SELECTION EXAMINATION FOR POSTGRADUATE DIPLOMA IN CRITICAL CARE

MEDICINE – NOVEMBER 2016

1. Regarding spinal cord

A. Tabes dorsalis affects posterior columns
B. In Brown sequard syndrome there is loss of ipsilateral pain and temperature
C. Exaggerated reflexes in spinal shock
D. Syringomyelia causes early loss of pain and temperature

2. Compliance of the lung

A. Reduced in pregnancy
B. Reduced in neonates
C. Increased in elderly
D. Reduced in emphysema

3. CXR findings in ARDS

A. Air trapping? Appearance
B. Basal patches more than apices
C. Frequent occurrence of pleural effusion
D. Persistence of CXR appearance even after clinical improvement
E. Improvement with diuretic bolus

4. Antibiotics used in MRSA

A. Vancomycin
B. Teicoplanin
C. Aztreonam
D. Cefotaxime
E. Meropenem

5. Organisms causing community acquired pneumonia

A. Cytomegalovirus
B. Influenza A
C. Acinetobacter

6. Causes of hyponatraemia
A. SIADH
B. Cirrhosis
C. Diabetes insipidus
D. Cerebral salt wasting syndrome

7. Polyuria caused by
A. 3% NaCl infusion
B. Posterior pituitary damage
C. Acute alcohol intake
D. Hyperaldosteronism
E. Acetazolamine

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8. Response to massive hemorrhage include
A. Increased production of acute phase proteins
B. Renin system activated
C. Reduction in Hb concentration
D. Increased diastolic blood pressure
E. Increased ANP production

9. Cytochrome p450 inducers

A. Cimetidine
B. Steroid hormones
C. Erythromycin
D. Carbamazepine
E. Metronidazole

10. Warfarin
A. In early pregnancy can cause fetal bone malformations
B. Will produce more anticoagulation in the fetus than the mother
C. Metabolized in the liver
D. Effects readily reversed by vitamin K

11. Diazepam
A. Effects produced by hyperpolarization of the membrane
B. Water soluble
C. Produces active metabolites
D. Increases the muscular tone

12. Wide QRS in ECG more than 0.12 sec seen in

A. Left BBB
B. Right BBB
C. Ventricular ectopic
D. Junctional escapes
E. VT

13. Standard precautions include

A. Using gloves to touch the intact skin
B. Sterile gloves when performing LP
C. Hand washing after touching patients immediate environment
D. Isolating a patient with chicken pox
E. Using N95 mask for H1N1 infection

14. Treatment of UTI

A. Blood culture should be taken in suspected acute pyelonephritis before starting
antibiotics
B. IV antibiotics are given in hospitalized patients with pyelonephritis
C. Broad spectrum IV antibiotics should be started in patients with mixed heavy growth
D. IV antifungals should be started for yeast positive catheterised patients

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15. Post surgical infection prevention
A. IV antibiotics for 48h in clean surgeries
B. Prophylactic antibiotics for patients on ventilators
C. Review the need of invasive lines
D. Prophylactic broad spectrum antibiotics before clean surgery
E. Surveillance for surgical site infection

16. Acute severe asthma

A. Increased mucous secretion
B. Mucosal oedema contributes to airway narrowing
C. Respiratory bronchioles are damaged
D. Salbutamol nebulization will worsen V/Q mismatch
E. PaCO2 of 45 implies impending respiratory arrest

17. Following relaxes bronchial smooth muscles

A. Hydrocortisone
B. Fexofenedine
C. Adrenaline
D. Triotropium bromide
E. Salbutamol

18. Which of the following has relatively more action on Beta 1 receptors
A. Adrenaline
B. Dopamine
C. Dobutamine
D. Noradrenaline
E. Milrinone

19. Regarding oxytocin

A. Receptors are also found in CNS
B. Effective in first trimester
C. Causes behavioral changes in the mother
D. Contraindicated in pre eclampsia
E. Causes hypotension

20. Physiological changes in pregnancy

A. Increase in plasma volume by 50%
B. Increase in RBC by 30%
C. Increase in PaCO2
D. Increased HCO3

21. Features of acute inflammation

A. Increased gap between endothelial cells
B. Margination of neutrophils along the vessels
C. Formation of histiocytes
D. Granuloma formation
E. Angiogenesis

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22. Structures in the superior mediastinum
A. Arch of aorta
B. Thoracic duct
C. Thymus
D. Enlarged retrosternal thyroid
E. Pericardium

23. Widening of mediastinum in chest x ray seen in

A. Rotation of the patient
B. Thymus in the children
C. Inspiratory film
D. Upper lobe collapse
E. Unfolding of aorta

24. Intracellular concentration is more than the extracellular concentration for which of the
following ions
A. Mg
B. PO4
C. Ca
D. HCO3
E. Cl

25. Mineral corticoid activity high in

A. Prednisolone
B. Hydrocortisone
C. Dexamethasone
D. Fludrocortisone
E. Testosterone

26. Regarding Networking in hospital settings

A. Can send messages instantly
B. One scanner can be used by several users
C. LAN has a high speed of communication
D. WAN is used to connect several computers within a geographic area

27. Health information system

A. Prevents medical errors
B. Will not improve the productivity
C. Patients personal information is at risk
D. Will not prevent duplication
E. Cost effective in long term

28. Hyperventilation causes

A. Carpopedal spasm
B. Respiratory acidosis
C. Peripheral vasodilation
D. Increased work of breathing
E. Increased cerebral blood flow

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29. Regarding larynx
A. Recurrent laryngeal nerve supplies cricothyroid muscle
B. Bilateral partial damage of Recurrent laryngeal nerve will need tracheostomy
C. In Unilateral damage to Recurrent laryngeal nerve, phonation is greatly affected
D. Left recurrent laryngeal nerve can be compressed by mediastinal mass

30. Regarding autonomic nervous system

A. There is a sympathetic ganglion for corresponding each spinal cord segments
B. Parasympathetics ganglion supplies nerve to lacrimal and salivary glands
C. Pre ganglionic fibers are myelinated
D. Cell bodies of sympathetic nerves lie in the lateral horns

31. Regarding Horners syndrome

A. Dry forehead
B. Ptosis
C. Conjunctival injection
D. Exophthalmus
E. Miosis

32. Higher CVP seen in

A. Pericardial effusion
B. Intra abdominal hypertension
C. Right ventricular myocardial infarction
D. Right pneumothorax
E. Portal vein thrombosis

33. High difference between alveolar and arterial Oxygen seen in

A. Higher inspired oxygen concentration
B. Pneumonia
C. CPAP

34. In diabetic ketoacidosis

A. Subcutaneous insulin is used
B. Dextrose infusion is contraindicated
C. Is a hypocoagulable state
D. Correcting the acidosis is more important than correcting the plasma volume
E. Total body potassium is depleted at the time of diagnosis

35. Anion gap acidosis occurs

A. When cations are more than the Anion
B. In ketoacidosis
C. In lactic acidosis
D. Diarrhoea
E. Uraemia

36. Regarding MRI

A. Uses magnetic and radio waves
B. Safe in pregnancy
C. Gadolinium is used as contrast media
D. High soft tissue visualization
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37. Pulse oxymetry
A. Uses red-light
B. Over reads at cool temperature
C. Over reads in smokers
D. Inaccurate in neonates due to the presence of fetal hemoglobin

38. Arterial PO2 value in an ABG denotes

A. The content of oxygen
B. Tissue delivery of oxygen
C. The tissue demand of oxygen
D. The amount of oxygen dissolved in blood
E. Alveolar capillary diffusion of oxygen

39. Regarding acid bace balance by the kidneys

A. Excreted mainly as H+ ions
B. Minimum urinary pH is 4.5
C. H+ Secreted mainly in the distal convoluted tubules
D. Glutamine is metabolized to NH4+ and HCO3- in the tubular cells

40. Regarding inspiratory capacity

A. It is the tidal volume plus inspiratory reserve volume
B. The amount of maximum air exchange that can occur with inspiration
C. The maximum air inhaled after a normal expiration
D. The total volume of air that can be filled by the lungs
E. Amount of air in the lungs after a normal expiration

41. Regarding CSF

A. Monocytes of 2-3
B. Protein content is elevated in Guillen Barre syndrome
C. Same glucose content as plasma
D. Absorbed by the choroid plexus

42. GFR can be accurately calculated using

A. Inulin
B. PAH
C. Creatinine
D. Urea
E. Sorbitol

43. HCO3 important because

A. of its abundance
B. H+ binds Hb in deoxygenated state with more affinity
C. HCO3 contributes to 50% of the intracellular buffer

44. During quite breathing following muscles are used in inspiration

A. Diaphragm
B. Internal intercostal
C. External intercostal
D. Scalene muscles
E. Abdominal muscles
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45. Insulin dependent glucose uptake occurs in
A. Pancreas
B. Liver
C. Brain
D. Skeletal muscle
E. Fat

46. Regarding antiplatelet drugs

A. Aspirin reversibly inhibits COX 1
B. Clopidogrel inhibits Glycoprotein IIb/IIIa Receptors
C. Abciximab inhibits ADP Receptors
D. Aspirin is used in the primary management of STEMI
E. Dypiridamole inhibits phosphodiesterases non specifically

47. Regarding knee jerk

A. Conditional reflex
B. Polysynaptic reflex
C. Carried by muscle spindle
D. Diminished in L4 root lesion
E. Exaggerated in spinal shock

48. Regarding USS

A. Doppler uss sound is audible
B. Transducer act as both transmitter and receiver
C. Gel decreases reflection
D. Fluid in the bladder increases the depth of visualization
E. Fasting increases reflection of the waves

49. ROTEM
A. Whole blood is used
B. Temperature correction is done
C. pH correction is done
D. Fibrinogen deficiency can be identified
E. Excess fibrinolysis can be identified

50. Regarding anaphylaxis

A. It's a type I hypersensitivity reaction
B. Occurs on the first exposure of the allergen
C. Hydrocortisone is the first line treatment
D. Cutaneous manifestations are pathognomonic

51. Effects of hypothermia include

A. Metabolic acidosis

52. Which of the following are true

A. Correlation coefficiency ranges from -1 to +
B. Correlation Tested to check the association between two variables
C. 3 SD covers 99.9% of population
D. Sample size will not affect the confidence interval
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 E. increasing the sample size will reduce the standard error of mean

53. Which of the following are true

A. Pie chart can be used for nominal and ordinal data
B. Simple bar chart can be used to describe two variables
C. Histogram has no gaps between bars
D. Two variables can be compared using scattered diagram
E. Bimodal distribution has two humps

54. Which of the following are true

A. Skewed distribution will affect the range of the data
B. In Skewed distribution, mode median and mean line in the same position
C. Standard deviation is a measure of dispersion
D. Regression coefficient?
E. Type 1 error is due to false positive results

55. Lesions and the findings

A. Pituitary adenoma- bitemporal hemianopia

56. Nociceptors are modulated by which of the following

A. Histamine
B. Bradykinin
C. Substance P
D. Potassium

57. Other stems

A. Diathermy Contraindicated in pacemaker
B. Isolation circuits prevents electrocution
C. Low frequency current has less dangerous effects to the body

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