59

23. Factors that affect blood flow through a rigid

tube include:
(a) The radius of the tube.
(b) Haematocrit.
(c) Reynolds number.
(d) The density of the fluid.
(e) Velocity of the fluid in the tube.
24. Appropriate early postoperative measures fol-
lowing microvascular free tissue transfer
include:
(a) Maintaining the core-peripheral temperature gradient
>1C.
(b) Maintaining blood haematocrit at 1825%.
(c) Keeping systolic blood pressure 20% above baseline
levels to ensure adequate flap perfusion.
(d) Facemask oxygen if SaO
2
< 92%.
(e) Regular flap inspection, if possible.
25. Regarding pre-eclampsia:
(a) It occurs in 10% of pregnancies.
(b) Its incidence is reduced by the use of low-dose aspirin.
(c) It occurs more frequently in diabetics.
(d) It may cause intra-uterine growth retardation.
(e) Oedema is essential for diagnosis.
26. Regarding drugs used to control the blood
pressure in pregnancy:
(a) Methyldopa is usually used for long-term treatment.
(b) Labetalol can only be given intravenously.
(c) ACE inhibitors are safe to use.
(d) Increments of hydralazine should be given every 5 min
for rapid control of the blood pressure.
(e) Glyceryl trinitrate is commonly used.
27. Severe pre-eclampsia is defined as any one of:
(a) Diastolic blood pressure > 100 mmHg.
(b) Oliguria < 400 ml per 24 h.
(c) Pulmonary oedema.
(d) Platelet count < 100,000 x 10
9
litre
1
.
(e) Proteinuria > 5 g per 24 h.
28. With regards to delivery for women with pre-
eclampsia:
(a) A platelet count of < 100,000 x 10
9
litre
1
is considered
an absolute contra-indication to a regional technique.
(b) General anaesthesia is the safest option for operative
delivery.
(c) Alfentanil 10 g kg
1
may be given to obtund the
hypertensive response to intubation.
(d) Short-acting opioids should also be given prior to
extubation.
(e) Hypotension with regional anaesthesia is more profound
in those already on anti-hypertensive treatment.
29. The FIO
2
delivered to a patients airway from
the following devices is usually patient depen-
dent:
(a) Nasal cannulae, 2 litre min
1
.
(b) Ventimask 0.4, 10 litre min
1
.
(c) Ventimask 0.6, 10 litre min
1
.
(d) Hudson mask, 2 litre min
1
.
(e) Mapleson A system, 6 litre min
1
.
30. A patient with a respiratory rate of 10 with a
tidal volume of 500 ml and I:E ratio of 1:2 has
the following parameters:
(a) Respiratory cycle of 5 sec.
(b) Inspiratory time of 2 sec.
(c) Peak inspiratory flow of 15 litre min
1
.
(d) Minute ventilation of 15 litre min
1
.
(e) Alveolar ventilation 6 litre min
1
.
31. A patient with a peak inspiratory flow of 40
litre min
1
will receive the required oxygen con-
centration if:
(a) The FIO
2
is 0.4 and the oxygen flow is 10 litre min
1
.
(b) The FIO
2
is 0.4 and the oxygen flow is 5 litre min
1
.
(c) The FIO
2
is 0.6 and the oxygen flow is 10 litre min
1
.
(d) The FIO
2
is 0.6 and the oxygen flow is 20 litre min
1
.
(e) The FIO
2
is 1.0 and the oxygen flow is 20 litre min
1
.
32. Guillain-Barr syndrome may be associated
with:
(a) Campylobacter jejuni infection.
(b) Use of the oral contraceptive pill.
(c) Renal transplantation.
(d) Aspirin therapy.
(e) HIV infection.
Multiple Choice Questions
British Journal of Anaesthesia | CEPD Reviews | Volume 3 Number 2 2003
The Board of Management and Trustees of the British Journal of Anaesthesia 2003
DOI 10.1093/bjacepd/mkg015

b
y

g
u
e
s
t

o
n

M
a
r
c
h

1
7
,

2
0
1
4
h
t
t
p
:
/
/
c
e
a
c
c
p
.
o
x
f
o
r
d
j
o
u
r
n
a
l
s
.
o
r
g
/
D
o
w
n
l
o
a
d
e
d

f
r
o
m

Multiple choice questions
60
British Journal of Anaesthesia | CEPD Reviews | Volume 3 Number 2 2003
33. In Guillain-Barr syndrome:
(a) Weakness typically occurs more in proximal than distal
muscles.
(b) Pathological changes tend to affect the motor end
plates.
(c) Hypoxaemia is an early indicator of disease progression.
(d) Ventricular arrhythmias may be an early feature.
(e) Sensory symptoms occur in up to 80% patients.
34. Recognised findings on investigation of Guillain-
Barr syndrome include:
(a) Hyponatraemia.
(b) Elevated transaminases.
(c) Low protein concentrations in the CSF.
(d) Antiganglioside antibody.
(e) ST segment depression on the ECG.
35. In the treatment of Guillain-Barr syndrome:
(a) Non-invasive ventilation is often useful in management
of patients with early ventilatory failure.
(b) Mechanical ventilation should be considered if maximal
inspiratory pressure is < 30 cmH
2
O.
(c) Plasmapheresis is contra-indicated in patients with IgA
deficiency.
(d) Plasmapheresis may exacerbate hypercalcaemia.
(e) Intravenous immunoglobulin therapy is the treatment of
choice in patients with uncontrolled sepsis
36. With respect to the pharmacology of
inhalational agents:
(a) Alveolar ventilation:FRC ratio increases with age.
(b) MAC falls with age.
(c) The MAC of sevoflurane increases for the first few
months of life.
(d) Blood:gas solubility increases with age.
(e) Respiratory rate increases during sevoflurane anaesthesia.
37. When comparing drug handling by neonates
with that of adults:
(a) V
D
is greater than in adults.
(b) Plasma protein binding is unchanged.
(c) Drug distribution occurs more rapidly in neonates.
(d) Drug elimination occurs more rapidly in neonates.
(e) GFR approaches adult levels by 1 month of age.
38. Regarding propofol in paediatric practice:
(a) It is licensed for use as an induction agent for children
aged 1 month or more.
(b) It is licensed for use as a maintenance agent for children
aged 2 years or more.
(c) Awakening from propofol anaesthesia occurs more
rapidly than following sevoflurane anaesthesia.
(d) It depresses airway reflexes to a greater degree than
thiopental.
(e) It reduces the incidence of postoperative nausea and
vomiting in high-risk surgery.
39. When using muscle relaxants:
(a) Neonates are less sensitive to non-depolarising muscle
relaxants.
(b) Neonates are less sensitive to depolarising muscle
relaxants.
(c) The paediatric diaphragm possesses fewer type 2 fibres.
(d) Atracurium exhibits prolonged excretion in neonates.
(e) Tetanic fade is seen in neonates in the absence of muscle
relaxants.
40. The membrane attack complex:
(a) Is part of the innate immune system.
(b) Is non-specific.
(c) Is the end-point of complement activation.
(d) Causes cell lysis.
(e) Augments phagocytosis.
41. T lymphocytes:
(a) Are memory cells.
(b) Are terminally differentiated.
(c) Do not secrete interferon gamma.
(d) Make antibodies.
(e) Are phagocytic.
42. Acquired immune responses:
(a) Comprise humoral and cell-mediated immune responses.
(b) Are specific.
(c) Are magnified on subsequent prior antigen exposure.
(d) Are distinct from innate immune responses.
(e) Require clonal expansion.
43. Cytokines:
(a) Are low molecular weight proteins.
(b) Are pleiotrophic in their actions.
(c) Are always glycosylated.
(d) Are part of the innate immune system.
(e) Act on the brain to cause fever.
44. Anti-inflammatory cytokines:
(a) Are released early in the inflammatory process.
(b) Are typified by IL-10.
(c) May account for the immune paralysis seen in some ICU
patients.
(d) Cause tissue healing and re-modelling.
(e) Inhibit white cell adhesion.

b
y

g
u
e
s
t

o
n

M
a
r
c
h

1
7
,

2
0
1
4
h
t
t
p
:
/
/
c
e
a
c
c
p
.
o
x
f
o
r
d
j
o
u
r
n
a
l
s
.
o
r
g
/
D
o
w
n
l
o
a
d
e
d

f
r
o
m