 3
QUESTION 4
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
QUESTION 7
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?
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
QUESTION 9
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
QUESTION 10
QUESTION 11
QUESTION 12 Describe the physiological factors influencing the carbon dioxide tension i n arterial blood.
QUESTION 13
QUESTION 14 Describe the compensatory mechanisms i n a fit person moving from the supine to the standing
position.
QUESTION 15
QUESTION 16 Briefly explain the principles of Doppler ultrasound used to measure cardiac o u t p u t
TULY/AVGVST
2005
QUESTION 1 Describe how isoflurane is metabolised. I n your answer give reasons why the overall extent of
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 i t 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 i n 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
its mechanism
of action,
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
QUESTION 12
FEBRUARY/MARCH
2004
Outline the effects of an opioid injected into the spinal intrathecal space.
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
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 i t 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.
JULY/AUGUST2004
QUESTION 1
Briefly describe how drugs produce their pharmacological effects. Illustrate each
mechanism with examples.
QUESTION 2
QUESTION 3
blocking drugs.
List the effects of histamine. Write a brief outline on the pharmacology of the H j
QUESTION 4
QUESTION 5
statistics
QUESTION 6
QUESTION 7
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 i n the body. How does i t 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 i n a blood
sample.
QUESTION 12
QUESTION 13
QUESTION 14 Briefly describe the difference between a single twitch and a tetanic contraction i n a skeletal
muscle fibre. Include i n your answer the physiological basis for the development of a
tetanic contraction.
QUESTION 15
QUESTION 16 Explain the physiological processes involved i n the development of interstitial oedema.
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
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
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
QUESTION 10
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 i n the measurement of systemic arterial
blood pressure using an automated oscillometric non-invasive monitor.
QUESTION 14
QUESTION 15
QUESTION 16 Describe the functions of the loop of Henle, including the physiological mechanisms
involved.
JULY/SEPTEMBER
2003
QUESTION 1 Draw and label, on the same X - Y axis, F A / F I 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 F A / F I curves explain the
differences between A and B, and A and C.
QUESTION 2 Describe the potential interactions of sevoflurane, desflurane and isoflurane w i t h 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 i n a normal h e a r t
QUESTION 10
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
QUESTION 14
QUESTION 15 Briefly describe the N M D A (N-methyl d-aspartate) receptor and its physiological role i n 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.
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
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
QUESTION 16
JULY/SEPTEMBER
QUESTION 1
2002
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
QUESTION 7 Outline the potential pharmacological advantages and disadvantages of intra-operative betablockade.
QUESTION 8
QUESTION 9 Draw a pressure volume loop for the left ventricle i n 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
QUESTION 12
QUESTION 13
QUESTION 14
QUESTION 15
QUESTION 16
AUGUST/SEPTEMBER
2001
QUESTION 1 Explain the effects of intermittent positive pressure ventilation on left ventricular o u t p u t
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
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
Outline the effects of an opioid injected into the spinal intrathecal space.
QUESTION 16 Briefly describe correlation and simple linear regression, and explain their differences.
What assumptions are common to both?
MARCH/APRIL
QUESTION 1
2001
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
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 i n 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
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
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
QUESTION 16
Describe the use of the null hypothesis and the P-value in a drug trial.
JULY/AUGUST
QUESTION 1
2000
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
QUESTION 7
QUESTION 8
QUESTION 9 What is an isomer? Briefly write an account of the types of isomers and significance in drugs
used in anaesthesia.
QUESTION 10
QUESTION 11
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
MARCH/APRIL
2000
QUESTION 7 List the hormones that regulate renal tubxilar reabsorption and describe their action and site of
action.
QUESTION 8
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
QUESTION 13 Briefly describe correlation and simple linear regression, and explain their differences.
What assumptions are common to both?
QUESTION 14
QUESTION 15
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.
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
QUESTION 4
QUESTION 5
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 " 9 5 % 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
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
infusion.
MARCH/APBIL1999
QUESTION 1
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
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 i n 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
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, E E G 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.
QUESTION 16 Describe the effects of the alpha-2 adrenoceptor agonists relevant to anaesthesia.
MAKCH/APML1998
QUESTION 1
QUESTION 2
QUESTIONS
QUESTION 4
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
HoAV does a fall i n temperature Influence blood gas solubilit>^ and acid
base values?
QUESTION 9
Q U E S T I O N 10
Q U E S T I O N 11
Q U E S T I O N 12
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.
Q U E S T I O N 13
Q U E S T I O N 14
Q U E S T I O N 15
Q U E S T I O N 16
C o m p a r e the m e t a b o l i s m of sttxamethontum to t h a t of a t r a c u r i u m .
Outline the potential for methox)'flurane and sevoflurane to produce
toxic effects on the kidney.
AUGUST/SEPTEMBER
1998
QUESTION 1
Describe the concept of renal clearance and its use to estimate glomerular
filtration rate.
QUESTION 2
Describe the compensator^' mechanisms in a fit person moving from the supine
to the erect position.
QUESTION 3
QUESTION 4
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
QUESTION 9
Q U E S T I O N 10
feedback.
Q U E S T I O N 12
Q U E S T I O N 13
Q U E S T I O N 14
Q U E S T I O N 15
Briefly describe the correlation and simple linear regression, and explain their
differences. What assumptions are common to both?
Draw and explain the characteristics of a log dose - response cun'e that
describes tlie major clinical effect of vecuronium. List factors encountered in
clinical practice that may alter this cun'e.
Outline the cheraistrj' of heparin. Describe its mechanism of action and list its
toxic effects.
AUGVST/SEPTEMBEIl,
QUESTION 1
QUESTION 2
1997
E x p l a i n the local effects of a decrease in plasma colloid osmotic pressure
in a skeletal muscle capillary bed.
QUESTION 3
QUESTION 4
QUESTION 5
QUESTION 6
QUESTION?
QUESTION 8
QUESTION 9
Q U E S T I O N 10
Q U E S T I O N 11
Q U E S T I O N 12
Q U E S T I O N 13
Q U E S T I O N 14
isoflurane
Q U E S T I O N 15
Q U E S T I O N 16
MARCH/APmi,
1997
QUESTION 1
QUESTION 2
QUESTION 3
QUESTION 4
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
QUESTION 9
Compare the effect on arterial blood carbon dioxide and oxygen levels of
ventilation/perfusion inequalities.
Q U E S T I O N 10
Q U E S T I O N 11
Q U E S T I O N 12
Q U E S T I O N 13
Q U E S T I O N 14
Q U E S T I O N 15
Q U E S T I O N 16
MARCH/APRIL,
1996
PHYSIOLOGY
QUESTION 1
QUESTION 2
L i s t the n o r m a l values ixr mixed venous blood gases and explain briefly the
factors d e t e r m i n i n g m i x e d venous oxygen tension.
Briefly describe the measurement of blood pressure using an automated
oscfliometric non-invasive blood pressure monitor. Briefly oufline the problems
of this tj'pe of monitor.
QUESTION 3
Draw a pressure-volume loop for a left ventricle in a healthy adult and state the
normal pressures and volumes. Outline the information which can be obtiiined
f r o m a pressure-volume loop and how such a loop can be constructed.
QUESTION 4
Outline the factors contributing to the generation and maintenance of the resting
membrane potential.
QUESnON 5
Compare the effects of a six hour fast from fluids and food w i t h those of a twenty
four hour fast in a healthy adult-
QUESTION 6
Define thermoneutral zone. Briefly explain how the body regulates temperature
when the ambient temperature exceeds the thermoneutral zone.
QUESTION 7
I n the diagram below indicate how the solvent and solute move across the semipermeable membrane and give a brief explanation of the principles involved.
BLOOD
Potassium
(6.5 mwol-L"')
Urea
(40 mmol-L"')
Osmolalit}'
(320 mosmoLL"^)
Pressure
(100 mmHg)
SEMIPERMEABLE MEMBRANE
DIALYSATE
Potassium
(3.5 mmol.L"^)
QUESTION 8
Urea
(0 mmol.L'')
Osmolalitj'
(346 mosmoLL"^)
Pressure
(10 mm'Hg)
List the physiological factors which determine intracranial pressure and explain
briefly how i t is controlled.
PHARMACOLOGY
QUESTION 9
Q U E S T I O N 10
Q U E S T I O N 11
QUESTION 12
Q U E S T I O N 13
D e s c r i b e b r i e f l y t h e c e n t r a l n e r v o u s system effects o f i s o f l u r a n e .
Describe briefly the mechanism of action of dantrolene. List its adverse effects
and oufline its uses in anaesthesia.
Describe briefly the pharmacokinetics of pethidine.
Define M A C and outline the factors which influence i t Briefly e.xplain MAC-hoar,
MAC-awake, and M A C - b a r and the application of these terms.
Describe briefly the factors determining transdermal uptake o f drugs and give
some examples of drugs which can be administered by the transdermal route.
Briefly' outline the advantages and disadvantages of transdermal adnunistradon of
drugs.
Question 14 statistics
Q U E S T I O N 15
QUESTION 16
AUGUST/SEPTEMBER,
QUESTION 1
QUESTION!
1996
QUESTIONS
QUESTION 4
Explain briefly the mecham'sms that maintain cerebral blood flow on moving
from a supine to a standing position.
QUESTION 5
QUESTION 6
QUESTION 7
QUESTION 8
Question 10 statistics
QUESTION 9
Q U E S T I O N 11
Q U E S T I O N 12
Briefly outline the effects of the volatile Inhalational agents on muscle tissues,
indicating postulated mechanisms and clinical significance
Briefly describe how drugs may produce their pharmacological effects.
Illustrate each mechanism "vvith examples.
Q U E S T I O N 13
Q U E S T I O N 14
Q U E S T I O N 15
Q U E S T I O N 16
AUGUST/SEPTEMBER
1995
PHYSIOLOGY
Q U E S T I O N 1:
Define "Venous A d m i x t u r e " . Briefly explain how venous admixture influences arterial oxygen
tension, and how an increase in inspired oxygen concentration may affect this.
Q U E S T I O N 2:
E x p l a i n the physiological processes which cause oliguria in response to hypovnlaemic shock.
QUESTIONS:
Briefly outline the differences between the pulmonar)' circulation and flie systemic circulation
Q U E S T I O N 4:
Draw a labelled diagram of a cardiac muscle action potential highlighting the sequence of changes in
ionic conductances. Explain the terms "threshold", "excitabUitj'", and "irritability" >Yith the aid of the
diagram.
Q U E S T I O N 5;
Outline the effects of intravenously administering 500 ml of 20% mannitol, and the potential problems
associated with its use.
Q U E S T I O N 6:
L i s t the physiological factors which deternune intracraiual pressure and explain briefly how it is
controlled.
QUESTION?;
Briefly differentiate betsveen the terms "heat" and "temperature", explain briefly the prmciples of a
thermistor indicating its advantages and disadvantages.
QUESTIONS:
Outline the physiological consequences of hj'perosmolar diabetic keto acidosis
Q U E S T I O N 9:
List the physiological factors which increase respirator}' rate and include a brief explanation of the
mechanism by which each achieves this increase.
Q U E S T I O N 10:
Briefly explain the changes that occur in stored whole blood.
AUGUST/SEPTEmER
1995
PHARMACOLOGY
Q U E S T I O N 1;
Describe the clearance of drugs by the kidney.
Q U E S T I O N 2:
Briefly describe the pharimacological effects of paracetamol. List its clinical indications and outline the
mechanisms for its toxicity.
Q U E S T I O N 3:
Give a brief account of drug protein binding and outline its significance.
Q U E S T I O N 4;
Outline the chemistry of heparin. Describe its mechanism of action and Ust its toxic effects.
QUESTIONS:
Briefly outline the effects of the volatile agents on muscle tissues. Include a description of how these
effects are mediated and their cUnical significance.
Q U E S T I O N 6:
Outline the influence of pregnancy on pharmacokinetics.
Question 7 Statistics
Q U E S T I O N 8:
Oufline the factors that determine recover}' (offset of effect) after ceasing a drug Infusion. Explain the
relevance of a drug's elimination half time.
Q U E S T I O N 9:
Using opioids as examples, describe and illustrate vs'ith graphs what you understand by the terms
"potency", "efficacy", "partial agonis", "competitive antagonist", and "therapeutic index".
Q U E S T I O N 10:
Draw a graph comparing the ratio of inspired to alveolar concentrations during thefii-sthalf hour of
administration for nitrous oxide, isoflurane, and halothane. Outline the reasons for the obsen'ed
differences between the agents and indicate the effects of non concurrent increases in alveolar
ventilation and cardiac output.