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Question 1
Incorrect
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Which of the following is NOT a common side effect of diazepam:
Your Answer: Ataxia
Correct Answer: Bradycardia
Explanation:Adverse effects include:
Drowsiness and lightheadedness
Confusion and ataxia (especially in the elderly), amnesia, muscle weakness
Headache, vertigo, tremor, dysarthria, hypotension, decreased libido, erectile dysfunction, gynaecomastia, urinary retention
Paradoxical effects such as talkativeness, excitement, irritability, aggression, anti-social behaviour, and suicidal ideation
Withdrawal symptoms, for example anxiety, depression, anorexia, impaired concentration, insomnia, abdominal cramps, palpitations, tremor, tinnitus and perceptual disturbances
Tolerance and dependence (people who use benzodiazepines longer term can develop tolerance and eventual dependence) -
This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 2
Correct
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Which of the following is a contraindication to using nitrous oxide:
Your Answer: Raised intracranial pressure
Explanation:Nitrous oxide should not be utilized in patients with an air-containing confined area because it diffuses into these spaces, causing a rise in pressure. This includes circumstances like pneumothorax, intracranial air after a head injury, imprisoned air from a recent undersea dive, a recent intraocular gas injection, or intestinal blockage. Nitrous oxide increases cerebral blood flow and should be avoided in individuals who have or are at risk of having high intracranial pressure.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 3
Correct
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In relation to ketamine, which of the following statements is TRUE:
Your Answer: It is usually associated with tachycardia, increased blood pressure and increased cardiac output.
Explanation:Ketamine has hypnotic, analgesic and local anaesthetic properties. Major adverse effects include Hypertension, Increased cardiac output, Increased ICP, Tachycardia, Tonic-clonic movements, Visual hallucinations and Vivid dreams.
Ketamine is mostly utilized in paediatric anaesthesia, especially when repeated dosing is necessary (such as for serial burns dressings). Ketamine has little effect on respiratory drive, and protective airway reflexes are unaffected. Ketamine is also a bronchial smooth muscle relaxant, hence it plays a unique function in the treatment of severe asthma. -
This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 4
Correct
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In the United Kingdom, which of the following is the most often used intravenous aesthetic:
Your Answer: Propofol
Explanation:In the United Kingdom, propofol is the most widely used intravenous anaesthetic. In adults and children, it can be used to induce or maintain anaesthesia, although it is not commonly used in newborns. It can also be used to sedate individuals in intensive care and for sedation during operations.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 5
Correct
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Naloxone is a reversal agent for which of the following groups of drugs:
Your Answer: Opioids
Explanation:Naloxone is a specific antagonist of mu(μ)-opioid receptors, the specific antidote for opioid overdose and will reverse respiratory depression and coma if given at sufficient dosage. The initial dose is usually 0.8 mg (2 mL) intravenously (the dose range suggested by BNF is 0.4-2 mg). It can also be given by intramuscular injection if the intravenous route is not feasible.
As naloxone has a shorter duration of action than most opioids, close monitoring and repeated injections are necessary according to the respiratory rate and depth of coma. The dose is generally repeated every 2-3 minutes to a maximum of 10 mg. When repeated doses are needed, naloxone may be given by a continuous infusion adjusted according to the vital signs. Initially, the infusion rate can be set at 60% of the initial resuscitative IV dose per hour.
In opioid addicts, naloxone administration may precipitate a withdrawal syndrome with abdominal cramps, nausea and diarrhoea, but these usually settle within 2 hours. -
This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 6
Correct
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Which of the following local anaesthetics has the longest duration of action:
Your Answer: Bupivacaine
Explanation:Bupivacaine has a longer duration of action than the other local anaesthetics, up to 8 hours when used for nerve blocks. It has a slow onset, taking up to 30 minutes for full effect. It is often used in lumbar epidural blockade and is particularly suitable for continuous epidural analgesia in labour, or for postoperative pain relief. It is the principal drug used for spinal anaesthesia.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 7
Incorrect
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Atracurium is used as a muscle relaxant during endotracheal intubation. This drug’s mechanism of action is best described by which of the following?
Your Answer: Acetylcholinesterase inhibitor
Correct Answer: Nicotinic acetylcholine receptor antagonist
Explanation:Atracurium is a non-depolarizing neuromuscular blocker that is used to help with intubation and controlled ventilation by causing muscle relaxation and paralysis.
At the neuromuscular junction’s post-synaptic membrane, atracurium competes with acetylcholine for nicotinic (N2) receptor binding sites. This prevents the receptors from being stimulated by acetylcholine.
Muscle paralysis occurs gradually due to the competitive blockade.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 8
Correct
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Which of the following intravenous induction drugs results in the highest drop in blood pressure:
Your Answer: Propofol
Explanation:Propofol’s most frequent side effect is hypotension, which affects 17% of paediatric patients and 26% of adults. This is attributable to systemic vasodilation as well as a decrease in preload and afterload. Propofol has a little negative inotropic impact as well. The drop in blood pressure is dosage-dependent and is more noticeable in the elderly, thus this should be expected.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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Question 9
Correct
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Which of the following statements about propofol is TRUE:
Your Answer: Propofol has some antiemetic action.
Explanation:Propofol has some antiemetic properties. It’s for this reason that it’s used to treat postoperative nausea and vomiting. Propofol is mostly processed in the liver, with the kidneys excreting just around 1% of it unaltered. Propofol, unlike thiopental, does not produce tissue necrosis when it is extravasated. Propofol lowers intracranial pressure via lowering brain metabolic rate and cerebral blood flow. Propofol is thought to be safe for people with bronchial asthma and chronic obstructive pulmonary disease.
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This question is part of the following fields:
- Anaesthesia
- Pharmacology
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SESSION STATS - PERFORMANCE PER SPECIALTY
