Mechanism of action of inotropic drugs

The following drugs are correctly paired with their mechanism of action EXCEPT

which one?

a) Dopexamine – dopamine and beta-adrenergic agonist

b) Prenalterol – beta-adrenergic agonist

c) Digoxin – inhibition of sodium–potassium ATPase pump

d) Bucladesine – phosphodiesterase inhibitor

e) Istaroxime – calcium channel stimulator

Elective neurosurgery

Which one of the following statements is TRUE regarding anaesthesia for routine

elective neurosurgery?

a) Desflurane is the agent of choice for many neuroanaesthetists

b) Dense neuromuscular blockade is required for a craniotomy

c) Permissive hypothermia is usually employed for cerebral protection

d) Resection of cortex is profoundly stimulating

e) A central venous catheter is mandatory for a craniotomy in a head-up position

Drugs in porphyria

You are working in the developing world and a patient with known acute intermittent

porphyria presents for emergency surgery. Which one of the following pharmaceuticals

would it be best to AVOID in this patient?

a) Suxamethonium

b) Halothane

c) Aspirin

d) Pancuronium

e) Ropivacaine

Wegener’s granulomatosis

A previously fit and well 31-year-old male patient requiring ventilation for severe respiratory failure characterised by haemoptysis and hypoxia was found to have diffuse pulmonary haemorrhage. He also tested positive for haematuria and proteinuria. His tests for c-ANCAs (classical antineutrophil cytoplasmic antibodies) were  positive, confirming the diagnosis of Wegener’s granulomatosis. Once the diagnosis has been made, which one of the following would be the PREFERRED drug therapy?

a) Cyclophosphamide i.v. 1 g/day

b) Methylprednisolone i.v. 30 mg/day

c) Ciclosporin i.v. 200 mg/day

d) Azathioprine i.v. 250 mg/day

e) Methotrexate i.v. 7.5 mg/week

Xenon

Regarding xenon, the following statements are true EXCEPT which one?

a) Xenon has analgesic as well as anaesthetic properties

b) Xenon may protect against hypoxic neuronal injury

c) A worldwide conversion to xenon use for anaesthesia would be beneficial with respect to climate change

d) Xenon’s first reported use as an anaesthetic was in 1951

e) Xenon has a blood:gas partition coefficient of 0.115

Pulmonary oedema

A 35-year-old male presents to the intensive care unit with respiratory failure requiring mechanical ventilation. His chest X-ray shows bilateral pulmonary infiltrates. Which of the following statements makes a diagnosis of non-cardiogenic pulmonary oedema MOST LIKELY?

a) The presence of peribronchial cuffing

b) Even or central radiographic distribution of the pulmonary oedema

c) The presence of septal lines

d) The presence of an air bronchogram

e) The presence of pleural effusions

Estimated glomerular filtration rate

The following are used by a laboratory to calculate an estimated glomerular filtration rate EXCEPT for which one?

a) Age

b) Weight

c) Ethnic group

d) Local variations in serum creatinine measurement

e) Gender