1.

Coronary blood flow

A. is about 500 ml/min at rest B. is measured using Kety method C. is altered directly by vagal activity D. is maximal during ventricular systole E. is autoregulated FTFFT

2.

Regarding blood plasma I. J.

F. It makes up about 4% of the total body weight G. The principal cation is sodium H. It contains fructose It is used for the direct Coombs test Total plasma protein ranges from 20 - 40 g/L

TTTFF 3. K. It makes up about 40% of the body weight L. Measured using dilution technique with deuterium oxide M. Inorganic phosphate is the most abundant anion N. K+ concentration is approximately 100 mmol/L O. Its proportion varies little between tissues TTTFF 4. P. 'Cannon' waves occur with junctional rhythm Q. 'H' wave is associated with bradycardia R. Peaks with the 'a' wave at end diastole S. The 'c' wave is a diastolic component T. The 'x' descent is a systolic component Concerning the CVP waveform TTTFT 5. Regarding thyroid hormones U. Thyroxine (T4) is more active than Triiodothyronine (T3) V. More than 99% of active hormone is protein-bound W. The actions are mediated via receptors on the cell surface X. Cause reduced carbohydrates metabolism Y. Is de-iodinated in the liver FTFFT 6. Regarding gastric physiology Z. There is approximately 3 litres of gastric secretion per day AA. The parasympathetic innervation is from the coeliac plexus BB. Gastric emptying is controlled by periodic relaxations of Regarding intracellular fluid

the pyloric sphincter CC. Cathecolamines inhibit the gastric secretion DD. The gastric contents are normally sterile TFFTT 7. Regarding carbon dioxide transport in blood EE. Carbonic anhydrase is present in plasma FF. 25% of carbon dioxide is dissolved GG. Majority is carried as bicarbonate

HH. Is facilitated by deoxygenated haemoglobin II. 50 ml of carbon dioxide is carried per 100 ml in arterial blood FFTTT

-1-

8.

Regarding peripheral chemoreceptors

JJ. Present in the carotid sinus KK. Sensitive to changes in PaCO2 LL. Stimulated by cyanide

MM. Respond to anaemia NN. Are supplied by the glossopharyngeal nerve FTTFT 9. OO. are more influenced by PaO2 than oxygen content . PP. are stimulated by a fall in pH . QQ. are stimulated by a fall in blood flow . RR. contain chemoreceptors . SS. have a greater blood supply per gram than the brain . The carotid bodies TTTTT 10. Relaxation of the pregnant uterus is produced by WW. halothane XX. rocuronium FFTTF 11. Hyperkalaemia causes BBB. CCC. FFTTF 12. Autoregulatory mechanisms used in hypovolaemic shock include angiotensin II FFF. an increase in precapillary sphincter tone GGG. an increase in capillary hydrostatic pressure HHH. stimulation of the juxtaglomerular apparatus FTTTT 13. .Amiodarone LLL. MMM. FTFTT 14. Regarding steroid therapy PPP. QQQ. RRR. FFTTF NNN. Hydrocortisone replacement alone is sufficient in Addison's disease OOO. Dexamethasone is suitable for replacement therapy Methylprednisolone is a more potent anti-inflammatory agent than hydrocortisone Prolonged steroid therapy causes osteoporosis Cortisone does not cause fluid retention III. is a class IB anti-arrhythmic drug JJJ. acts by prolonging cardiac action potential KKK. half-life is less than 4 weeks pulmonary toxicity is one of its side effect interferes with tests of thyroid function DDD.decrease in baroreceptor activity EEE. an increase in YY. U waves on the electrocardiogram ZZ. increased amplitude of the P waves AAA. prolonged QRS complexes ventricular fibrillation cardiac arrest in systolic phase TT. epidural anaesthesia UU. nitrous oxide VV. ritodrine

-2-

15. Regarding first-order kinetics

SSS. A constant proportion of drug metabolised in a given time period TTT. Ethanol is an example UUU. The enzyme responsible for the reaction is saturated VVV. The rate of elimination and elimination half-life is constant,irrespective of plasma concentration WWW. The reaction is represented by a linear relationship TFFFF

16. Regarding antiemetic drugs

XXX. Those which act as antidopaminergic agents can cause extrapyramidal s symptoms YYY. Domperidone reduces vomiting by an antiserotonin action ZZZ. Extrapyramidal symptoms after administration of droperidol are unlikely 6 hours after administration AAAA. Phenothiazine reduce nausea and vomiting by anti dopaminergic, antihistamine and antimuscarinic actions BBBB. Metoclopramide and cyclizine have primarily anticholinergic actions. TFFTF

17. Dantrolene FFFF. GGGG. FTTTT 18. Naloxone KKKK. LLLL. TFFTT

CCCC. is useful when given intramuscularly DDDD. contains mannitol EEEE. interferes with calcium ion release from sarcoplasmic reticullum interacts with verapamil causes sedation

HHHH. is a ?-receptor antagonist IIII. is an analogue of morphine JJJJ. is a respiratory stimulant in normal man causes pulmonary oedema as a complication has a duration of action of one to four hours

19. Regarding uptake of a volatile anaesthetic agent

MMMM. Increased if ventilation increases NNNN. More rapid when cardiac

output decreases OOOO. Reduced with less soluble agent PPPP. greater when the difference between inspired and alveolar concentration are higher QQQQ. the second-gas effect allows the maintenance concentration of TTFTF 20. Concerning anaphylaxis occurring during the perioperative period RRRR. Adrenaline is the first drug of choice SSSS. It is most

commonly due to muscle relaxants TTTT. It is IgE mediated UUUU. Serum tryptase has a half-life of one (1) hour VVVV. Serum tryptase levels can distinguish between anaphylactic and anaphylactoid reactions TTTFF

-3-

21. Regarding sodium nitroprusside YYYY. ZZZZ. AAAAA. TTTFF

WWWW. The intraoperative dose range is 0.5-6 mcg/kg/min XXXX. Acts on both arterial and venous smooth muscle Plasma half-life is 2 minutes Stimulates hypoxic pulmonary vasoconstriction Reduces renal blood flow

22. Epileptiform EEG activity are induced by EEEEE. FFFFF. TFTFF 23. With regard to local anaesthetics: etomidate isoflurane

BBBBB. enflurane CCCCC. midazolam DDDDD. methohexitone

GGGGG. act by preventing sodium acces to the axon interior by occupying the transmembrane sodium channel HHHHH. Bupivacaine carbonate compared to bupivacaine hydrochloride has a longer onset of action and less intense block IIIII. The shortest duration of action of local anaesthetics follows intrathecal injection, the longest durations follow major peripheral nerve blocks JJJJJ. Prilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine KKKKK. The Cm of lignocaine is less than of bupivacaine TFTFF

24. The factors affecting the rate of transport of a drug across the placenta are a) degree of ionization b) degree of protein binding c) placental blood flow d) pK of the drug e) lipid solubility of the drug TTFTT LLLLL. MMMMM. NNNNN. OOOOO. PPPPP. 25. Regarding the binding of a drug to plasma proteins SSSSS. TTTTT. UUUUU. TTFTT 26. Nitrous oxide YYYYY. ZZZZZ. TTTFT 27. The following interactions are antagonistic AAAAAA. Histamine and adrenaline VVVVV. has MAC of 105% WWWWW. has critical temperature of 36.5 degree Celcius XXXXX. induces bone marrow aplasia causes increase in cardiac output causes diffusion hypoxia at the termination of anaesthesia QQQQQ. Prolongs its biological half-life RRRRR. Is different in arterial and venous blood

Is higher with lignocaine than bupivacaine Slows glomerular filtration of the drug Pethidine binds more to alpha-1 acid glycoprotein than albumin

-4-

BBBBBB. CCCCCC. DDDDDD. EEEEEE. TTTFF

Flumazenil and midazolam Atenolol and salbutamol Protamine and warfarin Aminoglycoside and atracrurium

28. The action of non-depolarising muscle relaxant is prolonged by a HHHHHH. hypermagnesaemia IIIIII. lithium JJJJJJ. hyperthermia FFTTF 29. Concerning magnesium

FFFFFF. a GGGGGG.

hyponatraemi hyperkalaemi

KKKKKK. Normal plasma concentration is 3-5 mmol/L LLLLLL. Present mainly in bone MMMMMM. Deficiency cause muscle weakness NNNNNN. Potentiates the action of Ca2+ at the neuromuscular junction OOOOOO. It reduces peripheral vascular tone FTTFT

30. Salbutamol causes SSSSSS. TTTTTT. FFFTT 31. Regarding clonidine

PPPPPP. QQQQQQ. RRRRRR.

increase in uterine contractility worsening of intermittent claudication hyperkalaemia

tremor tachycardia

UUUUUU. It is a selective ?2-agonist VVVVVV. It causes hypertension following abrupt cessation WWWWWW. Oral bioavailability is 100% XXXXXX. Anxiety is a side-effect YYYYYY. Reduces cardiac contractility TTTFF

32. Concerning nitric oxide (NO)

ZZZZZZ. Is the active ingredient of glyceryl trinitrate AAAAAAA. Improves platelet functions BBBBBBB. Is usually administered in doses of 10-50 ppm CCCCCCC. Produces relaxation of the smooth muscle DDDDDDD. Methaemoglobinemia is one of it's adverse effects TFTTT

33. Hypothermia causes

EEEEEEE. coagulopathy FFFFFFF. respiratory depression GGGGGGG. J waves on the ECG

HHHHHHH. diuresis IIIIIII. hypoglycaemia TTTTF 34. During the process of hemostasis JJJJJJJ. The extrinsic cascade is initiated by contact between factor XII and collagen fiber

-5-

KKKKKKK. Vitamin K is required for the formation of prothrombin LLLLLLL. Local vasoconstriction occurs in respond to serotonin released by platelets MMMMMMM. Clot formation is due to conversion of fibrin to fibrinogen NNNNNNN. Primary hemostasis is controlled by the balance between Thromboxane A2 and Prostacyclin FTTFT 35. Regarding pulmonary circulation OOOOOOO. Normal pulmonary capillary pressure is about 10 mmHg PPPPPPP. The volume of blood in the pulmonary vessels is

about 1 liter at any time QQQQQQQ. PGF2? causes pulmonary vasoconstriction RRRRRRR. Pulmonary blood volume increase when changing posture from supine to erect SSSSSSS. Receive blood from both the pulmonary and bronchial arteries TTTFT 36. Alveolar minute ventilation TTTTTTT. is equal to total minute ventilation minus the dead space ventilation UUUUUUU. is calculated from the alveolar air equation VVVVVVV. is proportionate to alveolar CO2 concentration WWWWWWW. is about 4.5 L/min at rest XXXXXXX. is more in the apical than basal region in upright position TFFTT 37. Action of acetylcholine on muscarinic receptors AAAAAAAA. BBBBBBBB. CCCCCCCC. FTFTF 38. With reference to the normal human heart : DDDDDDDD. The most rapidly conducting fibres in the heart are purkinje fibres EEEEEEEE. The last part of the ventricle to YYYYYYY. stimulates adrenaline secretion in the adrenal medulla ZZZZZZZ. causes vasodilatation

decreases bronchial tone increases lacrimation on M2-type causes gastric acid secretion

be activated is the apex FFFFFFFF. The duration of an action potential in the ventricular muscle fibre is about the same as in a skeletal muscle fibre GGGGGGGG. The T wave of the ECG occurs at the beginning of the absolute refractory period of the ventricle HHHHHHHH. Left axis deviation leads to abnormally large R wave in standard limb lead I TFFFF 39. Concerning metabolic alkalosis IIIIIIII. Causes hypoventilation JJJJJJJJ. Is caused by massive blood transfusion KKKKKKKK. Is treated with acetozolamide LLLLLLLL. Increase free ionized calcium concentration MMMMMMMM. Tetany is a complication TTTFT 40. In the autonomic nervous system NNNNNNNN. the parasympathetic system is transmitted in cranial nerves and sacral fibres from the spinal cord

-6-

OOOOOOOO. parasympathetic effects are identical to those of acetylcholine PPPPPPPP. postganglionic sympathetic fibres release cathecolamines, except at sweat and adrenal glands QQQQQQQQ. sympathetic effects are more localized than parasympathetic actions RRRRRRRR. parasympathetic stimulation increases bladder emptying TFTFF 41. Regarding renal regulation of water and sodium SSSSSSSS. The ascending limb of loop of Henle is impermeable to water TTTTTTTT. Sodium reabsorption from the

loop of Henle occurs passively UUUUUUUU. Under conditions of maximum antidiuresis, 5% of water reabsorption occurs in the distal tubule VVVVVVVV. Sodium excretion affected by blood flow in the vasa recta WWWWWWWW. Prolonged thirst induces aldosterone production TFFTT 42. The stress response to surgery includes XXXXXXXX. Increases in ACTH, cortisol and growth hormone YYYYYYYY. Increased lipolysis

ZZZZZZZZ. Protein catabolism AAAAAAAAA. Increased glucagon secretion BBBBBBBBB. Reduced insulin secretion TFTTT 43. Causes of hyponatremia is/are CCCCCCCCC. Heart failure DDDDDDDDD. Primary hyperaldosteronism EEEEEEEEE. Excessive use of Loop diuretics FFFFFFFFF. Syndrome of Inappropriate Antidiuretic Hormone GGGGGGGGG. Chlorpropamide treatment TFTTT 44. Concerning pulmonary surfactant KKKKKKKKK. LLLLLLLLL. FTTFT 45. Regarding cerebrospinal fluid (CSF) MMMMMMMMM. its osmolality is identical to plasma osmolality . NNNNNNNNN. its glucose content is two-thirds HHHHHHHHH. Increases surface tension in alveoli IIIIIIIII. Prevents pulmonary oedema JJJJJJJJJ. Deficiency results in hyaline membrane disease Decreases lungs compliance Is produced by the type II alveolar cells

of plasma concentration . OOOOOOOOO. its potassium content is slightly higher than in plasma . PPPPPPPPP. the rate of formation is approximately 150 ml per day. the total volume is approximately 150 ml. TTFFT QQQQQQQQQ. 46. Regarding liver circulation TTTTTTTTT. UUUUUUUUU. VVVVVVVVV. RRRRRRRRR. Oxygenated blood is delivered by branches of the hepatic artery SSSSSSSSS. Total blood flow is half of the cardiac output It augments blood volume up to 300 mls during haemorrhage The portal venous pressure is about 10 mmHg The portal vein has dopaminergic receptors

-7-

TFTTT 47. Non-respiratory functions of the lung includes WWWWWWWWW. angiotensin I XXXXXXXXX. activation of metabolism of

circulating adenine nucleotides YYYYYYYYY. the synthesis of circulating kallikrein ZZZZZZZZZ. histamine metabolism AAAAAAAAAA. the inactivation of circulating adrenaline TTTFF 48. Pulmonary vascular resistance DDDDDDDDDD. EEEEEEEEEE. FFFFFFFFFF. TTTFF 49. In the fetus GGGGGGGGGG. Blood can flow from the vena cava to the descending aorta without passing through the left atrium or left ventricle HHHHHHHHHH. Blood from the ductus arteriosus is more saturated than blood from the ductus venosus IIIIIIIIII. The ductus arteriosus normally closes within 1 hour of birth JJJJJJJJJJ. The foramen ovale closes as a result of pressure reversal between the left atrium and right atrium KKKKKKKKKK. Transition from fetal to adult circulation result from a decrease in pulmonary artery pressure TFFTT 50. When breathing out against a closed glottis, the rises NNNNNNNNNN. OOOOOOOOOO. PPPPPPPPPP. TTFFF 51. The following are true about neonatal physiology: QQQQQQQQQQ. Ductus arteriosus closes after three months (F). RRRRRRRRRR. Glomerulo filtration LLLLLLLLLL. heart rate slows transiently MMMMMMMMMM. intratracheal pressure BBBBBBBBBB. is increased in chronic hypoxia CCCCCCCCCC. has a value approximately 20% of the systemic circulation is measured using a flow-directed balloon catheter with a thermistor tip is increased by isoprenaline is increased when pulmonary venous pressure increased

left ventricular output has a sustained increase right ventricular output increases systolic arterial pressure falls then rises

rate is 1/3 of adult values (T). SSSSSSSSSS. Specific compliance is the same as the adult (T). TTTTTTTTTT. The cardiac output dependent on the heart rate (T). UUUUUUUUUU. Total body water comprises 70% of the neonate (T FTTTT 52. Levobupivacaine is anaesthesia. YYYYYYYYYY. VVVVVVVVVV. equipotent with bupivacaine. WWWWWWWWWW. less CNS toxic than bupivacaine . XXXXXXXXXX. longer lasting than ropivacaine for spinal more cardiotoxic than ropivacaine .

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ZZZZZZZZZZ. FTTTF 53. Concerning etomidate

the R(+)-enantiomer of bupivacaine .

AAAAAAAAAAA. Is a carboxylated imidazole compound BBBBBBBBBBB. Inhibits adrenal steroid synthesis CCCCCCCCCCC. Presented in 35% propylene glycol DDDDDDDDDDD. Metabolize in the liver by ester hydrolysis EEEEEEEEEEE. Causes more respiratory depression than thiopentone TTTTF

54. Protamine

FFFFFFFFFFF. it is predominantly antithrombotic GGGGGGGGGGG. is a basic protein molecule HHHHHHHHHHH. protamine heparin complex rarely mediates pulmonary hypertension IIIIIIIIIII. dose of 1mg is required for every 100u of heparin circulating in blood ( Stoelting p458) JJJJJJJJJJJ. Hexadimethrine is alternative in patients allergic to TTTTT

55. The following statement regarding Diuretics are true

KKKKKKKKKKK. Frusemide reduces renal blood flow LLLLLLLLLLL. Mannitol has no effect

on the renal blood flow MMMMMMMMMMM. Amiloride is a potassium sparing diuretic NNNNNNNNNNN. Hyponatremia is more likely in patients taking loop diurtics than thiazide diurtics e Thiazide act principally on the cortical portion of ascending loops of Henle FFTFT OOOOOOOOOOO. 56. Regarding Diuretics (Stoelting p440) PPPPPPPPPPP. Acetazolamide acts on the proximal convoluted tubules QQQQQQQQQQQ. Loop acts on the medullary

portion of ascending loops of Henle RRRRRRRRRRR. Thiazide causes metabolic alkalosis as a side effect SSSSSSSSSSS. Frusemide enhances aminoglycoside nephrotoxicity TTTTTTTTTTT. Mannitol is used as a prophylaxis against acute renal failure TTTTT 57. Respiratory physiology in the neonate, compared with the adult, shows Higher respiratory rate VVVVVVVVVVV. Higher airway resistance WWWWWWWWWWW. Higher physiological dead space XXXXXXXXXXX. Almost entirely diaphragmatic ventilation YYYYYYYYYYY. Lower lung compliance TTFTT 58. In fetal circulation ZZZZZZZZZZZ.Blood in ductus arteriosus is more saturated than blood in ductus venosus AAAAAAAAAAAA. Blood in the umbilical veins is 50% saturated BBBBBBBBBBBB. Blood can pass from the inferior vena cava to the aorta without passing through the heart CCCCCCCCCCCC. The PaO2 in the umbilical artery is 20 mmHg DDDDDDDDDDDD. Blood passing to the brain and arms is better oxygenated than that passing UUUUUUUUUUU. UUUUUUUUUUU. UUUUUUUUUUU.

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FFFTT 59. In the cardiac cycle EEEEEEEEEEEE. atrial systole FFFFFFFFFFFF. Left ventricular volume is maximal at the end of

The mitral valve closes by contraction of the papillary muscles GGGGGGGGGGGG. The left ventricular pressure is maximal just before the aortic valve opens HHHHHHHHHHHH. The ejection fraction is about 85% IIIIIIIIIIII. The dicrotic notch is due to rebound of the aortic valve TFFFF 60. Regarding CVSPreload is the muscle length prior to contractility JJJJJJJJJJJJ. Afterload is the tension (or the arterial pressure) against

which the ventricle must contract. KKKKKKKKKKKK. Preload is dependent of ventricular filling (or end diastolic volume.) LLLLLLLLLLLL. The most important determining factor for preload is venous return. MMMMMMMMMMMM. Afterload for the left ventricle is determined by aortic pressure TTTTT NNNNNNNNNNNN. 61. Physiological changes in obesity include OOOOOOOOOOOO. Decrease in total body water PPPPPPPPPPPP. Increase gastric emptying QQQQQQQQQQQQ. Increase total lung capacity RRRRRRRRRRRR. Increase oxygen consumption SSSSSSSSSSSS. Increase in cardiac output TFFTT 62. Dopamine TTTTTTTTTTTT. increases the creatinine clearance UUUUUUUUUUUU. has a renal protective reflex property VVVVVVVVVVVV. increases intracellular calcium concentration WWWWWWWWWWWW. usually increases cardiac output at dose of 2mic/kg/min XXXXXXXXXXXX. splanchnic oxygen requirement is increased FFTTT 63. Regarding Heparin YYYYYYYYYYYY. They produce their anticoagulant effects by binding to antithrombin ZZZZZZZZZZZZ. It acts through inhibition of thrombin induced activation of factor V and VII AAAAAAAAAAAAA. it does not inhibit platelet function BBBBBBBBBBBBB. It is present endogenously in Mast cells CCCCCCCCCCCCC. It crosses the placenta TTFTF 64. Regarding Antibiotics DDDDDDDDDDDDD. The drug of choice for treatment of Rickettsia is tetracycline EEEEEEEEEEEEE. The drug of choice for treatment of methicillin resistant staph aureus is vancomycin FFFFFFFFFFFFF. Probenecid prolongs the duration of action of Penicillin GGGGGGGGGGGGG. Cloxacillin is pencillinase susceptible penicillins HHHHHHHHHHHHH. Allergic reaction to penicillin is mediated through IgE antibodies TTTFT

- 10 -

65. Regarding Local anesthetic agent

Are marketed as water soluble hydrochloric salt KKKKKKKKKKKKK. Ropivacaine was developed as a pure S enantiomer LLLLLLLLLLLLL. pKa of bupivacaine is 8.1 MMMMMMMMMMMMM. Elimination half time of bupivacaine is 210 minutes TTTTT 66. Regarding local anaesthetic agent NNNNNNNNNNNNN. alter the resting transmembrane potential or threshold potential OOOOOOOOOOOOO. sodium channels is a specific

IIIIIIIIIIIII. in 1943 JJJJJJJJJJJJJ.

Lidocaine was synthesized by Lofgren

receptor for local anesthetic PPPPPPPPPPPPP. after binding they stabilize inactivated closed states of sodium channel QQQQQQQQQQQQQ. sodium channels in inactivated state are permeable to sodium RRRRRRRRRRRRR.differential blockade is selective blockade of preganglioic sympathetic B fibers with low concentration FTTFT 67. Regarding elimination half time SSSSSSSSSSSSS. is time necessary for the plasma concentration of a drug to decrease to 50% during the elimination phase TTTTTTTTTTTTT. it is directly proportional to clearance of drug UUUUUUUUUUUUU. it is directly proportional to Vd VVVVVVVVVVVVV. it is independent of the dose of drug administered. WWWWWWWWWWWWW. Amount of drug remaining in the body is related to number of elimination half times that have elapsed TFTTT 68. In the liver XXXXXXXXXXXXX. 25% of blood supply comes from hepatic artery YYYYYYYYYYYYY. Halothane decreases hepatic oxygen supply to a greater extent than isoflurane or sevoflurane ZZZZZZZZZZZZZ. Hepatic autoregulation is not affected by fasting AAAAAAAAAAAAAA. Metabolism of drugs occurs in the smooth endoplasmic reticulum of hepatocytes BBBBBBBBBBBBBB. Portal venous pressure is 7-10 mm of Hg TTFTT 69. Physiological right-to-left shunt (venous admixture) is DDDDDDDDDDDDDD. Partly from Thebesian veins EEEEEEEEEEEEEE. 10% of total pulmonary blood flow FFFFFFFFFFFFFF. Increased by pulmonary hypertension GGGGGGGGGGGGGG. Increased during sleep TTFFT 70. Regarding Neostigmine HHHHHHHHHHHHHH. It inhibits true cholinesterase IIIIIIIIIIIIII. Elimination half time is about 60-120 minutes JJJJJJJJJJJJJJ. Is poorly lipid soluble KKKKKKKKKKKKKK. Its onset of action is faster than edrophonium LLLLLLLLLLLLLL. Used in treatment of paralytic ileus CCCCCCCCCCCCCC. Partl y flow from bronchial veins into pulmonary veins

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TTTFT 71. Regarding the anion gap MMMMMMMMMMMMMM. The cations used in the calculation of the anion gap are sodium and potassium NNNNNNNNNNNNNN. The anions used in the calculation of the anion gap are chlorides and phosphates OOOOOOOOOOOOOO. The normal anion gap is between 8 - 10 mmol/L PPPPPPPPPPPPPP. Lactic acidosis causes a metabolic acidosis with a normal anion ga QQQQQQQQQQQQQQ. Renal failure causes a metabolic acidosis with a high anion gap TFFFT 72. The saturation of arterial blood with oxygen depends on RRRRRRRRRRRRRR. alveolar oxygen tension SSSSSSSSSSSSSS. haemoglobin

content TTTTTTTTTTTTTT. cardiac output UUUUUUUUUUUUUU. arterial carbon dioxide tension TFTTT VVVVVVVVVVVVVV. 73. Concerning composition of body fluids WWWWWWWWWWWWWW. Intracellular fluid is approximately twice the volume of the extracellular fluid XXXXXXXXXXXXXX. Extracellular volume grossly depleted in intestinal obstruction YYYYYYYYYYYYYY. Protein content of interstitial fluid is higher compared to intracellular fluid and plasma ZZZZZZZZZZZZZZ. Ratio of extracellular / intracellular volume is smaller in infants compared to adult AAAAAAAAAAAAAAA. Normal plasma protein oncotic pressure is 25 mm Hg TTFFT 74. The respiratory center in the brain stem receives input from BBBBBBBBBBBBBBB. carotid bodies CCCCCCCCCCCCCCC. The Join

t receptors on respiratory muscles DDDDDDDDDDDDDDD. Oxygen-sensitive chemoreceptors in the medulla EEEEEEEEEEEEEEE. Bronchiolar strech receptors via sympathetic stimulations FFFFFFFFFFFFFFF. Receptors which respond to the hydrogen ion concentration in the CSF TTFFT 75. Regarding the lung volumes and capacities : GGGGGGGGGGGGGGG. At age 66, closing capacity is lower than FRC in the upright position. Air present in the lungs after maximal inspiratory effort is the

HHHHHHHHHHHHHHH. residual volume IIIIIIIIIIIIIII. Normal Vital capacity is about 60-70ml/kg JJJJJJJJJJJJJJJ. FRC decreases as a patient moved from upright to a supine position KKKKKKKKKKKKKKK. Vital capacity includes tidal volumes, expiratory reserve volume and residual volume TFTTF 76. Regarding pressures during respiratory cycle in spontaneous ventilation: LLLLLLLLLLLLLLL. LLLLLLLLLLLLLLL. atmospheric ( zero . at end- inspiration Alveolar pressure is normally

- 12 -

MMMMMMMMMMMMMMM. Intrapleural pressure is -5cm H2O before inspiration begins NNNNNNNNNNNNNNN. Transpulmonary pressure is a combination of alveolar and intrapleural pressure OOOOOOOOOOOOOOO. Fall in intrapleural pressure during inspiration is due to a fall in the elastic recoil PPPPPPPPPPPPPPP. With forced expiration, the intrapleural pressure exceeds zero. TTFFT 77. Regarding lung compliance QQQQQQQQQQQQQQQ. normally 0.2 L/ cm H2O RRRRRRRRRRRRRRR. dynamic compliance is usually measured at the end of inspiration during intermittent positive

pressure ventilation SSSSSSSSSSSSSSS. increased in emphysema TTTTTTTTTTTTTTT. low lung compliance is associated with rapid and shallow respiration UUUUUUUUUUUUUUU. the compliance is different at apical and basal of the lungs TFTTT 78. During intrauterine life, VVVVVVVVVVVVVVV. all the fetal blood returning from the placenta flows directly into inferior vena cava WWWWWWWWWWWWWWW. fetal blood carries more oxygen than maternal blood at low PO2 XXXXXXXXXXXXXXX. umbilical venous blood has a PO2 of 30-40 mmHg YYYYYYYYYYYYYYY. blood on the right side of the fetal heart is better oxygenated than that on the left side ZZZZZZZZZZZZZZZ. pulmonary vascular resistance is higher than after birth FFTTF 79. The pathways of pain sensation include AAAAAAAAAAAAAAAA. a-delta fibres which terminate in lamina 1 of the dorsal horn BBBBBBBBBBBBBBBB. second order neurons which ascend in the ipsilateral spinothalamic tra CCCCCCCCCCCCCCCC. c fibres which release histamine and serotonin DDDDDDDDDDDDDDDD. synapses in the substantia nigra of the spinal cord EEEEEEEEEEEEEEEE. descending pathways in the dorsolateral colums TFFFT 80. Regarding drug administration : FFFFFFFFFFFFFFFF. Sublingual route avoids firstpass inactivation in the liver GGGGGGGGGGGGGGGG. Suppositories expose the drug

to first-pass metabolism HHHHHHHHHHHHHHHH. Distribution of nebulised drug in the respiratory tree depends on the particle size IIIIIIIIIIIIIIII. Highly water soluble drugs are administered by transdermal route JJJJJJJJJJJJJJJJ. Drugs given by oral route should have a very high exraction ratio TFTFF 81. Regarding protein binding of drugs in plasma : KKKKKKKKKKKKKKKK. Highly protein bound drugs have a longer biological half-life LLLLLLLLLLLLLLLL. Protein binding is different markedly in arterial and venous blood MMMMMMMMMMMMMMMM. Free drug concentration is not altered in hypoalbuminaemics states

- 13 -

NNNNNNNNNNNNNNNN. Alpha-1 acid glycoprotein principally binds to basic drugs OOOOOOOOOOOOOOOO. Greater the protein binding, lesser is the volume of distribution TFFTT 82. First-order processes PPPPPPPPPPPPPPPP. apply to enzyme- mediated reactions QQQQQQQQQQQQQQQQ. are characterized by high rates of reaction when the concentrations of reacting substances are high. RRRRRRRRRRRRRRRR. can properly be described in terms of t1/2 SSSSSSSSSSSSSSSS. are involved in elimination of most drugs TTTTTTTTTTTTTTTT. change to zero-order kinetic at very high drug doses TTFTT 83. The following statements about drug half-life are correct : UUUUUUUUUUUUUUUU. Half -life of a drug is shorter than its time constant VVVVVVVVVVVVVVVV. Drug given by infusion without a bolus reach a steady state in five half-lives WWWWWWWWWWWWWWWW. Extent of drug distribution into extracellular fluid is unlikely to affect t1/2. XXXXXXXXXXXXXXXX. Context sensitive half-life can be use for any drug YYYYYYYYYYYYYYYY. About 94% of a drug is cleared of the body in four half-lives TTFFT 84. Regarding of bio-availability of drugs : ZZZZZZZZZZZZZZZZ. Is indicated by area under the plasma concentration - curve time AAAAAAAAAAAAAAAAA. Bio-availability of intravenous drug must be less than 100% BBBBBBBBBBBBBBBBB. Is reduced by destruction of drug in the gut CCCCCCCCCCCCCCCCC. Is reduced by metabolism of drug in the liver DDDDDDDDDDDDDDDDD. Is greater by sublingual route than enteral route. TFTTT 85. A competitive antagonist EEEEEEEEEEEEEEEEE. combines with the same receptor as the agonist drug FFFFFFFFFFFFFFFFF. shift the log dose response curve for the

agonist to the right GGGGGGGGGGGGGGGGG. depresses the maximum obtainable response of the agonist HHHHHHHHHHHHHHHHH.will affect the affinity of the agonist for its receptor IIIIIIIIIIIIIIIII. need not have a close structural similarity to the agonist TTFFT 86. The following drugs are excreted largely unchanged by the kidney : KKKKKKKKKKKKKKKKK. Morphine LLLLLLLLLLLLLLLLL. Propofol MMMMMMMMMMMMMMMMM. Levo-bupivacaine NNNNNNNNNNNNNNNNN. Vecuronium FFFFF 87. Factors which affect the peak effect of intravenous anaesthetics include OOOOOOOOOOOOOOOOO. OOOOOOOOOOOOOOOOO. PPPPPPPPPPPPPPPPP. volume of distribution dose administered JJJJJJJJJJJJJJJJJ. ocaine Lign

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QQQQQQQQQQQQQQQQQ. hepatic clearance RRRRRRRRRRRRRRRRR. rate of injection SSSSSSSSSSSSSSSSS. cardiac output TFFTT 88. Regarding propofol : TTTTTTTTTTTTTTTTT. Is insoluble in water UUUUUUUUUUUUUUUUU. Is bound to albumin up to 97-98 % VVVVVVVVVVVVVVVVV. Reduces sodium channel opening times in neuronal membranes WWWWWWWWWWWWWWWWW. Is hypertonic XXXXXXXXXXXXXXXXX. Does not cause tachycardia TTTFT 89. Ketamine YYYYYYYYYYYYYYYYY. binding to NMDA receptors ZZZZZZZZZZZZZZZZZ. has marked analgesic properties mediated by its

causes a fall in cardiac output and a rise in heart rate AAAAAAAAAAAAAAAAAA. is contraindicated in patients with raised intracranial pressure BBBBBBBBBBBBBBBBBB. has active metabolites CCCCCCCCCCCCCCCCCC. causes postoperative dreaming and hallucinations which is less frequent in children TFTTT 90. Regarding Midazolam : DDDDDDDDDDDDDDDDDD. Has t 1/2 of less than 2 hours EEEEEEEEEEEEEEEEEE. Is water soluble at pH of 6 FFFFFFFFFFFFFFFFFF. Has an active metabolite GGGGGGGGGGGGGGGGGG. Can have a prolonged effect if it given with erythromycin HHHHHHHHHHHHHHHHHH. Bioavailability following intramuscular injection is 90 % TFTTT 91. Regarding inhalational agents : IIIIIIIIIIIIIIIIII. The blood gas partition co-efficient of desflurane is 0.42 JJJJJJJJJJJJJJJJJJ. Desflurane will cause sympathetic

stimulation KKKKKKKKKKKKKKKKKK. Sevoflurane can degrade to compound A in soda lime LLLLLLLLLLLLLLLLLL. Desflurane is suitable for inhalational induction MMMMMMMMMMMMMMMMMM. Desflurane can be used in halothane vaporizer TTTFF 92. The speed of induction with inhalational agents NNNNNNNNNNNNNNNNNN. Is quicker in patients with high FRC OOOOOOOOOOOOOOOOOO. Is quicker if

the agent is very soluble in blood PPPPPPPPPPPPPPPPPP. Is slower in the presence of right to left shunt QQQQQQQQQQQQQQQQQQ. Is unchanged in the presence of left to right shunt with normal systemic flow RRRRRRRRRRRRRRRRRR. Is quicker when used with nitrous oxide FFTTT 93. Nitrous oxide SSSSSSSSSSSSSSSSSS. TTTTTTTTTTTTTTTTTT. centigrade is stored as liquid is a gas above a temperature of 36 degree

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UUUUUUUUUUUUUUUUUU. cylinders should have filling ratio of 0.65-0.75 VVVVVVVVVVVVVVVVVV. content in a cylinder is always reflected from its pressure gauge WWWWWWWWWWWWWWWWWW. is 34 times less soluble than N2. TTTTF 94. Regarding opioid receptors : XXXXXXXXXXXXXXXXXX. Morphine acts on kappa receptors YYYYYYYYYYYYYYYYYY. The effect of stimulation of sigma receptors is dysphoria and hallucination ZZZZZZZZZZZZZZZZZZ. Euphoria is due to stimulation of delta receptors AAAAAAAAAAAAAAAAAAA. Nalorphine antagonizes kappa receptors BBBBBBBBBBBBBBBBBBB. Pentazocine is partial agonist TTFFT 95. Pethidine CCCCCCCCCCCCCCCCCCC. is structurally related to morphine DDDDDDDDDDDDDDDDDDD. onset of analgesic activity after intramuscular injection is 35 minutes EEEEEEEEEEEEEEEEEEE. in equianalgesic doses, pethidine and morphine produce equal amount of sedation FFFFFFFFFFFFFFFFFFF. respiratory depression caused by it can be antagonized by nalorphine GGGGGGGGGGGGGGGGGGG. about 60% is bound to plasma proteins TFFTF 96. Regarding narcotic antagonists : HHHHHHHHHHHHHHHHHHH. Nalorphine induces antidiuretic effect IIIIIIIIIIIIIIIIIII. Naloxone is one-fifth as potent as

nalorphine JJJJJJJJJJJJJJJJJJJ. Naloxone precipitates a withdrawal syndrome after chronic doses of pentazocine KKKKKKKKKKKKKKKKKKK. Naloxone is metabolized and excreted by the kidneys LLLLLLLLLLLLLLLLLLL. Naloxone is one-fifth as potent when given orally as compared with parenteral administration FFTFF 97. Rocuronium MMMMMMMMMMMMMMMMMMM. is an aminostereroid NNNNNNNNNNNNNNNNNNN. is stable in aqueous solution OOOOOOOOOOOOOOOOOOO. undergoes principally hepatic

elimination PPPPPPPPPPPPPPPPPPP. has provide intubating conditions within 60 seconds QQQQQQQQQQQQQQQQQQQ. It release histamine TTTTF 98. Glycopyrrolate RRRRRRRRRRRRRRRRRRR. can act at central cholinergic receptors SSSSSSSSSSSSSSSSSSS. can increase the physiological dead space TTTTTTTTTTTTTTTTTTT. dilate the pupil UUUUUUUUUUUUUUUUUUU. is equally effective when given orally VVVVVVVVVVVVVVVVVVV. is five times potent as antisialagogue than atropine FTFFT 99. Adrenaline WWWWWWWWWWWWWWWWWWW. is a bronchodilator

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XXXXXXXXXXXXXXXXXXX. is released in postsynaptic sympathetic nerve endings YYYYYYYYYYYYYYYYYYY. differs from noradrenaline by having an extra methyl group ZZZZZZZZZZZZZZZZZZZ. is commonly used with local anesthetics in a concentration of 1 : 80,00 AAAAAAAAAAAAAAAAAAAA. will elevate the blood sugar TFTFT 100.Morphine BBBBBBBBBBBBBBBBBBBB. is a phenanthrene derivative CCCCCCCCCCCCCCCCCCCC. is the analgesic of choice in biliary colic DDDDDDDDDDDDDDDDDDDD. has an anticholinergic effect EEEEEEEEEEEEEEEEEEEE. decreases intracranial pressure FFFFFFFFFFFFFFFFFFFF. is a good anticonvulsant TFTFF 101.Atropine GGGGGGGGGGGGGGGGGGGG. increase the risk of regurgitation HHHHHHHHHHHHHHHHHHHH. is contraindicated intravenously in glaucoma IIIIIIIIIIIIIIIIIIII. causes hyperthermia JJJJJJJJJJJJJJJJJJJJ. is equipotent with hyoscine as antisialogogue KKKKKKKKKKKKKKKKKKKK. dose of 2-3 mg intravenously block the vagal nerve completely TFTFT 102.Regarding phenoxybenzamine LLLLLLLLLLLLLLLLLLLL. Blocks ?2-receptors more than ?1-receptors MMMMMMMMMMMMMMMMMMMM. Is a non-

competitive antagonist NNNNNNNNNNNNNNNNNNNN. Causes reflex tachycardia OOOOOOOOOOOOOOOOOOOO. Reduces supine blood pressure in normal subjects PPPPPPPPPPPPPPPPPPPP. Elimination half life is 24 hours FTTTT 103.Drugs readily cross the blood-brain barrier QQQQQQQQQQQQQQQQQQQQ. Mannitol RRRRRRRRRRRRRRRRRRRR. Physostigmin e

SSSSSSSSSSSSSSSSSSSS. Glycopyrollate TTTTTTTTTTTTTTTTTTTT. Atracurium UUUUUUUUUUUUUUUUUUUU. Propofol FTFFT 104.Regarding frusemide VVVVVVVVVVVVVVVVVVVV. Primary site of action is in the loop of Henle WWWWWWWWWWWWWWWWWWWW. Causes

hyperuricaemia XXXXXXXXXXXXXXXXXXXX. Enhances the excretion of calcium YYYYYYYYYYYYYYYYYYYY. Hyponatraemic acidosis is the adverse effect ZZZZZZZZZZZZZZZZZZZZ. 80% is excreted in the urine as unchanged TTTFT 105.The volume of distribution of a drug AAAAAAAAAAAAAAAAAAAAA. refers to the peripheral compartment of the two-compartment model

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BBBBBBBBBBBBBBBBBBBBB. concentration of drug CCCCCCCCCCCCCCCCCCCCC. blood DDDDDDDDDDDDDDDDDDDDD. EEEEEEEEEEEEEEEEEEEEE. FTTTF 106.Concerning sulphonylureas

makes the assumption that there is a uniform is calculated using the measured concentration in the is affected by differential regional blood flow is high in hydrophilic drugs

FFFFFFFFFFFFFFFFFFFFF. Act mainly by increasing the secretion of insulin GGGGGGGGGGGGGGGGGGGGG. Reduce plasma

cholesterol level HHHHHHHHHHHHHHHHHHHHH. Highly protein-bound IIIIIIIIIIIIIIIIIIIII. Increase the peripheral uptake of the glucose JJJJJJJJJJJJJJJJJJJJJ. Cause cholestatic jaundice TTTFT 107.Regarding drug metabolism KKKKKKKKKKKKKKKKKKKKK. Morphine forms a conjugated glucuronide LLLLLLLLLLLLLLLLLLLLL. Phenytoin is a drug metabolism

inducer MMMMMMMMMMMMMMMMMMMMM. Laudanosine is produced by Hofmann degradation of atracurium NNNNNNNNNNNNNNNNNNNNN. Pethidine metabolism requires catechol-omethyltransferase OOOOOOOOOOOOOOOOOOOOO. Hydrolysis is a phase II of drug metabolism TTTFF 108.The substances that cannot pass through cell membrane easily are PPPPPPPPPPPPPPPPPPPPP. PPPPPPPPPPPPPPPPPPPPP. All ions including hydrogen ions! QQQQQQQQQQQQQQQQQQQQQ. Mid to large polar molecules including glucose RRRRRRRRRRRRRRRRRRRRR. Amino acids SSSSSSSSSSSSSSSSSSSSS. Macromolecules such as proteins, polysaccharides TTTTTTTTTTTTTTTTTTTTT. oxygen TTTTF 109.The Passive transport mechanisms are UUUUUUUUUUUUUUUUUUUUU. Simple diffusion VVVVVVVVVVVVVVVVVVVVV. Osmosis WWWWWWWWWWWWWWWWWWWWW. Facilitated Diffusion eg Simple protein channels XXXXXXXXXXXXXXXXXXXXX. Endocytosis YYYYYYYYYYYYYYYYYYYYY. Bulk flow mechanisms TTTFF 110.When considering the uptake of a volatile anaesthetic agent ZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZ.

the rate of uptake is increased if ventilation increases AAAAAAAAAAAAAAAAAAAAAA. induction is more rapid if cardiac output decreases BBBBBBBBBBBBBBBBBBBBBB. induction is less rapid with less soluble agent

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CCCCCCCCCCCCCCCCCCCCCC. the effect of changing cardiac output on the rate of uptake Will be greater with a more soluble agent DDDDDDDDDDDDDDDDDDDDDD.the second-gas effect allows the maintenance concentration of TTFTF 111.Clonidine EEEEEEEEEEEEEEEEEEEEEE. is a partial agonist at ?2-adrenoceptors FFFFFFFFFFFFFFFFFFFFFF. cause hypertension if infused intravenously GGGGGGGGGGGGGGGGGGGGGG. is well absorbed when taken orally HHHHHHHHHHHHHHHHHHHHHH.anxiety is an important side-effect IIIIIIIIIIIIIIIIIIIIII. reduces cardiac contractility TFTFF 112.Recognised non-respiratory functions of the lung include JJJJJJJJJJJJJJJJJJJJJJ. activation of angiotensin I KKKKKKKKKKKKKKKKKKKKKK.metabolism of circulating adenine nucleotides LLLLLLLLLLLLLLLLLLLLLL. the synthesis of circulating kallikrein MMMMMMMMMMMMMMMMMMMMMM. the inactivation of circulating bradykinin NNNNNNNNNNNNNNNNNNNNNN.the inactivation of circulating adrenaline TTTTF 113.The actions of non-depolarising neuromuscular blocking drugs OOOOOOOOOOOOOOOOOOOOOO. OOOOOOOOOOOOOOOOOOOOOO. potentiated by inhalational anaesthetic vapours PPPPPPPPPPPPPPPPPPPPPP. when given in repeated doses can be described as dual block QQQQQQQQQQQQQQQQQQQQQQ.Attenuated by intraperitoneal tobramycin RRRRRRRRRRRRRRRRRRRRRR. potentiated in patients with multiple neurofibromatosis SSSSSSSSSSSSSSSSSSSSSS. Attenuated in hypoproteinaemia TFFTF 114.Regarding NMBlockade TTTTTTTTTTTTTTTTTTTTTT. ED95 represents the potency of NMB drug in the presence of N20-barbiturate opioid anesthesia UUUUUUUUUUUUUUUUUUUUUU. NMB drugs affect small muscles before diaphragm VVVVVVVVVVVVVVVVVVVVVV.Adductor pollicis monitoring is a poor indicator of laryngeal relaxation WWWWWWWWWWWWWWWWWWWWWW. TOF stimulation reflects events in the post junctional membrane XXXXXXXXXXXXXXXXXXXXXX.A single twitch response evoked reflects events in TTTFF 115.Pulmonary surfactant YYYYYYYYYYYYYYYYYYYYYY. increases surface tension differentially in differently sized alveoli ZZZZZZZZZZZZZZZZZZZZZZ. helps prevent pulmonary

oedema AAAAAAAAAAAAAAAAAAAAAAA. increases alveolar ciliary motion BBBBBBBBBBBBBBBBBBBBBBB. aids diffusion from the alveolus to the pulmonary capillary CCCCCCCCCCCCCCCCCCCCCCC. is secreted by the type II alveolar cells FTFFT

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116.Pulmonary vascular resistance in adults

DDDDDDDDDDDDDDDDDDDDDDD. is increased in chronic hypoxia EEEEEEEEEEEEEEEEEEEEEEE. has a value approximately one-sixth that of the systemic circulation FFFFFFFFFFFFFFFFFFFFFFF. can be measured using a flow-directed balloon catheter with a thermistor tip GGGGGGGGGGGGGGGGGGGGGGG. is decreased by isoprenaline HHHHHHHHHHHHHHHHHHHHHHH. is decreased by 5-hydroxytryptamine (5-HT) TTT?T

117.In the local regulation of the microcirculation

IIIIIIIIIIIIIIIIIIIIIII. Autoregulation occurs in most vascular beds JJJJJJJJJJJJJJJJJJJJJJJ. Potassium causes

vasoconstriction KKKKKKKKKKKKKKKKKKKKKKK. Endothelin is an extremely potent vasoconstrictor LLLLLLLLLLLLLLLLLLLLLLL. Endothelium-derived relaxing factor is nitric oxide MMMMMMMMMMMMMMMMMMMMMMM. Adenosine produces endotheliumindependent relaxation of vascular smooth muscle TFTTT 118.The volume of distribution of a drug NNNNNNNNNNNNNNNNNNNNNNN. refers to the peripheral compartment of the two-compartment model OOOOOOOOOOOOOOOOOOOOOOO. makes the assumption that there is a uniform concentration of drug PPPPPPPPPPPPPPPPPPPPPPP. is calculated using the measured concentration in the blood or plasma QQQQQQQQQQQQQQQQQQQQQQQ. is affected by differential regional blood flow RRRRRRRRRRRRRRRRRRRRRRR. will be relatively low if hydrophilic and extensively bound to plasma proteins FTTTT 119.Frusemide SSSSSSSSSSSSSSSSSSSSSSS. has its primary site of action in the loop of Henle TTTTTTTTTTTTTTTTTTTTTTT. commonly causes hyperuricaemia UUUUUUUUUUUUUUUUUUUUUUU. enhances the excretion of calcium VVVVVVVVVVVVVVVVVVVVVVV. hyponatraemic acidosis is the adverse effect WWWWWWWWWWWWWWWWWWWWWWW. reduces the efficacy of concurrently prescribed lithium TTTFF 120.The volume of distribution of a drug XXXXXXXXXXXXXXXXXXXXXXX. refers to the peripheral compartment of the two-compartment model YYYYYYYYYYYYYYYYYYYYYYY. makes the assumption that there is a uniform concentration of drug ZZZZZZZZZZZZZZZZZZZZZZZ. is calculated using the measured concentration in the blood or plasma AAAAAAAAAAAAAAAAAAAAAAAA. is affected by differential regional blood flow BBBBBBBBBBBBBBBBBBBBBBBB. will be relatively low if hydrophilic and extensively bound to plasma proteins FTTTT 121.Sodium nitroprusside CCCCCCCCCCCCCCCCCCCCCCCC. the intraoperative dose range is 0.5-6 mg/kg/min

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DDDDDDDDDDDDDDDDDDDDDDDD. metabolism to cynide occurs non-enzymetically in blood EEEEEEEEEEEEEEEEEEEEEEEE. metabolism produces thiocynate which is excreted in urine FFFFFFFFFFFFFFFFFFFFFFFF. it produces dilation predominantly of resistance vessels GGGGGGGGGGGGGGGGGGGGGGGG. reduces renal blood flow FTTFF 122.Regarding amiodarone HHHHHHHHHHHHHHHHHHHHHHHH. prolongs action potential duration in SA node IIIIIIIIIIIIIIIIIIIIIIII. shorten repolarisation in AV node JJJJJJJJJJJJJJJJJJJJJJJJ. cause photosensitivity KKKKKKKKKKKKKKKKKKKKKKKK. will have effect on thyroid function on long treatment LLLLLLLLLLLLLLLLLLLLLLLL. slows conduction velocity in His-purkinjee system TFTTT 123.With regard to local anaesthetics: MMMMMMMMMMMMMMMMMMMMMMMM. act by preventing sodium acces to the axon interior by occupying the transmembrane sodium channel NNNNNNNNNNNNNNNNNNNNNNNN. Bupivacaine carbonate compared to bupivacaine hydrochloride has a longer onset of action and less intense block OOOOOOOOOOOOOOOOOOOOOOOO. The shortest duration of action of local anaesthetics follows intrathecal injection, the longest durations follow major peripheral nerve blocks PPPPPPPPPPPPPPPPPPPPPPPP. Prilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine QQQQQQQQQQQQQQQQQQQQQQQQ. The Cm of lignocaine is less than of bupivacaine TFTFF 124.Ropivacaine RRRRRRRRRRRRRRRRRRRRRRRR. is a pure R enantiomer SSSSSSSSSSSSSSSSSSSSSSSS. is more cardiotoxic than bupivacaine TTTTTTTTTTTTTTTTTTTTTTTT. produces a motor block of more pronounced degree and duration than bupivacaine UUUUUUUUUUUUUUUUUUUUUUUU. gives rise to a sensory block that is similar to bupivacaine VVVVVVVVVVVVVVVVVVVVVVVV. is more lipid soluble than bupivacaine FFFTF 125.Regarding antiemetic drugs WWWWWWWWWWWWWWWWWWWWWWWW. Tho se which act as antidopaminergic agents can cause extrapyramidal symptoms XXXXXXXXXXXXXXXXXXXXXXXX. Domperidone reduces vomiting by an antiserotonin action YYYYYYYYYYYYYYYYYYYYYYYY. Extrapyramidal symptoms after administration of droperidol are unlikely 6 hours after administration ZZZZZZZZZZZZZZZZZZZZZZZZ. Phenothiazine reduce nausea and vomiting by anti dopaminergic, antihistamine and antimuscarinic actions AAAAAAAAAAAAAAAAAAAAAAAAA. Metoclopramide and cyclizine have primarily anticholinergic actions. TFFTF 126.Of the sympathomimetic drugs BBBBBBBBBBBBBBBBBBBBBBBBB. alpha-2 adrenergic drugs stimulate noradrenaline release

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CCCCCCCCCCCCCCCCCCCCCCCCC. beta-2 adrenergic drugs stimulate glycogenolysis and gluconeogenesis DDDDDDDDDDDDDDDDDDDDDDDDD. alpha-1 agonists decrease intracellular calcium EEEEEEEEEEEEEEEEEEEEEEEEE. adrenaline has alpha-1 and alpha -2 actions and beta-1 and beta-2 actions FFFFFFFFFFFFFFFFFFFFFFFFF. beta-2 agonists cause uterine relaxation FTFTT 127.Regarding diuretics GGGGGGGGGGGGGGGGGGGGGGGGG. Frusemide inhibits the chloride reabsorption in the distal tubules HHHHHHHHHHHHHHHHHHHHHHHHH. Thiazides causes hypokalaemic acidosis IIIIIIIIIIIIIIIIIIIIIIIII. Ethacrynic acid increases the excretion of potassium and hydrogen ion JJJJJJJJJJJJJJJJJJJJJJJJJ. Xanthines decrease the glomerular filtration rate KKKKKKKKKKKKKKKKKKKKKKKKK. Duration of action of frusamide will last for 4 hours FFTFT 128.Regarding esmolol LLLLLLLLLLLLLLLLLLLLLLLLL. is beta-1 selective blocker MMMMMMMMMMMMMMMMMMMMMMMMM. has an elimination half-life of 9 minutes NNNNNNNNNNNNNNNNNNNNNNNNN. is metabolise by plasma pseudocholinesterase OOOOOOOOOOOOOOOOOOOOOOOOO. has histamine release PPPPPPPPPPPPPPPPPPPPPPPPP. is useful in management of supraventicular arrhytmias TTFFT 129.Drugs actions on the cardiovascular system include QQQQQQQQQQQQQQQQQQQQQQQQQ. QQQQQQQQQQQQQQQQQQQQQQQQQ. adrenaline causes alpha and beta-1 and beta-2 stimulation, while noradrenaline stimulates alpha and beta-1 not beta-2 activity RRRRRRRRRRRRRRRRRRRRRRRRR. isoprenaline has more beta than alpha effect on the heart SSSSSSSSSSSSSSSSSSSSSSSSS. dopamine increases peripheral resistance, dobutamine reduces it TTTTTTTTTTTTTTTTTTTTTTTTT. dopexamine causes dilatation of renal, cerebral, coronary and mesenteric beds UUUUUUUUUUUUUUUUUUUUUUUUU. nitroglycerine causes mainly arterial vasodilatation, nitroprusside mainly venous dilatation TTTTF 130.Heparin VVVVVVVVVVVVVVVVVVVVVVVVV.has molecular weight between 300060,000 daltons WWWWWWWWWWWWWWWWWWWWWWWWW. acts by binding to antithrombin III XXXXXXXXXXXXXXXXXXXXXXXXX. has antiplatetelet activity YYYYYYYYYYYYYYYYYYYYYYYYY. prolongs the prothrombin time ZZZZZZZZZZZZZZZZZZZZZZZZZ. has a shorter duration of action than low molecular weight heparin TTTFT 131.The factors affecting the rate of transport of a drug across the placenta are AAAAAAAAAAAAAAAAAAAAAAAAAA. degree of ionization

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BBBBBBBBBBBBBBBBBBBBBBBBBB. degree of protein binding CCCCCCCCCCCCCCCCCCCCCCCCCC. placental blood flow DDDDDDDDDDDDDDDDDDDDDDDDDD. pK of the drug EEEEEEEEEEEEEEEEEEEEEEEEEE. lipid solubility of the drug TTFTT 132.Oxygen is transport from the alveoli into the blood in pulmonary capillaries by FFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFFFFFFFFFFFFFFFFFFF. GGGGGGGGGGGGGGGGGGGGGGGGGG. Passive diffusion HHHHHHHHHHHHHHHHHHHHHHHHHH. Facilitated diffusion IIIIIIIIIIIIIIIIIIIIIIIIII. Active transport JJJJJJJJJJJJJJJJJJJJJJJJJJ. Secondary active transport FTFFF 133.In the conducting system of the heart KKKKKKKKKKKKKKKKKKKKKKKKKK. The SA node develops from the structures on the right side of the embryo LLLLLLLLLLLLLLLLLLLLLLLLLL. His-purkinje have the fastest conduction velocities in the heart MMMMMMMMMMMMMMMMMMMMMMMMMM.Atrial conduction is slowed by a decrease in temperature NNNNNNNNNNNNNNNNNNNNNNNNNN. The PR interval represents the duration of atrial depolarization OOOOOOOOOOOOOOOOOOOOOOOOOO. Final repolarization is due to activation of calcium channels TTTFF 134.Regarding coronary blood flow PPPPPPPPPPPPPPPPPPPPPPPPPP. The main blood supply to the AV node is from right coronary artery QQQQQQQQQQQQQQQQQQQQQQQQQQ. Mean arterial pressure is more determinant of myocardial blood flow than arterial diastolic pressure RRRRRRRRRRRRRRRRRRRRRRRRRR. Myocardial oxygen consumption and coronary blood flow bear a linear relationship SSSSSSSSSSSSSSSSSSSSSSSSSS. Coronary blood flow will be improved by slowing the heart rate TTTTTTTTTTTTTTTTTTTTTTTTTT. Normal myocardial oxygen extraction ratio is 70 %. TFTTT 135.In normal healthy man at rest in the supine position UUUUUUUUUUUUUUUUUUUUUUUUUU. UUUUUUUUUUUUUUUUUUUUUUUUUU. left ventricular end diastolic volume is about 20 mls. VVVVVVVVVVVVVVVVVVVVVVVVVV. the first heart sound coincides with the onset of ventricular systole WWWWWWWWWWWWWWWWWWWWWWWWWW. cardiac output is approximately 75mls/beat XXXXXXXXXXXXXXXXXXXXXXXXXX. left ventricular end diastolic pressure ( LVEDP . is about 5 mmHg YYYYYYYYYYYYYYYYYYYYYYYYYY. the second heart sound coincides with end of T wave of ECG FTTTT Filtration

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136.Regarding the autoregulatory mechanisms in acute hypovolaemia ZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZZZZZZ. an increase in sympathetic activity AAAAAAAAAAAAAAAAAAAAAAAAAAA.an increase in capillary hydrostatic pressure BBBBBBBBBBBBBBBBBBBBBBBBBBB. a decrease in baroreceptor activity CCCCCCCCCCCCCCCCCCCCCCCCCCC. an increase in arteriovenous oxygen content difference DDDDDDDDDDDDDDDDDDDDDDDDDDD.an increase in angiotension II. TFTFT 137.In normal resting condition , a bradycardia would be expected to occur following EEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEEEEEEEEEEEEEEEEEEEE. incr eased carotid sinus pressure FFFFFFFFFFFFFFFFFFFFFFFFFFF. increased right atrial pressure GGGGGGGGGGGGGGGGGGGGGGGGGGG.application of pressure of the eye ball HHHHHHHHHHHHHHHHHHHHHHHHHHH.following the release of a valsalva manoeuvre IIIIIIIIIIIIIIIIIIIIIIIIIII. expiration TTTTF 138.Acetylcholine is the neurotransmitter at JJJJJJJJJJJJJJJJJJJJJJJJJJJ. sympathetic nerve terminal supplying the heart KKKKKKKKKKKKKKKKKKKKKKKKKKK. sym pathetic nerve terminal at the adrenal medulla LLLLLLLLLLLLLLLLLLLLLLLLLLL. parasympathetic nerve terminal supplying the lacrimal gland MMMMMMMMMMMMMMMMMMMMMMMMMMM. sympathetic nerve terminal supplying sweat gland NNNNNNNNNNNNNNNNNNNNNNNNNNN.sympathetic ganglia FTTTT 139.Concerning glomerular filtration OOOOOOOOOOOOOOOOOOOOOOOOOOO. Nor mally about 20% of renal plasma flow PPPPPPPPPPPPPPPPPPPPPPPPPPP. GFR is directly proportional to systemic arterial pressure QQQQQQQQQQQQQQQQQQQQQQQQQQQ.Tubular function is more important than GFR in determining the rate of urine production RRRRRRRRRRRRRRRRRRRRRRRRRRR. Blood in efferent arteriole is more viscous than that in afferent arteriole SSSSSSSSSSSSSSSSSSSSSSSSSSS. Glomerular filtration is a type of ultrafiltration TFFFT 140.The anion gap TTTTTTTTTTTTTTTTTTTTTTTTTTT. Is calculated from plasma concentration of sodium, bicarbonate and phosphate UUUUUUUUUUUUUUUUUUUUUUUUUUU. The normal value is between 15-18 mmol/l VVVVVVVVVVVVVVVVVVVVVVVVVVV.Is normal in renal tubular acidosis WWWWWWWWWWWWWWWWWWWWWWWWWWW. High in aspirin overdose XXXXXXXXXXXXXXXXXXXXXXXXXXX.Is decreased when plasma albumin is decreased FFTTT

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141.Concerning of blood coagulation :

YYYYYYYYYYYYYYYYYYYYYYYYYYY. Fibr inogen is present in low concentrations in patients with liver disease ZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Calcium ions are required to convert fibrin monomer to fibrin threads AAAAAAAAAAAAAAAAAAAAAAAAAAAA. Heparin is secreted by circulating eosinophil cells. BBBBBBBBBBBBBBBBBBBBBBBBBBBB. Haemophiliacs have a lack of factor VIII and IX CCCCCCCCCCCCCCCCCCCCCCCCCCCC. Normal prothrombin time is between 20s and 30s. TTFTF

142.Regarding the passage of glomerular filtrate through the renal tubules : DDDDDDDDDDDDDDDDDDDDDDDDDDDD. DDDDDDDDDDDDDDDDDDDDDD DDDDDD. Thick ascending limb of loop dilutes the filtrates by its powerful sodium pumps EEEEEEEEEEEEEEEEEEEEEEEEEEEE. A substance suitable for measuring glomerular filtration rate should be absorbed or secreted by tubules FFFFFFFFFFFFFFFFFFFFFFFFFFFF. Distal tubule is normally impermeable to water GGGGGGGGGGGGGGGGGGGGGGGGGGGG. Glucose is absent in the filtrate in Loop of Henle HHHHHHHHHHHHHHHHHHHHHHHHHHHH. Sodium concentration in descending limb of loop is same as that in distal convulated tubule TFTTF 143.Thyroid hormones will IIIIIIIIIIIIIIIIIIIIIIIIIIII. sensitize the myocardium to catecholamines JJJJJJJJJJJJJJJJJJJJJJJJJJJJ. lower the plasma cholesterol KKKKKKKKKKKKKKKKKKKKKKKKKKKK. increase the formation of messenger RNAs LLLLLLLLLLLLLLLLLLLLLLLLLLLL. reduce albumin synthesis MMMMMMMMMMMMMMMMMMMMMMMMMMMM. iodine is absorbed from gastrointestinal tract in ionized form TTTFT 144.Insulin secretion NNNNNNNNNNNNNNNNNNNNNNNNNNNN. is about 1-2 U/ hour in the basal state OOOOOOOOOOOOOOOOOOOOOOOOOOOO. is increased 5-10 times following ingestion of food PPPPPPPPPPPPPPPPPPPPPPPPPPPP. is increased by glucagons QQQQQQQQQQQQQQQQQQQQQQQQQQQQ. is depressed in starvation RRRRRRRRRRRRRRRRRRRRRRRRRRRR. is increased in perioperative period TTTTF 145.Motility of the gastrointestinal tract is increased by SSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSS.

vagal blockade TTTTTTTTTTTTTTTTTTTTTTTTTTTT. mechanical obstruction UUUUUUUUUUUUUUUUUUUUUUUUUUUU. stimulation of splanchnic nerves VVVVVVVVVVVVVVVVVVVVVVVVVVVV. pregnancy WWWWWWWWWWWWWWWWWWWWWWWWWWWW. neostigmine FTFFT

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146.Regarding the neuromuscular junction:

XXXXXXXXXXXXXXXXXXXXXXXXXXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXX.

The synaptic cleft is about 50-70 nm wide YYYYYYYYYYYYYYYYYYYYYYYYYYYY. The postjunctional membrane is thrown into folds ZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Acetylcholine receptor has five protein subunits AAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Two alpha subunits of acetylcholine receptor have to be activated for the channel to open BBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Acetylcholine is synthesized from choline and acetic acid TTTTF 147.The liver CCCCCCCCCCCCCCCCCCCCCCCCCCCCC. receives most of its blood supply from the portal vein DDDDDDDDDDDDDDDDDDDDDDDDDDDDD. involve in vasopressin metabolism and inactivation EEEEEEEEEEEEEEEEEEEEEEEEEEEEE. produces heparin FFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has a normal portal venous pressure of greater than 20mmHg GGGGGGGGGGGGGGGGGGGGGGGGGGGGG. receives approximately 25% of the cardiac output TTFFT 148.Regarding cerebral blood flow : HHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Brai n receives 15% of cardiac output IIIIIIIIIIIIIIIIIIIIIIIIIIIII. Cerebral blood flow rises by

2% for each mm rise in PaCO2 JJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Volatile anaesthetics reduce cerebral blood flow KKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Volatile anaesthetics can impair the autoregulation of cerebral blood flow LLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Cerebral blood flow is relatively constant between CPP of 50-150 mmHg. TTFTT 149.Regarding cerebrospinal fluid ( CSF . : MMMMMMMMMMMMMMMMMMMMMMMMMMMMM. MMMMMMMMMMMMMM MMMMMMMMMMMMMMM. Normal specific gravity is between 1.003 and 1.009 NNNNNNNNNNNNNNNNNNNNNNNNNNNNN. The rate of formation is increased if the intracranial pressure rises. OOOOOOOOOOOOOOOOOOOOOOOOOOOOO. The pressure normally alters with respiration. PPPPPPPPPPPPPPPPPPPPPPPPPPPPP. CSF glucose level is independent on plasma glucose level QQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. CSF flow will passes into dural venous sinuses via arachnoid villi. TFTFT 150.A shift of the oxygen dissociation curve to the right RRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRR. is associated with Bohr effect in hypercapnia. SSSSSSSSSSSSSSSSSSSSSSSSSSSSS. is favoured by a rise in temperature

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TTTTTTTTTTTTTTTTTTTTTTTTTTTTT. favours the passage of oxygen from blood to tissues UUUUUUUUUUUUUUUUUUUUUUUUUUUUU. occurs when fetal blood is replaced by adult blood VVVVVVVVVVVVVVVVVVVVVVVVVVVVV. occurs in stored blood TTTTF 151.In cell metabolism WWWWWWWWWWWWWWWWWWWWWWWWWWWWW. 1 molecule will yield 38 molecules of ATP. XXXXXXXXXXXXXXXXXXXXXXXXXXXXX. The Kreb's cycle can operate for a limited time anaerobically YYYYYYYYYYYYYYYYYYYYYYYYYYYYY. The components of the Kreb's cycle are supplied entirely from carbohydrate metabolism ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. The RQ is higher for carbohydrates than fats AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Aerobic glycolysis is a process when pyruvate enters the citric acid cycle and produce CO2 and H2O TFFFT 152.Motility of the gastrointestinal tract is increased by BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. BBBBBBBBBBBBBBBBBBBBBBBB BBBBBB. Sympathetic block up to T4 CCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Increased circulating adrenaline DDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. stimulation of splanchnic nerves EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. pregnancy FFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Anticholinesterase drug TFFFT 153.Compared with that of a normal adult, the newborn infant's GGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. GGGGGGGGGGGGGGGGGGGGGG GGGGGGGG. kidneys have less ability to excrete a concentrated urine HHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. blood - brain barrier is less permeable to bilirubin IIIIIIIIIIIIIIIIIIIIIIIIIIIIII. heat regulation is more efficient because of its ability to metabolise brown fat JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. blood has greater affinity for oxygen at low oxygen pressures KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. carbohydrate reserve is greater TFFTF 154.Concerning composition of body fluids LLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Plas ma constitutes a quarter of extracellular fluid volume MMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. Extracellular volume grossly depleted in intestinal obstruction NNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Protein content of interstitial fluid is higher compared to intracellular fluid and plasma OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Ratio of extracellular / intracellular volume is smaller in infants compared to adult PPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Normal osmolality of plasma is 280 mosmoles /kg. TTFFT

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155.Regarding pressures during respiratory cycle : QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. QQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQ. Alveolar pressre rises to allow inspiratory flow to occur RRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Intrapleural pressure is -5cm H2O before inspiration begins SSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Alveolar pressure is positive during expiration TTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Fall in intrapleural pressure during inspiration is due to a fall in the elastic recoil UUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. With forced expiration, the intrapleural pressure exceeds zero. FTTFT 156.Alveolar- arterial oxygen difference ( A-a DO2 ) VVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VVVVVVVVVVVVVVVVVVVVVV VVVVVVVV. is normally 15-25 mmHg while breathing room air WWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. is increased under anaesthesia due to increased ventilation/ perfusion mismatch XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. is decreased in one lung ventilation YYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. is increased in the presence of right to left intracardiac shunts ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. is decreased in excessive exercise TTFTF 157.Lung compliance AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is normally 0.2 L/ cm H2O BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. reduces with loss of pulmonary surfactant CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is increased in emphysema DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. increases after induction of general anaesthesia EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is different at apical and basal of the lungs TFTFT 158.Regarding the carotid bodies : FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Have cells which responds to increase in arterial PH. GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Hav e the highest blood flow ( ml/ unit weight ) in the body HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Stimulate maximally the respiratory drive when PaO2 35-70 mmHg IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. It"s discharge is increased by anaemia JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. The afferent nerve is via glossopharyngeal nerve. FTTFT 159.In an awake upright spontaneously breathing patient KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. KKKKKKKKKKKKKKKKKKKKKK KKKKKKKKK. ventilation per unit lung volume is smallest at the apex of the lungs. LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. basal alveoli are bigger than apical alveoli MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. basal alveoli expand more than apical alveoli during inspiration NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. pleural pressure is less negative at the base of lungs

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OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. last part of the expired air comes from the apical alveoli. TFTTT 160.Regarding coronary blood flow PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Subendocardi um is more vulnerable to ischaemia than epicardium QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Ade nosine is a coronary vasodilator. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Myocardial oxygen consumption and coronary blood flow bear a linear relationship SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Coronary blood flow will be improved by slowing the heart rate TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Normal myocardial oxygen extraction ratio is 70 %. TTTTT 161.In normal healthy man at rest in the supine position UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. UUUUUUUUUUUUUUUUUUUUUU UUUUUUUUU. left ventricular end diastolic volume is about 20 mls. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. the first heart sound coincides with the onset of ventricular systole WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. cardiac output is approximately 75mls/beat XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. left ventricular end diastolic pressure ( LVEDP ) is about 5 mmHg YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. the second heart sound coincides with end of T wave of ECG FTTTT 162.With reference to the normal human heart : ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. The most rapidly conducting fibres in the heart are purkinje fibres AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.The last part of the ventricle to be activated is the apex BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. The duration of an action potential in the ventricular muscle fibre is about the same as in a skeletal muscle fibre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. The T wave of the ECG occurs at the beginning of the absolute refractory period of the ventricle DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.Left axis deviation leads to abnormally large R wave in standard limb lead 1. TFFFF 163.In normal resting condition , a bradycardia would be expected to occur following EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEE. increased carotid sinus pressure FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. increased right atrial pressure GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG.application of pressure of the eye ball HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH.following the release of a valsalva manoeuvre IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. expiration TTTTF

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164.In the autonomic nervous system,

JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. the parasympathetic system is transmitted in cranial nerves and sacral fibres from the spinal cord KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK.parasympathetic effects are identical to those of acetylcholine LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL.postganglionic sympathetic fibres release cathecolamines, except at sweat and adrenal glands, where acetylcholine is released MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. sympathetic effects are more localized than parasympathetic actions NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN.parasympathetic stimulation increases bladder emptying TFTFF

165.The countercurrent concentrating mechanism in kidney OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO.OOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOO. depends on active transport of sodium and chloride out of ascending loop of Henle PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. allows an osmolality of 1200 mosmoles/kg in distal tubules QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ.occurs predominantly in the cortical nephrons RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. relies on the free movement of water and electrolytes across the walls of vasa recta SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. depends on a low concentration of urea in the medullary interstitium TFFTF 166.Factors determining urinary sodium loss include : TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT.TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Plasma sodium concentration UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU.Glomerular filtration rate VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV.Circulating renin levels WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. Distal tubular fluid anion concentration XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.Plasma hydrogen ion concentration TTTTF 167.Concerning of blood coagulation : YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Fibrinogen is present in low concentrations in patients with liver disease ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ.Calcium ions are required to convert fibrin monomer to fibrin threads AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Heparin is secreted by circulating eosinophil cells. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Haemophiliacs have a lack of factor VIII and IX CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Normal prothrombin time is between 20s and 30s. TTFTF

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168.Regarding the passage of glomerular filtrate through the renal tubules : DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. DDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDD. Thick ascending limb of loop dilutes the filtrates by its powerful sodium pumps EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. A substance suitable for measuring glomerular filtration rate should be absorbed or secreted by tubules FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Distal tubule is normally impermeable to water GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Glucose is absent in the filtrate in Loop of Henle HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Sodium concentration in descending limb of loop is same as that in distal convulated tubule TFTTF 169.Thyroid hormones will IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. sensitize the myocardium to catecholamines JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. lower the plasma cholesterol KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. increase the formation of messenger RNAs LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. reduce albumin synthesis MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. iodine is absorbed from gastrointestinal tract in ionized form TTTFT 170.Insulin secretion NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. is about 1-2 U/ hour in the basal state OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. is increased 5-10 times following ingestion of food PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is increased by glucagons QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. is depressed in starvation RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. is increased in perioperative period TTTTF 171.Motility of the gastrointestinal tract is increased by SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. vagal blockade TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. mechanical obstruction UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. stimulation of splanchnic nerves VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. pregnancy WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. neostigmine FTFFT 172.Regarding the neuromuscular junction: XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. XXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX. The synaptic cleft is about 50-70 nm wide YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. The postjunctional membrane is thrown into folds ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Acetylcholine receptor has five protein subunits AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Two alpha subunits of acetylcholine receptor have to be activated for the channel to open

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BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Acetylcholine is synthesized from choline and acetic acid TTTTF 173.The liver CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. receives most of its blood supply from the portal vein DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. involve in vasopressin metabolism and inactivation EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. produces heparin FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has a normal portal venous pressure of greater than 20mmHg GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. receives approximately 25% of the cardiac output TTFFT 174.Regarding cerebral blood flow : HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Brain receives 15% of cardiac output IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Cerebral blood flow rises by 2% for each mm rise in PaCO2 JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Volatile anaesthetics reduce cerebral blood flow KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Volatile anaesthetics can impair the autoregulation of cerebral blood flow LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Cerebral blood flow is relatively constant between CPP of 50-150 mmHg. TTFTT 175.Regarding cerebrospinal fluid ( CSF ) : MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. MMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMM. Total volume is 250-300ml. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Produce by choroids plexuses in the rate of 3ml/min OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Normal CSF protein level is 0.2-0.4 g/ L. PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. CSF glucose level is independent on plasma glucose level QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. CSF flow will passes into dural venous sinuses via arachnoid villi. FFTFT 176.A shift of the oxygen dissociation curve to the right RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRR. is associated with Bohr effect in hypercapnia. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. is favoured by a rise in temperature TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. favours the passage of oxygen from blood to tissues UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. occurs when fetal blood is replaced by adult blood VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. occurs in stored blood TTTTF

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177.Severe hyperkalaemia is associated with WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. WWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWW. absent p waves in ECG XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. chronic ACE inhibitor intake YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. decreased serum bicarbonate level ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. suxamethonium administration in immediate burn AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. aldosterone deficiency TTTFT 178.Compared with that of a normal adult, the newborn infant's BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. BBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBB. kidneys have less ability to excrete a concentrated urine CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. blood - brain barrier is less permeable to bilirubin DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. heat regulation is more efficient because of its ability to metabolise brown fat EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. blood has greater affinity for oxygen at low oxygen pressures FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. carbohydrate reserve is greater TFFTF 179.During intrauterine life, GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. all the fetal blood returning from the placenta flows directly into inferior vena cava HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. fetal blood carries more oxygen than maternal blood at low PO2 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. umbilical venous blood has a PO2 of 30-40 mmHg JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. blood on the right side of the fetal heart is better oxygenated than that on the left side KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. pulmonary vascular resistance is higher than after birth FFTTF 180.The following increase during pregnancy : LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. LLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLL. Plasma volume MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. Fibrinogen NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Gastric emptying time OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Glucose tolerance PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Arterial PaCO2 TTTFF 181.Atrial natriuretic peptide QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Is released via coronary sinus RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Is

potent vasodilator SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Improves renal blood flow TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Increases the glomerular filtration rate UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Augment the release of ADH

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TTTTF 182.The pathways of pain sensation include VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVV. a-delta fibres which terminate in lamina 1 of the dorsal horn WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. second order neurons which ascend in the ipsilateral spinothalamic tra XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. c fibres which release histamine and serotonin YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. synapses in the substantia nigra of the spinal cord ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. descending pathways in the dorsolateral colums TFFFT 183.Regarding drug administration : AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. AAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAA. Sublingual route avoids first-pass inactivation in the liver BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Suppositories expose the drug to first-pass metabolism CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Distribution of nebulised drug in the respiratory tree depends on the particle size DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Highly water soluble drugs are administered by transdermal route EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Drugs given by oral route should have a very high exraction ratio TFTFF 184.Regarding protein binding of drugs in plasma : FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFF. Highly protein bound drugs have a longer biological half-life GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Protein binding is different markedly in arterial and venous blood HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Free drug concentration is not altered in hypoalbuminaemics states IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Alpha-1 acid glycoprotein principally binds to basic drugs JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Greater the protein binding, lesser is the volume of distribution TFFTT 185.First-order processes KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. appl y to enzyme- mediated reactions LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. are characterized by high rates of reaction when the concentrations of reacting substances are high. MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. can properly be described in terms of t1/2 NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. are involved in elimination of most drugs OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. change to zero-order kinetic at very high drug doses

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TTFTT 186.The following statements about drug half-life are correct : PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. PPPPPPPPPPPPPPPPPPPPPPPPPPPPP PPPPPPP. Half-life of a drug is shorter than its time constant QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Drug given by infusion without a bolus reach a steady state in five half-lives RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Extent of drug distribution into extracellular fluid is unlikely to affect t1/2. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Context sensitive half-life can be use for any drug TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. About 94% of a drug is cleared of the body in four half-lives TTFFT 187.Regarding of bio-availability of drugs : UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. UUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUUUU. Is indicated by area under the plasma concentration curve time VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Bio-availability of intravenous drug must be less than 100% WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. Is reduced by destruction of drug in the gut XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Is reduced by metabolism of drug in the liver YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Is greater by sublingual route than enteral route. TFTTT 188.A competitive antagonist ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. combines with the same receptor as the agonist drug AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. shift the log dose response curve for the agonist to the right BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. depresses the maximum obtainable response of the agonist CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. will affect the affinity of the agonist for its receptor DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.need not have a close structural similarity to the agonist TTFFT 189.The following drugs are excreted largely unchanged by the kidney : EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEEEEE. Lignocaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Morphine GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG.Propofol HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Levo-bupivacaine IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII.Vecuronium FFFFF 190.Factors which affect the peak effect of intravenous anaesthetics include JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. dose administered

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KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK.volume of distribution LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. hepatic clearance MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. rate of injection NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN.cardiac output TFFTT 191.Regarding propofol : OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Is insoluble in water PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Is bound to albumin up to 97-98 % QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ.Reduces sodium channel opening times in neuronal membranes RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Is hypertonic SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Does not cause tachycardia TTTFT 192.Ketamine TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. has marked analgesic properties mediated by its binding to NMDA receptors UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. causes a fall in cardiac output and a rise in heart rate VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV.is contraindicated in patients with raised intracranial pressure WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. has active metabolites XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.causes postoperative dreaming and hallucinations which is less frequent in children TFTTT 193.Regarding Midazolam : YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Has t 1/2 of less than 2 hours ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Is water soluble at pH of 6 AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Has an active metabolite BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Can have a prolonged effect if it given with erythromycin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Bioavailability following intramuscular injection is 90 % TFTTT 194.Regarding inhalational agents : DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. DDDDDDDDDDDD DDDDDDDDDDDDDDDDDDDDDDDDDD. The blood gas partition co-efficient of desflurane is 0.42 EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Desflurane will cause sympathetic stimulation FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Sevoflurane can degrade to compound A in soda lime GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Desflurane is suitable for inhalational induction HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Desflurane can be used in halothane vaporizer

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TTTFF 195.The speed of induction with inhalational agents IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Is quicker in patients with high FRC JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Is

quicker if the agent is very soluble in blood KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Is slower in the presence of right to left shunt LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Is unchanged in the presence of left to right shunt with normal systemic flow MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. Is quicker when used with nitrous oxide FFTTT 196.Nitrous oxide NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. is stored as liquid OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. is a gas above a temperature of 36 degree centigrade PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. cylinders should have filling ratio of 0.65-0.75 QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. content in a cylinder is always reflected from its pressure gauge RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. is 34 times less soluble than N2. TTTTF 197.Regarding opioid receptors : SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Mor phine acts on kappa receptors TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. The effect of stimulation of sigma receptors is dysphoria and hallucination UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Euphoria is due to stimulation of delta receptors VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Nalorphine antagonizes kappa receptors WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. Pent azocine is partial agonist TTFFT 198.Pethidine XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. is structurally related to morphine YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. onset of analgesic activity after intramuscular injection is 35 minutes ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. in equianalgesic doses, pethidine and morphine produce equal amount of sedation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. respiratory depression caused by it can be antagonized by nalorphine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. about 60% is bound to plasma proteins TFFTF 199.Regarding narcotic antagonists : CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Nalorphine induces antidiuretic effect DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Naloxone is one-fifth as potent as nalorphine

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EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Naloxone precipitates a withdrawal syndrome after chronic doses of pentazocine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Naloxone is metabolized and excreted by the kidneys GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Naloxone is one-fifth as potent when given orally as compared with parenteral administration FFTFF 200.Rocuronium HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. is an aminostereroid IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is stable in aqueous solution JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. undergoes principally hepatic elimination KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has provide intubating conditions within 60 seconds LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. It release histamine TTTTF 201.Glycopyrrolate MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. MM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. can act at central cholinergic receptors NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. can increase the physiological dead space OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. dilate the pupil PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is equally effective when given orally QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. is five times potent as antisialagogue than atropine FTFFT 202.Adrenaline RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. is a bronchodilator SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. is released in postsynaptic sympathetic nerve endings TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. differs from noradrenaline by having an extra methyl group UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. is commonly used with local anesthetics in a concentration of 1 : 80,00 VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. will elevate the blood sugar TFTFT 203.Regarding amiodarone WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. WW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. prol ongs action potential duration in SA node XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. shorten repolarisation in AV node YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. cause photosensitivity ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. will have effect on thyroid function on long treatment AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. slows conduction velocity in His-purkinjee system

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TFTTT 204.With regard to local anaesthetics: BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB.BBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBB. act by preventing sodium acces to the axon interior by occupying the transmembrane sodium channel CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Bupivacaine carbonate compared to bupivacaine hydrochloride has a longer onset of action and less intense block DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. The shortest duration of action of local anaesthetics follows intrathecal injection, the longest durations follow major peripheral nerve blocks EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Prilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. The Cm of lignocaine is less than of bupivacaine TFTFF 205.Ropivacaine GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. is a pure R enantiomer HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. is more cardiotoxic than bupivacaine IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. produces a motor block of more pronounced degree and duration than bupivacaine JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. gives rise to a sensory block that is similar to bupivacaine KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is more lipid soluble than bupivacaine FFFTF 206.Regarding antiemetic drugs LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Tho se which act as antidopaminergic agents can cause extrapyramidal symptoms MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. Do mperidone reduces vomiting by an antiserotonin action NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Extrapyramidal symptoms after administration of droperidol are unlikely 6 hours after administration OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Phenothiazine reduce nausea and vomiting by anti dopaminergic, antihistamine and antimuscarinic actions PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Metoclopramide and cyclizine have primarily anticholinergic actions. TFFTF 207.Of the sympathomimetic drugs QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. QQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQQQQQQ. alpha-2 adrenergic drugs stimulate noradrenaline release RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR.beta-2 adrenergic drugs stimulate glycogenolysis and gluconeogenesis SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. alpha-1 agonists decrease intracellular calcium TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. adrenaline has alpha-1 and alpha -2 actions and beta-1 and beta-2 actions UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. beta-2 agonists cause uterine relaxation

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FTFTT 208.Regarding diuretics VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Frusemide inhibits the chloride reabsorption in the distal tubules WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. Thiazides causes hypokalaemic acidosis XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Ethacrynic acid increases the excretion of potassium and hydrogen ion YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Xanthines decrease the glomerular filtration rate ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Duration of action of frusamide will last for 4 hours FFTFT 209.Regarding esmolol AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is beta-1 selective blocker BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has an elimination half-life of 9 minutes CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is metabolise by plasma pseudocholinesterase DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. has histamine release EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is useful in management of supraventicular arrhytmias TTFFT 210.Drugs actions on the cardiovascular system include FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFF. adrenaline causes alpha and beta-1 and beta-2 stimulation, while noradrenaline stimulates alpha and beta-1 not beta-2 activity GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. isoprenaline has more beta than alpha effect on the heart HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. dopamine increases peripheral resistance, dobutamine reduces it IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. dopexamine causes dilatation of renal, cerebral, coronary and mesenteric beds JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. nitroglycerine causes mainly arterial vasodilatation, nitroprusside mainly venous dilatation TTTTF 211.Heparin KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has molecular weight between 3000-60,000 daltons LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. acts by binding to antithrombin III MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. has antiplatetelet activity NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. prolongs the prothrombin time OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. has a shorter duration of action than low molecular weight heparin TTTFT

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212.The factors affecting the rate of transport of a drug across the placenta are PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. PPPPPPPPPPPPPPPPPPPPPPPPPPPPP PPPPPPPPPPPP. degree of ionization QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. degree of protein binding RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. placental blood flow SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. pK of the drug TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. lipid solubility of the drug TTFTT 213.Concerning the ABO blood groups: UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. UUUUUUUUUUUU UUUUUUUUUUUUUUUUUUUUUUUUUUUUU. A person of group O is a universal recipient VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. A person of group B always has anti-A agglutinins in his plasma WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. In an incompatible blood transfusion reaction, donor cells are lysed by recipient antibodies XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Disseminated intravascular coagulopathy is one of complication of mis-matched transfusion YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. For ABO incompatibility, samples of recipient and donor should be taken for analysis. FTTTF 214.The carotid sinuses ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. have stretch receptors in their walls AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.give afferent impulses via the glossopharyngeal nerve BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. stimulate the respiratory centre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. contain chemoreceptors DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.stimulate the vasomotor centre TTFFT 215.Regarding the autoregulatory mechanisms in acute hypovolaemia EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEEEEEEEEEEEEE EEEEEEEEEEEEEEEEEEEEEE. an increase in sympathetic activity FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. an increase in capillary hydrostatic pressure GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG.a decrease in baroreceptor activity HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. an incease in arteriovenous oxygen content difference IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. an increase in angiotension II. TFTFT 216.Coronary artery flow in adult is JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. y 5% of the cardiac output approximatel

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KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK.has diastolic pressure as its determinant LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. reduced in severe tachycardia MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. basi cally under humoral control NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN.reduced in hypoxia. TTTFF 217.The T wave of the ECG occurs OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO.OOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. at the time of the second heart sound PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. during ventricular diastole QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ.during atrial systole RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. at the beginning of the refractory period SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. during repolarization of the ventricles TFFFT 218.Acetylcholine is the neurotransmitter at TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTTTTTTTTTTTTTTTTTTT TTTTTTTTTTTTTTTTTTTTTT. sympathetic nerve terminal supplying the heart UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU.sympathetic nerve terminal at the adrenal medulla VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV.parasympathetic nerve terminal supplying the lacrimal gland WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW . sympathetic nerve terminal supplying sweat gland XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.sympathetic ganglia FTTTT 219.Regarding the lung volumes and capacities : YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY.YYYYYYYYYYYY YYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. The air inspired with the a maximal inspiratory effort in excess of tidal volume is inspiratory reserve volume ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Air present in the lungs after maximal inspiratory effort is the residual volume AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Vital capacity is decreased in asthma BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Normal maximal voluntary ventilation is 250-300 L/min CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Vital capacity includes tidal volumes, expiratory reserve volume and residual volume TFTFF DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. pulmonary 220.In normal human lungs; vascular resistance is decreased by norepinephrine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. beta-2-agonists cause bronchoconstriction FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. pulmonary vascular resistance is increased by serotonin

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GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. vascular resistance is decreased by histamine HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. vascular resistance is decreased by norepinephrine FFTTF 221.Pulmonary surfactant

pulmonary pulmonary

IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is produced by the type I alveolar cells JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. increases alveolar

ciliary motion KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is decreased by increased FiO2 LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. aids diffusion from the alveolus to the pulmonary capillary MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. appears at about 24 weeks of gestation. FFTFT 222.In fit adult person, anatomical dead space NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. NNNNNNN NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. increases with increasing lung volumes OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. can be measured by fowler's method PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Increases with hypoventilation QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Is reduced when neck is flexed RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Is increased in pulmonary embolism TTFTT 223.Regarding Pulmonary circulation SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Dependent parts of the lung receive greater blood flow than nondependent lungs. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Amount of blood in the pulmonary circulation is between 0.5 to 1.0 L UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Pulmonary blood volume increases from erect to supine position VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Barbiturate administration causes a rise in a pulmonary blood volume WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW W. Pulmonary vascular pressures are between one-sixth to one-tenth of the systemic arterial pressure. TTTFT 224.Regarding cerebral circulation XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. cerebral metabolic rate for oxygen is about 3.5 ml/100g of brain per min. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. hypoxia cause cerebral vasodilatation ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. autoregulation is impaired in the presence of intracerebral tumor AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. chronic hypertension shift the autoregulatory curve to the left

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BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. will increase cerebral blood flow. TTTFT 225.Cerebrospinal fluid

volatile anaesthetics

CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is formed by secretion and filtration of plasma DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. total volume is 300-400 ml EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. leaves the 3rd vetricles via the foramen of Magendie FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. glucose level is dependent on plasma glucose level GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. has higher sodium level compare to plasma sodium TFFTF

226.Carbon dioxide is carried in the blood HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. HHHHHHH HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. in the red blood cells IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. as carbonic acid , which is buffered JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. in direct combination with reduced haemoglobin KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. as phosphate esters LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. combined with plasma protein TTTFF 227.Regarding nerve fibres: MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. Pain fibres (A-? and C-fibres. are unmylinated NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. The larger fibres are more susceptible to local anaesthetics OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. conduction involves sodium and chloride permeability PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Conduction is fastest in mylinated fibres QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Resting membrane potential is +90 millivolts FFFTF 228.In cell metabolism RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. 1 molecule will yield 38 molecules of ATP. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. The Kreb's cycle can operate for a limited time anaerobically TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. The components of the Kreb's cycle are supplied entirely from carbohydrate metabolism UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. The RQ is higher for carbohydrates than fats

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VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Aerobic glycolysis is a process when pyruvate enters the citric acid cycle and produce CO2 and H2O TFFFT 229.The proximal convoluted tubules WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WW. WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWW. Absorb most of water and salt of the glomerular filtrate XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. reabsorb all the glucose in the glomerular filtrate YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. contain juxtaglomerular cell which secret renin ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. are the main target cells for antidiuretic hormone (ADH. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. it is responsible for reducing the volume of glomerular filtrate by 80% TTFFT 230.Compared with extracellular fluid , the intracellular fluid contains a greater concentration of : BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. sodium ions CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. magnesium ions DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. proteins EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. hydrogen ions FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. bicarbonate ions FTTTF 231.Cardiac muscle differs from skeletal muscle in that it : GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. GGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. has longer refractory period HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. depolarises spontaneously IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. has intercalated disc JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. can only contract isometrically KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has a lower extraction ratio for oxygen TTTFF 232.The blood supply of the liver LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. LLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. represents 15% of the total cardiac output MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM M. the portal vein oxygen saturation is normally 85 % NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. symphatetic activation results in a decrease hepatic blood flow OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. the portal vein pressure is normally 40 mmHg PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. 70 % of the hepatic blood flow in adults is derived from the hepatic artery FTTFF

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233.With regard to pain pathway QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. QQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. free nerve endings are the receptors that responds to pain stimuli RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. sharp pain is conducted in the C fibers rather than the A-delta fibers SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. enters the spinal cord via the anterior horn cell TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. travels up the cord in the ipsilateral spinothalamic tract UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. enters the thalamus through the reticular formation TFFFT 234.With regard to tyroid hormones VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VVVVVVV VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. it is controlled by thyrotropine releasing hormone WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWW. it increases activity of iodin pump in thyroid gland XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. it reduced number of thyroid cells YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. it is produced by somatotropic cell ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. is a glycoprotein with molecular weight about 28000 FTTFT 235.With regard to haemostasis AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. AAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Factor VIII is common to both the intrinsic and extrinsic coagulation pathways BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Calcium ions is a factor in blood coagulation CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Heparin inhibit platelets aggregation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Effects of warfarin may be monitored using activated partial thromboplastin time EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Aspirin impair the action of platelets FTFFT 236.The following physiological changes occur during pregnancy FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFFFFFFFFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFF. a decreased platelet count GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. hypercoagula ble state HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. an increased minute volume due to an increased respiratory rate IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. a rise in renal threshold for glucose JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. inhibition of fibrinolysis

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TTFFT 237.After the fetus is born TFFFT

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. KKKKKKK KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. its systemic vascular resistance rises LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. its pulmonary vascular resistance rises MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MM. there is reversal of flow in the ductus arteriosus NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. the opening between the two ventricles closes OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. the opening between the two atrial closes TTFFT 238.Insulin PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. release is increased by sulphonyl urea type of hypoglycemic drugs QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. has a half life of five minutes in circulation RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. increases the number of glucose transporters in the cells SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. secretion is reduced by surgical stress response TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. is normally secreted at a rate of about 40-50U/day TTTTT 239.Countercurrent mechanism UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. UUUUUUU UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. in the descending Loop of henle water moves into the interstitium VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. thin ascending limb is permeable to Na+ and urea WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWW. thick ascending limb contains a higher concentration of ATP ase XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Loop of henle is countercurrent exchanger YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Vasa rectae is countercurrent multiplier TTTTF 240.In the autonomic nervous system, ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZZZZZZZZZZZZ ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ.the parasympathetic system is transmitted in cranial nerves and sacral fibres from the spinal cord AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.parasympath etic effects are identical to those of acetylcholine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Noradrenalin e is not metabolized by COMT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Nicotinic receptors are present in the parasympathetic and sympathetic ganglion

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DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. wn regulation of receptors is seen in chronic heart failure TFFTT 241.The anion gap

Do

EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Is calculated from plasma concentration of sodium, bicarbonate and phosphate FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. The normal value is between 15-18 meq/l GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Is normal in renal tubular acidosis HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Hig h in aspirin overdose IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Is decreased when plasma albumin is decreased FFTTT

242.Motility of the gastrointestinal tract is increased by JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Sympathetic block up to T4 KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Incr eased circulating adrenaline LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. stimulation of splanchnic nerves MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMM. pregnancy NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Anti cholinesterase drug TFFFT 243.Regarding the bio-availability of drugs: OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO.OOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Is indicated by area under the plasma concentration - curve time PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Is a number of unchanged drug that reaches the systemic circulation. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Is reduced by destruction of drug in the gut RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Is reduced by metabolism of drug in the liver SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Is greater by sublingual route than enteral route TFTTT 244.A competitive antagonist TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTTTTTTTTTTTTT TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. can be displaced by agonist with higher concentration UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU.combines with the same receptor as the agonist drug VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. shift the log dose response curve for the agonist to the right

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WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWW. depresses the maximum obtainable response of the agonist XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. will affect the affinity of the agonist for its receptor TTTFF 245.Regarding propofol: YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YY YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Is water soluble ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Is bound to albumin up to 97-98 % AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Is not contraindicated to patients with egg allergies. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Is hypertonic CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Conjugates in liver to inactive metabolites. FTTFT 246.Ketamine DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. DD DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. causes a fall in cardiac output EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is a potent bronchodilator FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has active metabolites GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. caus es postoperative dreaming and hallucinations which is less common in children HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. has marked analgesic properties mediated by its binding to NMDA receptors FTTTT 247.Regarding Midazolam: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. cause more significant reduction of blood pressure compare to diazepam JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Is water soluble at pH

of 6 KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Has an active metabolite LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Erythromycin inhibits the midazolam metabolism MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMM. Bioavailability following intramuscular injection is 90 % TFTTT 248.Nitrous oxide NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. NN NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. is stored as liquid OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. is a gas above a temperature of 36 degree centigrade PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is flammable

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QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. cont ent in a cylinder is always reflected from its pressure gauge RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. is 34 times less soluble than Nitrogen TTFTF 249.Concerning muscle relaxants, SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSS SSSSSSSSSSSSSSSSSSSSSSSSSS. Rocuronium is a steroidal compound TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Mivacurium is not suitable for intravenous infusion UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Roc uronium is metabolized by pseudo-cholinesterase VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Vec uronium has significant vagolytic effects WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWW. Mivacurium has a faster onset than rocuronium TFFFF 250.Glycopyrrolate XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. XX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. can act at central cholinergic receptors YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. can increase the physiological dead space ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. dilate the pupil AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is equally effective when given orally BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is five times more potent as antisialogogue than atropine FTFFT 251.Amiodarone CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. prolonge action potential duration in SA node DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. shor ten repolarisation in AV node EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. causes photosensitivity FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. affect thyroid function on long term treatment GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. slow s conduction velocity in His-purkinjae system TFTTT 252.With regard to local anaesthetics: HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. acts by preventing sodium access to the axon interior by occupying the transmembrane sodium channel HH It

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IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Bupivacaine carbonate compared to bupivacaine hydrochloride has a longer onset of action and less intense block JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. The shortest duration of action of local anaesthetics follows intrathecal injection KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Pril ocaine is more toxic to the cardiovascular and central nervous systems than lignocaine LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. The Cm of lignocaine is less than of bupivacaine TFTFF 253.Metoclopramide MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMM. MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMM. Blocks central dopamine receptors NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Effe ctive in treatment of opioid induced gastric stasis. OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Has no extrapyramidal side effect. PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Does not cross into breast milk. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Is effective in high intravenous doses for the emesis of chemotherapy. TFFFT 254.With regards to non steroidal anti-inflammatory drugs: RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRR RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. They are effective analgesics even without presence of inflammation. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. They inhibit cyclooxygenase. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. 50% of asthmatics are allergic to aspirin. UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. If the effect on platelet function is to be avoided, aspirin needs to be stopped at least 2 weeks before surgery. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Ren al damage is a known complication. FTFTT 255.Antihypertensive drugs actions include: WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWW. WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWW. Clonidine reduces the blood pressure by its agonist activity on alpha-1 adrenoceptors. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Dilti azem is an angiotensin converting enzyme inhibitor YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Nife dipine acts as a calcium channel entry blocker ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. Sodium nitroprusside causes metabolic acidosis with prolonged infusion. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Chr onic cough is a known side effect of angiotensin II inhibitors.

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FFTTF 256.Recognised method of prologing the action of ligocaine includes: BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. BBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Addition of adrenaline CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Carbonation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Usin g a more concentrated solution EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Mixing with dextran in saline FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Increasing the volume of drug injected. TFTTT 257.Phenytoin GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. GG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. is the drug of choice for complete heart block HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. is broken down chiefly by cholinesterase IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is useful in treatment of arrhytmias associated with digitals JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ.increases diastolic depolarization KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. incr eases automaticity FFTFF 258.Distribution volume is LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. LLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. large in drugs with high lipid solubility. MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMM. small in drugs with low plasma protein binding. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. larg e in drugs with high tissue binding. OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. imp ortant for calculation of loading dose. PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. helpful in assessing the suitability for hemodialysis. TFTTT QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. deri 259.Regarding sympathomimetics ved from beta-phenylethylamine RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. all contain catechol ring SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. dopamine is a naturally occuring catecholamines TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. adrenaline is the most potent activator of alpha adrenergic receptor UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. nora drenaline causes bronchodilatation and is good for asthmatic patient TFTTF

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260.Mivacurium VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. VV VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. is a depolarizing muscle relaxant WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWW. can trigger malignant hyperthermia XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. has duration of action twice that of succinylcholine YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. is hydrolyzed by plasma cholinesterase ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. causes histamine release FFTTT 261.Pancuronium : AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. not cross the placenta in clinically significant amounts BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. es tachycardia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. es hypotension DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. cause prolonged paralysis in patient taking streptomycin EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. causes dilatation of the pupil TTFTF 262.Thiopentone : FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. at normal plasma pH, is 50 - 75% bound to plasma proteins GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. is a thiosubstituted succinylurea HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. in 2.5% solution it has a pH greater than 10 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. after redistribution it is rapidly metabolised in the liver JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. its excretion is usefully accelerated by a forced alkaline diuresis TFTFF 263.Fentanyl KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. KK KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is a synthetic opioid LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. its analgesic potency is 1000 times of alfentanil MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMM. sedative effect is more than pethidine NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. plas ma clearance is less than mophine OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. dura tion of action is about 20 minute AA does caus caus may

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TFFTT 264.. Warfarin : PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is an antagonist of Vit K QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. com petes with phenylbutazone at plasma binding sites RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. does not affect already synthesized clotting factors SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. is contraindicated in severe hypertension TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. prevent fibrinolysis TTTTF 265.Regarding drug administration: UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. UU UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Subl ingual route avoids first-pass inactivation in the liver VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Sup positories expose the drug to first-pass metabolism WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWW. Distribution of nebulised drug in the respiratory tree depends on the particle size XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. Hig hly water soluble drugs are administered by transdermal route YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Dru gs given by oral route should have a very high extraction ratio TFTFF 266.Plasma ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. 4% of total body weight AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.prin cipal plasma cation is Na+ 140 mmol/L BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. also contain fructose,galactose and mannose CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. albu min is the most abundant plasma protein DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. total plasma protein ranging from 20 - 40 g/L TTTTF 267.Intracellular fluid EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEE EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. 40% of body weight FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. volume is measured directly with markers GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. inorganic phosphate is the most important anion HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. K+ concentration is approximately 150 mmol/L IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. its proportion varies little between tissues TFTTF

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268.Coronary blood flow

JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. is about 500 ml/min at rest KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. supplies muscle that takes up 40 ml oxygen per minute at rest LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. is altered directly by vagal activity MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMM. ceases in systole NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. is auroregulated FTFFT

269.Drugs readily cross the blood-brain barrier OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO.OO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Ben zylpenicillin PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Hyoscine hydrobromide QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Glycopyrollate RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Atra curium SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Propofol FTFFT 270.In first-order kinetics TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTTTTTTTT TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. A constant proportion of drug metabolised in a given time period UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU.The absolute amount eliminated is greatest when plasma concentration is greatest VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. The enzyme responsible for the reaction is saturated WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWW. The rate of elimination and elimination half-life is constant,irrespective of plasma concentration XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. The reaction is represented by a linear relationship TTTFF 271.Carbon dioxide transport in blood YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Carbonic anhydrase is present in plasma ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. 25% of carbon dioxide is dissolved AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 50% is carried as bicarbonate BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Tran sport of carbon dioxide is facilitated by deoxygenated haemoglobin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Som e of the carbon dioxide reacts with haemoglobin to form carbamino

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FFFTT 272.Dantrolene DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Is useful when given intramuscularly EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Contains 3 g mannitol in each 20 mg vial of Dantrium FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. The dose for treayment of malignant hyperthermia should not exceed 1 mg/kg in 24 hours GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Interacts with verapamil HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Causes hyperkalaemia FTFTF 273.Primary haemostasis depends upon IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. blood coagulation JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. plat

elet aggregation and adhesiveness KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. vascular factors LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. prostaglandin release MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMM. serotonin FTTTF 274.Relaxation of the pregnant uterus is produced by NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. Epidural anaesthesia OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. Nitrous oxide PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Ritodrine QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Halothane RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Am yl nitrate FFTTT 275.Abnormal high plasma potassium causes SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSS SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. U waves on the electrocardiogram TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. increased amplitude of the P waves UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. prolonged QRS complexes VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. ventricular fibrillation WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWW. increased digitalis toxicity

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FFTTT 276.Nitrous oxide XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. does not combine with haemoglobin YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. is not a trigger of malignant hyperpyrexia ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. induces bone marrow aplasia AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is partially metabolised by intestinal bacteria BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. caus es diffusion hypoxia at the termination of anaesthesia TTTTT 277.The following interactions are antagonistic CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CC CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Nal oxone and dextropropoxyphe DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Acetylcysteine and paracetamol EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Atenolol and salbutamol FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Protamine and warfarin GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Tranexamic acid and streptokinase TTTFT 278.The action of non-depolarising muscle relaxant is prolonged by HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH. Hyponatraemia IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Hyperkalaemia JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Hypermagnesaemia KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Lithium LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Gentamycin FFTTT 279.Magnesium MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMM. MMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMM. Normal plasma concentration is 3-5 mmol/L NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. 99% in the body is intracellular OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. When deficient may cause muscle weakness and dysrhythmias

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PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Potentiates the action of Ca2+ at the neuromuscular junction QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. It reduces peripheral vascular tone FTTFT 280.Cardiac effects of hypothermia include RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RR RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Bra dycardia SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Ventricular fibrillation TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. J waves on the ECG UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. Atrial fibrillation VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. Reduced cardiac output in response to reduced tissue oxygen TTTTF 281.Ropivacaine WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWW. WWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWW. is an ester-linked local anaesthetic XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. is more lipid soluble than bupivacaine YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. has a duration of action similar to lignocaine at equipotent doses ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. is a vasoconstrictor at clinical concentrations AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA . has convulsions in toxic dose FFFTT 282.In the normal pulmonary circulation BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. BB BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. capi llary pressure is about 10 mmHg CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. angi otensin II is inactivated DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD D. PGF2? causes vasoconstriction EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. the velocity of blood in the root of the pulmonary artery is the same as that in the aorta FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. of the fetus,about 15% of the cardiac output goes to the lungs TFTTT 283.Alveolar minute ventilation GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

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IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is equal to tidal volume multiplied by respiratory rate JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. is about 4.5 L/min at rest KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK K. varies with posture TFFTT 284.Acetylcholine acting at muscarinic receptors LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. LLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. stimulates adrenaline secretion in the adrenal medulla MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMM. causes vasodilatation NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN N. decreases bronchial tone OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO . increases ureteric tone PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. has prejunctional effects at the neuromuscular junction FTFTT 285.Alpha-adrenergic stimulation produces QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ Q. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQ. vasodilation RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. tach ycardia SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. uterine relaxation in pregnancy TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. a positive inotropic effect UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU . intestinal relaxation FFFFT VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV 286.In an uncompensated respiratory alkalosis V. patient will be hypoventilating WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWW. base excess exceeded 10 mmol/L XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX X. arterial pH is 7.65 or above YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY Y. concentration of ionised calcium in the plasma is decreased ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. tetany is a complication FFTTT 287.The velocity of impulse propagation along nerve fibres AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA A. increases with diameter in myelinated fibres BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is independent of diameter in unmyelinated fibres CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is altered in hypokalaemia

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DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DD. is fastest in A? fibres 70-120 ms-1 EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is depend upon local oxygenation TFFTT 288.In the renal's regulation of water and sodium FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. the ascending limb of loop of Henle is impermeable to water GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GG. sodium reabsorption from the loop of Henle occurs passively HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HH. under conditions of maximum antidiuresis, 5% of water reabsorption occurs in the distal tubule IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. sodium excretion affected by blood flow in the vasa recta JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. prolonged thirst induces aldosterone production TFFTT 289.The stress response to surgery includes KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KK. KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKK. Increases in ACTH, cortisol and growth hormone LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Incr eased lipolysis MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMM. Protein catabolism NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NN. Increased glucagon secretion OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO O. Reduced insulin secretion TFTTT 290.The treatment of bupivacaine induced cardiac arrest PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. PPPPPPPPP PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Rapid reversal of hypoxia and metabolic acidosis QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQ. Prolonged cardiopulmonary resuscitation RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. Lign ocaine for the treatment of ventricular tachycardia SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Control of convulsions to decrease hypoxia and lactic acidosis TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. Bret ylium for the treatment of cardiac arrhythmias TTFTT UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU 291.Nitric oxide (NO)

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VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VV. Improves platelet functions WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWW. Is usually administered in doses of 10-50 ppm XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XX. Nitrous oxide (N2O) is it's by product causing toxicity YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YY. Methaemoglobinemia is one of it's adverse effects TFTTT 292.Morphine ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZ ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. is a phenanthrene derivative AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AA. is the anagesic of choice in biliary and renal collic BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has an anticholinergic effect CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. decreases intracranial pressure DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDD. is a good anticonvulsant TFTFF 293.Atropine and hyoscine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEE EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. increase the risk of regurgitation FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. are contraindicated intravenously in glaucoma GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGG. cause mild neuromuscular blockade in large doses HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHH. are equipotent as drying agents IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. produce confusional states TFFFF 294.Phenoxybenzamine JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. blocks both ? 1- and ?2-receptors KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKK. is a non-competative antagonist LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. caus es reflex tachycardia MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMM. reduces supine blood pressure in normal subjects NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNN. cause sedation and fatigue TTTTT 295.Isoflurane and enflurane OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OO. they have similar boiling points PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. isoflurane has the higher molecular weight

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QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQ. they are both contraindicated in anephric patients RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. adrenaline infiltration is safe SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. both give measurable fluoride ion in the serum TFFTT 296.Thyroid hormones TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTT TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. thyroxine (T4) is the most active natural compound UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UU. more than 99% of active hormone is protein-bound VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVV. their actions are mediated via receptors on the cell surface WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWW. an increase in metabolic rate occurs within minutes of increased hormone activity XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXX. they increase the number of cardiac ?-adrenoceptors FTFFT 297.Etomidate YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYY. has no muscle-relaxing properties ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. inhi bits adrenal steroidogenesis AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAA. increases the tone of pharyngeal muscle BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. does not cause hypotension on induction of anaesthesia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. produces a low incidence of allergic-type reactions TTFFT 298.Amiodarone DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDD. DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDD. is a class I B anti-arrhythmic drug EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. does not cause clinically important myocardial depression FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is unlikely to cause side-effects if trouble free for the first 3 months of treatment GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGG. pulmonary toxicity is one of its side effect HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHH. interferes with tests of thyroid function FTFTT

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299.Regarding steroid therapy

IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. hydrocortiso ne replacement alone is sufficient in Addison's disease JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. dexa methasone is suitable for replacement therapy KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKK. methylprednisolone is a more potent anti-inflammatory agent than hydrocortisone LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. prol onged steroid therapy may cause osteoporosis MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMM. cortisone does not cause fluid retention FFTTF

300.In the stomach NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNN. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNN. there is approximately 3 litres of gastric secretion per day OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOO. the parasympathetic innervation is from the coeliac plexus PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. gastric emptying is controlled by periodic relaxations of the pyloric sphincter QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQ. cathecolamines inhibit secretion RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. the contents are normally sterile TFFTT 301.Tachyphylaxis occurs during short-term treatment with SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. ephedrine

TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTT TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. trimetaphan UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUU. suxamethonium VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVV. noradrenaline WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWW. sodium nitroprusside TTTFT 302.Peripheral chemoreceptors XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX. present in the carotid bodies YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYY. present in the adrenal medulla ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. pres ent in the aortic arch AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAA. present in the right atrium BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. are supplied by the glossopharyngeal nerve TFTFT

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303.Naloxone CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is a ?-receptor antagonist DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDD. is an analogue of morphine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is a respiratory stimulant in normal man FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. reverses the analgesic effects of placebo GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGG. has a duration of action of one to four hours TFFTT 304.The central chemoreceptors HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHH. are more sensitive to changes in the chemical composition of cerebrospinal fluid than of blood IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. are directly influenced by changes in arterial oxygen content JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. are located within the respiratory centre of the medulla KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKK. respond directly to changes in pH rather than to changes in carbon dioxide tension LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. are bathed directly by cerebrospinal fluid TFFTF 305.Thiopentone has a short duration of action because MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMM. MMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. it is metabolised by the liver NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNN. it is redistributed to muscle OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOO. it is specifically bound to the reticular activating system PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. it is usually given by rapid intravenous injection QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQ. it induces tachyphylaxis FTFTF 306.Drugs that cause local venous thrombophlebitis RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR. methohexitone SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. pancuronium TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. thio pentone

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UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUU. etomidate VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVV. diazepam FFTTT 307.Extracellular fluid WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWW. WWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. cont ains sodium and chloride as the predominant ions XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXX. has the same osmotic concentration as sea water YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYY. accounts for about 45% of body weight in a normal adult ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. incl udes the plasma volume AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAA. is a higher propotion of body weight in infancy than in old age TFFTT 308.Sodium nitroprusside BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB B. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBB. the intraoperative dose range is 0.5-6 mg/kg/min CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC C. metabolism to cynide occurs non-enzymetically in blood DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDD. metabolism produces thiocynate which is excreted in urine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. it produces dilation predominantly of resistance vessels FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. reduces renal blood flow FTTFF 309.Epileptiform EEG activity are induced by GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGG. GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGG. enflurane HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHH. midazolam IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. methohexitone JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. etomidate KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKK. isoflurane TFTFF LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. incr 310.Pulmonary surfactant eases surface tension differentially in differently sized alveoli MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMM. helps prevent pulmonary oedema

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NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNN. increases alveolar ciliary motion OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOO. aids diffusion from the alveolus to the pulmonary capillary PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is produced by the type II alveolar cells FTFFT 311.The actions of non-depolarising neuromuscular blocking drugs QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQ. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQ. are potentiated by anaesthetic vapours RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR R. when given in repeated doses can be described as dual block SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. are potentiated by intraperitoneal tobramycin TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. are potentiated in patients with multiple neurofibromatosis UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUU. are potentiated in hypoproteinaemia TFTTT 312.In human nutrition VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVV. Basic energy requirement for a 70 kg man is about 8400 kJ (2000 kcal) WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWW. carbohydrates are the most compact energy source XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXX. the respiratory quotient (RQ) decreases when fat is the main energy source being utilised YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYY. essential amino acids are those which participate in metabolic reactions ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. a high protein diet raises the metabolic reactions TFTFT 313.The binding of a drug to plasma proteins AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAA. prolongs its biological half-life BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BB. is likely to be different in arterial and venous blood CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CC. is only of importance to albumin DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDD. slows glomerular filtration of the drug EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. prev ents renal tubular secretion of the drug TTFTF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF.the rate of 314.When considering the uptake of a volatile anaesthetic agent

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GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGG. induction is more rapid if cardiac output decreases HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHH. induction is less rapid with less soluble agent IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. the effect of changing cardiac output on the rate of uptake will be greater with a more soluble agent JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. the second-gas effect allows the maintenance concentration of TTFTF 315.Aminophylline KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKK. KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKK. is a methylxanthine LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. inter acts with adenosine receptors MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMM. is a central respiratory depressant NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNN. increases cardiac contractility OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOO. causes generalised epileptiform seizures TTFTT 316.Clonidine PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP.PPPPPPPPP PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is a partial agonist at ?2-adrenoceptors QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQ. cause hypertension if infused intravenously RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RR. is well absorbed when taken orally SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS.anxiety is an important side-effect TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. redu ces cardiac contractility TFTFF 317.Intracranial pressure is increased by UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUU. halothane VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVV. suxamethonium WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWW. morphine XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXX. nitroglycerine YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYY. etomidate TTFTF

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318.In the liver ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. ZZZ ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. oxy genated blood is delivered by branches of the hepatic artery AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAA. total blood flow is half the cardiac output BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBB. flow is from the periphery of the acini to the hepatic vein at the centre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCC. portal venous pressure is about 10 mmHg DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDD. adenosine is important in local regulation of blood flow TFFTT 319.Recognised non-respiratory functions of the lung include EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. activation of angiotensin I FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. met abolism of circulating adenine nucleotides GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGG. the synthesis of circulating kallikrein HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHH. the inactivation of circulating bradykinin IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. the inactivation of circulating adrenaline TTTTF 320.Pulmonary vascular resistance JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ.

is increased in chronic hypoxia KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKK. has a value approximately one-sixth that of the systemic circulation LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. can be measured using a flow-directed balloon catheter with a thermistor tip MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMM. is increased by isoprenaline NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNN. is decreased by 5-hydroxytryptamine (5-HT) TTTFF 321.Frusemide OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOO. OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOO. has its primary site of action in the loop of Henle PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. com monly causes hyperuricaemia QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQ. enhances the excretion of calcium RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRR. hyponatraemic acidosis is the adverse effect SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. redu ces the efficacy of concurrently prescribed lithium

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TTTFF 322.The volume of distribution of a drug TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. refers to the peripheral compartment of the two-compartment model UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUU. makes the assumption that there is a uniform concentration of drug VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVV. is calculated using the measured concentration in the blood or plasma WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWW. is affected by differential regional blood flow XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXX. will be relatively low if hydrophilic and extensively bound to plasma proteins FTTTT 323.The sulphonylureas YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYYYYYY. rarely cause hypoglycaemia ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. act mainly by increasing the secretion of insulin AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAA. are highly protein-bound BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBB. are safe to use in chronic renal failure CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCC. are used as a diagnostic test in the incipient diabetic FTTFF 324.In the metabolism of these drugs DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDD. DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDDDDDDD. morphine forms a conjugated glucuronide EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. penicillin is mainly hydrolysed FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. one of the major metabolic products of halothane is monofluoroacetic acid GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGG. pethidine metabolism requires catechol-o-methyltransferase HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHH. cocaine is hydrolysed TFFFT 325.Dextran solutions IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. interfere with subsequent cross-matching JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. have useful oxygen-carrying capacity KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKK. serious anaphylactoid reactions is a complication

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LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. decrease the plasma ionised calcium if infused rapidly MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMM. acute renal failure is a complication TFTFT 326.Concerning skeletal muscle NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNN. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNNNNNNNN. each fibre has one motor endplate OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOO. the motor endplate is at the proximal end of the fibre PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. dep olarisation causes electrical changes only in the muscle fibre near the endplate QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQ. the resting potential difference at the endplate is 20mV less than the rest of the muscle RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRR. each fibre is no longer than 1 mm TFFFF 327.With regard to pharmacokinetics SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSS SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. A zero order kinetics indicates metabolism at a constant rate TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. First order kinetics can change to zero order kinetics UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUU. A three compartment model is a feature of fat soluble drugs VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVV. Drugs with large volumes of distribution have long half-lives WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWW. Compartments refer to anatomical structures TTTTF 328.The clearance of the drugs XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX. Represents the removal of a givenamount of the drug in unit time YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYY. represents the rate of elimination per unit concentration in blood ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. equals the volume of distribution multiplied by the haklf life AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAA. equals the volume of distribution multiplied by constant BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBB. is inversely proportional to the half life TFFTT 329.Minimum alveolar concentration CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCC. is an index of potency of intravenous anaesthetics

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DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDD. is measured in volumes % EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. can be determined by probit analysis FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is affected by age GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGG. is a correlate of oil/water solubility FTFTF 330.Isoflurane HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHHHHHH.has the same molecular weight as enflurane IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. if put in a calibrated halothane vaporizer, it will deliver a dangerously high concentration of isoflurane JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. reduces the blood pressure, mainly by depressing cardiac output KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKK. has a MAC of 1.68% LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. causes minimal changes in cerebral blood flow at light levels of anaesthesia TFFFT 331.Sodium dantrolene MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMM. MMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM. is a neuromuscular blocker NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNN. may cause dangerous rise in serum calcium OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOO. can be used preoperatively to reduce suxamethonium pains PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is useful in the treatment of malignant hyperpyrexia QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQ. is a skeletal muscle relaxant FFTTT 332.Halothane decreases the blood pressure as a result of RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRRRRR.direct myocardial depression SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. peri pheral vasodilatation TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT. a central action on the vasomotor centre UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUU. ganglion blockade VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVV. baroreceptor inhibition TTTTT

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333.Bupivacaine WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWW. WWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWW. produces depolarisation in the neural membrane of peripheral nerves XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXX. is detoxified in the liver YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYY. is an ester ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ. can cause methaemoglobinemia AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAA. 30 ml of 0.5% is recommended dose in a 75kg man TTTTT 334.Levobupivacaine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBB. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBB. has an efficacy equivalent to bupivacaine for both anaesthesia and analgesia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCC. has enhanced safety profile compared to bupivacaine DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDD. Chirocaine is an example of levobupivacaine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE E. Consists only of the S(-) enantiomer of bupivacaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Excr eted mainly by the kidney TTTTT 335.Ropivacaine GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGG. GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGG. is a racemic mixture HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHH. is less cardiotoxic than bupivacaine IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is more potent than bupivacaine JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. has the same pKa as bupivacaine KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKK. poduces greater motor block than bupivacaine FTFTF 336.Ketamine hydrochloride LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL . is an arylcycloalkylamine MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMM. increases pulmonary vascular resistance NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNN. increases myocardial contractility in vivo OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOO. has bronchodilatory properties

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PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. eases tone in skeletal muscles TFTTT 337.Benzodiazepines

incr

QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQ. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQ. are extensively excreted in the urine RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRR. are highly protein bound SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. whe n used chronically, induce hepatic microsomal enzymes TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT . are antalgesic UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUU. cross the placenta FTFFT 338.Propofol VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVV. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVVVVV. is presented in 10% soya nean oil WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWW. decreases blood pressure mainly by vasodilatation XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXX. is broken down by plasma cholinesterase YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYY. 4-5 mg/kg is the standard induction dose in healthy adults ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ . Is more respiratory depressant than thiopentone TTFFT 339.Lung surfactant AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAA. decreases compliance BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBB. increases surface tension CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCC. is released from the pulmonary circulation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDD. is made of molecules that are partly lipophilic and partly hydrophilic EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EE. is produced in type I pneumocytes FFFTF 340.Physiological dead space FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. chan ges with posture

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GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGG. decreases with exercise HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHH. includes anatomical dead space IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is responsible for the difference between mixed expired gas and alveolar gas JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. is diffusion dependent TFTTF KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK 341.Closing capacity: KKKKKKKKKKKK. Increases with age LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL L. Is measured using the single breath nitrogen washout technique MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMM. Decreases with obesity NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNN. Is smaller than closing volume OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOO. Encroaches on tidal breathing at a mean age of 66 in supine subjects TTFFF 342.During quiet inspiration PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. PPP PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Alv eolar volume increases by 30% QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQ. Abdominal muscle are active RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRR. Sacrospinalis muscles are active SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Intra thoracic pressure decreases by a few mmHg TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT T. The ribcage does not move TFFFF 343.The pulmonary circulation UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUU. UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUUUUUUUUU. Contains 30% of the blood volume VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVV. Pulmonary vascular resistance increases with hypoxia WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWW. Pulmonary vascular resistance is markedly less than systemic vascular resistance XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXX. Pulmonary artery pressure is 25/9 mmHg YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYY. Pulmonary artery pressure increases with exercise FTTTT ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ 344.The physiological response to haemorrhagic shock consists of

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AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAA. Production of renin BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBB. Increased production of erythropoietin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCC. Increased baroreceptor activity DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDD. Increased chemoreceptor activity TTTFT 345.The oxy-haemoglobin dissociation curve EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEE. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEEEEE. in healthy adults has a P50 value of 3.4kPa FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is moved to the left by a fall in pH GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGG. is move to the right by a fall in temperature HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHH. in the fetus has a lower p50 than in adult IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is moved to the right by an increase in th 2,3 DPG concentration in RBC TFFTT 346.The following ions have a higher intracellular than extracellular concentration: JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Sodium KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKK. Calcium LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LL. Potassium MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMM. Chloride NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNN. Bicarbonate FFTFF 347.Regarding pressures during respiratory cycle : OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOO. OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOO. Alveolar pressre rises to allow inspiratory flow to occur PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Intra pleural pressure is -5cm H2O before inspiration begins QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQ. Alveolar pressure is positive during expiration RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRR. Fall in intrapleural pressure during inspiration is due to a fall in the elastic recoil SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Wit h forced expiration, the intrapleural pressure exceeds zero. FTTFT

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348.Variations in coronary blood flow TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TT. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTTT. the heart extracts up to 95% of the oxygen from each unit of blood delivered to it UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUU. oxygen consumption can be increased significantly only by increasing blood flow VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVV. autoregulation is well developed in the heart WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWW. the alpha-adrenegic receptors of the coronary arterioles mediate vasoconstriction XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXX. stimulation of vagal fibres to the heart constricts the coronaries FTTTF 349.The a wave of the central venous pressure waveform: YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. Is caused by atrial contraction ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZ. Is not seen in atrial fibrillation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAA. Is caused by atrial filling during ventricular contraction BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBB. Decreases with inspiration CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCC. Is followed by the v wave TTFFF 350.Vagal stimulation produces: DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDD. DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. fall in heart rate EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEE. decrease. in atrial contractility FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. An increase in ventricular contractility GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGG. Slowing of A-V conduction HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHH. A fall in stroke volume TFFTF 351.Alveolar- arterial oxygen difference ( A-a DO2 ) IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIII. is normally 15-25 mmHg while breathing room air JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. is increased under anaesthesia due to increased ventilation/ perfusion mismatch KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKK. is decreased in one lung ventilation

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LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLL. is increased in the presence of right to left intracardiac shunts MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMM. is decreased in excessive exercise TTFTF 352.Lung compliance NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNN. NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN. is normally 0.2 L/ cm H2O OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOO. reduces with loss of pulmonary surfactant PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. is increased in emphysema QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQ. increases after induction of general anaesthesia RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRR. is different at apical and basal of the lungs TFTFT 353.Regarding the carotid bodies : SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Have cells which responds to increase in arterial PH. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTT. Have the highest blood flow ( ml/ unit weight ) in the body UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUU. Stimulate maximally the respiratory drive when PaO2 35-70 mmHg VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVV. It"s discharge is increased by anaemia WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWW. The afferent nerve is via glossopharyngeal nerve. FTTFT 354.In an awake upright spontaneously breathing patient XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX. ventilation per unit lung volume is smallest at the apex of the lungs. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYY. basal alveoli are bigger than apical alveoli ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZ. basal alveoli expand more than apical alveoli during inspiration AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAA. pleural pressure is less negative at the base of lungs BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBB. last part of the expired air comes from the apical alveoli. TFTTT

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355.Regarding coronary blood flow CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCC. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCCCCCCCCCCCC. Subendocardium is more vulnerable to ischaemia than epicardium DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDD. Adenosine is a coronary vasodilator. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEE. Myocardial oxygen consumption and coronary blood flow bear a linear relationship FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Coronary blood flow will be improved by slowing the heart rate GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGG. Normal myocardial oxygen extraction ratio is 70 %. TTTTT 356.In normal healthy man at rest in the supine position HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHH. HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH.left ventricular end diastolic volume is about 20 mls. IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. the first heart sound coincides with the onset of ventricular systole JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. cardiac output is approximately 75mls/beat KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKK. left ventricular end diastolic pressure ( LVEDP ) is about 5 mmHg LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLL. the second heart sound coincides with end of T wave of ECG FTTTT 357.The respiratory center in the brain stem receives input from MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMM. The aortic and carotid bodies NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNN. Mechanoreceptors of the larynxs OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOO. Oxygen-sensitive chemoreceptors in the medulla PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Bronchiolar strech receptors via sympathetic stimulations QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQ. Receptors which respond to the hydrogen ion concentration in the CSF TTFFT 358.Oxygen is transport from the alveoli into the blood in pulmonary capillaries by RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRR. RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRRRRRRRRRRRRRRR. Filtration SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Passive diffusion TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTT. Facilitated diffusion UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUU. Active transport

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VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVV. Secondary active transport FTFFF 359.In the conducting system of the heart WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWW. WWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWW. The SA node develops from the structures on the right side of the embryo XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXX. Sympathetic innervation of the right side supply to the AV node YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYY. Atrial conduction is slowed by a decrease in temperature ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZZ. The PR interval represents the duration of atrial depolarization AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAA. The action potential in SA and AV nodes are largely due to Na+ TFTFF 360.In cell metabolism BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBB. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBBBB. 1 molecule will yield 38 molecules of ATP. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCC. The Kreb's cycle can operate for a limited time anaerobically DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDD. The components of the Kreb's cycle are supplied entirely from carbohydrate metabolism EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEE. The RQ is higher for carbohydrates than fats because extra oxygen is needed to burn carbohidrates FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Aerobic glycolysis is a process when pyruvate enters the citric acid cycle and produce CO2 and H2O TFFFT 361.The velocity of conduction of a nerve action potential GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGG. GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG. Is highest in preganglionic autonomic nerve fibres HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHH. A? has a higher conduction velocity than A? IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Is faster in unmyelinated fibres than the myelinated one JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Is inversely related to the cross-sectional area of the axon KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKK. is decreased by cooling the nerve FTFFT

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362.Pulse pressure increases with an increase in LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLL. Stroke volume MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMM.Blood viscosity NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNNN. Systemic vascular resistance OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOO. Arterial partial pressure of oxygen PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Left ventricular end-diastolic volume TFFFT 363.In Cardiac cycle QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQ. QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ. Mitral valve closure occurs before tricuspid valve closure RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRRR. Carotid pressure is highest at the start of ventricular systole SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Left ventricular volume is lowest when mitral valve opens TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTTT. Atrial contraction is of more importance to ventricular filling if heart rate increase UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUU. Late in diastole, the mitral and tricuspid valves are closed while the aortic and pulmonary valves are open TFTTF 364.In the autonomic nervous system, VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVV. VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV. the parasympathetic system is transmitted in cranial nerves and sacral fibres from the spinal cord WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWW. parasympathetic effects are identical to those of acetylcholine XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX. Noradrenaline is not metabolized by COMT YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYY. Nicotinic receptors are present in the parasympathetic and sympathetic ganglion ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZZZ. Down regulation of receptors is seen in chronic heart failure TFFTT 365.Regarding the neuromuscular junction: AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAA. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. The synaptic cleft is about 5070 nm wide BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBB. The postjunctional membrane is thrown into folds

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CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCC. Acetylcholine receptor has five protein subunits DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDDD. Two alpha subunits of acetylcholine receptor have to be activated for the channel to open EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEE. Acetylcholine is synthesized from choline and acetic acid TTTTF 366.The normal Electrocardiogram FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Can give good information regarding myocardial contractility GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGG. The electrodes are silver/silver chloride electrode HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHH.CM5 is a modification of lead V5 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. Between the T wave and the next P wave, the myocardial potential is zero JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. Repolarisation takes place in the opposite direction as depolarisation FTTFT 367.The pathways of pain sensation include KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKK. KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. a-delta fibres which terminate in lamina 1 of the dorsal horn LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLL. second order neurons which ascend in the ipsilateral spinothalamic tra MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMM. c fibres which release histamine and serotonin NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNNNN. synapses in the substantia nigra of the spinal cord OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOO. descending pathways in the dorsolateral colums TFFFT 368.Regarding drug administration : PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP. Sublingual route avoids first-pass inactivation in the liver QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQ. Suppositories expose the drug to first-pass metabolism RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRRRR. Distribution of nebulised drug in the respiratory tree depends on the particle size SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS. Highly water soluble drugs are administered by transdermal route TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTTTT. Drugs given by oral route should have a very high exraction ratio

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TFTFF 369.First-order processes UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUU. UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU. apply to enzyme- mediated reactions VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVV. are characterized by high rates of reaction when the concentrations of reacting substances are high. WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWW. can properly be described in terms of t1/2 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXX. are involved in elimination of most drugs YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYYY. change to zero-order kinetic at very high drug doses TTFTT 370.The following statements about drug half-life are correct : ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZZZZ. ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZZZZZZZZZZZZZ. Half-life of a drug is shorter than its time constant AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAA. Drug given by infusion without a bolus reach a steady state in five half-lives BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBB. Extent of drug distribution into extracellular fluid is unlikely to affect t1/2. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCC. Context sensitive half-life can be use for any drug DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD DDDDDDDDDDDDDDDDDD. About 94% of a drug is cleared of the body in four halflives TTFFT 371.Nitrous oxide EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEE. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEEEEEEEEEE. is stored as liquid FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF F. is a gas above a temperature of 36 degree centigrade GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGG. cylinders should have filling ratio of 0.65-0.75 HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHHHHHHH. content in a cylinder is always reflected from its pressure gauge IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII. is 34 times less soluble than N2. TTTTF 372.Regarding opioid receptors : JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ. kappa receptors Morphine acts on

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KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK KKKKKKKKKKKKKKKKKK. The effect of stimulation of sigma receptors is dysphoria and hallucination LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLL. Euphoria is due to stimulation of delta receptors MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMMMM. Nalorphine antagonizes kappa receptors NNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNNN NNNNNNNNNNNNNNNNNN. Pentazocine is partial agonist TTFFT 373.Pethidine OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOO. OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO. is structurally related to morphine PPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPPP P. onset of analgesic activity after intramuscular injection is 35 minutes QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQ. in equianalgesic doses, pethidine and morphine produce equal amount of sedation RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR RRRRRRRRRRRRR.respiratory depression caused by it can be antagonized by nalorphine SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS S. about 60% is bound to plasma proteins TFFTF 374.Rocuronium TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTTTTT. TTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTTT TTTTTTTTTTTTTTTT. is an aminostereroid UUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUUU UUUUUUUUUUUUUUUUU. is stable in aqueous solution VVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVVV VVVVVVVVVVVVVVVVVV. undergoes principally hepatic elimination WWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWWW WWWWWWWWWWWWWWWWWWWWWWWWWWWWWW. has provide intubating conditions within 60 seconds XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXX. It release histamine TTTTF 375.A drug that is strongly protein-bound: YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYYYY. YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY YYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYYY. will be metabolised rapidly ZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ ZZZZZZZ. may interfere with the pharmacodynamics of warfarin AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAA. will induce liver microsomal enzymes

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BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBB. will cause an increase in the serum albumin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCCC. will have a relatively low 'free' concentration in the plasma FTFFT

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