Anzca MCQ Saqs Viva Question Bank Pharmacology Including Statistics

ANZCA MCQ SAQs VIVA
Question Bank
Pharmacology including Statistics
Updated Feb 2008
MCQ-General Pharmacology
From Anaesthesia_MCQ
Back to: Primary Pharmacology
Black Bank
GP01 [Mar96] A drug is given at a dose of 50 mg/kg

to a 70 kg man. The plasma concentration after giving it
is 10 mg/ml. The elimination half-life is 8 hours.
Clearance would be:
A. 1.3 l/h
B. 3 l/hr
C. ?
D. 125 l/hr
GP02 [Mar96] A drug is given orally and 95%

absorbed. Only 25% reaches the general circulation due
to hepatic first pass metabolism. If hepatic blood flow is
1500 mls/min, the hepatic clearance is:
A. 400 mls/min
B. ?
C. 1100 mls/min
D. ?
E. 1425]] mls/min
C: Has a dose response curve similar to that of a full

agonist in the presence of a non-competitive antagonist.
D. ?
GP08 [Jul98] [Jul01] [Mar02] Placental transfer of

drugs:
A. Increases in late pregnancy
B. Increases late because of decreased albumin
C. Do not cross if MW > 600 daltons
D. Lipid soluble drugs diffuse through placenta
depending on concentration gradient
E. Icreased diffusion if greater plasma protein binding
in fetus
GP09 [Jul98] [Jul99] Regarding pharmacokinetics:

A. ?
B. Half-life is inversely proportional to clearance
C. ?
D. Half-life is proportional to steady-state
E. B & D
GP10 [Jul99] [Jul04] An ether bond:
(no other details)
A. Formed from condensation of 2 alcohols

B. Hydroxyl group on middle bond
C. ?
GP04 [Jul97] Rectal administration of drugs:
GP11 [Feb00] [Mar03] The NMDA receptor
GP03 [Jul97] Histamine release
A. Gives predictable blood levels

B. From lower 1/3rd avoids first pass & upper 2/3rds
doesnt
C. None undergoes first pass metabolism
D. All of it undergoes first pass metabolism
A. Ketamine is an agonist
B. Requires glycine as a modulating protein (YES
PROTEIN ! ) to have its effect
C. Mg+2 blocks the receptor
D. Is not permeable to Calcium
GP05 [Mar99] [Jul00] [Apr01] [Jul04] LD50 is:
GP12 [Feb00] [Jul02] Activated charcoal:
A. Median lethal dose

B. Determined in phase I clinical trial
C. Determined from log-dose response curve
D: Dose causing death in 50% of animals within ?1/?4
hours
E. Half the mean lethal dose.
F. Best expressed as ratio of lethal dose in 50% of
animals to effective dose in 50%
GP06 [Mar99] [Feb00] [Jul02] [Mar03] Which ONE

of the following crosses the blood-brain barrier?
A. GABA
B. Propranolol
C. Suxamethonium
D. Edrophonium
E. Dopamine
GP07 [Jul98] [Jul99] [Apr01] With regard to drugreceptor binding:

A. A competitive antagonist has no intrinsic activity
B. A partial agonist has less receptor affinity than a full
agonist
C. KD is maximal intrinsic efficacy
GP07b [Feb00] [Feb04] [Jul04] A partial agonist:

A. Always antagonises a full agonist
B: Can never be used to antagonise a full agonist
A. Should be given with sorbitol

B. Is not effective against theophylline
C. Should be given with ipecac
D. Should be given in a drug:charcoal ratio of 1:10
GP13 [Apr01] [Jul04] Therapeutic index:

A. Easy to determine in humans
B. ?
C.
D.
E. Derived from LD50/ED50
GP14 [Apr01] [Jul04] (A Basic drug with a pKa of

8.7)
A. ?
B. ?
C. Will be predominantly ionised at plasma pH
GP15 [Apr01] [Jul02] [Mar03] Oxygen toxicity

A. Causes convulsions at less than 100 kPa
B. Causes lipid peroxidation at less than 100 kPa
GP16 [Jul01] With regard to log/dose response curves:

A. The response is fairly linear over the 20-80% range.
B. The Dose is fairly linear over the 20-80% range
C. The ED50 and slope are characteristic for each drug
D. ?
E. ?
GP17 - renumbered to another section.

GP18 [Jul01] With regards to diffusion through a
membrane:
A. Directly proportional to thickness
B. Inversely proportional to thickness
C. Inversely proportional to Surface area
D. Inversely proportional to concentration difference
E. ?
GP19 [Mar02] [Mar03] Which of following act via

ligand gated channel?
A. ?
B. ?
C. Morphine
D. Vecuronium
E. ?
GP20 [Jul02] Zero order kinetics means:

A. ?
B. ?
C. Drug is eliminated at a constant rate regardless of
dose.
D. Elimination half time will vary according to dose.
E. ?
GP21 [Feb04] All exist as Racemic mixtures except:

A. Thiopentone
B. Lignocaine
C. Bupivucaine
D. Isoflurane
E. Enflurane
GP22 [Feb04] Clearance of a drug with a high hepatic

extraction will be:
A. Decreased in shock ???
B. Increased in high output states ???
GP23 [Feb04] Chemoreceptor trigger zone

A. Contains 5HT3 and D2 receptors
B. Not involved in inner ear mediated nausea
C. ?
GP24 [Feb04] [Jul04] Glutamate

A. Dissociates slowly from the NMDA receptor
B. Does not act at AMPA and kainite receptors
C. Inhibitory neurotransmitter in CNS
D. ?
GP25 [Feb04] Regarding pharmacokinetics in

pregnancy:
A. paracetamol uptake increased
B. increased sensitivity and faster onset with
thiopentone
C. hepatic clearance decreased by decreased protein
binding
GP26 [Jul04] Which is an antagonist at the NMDA

receptor?
A. Dexamethasone
B. Dextropropoxyphene
C. Dexmedetomidine
D. Dextromethorphan
E. Dexmethamphetamine
GP27 [Jul04] Comparing dexamethasone and

hydrocortisone:
A. Both are endogenous hormones
B. Dexamethasone has 8x potency of hydrocortisone
C. Both have mineralocorticoid activity
D. Dexamethasone is the only water-soluble
compound
MCQ-General Anaesthetics - Inhalational

Back to: Primary Pharmacology Black Bank
IN01 [Mar96] Which compound(s) is/are broken down

in soda-lime?
A. Nitrous oxide
B. Halothane
C. Sevoflurane
D. Desflurane
E. All of the above
IN02 [Mar96]
Regarding nitrous oxide at 70%:
A. Synthetised from ? & N2 at 273C
B. Decreases muscle blood flow by 30%
C. Decreases cerebral autoregulation 24%
D. ?
IN02b [Jul97]
Nitrous Oxide:
A. ?Increases/decreases CBF
B. Is an effective oxidant
C. Is made by heating nitrogen and oxygen in an iron
retort
D. Decreases pulmonary artery pressure in neonates
IN03 [Mar96] [Jul96] [Jul97] [Jul98] [Jul99]

The following drugs are (potent) triggers for malignant
hyperthermia EXCEPT:
A. Decamethonium
B. Suxamethonium
C. Isoflurane
D. Halothane
E. Calcium
F. Sevoflurane
G. Tubocurarine
H. Nitrous oxide
(Different options on different papers)
IN04 [Mar96] [Mar03] IPPV with isoflurane at 1

MAC results in:
A. Depresses cardiovascular reflexes more than
halothane
B. Causes decreased conduction velocity
C. Maintains cerebral autoregulation
D. Equal respiratory depression to enflurane
E. Reduction in cardiac output by 25%
F. Increased vasodilatation
IN05 [Mar96] [Mar98] The effect of increased cardiac

output on Pa versus time for volatile agents is:
A. No effect
B. Decrease slope
C. Decrease then increase slope
D. Increase then decrease slope
IN06 [Mar96] [Jul97] [Apr01]
Nitrous oxide (N2O):

A. Supports combustion
B. Is flammable
C. Causes muscle rigidity
D. In tissues is slower to reabsorb than oxygen
E. Has a partition coefficient of 0.76
F. All of the above
G. Is formed by heating oxygen & nitrogen
H. Induces methionine synthetase
I. Oxidises the cobalt in vitamin B12
IN06b [Mar98] [Jul98] Nitrous oxide:

A. Has MW of 42
B. Critical temperature 32 C
C. Formed by using iron as a catalyst
D. Does not support combustion
E. ?? has saturated vapour pressure of 24]] kPa
F. Produced using ammonium sulphate in an iron retort
G. Boiling point 32C
H. ??. . . ammonium nitrate . . . copper vessel ??
(Multiple options as this represents 2 separate N2O
questions on Mar98 paper)
IN07 [Mar97] [Mar03] Desflurane

A. Takes 5 minutes to reach equilibrium
B. Is fastest to approach equilibrium of any inhaled
anaesthetic agent
C. Is a fluorinated diethyl ether
D. ?
IN08 [Mar97] [Jul97] Regarding sevoflurane:

A. The vapour pressure is less than enflurane
B. The vapour pressure is greater than isoflurane
C. Cardiovascular side effects are similar to
isoflurane
D. Molecular weight less then isoflurane
E. Boiling point greater than enflurane
IN08b [Jul97] [Feb00] Sevoflurane:

A. Is a methylethyl ether
B. Is odourless
C. Is stable in soda lime at 37 degrees
D. Has a boiling point higher than enflurane
E. Has a molecular weight lower than desflurane
IN08c [Jul98] [Jul99] Sevoflurane:

A. Molecular weight greater then enflurane
B. MAC less than enflurane
C. Contains Cl & F
D. SVP > enflurane
IN09 [Mar97] [Jul98] [Jul00] Uptake of N2O when

breathing 70%:
A. More than one litre absorbed in the first minute
B. Equilibrium (?90%) is achieved in 3mins
C. Absorb 10 litres ?at time of ?90% equilibration / ?in
first 3 mins
D. At steady state, uptae is 200mls/min
E. Produces surgical anaesthesia
IN10 [Mar97] [Jul98] [Mar99] [Jul01] [Jul04] N2O

causes the second gas effect because:
A. It is relatively insoluble
B. Reaches equilibrium faster than the more soluble
second gas
C. Larger volume
D. Its high concentration
IN11 [Jul97] Desflurane:

A. Is non-irritant to the airways
B. Is more/less potent than sevoflurane
C. Has a higher molecular weight than ?isoflurane/?
enflurane
D. Is a chlorinated methyl ethyl ether
IN12 [Jul97] [Apr01] Effects of volatile agents

include:
A. Halothane increases hepatic artery and portal blood
flow
B. Isoflurane causes hypotension by reducing cardiac
output
C. ?
D. ?
IN12b [Feb04] Volatile agents:

A. Halothane causes less cerebral vasodilation than
enflurane
B. Isoflurance causes less cerebral vasodilation than
halothane
IN13 [Jul97] [Jul98] [Jul99] [Apr01] Problems with

MAC:
A. Large interspecies variability
B. Affected by temperature and other factors
C. Affected by obesity
D. ?
IN13b [Mar96] [Jul98] [Feb00] [Jul01] MAC:

A. Is decreased in the elderly
B. Is unchanged throughout pregnancy
C. Increases in hypothermia
D. ?Decreased/?increased with hyper/hypo-kalaemia
E. ?
Alt version (Jul 01) All the factors decrease MAC
except:
A. Pregnancy
B. Hyperthermia
C. Hypothermia
D. Hypoxia
E. ?
IN13c [Mar99] [Apr01] [Jul01] MAC:

A. Highest between ages 2 to 5 yrs
B. Increases with pregnancy
C. MAC BAR is concentration at which 95% do not
move
D. Is 0.2% halothane in 70% N2O
E. ?
Jul 01 version: With regards to MAC:
A. The MAC of Halothane with 70%N2O is 0.29
B. Concentration at which 95% of patients dont move

after a surgical stimulus
C. MAC- BAR ??
D. Decreased by increased CO2
E. ?
IN14 [Mar98] [Mar99] Systemic vascular resistance is

LEAST changed with:
A. Isoflurane
B. Sevoflurane
C. Desflurane
D. Enflurane
E. Halothane
IN15 [Mar98] [Jul98] [Mar99] MAC awake during

emergence when patient will respond to command:
A. 0.1
B. 0.2
C. 0.3
D. 0.5
E. ?0.7 ?0.8
IN16 [Jul98] [Jul99] Isoflurane & enflurane are:

A. Structural isomers
B. Enantiomers
C. Diastereomers
D. Optical isomers
E. Configurational isomers
IN17 [Mar96] [Jul96] Sevoflurane:

A. Is broken down in the body to Compound A which
has been shown to be toxic to rats
B. Has a blood:gas partition coefficient of 2.3
C. Is a irritant causing coughing on induction
D. Has a boiling point of 24]] degrees centigrade
E. Has Cl & F atoms in its structure
F. None of the above
(Note: Compound A is a breakdown product produced
in the CO2 absorber; it is not produced by
biotransformation)
IN18 [Mar99] [Feb00] With isoflurane anaesthesia,

MAC awake is:
A. 0.1% vol
B. 0.3% vol
C. 0.5% vol
D. 0.5% vol
E. 1% vol
IN19 [Mar99] [Jul04] Isoflurane:

A. Is a halogenated methyl ethyl ether
B. Higher boiling point than sevoflurane
C. No odour
D. Enantiomer of enflurane
IN20 [Mar99] MAC of halothane with 70% N2O is:

A. 0.25%
B. 0.5%
C. 0.75%
D. 1.0%
IN21 [Mar99] All reduce MAC except:

A. Aminopyridine
B. ?
IN22 [Jul98] N2O is NOT relatively contra-indicated

with:
A. Pneumothorax
B. Ear surgery
C. Postop nausea & vomiting
D. Renal failure
IN23 [Jul99] [Jul02] [Mar03] [Jul04] Which of the

following does NOT affect the speed of induction with
a volatile agent?
A. FRC
B. Obesity
C. pCO2
D. Cardiac output
E. Body mass
F. MAC
Alt version: Regarding the time constant for volatile
anaesthetic uptake in the lungs
A. Affected by agent concentration
B. Affected by obesity
C. Not affected by FRC
D. Affected by restrictive lung disease
IN24 [Feb00] 22g of Nitrous oxide at STP occupies a

volume of:
A. 3.6 L
B. 11.2 L
C. 22]] L (? or 22.4 L)
D. 44.1 L
IN25 [Jul00] [Mar03] [Jul04] Wash in (? washout) of

volatile anaesthetics is reduced in neonates because:
A. Reduced FRC
B. Increased cardiac index
C. Decreased plasma protein levels?
D. (Something about blood:gas partition coefficients
being different in neonate)
Alt version which probably is the same question
remembered differently:
The washout of inhalational anaesthetics
A.. Increases with elimination by the liver
B.. Related considerably with the duration of
anaesthesia
C. Increases in the neonates compared to an adult
IN26 [Jul01] With regard to compound A:

A. Increased production in Baralyme compared to
sodalime
B. More likely in children
C. Sevofluranes metabolites cause hepatotoxicity
D. Sevoflurane is METABOLISED to Compound A in
the liver
E. ?
IN27 [Jul01] Concerning the effects of various volatile
agents on cerebral blood flow under conditions of 1

MAC and normocarbia:
A. Halothane produces greater increase than enflurane
B. Isoflurane produces greater increase than enflurane
C. Any change produced depends upon cerebral
metabolic rate
D. Change in CBF is due to change in cardiac output
E.
IN28 [Jul01] Which of the following drugs is NOT

associated with EEG epileptiform activity
A. Propofol
B. Enflurane
C. ?
D. ?
E. ?
IN29 [Jul04] Which does not increase risk of increased

carboxyhaemoglobin in blood during anaesthesia?
A. Dry absorbent
B. Baralyme
C. Low flows
D. Desflurane
E. Halothane
IN30 [Jul04] The concentration effect for N20 is due to

A. Increased conc of N20
B. Faster eqilibrium of N20 than the second soluble
second gas
C. ?
D. ?
MCQ-General Anaesthetics - Intravenous

Back to Primary Pharmacology Black Bank |
Jump to IV05 IV10 IV15 IV20
See also Finals Black Bank for MCQs in this area:
MCQ-Intravenous anaesthetics
IV01 [Mar96] [Mar97] [Jul97] Propofol:
A. Has a pKa of 7
B. Has a pH of 11
C. Causes hypotension due to myocardial depression
D. Has 98% protein binding
E. ?
IV02 [Mar96] [Jul97] [Apr01] Thiopentone causes a

decrease in BP by:
A. Direct decrease in myocardial contractility
B. Fall in systemic vascular resistance
C. Decrease in venous tone
D. ?
IV03 [Mar96] [Jul96] [Jul97] [Mar99] Ketamine:

A. Is a direct inotrope
B. Causes bronchodilatation
C. Less likely to see emergence delirium (?
psychotomimetic effects) in ?older/?younger females
D. Reduces pharyngeal secretions
E. Leaves airway reflexes reliably intact
(See IV17 for another Ketamine Q)
IV04 [Mar96] [Apr01] With regards the action of

midazolam:
A. Ring closure occurs immediately on injection
B. ?
C. ?
IV05 [Jul97] [Mar99] [Jul99] [Apr01] Propofol

depresses cardiac output predominantly by:
A. Direct depression of myocardial contractility
B. Decreased SVR
C. ?
D. ?
IV06 [Jul97] [Apr01] Methohexitone:
A. Near Cl- channel

B. Inside the channel
C. Outside the channel
D. On the alpha subunit
IV08 [Mar98] [Jul01] The drug with the largest

volume of distribution at steady state is:
A. Propofol
B. Midazolam
C. Etomidate
D. Thiopentone
E. Methohexitone
IV09 [Jul98] [Jul04] GABA:

A. Is the principal inhibitory neurotransmitter in the
spinal cord
B. Barbiturates decrease the dissociation time between
GABA and its receptor
C. ??A & B types??
D. ?
(see also IV18 )
IV10 [Mar96] Propofol is structurally related to:

A. Althesin
B. Etomidate
C. Ketamine
D. ?
E. None of the above
IV11 [Mar99] [Feb00] Midazolam:

A. Water soluble at physiological pH
B. Undergoes oxidative metabolism
C. More lipophilic than lorazepam
D. Causes hypotension
E. Has a pKa of 7.4 (or ? 8.1)
F. Causes retrograde amnesia
IV12 [Jul98] Thiopentone:

A. Is the sulphur analogue of phenobarbitone
B. Has higher protein binding than its oxy analogue
C. ? 6% sodium bicarbonate
D. Isotonic at 2.5% concentration
IV13 [Jul98] Propofol clearance is significantly
A. Has a molecular weight of 285

B. Has a melting point of 158 degrees
C. A 2.5% solution is isotonic
D. Is yellow
E. Has 4 isomers
increased in:
A. Elderly
B. Metabolic acidosis
C. Pregnancy
D. ? (See also IN13b)
IV06b [Mar02] Methohexitone
IV14 [Feb00] [Jul04] Thiopentone:
A. Is a oxythiobarbiturate
B. Breakdown is principally by splitting of ring
C. Longer duration than thio/ or maybe greater protein
binding compared to thio??
D. ?
E. ?
A. 100% reabsorbed in renal tubule

B. Does not cross the placenta in significant amounts
due to high plasma protein binding
C. ??accumulate in the foetus
IV07 [Mar98] Benzodiazepine binding site on GABA

receptor is:
short period
B. ??
IV15 [Jul00] Thiopentone:

A. ? Tachyphylaxis if multiple administration in
IV16 [Jul00] Propofol:

A. 10% eliminated unchanged
B. Undergoes oidative metabolism
C. Clearance depends on hepatic bloodflow
D. No effect / chronic liver disease
E. ?
IV17 [Apr01] Ketamine:

A. Direct acting negative isotope (It did say this)
B. ?Indirectly acts on SNS peripherally
C. Directly on the sympathetic ganglia
D. ?
E. ?
Alt version: Ketamine:
A. Is a negative isotope (it was isotope and not
inotrope)
B. ?
C. Directly stimulates autonomic ganglia
D. Is a competitive antagonist at NMDA receptors
E. Directly stimulates alpha and beta receptors?
Comments:
[1] Both independently submitted versions of this MCQ
contained a comment that one of the options was
negative isotope - ???
[2] Using the information contained in these 2
submitted versions, we can attempt to reconstruct the
whole question as below. However, the question still
does not look right: for example 3 options say directly
and only one says indirect & the other does not use
either term, so by frequency analysis, this suggests
that one of A, C or E is correct. The problem with this
is the College has in recent times been going through
their whole MCQ Bank trying to eliminate this type of
design problem where you can guess or narrow in
towards the answer by looking at the frequency of
numbers or words in the different options.
Reconstructed IV17:
Ketamine:
A. Direct acting negative isotope
B. ?Indirectly acts on sympathetic nervous system
peripherally
C. Directly on the sympathetic ganglia
D. Is a competitive antagonist at NMDA receptors
E. Directly stimulates alpha and beta receptors
IV17a [Jul04] Ketamine:

A. Is a NON-competitive antagonist at NMDA
receptors
B. ?Direct acting negative inotrope
C. ?Indirectly acts on sympathetic nervous system
peripherally
D. ?Directly on the sympathetic ganglia
E. ?Directly stimulates alpha and beta receptors
IV18 [Jul01] With regard to GABA receptors: (OR:

Which of the following is INCORRECT about GABA
neurotransmission:)
A. GABA-A found all over the body
B. Is an excitatory transmitter in 20% of CNS synapses
C. GABA-B is predominately post-synaptic

D. GABA receptor located in spinal cord, medulla and
rest in Cortex.
E. Is metabolised by deamination
F. Is metabolised by transamination by ?GABA
transaminase
G. Stimulated by benzodiazepines
H. Opposes action of glycine
(Above is a composite of options from two GABA
questions which were on the Jul 01]] paper.)
IV19 [Jul01] Propofol

A. Causes decreased hepatic blood flow to influence its
own clearance
B. Relatively low clearance in Children
C. Has a high rate of transfer from the peripheral to the
central compartment on ceasing an infulsion
D. Has clinically significant metabolites
E. Elimination halflife of 5 minutes
[[IV20 [Mar02] Which one of the following induction
agents does NOT exert its main effect via the GABA
receptor?
A. Ketamine
B. Thiopentone
C. Propofol
D. Midazolam
E. Methohexitone
IV21 [Feb04] Sodium carbonate added to

Thiopentone:
A. As a bacteriostatic agent
B. To neutralise Thiopentones acidity
C. To increase ionised portion
D. Enhances activity
IV22 [Jul04] Which agent does not cause increased

heart rate on induction of anaesthesia?
A. Thiopentone
B. Etomidate
C. Propofol
D. Ketamine
E. Methohexitone
IV23 [Jul04] Benzodiazepine receptor has

A. Two glycine binding sites
B. ?
IV24 [Jul04] Midazolam
A. Bioavailability 10%
B. Bioavailability 50%
C. Elimination t1/2 30]] min
D. Elimination t1/2 30]] hours
E. ?
MCQ-Local Anaesthetics
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Jump to LA10 LA15 LA20
(see also LA09, LA10)
Black Bank |
LA01 [Mar96] [Mar97] [Jul97] [Mar99] [Jul01]

Lignocaine has a pKa of 7.9 At pH 6.9, the percentage
ionised is:
A. 1% (or 5%)
B. 10%
C. 50%
D. 90%
E. 99%
(Also remembered as: With a pKa of 7.9, what percent
of lignocaine is ionised at intracellular pH?)
LA02 [Mar96] [Jul04] Cocaine:

A. Blocks reuptake of dopamine and noradrenaline
B. Central effects are due to noradrenaline
C. Crosses lipid soluble membranes because its pKa is
2.8
D. Is not metabolised by plasma pseudocholinesterase
E. Rapidly absorbed by nasal mucosa
LA03 [Mar96] [Mar03] Ropivacaine:

A. Produces greater motor block than bupivacaine
B. Is prepared as the R enantiomer
C. Is less lipid soluble than lignocaine
D. Has the same cardiotoxicity as lignocaine
LA03b [Mar97] [Feb00] Ropivacaine
LA06 [Jul97] [Jul04] Lignocaine works by:

A. Altering Na+ permeability
B. Altering membrane structure
C. Reduced Ca++ permeability
D. Increased K+ permeability
E. Ca++ binding to tropomyosin
LA07 [Jul97] Lignocaine:

A. Has ?% uptake in lung
B. Is 24% ionised at physiological pH
C. Reduces Na+ conductance (?)
D. ?

A. Has active metabolites
B. Metabolism faster in females because of
progesterone
C. Metabolism is independent of liver blood flow
D. ?
LA09 [Mar98] [Feb00] Protein binding of local

anaesthetics (in decreasing order):
A. Procaine > bupivacaine > lignocaine > prilocaine
B. Bupivacaine > lignocaine > prilocaine > procaine
C. Prilocaine > bupivacaine > lignocaine > prilocaine
D. Lignocaine > bupivacaine > prilocaine > procaine
E. Bupivacaine > lignocaine > procaine > prilocaine
F. Bupivacaine>procaine>lignocaine>prilocaine
A. Is a pure R isomer
B. Is an isomer of bupivacaine
C. Provides more motor block than bupivacaine
D. Has more toxicity than bupivacaine
E. Has similar physico-chemical properties to
bupivacaine
LA10 [Mar98] Local anaesthetics are metabolized in
LA03c [Mar98] [Jul98] Ropivacaine differs from
LA11 [Mar98] Saxitoxin site on sodium channel is:
bupivacaine mainly by:

A. More motor blockade than bupivacaine
B. Mainly affecting A beta rather than A delta fibres
C. Lower cardiac toxicity than bupivacaine
D. ?
LA12 [Jul98] The site of action of benzocaine is:
LA04 [Mar96] [Mar99] Bupivacaine:

A. Is an aminoester local anaesthetic
B. Is formed by substituting butyl for methyl on amino
group of mepivacaine
C. ?Less/more toxic than tetracaine
D. Adrenaline solution contains sodium metabisulphite
E. Equipotent to etidocaine in causing motor block
LA05 [Jul97] With regard to molecular weight of local

anaesthetics, which is the correct sequence?
A. Cinchocaine > bupivacaine > lignocaine > prilocaine
B. Bupivacaine > lignocaine > cinchocaine > prilocaine
C. Bupivacaine > lignocaine > prilocaine > cinchocaine
D. Prilocaine > bupivacaine > cinchocaine > lignocaine
E. Lignocaine>bupivacaine>prilocaine>cinchocaine
the following order:

A.
Bupivacaine>ropivacaine>lignocaine>prilocaine>proca
ine
B to E. (The above in different orders)
A. Inside channel
B. Outside channel
C. On membrane outside
D. ?
A. Same site as saxitoxin

B. Inside Na+ channel /OR: At the channel mouth
C. At axoplasmic end of Na+ channel
D. At Ca++ channel
E. In the cell membrane
LA13 [Jul98] EMLA cream contains:

A. Soluble in water at >16 degrees C
B. 20% ionised at pH ??
C. 80% ionised at pH ??.. OR: Base contains 80% local
anaesthetic
D. ?? amount of ionised drug
E. All of the above
LA14 [Mar99] [Mar03] What factor (?does not)
influence the peak plasma levels after epidural injection

of local anaesthetic?
A. Vasoconstrictor
B. Natural vasoconstrictor activity of the drug
C. Hepatic clearance
D. Renal clearance
LA15 [Mar99] [Mar03] Which ONE of the following

is an amide?
A. Tetracaine
B. Procainamide
C. Procaine
D. Prilocaine
E. Cinchocaine
LA15b [Jul01] The following are all amides except:

A. Bupivicaine
B. Prilocaine
C. Etidocaine
D. Tetracaine
E. Dibucaine

A. Anti-arrhythmic effect - ??Na channel /open &
inactivated state
B. Prolongs QRS
C. ?
D. ?
LA17 [Jul99] [Feb00] [Jul00] [Jul01] [Jul03]

A solution of local anaesthetic contains 1:100,000
adrenaline. How much adrenaline has been added?
A. 0.01%
B. 0.1%
C. 10 mcg/ml
D. 100 mcg/ml
E. 1000 mcg/ml
LA18 [Feb00] Regarding the addition of adrenaline to

a local anaesthetic administered epidurally, which of the
following is NOT true?
A. Significantly prolongs the duration of action of
bupivacaine
B. Causes tissue acidosis at the site of injection
C. Causes vasoconstriction
D. ?
LA19 [Jul00] [Jul01] Regarding local anaesthetic

plasma protein binding
A. Is predominantly by albumin
B. Is predominantly by alpha-1 acid glycoprotein
C. Is greater for tetracaine than for bupivacaine
D. Neonates have a greater number of binding sites
E. Plasma binding is directly proportional to local
anaesthetic concentration.
(Comment: wording in option E was 'plasma binding' &
not 'plasma protein binding')
LA20 [Jul01] For a local anaesthetic agent at a given

concentration:
A. Effect is NOT dependent on resting membrane

potential
B. Faster onset with increasing frequency of stimulation
of nerve
C. Unionised form blocks the surface receptor
D. Agent blocks the channel in the activated state
E. Faster onset with more negative resting membrane
potential.
LA21 [Feb04] Lignocaine

A. Over 50% unionised at pH 7.4 ??
B. Decreased metabolism with GA ??
C. ?
D. ?
MCQ-Muscle Relaxants & Antagonists

Primary Pharmacology Black Bank
MB04 [Mar96] [Jul02] The action of nondepolarising
These MCQs were previously coded with the MR prefix

but this has been changed to MB to avoid conflict with
the MR coded 'Medicine-Respiratory' Part 2 Black
Bank MCQs.
neuromuscular blocking agents is PROLONGED by:

A. Respiratory acidosis
B. Increased temperature
C. Increased calcium
D. Increased potassium
E. Decreased magnesium
MB01 [Mar96] [Jul97] With regard to tetanic
MB05 [Mar96] Agents prolonging nondepolarising
stimulation by a nerve stimulator:

A. Used to determine residual curarisation
B. Degree of fade is independent of stimulus duration
C. Degree of fade is dependent on stimulus intensity
D. Used to check depth of anaesthesia
NMBA by desensitising the post-junctional membrane :

A. Phenytoin
B. Halothane
C. Lignocaine
D. Verapamil
MB02 [Mar96] [Apr01] Hyperkalaemia with

suxamethonium is associated with:
MB06 [Mar96] [Jul98] Which drugs (?competitively)
A. Abdominal infection
B. Parkinson's disease
C. Meningomyelocoele
D. Cerebral palsy
E. Myotonic dystrophy
MB03 [Mar96] [Jul96] [Jul97] [Mar98] [Mar99]
inhibit acetylcholinesterase?
A. Neostigmine
B. Pyridostigmine
C. Physostigmine
D. Edrophonium
E. All of the above
[Jul99] [Feb00] Which of the following is NOT

metabolised by plasma cholinesterase?
A. Procaine
B. Cocaine
C. Dibucaine
D. Suxamethonium
E. Esmolol
F. Mivacurium
MB06b [Jul00] [Apr01] The activity of plasma
MB03b [Mar98] [Apr01] Which of the following is
MB06c [Jul04] Which decrease plasmacholinesterase
metabolised by plasma cholinesterase?

A. Remifentanil
B. Procaine
C. Esmolol
D. ?
E. All of the above
MB03c [Jul98] [Feb00] Esterases metabolise all

EXCEPT:
A. Remifentanil
B. Dibucaine
C. Pyridostigmine
D. ?
MB03d [Feb04] Which drug has a significantly

prolonged duration of action in plasma cholinesterase
deficiency?
A. Remifentanil
B. Procaine
C. Mivacurium
D. Rocuronium
E. Cocaine
cholinesterase is decreased by the following drugs

except:
A. Neostigmine
B. Organophosphates
C. THA
D. Metoclopramide
E. Cimetidine
activity? (remembered options from 2 questions)

A. Hepatic disease
B. Cyclophosphamide
C. Six weeks post partum
D. Hyperthyroidism
E. Obesity
F. Cytotoxic drugs
G. Pregnancy
E. Dibucaine number of 20
MB07 [Mar97] [Jul98] [Jul99] [Feb00] [Apr01]

Regarding vecuronium:
A. It accumulates in renal failure
B. Is a benzylisoquinolinium
C. Is a bisquaternary amine
D. Is more lipid soluble than pancuronium
E. Is predominantly renally excreted
MB08 [Jul97] [Jul98] [Mar99] [Jul02] [Mar03] In

reversing neuromuscular blockade, which of the
following combinations is best matched with respect to
time of onset?
A. Atropine & neostigmine
B. Atropine & glycopyrrolate
C. Atropine & edrophonium

D. Atropine & physostigmine
E. Glycopyrrolate and edrophonium
(Comment: Option B is an unusual distractor for this
question but it has been confirmed by a couple of
people that this is the way it is on the paper)
MB09 [Jul97] [Jul98] [Mar99] [Jul99] [Jul00]
C. After 2 x ED95 dose 95% return of twitch height

after 15mins
July 2002]] version included the following options:
C. Does not usually require reversal
D. Duration of action may be prolonged by anticholinesterases
[Mar03] Plasma cholinesterase:

A. Metabolises dibucaine
B. Metabolises esmolol
C. Hydrolyses mivacurium at 80% the rate of
suxamethonium
D. Is unaffected by neostigmine
MB12b [Jul00] Mivacurium administered at a dose
MB09b [Jul01] [Jul04] Suxamethonium

A. Bigger molecule than vecuronium
MB13 [Mar98] [Jul99] [Jul01] The Recovery Index
B. Needs to occupy 80% of nicotinic receptors to get

effect
C. Resistant to hydrolysis by acetylcholinesterase
D. ??Is an antagonist at nicotinic receptors
E. Increasing dose produces similar block
MB10 [Jul97] [Jul98] With regard to the nerve

stimulator in competitive blockade:
A. Fade is dependent on stimulating frequency
B. TOFC of four is a sign of adequate reversal
C. ?
D. ?
MB11 [Jul97] Anticholinesterase agents:Both correct

A. Carbamates duration of action is related to the time
required for dissociation from the anionic site.
B. Carbamates act by acetylation of the esteratic site.
C. ?
(See also [[MB11b, [[MD28)
MB11b [Jul00] [Apr01] [Jul02] [Jul04]

Carbamylation of acetylcholinesterase: (Jul02:
Phosphorylation of acetylcholinesterase: )
A. Ionic bonding at anionic site
B. Ionic bonding at esteratic site
C. Covalent bonding at anionic site
D. Covalent bonding at esteratic site
E. None of above
(see also MB27 for similar Q)
MB12 [dgj] [Jul00] [Jul02] [Jul04] Mivacurium:

A. Is metabolised at 80% the rate of suxamethonium
B. Takes 15 mins from ED95 dose to recovery of 95%
twitch height
C. Has an ED95 of 1.5 mg/kg
D. Trigger for malignant hyperthermia
E. ? Duration of action is increased in renal failure
July 2000 version: Mivacurium:
A. Twice the ED95 dose is 1.5mg/kg
B. is metabolised at 80 to 90% the rate of
suxamethonium
of 2 times the ED95 dose produces relaxation for:

A. 10 mins
B. 15 mins
C. 20 mins
D. 25 mins
25% to 75% is 7 minutes for which drug?

A. Vecuronium
B. Rocuronium
C. Mivacurium
D. Suxamethonium
Also recalled as: A muscle relaxant is administered at
twice ED95 for a short dental case. Return of normal
TOF ratio occurred at 7minutes. The muscle relaxant
used was:
A. Suxamethonium
B. Vecuronium
C. Atracurium
D. Rocuronium
E. Mivacurium
MB14 [Mar98] [Jul00] [Mar03] Release of

acetylcholine at the motor endplate:
A. ?? gentamicin
B. Botulinum toxin works by ??
C. ?
D. ?
July 2000 version: Release of acetylcholine at motor
endplate:
A. Hemicholinium directly interferes with releae
B. Only in response to action potential
C. Decreased by aminoglycosides / ?? prejunctional
effect
D. Is Ca2+ dependent process
E. Always causes an action potential
MB15 [Mar98] Gentamicin potentiates nondepolarising neuromuscular block by:

A. Interfere with Ca++ influx for exocytosis
B. ?
C. ?
MB16 [Jul98] [Mar99] [Feb00] [Jul01] [Mar03]

Rocuronium:
A. Monoquaternary at physiological pH
B. More lipid soluble than pancuronium
C. 30% metabolised (?deacetylated) in the liver
D. Rapid onset is due to its high potency
E. Fastest onset is with 2 times ED95 dose
F. Is bisquaternary
F. Mivacurium
MB17 [Mar96] Plasma cholinesterase is inhibited 80%
MB23b [Jul04] Which of these NDNMB has a
by 10 -5 molar dibucaine:
A. In late pregnancy
B. ?
C. ?
MB18 [Mar99] Which of the following do NOT

prolong neuromuscular blockade?
A. Volatile anaesthetics
B. Antibiotics
C. Phenytoin
D. Beta-blockers
E. Hyperthermia
(see also MB26)
MB19 [Jul98] Malignant hyperthermia causes:

A. Hypertension
B. Whole body rigidity
C. Tachyphylaxis with a suxamethonium infusion
D. ?
MB20 [Jul99] [Jul01] Edrophonium:

A. Longer halflife than neostigmine
B. Onset slower than neostigmine
C. ?Pyridostigmine
D. Binds to anionic site of cholinesterase
E. Relieves symptoms of myaesthenia gravis
F. ? Is reliable in reversing a Phase 2 block
MB20b [Apr01] ("Edrophonium Q about

elimination half times and metabolism")
A. ?
B. ?
MB21 [Jul99] . .? . . with return of TOF ratio:

A. ?
B. ?
C. ?
D. ?
E. ?Neostigmine may prolong the action of
Mivacurium
MB22 [Jul99] [Apr01] Atracurium:

A. Has an active metabolite
B. Ester metabolism is a minor pathway of elimination
C. Metabolism is by Hofmann elimination which is pH
dependent (Did not include temperature)
D. ?
E. ?
MB23 [Feb00] [Jul04] What muscle relaxant has an

active metabolite with a half-life twice
that of the parent compound?
A. Rocuronium
B. Vecuronium
C. Pancuronium
D. Atracurium or Cisatracurium
metabolite thats 50-70% as active as its parent drug

A. Atracurium
B. Vecuronium
C. Rocuronium
D. dTC
MB24 [Feb00] Succinylcholine can cause:

A. Bradycardia
B. Histamine release
C. Tachycardia
D. Hypertension
E. All of the above
MB25 [Feb00] Neostigmine reversal of
nondepolarising neuromuscular block
A. Not affected by enflurane at 2 MAC
B. Varies depending on use of NDNMA by bolus or
infusion
C. Is/isn't affected by age
D. ?
MB26 [Feb00] Which of the following is associated

with a decrease in duration or effect of nondepolarising
neuromuscular blocking drugs:
A. Volatile anaesthetic alkanes
B. Volatile anaesthetic ethers
C. Aminoglycoside antibiotics
D. Aminopyridine derivatives
E. Local anaesthetic esters
(see also MB18)
Alt version: Which of the following decreases the
duration/depth of neuromuscular blockade?
A. Enflurane at 2 MAC
B. Aminoglycosides
C. Bolus doses versus infusion
D. Aminopyridines
MB26b [Jul01] Neuromuscular blockade NOT
prolonged by:
A. Hyperthermia
B. Gentamicin
C. Volatile agents
D. Hypothermia
E. ?
MB27 [Jul00] [Apr01] [Jul04] Neostigmine's

mechanism of action:
A. Binds covalently to esteric site on AChEsterase
B. Binds electrostatically to esteric site on AChEsterase
C. Binds to anionic site
D. Forms complex with AChEsterase with a shorter
halflife than acetylcholine
E. (Some other long winded explanation requiring 30
seconds to read and impossible to remember.)
MB28 [Jul00] With depolarising neuromuscular

blocker:
A: Is competitively antagonised by NDMR

B: ("Something about tetany & fade")
C. ?
D. ?
E: Shows post tetanic potentiation
MB29 [Jul00] Rocuronium administered in 2 times the

ED95 dose:
A. Rapid onset, short duration
B. Rapid onset, Intermediate duration
C. Slow onset, intermediate duration
D. Slow onset, long duration
E. (some other combination.)
MB30 [Apr01] Anticholinesterase drugs

A. ?
B. ?
C. Used in treatment of Glaucoma D. ?
MB31 [Apr01] Neostigmine:

A. Tertiary ammonium compound
B. ? no, quaternary
C. ?
MB32 [Jul01] [Jul04] The dibucaine number for a

normal person is:
A. 20
B. 40
C. 60
D. 80
E. 100
MB33 [Jul01] Muscle relaxants are less likely to cause

anaphylaxis if:
A. Injected slowly
B. Suxamethonium is the most common cause
C. H1 and H2 blockers prevent anaphylaxis
D. Always fatal
E. ?
MB34 [Jul01] Laudanosine:

A. ?
B. ?
C. ?
D. ?
MB35 [q[ All of the following result in prolongation

of Vecuronium block except:
A. Concomitant insulin and dextrose infusion
B. Prior suxamethonium blockade
MB36 [Feb04] Post suxamethonium myalgia:

A. Preceeded by transient myoglobinuria
B. More common in the elderly
C. Can be prevented by pre-treatment with 0.04 mg/kg
of D-tubocurarine
MB37 [Feb04] Regarding anticholinesterases:

A. Pyridostigmine is a tertiary amine
B. Quaternary ammonium anticholinesterases have a

larger volume of distribution than non-depolarising
muscle relaxants
C. Edrophonium has a slower onset of action than
neostigmine
D. Neostigmine has a longer duration of action than
pyridostigmine
E. Edrophonium binds covalently to the esteratic site of
acetylcholine
MB37b [Jul04] Regarding Antiacetylcholinesterase

A. Given orally to treat glaucoma
B. Edrophonium is a long acting AChE inhibitor
C. Physostigmine is quarternary ammonium
D. ?
MB38 [Jul04] Which is the best indicator of adequate

reversal?
A. TOF Count of 4
B. No fade on DBS
C. No fade to 200 Hz tetanus
D. Head lift??
E. Evidence of post-tetanic facilitation
MB38b [Jul04] Residual curarization is best evaluated

with:
A. TOF 1:4 > 50%
B. Equal twitch height on DBS
C. ?Degree of fade is independent on stimulus intensity
D. ?Used to check depth of anaesthesia
E. ?
MB39 [Jul07] Sugammadex binds most avidly to:

A. Pancuronium
B. Rocuronium
C. Vecuronium
D. Atracurium
E. Cisatracurium
MCQ-Major Analgesics / Opioids


OP01 [Mar96] With regards to pethidines physical
properties:
A. It has an octanol coefficient of 10
B. It has a pKa of 8.4
C. ?
D. ?
E. ?
OP02 [Mar96] Which factor does NOT predispose to

bradycardia with fentanyl in doses of 50 mcg/kg?
A. Calcium channel antagonist
B. Beta-blocker
C. Benzodiazepines
D. ?
E. Slow injection of drug
OP03 [Mar96] [Mar99] [Jul99] [Feb00] [Apr01]

Naloxone:
A. Is not an antagonist of agonist-antagonist drugs
B. Is not an antagonist at ?mu & sigma receptors
C. Causes pulmonary oedema
D. Can cause hypotension in experimental shock animal
models
E. May cause an abrupt increase in sympathetic tone
OP03b [Mar97] Naloxone:

A. Is effective at antagonising a full agonist but not a
partial agonist
B. Causes pulmonary oedema
C. ?
D. ?
OP04 [Mar96] [Jul99] {Diagram of numbered

structure of morphine}
OP06 [Mar96] Regarding the clearance of morphine:

A. Affected by cirrhosis
B. Affected by hepatic blood flow
C. Shows low hepatic extraction ratio
D. ?
E. ?
OP07 [Jul97] [Mar99] [Jul99] [Jul00] [Feb04] [Jul04]

Fentanyl:
A. With pKa 8.4 is 90% ionised at physiological pH
B. Has an octanol coefficient of 10
C. Is 1,000 times more potent than morphine
D. Has first-pass lung uptake reduced to 20% by
propranolol
E. Has up to 50% uptake in the lung
F. Elimination half-life < 2 hour
G. Carried on albumin mostly
H. Carried on alpha-1 acid glycoprotein mostly
I. Can cause hypertension with MAOI
J. Alfentanil acts faster as it has a higher unionised,
unbound fraction
OP08 [Jul97] An opioid which can not be used for

TIVA:
A. Morphine
B. Pethidine
C. Fentanyl
D. Sufentanil
E. Alfentanil
OP09 [Mar98] Nalbuphine:

A. Works at mu receptor only
B. Has same side effects as pentazocine
C. ?
D. ?
OP10 [Mar98] Pethidine
Which substitutions correct?

A. N17 substitution gives antagonist activity
B. C6 methylation produces codeine
C. Glucuronidation occurs at C2
D. Diacetylation decreases lipid solubility
A. 100mg is equal to 10mg morphine in effect

B. Increases heart rate
C. No effect on cardiac output
D. Is preferred to morphine for analgesia
E. ?
Also remembered as:

Morphine base structure with questions about
substitutions
A. C3 and C6 increase lipid solubility
B. Acetyl group on ?C3 gives heroine
C. N- substitution gives antagonist
D. C5 glucuronidation site
E. C3 methyl gives codeine
OP10b [Mar98] Pethidine produces:
OP05 [Mar96] [Jul98] [Jul00] Pethidine in doses of

2 to 2.5 mg/kg causes all of the following EXCEPT:
A. Bradycardia
B. Decreased systemic vascular resistance
C. ?Normal arterial BP / ?decreased BP
D. Increased cardiac output
A. Miosis
B. More severe hypotension with comparable dose of
morphine
C. More biliary spasm than morphine
D. ?
OP11 [Mar98] TIVA with morphine causes the

following EXCEPT:
A. Mydriasis
B. Muscle rigidity
C. Respiratory depression
D. ?
OP12 [Mar98] [Jul98] [Jul02] [Mar03] Codeine:

A. Substitution at C6 position of morphine
B. 10% of codeine is metabolised to diacetyl morphine

C. IM 100mg is equivalent to 10 mg morphine
D. Methyl substitution at the ?C5/?C6 position of
morphine
E. Can be safely given IV because causes no histamine
release
F. Has higher first pass effect than morphine
OP13 [Jul98] Morphine metabolism:

A. Principally metabolised to morphine-6-glucuronide
OP19b [Jul01] [Jul04] Alfentanil works faster than

fentanyl because:
A. More lipid soluble
B. Higher concentration unbound, unionised at
physiological pH
C. Decreased protein binding
D. Larger volume of distribution
E. ?
B. Metabolites have shorter half-life

C. Found in extrahepatic sites
D. Metabolites freely cross the blood-brain barrier
E. ?All have analgesic effect / ? Are 30% renally
excreted
F. In neonates, predominantly by sulphation
G. In adults, mostly to morphine-3-glucuronide
OP20 [Jul00] [Apr01] Methadone:

A. Phenanthrene derivative
OP14 [Jul98] Buprenorphine:
OP21 [Apr01] Tramadol:
A. Effective orally
B. ?
C. ?
A. Has beta blocking properties

B. Blocks noradrenaline reuptake
C. Has greater opioid activity than morphine (OR: As
potent a mu agonist as morphine)
D. Is directly inhibited by yohimbine
E. Only the +ve enantiomer is active
OP15 [Mar99] [Feb00] [Jul02] Sufentanil:

A. 30 times as potent as fentanyl
B. < 7% excreted unchanged in urine
C. Greater protein binding than fentanyl
D. Half-life of elimination between fentanyl &
alfentanil
E. Predominantly bound by ?albumin/ ? alpha1-acid
glycoprotein
OP16 [Mar99] [Jul00] Pethidine is the traditionally

favoured opioid in obstetrics because:
A. Norpethidine does not cross the placenta
B. Does not undergo ion trapping
C. Causes less neonatal depression
D. It does not cross the placenta
E. It is thought to cause less respiratory depression in
the neonate.
OP17 [Mar99] Pethidine:

A. Better bioavailability than codeine
B. ?
C. ?
D. ?
OP18 [Jul99] Pethidine:

A. Norpethidine metabolite
B. Pethidine 6-glucuronide
C. ?
OP19 [Jul00] Alfentanil is more lipid soluble than

fentanyl because:
A. Has a pKa of 8.4 & is 90% unionized at
physiological pH
B. ?n-Octanol coefficient is [some five digit num]
[Jul96] [Mar98] [Jul04].
C. ?
D. ?
B. ?metabolism
C. Peak plasma levels at 3 hours
D. Used in chronic cancer pain due to non addictive
potential
E. ?d & l isomers
OP22 [Jul01] The most unlikely thing to occur with

morphine administered in recovery is:
A. Constipation
B. Respiratory depression
C. Sedation
D. Nausea and vomiting
E. Physical dependance
F. Pruritis
OP23 -Deleted
OP24 [Jul01] Extrahepatic de-esterfication of
Remifentanil
A Occurs in RBC
B By Plasma Cholinesterase
C NOT in incubated blood
D Has (?mean) clearance less than 1L/min
E Has an active metabolite
Alt options:
C. Hydrolysis does not occur in vitro in incubated blood
E. The drug is hydrolysed to an active metabolite which
undergoes further hydrolysis
(Q75 Jul01)
OP25 [Jul01] The following are metabolites of

morphine except:
A. Morphine-6-glucuronide
B. Morphine-3-glucuronide
C. Normorphone
D. Codeine
E. Hydromorphine
OP26 [Jul01] Fentanyl given at dose of 50-150 mcg/

kg:
A. Causes potent cardiac depression
B. Does not cause muscle rigidity

C. Has an elimination half-time of more than 3 hours
D. Not enough to relieve the stress response to surgery
E. Preserve cardiac output
OP27 [Jul04] Prolonged duration of action of

morphine in renal failure is due to
A. Morphine 3-glucuronide
B. Morphine 6-glucuronide
C. Metabolism of morphine
D. ?
E. ?
OP28 [Jul-06] Which is NOT a side effect of

morphine:
A. Seizures
B. Mydriasis
D. Histamine release
E. ?
MCQ-Anticholinergics/Antimuscarinics

AH01 [Jul97] [Mar98] [Jul98] [Mar99] [Jul99]
Glycopyrrolate:
A. Has mandelic acid rather than tropic acid
B. Tertiary amine
C. ?
D. ?
(See also MB08)
AH02 [Jul98] [Mar99] [Jul00] Hyoscine:

A. ?
B. Quaternary ammonium compound
C. ?
D. Causes mdriasis
E. Causes confusion in the elderly
AH03 [Jul99] [Feb00] Scopolamine d & l isomers:

A. d is active
B. Provided as racaemic product
C. Doesn't cause central effects
D. ?
AH04 [Jul00] Atropine:

A. ?
B. Increases anatomical & alveolar dead space
C. ?
D. ?
AH05 [Jul01] [Mar03] Atropine & glycopyrrolate:

A. Both are naturally occurring
B. Cause confusion in the elderly
C. ?
D. ?
E. ?
AH06 [Jul04] Which of the following is the most toxic

effect of atropine in children?
A. Hypotension
B. Tachycardia
C. Hyperthermia
D. Hypertension
AH07 [Apr07] The nerve agent sarin:

A. should not be treated with anticholinesterase if there
is tachycardia
B. something about pyridostigmine
C. symptoms can include fasciculations and paralysis
D. something about pralidoxime unblocking the
receptor (a red herring teaser)
E. ?
MCQ-Psychotherapeutic Drugs
D.
PS08 [Mar99] [Jul00] Flumazenil:
PS01 [Mar96] [Jul98] [Jul01] [Jul02]

Benzodiazepines:
A. Are all lipid soluble (OR: None are water-soluble)
B. Are all renally excreted unchanged
C. Causes retrograde amnesia
D. Lorazepam is more lipophilic than midazolam
E. Block GABA receptors
F. Have high therapeutic index
PS02 [Mar97] [Jul97] [Jul99] [Mar03] Which is

TRUE regarding monoamine oxidase inhibitors
(MAOI)?
A. Should/must be ceased for two weeks prior to
general anaesthesia
B. Cause hypotension and sedation in combination with
pethidine
C. Inhibit activity of indirect sympathomimetics
D. Ingested tyramine causes hypertension due to
indirect effects
E. Includes doxepin and amitriptyline
PS03 [Jul97] [Jul98] [Jul00] [Jul01] Neuroleptic

malignant syndrome:
A. Occurs only with chronic use
B. 80% (60%) mortality
C. ?Treated /? not treated with dantrolene
D. Can be caused by acute withdrawal of L-Dopa
therapy
E. Is treated with bromocriptine
PS04 [Jul97] Inhibitors of monoamine oxidase A

A. Allow tyramine to enter the circulation from the gut
B. ?
C. ?
D. ?
PS05 [Jul97] [Feb00] Benzodiazepines:

A. Have no analgesic effect
B. Have an antanalgesic effect
C. Have an analgesic effect
D. Have dose-related analgesic and antanalgesic effects
PS06 [Jul98] [Jul99] [Mar03] [Jul04] The

benzodiazepine with the longest elimination half-life is:
A. Diazepam
B. Oxazepam
C. Temazepam
D. Midazolam
E. Lorazepam
F. Flunitrazepam
PS07 [Jul98] Fluoxetine:

A. Inhibits noradrenaline & adrenaline uptake
B. Inhibits serotonin uptake
C. ?
A. Formulated In propylene glycol in commercial

preparation
B. Inverse agonist
C: Is slowly metabolised making resedation unlikely
D. Does not reliably reverse sedation and resp
depression (in large agonist dose ?)
E. Is a partial agonist at mu opioid receptors
Option D has also been remembered as:
D. May significantly reverse evidence of sedation
whilst hypoxia or hypercapnia persist
D. Reliably reverses the sedating effects of
benzodiazepines but marked respiratory depression still
can occur
PS09 [Mar99] Diazepam:

A. Half-life of 5 to 10 hours
B. Metabolised to oxazepam & temazepam /?
desmethyldiazepam
C. ?
D. ?
PS10 [Mar99] [Jul99] Droperidol:

A. Substituted phenothiazine
B. Reliably produces mental tranquility
C. Does not act (directly) on CTZ
D. Alpha-blockade with hypotension is not a problem
with 2mg dose
E. Slows alpha rhythm on EEG
(Note: Mar 99 paper had 2 questions on droperidol)
PS11 [Mar99] Monoamine oxidase inhibitors

(MAOI):
A. Moclobemide is a reversible inhibitor
B. Interacts with tyramine to cause hypertension
C. Interacts with pethidine to cause hypothermia
D. ?
PS11b [Feb04] Monoamine oxidase inhibitors

A. Mobenclamide is a reversible type B inhibitor
B. Prevent hepatic metabolism of tyramine enabling it
to enter the circulation and act as an indirect agonist ??
PS12 [Jul99] [Apr01] Metabolites of diazepam, all

EXCEPT:
A. Temazepam
B. Oxazepam
C. Desmethyldiazepam
D. Lorazepam
PS13 [Jul00] With respect to action of midazolam:

A. Acts on GABA-B receptors
B. increases duration of opening of Cl channels
C. ? competes with barbiturates for receptor site on
GABA receptor
D. Metabolism is decreased by cimetidine
E. Decreases chloride conductance
F. Interacts with the B1 subunit of GABA
PS14 [Jul00] Benzodiazepines - which statement is

true ?
A. ?
B. Midazolam has ?active / ?inactive metabolites
C. ?
D. All depend on hepatic clearance
PS15 [Jul00] [Mar03] [Jul04] Tricyclic

antidepressants:
A. Do not cause sedation
B. Formed from modification of the phenothiazine ring
C. Avoid anti-cholinergic effects compared to other
anti-depressants
D. Does not decrease reuptake of 5HT ?at 5HT3 R
E. Decrease CNS amine levels
PS16 [Jul00] Diazepam 0.1 mg/kg given orally, the

percent absorption is:
A. 100%
B. 94%
C. ?
D. ?
PS17 [Feb04] Clinical uses of Diazepam include:

A. Anticonvulsant
B. Skeletal muscle relaxation
C. Treatment of Delerium Tremens
D. Induction of anaesthesia
E. All of the above
MCQ-Cardiovascular Drugs
D. Direct this and indirect that (etc)
CD03b [Apr01] [Mar02] Ephedrine:
CD01 [Mar96] [Mar98] [Mar99] [Jul01] Milrinone:

A. Decreases pulmonary vascular resistance
B. Increases systemic vascular resistance
C. Is poorly absorbed when given orally
D. Chronic use causes thrombocytopaenia
A. ?Increases/?decreases skeletal muscle blood flow

B. Acts only by indirect effects
C. Not metabolised by GIT MAO
D. Not metabolised by COMT
E. Increase renal blood flow
CD03c [Jul01] [Jul04] Ephedrine has:
Alt version: Milrinone causes:

A. Chronic use causes thrombocytopaenia
B. Pulmonary vasoconstriction
C. Not effective orally
D. ?
E. ?
A. Direct agonist on alpha receptors

B. Direct and indirect effects on alpha and beta
receptors
C. Indirect actions on alpha receptors
D. Direct actions on beta receptors
E. Indirect actions on beta receptors
CD01b [Mar97] Milrinone:
CD04 [Mar96] [Jul98] The principal (?urinary)

metabolite of adrenaline is:
A. Cannot be given orally

B. Is a phosphodiesterase III inhibitor that decreases
cyclic AMP
C. Decreases peripheral vascular resistance
D. Increases pulmonary vascular resistance
CD01c [Feb00] Milrinone

A. Is structurally related to thyroid hormone
B. Is arrhythmogenic
C. Has its effects via cAMP mediated increase in
intracellular Ca2+
D. Increases myocardial oxygen consumption
CD02 [Mar96] [Mar03] Sodium nitrite used in

cyanide toxicity:
A. Increases methaemoglobinaemia
B. To produce increased hepatic sulphydryl groups
C. Increases conversion to cyanocobalamin (?
hydroxycobalamin)
D. Displaces cyanide from haemoglobin
E. Enhances oxidative phosphorylation
(see also CD06, CD37)
CD03 [Mar96] [Jul96] [Jul98] [Jul99] [Feb00]

[Apr01] [Mar03] [Jul04] Ephedrine:
A. Is resistant to metabolism by MAO
B. Is metabolised by COMT
C. Action is totally indirect
D. Acts via direct & indirect beta effect
E. Action is purely alpha agonist
(Alternative versions) Ephedrine:
A. Has direct alpha actions only
B. Has direct beta actions only
C. Has indirect (alpha) actions only
D. ?
E. Has both indirect & direct actions on alpha & beta
receptors
Ephedrine:
A. Alpha 1 and 2 and beta 1 & 2 & 3
B. More alpha than beta
C. Indirect this and direct that
A. Normetanephrine
B. Metanephrine
C. 3,4-dihydroxy-mandelic acid
D. 3-methoxy, 4-hydroxymandelic acid
E. 3-Methoxy 4-hydroxy phenylalanine
CD05 [Mar96] [Jul97] [Jul98] [Mar99] [Feb00]

[Apr01] [Jul01] [Feb04] Thiazide diuretics:
A. Work mainly on PCT
B. Not effective if severely sodium depleted
C. Action is independent of acid-base balance
D. Increase GFR immediately
E. Decrease BP by decreasing contractility
F. Cause hypoglycaemia
G. Interferes with kidney concentrating mechanisms
H. Causes hypocalcaemia
I. Used to treat hypercalcaemia
J. Potentiate hyperglycaemia
K. Are effective as antihypertensives by decreasing
cardiac output
L. Cause hypernatraemia
M. Washes out the medullary concentration gradient
(Multiple options remembered so possibly an amalgam
of 2 questions)
MCQ-17 on July 2001 paper:
Thiazide diuretics:A. Increase calcium excretion in the urine.
B. Decreased efficacy in sodium depletion.
C. Main site of action is the proximal tubule.
D. Cause equivalent amount of diuresis to frusemide
E. ?
July 2004 version Frusemide (furosemide), not
thiazides
CD06 [Mar96] Sodium nitroprusside in healthy

patient:
A. Decreases venous more then arterial resistance
B. Has no effect on control of pulmonary vascular
resistance
C. Decreases cerebral blood flow
D. Causes uterine relaxation

E. Does not inhibit hypoxic pulmonary vasoconstriction
CD07 [Mar96] [Mar97] [Jul97] [Mar98] [Jul98]

[Jul99] [Feb00] [Apr01] [Mar03] Which one of the
following statements about clonidine is correct?
A. Increase MAC requirements
B. Cause transient hypertension with IV administration
C. With IV bolus causes hyper- then hypo-tension
D. Causes hypotension immediately
E. Is not (?administered/absorbed) transdermally
(see also [[CD12, [[CD36)
CD08 [Mar97] [Mar99] Regarding Digoxin:

A. The aglycone portion causes the cardiac effects
B. The glycone portion causes the cardiac effects
C. ?
D. ?
CD09 [Mar97] [Jul99] Digoxin:

A. Decreases ventricular response due to vagal
stimulation in AF
B. Decreases myocardial oxygen consumption
C. Increases the R-T interval
D. Decreases AV conduction
CD10 [Jul97] [Jul00] [Apr01] [Jul02] Which of the

following ECG changes would be most likely in
digoxin toxicity:
A. Increased PR interval
B. Increased QT interval
C. Peaked T waves
D. ST elevation
E. Ventricular extrasystoles
July 2000 version: Digoxin toxicity:
A. Inverted T waves
B. Prolonged PR interval
C. Xanthopsia
D. Prolonged PT interval
CD11 [Jul97] [Jul98] Regarding digoxin

overdose/toxicity:
A. Serum level > 2.1 ng/ml is toxic
B.
C. Causes a long PR interval
D. Causes xanthopsia (OR: 'causes yellow vision')
E. Causes a long QT interval and bigeminy
CD12 [Jul97] [Mar02] [Jul02] [Jul04] Clonidine:

A. Elimination half-life of 3 hours (??or 3 to 6 hrs)
B. Excreted 50% unchanged in the urine (or 50%
renally excreted)
C. Oral bioavailability 50%
D. Cannot be absorbed topically
E. Is highly protein bound
CD13 -Deleted- same Q as CD05

CD14 [Jul97] [Jul98] [Jul00] [Jul04] Adenosine:
A. Slows conduction velocity and increases refractory

period
B. Is metabolised in plasma
C. Decreases urate levels
D. Methylxanthines increase response
(see also CD34)
CD15 [Jul97] [Jul99] Catecholamine substituition:

A. Alpha carbon CH3 substituition gives beta
selectivity
B. Beta-hydroxy substituition gives increased affinity
C. D-dobutamine antagonist, L-dobutamine agonist
D. ?
CD16 [Mar96] [Jul96] [Jul97] [Jul98] Esmolol:

A. Active at beta-1 & beta-2 receptors
B. Half-life < 2 minutes
C. Has methanol as a metabolite
D. Is metabolised by (?acetyl/?plasma) cholinesterase
E. Is excreted unchanged in the urine
F. Is a non-selective beta-1 receptor antagonist
CD16b [Feb04] [Jul04] Esmolol

A. Is a non-selective beta antagonist
B. Has intrinsic sympathomimetic activity
C. Does not have membrane stabilising activity
D. ?
CD17 [Jul97] [Jul98] [Mar99] [Jul99] [Jul01] [Jul04]

Osmotic diuretics (?Mannitol):
A. Less sodium delivered to distal tubule
B. Hypotonic medulla
C. Increased sodium loss
D. Urine osmolality > plasma osmolality
E. Increased sodium reabsorption / ?causes
hytpernatraemia
F. ?MW greater than 600
G. Washes out the medullary interstitial gradient
(see also MD07)
MCQ-16 on July 2001]] paper:
Osmotic diuretics:
A. Include mannitol and the dextrans.
B. Wash out the medullary osmotic gradient.
C. Cause sodium retention
D. ?
E. Have a molecular weight >600
CD18 [Jul97] Guanethidine:

A. Causes sedation as a side effect
B. Postural hypotension occurs
C. Decreases reuptake of catechols presynaptically
D. ?
CD18b [Jul98] [Jul01] (Q24]] on Jul01]] paper)

Guanethidine:
A. Acts primarily at?/on? the CNS
B. Produces anti-hypertensive effect primarily by
presynaptically inhibiting release of noradrenaline
C. Highly lipid soluble
D. Mental depression is a troublesome side effect
E. Orthostatic hypotension is not a prominent side

effect
CD19 [Jul97] [Jul99] Labetalol:

A. Alpha agonist & beta agonist
B. Alpha agonist & beta antagonist
C. Alpha antagonist & beta antagonist
D. Is a more potent alpha blocker than
phenoxybenzamine
E. Alpha > beta effect
CD20 [Mar98] [Jul98] [Jul99] [Feb00] [Apr01]

[Jul04] Frusemide:
A. 30% plasma protein binding
B. ??% absorption
C. Elimination half-life less than one hour
D. Promotes active secretion
E. Affects the uricosuric effect of probenecid
F. Effects not decreased until large decrease in GFR
G. Causes a diuresis which is dependant on GFR over a
wide range
Apr 2001 version: Frusemide:
A. Has 30% (?35%) protein binding
B. Has an elimination half-life less than 1 hour
C. 90% excreted in bile
D. Increases rate of secretion in the renal tubules
CD20b [Jul00] [Jul02] Frusemide does NOT cause:

A. Hyponatremia
B. Hypokalemia
C. Hypouricemia
D. Hypomagnesemia
E. Hypocalcemia
CD21 [Mar98] [Jul98] The antiarrhythmic effect of

lignocaine:
A. Because it incvreases the refractoriness of in cardiac
muscle
B. Therapeutic level 2-5ng/ml
C. ?
CD22 [Jul98] [Feb04] [Jul04] The effects of beta

blockers the following is not true
A. Relax uterine muscle
B. Increased AV conduction
C. Decreased lipolysis
D. Increased SVR
E. Mask hypoglycaemia
F. Negative inotropy
G. Opposing effects of insulin
H. Lipolysis
CD23 [Mar96] [Jul96] [Jul00] [Apr01] Phentolamine:

A. Is a selective alpha-1 antagonist
B. Binds covalently to the alpha receptor
C. Causes bradycardia
D. Is a selective alpha-2 antagonist
E. Increases cardiac output
CD24 [Mar96] [Feb00] [Mar03] A non-selective beta-
blocker with low extraction ratio, long half-life and

ISA:
A. Atenolol
B. Propranolol
C. Metoprolol
D. Labetolol
E. ?
CD24b [Mar02] [Jul02] Which ONE of the following

is water soluble, half life 6-8hrs, (and something
else)?
A. Esmolol
B. Metoprolol
C. Propranalol
D. ?
E. Atenolol
CD25 -Deleted - same Q as [[CD05

CD26 [Jul98] [Mar99] [Mar03] [Feb04] [Jul04]
Sotalol:
A. Non-selective beta-blocker
B. Contraindicated in long QT
C. Increases K+ conductance
D. Used in the treatment of torsades
E. Class II anti-arrhythmic drug
F. Is a selective beta 1 antagonist
G. Blocks K+ channels
CD27 [Mar99] Trimetaphan:

A. Crosses the blood-blood barrier
B. Incompatible with thiopentone
C. ?
CD28 [Mar99] Diazoxide:

A. Has diuretic activity
B. Opens ATP-dependent K channels
C. Not absorbed orally
D. ?
CD29 [ghj] [Jul00] Phenylephrine:

A. Metabolised by COMT
B. Causes mydriasis
C. Metabolised by MAO
D. Effect lasts (?same time as/?longer than)
noradrenaline
E. Acts by indirect method only
CD30 [Jul98] Regarding hydrallazine:

A. Fast acetylators have shorter half lives than slow
acetylators
B. Acts via SNS mechanism
C. Slow acetylators decrease half-life
D. Has diuretic action
E. Clearance > 50ml/kg/min
CD31 [Mar99] Which ONE of the following betablockers is selective fore beta-1 receptors?
(No other details)
CD32 [Jul99] Which of the following statements about

hydrallazine is (?true/false)?:
A. Acts via alpha 1 receptors
B. ?
C. ?
D. ?
E. Has a duration of action of 1-2 hours
CD33 [Jul99] Concerning Dobutamine

A. Levo has alpha 1 antagonist and beta agonist effects
B. Levo has partial alpha agonist effect and beta effects
C. Is a pure beta agonist
D. ?
CD34 [Feb00] [Apr01] [Jul01] Adenosine

A. Causes AV block via action at A1 receptors
B. Causes bronchoconstriction via A2 receptors
C. Causes renal vasodilation
D. Causes profound depression of the SA node
E. Decreases AV transmission
(see also [[CD14)
CD35 [Feb00] Mechanism of action of hydralazine

A. Selective cerebral, coronary, renal vasodilator
B. Alpha agonist
C. None of the above
D. ?
CD36 [Jul00] [Jul04] Clonidine:

A. Causes hypertension and tachycardia
B. Causes bradycardia
C. A single dose given orally is significantly less
effective then an intravenous dose
D. Counteracts the hypertensive response in
phaeochromocytoma
E. ?
CD36b [Jul04] Clonidine can cause these, except
CD39 [Jul01] [Jul04] Amiloride:

A. Potassium sparing antidiuretic which blocks the
aldosterone receptor
B. Blocks luminal sodium channels in the collecting
tubules
C. Increases potassium excretion.
D. Is metabolised by the liver.
E. Has a short elimination half time.
CD40 [Jul01] With regard to sodium nitrite in cyanide

(CN) toxicity:
A. Causes MetHb
B. Used to create more hydrocobalamin
C. Used to displace CN from Hb
D. Creates more sulfhydryl groups
CD41 [Jul01] Methylxanthines:

A. (Something about Ca++ currents)
B. (Something about K+ currents)
C. Inhibit adenosine receptors
D. Decrease plasma glucose level
E. Cause diuresis by acting on renal tubules
F. Physically addictive
CD42 [Feb04] [Jul04]

Which is the initial drug to use in the treatment of
ventricular fibrillation?
A. Amiodarone
B. Lignocaine
C. Adrenaline
D. Magnesium
E. Sotalol
CD43 [Feb04] All are side effects of Thiazides

except:
A. Hypokalaemia
B. Hypernatraemia
C. Impaired carbohydrate tolerance
D. Pancreatitis
A. Bradycardia
B. Apnoea
C. Sedation
D.
CD44 [Feb04] Why do you give adrenaline for VF?
CD37 [Jul00] [Jul04] The first sign of sodium

nitroprusside toxicity is:
CD45 [Feb04] Nitroprusside toxicity:
A. Cyanide toxicity
B. Tachyphylaxis
C. Hypotension
D. ?
CD38 [Apr01] Dexmedetomidine:

A. Alpha-1 antagonist
B. ?
C. Decrease in intraocular pressure
D. Partial alpha2 agonist
E. Less selective than clonidine
A. To coarsen fine VF
B. To improve coronary blood flow
C. Increase chronotropy
A. Treat with ??? B.

CD46 [Jul04] Which of the following is a sign of
SNP toxicity?
A. Tachyphylaxis
B. Decreased mixed venous PO2
C. Sudden decrease in arterial PO2
D. ?Hypotension
CD47 [Jul04] Dihydropyridine Ca channel blocker

causes peripheral oedema due to
A. vasodilator causing redistribution of ECF
B. has a mild antidiuretic effect, and therefore easily
treatable with diuretic
C. salt and water retention due to hypotension

D.
CD48 [Jul04] Isoprenaline

A. can be used as a substitute to Metaraminol for
treatment of hypotension
B. used extensively to treat ischaemic heart disease
C. cause decrease SVR
D. cause bradycardia
E. ?
MCQ-Endocrine Drugs

EN01 [Mar96] [Jul97] Chlorpropamide:
A. Inhibits ADH secretion
B. Has a short duration of action (? Half-life < 12]] hrs)
C. Increases glucose entry into cells
D. Is prolonged in renal failure
EN02 [Jul97] [Jul01] Sulphonylureas:

A. High incidence of lactic acidosis
B. Good in patients with depleted insulin stores
C. Metformin & phenformin are examples
D. Increased glucose utilisation in the peripheries
E. Are related to sulphonamides
Jul 01 version: With regards to sulfonylureas:
A. Work effectively if Insulin stores depleted
B. Cause a lactic acidosis
C. Tolbutamide, (something else), phenylformin are
examples (? Spelling)
D. Highly protein bound
E. ?
EN03 [Jul01] Glipizide is:

A. A biguanide
B. Half life 4-6hrs
C. Causes metabolic acidosis /lactic acidosis
D. Not contraindicated in hepatic failure
E. Highly bound to albumin
F. Is ineffective in patients with low insulin stores
MCQ-Miscellaneous Drugs
Primary Pharmacology Black Bank | Jump to

MD10 MD20 MD30 MD40 MD50
MD01 [Mar96] [Jul97] [Mar03] Oxytocin:
A. Synthetised in posterior pituitary
B. Poorly absorbed orally
C. Metabolised by oxytocinase in the liver
D. Bolus dose will increase central venous pressure
E. Bolus dose will increase systemic vascular resistance
F. Metabolised by the liver and kidney
(see also EM15)
MD01b [Mar99] [Jul99] Oxytocin:

A. Has diuretic effect
B. Partially depolarises uterine muscle / ?effect on
membrane threshold
C. Causes emesis
D. Increases threshold of receptors for depolarisation
E. Hypertension
MD01c [Feb00] Oxytocin:

A. Ringed octapeptide
B. Effects on uterus antagonized by beta agonists
C. ADH like effect
D. ?
MD02 [Mar96] [Mar97] [Jul97] [Jul98] [Jul99]

[Feb00] Cisapride:
A. Will increase gastric motility in the presence of
atropine
B. Can be used to treat opioid induced gastric stasis
C. Decreases/increases lower oesophageal sphincter
tone (?due to atropine)
D. Decreases gastric pH
E. Increases gastric volume
F. Blocks histamine receptors
G. Agonist at D2 receptors
Apr 2001 version: Paracetamol:

A. Frequently causes dyspepsia (?gastric irritation)
B. Acid-base abnormalities common with overdose
C. Maximum dose 4 grams in adult
D. ?
E. ?
MD04b [Jul98] [Mar99] [Feb00] [Jul04] Paracetamol:

A. Is a powerful anti-inflammatory agent
B. Should never be given in a dose > 20 mg/kg to
children
C. Increased risk of hepatic necrosis in chronic
alcoholics
D. Sulphate conjugation is major metabolic pathway
E. pKa 3.5
F. ?Glutathione conjugation
Alt version remembered from Feb 2000:
Paracetamol:
A. Has analgesic, antipyretic and anti-inflammatory
effects
B. Is metabolised to BENZOQUINONIMINE which is
inactivated by conjugation to glutathione
C. Dose should not exceed 4000mg/day in an adult
D. Gastric irritation is common
July 2004
Paracetamol:
A. Has analgesic, antipyretic and anti-inflammatory
effects
B. Is metabolised to N-methyl-p-benzoisopuinonimine
conjugated to glutathione
C. Toxic dose is 10 times the normal ?daily dose?
D. pKa 3.5
E. ?
MD04c [Jul00] Paracetamol:

A. Minimum toxic dose 8-12G/day in an adult
B.-E. ?
MD03 [Mar96] [Jul97] [Jul98] Regarding the plasma
MD05 [Mar96] Aspirin:
half-life of heparin:
7A. Clearance affected by warfarin
B. Depends on site of injection
C. Less for low MW heparins
D. Depends on dose given
A. At low doses inhibits prostacyclin

B. Reversibly inhibits lipoxygenase
C. Irreversibly inhibits cycloxygenase
D. Can cause asthmatic reactions
MD03b [Jul97] Heparin:

A. Has a half life dependent on dose
B. Inactivates factors XII, XI, X, IX
C. ?
D. ?
(see also [[MD49)
MD04 [Mar96] [Jul99] [Apr01] Paracetamol:

A. Has an active metabolite
B. Interferes with renal blood flow
C. Does NOT cause gastric irritation
D. Causes methaemoglobinaemia
E. Maximum adult dose 4g
MD06 [Mar97] [Jul97] [Jul99] [Feb00] Serotonin (5HT) is most common in:
A. Platelets
B. Enterochromaffin cells
C. Cerebral cortex (?neurones)
D. Pineal gland
E. GIT
F. Mast cells
MD07 [Mar97] [Jul97] [Jul98] [Mar99] [Feb00]

Mannitol:
A. Metabolised in the liver
B. Half-life is proportional to GFR
C. Increases Na+
D. Excretion is dependent on GFR
E. Urine will be hyperosmolar compared to plasma

F. Absorbed orally
G. Isotonic
H. Clearance dependent on GFR
(see also [[CD17)
MD07b [Feb04] Mannitol:

A. is a sugar and is not metabolised
B. does not increase delivery of sodium to distal tubule
MD08 [Mar97] [Jul97] [Mar99] [Mar03] [Jul04]

Gastric drugs: Which is true?
A. Sucralfate is a mixture of sulphated sucrose and
bismuth that sits in the ulcer
B. Gastrin & acetylcholine directly & indirectly inhibit
H+ secretion
C. Misoprostil decreases gastric acid and causes marked
constipation
D. Pirenzipine is less effective than H2 blockers
E. Omeprazole reversibly inhibits proton pump
MD09 [Mar97] [Feb00] A decrease in renal function

might be expected with:
A. Gentamicin
B. Cis-platin
C. Busulphan
D. Methotrexate
E. All of the above
MD10 [Mar97] [Jul02] Thrombocytopaenia is a sideeffect of which ONE of the following:

A. Busulphan
B. Cis-platin
C. Methotrexate
D. All of the above
E. ?
MD11 [Jul97] [Jul98] [Jul99] Theophylline levels

increased with:
A. Smoking
B. Phenytoin
C. Cimetidine
D. ?
MD12 -renumbered EN02

MD13 [Jul97] [Feb00] When a beta agonist binds to a
G-protein:
A. There is a fall in cAMP
B. The signal is amplified 108 times
(Comment: Several sources indicate that the wording on
the paper in July 97 was as above but this doesn't make
sense as a beta-agonist does not bind directly to the G
protein but to a G-protein coupled receptor)
(Comment Mar 2000: This question has now been
corrected to read: "When a ligand binds to a receptor
linked to a G-protein:")
(see also EM18 in Physiol MCQs)
MD14 [Jul97] [Apr01] Dantrolene:

A. Is a benzyl-isoquinoline derivative
B. Undergoes oxidative and reductive metabolism

C. Inhibits sodium channel activation
D. Causes a marked reduction in contractility
E. Not effective as prophylaxis because of poor oral
bioavailability
F. Acts via ryanodine receptor
Alt version: Dantrolene:
A. Benzylisoquinolonium
B. Undergoes hepatic and renal metabolism
C. Profound myocardial depression
D. Poor oral bioavailability
MD15 [Jul97] Omeprazole:

A. Irreversibly inhibits the parietal cell
B. Acts at apical membrane of parietal side
C. Acts at the basolateral membrane of the parietal
MD16 [Mar98] Diclofenac:

A. Plasma protein binding is ....%
B. Percent absorption . . %
C. Mechanism of action via increase in endorphins
D. ?
MD17 [Mar98] [Apr01] [Jul04] Regarding

phenytoin
A. Acts via blockade of Na channels and via effect on K
channels
B. Weak base with pKa 8.3
C. Has active metabolites
D. ?
E. ?
MD18 [Mar98] [Mar99] [Feb00] [Apr01] [Jul02]

[Mar03] Which ONE of the following decrease gastric
pH?
A. Omeprazole
B. Famotidine
C. Calcium salts
D. Misoprostil
E. PGE2
July 2000, 2002 and 2003 version : Which ONE of the
following decreases gastric acid secretion?:
A. ?
B. Misoprostil
C. Cisapride
D. Na citrate
E. Metoclopramide
Apr 2001 version: Decrease gastric pH:
A. Calcium salts
B. H2 antagonists (?ranitidine)
C. Omeprazole
D. Pirenzipine
E. PGE2
MD19 [Jul98] [Mar99] [Feb00] [Jul01] [Jul04]

NSAIDs:
A. Exhibit no selectivity for COX 1 & 2
B. Exert renal effects other than effect on afferent

arterioles
C. Cause renal toxicity separate to inhibition of
prostaglandins
D. Aspirin & ketorolac irreversibly bind COX1 & 2
E. Directly cause gastrointestinal ulceration
Alt version: NSAIDs:
A. All inhibit COX 1
B. Aspirin and ketoralac inhibit COX irreversibly
C. They can cause renal toxicity by mechanisms other
than alterations in renal blood flow by PG mediators.
MD20 [Jul98] [Mar99] [Feb06] Irreversible

cardiomyopathy can be due to: (OR: Which of the
following causes dose-dependent cardiac toxicity?)
A. Vincristine
B. Bleomycin
C. Danorubicin
D. Asparaginase
E. Cyclophosphamide
F. All of the above
MD21 [Jul98] [Jul99] [Mar02] Streptokinase:

A. Acts on circulating plasmin
B. ?
C. Is antagonised by aminocaproic acid (EACA)
D. ?
E. ?
MD22 [Mar99] [Apr01] [Mar03] Gastric lavage:

A. Not useful if more than one hour has elapsed
B. In children, use normal saline instead of water
C. Contraindicated if poison corrosive
D. Is performed in the right lateral position
E. Should not be performed in the unconscious
(Comment: The restriction in unconscious patients is
they should be intubated for airway protection)
MD23 [Mar99] [Apr01] Long term prednisolone

20mg/day will result in:
A. Increased lymphocyte count
B. Increased capillary permeability
C. Metabolic alkalosis
D. ??glucose
MD24 [Mar99] NSAIDs cause gastric side-effects by:

A. Direct effects on mucosa
B. Indirect effects
C. ?
MD25 [Mar99] Phenylbutazone:

A. Interferes with heparin metabolism
B. Increases warfarin plasma concentration
C. Decreases warfarin plasma concentration
D. Reduces the elimination of warfarin
July 2000 version: Phenylbutazone's effect on the
coagulation system are due to:
A. Binding to albumen, displacing warfarin
B. Inhibiting warfarin metabolism
C. ? some interaction with aspirin
D. ? effect on platelets
MD26 [Jul98] [Jul99] With respect to prednisone:

A. [[Prednisone] is converted to active prednisolone in
the gut
B. Prednisone 5mg is equivalent to 100mg cortisol
C. Betamethasone has equivalent mineralocorticoid
activity
D. Methylprednisolone ?
Alternative version of options A & E:
A. Prednisone is converted to prednisolone after
absorption from the gut.
E. Betamethasone has adrenocorticoid and
mineralocorticoid activity
MD27 [Jul98] [Jul99] [Jul00] Aspirin:

A. Greatest absorption is from the stomach
B. Peak plasma level is achieved in 30]] minutes
C. Has cross-reactivity with all NSAIDs
D. Half-life 4 hours
July 2000 version: Aspirin:
A. Plasma half-life 4 hrs
B. Peak plasma concentration within 10mins of oral
administration
C. Requires conversion to salicylic acid for activity
D. ? is more ?? than salicylic acid
E. Better absorption if food in stomach
F. Cross reactive sensitivity with all NSAIDs
MD28 [Jul98] [Mar03] Organophosphates:

A. Phosphorylate the esteratic site
B. Phosphorylate the anionic site
C. ?
D. ?
(See also MB11, MB27)
MD29 [Mar99] [Feb00] Warfarin affects:

A. Factor XIII
B. Protein S (? or Protein C)
C. ?
MD30 [Jul99] [Feb00] Bleomycin

A. Related to nitrogen mustard
B. Can cause agranulocytosis (or: frequently causes
myelosuppression)
C. Causes pulmonary toxicity in 90% of patients
D. Is an alkylating agent
E. Causes pulmonary oxygen toxicity due to production
of superoxide radicals
MD31 [Jul99] Which drug causes the most

anaphylaxis?
A. Suxamethonium
B. High potency non-depolarisers
C. ?
D. ?
MD32 [Jul99] [Jul04] Syrup of Ipecac:

A. Is not effective in phenothiazine overdose
B. Has peripheral irritant and direct CTZ action
C. The syrup is more potent than the fluid

D. ?
G: Is/isnt a quaternary ammonium that does/doesnt

cross BBB
MD33 [Feb00] Regarding antiemetics which drug has
MD39 [Jul00] Drugs filtered and secreted in the PCT
anti-5HT3, anti-H1 and anti-D2 actions:

A. Ondansetron
B. Scopolamine
C. Domperidone
D. Droperidol
E. Prochlorperazine
F. Chlorpromazne
Alternative versions:
Which of the following anti-emetics have D2,
ACh, 5 HT-3 antagonist
effects?
Which drug is a D2 antagonist, H1 antagonist
and 5HT3 receptor antagonist?
include:
A. Penicillin
B. Probenecid
C. Chlorothiazide
D. ?
Also remembered as:
Which basic drug is secreted by the kidney for
excretion?
A. Procainamide
B. Probenecid
C. Penicillin
D. Acetazolamide
MD34 [Jul99] [Feb00] With regard to nitric oxide

A. It is anaesthetic at high concentration
B. May improve V:Q mismatch
C. Is a liquid in the cylinder, gas at room temperature
D. ?
MD35 [Feb00] [Jul01] Ethanol

A. About 35% excreted via the lungs
B. Concentration falls at a fixed rate with respect to
time
C. Only 60% is metabolised, the remainder being
excreted in expired air
D. Is excreted at a rate independent of the plasma
concentration
E. Constant elimination independent of plasma
concentration
F. Elimination is not dependant upon amount absorbed
from GIT
MD36 [Feb00] Which drugs cause convulsant
MD40 [Jul00] Which of the following is bacteriostatic

only?
A. Penicillin
B. Gentamicin
C. Vancomycin
D. Trimetophan
E. ?Cefoxitin /?cefuroxime
(see also [[MD40)
MD41 [Jul00] With respect to serotonergic receptor

action, which ONE of the following is true?
A. Sumiatriptan is a 5HT1 antagonist
B. Ondansetron is a 5HT3 agonist
C. ?Serotonin is a 5HT3 agonist
D. Metoclopramide is a 5HT4 agonist
E. ?
MD42 [Jul00] Acetazolamide:

A. ? secreted by the renal tubules
B. ? diuresis
C. ? develop tachyphylaxis
activity?
A. Cocaine
B. Lithium
C. Norpethidine
D. Enflurane
E. All of the above
MD43 [Jul00] Best antiemetic for motion sickness:
MD37 [Feb00] Metoclopramide
MD44 [Jul00] Complications of salbutamol used in
A. Increases gastric emptying faster with an oral dose

than an IV dose
B. Causes diarrhoea in children
C. Is a dopamine agonist
D. ?
MD38 [Feb00] [Jul00] Physostigmine

A. Causes (? excitatory activity / ?alerting response) on
the EEG
B. Doesnt cross the blood brain barrier
C. Doesnt cause sedation
D. Only has its effects at nicotinic receptors
E. Causes amnesia
F. Causes excitatory activity on the EEG
A. Metoclopramide
B. Ondansetron
C. ?
D. ?
E. Hyoscine
asthma treatment include the following EXCEPT:

A. Tachycardia
B. Decreased V/Q mismatch
C. Tremors
D. Pulmonary oedema
E. Hyperkalaemia
MD45 [Apr01] (Antibiotic sensitivities against certain

bacteria)
A. Penicillin and ?
B. Amoxycillin and staph +?
C. Flucloxacillin and G +ve?
D. ?cephalosporin and ?
MD46 [Apr01] Aspirin overdose
MD54 [Jul02] Which of the following drug
A.Causes metabolic & respiratory acidosis

B. Causes metabolic & respiratory alkalosis
C. Causes metabolic alkalosis & respiratory acidosis
D. Causes metabolic acidosis & respiratory alkalosis
MD47 [Apr01] Atropine overdose in neonates
interactions is mediated by serotonin?

A. ?
B. ?
C. ?
D: Pethidine & Tranylcypromine
E. ?
A. Causes hyperpyrexia
B. ??
MD55 [Feb04] Metabolism of which drug is decreased
MD49 [Apr01] [Jul01] [Jul02] [Jul04] Low molecular

weight heparin
A.Has better bioavailability
B. Molecular weight 1/10 that of normal heparin
C. More protein bound than heparin
D. ?
E. ?
MD50 [Apr01] [Jul01] [Mar03] [Jul04] Desmopressin

A Increases factor X
B Increases factor V
C Causes sustained severe hypertension
D Can be used to improve haemostasis in haemophilia
E Increases factor VIII activity
F. ?v2B receptors?
MD51 [Jul01] An intravenous infusion of 8.4%

sodium bicarbonate to a healthy adult may
cause:
A. Hypotonicity
B. Intracellular Acidosis
C. Ionized Hypercalcaemia
D. ?Respiratory Alkalosis
E. Rebound Metabolic Acidosis
MD51b [Feb04] Bicarbonate

A. Complications include intracellular acidosis
B. 100ml of 8.4% NaCO3 has 200 milliosmoles
C. ?
MD52 [Jul01] [Jul04] Cyclo-oxygenase-1 (COX-1)

isoenzyme:
A. Is increased by inflamation
B. Is ?predominant mode of action of indomethacin
C. Is increased by lipopolysaccaride
D. Is NOT involved in gastric mucosal protection
E. Is increased by cytokines
MD53 [Jul01] Caffeine

A. Is a CNS depressant
B. Causes cerebral vasoconstriction
C. Reduces the acidity of gastric fluid secretion (or: Not
a gastric irritant)
D. Reduces plasma glucose level
E. Is a potent diuretic.
F. Has been shown to be dependence producing
G. Does not show an improvement in psychomotor
function
in pseudocholinesterase activity:
A. Mivacurium
B. Cocaine
C. Procaine
D. Remifentanil
E. Esmolol
MD56 [Jul04] What drugs affecting ganglia ?

A. Hexamethonium,
B. ?carbachol
C. ?
MD57 [Jul04] Which of these agents does not reduce

uterine contractions?
A. Nifedipine
B. Gycerol trinitrate
C. Indomethicin
D. Isoprenaline
E. Phenytoin
MD58 [Jul04] Which of the following is the MOST

COMMON side effect of oxytocin?
A. Hypotension
B. ADH effect
C. Supraventricular tachycardia
MD59 [Jul04] Cause of hypotension during iv

Vancomycin administration
A. ?
B. ?
C. ?
MCQ-Statistics & Drug Trials

Back to: Primary Pharmacology
Jump to: SP05 SP10 SP15 SP19
Black Bank |
SP01 [Mar96] [Jul98] [Jul99] [Feb06] Tests that use

ranking of data:
A. Can be applied to any distribution
B. Include the chi square test
C. Have greater power than non-ranking tests
D. Are preferred when normal distribution cannot
be confirmed
SP02 [Mar96] [Feb00] [Jul02] [Mar03] [Feb06]

Standard error of the mean:
A. Is proportional to N
B. Is greater for sample than SD of population
C. Measures variance within a sample
D. Measures dispersion around population mean
E. The difference between the sample mean and the
population mean.
Alt version: Standard error of the mean:
A. Measure of sample variability
B. Measure of difference between sample & population
mean
C. SEM > SD
D. ?
SP03 [Mar96] [Jul98] [Mar02] [Jul02] Use of chisquare test inaccurate with:
A. 2x2 contingency table
B. Expected value of any cell < 5
C. Observed value in any cell < 5
D. ?
Alt version: Chi square contingency tables
A. Use Fisher test if observed <5
B. Use Fisher test if expected <5
C. ?
D. ?
SP04 [Jul97] The mean in a very large sample:

A. Numerically greater than the standard deviation
B. Is always equal to the mode
C. Is more than the median
D. Represents a normal distribution
E. Gets larger as the sample size increases
SP05 [Mar98] [Jul02] [Mar03] The standard normal

distribution:
A. Standard deviation is one
B. Mean, median & mode are the same
C. Mean is one
D. Mode is one
ST06 [Mar98] [Jul00] In a study for depth of epidural

catheter insertion, the mean is 4.4 and the standard
deviation is 0.3 Which ONE of the following is true?
A. If a normal distribution, 68% of values wold lie
between 4.1 and 4.7cm
B. None was greater than 5.5 cm (or ?6.8cm)

C. The least distance was...??
D. 99% of the sample lies within 1.96 SD of the mean
E: 500 patients had catheters at some length.
SP07 [Mar98] Simple linear regression:

{graph of straight line crossing y axis at +3}
A. y = 3 + 6x
B. y = 3 + 0.6x
C. ?
D. None of the above
SP08 [Jul98] [Mar99] [Jul01] Which one of the

following statements regarding the standard
deviation is true?
A. Mean +/- one SD includes 50% of values
B. Mean +/- one SD includes 66.7% of values
C. Mean +/- two SDs include 99%
D. Mean +/- three SDs include 99.73%
E. Mean +/- 1.96 SD includes 99.73%
SP09 [Jul98] Ordinal data:

A. Assumes a normal distribution
B. ?
C. ?
SP10 [Feb00] Paired t-test

A. Assumes the normal distribuation
B. Is a nonparametic test
SP11 [iq In a clinical trial, a patient either vomits or

not. What type of data is this?
A. Ordinal
B. Nominal
C. Ratio
D. Interval
SP12 [Feb00] [Jul00] [Apr01] Odds ratio:

A. Is prevalence vs. incidence
B. Gives an indication of ?? in exposed vs non-exposed
patients
??C. Formula is Number of positive outcomes/ Number
of negative outcomes
??C. Formula is Number of positive outcomes/ Number
of possible positive outcomes
D. Gives the prediction of a disease outcome knowing
the risk factors
E. Gives prediction of risk factors with a known disease
outcome
SP13 [Jul00] With respect to 95% confidence

intervals:
A. Equals mean +/- 1.96 SE
B. Will contain the population mean 95% of the time
C. Tells variability of sample
D. Tells 5% chance of finding sample result
E. Assumes a normal distribution
SP14 [Jul01] [Jul04] Students t-test

A. Used to compare 2 groups
B. Used if groups have different variance
C. For small size samples

D. ?
E. ?
SP15 [Jul01] [Jul04] All of the following tests

EXCEPT one, can all be used to compare two dissimilar
groups:
A. Chi square
B. Mann whitney U test
C. Wilcoxon signed ranks sum test
D. Spearman rank order
E. Kruskall Wallis
(Alt version: Tests applied to small groups include all
EXCEPT: )
SP16 [Feb04] The central limit theorem states that:

A. Long option mentioning mean, median and mode
B. Best measure of central tendency is mean
C. With repeated sampling, distribution approaches that
of normal distribution
D. With increasing sample size the sample means
approximate a normal distribution.
E. If the 95% confidence interval includes zero then it is
not statistically significant
(Alt: E. 95% confidence interval contains zero )
SP17 [Feb04] [Jul04] What kind of data is the ASA

classification?
A. Nominal.
B. Ordinal
C. Interval
D. Ratio.
E. Parametric.
SP18 [Feb04] [Jul04] Repeated statistical testing:

A. Increases alpha (Type I) error
B. Increases beta (Type II) error
C. Decreases power
D. ?
SP19 [Jul04] Question about study [[Statistical power|

power]
A. Refers to the ability of study to detect a difference if
one exists.
B. ?
C. ?
Primary MCQs-Feb 2007

Primary Physiology Black Bank | Primary

Pharmacology Black Bank
MCQ papers: Feb06 | Jul06 | Feb07 | Jul07 | Feb08
This page contains all the MCQs that were

posted from the Primary Exam on 26 February
2007.
Not all the questions have been added to the
Black Bank yet.
NOTE
* Please classify MCQs into the
appropriate area if possible
If not, then just place them in the
"Unclassified MCQ" section.
* Please don't use ALL CAPITAL
LETTERS as that is hard to read.
Pharmacology
General pharmacology
GP05 LD50 is:
A. median lethal dose
B. determined in phase I clinical trials
C. dose causing death in 50% of animals within 1hr
D. ...
E. ...
Which of the following does NOT decrease ACH
release from presynaptic terminal
A. aminoglycosides
B. magnesium
C. acetylcholine
D. isoflurane
E. ?
GP28 A drug has hepatic extraction ratio of 0.7 and is

30% abosorbed, what is the bioavailability
A. 0.3
B. 0.7
C. 0.21
D. 0.09
E. 0.03
GP51Which is an antagonist at the NMDA receptor?

A. Dexamethasone
C. Dexmedetomidine
D. Dextromethorphan
E. Dexmethamphetamine
With regards to diffusion through a membrane:
A. Directly proportional to thickness
B. Inversely proportional to thickness
C. Inversely proportional to Surface area
D. Inversely proportional to concentration difference
E. Directly proportional to molecular size
All exist as racemic mixtures except
A. thiopentone
B. lignocaine
C. bupivacaine
D. isoflurane
E. enflurane
G Proteins
A. Alpha subunit unit has GTPase activity
B. Has seven transmembrane subunits
C. G protein RECEPTOR hsa three subunits
D.
All are second messengers except
A. Nitric Oxide
B. Ca++
C. cAMP
D. cGMP
E. G proteins
When giving a loading dose prior to an infusion the
following is not taken into consideration.
A. Volume of distribution.
B. Context sensitive half time.
C. ?Keo
Which of these is a constituent of Ringer's lactate?
A. 150mmol/L Na.
B. 150mmol/L K.
C.
Inhalational anaesthetics
IN MAC can be considered as
A. measure of median effective dose
B. ?
C. ?
D. ?
E. ?
IN02 Nitrous oxide at 70%

A. 99% equilibrium at 3 min
B. about 10L uptake within first 3 min
C. reduces muscle blood flow by 30%
D. decrease cerebral autoregulation by 70%
E. ...
IN35 Which of the following regarding nitrous

oxide and Xenon is true?
A. Xenon limited by cost
B. Xenon is less lipid soluble than nitrous
C. Nitrous and Xenon have MAC of > 100% and <
100% respectively
D. Nitrous/both will induce surgical anaesthesia
E. Both are synthesised from readily available
chemicals
Comment: I think the stem was which is FALSE?
Anaesthetic preconditioning:
A. Greater that 1 MAC isoflurane required
B. Related to effects of adenosine
C. Related to K+ ATP channels
D. ?
E. ?
Regarding Isoflurane metabolism:
A. 0.02%
B. O.2% by CYT P450 2E1.
IV anaesthetics
IV Thiopentone vs Propofol
A. tachycardia is less with thiopentone
B. SVR decrease is more with propofol
C. ?
D. ?
E. ?
IV After an IV bolus of thiopentone, amount
remaining in brain after 30min is
A. 0.2%
B. 0.5%
C. 1%
D. 10%
E. 30%
Local anaesthetics
LA Order of potency of local anaesthetics:
A. Bupivacaine > levobupivacaine > Ropivacaine >
Lignocaine
B. Bupivacaine = levobupivacaine > Ropivacaine >
Ligoncaine
C. Ropivacaine> Levobupivacaine > Bupivacaine>
lignocaine.
D.
E.
Lignocaine has pKa of 7.9, the percentage ionised at

pH 6.9 is
A.
B. 11%
C. 50%
D. 91%
E. 99%
Muscle relaxants & antagonists
Malignant hyperthermia is not associated with:
A. Hyperthermia
B. DIC
C. Resistance to relaxants
D. Respiratory acidosis
Opioids
Opioid receptors:
A. Mu, kappa and delta receptors are found in all
laminae in dorsal horn
B.
C.
D. Drugs with solely delta agonism have no analgesic
properties
E.
Cardiovascular drugs
Regarding pharmacologic management of ventricular
fibrillation:
A. epinephrine at 100mcg/kg improves outcomes in
in hospital arrest
B. vasopressin improves cardiac and coronary perfusion
by action at V1 receptors
C. Lignocaine 1.5mg/kg is first line
D. Amiodarone increases risk of Torsades
E.
Which is not a side effect of amiodarone?
A. cardiomyopathy
B. thyrotoxicosis
C. corneal microdeposits
D. pulmonary fibrosis
E. photodermatitis
Dexmedetomidine (repeated)
A. MAC sparing for isoflurane by maximal 30%
B. can cause bradycardia & sinus arrest
C. increases CBF
D. ...
E. ...
Example of a beta-1 selective antagonist with a plamsa
half life of 6-7 hours and renal elimination (repeated)
A. propranolol
B. metoprolol
C. esmolol
D. ....
E. atenolol
ECG changes associated with digoxin at therapeutic
levels (repeated)
A. shortened PR interval
B. prolonged PR interval
C. ST segment changes
D. Peaked T- waves
E. ?
Which is NOT a side effect of non-selective beta
blockade
A. urinary retention
B. bronchospasm
C. hyperglycaemia
D. Hyperkalaemia
E. ?
Milrinone:
A. increased cAMP ?
B. alpha 1 adrenergic receptors ???
C. mechanism of action is a cAMP dependent rise in
intracellular calcium
D. ?increases myocardial oxygen demand
E.
Thiazide diuretics are not associated withA. Hyperglycaemia.
B. Hypermagnesmia
C. Hyperuricaemia.
D. Hyponatraemia.
E. Hypokalaemia.
Miscellaneous drugs
Which one of the following is true about
aminoglycosides?
A. Does NOT cause ototoxicity
B. Does NOT cause nephrotoxcity
C. Does NOT potential NMJ blockers
D. Contraindicated in Myasthenia gravis
E. Is NOT highly protein bound

Which one of the following is NOT true about
aminoglycosides:
A. Do cause ototoxicity
B. Do cause nephrotoxicity
C. Are highly protein bound
D. Contraindicated in Myaesthenia gravis
E. Potentiate NMJ blockade
Which of the following drugs does NOT reduce uterine
tone (repeat MCQ):
A. magnesium sulphate
B. isoprenaline
C. indomethacin
D. Nitrates
E. phenytoin
With regard to oxgygen (repeat of July 06)
A. causes pulmonary toxicity at less than 100kPa
B. medical grade is 95% pure
C. the only gas that ignite a glowing splint
D. some CNS toxicity at 100kPa
E. produced by hydrolysis on commercial level?
With regard to drug administration in a neonate (repeat
July 06)
A. aminoglycosides need to be given in higher
relative dose because proportion of water is greater
B. concentration of free/unbound drug is lower
C. highly protein bound reduces serum bilirubin
D. renal clearance is higher in first few days of life
compared with the second week
E. prenatal maternal drug administration has no effect
on neonatal drug metabolism
Which of the following antiemetics does not easily
cross the blood brain barrier?
A. Metoclopramide
B. Ondansetron
C. Domperidone
D. Prochlorperazine
E. Droperidol
Which of these anticonvulsants acts on the GABA
Receptor.
A. Ethosuccimide.
B. Carbamezipine.
C. Vigabatrin.
D. Lamotrigine.
E. Phenytoin.
MD60 Which of the following is a non particulate

antacid
A. Aluminium
B. Sodium citrate
C. Magnesium
D. Cimetidine
E. ?
Statistics and Drug Trials
A drug that has reached a stage 2 trial:
A. Can be used in a clinically in a teaching hospital

B. Has not had pharmacokinetic data determined
C. Is to be trialled on the target population
D. Has not yet been tested on humans
E. ?
SP21 Which is true linear regression:

A. Line goes through origin
B. Can be used for categorical data
C. Calculated by method of least squares
D. X and Y axis interchangeable
E. ?
Standard errorA. Difference between population mean and sample
mean
Unclassified MCQs
July-2006 Primary MCQs


Please post remembered MCQs from the 17th

July 2006 MCQ paper on this page.
Classify into the appropriate section if you
can; if not, just post into the "unclassified"
section.
If the MCQ is a repeat and you know the Black
Bank Code, then you can just indicate that
code (& note any differences from the Black
Bank version)
PHARMACOLOGY MCQs
Unclassified Pharm MCQs
MCQ-General Pharmacology
The production of toxic metabolites with administration
of nitric oxide is maximal under which circumstances?
A. FIO2 of greater than 80%
B. PEEP > 20 cmH2O
C. NO at 40 ppm
D. Rapid resp rate? (I forgot this one)/high frequency
ventilation
E. Polycythaemia with Hb >19g/dL
CM03 With regard to oxygen:

A. The only gas that can reignite a glowing splint
B. Causes pulmonary (?oxygen toxicity/?hypertension)
at less than 100 kPa
C. Some CNS toxicity occurs at 100 kPa
D. Medical grade is 95% pure
E. Produced commercially by hydrolysis of water
MCQ-General Anaesthetics Inhalational

[July 06]The following compound is not degraded by
Soda Lime
A. Nitrous oxide
B. Halothane
C. Sevoflurane
D. Isoflurane
E. Desflurane
[July 06] Regarding 70% nitrous oxide:
A. 90% equilibration at 3 minutes
B. uptake of 10 liters at 90% equilibration
C. decreases muscle blood flow by 30%
D. Decreases cerebral autoregulation by 24%
E. produces surgical anaesthesia
MCQ-General Anaesthetics Intravenous

MCQ-Local Anaesthetics
Order of protein binding, from highest to lowest
A.
Bupivacaine>procaine>lignocaine>prilocaine
B. ?
C. ?
D. Bupivicaine > lignocaine > procaine > prilocaine
E. Bupivicaine > procaine > prilocaine > lignocaine
Lignocaine:
A. with a pKa of 7.9 is 24% ionised at pH 7.4
B. has a clearance independent of liver blood flow.
C. ?
MCQ-Muscle Relaxants & Antagonists

Which drug has the longest (highest) ED95?
A. Pancuronium
B. Atracurium
C. Rocuronium
D. Cisatracurium
Edrophonium:
A. has a longer half life than neostigmine
B. ?
MCQ-Major Analgesics / Opioids

OP28 [Jul-06] Which is NOT a side effect of
morphine:
A. Seizures
B. Mydriasis
E. Immunosupression.
Mu receptors:
A. are present in all laminae of the spine.
B. ?
MCQAnticholinergics/Antimuscarinics
MCQ-Psychotherapeutic Drugs
MCQ-Cardiovascular Drugs
CD24c [Jul06] Which one of the following selective
beta blockers has a low extraction ratio and is
predominantly excreted in urine?
A. Propranolol
B. Esmolol
C. Atenolol
D. Metoprolol
An example of a beta-1 selective antagonist, with a
plasma half-life of 6-7 hours, and renal elimination is:
A. propranolol
B. metoprolol
C. esmolol
D. atenolol
Nitroprusside
A. May cause coronary steal (was it this q or one on
GTN?)
B. Cyanide is converted to thiocyanate by rhodenese in

the liver and kidney
C. ?
D. ?
E. ?
[Jul06] Which of the following is true regarding
vasopressin receptors:
A. V1a receptors are the most widespread
B. V2 receptors are located in the heart
C. V1b receptors are only located in the kidney
MCQ-Endocrine Drugs
MCQ-Miscellaneous Drugs
Which of the following agents has a prolonged duration
of action in pseudocholinesterase deficiency?
A. Mivacurium
B. Atracurium
C. Cocaine
D. Remifentanil
E. Esmolol
Note: this question appeared twice in almost identical
form on the paper.
With regards to Fresh frozen plasma, which is not
true?
A. In treated to inactivate viruses
B. ?
C. Has a high Sodium load
D. Contains all the factors necessary for coagulation
excluding platelets
E. Is ineffective to treat ATIII deficiency
MCQ-Statistics & Drug Trials

Which is true about a simple linear regression equation?
A. Line goes through origin.
B. Slope of line is zero
C. Line goes through the mean
D. Line describes a cause and effect relationship
E. ?
Primary MCQs-Feb 2006



2006.
Black Bank yet.
Pharmacology
GP. Which only act at G protein coupled receptors
A. acetylcholine
B. histamine
C. glutamate
D. glycine
GP. Regarding the management of poisoning. In what
order would you perform the following:
1. minimise absorption, increase excretion
2. ensure safety of health workers
3. manage airway, B, C
4. treat pharmacologic and toxicological
effects
A. 1,2,3,4
B. 2,3,1,4
C. 2,3,4,1
D. 4,3,2,1
E. 4,2,3,1
Did they intend the word organophosphorous to be
there? - It wasnt there
GP. Weak base with pka 8.9, what is percent ionised at
pH 7.9?
A. 10%
B. 20%
C. 90%
D. 99%
Inhalational anaesthetics
IN ?? increased sympathetic discharge is likely if
increased %absorption of sevoflurane ?? (might have
been an option to one of the volatile questions
IN. Uptake of inhaled anaesthetics is not affected by
A. age
B. MAC
C. concentration of agent
D. solubility of agent
E. cardiac output
IV anaesthetics
IV. Proprofol:
A. substituted isopropylphenol
B. 20% egg phosphatide
C. 80% protein bound
D. causes histamine release
IV. Midazolam:
A. two glycine binding sites on GABA receptor
B. acts at Gaba B receptors
C. stimulates chloride channel opening at GABA B
D. agonist at mu opioid receptors
IV. What has the largest volume of distribution?
A. thiopentone
B. propofol
C. dexemedetomidine
D. midazolam
E. ?
IV. Which agent has no antiemetic effects
A. propfol
B. midazolam
C. scopolamine
D. etomidate
E. ?
IV -. Thiopentone:
A. faster onset with acidosis or
B. predominantly ionised in acidotic environment
C. mostly bound to albumin after injection
D. ?
Local anaesthetics
LA Cocaine effects...
A. Cocaine toxicity is similar to amphetamine toxicity
B. Central effects are due to noradrenaline
C. Vasodilator
D. Maximal effect within 5 minutes
E. ?
MB Which drug is likely to have prolonged duration in
pseudocholinesterase deficiency:
A. Mivacurium
B. Cocaine
C. Procaine
D. Esmolol
E. Remifentanil
IN. MAC what is true

A. not affected by changes in sodium
B. not affected by changes in potassium
C. not affected by pregnancy
D. affected by age 40-80
MB. Non-depolarising neuromuscular block prolonged

with
A. [[Phenytoin}}
B. Hypomagnesemia
C. Respiratory acidosis
D. Hyperkalaemia
E. ?
IN Which is true?
A. MAC of Des greater than sevo
B. Sevoflurane is more rapidly excreted than iso
despite having a larger tissue/blood partition coefficient
MB Which drugs do not cause prolongation of blockade

by inhibiting calcium channel on nerve terminal?
A. Aminoglycosides
B. Frusemide
C. Ca blockers
D. Volatiles
E. Magnesium
MB Edrophonium question (repeat)
A. Has quicker onset than neostigmine
B. Has shorter half life than neostigmine
C. Is a tertiary amine (all options same as previous)
D. ?
MB Pyridostigmine:
A. is a tertiary amine
B. ?
C. ?
D. ?
E. May improve symptoms of myaesthenia gravis
Opioids
OP Remifentanil
A. is metabolised by red cell esterases
B.
C.
D.
E. has active metabolites that are hydrolysed to inactive
metabolites
OP Naloxone:
A. selective mu antagonist only
B. intrinsic activity when given alone
C. mu, kappa, delta activity is equal
D. causes APO
E. half life 6-8 hours
OP Tramadol:
A. prevents reuptake of serotonin and noradrenalin
B. ?
C. ?
OP Opioids
A. spinal receptors exist for mu and delta but not kappa
B. mu receptors found in all lamina of dorsal horn
C. those with only delta agonist activity are not
analgesic
D. tramadol, codeine and oxycodone metabolised
by cyp2d6 to active metabolites
E. tramadol, hydromorphone and codeine have active
metabolites
F. morphine-3-glucuronide is very potent at mu
receptors
OP. Which ONE of the following is true?
A. oxycodone, codeine and tramadol result in
metabolites that are active
B. tramadol, morphine and hydromorphone have active
metabolites
C. ?
OP. Opioids
A. phenylpiperidinies are predominately metabolised by
reduction in the liver
B. ?
C. ?
OP. Regarding tolerance to clinical use of opioids
A. Cross tolerance is complete for all opioids
B. Mechanism may be Phosphorylation of receptors and
internalisation
C. Physical dependence is not a problem
D. psychological dependence does not always occur
E. ?
CD Regarding esmolol:
A. is metabolised by red cell esterases
B. half life something?
C. intrinsic sympathomimentic
D. (no option about not being a membrane stabiliser)
E. ?
CD. Phenylephrine and metaraminol
A. are resistant to metabolism by COMT
B. have both indirect and direct effects
C. have only direct effects
D. ?
CD. Digoxin:
A. inhibits Na+/Ca2+ exchange
B. has a central effect on vagal nuclei
C. Increases atrial refractoriness
D. ?
CD Phentolamine:
A. Selective alpha-1 antagonist
B. Causes bradycardia
D. Causes increased cardiac output
E. Selective alpha 2 antagonist
CD Dexmedetomidine:
A. MAC sparing for isoflurane by maximal 30%
B. Causes bradycardia and sinus arrest
C. ?
Miscellaneous drugs
MD With regard to drug administration in neonate,
A. Aminoglycosides need to be given in higher relative
dose because proportion of water is greater
B. Concentration of free/unbound drug is lower
C. Highly protein bound reduces serum bilirubin
D. Renal clearance is higher in first few days of life
compared with the 2nd week
E. Prenatal maternal drug administration has no effect
on neonatal drug metabolism
MD. Which drugs increase gastric emptying?
A. Omeprazole
B. Domperidone
C. Prochlorperazine
D. Atropine
E. Midazolam
MD. Metoclopramide
A. Substituted benzamide
B. Phenothiazine
c. Half life of: 2 hours
MD. Dexemedetomidine
A. Increases CBF
B. Decrease MAC of isoflurane up to maximum of 30%
C. May cause bradycardia and sinus arrest
D. ?
MD. Warfarin:
A. Is a racemic mixture
B. R isomer is more potent than S isomer
C. Doesn't cross placenta
D. Onset of action depends on speed of synthesis of
coagulation factors
MD. Clopidogrel has its effects by:
A. Binding to GP2b3a receptor
B. Inhibits uptake and binding of ADP
C. Binds to ADP receptor preventing activity
D. Plasma levels elevated for about 7 days after ceasing
MD. PGI2 and PGE2 causes all except
A. Hypotension
B. Abdomial pain
C. Fever
D. Nausea and vomiting
E. Bronchoconstriction
MD. Salbutamol:
A. ?? Myosin light chain kinase
MD. Aspirin:
A. Uncouples oxidative phosphorylation in skeletal
muscle in overdose.
B. plasma levels elevated for about 7 days after ceasing.
C. something about increasing excretion by changing
urine pH
D. half life of 6 hours or something
MD. Phenytoin, which is not true?
A. actions on Ca2+ channels
B. actions on GABA channels
C. direct action on membranes
D. actions on Na+ channels
MD20 Which of the following causes irreversible

cardiotoxicity?
A. Vincristine
B. Bleomycin
C. Asparaginase
D. Danorubicin
MD Oxytocin
A. t1/2 of 5 min
B. Strong antidiuretic effect
C. ?
Statistics
SP02 Standard error of the mean:
A. variability of samples
B. The difference between the sample mean and the

population mean.
C. ?
D. ?
SP01 Tests involving ranking of data:

A. Are preferred when normal distribution cannot be
confirmed
B. Include chi squared test
C. something about having more power (but not in
those exact words)
D. (?? Have more power than parametric tests)
Can't remember which
??
General comments about the paper
"very few MCQ questions in physiology were
repeated or slightly altered, most questions
were brand new"
. . It seems after the recent successes of >90% passing
both physiol and pharm MCQs, the examiners have
really dug deep to try and reduce those percentages. got
a real shock on the day. not what everyone said it would
be like!
Primary MCQs-July2008

MCQ papers: Feb06 | Jul06 | Feb07 | Jul07 |
Feb08
This page contains MCQs that were on the

Primary Exam on 21 July 2008.
Black Bank yet.
GUIDELINES
*Mark MCQs with *new* if you believe
it is a new question, or *repeat* if
you believe it to be a repeat.
appropriate area if possible. If not,
then just place them in the
*If you need help on how to edit a
page see here.
Unclassified Pharmacology
(newish) Adrenaline added to local anaesthetic at 1:200
000. The concentration is:
A: 50 mcg/ml
B: 5 mcg/ml
C: 0.1 mcg/ml (etc)
Question about Clonidine
(new) Which of the following has it's action related to a
ligand gated ion channel?
A. Metoclopramide
B. Phenylephrine
C. Morphine
D. Salbutamol
E. Vecuronium
Question about NO MOA
(new) Which of the following has the highest oral
bioavailability
A. Metoprolol
B. Esmolol
C. Labetalol
D. Atenolol
E. Carvedilol
(new) Esmolol and Sotalol (not remembered accurately)
A. Are both class III anti-arrhythmics
B. Both have 90% bioavailbility
C. Prolong QT
D. Depress SA node and prolong AV
E. Decrease refractory period
(new) Nitrous Oxide:
A. Inhibits methionine synthetase
B. Decreases homo-cysteine levels
C. Increases s-adenyl-methionine levels

D. A and B
E. B and C
Quantal dose response curves:
A. Can be used to determine potency
B. Can be used to determine efficacy
C. Can be used to determine therapeutic index
D. Can be used to deteremine the 50% effective
response
E.
Ketamine
A. Is chemically related to Phencyclidine
B.
C. Is a competitive antagonist at NMDA receptors
D.
E. Is antagonised by Mg2+
Most important contraindication for beta blockers
A. Asthma
B. Heart Failure
C. First line treatment in phaeochromocytoma
D. Hypertension in Diabetes
ACEi
A. Contraindicated in heart failure
B. Preferred method of treating hypertension in
diabetics
C. Something about oedema
(repeat) Which of the following causes least decrease in
SVR
A. Isoflurane
B. Sevoflurane
C. Desflurane
D. Enflurane
E. Halothane
(repeat) Propofol
A. Faster blood/brain equilibration than Thiopentone
Fentanyl in a dose of 30mcg/kg which is FALSE (not
remembered accurately)
A. Will cause hypotension
B. Will decrease MAC by 80%
C. Decreased sympathetic output
(repeat) Bupivacine has pka of 8.1, what is its pH when
ratio of ionised to unionised fraction is 100:1?
A. 6.1
B. 5.1
C. 10.1
D. 6.5
(repeat) Which benzodiazepine has the longest terminal
elimination half time?
A. diazepam
B. temazepam
C. lorazepam
D. oxazepam
E. flunitrazepam
(repeat) Propofol clearance is :

A. significantly decreased in liver failure
B. decreased in pregnancy
C. significantly increased in neonates
D. significantly decreased in renal failure
E. Unchanged in the elderly
(repeat) what antagonises the effect of neostigimine on
its reversal of neuromuscular blockade
A. hyperkalaemia
B. hypomagnemesaemia
C. respiratory acidosis
D. metabolic acidosis
E. respiratory alkalosis
Warfarin
A. Depends on the time to produce new clotting factors
for onset
B. Is clinically used as a racemic mixture
C.
D. Only the R-isomer is effective
E.
Anticholinergic syndrome treated with:
A. Atropine
B. Pyridostigmine
C. Physostigmine
D. Neostigmine
E. Edrophonium
(new) In regards to AntiChE
A. Pyridostigmine has a tertiary amine
B. Onset of Edrophonium is longer than Neostigmine
C.
D.
E.
(repeat) Sarin gas
A. Causes dry, red skin
B. Anticholinergic treatment contraindicated with
tachycardia
C.
D. Causes fasciculation and paralysis
Metoclopramide
A. Is a dopamine agonist
B.
C.
D.
E. Increases gastric emptying thorugh it's effect on H1
receptors
(repeat) Central limit theorem (not accurately
remembered)
A. In a large sample the means will approach a normal
distribution
B. Something about confidence intervals
C.
D.
E.
Chemoreceptor Trigger Zone (inaccurately remebered)

A. Not affected by drugs that cannor cross blood brain
barrier
B. Receives multiple synaptic, csf and blood inputs
C. Contains dopamine and histamine receptors
The beta blocker with the greatest bioavailability is:
A. Atenolol
B. Metoprolol
C. Sotalol
D. Labetalol
E. Carvedilol
Central anticholinesterase syndrome can be treated
with: (Not sure about the "incorrect" answers, but
physostigmine was definitely there
A. Pralidoxime
B. Pyridostigmine
C. Atropine
D. Glycopyrrolate
E. Physostigmine
Once commenced on an infusion, propofol bottle must
be discarded after:
A. 6hrs
B. 12 hours
C. 16 hours
D. 24 hours
E. 30 hours
(12, 24 and 30 were definitely options) Not sure about
the other two. a was definately 6hrs
The component that emulsifies propofol is:
A. Soy oil
B. Glycerol
C. Sodium metabilsulphite
D. Egg lecithin
E. ??
A few repeats:
MB 37
PS06
Which of the following is not a ligand gated receptor:
A. nicotinic Ach receptor
B. alpha 2 adrenergic receptor
C. 5HT3 receptor
D. ?
IV anaesthetics
Propofol clearance is :
A. significantly decreased in liver failure
B. ncreased/decreased in pregnancy
C. significantly increased in neonates
D. significantly decreased in renal failure
E. Unchanged in the elderly
Bupivacine has pKa of 8.1, what is its pH when ratio of
ionised to unionised fraction is 100:1?
A. 6.1
B. 5.1
C. 10.1
D. 6.5
Something similar to:

What antagonises the effect of neostigimine on its
reversal of neuromuscular blockade
A. hyperkalaemia
B. hypomagnemesaemia
C. respiratory acidosis
D. metabolic acidosis
E. respiratory alkalosis
Primary MCQs-Feb2008

| Jul08

2008.
Black Bank yet.
GUIDELINES
*Mark MCQs with *new* if you believe
it is a new question, or *repeat* if
you believe it to be a repeat.
appropriate area if possible. If not,
then just place them in the
*If you need help on how to edit a
page see here.
Pharmacology
Unclassified Pharmacology
Which of the following is not a ligand gated receptor:
a)nicotinic Ach receptor
b)alpha 2 adrenergic receptor
c)HT3 receptor
d)?
IV anaesthetics
Propofol clearance is :
a)significantly decreased in liver failure
b)increased/decreased in pregnancy
c)significantly increased in neonates
d)significantly decreased in renal failure
e)Unchanged in the elderly
Thiopentone compared to propofol has:
a)shorter effect site equilibrium time
b)?
c)?
d)?
Which benzodiazepine has the longest terminal
elimination half time?
a)diazepam
b)temazepam
c)lorazepam
c)oxazepam
Local anaesthetics
Bupivacine has pka of 8.1, what is its pH when ratio of
ionised to unionised fraction is 100:1?
a)6.1
b)5.1
c)10.1
d)6.5
Which of the following is an amide local anaesthetic:
a)dibucaine
b)cocaine
c)procaine
d)amethocaine
e) Procainamide (I think)
Which neuromuscular blocking agent is the least
metabolised:
A) Vecuronium
B) Rocuronium
C) Cisatracurium
D) Atracurium
E) Pancuronium
what antagonises the effect of neostigimine on its
reversal of neuromuscular blockade
a)hyperkalaemia
b)hypomagnemesaemia
c)respiratory acidosis
d)metabolic acidosis
e)respiratory alkalosis
ED95 for neuromuscular blockade means:
a)dose where twitch is reduced by 95%
b)dose where twitch is reduced to 95%
c)dose where 95% of the population is paralysed
d)?
Opioids
A bolus dose of morphine has a longer duration of
action compared with fentanyl (repeat)
a)larger volume of distribution
b)less lipid solubility
c)longer elimination half time
opiod receptors:
a)found in all lamina of dorsal horn of spinal cord
b)opiods with only delta agonist activity doesn't have
analgesic property
Atenolol:
a)has higher lipid solubility than propanolol
b)is a nonselective beta blocker
c)
d)
Miscellaneous drugs
Hyoscine can:
A) Cause post op confusion in the elderly
B) Cause nausea and vomiting
C) Has a Quartenary Nitrogen
D) ?Is related to Atropine
Which of the following causes reversible inhibition of
platelet function?
A. aspirin
B. heparin
C. warfarin
D. diclofenac
E. clopidogrel
Which following drug is not a serotonin receptor
antagonist?
a)sumatriptan
b)clozapine
c)ketanserin
d)ondasetron
Regarding antibacterial agents, which of the following
is true?
a) Isopropyl alcohol is sporicidal
b) chlorhexidine is antibacterial in 1 minute
c) povidone iodine is antibacterial in 1 minute
d) chlorhexidine is neutralised by skin moisturises
e) Isopropyl alcohol is able to penetrate proteins
Metoclopramide:
A. Able to reverse opiod induced delayed emptying of
the stomach
B. Is a H1 antagonist
C. Causes constipation
D. Increases lower oesophageal sphincter tone
E. ?
Regarding metformin and glimepiride:
a)both don't have therapeutic effects above what insulin
offers
b)metformin is renally metabolised whereas glimepiride
is metabolised totally by the liver
c)obesity is a problem side effect
d)both cause metabolic acidosis
Which of the following anticonvulsants work by
modifying GABA transmission?
A. lamotrigine
B. vigabatrin
C. phenytoin
D. ethosuximide
E.
Which of the following produces contractions in uterine
muscle?
a)PGE2
b)beta blockers
c)PGF2alpha
d)magnesium
Different question to above:
BL02 Which one causes bronchodilation?
A. PGE2
B-E. some other stems which were all constrictors
(NOTE: This seems to be BL02 from the Physiology
MCQs though recorded here as a Pharm MCQ (??).
Anyone got any other information? In the meantime
temporarily code as BL02) Definitely in the pharm
paper, only did the pharm paper this sitting!!!
Statistics and Drug Trials
Only 2 stats questions in the whole paper
Repeat regarding central mean theory...
General comments/opinions about the paper
I thought it was a fair paper, nothing too unexpected.
Not many repeat MCQ's.
Some typographical errors in the paper, which may
unfortunately alter some answers.
i thought there was at least 50% repeats!
July 2007 MCQs


PHARMACOLOGY MCQs
Unclassified Pharm MCQs
General Pharmacology
Hypertonic fluid is used in resuscitation for:
A. increase in total body sodium.
B. reduction in viscosity.
C. improve coagulation.
D. reduce intracellular oedema.
E. rapid expansion of intravascular volume.
A drug has an ionized to unionized ratio of 100:1. If the
pH is x, what is the pKa of the drug? (similar to
previous question regarding lignocaine)
I remembered it as "if pKa is x, then pH is"
A. x
B. x-1
C. x+1
D. x-2
E. x+2
Acids Ionised Above pKa
Bases Ionised Below pKa
Ratios: pH-pKa =
-2:
99:1
-1:
90:10
-0.5: 75:25
0:
50:50
0.5: 25:75
1:
10:90
2:
1:99
Just remember the above and whether the drug is an
acid or a base.
This question was, bupivacaine has pKa 8.19, if its
ionised to unionised ratio was 100:1, what is the pH?
A: 5.19
B: 6.19
C: 7.96
D: 8.19
E: 10.19
As Above, Bupivicaine is a weak base, ionised below
pKa (8.19)
Ratio 100:1 means pH-pKa = -2
Therefore ph = 6.19.
(Note this gives 99:1, but ph 5.19 gives ratio 99.9:0.1
therefore I think B most correct.)
GP29 Which of the following drugs cannot cross the

BBB?
A. Ondansetron
B. Scopolamine
C. Metoclopramide
D. Droperidol
E. Domperidone
A drug is 30% absorbed, if hepatic extraction is 0.7,
what is the oral bioavailability? (rpt)

A. 0.3
B. 0.7
C. 0.21
D. 0.09
E. 0.03
Bioavailability = Absorption X (1-HER)
Bioavailability = 0.3 X (1-0.7) = 0.09
GP 28Which is not a ligand gated channel?.

A. Alpha-2 Receptor
B. 5HT3 Receptor
C. Nicotinic cholinergic receptor
D. GABA receptor
E. ?
G proteins
A. Always have 3 subunits
B. Alpha subunit has intrinsic GTPase activity
C. One G protein only attached to one G protein
coupled receptor
D. Spans membrane 7 times
Electrical events in GABA transmission
A. Presynaptically inhibits GABA-A
B. Presynaptically inhibits GABA-B
C. ?
D. ?
E. ?
General Anaesthetics - Inhalational
Anaesthetic preconditioning...
A. Sevoflurane and propofol are equally effective
B. At least 1.0 MAC Isoflurane necessary
C. something about Adenosine receptors
D. thought to be due to closure of KATP channels
E. Opioids do not produce preconditioning
Question regarding isoflurane metabolism (old MCQ):
A. 0.2% by CYP2E1
B. 0.02%
C. ?
D. ?
E. ?
Therapeutic ratio (or index) of inhalational anaesthetics
such as sevoflurane and isoflurane:
A. Less than 2
B. 2 - 4
C. 4 - 8
D. 8 - 10
E. Greater than 10
General Anaesthetics - Intravenous
Question comparing CV side-effects of thiopentone and
propofol. (same/similar to old MCQ)
A. ?
B. ?
Question regarding propofol clearance
A. Undergoes oxidative metabolism.
B. age/sex
C. liver blood flow
D. 10% urine metabolites

E. chronic liver disease
C. No fade on DBS
D. No fade with tetany.
E. ?
Propofol clearance
A. The same as hepatic blood flow
B. Increased in children
C. ? Increased/? Decreased in pregnancy
D. No change in elderly
E. Decreased in renal dysfunction
MB39 Sugammadex binds most avidly to:
What does not occur with dose of thiopentone?

A. Decrease in cardiac output & vasodilatation
B. ?
C. Decreased in CMRO2 by 55%
D. ?
E. Wakening at increased venous (arm) concentrations
of thiopentone with repeated bolusing
A. Pancuronium
B. Rocuronium
C. Vecuronium
D. Atracurium
E. Cisatracurium
(???was this in the paper??? I can't remember it.)
Which is the LEAST metabolised?
A. Pancuronium
B. Vecuronium
C. Rocuronium
D. Atracurium
E. Cisatracurium
Ketamine:
A. A racaemic mixture, contains mostly S isomer
B. Minimal effect on ICP
C. Theta waves ...?...
D. Something about infusions & ventilatory response to
pCO2
Vecuronium:
Local Anaesthetics
A solution of LA contains 1:200000 adrenaline. How
much adrenaline has been added? (same/similar to old
MCQ)
A. 5 mcg/mL
B. 50 mcg/mL
C. 500 mcg/mL
D. 0.5 mcg/mL
E. 0.05 mcg/mL
A. Persistent binding on nicotinic cholinergic receptors

B. Inactivates Na+ channels
C. Direct blockade of open channel
Lignocaine
A. Not absorbed via GIT
Systemic absorption of LA given epidurally depended
on all except: (old)
A. Adrenaline added
B. Intrinsic vasoconstrictor activity
C. Hepatic metabolism
D. Renal clearance
Muscle Relaxants & Antagonists
Question regarding active metabolites of the ND
NMJBs (same/similar to an old MCQ).
A. Vecuronium
B. Pancuronium
C. Rocuronium
D. ?? cis/atracurium
E. ?
Definition of the ED95 (with respect to NMJBs):
A. Twitch height decreased BY 95%.
B. Twitch height decreased TO 95%.
C. Percentage paralysed is 95%.
D. Percentage not paralysed is 95%.
Best Indicator of adequate reversal of NM blockade
(same/similar to an old MCQ)
A. TOFR > 50%
B. PTC of 11
A. Metabolism involves 3- & 17-deacetylation

B. ?
C. ?
Mechanism of neuromuscular block of
suxamethonium
A patient is reversed with 50mcg/kg neostigmine and

20mcg/kg atropine then develops laryngospasm and is
given 1.5mg/kg suxamethonium. The most likely
outcome is:
A. Decreased duration of block
B. Increased duration of block
Major Analgesics / Opioids
Question relating to pethidine:
A. Causes serotonin reuptake inhibition.
B. ?
Regarding codeine, which is false:
A. Less efficacy as an analgesic compared to equipotent
doses of morphine
B. ?
C. ?
D. ?
Opioids (rpt Q)
A. Tramadol, codeine, oxycodone metabolised by
CYP2D to active metabolites
B. Tramadol, codeine, hydromorphone has active
metabolites
Single bolus of morhpine 10mg has longer duration of
action than single bolus of fentanyl 50 mcg because
morphine, when compared to fentanyl has:
A. Lower lipid solubiltiy
B. Smaller volume of distribution
A 50-100 mcg/kg dose of fentanyl (old Q)
A. Elimination half life greater than 3 hrs
B. Does not adequately supress stress response to

surgery
Anticholinergics/Antimuscarinics
AH07 The nerve agent sarin:
A. should not be treated with anticholinesterase if there
is tachycardia
B. something about pyridostigmine
C. symptoms can include fasciculations and paralysis
D. something about pralidoxime unblocking the
receptor (a red herring teaser)
E. ?
sorry not remembered well but at least you know to
look up sarin in your spare time!!
Plasma cholinesterase
A. Hydrolyses succinylcholine to succinylmonocholine
B. Large amounts in red cells
C. Metabolises remifentanil
What does not cause decreased plasma cholinesterase
activity?
A. Pregnancy
B. Pancuronium
C. Neotigmine
D. Frusemide
Psychotherapeutic Drugs
abc Question regarding GABA ion
channels and the mechanism of action
of AEDs*repeat*
Options included 5 AEDs (1 or 2 of these were 'newer'
agents).
A. lamotrigine
B. vigabatrine
C. phenytoin
D. gabapentin
E.
The last option was ethosuccimide
Which ONE of these does NOT have anticonvulsant
effects?
A. lorazepam
B. acetazolamide
C. phenytoin
D. primadone
E. phenindione
Cardiovascular Drugs
Mechanism of action of vasopressin in weptic shock
include all except:
A. Potentiates action of catecholamines on blood
vessels
B. Increases release of noradrenaline from the adrenal
medulla
C. Preferentially vasoconstricts renal efferent arterioles
to maintain GFR
D. Acts via V1 receptors
E. Opposes vasodilatory action of nitric oxide
Something about selective alpha adrenoceptor agonists
A.
B.
C.
D. in carcionod treatment phenoxybenzamine used
following beta-blockade.
E.
Non-selective beta blockade causes :
A. Increased muscle blood flow.
B. Decreased uterine tone.
C. hyperglycaemia.
D. ?bronchodilation
E. ?mydriasis ?miosis
Which inotrope does not act by increasing cAMP?
A. Milrinone
B. Glucagon
C. Digoxin
D. ?
E. ?
Nitric oxide
A. ?something about PVR
B. Does not cause bronchodilatation
C. Released in response to actylcholine
D. ?
E. ?
CD49 Which one of the following is not an adverse

effect of Amiodarone?
A. Pulmonary fibrosis.
B. Photosensitive rash.
C. Corneal microdeposits.
D. cardiomyopathy
E. thyrotoxicosis
Adenosine & amiodarone
A. Both class III antiarrhythmics
B. Both decrease conduction through AV node and
increase refractory period
C. Both may cause hypotension, chest pain &
bronchospasm with bolus dose
MCQ-30 Milrinone
A. depresses thyroid function with prolonged
use
B. antiarrhythmic effects with class 3
properties
C. dose dependant increase in coronary oxygen
consumption
D. exerts its effect via cAMP dependant
increase in intracellular calcium
E. devoid of arrhythmic effects of
catecholamines
Phenylephrine
A. increases skin temperature
B. inactivated by COMT
C. increases gastric motility
D. causes mydriasis
E. has the same duration of action as noradrenaline
1:200000 Adrenaline is equivalent to
A. 5%
B. 0.01%
C. 5mg/ml
D.
E.
Endocrine Drugs
Miscellaneous Drugs
Which of the following drugs is an NMDA antagonist?
A. Dexamethasone
C. Dextromethorphan
D. Dexmedetomidine
E. Dexamphetamine
Which of the following drugs may cause mydriasis?
A. Phenylephrine
Which one causes reversible impairment of platelet
function
A. Aspirin
B. diclofenac
C. clopidogrel
D. heparin
E. warfarin
Answer: diclofenac
- Aspirin covalently, ie. irreversibly binds to cox-1
- Diclofenac reversibly binds to cox-1
- clopidogrel binds irreversibly to platelet ADP
receptors, thus inhibiting ADP activation of the
GPIIb/IIIa complex
- Heparin does not affect platelet function- is involved
in clotting cascade
- Warfrin does not affect platelet function - is involved
in clotting cascade
Also one about COXII
A. it is inducible with inflammation
B. ?
C. COXII inhibitors rarely cause cause gastric erosion
D. NSAIDS can ihibit the expression of COXII
caution: I think I haven't remembered this very well..
Serotonin
A. Impairs platelet aggregation
B. Pulmonary ?vasodilatation/?vasoconstriction
Which produces uterine contraction
A. PGF2 alpha
B. PGE2
c. NSAIEDS
Gentamicin, which is false (rpt Q)
A. Causes ototoxicity
B. Causes nephrotoxicity
C. High plasma protein binding
Thiazide diuretics are not associated with
A. Metabolic acidosis
B. Hypomagnesaemia
C. Hyperuricaemia
D. Hyponatraemia
E. Hypochloraemia
With regards to fresh frozen plasma, which is true?
A. Is treated to inactivate viruses
B. Contains all procoagulants excluding platelets
C. Is ineffective to treat ATIII deficiency
D. Must be crossmatched
Which of the following is a non-particulate antacid?
A. Na Citrate
B. ?
C. ?
D. ?
E. ?
The minimum daily aspirin dose that causes full platelet
inhibition:
A. 20mg
B. 40mg
C. 60mg
D. 100mg
E. 300mg
(I don't think 60mg was an option - I think the options
were 10mg 20mg 40mg 100mg 300mg)
Statistics & Drug Trials
Power is NOT dependent on: (? repeat)
A. number of participants
B. 95% Confidence interval
C. The size of the difference
D. The variability within the samples
E. Type II error
SP20 A drug that has completed phase I trials :

A. Has been tested on humans.
I actually thought it said something like:
A. has not been tested on humans
B. next will be tested in target group
C. nothing known about PK
D. can be used in large teaching hospitals
Standard error the mean
A. Difference between population & sample mean
B. Used to derive the range which likely includes the
population mean
MISC
GP14 [Apr01] [Jul04]
(A Basic drug with a pKa of 8.7)
A. ?
B. ?
C. Will be predominantly ionised at
plasma pH
Comments
A basic drug will be predominantly ionised at a pH
below its pKa
For a drug with a pKa of 8.7 undegoing the reaction: B
+ H+ <-> BH+:
At pH = pKa we can calculate the following:
pH = pKa + log([B]/[BH+]) (HendersonHasselbalch equation)
If pH = pKa then this simplifies to
pKa = pKa + log([B]/[BH+])
log([B]/[BH+]) = 0
Thus, taking anti-logs (easy as log 1 = 0):
([B]/[BH+]) = 1 so [B] = [BH+] -> 50% ionised & 50%
unionised
By doing similar calculations using the HendersonHasselbalch equation, the ratio B/BH+ can be
determined at any pH value. For example:
For pH = pKa + 1 -> 10% ionised & 90%
unionised (approx)
For pH = pKa -> 50% ionised & 50%
unionised
For pH = pKa - 1 -> 90% ionised & 10%
unionised
For pH = pKa - 2 -> 99% ionised & 1%
unionised
LA12 [Jul98]
The site of action of benzocaine is:
A. Same site as saxitoxin (alt
option: At the channel mouth )
B. Inside Na+ channel
C. At axoplasmic end of Na+ channel
D. At Ca++ channel
E. In the cell membrane
Comments
Option "E In the cell membrane" would be the best
answer.
Benzocaine is an ester local anaesthetic which is a
secondary amine.
It is unique among clinically useful LA's.
As a weak base with a low pKa (3.5) - therefore at
physiological pH exists primarily in an unionized form
rendering it lipid soluble (& water-insoluble).
Because of this it is suitable for topical anaesthesia of
mucus membranes (in concentrations up to 20%). Its
systemic toxicity is also diminished because of rapid
hydrolysis. It has a very rapid onset
Mechanism of action
"Certain local anaesthetics (eg
benzocaine) are only present in the
body as
uncharged, tertiary bases, and must

therefore act in a different way.
They
are believed to cause conduction
blockade by "membrane expansion" (ie
by
causing swelling of the lipoprotein
matrix of the Na+ channel. To some
extent,
other local anaesthetics, which are
partly present in the neurilemma as
the
uncharged base may act in this
manner."
- from Calvey & Williams "Principles
and Practice of Pharmacology for
Anaesthetists" 4th ed 2001, p152-3
So option "E In the cell membrane" would be the best
answer.
Benzocaine is a weak base
Potential problems with benzocaine
1. Allergic reactions
Metabolism to produce para-amino benzoic acid
(PABA) so potential for allergic reactions (like other
ester LAs)
2. Methaemoglobinaemia
Benzocaine can cause methaemoglobinaemia
[1] (http://www.jaoa.org/cgi/content/full/105/8/381)(so
dose is limited to 200-300mg in adults). Babies are at
higher risk
[2] (http://www.tiaft.org/tiaft98/thu/p/t_p_29.html)
because of their smaller weight (easier to give a high
dose) and because of lower levels of the enzymes which
convert met-HbF back to Hb. Treatment of
symptomatic methaemoglobinaemia is IV 1%
methylene blue at a dose of 1-2mg/kg over 20 minutes.
Note that with concentrations of 20%, one ml will
contain 200mg!
Regarding methaemoglobinaemia
"Of 198 reported adverse events of
all types reported with benzocaine,
132 cases (66.7%)
involved definite or probable
methemoglobinemia, including 107
serious adverse
events (81.1%) and two deaths (1.5%).
The formulation implicated was a
spray in 123 cases
(93.2%), a benzocaine-containing
lozenge in two cases (1.5%), and a
gel in one case. Of
the 69 cases that specified a dose,
37 (53.6%) indicated that a single
spray was applied,
which is approximately the
recommended amount.
"Health professionals involved in
endoscopy, intubation, bronchoscopy,
or similar invasive
procedures using benzocainecontaining sprays should know that

(1) administration may cause
MHb with potentially serious
consequences, (2) identifying the
reaction to benzocaine
usually requires cooximetry (although
it can be implied by symptoms), and
(3) treatment
involves immediate intravenous
administration of 1 to 2 mg/kg of
methylene blue."
- from
[3] (http://www.medscape.com/viewarti
cle/481037)
Pharmacology SAQ Listing

Question Coding
1st 2 numbers: year SAQ was asked
Next value: 'A' for Mar-Apr paper; 'B' for JulAug paper
Final no: Q number on paper
Example: '93B12" ->question 12 on Jul-Aug 1993
paper
EXCEPTION: old Qs just have the year listed (eg
'1991')
Pharmacology MCQs | Physiology SAQ
A list of Primary FANZCA Short Answer Questions
(Pharmacology SAQs). (The percentages are the pass
rate for the question at that exam).
Table of contents
[showhide]
1 General Pharmacology
1.1 Pharmacodynamics
1.2 Pharmacokinetics1.3
Other General
Pharmacology
2 Inhalational
Anaesthetic Agents
3 Intravenous
Anaesthetic Drugs &
Antagonists
4 Opioid Agonists &
Antagonists
5 Muscle Relaxants &
Antagonists
6 Local Anaesthetics
7 Autonomic &
Cardiovascular Drugs
7.1 Autonomic
Pharmacology7.2
Adrenoreceptor Drugs
7.3 Antihypertensives
(incl Diuretics)7.4 Antiarrhythmic Drugs
8 Miscellaneous
Pharmacology
8.1 Anti-emetic Drugs
8.2 Drugs affecting
Coagulation8.3 Obstetric
Pharmacology8.4
Gastrointestinal
Pharmacology8.5
NSAIDs / Paracetamol
8.6 Unclassified Drugs
9 Statistics
General Pharmacology
Pharmacodynamics
Pharm-08A5 Classify drugs that alter activity at
serotonin receptors with examples. Describe their
mechanisms of action and clinical indications.
Pharm-08A4 Outline the pharmacologic management
of bronchoconstriction in acute severe asthma. Include
mechanisms of action and potential adverse effects.
Pharm-06A1 Outline the pharmacologic management
of bronchoconstriction in acute severe asthma. Include
mechanisms of action and potential adverse effects.
Pharm-06A4 Describe the pharmacodynamic
properties of propofol and how this influences its
clinical usage.
Pharm-05B2 Using opioids as examples, describe
and illustrate with graphs what you understand by the
terms "potency", "efficacy", "partial agonist",
"competitive antagonist" and "therapeutic index". (83%
pass rate)
Pharm-04B1 Briefly describe how drugs produce
their pharmacological effects. Illustrate each
mechanism with examples. 67%
Pharm-03B3 Outline GABA's role as a
neurotransmitter and indicate how its actions may be
modified by pharmacological agents. 63%
Pharm-01A10 Outline GABA's role as a
neurotransmitter and indicate how its actions may be
modified by pharmacological agents 53%
Pharm-01A9 Briefly describe how drugs produce
their pharmacological effects. Illustrate each
Pharm-00B11 Describe the structure and function of
G proteins 50%
1999 Using opioids as examples describe and illustrate
with graphs what you understand by the terms 'potency',
'efficacy', 'partial agonist', 'competitive antagonist' and
'therapeutic index'. 77%
Pharm-97A9 Briefly describe the pharmacological
role of the nicotinic cholinergic receptor 62%
1997 Briefly describe the drug factors that may
predispose to thrombophlebitis
Pharm-96B12 Briefly describe how drugs may
produce their pharmacological effects. Illustrate each
Pharm-96A16 Define therapeutic index and briefly
outline its significance. Describe briefly also the
therapeutic ratio and the use of the of the cardiac/cns
toxicity ratio (cns = central nervous system) 79%
Pharm-95B9 Using opioids as examples, describe
and illustrate with graphs what you understand by the
terms potency, efficacy, partial agonist , competitive
antagonist and therapeutic index. 70%
1994 Briefly explain non-competitive antagonism at
receptor sites and give two examples
1994 Briefly describe the possible mechanism of action
of general anaesthetics
1993 Briefly outline the chemistry of soda lime and
the potential interactions with anaesthetic agents
Pharm-93A2 Define potency, affinity and efficacy

illustrating your answer by reference to opioids in
clinical use 84% [See also [[Pharm-95B9]
1991 Write short notes on log dose effect curves
Pharmacokinetics
Pharm-07A3 Discuss factors contributing to interindividual variability in the therapeutic response to
opioid analgesic medications. 69%
Pharm-07A2 After epidural injection in a health term
pregnant woman, discuss the factors influencing the
distribution of bupivacaine to (a) the maternal CSF and
spinal cord; (b) the maternal circulation; (c) the foetus.
46%
Pharm-06B3 Describe the factors which contribute to
the inter-individual variability in drug response seen
with intravenous anaesthetic induction agents. 42%
Pharm-05B4 Define the term context sensitive half
time. How does it differ from the half-life typically
quoted for a drug? Illustrate this concept by comparing
thiopentone vs. propofol and fentanyl vs. remifentanil.
73%
Pharm-04A5 Outline the effects of liver failure on
drug kinetics and dynamics. 52%
Pharm-02B2 Briefly describe the factors affecting the
uptake of orally administered medicines 67%
Pharm-02A10 Outline the factors that determine
recovery (offset of action) after ceasing a drug infusion.
43%
Pharm-01B9 What do you understand by the term
"clearance". Using propofol as an example, explain
briefly the importance of clearance. 77%
Pharm-01A11 Define the term 'context-sensitive half
time'. How does this differ from the elimination half
life? Illustrate your answer by comparing thiopentone
vs. propofol, and fentanyl vs. remifentanil 64%
Pharm-00A14 Discuss the roles of the plasma
esterases on drugs used in anaesthesia 67%
Pharm-99B16 Outline the factors that determine
recovery (offset of action) after ceasing a drug infusion.
55%
Pharm-98A13 Outline the factors that determine
recovery (offset of action) after ceasing a drug infusion
37%
Pharm-97A10 What do you understand by the term
'clearance'? Using propofol as an example, explain
briefly the importance of clearance
Pharm-96A13 Describe briefly the factors
determining transdermal uptake of drugs and give some
examples of drugs that can be administered by the
transdermal route. Briefly outline the advantages and
disadvantages of transdermal administration of drugs.
79%
Pharm-95B2 Describe the clearance of drugs by the
kidney
Pharm-95B3 Give a brief account of drug protein
binding and outline its significance
Pharm-95B8 Outline the factors that determine
recovery (offset of effect) after ceasing a drug infusion.
Explain the relevance of a drugs elimination half time.

6%
Pharm-95A3 Define Phase I and Phase II reactions in
drug metabolism. Provide examples with drugs used in
anaesthesia. 70%
Pharm-95A2 Define a 'steady state' in pharmacology.
List the advantages and disadvantages of a steady state
and outline the characteristics of drugs which make
them suitable for steady state pharmacology 65%
Pharm-95A4 Briefly describe the factors affecting
the uptake of orally administered medicines 76%
1994 Discuss the ways in which the consequences of
liver disease may influence drug disposition.
1992 Write short notes on binding of drugs to plasma
proteins
1992 Write short notes on measurement of whole body
drug clearance
1992 Write short notes on zero order kinetics
1992 Write short notes on Hepatic extraction ratios
1991 Write short notes on the clearance of drugs
1991 Write short notes on estimation of apparent
volume of distribution of a drug
1991 Write short notes on binding of drugs to plasma
proteins
1990 Define bio-availability. Discuss the factors which
determine the bio-availability of a drug.
Other General Pharmacology
Pharm-06A2 What is an isomer? Briefly write an
account of the types of isomers and their significance in
drugs used in anaesthesia.
Pharm-03A4 Outline the potential problems
associated with additives used to make medicines
suitable for intravenous injection. 43%
Pharm-00B15 Write brief notes on latex allergy
44%
Pharm-00B9 What is an isomer? Briefly write an
drugs used in anaesthesia 67%
Pharm-99B15 Briefly describe the preparation of
oxygen for medical use. List the physical properties of
oxygen. Outline the potential adverse effects associated
with its medical use. 50%
Pharm-98B16 Write brief notes on latex allergy 30%
Pharm-95A5 What is an isomer? Briefly write an
drugs used in anaesthesia 55%
1992 Write short notes on chemical additives to
anaesthetic solutions
Pharm-92A1 Discuss the factors which influence the
administration and dosage of drugs in the elderly.
Inhalational Anaesthetic Agents
Pharm-08A1 An 80 year old woman is undergoing
major emergency surgery. Describe the maintenance
inhaled concentration of sevoflurane you would choose
and the factors that might influence this.
Pharm-07B1 Describe the adverse effects that may
occur with the administration of desflurane.
Pharm-06B2 Compare and contrast the clinically
Pharm-96B11 Briefly outline the effects of volatile
significant respiratory, cardiovascular and central

nervous system effects of desflurane and isoflurane.
70%
Pharm-06A3 List the non-ideal features of nitrous
oxide.
Pharm-05B1 Describe how isoflurane is
metabolised. In your answer give reasons why the
overall extent of metabolism of isoflurane is so low.
44%
Pharm-04A1 Describe the effects of isoflurane on
intracranial metabolism, intracranial haemodynamics,
intracranial pressure and the EEG. 71%
Pharm-03B8 Outline the pharmacological differences
between neonates and adults with reference to
sevoflurane, vecuronium and morphine. 42%
Pharm-03B2 Describe the potential interactions of
sevoflurane, desflurane and isoflurane with
carbon dioxide absorbents. 60%
Pharm-03B1 Draw and label, on the same X - Y axis,
FA/FI curves for the following halothane concentrations
in oxygen, showing a 30 minute period from starting
administration. a. Halothane 1%, subject breathing
spontaneously. b. Halothane 6%, subject breathing
spontaneously. c. Halothane 6%, subject paralysed and
ventilated. With reference to the major factors
determining the shape of FA/FI curves explain the
differences between (a) and (b), and (a) and (c). 29%
Pharm-03A1 Briefly outline the effects of isoflurane
on skeletal, smooth and cardiac muscle tissues. Indicate
how these effects are mediated and their clinical
significance. 74%
Pharm-02B4 Briefly outline the potential interactions
between volatile agents and carbon dioxide absorbents
52%
Pharm-02B3 Draw a graph comparing the ratio of
inspired to alveolar concentrations during the first half
hour of administration for nitrous oxide, isoflurane, and
halothane. Outline reasons for observed differences
between the agents and indicate the effects of increases
in alveolar ventilation and cardiac output. 73%
Pharm-01B10 Briefly describe the adverse effects of
nitrous oxide. 76%
Pharm-01A12 Briefly describe the respiratory effects
of the volatile agents 58%
Pharm-00A9 Compare and contrast the effects of
halothane and isoflurane on the heart 65%
Pharm-99A14 Briefly outline the pharmacological
effects of the volatile anaesthetic agents on the kidneys.
64%
Pharm-98A16 Outline the potential for
methoxyflurane and sevoflurane to produce toxic
effects on the kidney 75%
Pharm-97B14 Compare and contrast the effects on
the heart of halothane and isoflurane 46%
Pharm-97A16 Discuss the possible effect of volatile
inhalational agents on the liver
Inhalational agents on the muscle tissues, indicating

postulated mechanisms and clinical significance. 43%
Pharm-96A9 Describe briefly the central nervous
system effects of isoflurane
Pharm-96A12 Define MAC and outline the factors
which influence it. Briefly explain MAC-hour, MACawake, MAC-bar and the applications of these terms
76%
Pharm-95B10 Draw a graph comparing the ratio of
inspired to alveolar concentrations during the first half
hour of administration for nitrous oxide, isoflurane and
halothane. Outline the reasons for the observed
differences between the agents and indicate the effects
of non-concurrent increases in alveolar ventilation and
cardiac output. 52%
Pharm-95A7 Explain briefly the potential advantages
and disadvantages of SEVOFLURANE 82%
Pharm-95B5 Briefly outline the effects of the volatile
agents on muscle tissues. Include a description of how
these effects are mediated and their clinical
significance. 55%
1993 Briefly outline the chemistry of soda lime and
the potential interactions with anaesthetic agents
1993 Describe the direct effects of isoflurane on the
cardiovascular system
1993 Explain how nitrous oxide may contribute to
adverse anaesthetic outcome
Intravenous Anaesthetic Drugs & Antagonists
Pharm-08A3 Describe the ideal pharmacokinetic and
pharmacodynamic properties of agents used for
sedation. Outline the pharmacology of midazolam and
propofol with reference to these ideal properties.
Pharm-07A7 Describe the pharmacology of
midazolam including its mechanism of action. 66%
Pharm-07A4 Discuss the suitability of ketamine as a
total intravenous anaesthetic agent in comparison with
propofol. 25%
Pharm-05A3 What factors may explain the interindividual variability in drug response seen with
intravenous anaesthetic induction agents?
Pharm04-B7 Outline the factors which influence the
elimination half life of propofol. 29%
Pharm-03B4 Describe how a computer-controlled
infusion device targets and maintains constant blood
concentrations of propofol. 33%
Pharm-03A2 Outline the neuropharmacology of
thiopentone, covering only its site of action, EEG
changes, effects on cerebral blood flow and intracranial
pressure. 80%
Pharm-02A16 Briefly outline the pharmacology of
flumazenil. 45%
Pharm-02A11 Briefly outline the effects of
thiopentone and ketamine not mediated via the central
nervous system. 77%
Pharm-01A13 Outline the NON-ideal features as an
intravenous induction agent of the current formulations
of propofol 55%
Pharm-00B14 Write short notes contrasting the

cardiovascular effects of propofol and ketamine seen
clinically 46%
Pharm-99B14 Briefly outline the actions of
intravenous induction agents not mediated via the
central nervous system. 24%
Pharm-99A13 Describe the neuropharmacology of
thiopentone covering its site of action, EEG changes,
effects on cerebral blood flow and intracranial pressure.
78%
Pharm-98B9 Write short notes contrasting the
cardiovascular effects of propofol and ketamine seen
clinically. 63%
Pharm-98A10 Outline the NON-ideal features as an
intravenous induction agent of the current preparation
of propofol. 67%
Pharm-97B9 List the properties of an ideal
intravenous anaesthetic. To what extent does
methohexitone conform to this ideal. 76%
Pharm-95A9 Briefly outline the effects of
intravenous induction agents not mediated via the
central nervous system, as well as their side effects.
Include a brief account of the mechanisms by which
these side effects are exerted 17%
1994 Describe the ideal intravenous anaesthetic agent.
Describe in detail the extent to which propofol
approaches this ideal.
1993 Briefly explain how knowledge of the
pharmacokinetic properties of propofol would enable it
to be used for the induction and maintenance of
anaesthesia by continuous infusion.
1992 Write short notes on Methohexitone
1991 Write short notes on Methohexitone
1990 Write short notes on the pharmacokinetics of
midazolam
Opioid Agonists & Antagonists
Pharm-07B3 Outline the important pharmacological
considerations concerning choice of opioid and dosage
when converting from intravenous morphine to oral
opioid analgesia in the post operative period.
Pharm-06A7 Briefly outline the pharmacology of
naloxone.
Pharm-05A2 Outline the acute adverse effects of
opioid receptor agonists. Describe the mechanism of the
acute adverse effects of opioid receptor agonists.
Pharm-04A4 Outline the effects of an opioid injected
into the spinal intrathecal space. 64%
Pharm04-B4 Write short notes on tramadol. 50%
Pharm-03A6 Explain how differences in the
pharmacokinetics of alfentanil and fentanyl can
influence the way they are administered intravenously.
51%
Pharm-02B6 Write brief notes on tolerance and
dependence in relation to opioid analgesics. N/A
Pharm-01B12 Outline the effects of an opioid
injected into the spinal intrathecal space 18%
Pharm-00B12 Explain how differences in the
pharmacokinetics of alfentanil and fentanyl can
influence the way they are administered intravenously

54%
Pharm-00A15 Describe the effects of opioids on the
respiratory system 75%
Pharm-99A10 Write a brief outline on the
pharmacology of remifentanil. 47%
Pharm-98B11 Describe briefly the acute unwanted
effects of the opioid agonist drugs 53%
Pharm-97B15 Briefly outline the pharmacology of
naloxone 57%
Pharm-96B9 Briefly explain the factors which
determine the duration of effect of intravenously
administered bolus doses of fentanyl. 70%
Pharm-96A11 Describe briefly the pharmacokinetics
of pethidine. 60%
1993 Discuss the advantages and disadvantages of
administering narcotics by intermittent injection or by
infusion.
1992 Write short notes on the cardiovascular effects of
narcotics
1991 Write short notes on narcotics administered via
the epidural route
Muscle Relaxants & Antagonists
Pharm-08A7 Describe the terms train-of-four
stimulation and double burst stimulation with respect to
the peripheral nerve stimulator. Describe their
advantages and disadvantages when used to evaluate
non-depolarising neuromuscular blockade.
Pharm-07B6 Describe how suxamethonium produces
neuromuscular blockade. WHat is the mechanism of
recovery of neuromuscular function and what
mechanisms may be involved in Phase II block?
Pharm-07A1 Describe the potential adverse effects of
administering neostigmine post operatively. 68%
Pharm-06B4 Describe the advantages and
disadvantages of rocuronium for rapid sequence
induction. 28%
Pharm-06A6 Explain the possible mechanism for
prolonged neuromuscular blockade after a four hour
procedure using a non-depolarising muscle relaxant.
Pharm-05A4 Outline the mechanism of action of
drugs that inhibit cholinergic transmission at the
neuromuscular junction giving examples. 59%
Pharm-04A2 Outline the factors determining speed
of onset of neuromuscular blocking agents. 71%
Pharm-04B6 Compare and contrast neostigmine and
the organophosphorus compounds. 52%
Pharm-03A8 Describe the onset and offset of
neuromuscular block at the diaphragm, larynx and
adductor pollicis after administration of 2.5 x ED95
dose of vecuronium. Comment on the differences
observed. What are the clinical implications of these
differences? 50%
Pharm-02B5 Outline the possible reasons for
prolongation of paralysis induced by an intravenous
dose of 1 mg.kg-1 of suxamethonium. Briefly indicate
the consequences of such a prolonged block. 60%
Pharm-01B13 Compare and contrast neostigmine
and the organophosphorus compounds. 64%
Pharm-01A14 Give examples of drugs that enhance

the action of the non-depolarising neuromuscular
blocking agents at the neuromuscular junction. Briefly
describe the mechanisms of these interactions.
Pharm-00B16 Compare and contrast the
pharmacology of atracurium and cis-atracurium 26%
Pharm-99B10 Outline factors determining speed of
onset of neuromuscular blocking agents 58%
Pharm-99A12 Explain the phenomena known as fade
and post tetanic facilitation associated with the use of
neuromuscular blocking agents. 43%
Pharm-98B13 Draw and explain the characteristics
of a log dose-response curve that describes the major
clinical effect of vecuronium. List factors encountered
in clinical practice that may alter this curve 46%
Pharm-98A15 Compare the metabolism of
suxamethonium to that of atracurium. 83%
actions of the anti-cholinesterases with reference to
edrophonium, neostigmine and the organophosphorus
compounds. Indicate the similarities and differences
with the 3 drugs
Pharm-97B11 Give examples of drugs that enhance
the action of the non-depolarising neuromuscular
blocking agents at the neuromuscular junction. Briefly
describe the mechanisms of their actions. 41%
Pharm-96B16 Outline briefly the possible reasons
for prolongation of paralysis induced by an intravenous
dose of 1mg/kg of suxamethonium. Briefly indicate the
consequences of such a prolonged block. 58%
1994 Explain the use of the peripheral nerve stimulator
in monitoring muscle relaxants and their offset.
1993 What factors may alter plasma cholinesterase
activity and how can this activity be measured
1993 Briefly discuss the side effects of atracurium
1992 Write short notes on atracurium
1990 Write short notes on post tetanic facilitation
1990 Write short notes on dibucaine number
Local Anaesthetics
Pharm-08A6 A surgeon wishes to use topical
anaesthetic in the nose before surgery in a 30 year old
70 kg man. He normally uses topical cocaine 5% plus
lignocaine 2% with adrenaline 1: 100,000 injection.
What volumes of cocaine 5 % and lignocaine can be
used safely? What are the potential toxic effects of
cocaine and how do lignocaine and adrenaline affect
this?
Pharm-07B5 Describe the factors which increase the
risk of systemic toxicity with amide local anaesthetic
agents.
Pharm-06A5 Write short notes on factors affecting
the speed of onset and durantion of effect of local
anaesthetics when used to produce peripheral nerve
block.
Pharm-05B3 Write brief notes on the physicochemical properties of lidocaine (lignocaine). 53%
Pharm-04A3 Briefly describe the factors that
determine skin penetration of local anaesthetics. Briefly
describe the formulation and pharmacology of EMLA

cream. 60%
Pharm-04B2 Write a brief description of the
pharmacology of ropivacaine. 46%
Pharm-03B7 Write short notes on factors affecting
the speed of onset and duration of effect of local
anaesthetics when used to produce peripheral nerve
block. 46%
Pharm-03A3 Explain how lignocaine prevents the
conduction of a nerve action potential. 37%
Pharm-02A9 Outline the toxicity of local
anaesthetics 57%
Pharm-01B11 Describe the required pharmacological
characteristics of local anaesthetic formulations
intended for topical use. 41%
Pharm-00B13 Write short notes on factors affecting
the speed of onset and duration of local anaesthetics
when used to produce peripheral nerve block 54%
Pharm-00A16 Briefly describe the factors that
determine skin penetration by local anaesthetics. What
is a eutectic mixture? Briefly describe the formulation
and pharmacology of EMLA cream? 73%
Pharm-99B11 Outline the toxicity of local
anaesthetics 36%
Pharm-98B15 Describe the pharmacology of
ropivacaine and explain why it may be considered a
safer agent than bupivacaine. 42%
Pharm-97A13 List the physico-chemical
characteristics of bupivacaine. Explain how they
influence its pharmaco-dynamic effects at the site of
administration
Pharm-97B10 Describe the ideal pharmacological
characteristics of local anaesthetic agents and
formulation intended for topical use, including their
clinical applications. 22%
Pharm-96B13 Outline briefly the pharmacokinetics
and pharmacodynamics of lignocaine. 54%
1995 Outline factors that determine latency (speed of
onset) of local anaesthetic drugs
1994 Compare and contrast ropivacaine and
bupivacaine
1993 Outline the factors which would make a local
anaesthetic agent suitable for use in obstetric practice
1993 Explain with the example of three local
anaesthetic agents of your choice, how their physicochemical properties influence their pharmacological
effects
1992 Write short notes on the cardiovascular toxicity of
bupivacaine
1991 Write short notes on transdermally administered
local anaesthetic agents
1991 Write short notes on the cardiovascular toxicity of
bupivacaine
Autonomic & Cardiovascular Drugs
Autonomic Pharmacology
Pharm-07A8 List the classes of drugs used clinically
Pharm-08A2 List the classes of drugs that are useful
to treat chronic left ventricular failure. Outline their

mechanisms of action. 65%
Pharm-06B1 Describe the use of different
sympathomimetics to treat hypotension occurring as a
result of subarachnoid block. Outline the advantages
and disadvantages of these agents. 73%
Pharm-05A7 Outline the main biochemical events
involved in noradrenergic transmission. Outline how
these may be altered by the use of MAO (monoamine
oxidase) inhibitors. 67%
Pharm-04A7 Describe the mechanism of action of
inotropes and provide examples. 67%
Pharm-04B8 List the classes of drugs used clinically
to treat chronic left ventricular failure. Outline their
mechanisms of action. 25%
Pharm-00A11 Outline the main biochemical event
involved in noradrenergic transmission, and how these
may be altered by the use of MAO (mono amine
oxidase) inhibitors 57%
Pharm-99A11 Briefly compare and contrast the
clinical pharmacology of atropine, hyoscine and
glycopyrrolate. 42%
Pharm-98A14 Discuss the use of different
vasoconstrictors to treat hypotension occurring as a
result of subarachnoid block 60%
Pharm-97A11 Outline the main biochemical event
involved in noradrenergic transmission, and how these
may be altered by the use of MAO (mono amine
oxidase) inhibitors
1994 Give a brief account of the actions of the alphaadrenergic agonists and their potential applications in
anaesthesia
1990 Write short notes on pyridostigmine
in inducing diuresis clinically. Outline their mechanism

of action.
Pharm-08A8 Define the mechanisms of action and
adverse effects of metoprolol, glyceryl trinitrate and
diltiazem when used to manage myocardial ischaemia.
Pharm-07B8 Write short notes on anti-hypertensive
drugs that exert their action via blocking the effects of
angiotensin.
Pharm-04A6 Outline the circulatory effects of
glyceryl trinitrate. 83%
Pharm-03A7 Classify diuretics, briefly explaining
their mode of action. 88%
Pharm-00B10 Classify diuretics giving examples
and briefly explaining their action 79%
Pharm-99B12 Briefly describe the mechanism and
treatment of the toxicity of sodium nitroprusside.
48%
1994 Write about the pharmacology of captopril
1994 Give a brief account of the pharmacological
actions and toxicity of nitric oxide
1994 Write about the pharmacology of nifedipine
1993 Compare and contrast nitroprusside and
nitroglycerin
1993 What is meant by the term calcium channel?
What are the effects of calcium channel blocking
agents?
1991 Discuss the mechanisms of action of drugs which
may be employed to lower blood pressure during
anaesthesia.
Adrenoreceptor Drugs
Pharm-05B8 Describe the adverse effects of beta
adrenoreceptor antagonists. 80%
Pharm-05A8 Outline the pathology of acute
anaphylactic reactions with reference to the mediators
released and their effects. Outline the role of
epinephrine and its mechanisms of action in treating
anaphylaxis. 43%
Pharm-03B6 List the potential clinical uses of an
alpha-2 adrenoceptor agonist and outline the limitations
of clonidine for each. 60%
Pharm-02B7 Outline the potential pharmacological
advantages and disadvantages of intra-operative betablockade. 76%
Pharm-01B15 Outline the potential benefits and
disadvantages of peri-operative beta-blockade 47%
Pharm-01A15 Compare and contrast the
pharmacology of esmolol and propranolol
Pharm-99A16 Describe the effects of the alpha 2
adrenoceptor agonists relevant to anaesthesia 63%
1991 Write short notes on Atenolol
Antihypertensives (incl Diuretics)
Anti-arrhythmic Drugs
Pharm-02A13 What are the side-effects of
amiodarone and what problems may develop during
concurrent anaesthesia? 44%
Pharm-96A15 Describe briefly the pharmacology of
adenosine and its potential uses in anaesthesia. 65%
1993 What are the effects of calcium channel blocking
agents
1990 Write short notes on calcium channel blocking
agents
Miscellaneous Pharmacology
Anti-emetic Drugs
Pharm-05B7 Briefly outline the pharmacology of
droperidol, emphasizing its mechanism of action,
perioperative use and side effects. 61%
Pharm-05A1 Classify anti-emetic drugs. Give
examples and describe side effects of each class.
Pharm-98B10 Describe the sites of action of
antiemetic agents used for postoperative nausea and
vomiting 77%
Pharm-97B16 Describe the location and function of
dopamine receptors. Give some examples of agonist
and antagonist drugs. 73%
1994 Write about the pharmacology of Droperidol
1991 What are the properties of the ideal antiemetic?
How might such a drug be evaluated clinically?
Drugs affecting Coagulation

Pharm-07B2 Outline the important pharmacological
considerations when stopping warfarin and
commencing prophylactic (low dose) low molecular
weight heparin (LMWH) in the peri-operative period.
Pharm-05A5 List the antiplatelet agents and outline
their mechanism of action, adverse effects, mode of
elimination and duration of action. 68%
Pharm-04A8 Describe briefly the side effects and
complications of heparin therapy. 71%
Pharm-02A15 Describe the mechanism of the
anticoagulant effect of coumarin derivatives and what
determines the onset and offset of action. 45%
Pharm-99A15 List the drugs used clinically as anticoagulants and anti-thrombotics. Write short notes on
the mechanisms of their actions. 65%
Pharm-95B4 Outline the chemistry of heparin.
Describe the mechanism of action and list its toxic
effects. 58%
Pharm-95A8 Describe the mechanism of action of
protamine when used to reverse effects of heparin.
Outline the side-effects of protamine 43%
Pharm-95A10 Outline the importance of vitamin K
and the factors determining its uptake 68%
1993 Discuss the pharmacology of drugs used in the
control of blood coagulation.
1990 Discuss the pharmacology of drugs used
therapeutically to alter coagulation
Obstetric Pharmacology
Pharm-02B1 Outline the influences of pregnancy on
pharmacokinetics. 39%
Pharm-00A12 Outline the pharmacology of oxytocin
77%
Pharm-96B14 Outline briefly the pharmacology of
oxytocin 54%
Pharm-95B6 Outline the influence of pregnancy on
pharmacokinetics 64%
1994 Give a brief account of the pharmacological
actions and side effects of prostaglandins used in
obstetrics
1992 Write short notes on placental transfer of drugs
Gastrointestinal Pharmacology
Pharm-05A6 Briefly outline pharmacological
methods of reducing gastric acidity. Indicate the
mechanisms of action and the advantages and
disadvantages of each method. 72%
Pharm-02A14 Briefly outline pharmacological
methods of reducing gastric acidity. Indicate the
mechanisms of action and their advantages and
disadvantages of each method 59%
Pharm-98A12 Classify the drugs which are useful for
reducing the volume and acidity of gastric contents,
giving an outline of the mechanism of effect for each
group. 46%
Pharm-96B15 Briefly give an account of the
pharmacological methods for reducing gastric acidity.
Indicate the mechanisms and their advantages and

disadvantages. 51%
NSAIDs / Paracetamol
Pharm-06B8 Describe the pathogenesis and
management of paracetamol toxicity. 86%
Pharm-06B5 Briefly explain the mechanisms
responsible for non-steroidal anti-inflammatory drug
(NSAID) induced side effects. Outline the advantages
and disadvantages of selective cyclooxygenase (COX 2)
inhibitors. 62%
Pharm-03B5 Describe the pharmacological effects of
paracetamol. Outline its toxicity and management. 86%
Pharm-02A12 Outline the mechanism of action of
non-steroidal anti-inflammatory drugs and their
potential adverse effects 72%
effects of paracetamol. Outline the mechanisms for its
toxicity. 70%
Pharm-97B12 Outline the mechanism of action of
non-steroidal anti-inflammatory drugs and their
potential adverse effects 65%
1995 Briefly describe the pharmacological effects of
paracetamol. List its clinical indications and outline the
mechanisms for its toxicity.
1993 Write about the pharmacology of ketorolac
Unclassified Drugs
Pharm-07B7 Outline the mechanisms of action and
potential adverse effects of the oral hypoglycaemic
agents. 47%
Pharm-07A6 Briefly outline the acute management
of malignant hyperthermia (during a relaxant general
anaesthetic). Describe the important aspects of
dantrolene pharmacology relevant to treating malignant
hyperthermia. 54%
Pharm-07A5 Classify non-opioid drugs used for the
treatment of neuropathic pain and indicate proposed
mechanisms of analgesic action and potential adverse
effects. 34%
Pharm-06B7 Outline the drug and non-drug
treatment of ventricular fibrillation in an adult. Briefly
describe their mechanisms of action. (Do not discuss
basic life support, airway therapies and oxygen) 44%
Pharm-05B5 Outline the advanced life support of
ventricular fibrillation in an adult including the
mechanism of action and potential adverse effects of
these therapies. (Do not discuss basic life support,
airway therapies and oxygen). 11%
Pharm-05B6 Discuss the therapeutic and unwanted
effects of dexamethasone. 67%
Pharm-04B3 List the effects of histamine. Write a
brief outline on the pharmacology of the H1 blocking
drugs. 26%
Pharm-02B8 Outline the pharmacological effects of
vasopressin 79%
Pharm-01B14 Outline the direct effects of
endogenously released histamine. 49%
confidence intervals and indicate why they may be
implications of the administration of a single dose of

gentamicin during anaesthesia. 75%
Pharm-98A9 List the effects of histamine. Write a
brief outline on the pharmacology of the H1 blocking
drugs. 62%
Pharm-96A10 Describe briefly the mechanism of
action of dantrolene. List it adverse effects and
outline its uses in anaesthesia. 64%
1994 Compare the advantages and disadvantages of
synthetic colloids and stable plasma protein solution in
volume replacement.
preferred to P-values. 30%

1997 In a clinical trial why is adequate power
important? What factors affect the determination of an
adequate sample size? 35%
Pharm-96B10 Describe briefly the use of the NULL
HYPOTHESIS in a drug trial and how the P-value is
relevant 62%
Pharm-96A14 Explain briefly the differences
between simple linear regression and correlation and
indicate the assumptions common to both.
Pharm-95B7 What is meant by '95% confidence
interval'? Explain the practical applications of
Pharm-95A6 Describe the NULL HYPOTHESIS
in a drug trial and how the P-value is relevant 53%
1994 Define Standard Deviation. Explain its
application to the use of drugs in clinical anaesthetic
practice.
1992 Write short notes on Students "t" test
1991 Write short notes on bias in drug trials and how its
influence may be reduced.
1991 Write short notes on non parametric
statistical tests.
1990 Write short notes on probability
Statistics
Pharm-07B4 A new clinical test called the

"intubation score" has a reported 90% sensitivity and
70% specificity when used to predict difficult
intubation. Describe how the accuracy, predictive value
and clinical utility of this test can be evaluated. How
will the incidence of difficult intubation affect the
performance of this test?
Pharm-06B6 A new clinical test called the
"intubation score" has a reported 90% sensitivity and
70% specificity when used to predict difficult
intubation. Describe how the accuracy, predictive value
and clinical utility of this test can be evaluated. How
will the incidence of difficult intubation affect the
performance of this test? 34%
Pharm-06A8 In a clinical trial, why is adequate
power important? What factors affect the
determination of an adequate sample size?
Pharm-04B5 What are the strengths and weaknesses
of the randomised controlled trial (RCT) study design?
49%
Pharm-03A5 Outline the important statistical issues
in designing a study to compare the duration of
analgesia of two drugs given for post-operative pain
relief. 38%
Pharm-01B16 Briefly describe correlation and
simple linear regression, and explain their differences.
What assumptions are common to both? 82%
Pharm-01A16 Describe the use of the null
hypothesis and P-value in a drug trial 89%
Pharm-00A13 Briefly describe correlation and
simple linear regression, and explain their differences.
What assumptions are common to both? 70%
Pharm-99B9 What is meant by '95% confidence
Pharm-99A9 In a clinical trial why is adequate
power important? What factors affect the
determination of an adequate sample size? 58%
Pharm-98B12 Briefly describe the terms correlation
and simple linear regression, and explain their
differences. What assumptions are common to both?
34%
Pharm-97A14 What is meant by '95% confidence
ANZCA Pharmacology Vivas

Please add what you remember of what you were asked
in the Primary Pharmacology Vivas. Indicate what
exam (eg Sept 2005) you sat.
August 2007 ANZCA
Ampoule of thio - what's in it, what are they
for. Draw graph of %ionized vs pH for thio.
Ampoule of 1% lignocaine - same questions,
same graph. Then propofol - what additives,
what for. But wait, there's more...Vec,
Perfalgan, Dantrolene, he had a whole stash
under the desk! Wanted to know what the
additives were and what their role was. What
is pKa - as in what is the Ka, what is the p.
Factors affecting onset of volatiles. How do
we tell if the volatile is working? MAC definition. How does lack of movement to
surgical stimulus help us to know if it's
working? (blathered about MACawake). Doseresponse curve for volatile vs benzodiazepine.
Vecuronium compare and contrast with
Rocuronium. ED95 definition, relation to
intubating dose. Problems with less potent
drugs. Neuromuscular monitoring - TOF, PTC,
DBS.
Tell me about Tramadol. Stopped when I
mentioned SS/SNRI. What other drugs act on
the serotonergic system? Can you give
tramadol to someone on MAOI? Serotonin
syndrome - what is it? What does tramadol do
to seizure threshold? How do the 5HT3
antagonists work? Do you think Tramadol
would increase nausea and vomiting? What
about SSRI? Do you know any other drugs
which are NAdr-reuptake inhibitors? Bell.
1.
2.
3.
4.
What is volatile "potency"? What is MAC?

What factors change MAC?
What are the mechanisms of transfer of
substances across the placental barrier? What
is the effect of protein binding, specifically in
reference to Warfarin.
What is tolerance? Draw dose-response curves,
and the effect of tolerance. What are the
mechanisms of tolerance?Give examples.
What are the kinetics of fentanyl? Compare
Alfentanil and Fentanyl. I volunteered the
graph of CSHT vs Duration.
August 2007 Day 3

Examiner 1
What influences the uptake of inhalational
agents? How do you assess the depth of
anaesthesia - how do you know whether the
person you are giving an anaesthetic to is not
aware? Discussed MAC, MAC_BAR, MAC
awake, what is the sensitivity and specificity of
MAC? Ideally what would it be, would you
rather MAC be more sensitive or more
specific?
Can you classify antiarrhythmics? Gave

Vaughan-Williams and "others". Lets talk
about others - discussion of adenosine (where
are adenosine receptors, what is its half life,
how does it work, SE), digoxin and then
amiodarone (specifically what is amiodarones
half life, how long does it take for a drug to
reach steady state, how long does it take
amiodarone to reach steady state, how does it
fit into V-W classification?
Examiner 2
Fentanyl vs alfentanil as above, which would
you use as an infusion and why - kinetics of
both and explain the effects clinically. Draw
CSHT vs time for both and explain differeces.
Lets talk about drugs that act on the uterus
- talked about
oxytocin/syntometrine/prostaglandins/misopro
stol and tocolytics. Discuss oxytocin - MOA,
SE, "say a surgeon asks you to give 15U
oxytocin as a push, what are you likely to see",
discuss the ergots, discuss GTN how does it
work?
ANZCA Pharmacology Primary Viva March/May 2006
Examiner 1
How do you classify beta blockers?
Tell me about drugs that affect gastric pH?
Examiner 2
You have a patient with myasthenia gravis
who needs a rapid sequence induction, what
are your pharmacological concerns?
Intranasal cocaine is being administered to a
patient undergoing sinus surgery, what are the
toxic potentials and what patient factors may
increase.
ANZCA Pharmacology Primary Viva August/Sept 2006
Examiner 1
What are the effects of a 15ml o.5%
bupivacaine bolus in a pregnant woman?
Ropivacaine vs bupivacaine: why different
toxic effects? What other different effects?
What treatment for hypertension intraoperatively?
Metoprolol vs esmolol
Examiner 2
Difference between
anaphylactic/anaphylactoid?
What common drugs trigger anaphylactic/oid
reactions in anaesthesia?
Treatment of anaphylactic/oid reactons? Why
adrenaline?
Midazolam: use as a pre-med, and

pharmacodynamics.
Fentanyl: use as a premed, pharmacodynamics,
and synergy with midzolam.
Pharmacodynamics of propofol
FRCA (UK) Pharmacology Primary Viva - May

2005
A drug company is manufacturing a new IV
anaesthetic agent, what features would you
like?
How would I improve propofol, what are the
problems with its use? Which causes more
hypotension on induction, propofol or
thiopentone, and why?
You swallow an aspirin. Describe its course.
They stopped me when the aspirin got to the
systemic circulation.
Define volume of distribution.
Define bioavailability.
Name a drug that is well absorbed across the
gastric mucosa.
Name a drug that is not well absorbed across
the gastrointestinal wall.
Discuss metabolism in the liver.
Describe the Vaughan-Williams classification
write down the classes and name a drug in
each one and say what they were used for.
ANZCA Pharmacology Primary Viva August/Sept 2005
Examiner 1
Define Bioavailability.
Draw conc vs time curve for oral dose.
Define significant parts of curve.
Difference between o/iv conc time curve.
Define Hepatic extraction ratio.
What is HER for morphine.
How do you convert iv to oral morphine dose?
Describe CVS effects of IV induction agents
(STP vs propofol vs Ketamine).
Compare with CVS effects of volatile agents
(Sevo vs Des vs Halo).
What is the cause of tachycardia associated

with desflurane?
Examiner 2
What are the advantages/disadvantages with
Nitrous oxide?
What are the possible side effects?
Specifics about methionine synthetase and
methionine deficiency.
What's in a bag of Hartmann's, 0.9%NaCl, 5%
Dextrose.
Osmolalities of same bags.
Which compartments do they go to and in
what proportions?
What hormones are involved in the elimination
of these fluids?
ANZCA Pharmacology Primary Viva - April
2005
Nitrous Oxide - Physicochemical
characteristics, Side Effects, Production
Statistics - Phases of a Trial, Power, Size of
trial
Lignocaine - Structure activity of LAs.Blood
levels with toxicity, CC:CNS Ratio, CVS
effects, Mechanism of cardiac dysryhtmia
Paracetamol - Identify structure,Metabolism,
Pharamacokinetics, toxicity
Bioavailabilty with panadol as example, Adult/
paediatrc dosing
ANZCA Pharmacology Primary Viva September 2003
Phenytoin - Pharmacokinetics, Mechanism of
action, Therapeutic levels
Benzodiazepines - Mechanism of action
Diuretics - Draw a nephron, Classes / site of
action, Mode of action, Frusemide as example
Propofol - Target levels with TCI, Effect site
concentration/time curves
MAC Awake
Statistics - Study size, Alpha/beta error, p
value definitions, etc.

Anzca MCQ Saqs Viva Question Bank Pharmacology Including Statistics

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Anzca MCQ Saqs Viva Question Bank Pharmacology Including Statistics

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ANZCA MCQ SAQs VIVA

Updated Feb 2008

GP01 [Mar96] A drug is given at a dose of 50 mg/kg

GP02 [Mar96] A drug is given orally and 95%

C: Has a dose response curve similar to that of a full

GP08 [Jul98] [Jul01] [Mar02] Placental transfer of

GP09 [Jul98] [Jul99] Regarding pharmacokinetics:

GP10 [Jul99] [Jul04] An ether bond:

(no other details)

A. Formed from condensation of 2 alcohols

GP04 [Jul97] Rectal administration of drugs:

GP11 [Feb00] [Mar03] The NMDA receptor

GP03 [Jul97] Histamine release

A. Gives predictable blood levels

GP05 [Mar99] [Jul00] [Apr01] [Jul04] LD50 is:

GP12 [Feb00] [Jul02] Activated charcoal:

A. Median lethal dose

GP06 [Mar99] [Feb00] [Jul02] [Mar03] Which ONE

GP07 [Jul98] [Jul99] [Apr01] With regard to drugreceptor binding:

GP07b [Feb00] [Feb04] [Jul04] A partial agonist:

A. Should be given with sorbitol

GP13 [Apr01] [Jul04] Therapeutic index:

GP14 [Apr01] [Jul04] (A Basic drug with a pKa of

GP15 [Apr01] [Jul02] [Mar03] Oxygen toxicity

GP16 [Jul01] With regard to log/dose response curves:

GP17 - renumbered to another section.

GP19 [Mar02] [Mar03] Which of following act via

GP20 [Jul02] Zero order kinetics means:

GP21 [Feb04] All exist as Racemic mixtures except:

GP22 [Feb04] Clearance of a drug with a high hepatic

GP23 [Feb04] Chemoreceptor trigger zone

GP24 [Feb04] [Jul04] Glutamate

GP25 [Feb04] Regarding pharmacokinetics in

GP26 [Jul04] Which is an antagonist at the NMDA

GP27 [Jul04] Comparing dexamethasone and

MCQ-General Anaesthetics - Inhalational

IN01 [Mar96] Which compound(s) is/are broken down

IN03 [Mar96] [Jul96] [Jul97] [Jul98] [Jul99]

IN04 [Mar96] [Mar03] IPPV with isoflurane at 1

IN05 [Mar96] [Mar98] The effect of increased cardiac

IN06 [Mar96] [Jul97] [Apr01]

Nitrous oxide (N2O):

IN06b [Mar98] [Jul98] Nitrous oxide:

IN07 [Mar97] [Mar03] Desflurane

IN08 [Mar97] [Jul97] Regarding sevoflurane:

IN08b [Jul97] [Feb00] Sevoflurane:

IN08c [Jul98] [Jul99] Sevoflurane:

IN09 [Mar97] [Jul98] [Jul00] Uptake of N2O when

IN10 [Mar97] [Jul98] [Mar99] [Jul01] [Jul04] N2O

IN11 [Jul97] Desflurane:

IN12 [Jul97] [Apr01] Effects of volatile agents

IN12b [Feb04] Volatile agents:

IN13 [Jul97] [Jul98] [Jul99] [Apr01] Problems with

IN13b [Mar96] [Jul98] [Feb00] [Jul01] MAC:

IN13c [Mar99] [Apr01] [Jul01] MAC:

B. Concentration at which 95% of patients dont move

IN14 [Mar98] [Mar99] Systemic vascular resistance is

IN15 [Mar98] [Jul98] [Mar99] MAC awake during

IN16 [Jul98] [Jul99] Isoflurane & enflurane are:

IN17 [Mar96] [Jul96] Sevoflurane:

IN18 [Mar99] [Feb00] With isoflurane anaesthesia,

IN19 [Mar99] [Jul04] Isoflurane:

IN20 [Mar99] MAC of halothane with 70% N2O is: