2.

Coronary blood %lo& +.

8egarding blood "lasma E. =. #.

Concerning 8egarding carbon intracellular the C>4 dioxide &ave%orm %luid trans"ort D. 5. 8egarding in 8egarding blood gastric thyroid "hysiology hormones

A. B. C. D. E.

is about 500 ml/min at rest is measured using Kety method is altered directly by vagal activity is maximal during ventricular systole is autoregulated

FTFFT F. t ma!es u" about #$ o% the total body &eight '. (he "rinci"al cation is sodium ). t contains %ructose . t is used %or the direct Coombs test *. (otal "lasma "rotein ranges %rom +0 , #0 g/TTTFF K. -. .. 0. 3. t ma!es u" about #0$ o% the body &eight .easured using dilution techni/ue &ith deuterium oxide norganic "hos"hate is the most abundant anion K1 concentration is a""roximately 200 mmol/ts "ro"ortion varies little bet&een tissues

TTTFF 4. 7. 8. 9. (. 5Cannon5 &aves occur &ith 6unctional rhythm 5)5 &ave is associated &ith bradycardia 4ea!s &ith the 5a5 &ave at end diastole (he 5c5 &ave is a diastolic com"onent (he 5x5 descent is a systolic com"onent

TTTFT :. >. @. A. B. (hyroxine ;(#< is more active than (riiodothyronine ;(=< .ore than ??$ o% active hormone is "rotein,bound (he actions are mediated via rece"tors on the cell sur%ace Cause reduced carbohydrates metabolism s de,iodinated in the liver

FTFFT C. (here is a""roximately = litres o% gastric secretion "er day AA. (he "arasym"athetic innervation is %rom the coeliac "lexus BB. 'astric em"tying is controlled by "eriodic relaxations o% the "yloric s"hincter CC. Cathecolamines inhibit the gastric secretion DD. (he gastric contents are normally sterile TFFTT EE. Carbonic anhydrase is "resent in "lasma FF. +5$ o% carbon dioxide is dissolved ''. .a6ority is carried as bicarbonate )). s %acilitated by deoxygenated haemoglobin . 50 ml o% carbon dioxide is carried "er 200 ml in arterial blood FFTTT

,2,

G.

8egarding "eri"heral chemorece"tors 2+. ?. Autoregulatory (he carotid bodies mechanisms 20. )y"er!alaemia 22. 8elaxation used in o% hy"ovolaemic the causes "regnant 2=. uterus 2#. .Amiodarone 8egarding shoc! is include "roduced steroid thera"y by **. 4resent in the carotid sinus KK. 9ensitive to changes in 4aC3+ --. 9timulated by cyanide ... 8es"ond to anaemia 00. Are su""lied by the glosso"haryngeal nerve FTTFT 33. are more in%luenced by 4a3+ than oxygen content . 44. are stimulated by a %all in ") . 77. are stimulated by a %all in blood %lo& . 88. contain chemorece"tors . 99. have a greater blood su""ly "er gram than the brain . TTTTT ((. e"idural anaesthesia ::. nitrous oxide >>. ritodrine @@. halothane AA. rocuronium FFTTF BB. : &aves on the electrocardiogram CC. increased am"litude o% the 4 &aves AAA. "rolonged 789 com"lexes BBB. ventricular %ibrillation CCC. cardiac arrest in systolic "hase FFTTF DDD. EEE. FFF. '''. ))). FTTTT . is a class B anti,arrhythmic drug classs c ***. acts by "rolonging cardiac action "otential +0,200 days KKK. hal%,li%e is less than # &ee!s ---. "ulmonary toxicity is one o% its side e%%ect .... inter%eres &ith tests o% thyroid %unction "revent "eri"heral t#,t= convert FTFTT 000. 333. 444. 777. 888. FFTTF )ydrocortisone re"lacement alone is su%%icient in Addison5s disease Dexamethasone is suitable %or re"lacement thera"y .ethyl"rednisolone is a more "otent anti,in%lammatory agent than hydrocortisone 4rolonged steroid thera"y causes osteo"orosis Cortisone does not cause %luid retention decrease in barorece"tor activity an increase in angiotensin an increase in "reca"illary s"hincter tone an increase in ca"illary hydrostatic "ressure stimulation o% the 6uxtaglomerular a""aratus ;no " &aveFtall t &aveF "roonged/rsFarrhythmia<

;diastolic<

,+,

25. 8egarding %irst,order !inetics +0. 2D. Concerning 999. 8egarding antiemetic ana"hylaxis drugs occurring 2E. 8egarding 2?. Dantrolene during the u"ta!e 2G. +2. "erio"erative 0aloxone 8egarding o% a volatile "eriod sodium anaesthetic nitro"russide agent 999. A constant "ro"ortion o% drug metabolised in a given time "eriod (((. Ethanol is an exam"le :::. (he enHyme res"onsible %or the reaction is saturated >>>. (he rate o% elimination and elimination hal%,li%e is constantFirres"ective o% "lasma concentration @@@. (he reaction is re"resented by a linear relationshi" TFFFF AAA. (hose &hich act as antido"aminergic agents can cause extra"yramidal s sym"toms BBB. Dom"eridone reduces vomiting by an antiserotonin action CCC. Extra"yramidal sym"toms a%ter administration o% dro"eridol are unli!ely D hours a%ter administration AAAA. 4henothiaHine reduce nausea and vomiting by anti do"aminergicF antihistamine and antimuscarinic actions BBBB. .etoclo"ramide and cycliHine have "rimarily anticholinergic actions. TFFTF CCCC. DDDD. EEEE. FFFF. ''''. FTTTT )))). is a I,rece"tor antagonist . is an analogue o% mor"hine ****. is a res"iratory stimulant in normal man KKKK. causes "ulmonary oedema as a com"lication ----. has a duration o% action o% one to %our hours TFFTT ..... 0000. 3333. 4444. 7777. TTFTF 8888. Adrenaline is the %irst drug o% choice 9999. t is most commonly due to muscle relaxants ((((. t is gE mediated ::::. 9erum try"tase has a hal%,li%e o% one ;2< hour >>>>. 9erum try"tase levels can distinguish bet&een ana"hylactic and ana"hylactoid reactions TTTFF @@@@. AAAA. BBBB. CCCC. AAAAA. (he intrao"erative dose range is 0.5,D mcg/!g/min Acts on both arterial and venous smooth muscle 4lasma hal%,li%e is + minutes 9timulates hy"oxic "ulmonary vasoconstriction 8educes renal blood %lo& ncreased i% ventilation increases .ore ra"id &hen cardiac out"ut decreases 8educed &ith less soluble agent greater &hen the di%%erence bet&een ins"ired and alveolar concentration are higher the second,gas e%%ect allo&s the maintenance concentration o% is use%ul &hen given intramuscularly contains mannitol inter%eres &ith calcium ion release %rom sarco"lasmic reticullum interacts &ith vera"amil causes sedation

,=,

++. E"ile"ti%orm +#. (he %actors a%%ecting EE' activity the rate are o% induced trans"ort byo% +=. +5. +E. +G. a drug @ith 8egarding (he across %ollo&ing action regard the o% the to non,de"olarising binding interactions "lacenta local anaestheticsJ o% are a are drug a< antagonistic degree muscle to "lasma o% relaxant ioniHation "roteins is "rolonged +D. 0itrous by oxide b< degree o% "rotein binding c< "lacental blood %lo& d< "K o% the drug e< li"id solubility o% the drug ((F((

TTTFF BBBBB. CCCCC. DDDDD. EEEEE. FFFFF. TFTFF '''''. act by "reventing sodium acces to the axon interior by occu"ying the transmembrane sodium channel ))))). Bu"ivacaine carbonate com"ared to bu"ivacaine hydrochloride has a longer onset o% action and less intense bloc! . (he shortest duration o% action o% local anaesthetics %ollo&s intrathecal in6ectionF the longest durations %ollo& ma6or "eri"heral nerve bloc!s *****. 4rilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine KKKKK. (he Cm o% lignocaine is less than o% bu"ivacaine TFTFF -----. ...... 00000. 33333. 44444. 77777. 88888. 99999. (((((. :::::. TTFTT >>>>>. @@@@@. AAAAA. BBBBB. CCCCC. TTTFT AAAAAA. BBBBBB. CCCCCC. DDDDDD. EEEEEE. TTTFF FFFFFF. hy"onatraemia )istamine and adrenaline FlumaHenil and midaHolam Atenolol and salbutamol 4rotamine and &ar%arin Aminoglycoside and atracrurium has .AC o% 205$ has critical tem"erature o% =D.5 degree Celcius induces bone marro& a"lasia causes increase in cardiac out"ut causes di%%usion hy"oxia at the termination o% anaesthesia 4rolongs its biological hal%,li%e s di%%erent in arterial and venous blood s higher &ith lignocaine than bu"ivacaine 9lo&s glomerular %iltration o% the drug 4ethidine binds more to al"ha,2 acid glyco"rotein than albumin en%lurane midaHolam methohexitone etomidate iso%lurane

,#,

+?. Concerning magnesium =0. 9albutamol causes=2. 8egarding clonidine =5. =+. 8egarding ==. =#. Concerning )y"othermia During the "ulmonary "rocess nitric causes oxide o% hemostasis circulation ;03< ''''''. )))))). . ******. FFTTF KKKKKK. 0ormal "lasma concentration is =,5 mmol/------. 4resent mainly in bone ....... De%iciency cause muscle &ea!ness 000000. 4otentiates the action o% Ca+1 at the neuromuscular 6unction 333333. t reduces "eri"heral vascular tone FTTFT 444444. 777777. 888888. 999999. ((((((. FFFTT ::::::. t is a selective I+,agonist >>>>>>. t causes hy"ertension %ollo&ing abru"t cessation @@@@@@. 3ral bioavailability is 200$ AAAAAA. Anxiety is a side,e%%ect BBBBBB. 8educes cardiac contractility TTTFF CCCCCC. s the active ingredient o% glyceryl trinitrate AAAAAAA. m"roves "latelet %unctions BBBBBBB. s usually administered in doses o% 20,50 ""m CCCCCCC. 4roduces relaxation o% the smooth muscle DDDDDDD. .ethaemoglobinemia is one o% it5s adverse e%%ects TFTTT EEEEEEE. coagulo"athy FFFFFFF. res"iratory de"ression '''''''. * &aves on the EC' ))))))). diuresis . hy"oglycaemia TTTTF *******. (he extrinsic cascade is initiated by contact bet&een %actor A and collagen %iber KKKKKKK. >itamin K is re/uired %or the %ormation o% "rothrombin -------. -ocal vasoconstriction occurs in res"ond to serotonin released by "latelets ........ Clot %ormation is due to conversion o% %ibrin to %ibrinogen 0000000. 4rimary hemostasis is controlled by the balance bet&een (hromboxane A+ and 4rostacyclin FTTFT 3333333. 0ormal "ulmonary ca"illary "ressure is about 20 mm)g increase in uterine contractility &orsening o% intermittent claudication hy"er!alaemia tremor tachycardia hy"er!alaemia hy"ermagnesaemia lithium hy"erthermia

,5,

=D. Alveolar minute ventilation #2. =E. @ith =G. Action 8egarding re%erence o% acetylcholine renal toregulation the normal on muscarinic o% human &ater and heart rece"tors sodium J =?. Concerning #0. n the autonomic metabolic nervous al!alosis system 4444444. (he volume o% blood in the "ulmonary vessels is about 2 liter at any time 7777777. 4'F+I causes "ulmonary vasoconstriction 8888888. 4ulmonary blood volume increase &hen changing "osture %rom su"ine to erect 9999999. 8eceive blood %rom both the "ulmonary and bronchial arteries TTTFT (((((((. is e/ual to total minute ventilation minus the dead s"ace ventilation :::::::. is calculated %rom the alveolar air e/uation >>>>>>>. is "ro"ortionate to alveolar C3+ concentration @@@@@@@. is about #.5 -/min at rest AAAAAAA. is more in the a"ical than basal region in u"right "osition TFFTT BBBBBBB. stimulates adrenaline secretion in the adrenal medulla CCCCCCC. causes vasodilatation AAAAAAAA. decreases bronchial tone BBBBBBBB. increases lacrimation CCCCCCCC. on .+,ty"e causes gastric acid secretion FTFTF DDDDDDDD. (he most ra"idly conducting %ibres in the heart are "ur!in6e %ibres EEEEEEEE. (he last "art o% the ventricle to be activated is the a"ex FFFFFFFF. (he duration o% an action "otential in the ventricular muscle %ibre is about the same as in a s!eletal muscle %ibre ''''''''. (he ( &ave o% the EC' occurs at the beginning o% the absolute re%ractory "eriod o% the ventricle )))))))). -e%t axis deviation leads to abnormally large 8 &ave in standard limb lead TFFFF . Causes hy"oventilation ********. s caused by massive blood trans%usion KKKKKKKK. s treated &ith acetoHolamide --------. ncrease %ree ioniHed calcium concentration ......... (etany is a com"lication TTTFT 00000000. the "arasym"athetic system is transmitted in cranial nerves and sacral %ibres %rom the s"inal cord 33333333. "arasym"athetic e%%ects are identical to those o% acetylcholine 44444444. "ostganglionic sym"athetic %ibres release cathecolaminesF exce"t at s&eat and adrenal glands 77777777. sym"athetic e%%ects are more localiHed than "arasym"athetic actions 88888888. "arasym"athetic stimulation increases bladder em"tying TFTFF 99999999. (he ascending limb o% loo" o% )enle is im"ermeable to &ater ((((((((. 9odium reabsor"tion %rom the loo" o% )enle occurs "assively ::::::::. :nder conditions o% maximum antidiuresisF 5$ o% &ater reabsor"tion occurs in the distal tubule >>>>>>>>. 9odium excretion a%%ected by blood %lo& in the vasa recta @@@@@@@@. 4rolonged thirst induces aldosterone "roduction

,D,

#+. (he stress res"onse to surgery includes #E. #=. 0on,res"iratory Causes o% hy"onatremia %unctions is/are o% the ##. #5. #D. #G. lung Concerning 8egarding 4ulmonary includes liver cerebros"inal vascular "ulmonary circulation resistance sur%actant %luid ;C9F<

TFFTT AAAAAAAA. ncreases in AC()F cortisol and gro&th hormone BBBBBBBB. ncreased li"olysis CCCCCCCC. 4rotein catabolism AAAAAAAAA. ncreased glucagon secretion BBBBBBBBB. 8educed insulin secretion TFTTT CCCCCCCCC. )eart %ailure DDDDDDDDD. 4rimary hy"eraldosteronism EEEEEEEEE. Excessive use o% -oo" diuretics FFFFFFFFF. 9yndrome o% na""ro"riate Antidiuretic )ormone '''''''''. Chlor"ro"amide treatment TFTTT ))))))))). ncreases sur%ace tension in alveoli . 4revents "ulmonary oedema *********. De%iciency results in hyaline membrane disease KKKKKKKKK. Decreases lungs com"liance ---------. s "roduced by the ty"e alveolar cells FTTFT .......... its osmolality is identical to "lasma osmolality . 000000000. its glucose content is t&o,thirds o% "lasma concentration . 333333333. its "otassium content is slightly higher than in "lasma . 444444444. the rate o% %ormation is a""roximately 250 ml "er day. the total volume is a""roximately 250 ml. ((FF( 777777777. 888888888. 3xygenated blood is delivered by branches o% the he"atic artery 999999999. (otal blood %lo& is hal% o% the cardiac out"ut (((((((((. t augments blood volume u" to =00 mls during haemorrhage :::::::::. (he "ortal venous "ressure is about 20 mm)g >>>>>>>>>. (he "ortal vein has do"aminergic rece"tors TFTTT @@@@@@@@@. activation o% angiotensin AAAAAAAAA. metabolism o% circulating adenine nucleotides BBBBBBBBB. the synthesis o% circulating !alli!rein CCCCCCCCC. histamine metabolism AAAAAAAAAA. the inactivation o% circulating adrenaline TTTFF BBBBBBBBBB. CCCCCCCCCC. DDDDDDDDDD. EEEEEEEEEE. FFFFFFFFFF. is increased in chronic hy"oxia has a value a""roximately +0$ o% the systemic circulation is measured using a %lo&,directed balloon catheter &ith a thermistor ti" is increased by iso"renaline is increased &hen "ulmonary venous "ressure increased

,E,

#?. n the %etus 50. @hen breathing out against a closed glottisF the 55. 52. (he 5+. -evobu"ivacaine %ollo&ing statement areis true 5=.about 5#. Concerning 4rotamine regarding neonatal Diuretics etomidate "hysiologyJ are true TTTFF ''''''''''. Blood can %lo& %rom the vena cava to the descending aorta &ithout "assing through the le%t atrium or le%t ventricle )))))))))). Blood %rom the ductus arteriosus is more saturated than blood %rom the ductus venosus . (he ductus arteriosus normally closes &ithin 2 hour o% birth **********. (he %oramen ovale closes as a result o% "ressure reversal bet&een the le%t atrium and right atrium KKKKKKKKKK. (ransition %rom %etal to adult circulation result %rom a decrease in "ulmonary artery "ressure TFFTT ----------. heart rate slo&s transiently ........... intratracheal "ressure rises 0000000000. le%t ventricular out"ut has a sustained increase 3333333333. right ventricular out"ut increases 4444444444. systolic arterial "ressure %alls then rises TTFFF 7777777777. 8888888888. 9999999999. ((((((((((. ::::::::::. FTTTT >>>>>>>>>>. e/ui"otent &ith bu"ivacaine. @@@@@@@@@@. less C09 toxic than bu"ivacaine . AAAAAAAAAA. longer lasting than ro"ivacaine %or s"inal anaesthesia. BBBBBBBBBB. more cardiotoxic than ro"ivacaine . CCCCCCCCCC. the 8;1<,enantiomer o% bu"ivacaine . FTTTF AAAAAAAAAAA. s a carboxylated imidaHole com"ound BBBBBBBBBBB. nhibits adrenal steroid synthesis CCCCCCCCCCC. 4resented in =5$ "ro"ylene glycol DDDDDDDDDDD. .etaboliHe in the liver by ester hydrolysis EEEEEEEEEEE. Causes more res"iratory de"ression than thio"entone TTTTF FFFFFFFFFFF. it is "redominantly antithrombotic '''''''''''. is a basic "rotein molecule ))))))))))). "rotamine he"arin com"lex rarely mediates "ulmonary hy"ertension . dose o% 2mg is re/uired %or every 200u o% he"arin circulating in blood ; 9toelting "#5G< ***********. )exadimethrine is alternative in "atients allergic to TTTTT KKKKKKKKKKK. Frusemide reduces renal blood %lo& -----------. .annitol has no e%%ect on the renal blood %lo& Ductus arteriosus closes a%ter three months ;F<. 'lomerulo %iltration rate is 2/= o% adult values ;(<. 9"eci%ic com"liance is the same as the adult ;(<. (he cardiac out"ut de"endent on the heart rate ;(<. (otal body &ater com"rises E0$ o% the neonate ;(

,G,

5D. 8egarding Diuretics ;9toelting "##0<5E. 5G. 8egarding D0. 8es"iratory n %etal circulation5?. C>94reload "hysiology D2. 4hysiological n in isthe thecardiac muscle neonateF changes cycle length com"ared "rior in obesity &ith to contractility the include adultF D+. sho&s Do"amine ............ Amiloride is a "otassium s"aring diuretic 00000000000. )y"onatremia is more li!ely in "atients ta!ing loo" diurtics than thiaHide diurtics e (hiaHide act "rinci"ally on the cortical "ortion o% ascending loo"s o% )enle FF(F( 33333333333. 44444444444. 77777777777. 88888888888. 99999999999. (((((((((((. TTTTT :::::::::::. )igher res"iratory rate >>>>>>>>>>>. )igher air&ay resistance @@@@@@@@@@@. )igher "hysiological dead s"ace AAAAAAAAAAA. Almost entirely dia"hragmatic ventilation BBBBBBBBBBB. -o&er lung com"liance TTFTT CCCCCCCCCCC. Blood in ductus arteriosus is more saturated than blood in ductus venosus AAAAAAAAAAAA.Blood in the umbilical veins is 50$ saturated BBBBBBBBBBBB. Blood can "ass %rom the in%erior vena cava to the aorta &ithout "assing through the heart CCCCCCCCCCCC. (he 4a3+ in the umbilical artery is +0 mm)g DDDDDDDDDDDD.Blood "assing to the brain and arms is better oxygenated than that "assing FFFTT EEEEEEEEEEEE. -e%t ventricular volume is maximal at the end o% atrial systole FFFFFFFFFFFF. (he mitral valve closes by contraction o% the "a"illary muscles ''''''''''''.(he le%t ventricular "ressure is maximal 6ust be%ore the aortic valve o"ens )))))))))))).(he e6ection %raction is about G5$ . (he dicrotic notch is due to rebound o% the aortic valve TFFFF ************. A%terload is the tension ;or the arterial "ressure< against &hich the ventricle must contract. KKKKKKKKKKKK.4reload is de"endent o% ventricular %illing ;or end diastolic volume.< ------------. (he most im"ortant determining %actor %or "reload is venous return. ............. A%terload %or the le%t ventricle is determined by aortic "ressure ((((( 000000000000. 333333333333.Decrease in total body &ater 444444444444. ncrease gastric em"tying 777777777777. ncrease total lung ca"acity 888888888888. ncrease oxygen consum"tion 999999999999. ncrease in cardiac out"ut TFFTT ((((((((((((. increases the creatinine clearance ::::::::::::.has a renal "rotective re%lex "ro"erty >>>>>>>>>>>>.increases intracellular calcium concentration AcetaHolamide acts on the "roximal convoluted tubules -oo" acts on the medullary "ortion o% ascending loo"s o% )enle (hiaHide causes metabolic al!alosis as a side e%%ect Frusemide enhances aminoglycoside ne"hrotoxicity .annitol is used as a "ro"hylaxis against acute renal %ailure

,?,

D=. 8egarding )e"arin D#. 8egarding Antibiotics DE. D5. 8egarding elimination DD. -ocalanaesthetic local anesthetic hal% time agent agent @@@@@@@@@@@@. usually increases cardiac out"ut at dose o% +mic/!g/min AAAAAAAAAAAA.s"lanchnic oxygen re/uirement is increased FFTTT

DG. n the liver

BBBBBBBBBBBB.(hey "roduce their anticoagulant e%%ects by binding to antithrombin CCCCCCCCCCCC. t acts through inhibition o% thrombin induced activation o% %actor > and > AAAAAAAAAAAAA. it does not inhibit "latelet %unction BBBBBBBBBBBBB. t is "resent endogenously in .ast cells CCCCCCCCCCCCC. t crosses the "lacenta TTFTF DDDDDDDDDDDDD. (he drug o% choice %or treatment o% 8ic!ettsia is tetracycline EEEEEEEEEEEEE. (he drug o% choice %or treatment o% methicillin resistant sta"h aureus is vancomycin FFFFFFFFFFFFF. 4robenecid "rolongs the duration o% action o% 4enicillin '''''''''''''. Cloxacillin is "encillinase susce"tible "enicillins ))))))))))))). Allergic reaction to "enicillin is mediated through gE antibodies TTTFT . -idocaine &as synthesiHed by -o%gren in 2?#= *************.Are mar!eted as &ater soluble hydrochloric salt KKKKKKKKKKKKK. 8o"ivacaine &as develo"ed as a "ure 9 enantiomer -------------. "Ka o% bu"ivacaine is G.2 .............. Elimination hal% time o% bu"ivacaine is +20 minutes TTTTT 0000000000000. alter the resting transmembrane "otential or threshold "otential 3333333333333. sodium channels is a s"eci%ic rece"tor %or local anesthetic 4444444444444. a%ter binding they stabiliHe inactivated closed states o% sodium channel 7777777777777. sodium channels in inactivated state are "ermeable to sodium 8888888888888.di%%erential bloc!ade is selective bloc!ade o% "reganglioic sym"athetic B %ibers &ith lo& concentration FTTFT 9999999999999. is time necessary %or the "lasma concentration o% a drug to decrease to 50$ during the elimination "hase (((((((((((((. it is directly "ro"ortional to clearance o% drug :::::::::::::. it is directly "ro"ortional to >d >>>>>>>>>>>>>. it is inde"endent o% the dose o% drug administered. @@@@@@@@@@@@@.Amount o% drug remaining in the body is related to number o% elimination hal% times that have ela"sed TFTTT AAAAAAAAAAAAA. +5$ o% blood su""ly comes %rom he"atic artery BBBBBBBBBBBBB. )alothane decreases he"atic oxygen su""ly to a greater extent than iso%lurane or sevo%lurane CCCCCCCCCCCCC. )e"atic autoregulation is not a%%ected by %asting AAAAAAAAAAAAAA. .etabolism o% drugs occurs in the smooth endo"lasmic reticulum o% he"atocytes BBBBBBBBBBBBBB. 4ortal venous "ressure is E,20 mm o% )g

, 20 ,

D?. (he E#. 4hysiological res"iratory right,to,le%t center in the shunt brain ;venous stem receives admixture< in"ut is %romE5. E0. Concerning E+. E=. 8egarding (he 8egarding saturation 0eostigmine the com"osition o% lung arterial volumes E2. o% blood body 8egarding and &ith %luids ca"acities oxygen the anion J de"ends ga" on TTFTT CCCCCCCCCCCCCC. 4artly %lo& %rom bronchial veins into "ulmonary veins DDDDDDDDDDDDDD. 4artly %rom (hebesian veins EEEEEEEEEEEEEE. 20$ o% total "ulmonary blood %lo& FFFFFFFFFFFFFF. ncreased by "ulmonary hy"ertension ''''''''''''''. ncreased during slee" TTFFT )))))))))))))). t inhibits true cholinesterase . Elimination hal% time is about D0,2+0 minutes **************. s "oorly li"id soluble KKKKKKKKKKKKKK. ts onset o% action is %aster than edro"honium --------------. :sed in treatment o% "aralytic ileus TTTFT ............... (he cations used in the calculation o% the anion ga" are sodium and "otassium 00000000000000. (he anions used in the calculation o% the anion ga" are chlorides and "hos"hates 33333333333333. (he normal anion ga" is bet&een G , 20 mmol/44444444444444. -actic acidosis causes a metabolic acidosis &ith a normal anion ga 77777777777777. 8enal %ailure causes a metabolic acidosis &ith a high anion ga" TFFFT 88888888888888. alveolar oxygen tension 99999999999999. haemoglobin content ((((((((((((((. cardiac out"ut ::::::::::::::. arterial carbon dioxide tension (F((( >>>>>>>>>>>>>>. @@@@@@@@@@@@@@. ntracellular %luid is a""roximately t&ice the volume o% the extracellular %luid AAAAAAAAAAAAAA. Extracellular volume grossly de"leted in intestinal obstruction BBBBBBBBBBBBBB. 4rotein content o% interstitial %luid is higher com"ared to intracellular %luid and "lasma CCCCCCCCCCCCCC. 8atio o% extracellular / intracellular volume is smaller in in%ants com"ared to adult AAAAAAAAAAAAAAA. 0ormal "lasma "rotein oncotic "ressure is +5 mm )g TTFFT BBBBBBBBBBBBBBB. (he carotid bodies CCCCCCCCCCCCCCC. *oint rece"tors on res"iratory muscles DDDDDDDDDDDDDDD. 3xygen,sensitive chemorece"tors in the medulla EEEEEEEEEEEEEEE. Bronchiolar strech rece"tors via sym"athetic stimulations FFFFFFFFFFFFFFF. 8ece"tors &hich res"ond to the hydrogen ion concentration in the C9F TTFFT '''''''''''''''. "osition. ))))))))))))))). residual volume At age DDF closing ca"acity is lo&er than F8C in the u"right Air "resent in the lungs a%ter maximal ins"iratory e%%ort is the

, 22 ,

ED. 8egarding "ressures during res"iratory cycle in s"ontaneous ventilationJEE. EG. 8egarding E?. G0. During (he "ath&ays intrauterine lung drug o% com"liance administration "ain li%eF sensationJ include . 0ormal >ital ca"acity is about D0,E0ml/!g ***************. F8C decreases as a "atient moved %rom u"right to a su"ine "osition KKKKKKKKKKKKKKK. >ital ca"acity includes tidal volumesF ex"iratory reserve volume and residual volume TFTTF ---------------. Alveolar "ressure is normally atmos"heric ; Hero . at end, ins"iration ................ ntra"leural "ressure is ,5cm )+3 be%ore ins"iration begins 000000000000000. (rans"ulmonary "ressure is a combination o% alveolar and intra"leural "ressure 333333333333333. Fall in intra"leural "ressure during ins"iration is due to a %all in the elastic recoil 444444444444444. @ith %orced ex"irationF the intra"leural "ressure exceeds Hero. TTFFT 777777777777777. normally 0.+ -/ cm )+3 888888888888888. dynamic com"liance is usually measured at the end o% ins"iration during intermittent "ositive "ressure ventilation 999999999999999. increased in em"hysema (((((((((((((((. lo& lung com"liance is associated &ith ra"id and shallo& res"iration :::::::::::::::. the com"liance is di%%erent at a"ical and basal o% the lungs TFTTT >>>>>>>>>>>>>>>. all the %etal blood returning %rom the "lacenta %lo&s directly into in%erior vena cava @@@@@@@@@@@@@@@. %etal blood carries more oxygen than maternal blood at lo& 43+ AAAAAAAAAAAAAAA. umbilical venous blood has a 43+ o% =0,#0 mm)g BBBBBBBBBBBBBBB. blood on the right side o% the %etal heart is better oxygenated than that on the le%t side CCCCCCCCCCCCCCC. "ulmonary vascular resistance is higher than a%ter birth FFTTF AAAAAAAAAAAAAAAA. BBBBBBBBBBBBBBBB. tra CCCCCCCCCCCCCCCC. DDDDDDDDDDDDDDDD. EEEEEEEEEEEEEEEE. TFFFT FFFFFFFFFFFFFFFF. 9ublingual route avoids %irst,"ass inactivation in the liver ''''''''''''''''. 9u""ositories ex"ose the drug to %irst,"ass metabolism )))))))))))))))). Distribution o% nebulised drug in the res"iratory tree de"ends on the "article siHe . )ighly &ater soluble drugs are administered by transdermal route ****************. Drugs given by oral route should have a very high exraction ratio TFTFF a,delta %ibres &hich terminate in lamina 2 o% the dorsal horn second order neurons &hich ascend in the i"silateral s"inothalamic c %ibres &hich release histamine and serotonin syna"ses in the substantia nigra o% the s"inal cord descending "ath&ays in the dorsolateral colums

, 2+ ,

G2. Factors GE. 8egarding &hich "rotein a%%ect binding the "ea! o% drugs e%%ect in o%"lasma intravenous JG+. G=. anaesthetics GD. First,order (he %ollo&ing "rocesses include statements drugs G#. G5. are excreted 8egarding A about com"etitive drug largely o% hal%,li%e bio,availability antagonist unchanged are correct byo% the Jdrugs !idney J J KKKKKKKKKKKKKKKK. )ighly "rotein bound drugs have a longer biological hal%,li%e ----------------. 4rotein binding is di%%erent mar!edly in arterial and venous blood ................. Free drug concentration is not altered in hy"oalbuminaemics states 0000000000000000. Al"ha,2 acid glyco"rotein "rinci"ally binds to basic drugs 3333333333333333. 'reater the "rotein bindingF lesser is the volume o% distribution TFFTT 4444444444444444. a""ly to enHyme, mediated reactions 7777777777777777. are characteriHed by high rates o% reaction &hen the concentrations o% reacting substances are high. 8888888888888888. can "ro"erly be described in terms o% t2/+ 9999999999999999. are involved in elimination o% most drugs ((((((((((((((((. change to Hero,order !inetic at very high drug doses TTFTT ::::::::::::::::. )al%,li%e o% a drug is shorter than its time constant >>>>>>>>>>>>>>>>. Drug given by in%usion &ithout a bolus reach a steady state in %ive hal%,lives @@@@@@@@@@@@@@@@. Extent o% drug distribution into extracellular %luid is unli!ely to a%%ect t2/+. AAAAAAAAAAAAAAAA. Context sensitive hal%,li%e can be use %or any drug BBBBBBBBBBBBBBBB. About ?#$ o% a drug is cleared o% the body in %our hal%,lives TTFFT CCCCCCCCCCCCCCCC. s indicated by area under the "lasma concentration , curve time AAAAAAAAAAAAAAAAA.Bio,availability o% intravenous drug must be less than 200$ BBBBBBBBBBBBBBBBB. s reduced by destruction o% drug in the gut CCCCCCCCCCCCCCCCC. s reduced by metabolism o% drug in the liver DDDDDDDDDDDDDDDDD. s greater by sublingual route than enteral route. TFTTT EEEEEEEEEEEEEEEEE. combines &ith the same rece"tor as the agonist drug FFFFFFFFFFFFFFFFF. shi%t the log dose res"onse curve %or the agonist to the right '''''''''''''''''.de"resses the maximum obtainable res"onse o% the agonist ))))))))))))))))).&ill a%%ect the a%%inity o% the agonist %or its rece"tor . need not have a close structural similarity to the agonist TTFFT *****************. -ignocaine KKKKKKKKKKKKKKKKK..or"hine -----------------. 4ro"o%ol .................. -evo,bu"ivacaine 00000000000000000.>ecuronium FFFFF 33333333333333333.dose administered 44444444444444444. volume o% distribution 77777777777777777.he"atic clearance 88888888888888888. rate o% in6ection

, 2= ,

GG. 8egarding "ro"o%ol JG?. Ketamine?0. 8egarding .idaHolam J?2. ?+. (he 8egarding s"eed o% inhalational induction agents &ith inhalational J?=. 0itrous agents oxide 99999999999999999. TFFTT (((((((((((((((((. s insoluble in &ater :::::::::::::::::. s bound to albumin u" to ?E,?G $ >>>>>>>>>>>>>>>>>.8educes sodium channel o"ening times in neuronal membranes @@@@@@@@@@@@@@@@@. s hy"ertonic AAAAAAAAAAAAAAAAA.Does not cause tachycardia TTTFT BBBBBBBBBBBBBBBBB.has mar!ed analgesic "ro"erties mediated by its binding to 0.DA rece"tors CCCCCCCCCCCCCCCCC. causes a %all in cardiac out"ut and a rise in heart rate AAAAAAAAAAAAAAAAAA. is contraindicated in "atients &ith raised intracranial "ressure BBBBBBBBBBBBBBBBBB. has active metabolites CCCCCCCCCCCCCCCCCC. causes "osto"erative dreaming and hallucinations &hich is less %re/uent in children TFTTT DDDDDDDDDDDDDDDDDD. )as t 2/+ o% less than + hours EEEEEEEEEEEEEEEEEE. s &ater soluble at ") o% D FFFFFFFFFFFFFFFFFF. )as an active metabolite ''''''''''''''''''. Can have a "rolonged e%%ect i% it given &ith erythromycin )))))))))))))))))). Bioavailability %ollo&ing intramuscular in6ection is ?0 $ TFTTT . (he blood gas "artition co,e%%icient o% des%lurane is 0.#+ ******************. Des%lurane &ill cause sym"athetic stimulation KKKKKKKKKKKKKKKKKK. 9evo%lurane can degrade to com"ound A in soda lime ------------------. Des%lurane is suitable %or inhalational induction ................... Des%lurane can be used in halothane va"oriHer TTTFF 000000000000000000. s /uic!er in "atients &ith high F8C 333333333333333333. s /uic!er i% the agent is very soluble in blood 444444444444444444. s slo&er in the "resence o% right to le%t shunt 777777777777777777. s unchanged in the "resence o% le%t to right shunt &ith normal systemic %lo& 888888888888888888. s /uic!er &hen used &ith nitrous oxide FFTTT 999999999999999999. is stored as li/uid ((((((((((((((((((. is a gas above a tem"erature o% =D degree centigrade ::::::::::::::::::. cylinders should have %illing ratio o% 0.D5,0.E5 >>>>>>>>>>>>>>>>>>. content in a cylinder is al&ays re%lected %rom its "ressure gauge @@@@@@@@@@@@@@@@@@. is =# times less soluble than 0+. TTTTF cardiac out"ut

, 2# ,

?#. 8egarding o"ioid rece"tors J?5. 4ethidine?D. AAAAAAAAAAAAAAAAAA. 8egarding narcotic antagonists J?E. 8ocuronium?G. ??. Adrenaline 200..or"hine 'lyco"yrrolate AAAAAAAAAAAAAAAAAA. .or"hine acts on !a""a rece"tors BBBBBBBBBBBBBBBBBB. (he e%%ect o% stimulation o% sigma rece"tors is dys"horia and hallucination CCCCCCCCCCCCCCCCCC. Eu"horia is due to stimulation o% delta rece"tors AAAAAAAAAAAAAAAAAAA. 0alor"hine antagoniHes !a""a rece"tors BBBBBBBBBBBBBBBBBBB. 4entaHocine is "artial agonist TTFFT CCCCCCCCCCCCCCCCCCC. is structurally related to mor"hine DDDDDDDDDDDDDDDDDDD. onset o% analgesic activity a%ter intramuscular in6ection is =5 minutes EEEEEEEEEEEEEEEEEEE. in e/uianalgesic dosesF "ethidine and mor"hine "roduce e/ual amount o% sedation FFFFFFFFFFFFFFFFFFF. res"iratory de"ression caused by it can be antagoniHed by nalor"hine '''''''''''''''''''. about D0$ is bound to "lasma "roteins TFFTF ))))))))))))))))))). 0alor"hine induces antidiuretic e%%ect . 0aloxone is one,%i%th as "otent as nalor"hine *******************. 0aloxone "reci"itates a &ithdra&al syndrome a%ter chronic doses o% "entaHocine KKKKKKKKKKKKKKKKKKK. 0aloxone is metaboliHed and excreted by the !idneys -------------------. 0aloxone is one,%i%th as "otent &hen given orally as com"ared &ith "arenteral administration FFTFF .................... is an aminostereroid 0000000000000000000. is stable in a/ueous solution 3333333333333333333. undergoes "rinci"ally he"atic elimination 4444444444444444444. has "rovide intubating conditions &ithin D0 seconds 7777777777777777777. t release histamine TTTTF 8888888888888888888. can act at central cholinergic rece"tors 9999999999999999999. can increase the "hysiological dead s"ace (((((((((((((((((((. dilate the "u"il :::::::::::::::::::. is e/ually e%%ective &hen given orally >>>>>>>>>>>>>>>>>>>. is %ive times "otent as antisialagogue than atro"ine FTFFT @@@@@@@@@@@@@@@@@@@. is a bronchodilator AAAAAAAAAAAAAAAAAAA. is released in "ostsyna"tic sym"athetic nerve endings BBBBBBBBBBBBBBBBBBB. di%%ers %rom noradrenaline by having an extra methyl grou" CCCCCCCCCCCCCCCCCCC. is commonly used &ith local anesthetics in a concentration o% 2 J G0F00 AAAAAAAAAAAAAAAAAAAA. &ill elevate the blood sugar TFTFT BBBBBBBBBBBBBBBBBBBB. is a "henanthrene derivative

, 25 ,

202.Atro"ine 20+.8egarding "henoxybenHamine 205.(he 20=.Drugs volume readily o%cross distribution the blood,brain o% a drugbarrier 20D.Concerning 20#.8egarding sul"honylureas %rusemide CCCCCCCCCCCCCCCCCCCC. is the analgesic o% choice in biliary colic DDDDDDDDDDDDDDDDDDDD. has an anticholinergic e%%ect EEEEEEEEEEEEEEEEEEEE. decreases intracranial "ressure FFFFFFFFFFFFFFFFFFFF. is a good anticonvulsant TFTFF ''''''''''''''''''''. increase the ris! o% regurgitation )))))))))))))))))))). is contraindicated intravenously in glaucoma . causes hy"erthermia ********************. is e/ui"otent &ith hyoscine as antisialogogue KKKKKKKKKKKKKKKKKKKK. dose o% +,= mg intravenously bloc! the vagal nerve com"letely TFTFT --------------------. Bloc!s I+,rece"tors more than I2,rece"tors ..................... s a non,com"etitive antagonist 00000000000000000000. Causes re%lex tachycardia 33333333333333333333. 8educes su"ine blood "ressure in normal sub6ects 44444444444444444444. Elimination hal% li%e is +# hours FTTTT 77777777777777777777. .annitol 88888888888888888888. 4hysostigmine 99999999999999999999. 'lyco"yrollate ((((((((((((((((((((. Atracurium ::::::::::::::::::::. 4ro"o%ol FTFFT >>>>>>>>>>>>>>>>>>>>. 4rimary site o% action is in the loo" o% )enle @@@@@@@@@@@@@@@@@@@@. Causes hy"eruricaemia AAAAAAAAAAAAAAAAAAAA. Enhances the excretion o% calcium BBBBBBBBBBBBBBBBBBBB. )y"onatraemic acidosis is the adverse e%%ect CCCCCCCCCCCCCCCCCCCC. G0$ is excreted in the urine as unchanged TTTFT AAAAAAAAAAAAAAAAAAAAA. com"artment model BBBBBBBBBBBBBBBBBBBBB. concentration o% drug CCCCCCCCCCCCCCCCCCCCC. blood DDDDDDDDDDDDDDDDDDDDD. EEEEEEEEEEEEEEEEEEEEE. FTTTF FFFFFFFFFFFFFFFFFFFFF. Act mainly by increasing the secretion o% insulin '''''''''''''''''''''. 8educe "lasma cholesterol level ))))))))))))))))))))). )ighly "rotein,bound . ncrease the "eri"heral u"ta!e o% the glucose *********************. Cause cholestatic 6aundice re%ers to the "eri"heral com"artment o% the t&o, ma!es the assum"tion that there is a uni%orm is calculated using the measured concentration in the is a%%ected by di%%erential regional blood %lo& is high in hydro"hilic drugs

, 2D ,

20E.8egarding drug metabolism 22=.(he 20G.(he actions 20?.(he 220.@hen 22+.8ecognised substances 4assive considering o% non,res"iratory trans"ort non,de"olarising that the cannot mechanisms u"ta!e "ass %unctions o% through neuromuscular a volatile are o% cell the anaesthetic lung membrane bloc!ing include agent easily drugsare 222.Clonidine TTTFT KKKKKKKKKKKKKKKKKKKKK. .or"hine %orms a con6ugated glucuronide ---------------------. 4henytoin is a drug metabolism inducer ...................... -audanosine is "roduced by )o%mann degradation o% atracurium 000000000000000000000. 4ethidine metabolism re/uires catechol,o, methyltrans%erase 333333333333333333333. )ydrolysis is a "hase o% drug metabolism TTTFF 444444444444444444444. All ions including hydrogen ionsK 777777777777777777777. .id to large "olar molecules including glucose 888888888888888888888. Amino acids 999999999999999999999. .acromolecules such as "roteinsF "olysaccharides (((((((((((((((((((((. oxygen TTTTF :::::::::::::::::::::. 9im"le di%%usion >>>>>>>>>>>>>>>>>>>>>. 3smosis @@@@@@@@@@@@@@@@@@@@@. Facilitated Di%%usion eg 9im"le "rotein channels AAAAAAAAAAAAAAAAAAAAA. Endocytosis BBBBBBBBBBBBBBBBBBBBB. Bul! %lo& mechanisms TTTFF CCCCCCCCCCCCCCCCCCCCC. the rate o% u"ta!e is increased i% ventilation increases AAAAAAAAAAAAAAAAAAAAAA.induction is more ra"id i% cardiac out"ut decreases BBBBBBBBBBBBBBBBBBBBBB. induction is less ra"id &ith less soluble agent CCCCCCCCCCCCCCCCCCCCCC. the e%%ect o% changing cardiac out"ut on the rate o% u"ta!e @ill be greater &ith a more soluble agent DDDDDDDDDDDDDDDDDDDDDD.the second,gas e%%ect allo&s the maintenance concentration o% TTFTF EEEEEEEEEEEEEEEEEEEEEE. is a "artial agonist at I+,adrenoce"tors FFFFFFFFFFFFFFFFFFFFFF. cause hy"ertension i% in%used intravenously ''''''''''''''''''''''.is &ell absorbed &hen ta!en orally )))))))))))))))))))))).anxiety is an im"ortant side,e%%ect . reduces cardiac contractility TFTFF **********************. activation o% angiotensin KKKKKKKKKKKKKKKKKKKKKK.metabolism o% circulating adenine nucleotides ----------------------. the synthesis o% circulating !alli!rein ....................... the inactivation o% circulating brady!inin 0000000000000000000000.the inactivation o% circulating adrenaline TTTTF 3333333333333333333333."otentiated by inhalational anaesthetic va"ours

, 2E ,

22#.8egarding 0.Bloc!ade225.4ulmonary sur%actant22D.4ulmonary 22E. n the 22G.(he volume local vascular regulation o% distribution resistance o% the o% microcirculation ain drug adults 4444444444444444444444. &hen given in re"eated doses can be described as dual bloc! 7777777777777777777777.Attenuated by intra"eritoneal tobramycin 8888888888888888888888. "otentiated in "atients &ith multi"le neuro%ibromatosis 9999999999999999999999. Attenuated in hy"o"roteinaemia TFFTF ((((((((((((((((((((((. ED?5 re"resents the "otency o% 0.B drug in the "resence o% 0+0,barbiturate o"ioid anesthesia ::::::::::::::::::::::.0.B drugs a%%ect small muscles be%ore dia"hragm >>>>>>>>>>>>>>>>>>>>>>.Adductor "ollicis monitoring is a "oor indicator o% laryngeal relaxation @@@@@@@@@@@@@@@@@@@@@@. (3F stimulation re%lects events in the "ost 6unctional membrane AAAAAAAAAAAAAAAAAAAAAA.A single t&itch res"onse evo!ed re%lects events in TTTFF BBBBBBBBBBBBBBBBBBBBBB.increases sur%ace tension di%%erentially in di%%erently siHed alveoli CCCCCCCCCCCCCCCCCCCCCC. hel"s "revent "ulmonary oedema AAAAAAAAAAAAAAAAAAAAAAA. increases alveolar ciliary motion BBBBBBBBBBBBBBBBBBBBBBB. aids di%%usion %rom the alveolus to the "ulmonary ca"illary CCCCCCCCCCCCCCCCCCCCCCC. is secreted by the ty"e alveolar cells FTFFT DDDDDDDDDDDDDDDDDDDDDDD. is increased in chronic hy"oxia EEEEEEEEEEEEEEEEEEEEEEE. has a value a""roximately one,sixth that o% the systemic circulation FFFFFFFFFFFFFFFFFFFFFFF. can be measured using a %lo&,directed balloon catheter &ith a thermistor ti" '''''''''''''''''''''''. is decreased by iso"renaline ))))))))))))))))))))))). is decreased by 5,hydroxytry"tamine ;5,)(< TTT?T . Autoregulation occurs in most vascular beds ***********************. 4otassium causes vasoconstriction KKKKKKKKKKKKKKKKKKKKKKK. Endothelin is an extremely "otent vasoconstrictor -----------------------. Endothelium,derived relaxing %actor is nitric oxide ........................ Adenosine "roduces endothelium, inde"endent relaxation o% vascular smooth muscle TFTTT 00000000000000000000000. re%ers to the "eri"heral com"artment o% the t&o, com"artment model 33333333333333333333333. ma!es the assum"tion that there is a uni%orm concentration o% drug 44444444444444444444444. is calculated using the measured concentration in the blood or "lasma 77777777777777777777777. is a%%ected by di%%erential regional blood %lo& 88888888888888888888888. &ill be relatively lo& i% hydro"hilic and extensively bound to "lasma "roteins

, 2G ,

22?.Frusemide2+0.(he volume o% distribution o% a drug2+2.9odium nitro"russide2++.8egarding 2+=.@ith regard 2+#.8o"ivacaine amiodarone to local anaestheticsJ FTTTT 99999999999999999999999. has its "rimary site o% action in the loo" o% )enle (((((((((((((((((((((((. commonly causes hy"eruricaemia :::::::::::::::::::::::. enhances the excretion o% calcium >>>>>>>>>>>>>>>>>>>>>>>. hy"onatraemic acidosis is the adverse e%%ect @@@@@@@@@@@@@@@@@@@@@@@. reduces the e%%icacy o% concurrently "rescribed lithium TTTFF AAAAAAAAAAAAAAAAAAAAAAA. re%ers to the "eri"heral com"artment o% the t&o, com"artment model BBBBBBBBBBBBBBBBBBBBBBB. ma!es the assum"tion that there is a uni%orm concentration o% drug CCCCCCCCCCCCCCCCCCCCCCC. is calculated using the measured concentration in the blood or "lasma AAAAAAAAAAAAAAAAAAAAAAAA. is a%%ected by di%%erential regional blood %lo& BBBBBBBBBBBBBBBBBBBBBBBB. &ill be relatively lo& i% hydro"hilic and extensively bound to "lasma "roteins FTTTT CCCCCCCCCCCCCCCCCCCCCCCC. the intrao"erative dose range is 0.5,D mg/!g/min DDDDDDDDDDDDDDDDDDDDDDDD. metabolism to cynide occurs non,enHymetically in blood EEEEEEEEEEEEEEEEEEEEEEEE. metabolism "roduces thiocynate &hich is excreted in urine FFFFFFFFFFFFFFFFFFFFFFFF. it "roduces dilation "redominantly o% resistance vessels ''''''''''''''''''''''''. reduces renal blood %lo& FTTFF )))))))))))))))))))))))). "rolongs action "otential duration in 9A node . shorten re"olarisation in A> node ************************. cause "hotosensitivity KKKKKKKKKKKKKKKKKKKKKKKK. &ill have e%%ect on thyroid %unction on long treatment ------------------------. slo&s conduction velocity in )is,"ur!in6ee system TFTTT ......................... act by "reventing sodium acces to the axon interior by occu"ying the transmembrane sodium channel 000000000000000000000000. Bu"ivacaine carbonate com"ared to bu"ivacaine hydrochloride has a longer onset o% action and less intense bloc! 333333333333333333333333. (he shortest duration o% action o% local anaesthetics %ollo&s intrathecal in6ectionF the longest durations %ollo& ma6or "eri"heral nerve bloc!s 444444444444444444444444. 4rilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine 777777777777777777777777. (he Cm o% lignocaine is less than o% bu"ivacaine TFTFF 888888888888888888888888. is a "ure 8 enantiomer 999999999999999999999999. is more cardiotoxic than bu"ivacaine

, 2? ,

2+5.8egarding antiemetic drugs2+D.3% the sym"athomimetic drugs2+E.8egarding 2+?.Drugs actions diuretics2+G.8egarding on the cardiovascular esmolol system include ((((((((((((((((((((((((. "roduces a motor bloc! o% more "ronounced degree and duration than bu"ivacaine ::::::::::::::::::::::::. gives rise to a sensory bloc! that is similar to bu"ivacaine >>>>>>>>>>>>>>>>>>>>>>>>. is more li"id soluble than bu"ivacaine FFFTF @@@@@@@@@@@@@@@@@@@@@@@@. (hose &hich act as antido"aminergic agents can cause extra"yramidal sym"toms AAAAAAAAAAAAAAAAAAAAAAAA. Dom"eridone reduces vomiting by an antiserotonin action BBBBBBBBBBBBBBBBBBBBBBBB. Extra"yramidal sym"toms a%ter administration o% dro"eridol are unli!ely D hours a%ter administration CCCCCCCCCCCCCCCCCCCCCCCC. 4henothiaHine reduce nausea and vomiting by anti do"aminergicF antihistamine and antimuscarinic actions AAAAAAAAAAAAAAAAAAAAAAAAA. .etoclo"ramide and cycliHine have "rimarily anticholinergic actions. TFFTF BBBBBBBBBBBBBBBBBBBBBBBBB. al"ha,+ adrenergic drugs stimulate noradrenaline release CCCCCCCCCCCCCCCCCCCCCCCCC. beta,+ adrenergic drugs stimulate glycogenolysis and gluconeogenesis DDDDDDDDDDDDDDDDDDDDDDDDD. al"ha,2 agonists decrease intracellular calcium EEEEEEEEEEEEEEEEEEEEEEEEE. adrenaline has al"ha,2 and al"ha ,+ actions and beta,2 and beta,+ actions FFFFFFFFFFFFFFFFFFFFFFFFF. beta,+ agonists cause uterine relaxation FTFTT '''''''''''''''''''''''''. Frusemide inhibits the chloride reabsor"tion in the distal tubules ))))))))))))))))))))))))). (hiaHides causes hy"o!alaemic acidosis . Ethacrynic acid increases the excretion o% "otassium and hydrogen ion *************************. Aanthines decrease the glomerular %iltration rate KKKKKKKKKKKKKKKKKKKKKKKKK. Duration o% action o% %rusamide &ill last %or # hours FFTFT -------------------------. is beta,2 selective bloc!er .......................... has an elimination hal%,li%e o% ? minutes 0000000000000000000000000. is metabolise by "lasma "seudocholinesterase 3333333333333333333333333. has histamine release 4444444444444444444444444. is use%ul in management o% su"raventicular arrhytmias TTFFT 7777777777777777777777777. adrenaline causes al"ha and beta,2 and beta,+ stimulationF &hile noradrenaline stimulates al"ha and beta,2 not beta,+ activity 8888888888888888888888888. iso"renaline has more beta than al"ha e%%ect on the heart 9999999999999999999999999. do"amine increases "eri"heral resistanceF dobutamine reduces it

, +0 ,

2=0.)e"arin2=2.(he 2=+.3xygen 2==. n the %actors conducting is trans"ort a%%ecting system %rom the rate o% thethe o% alveoli heart2=#.8egarding trans"ort into the o% ablood drug across in coronary "ulmonary the "lacenta blood ca"illaries %lo& are by (((((((((((((((((((((((((. do"examine causes dilatation o% renalF cerebralF coronary and mesenteric beds :::::::::::::::::::::::::. nitroglycerine causes mainly arterial vasodilatationF nitro"russide mainly venous dilatation TTTTF >>>>>>>>>>>>>>>>>>>>>>>>>. has molecular &eight bet&een =000,D0F000 daltons @@@@@@@@@@@@@@@@@@@@@@@@@. acts by binding to antithrombin AAAAAAAAAAAAAAAAAAAAAAAAA. has anti"latetelet activity BBBBBBBBBBBBBBBBBBBBBBBBB. "rolongs the "rothrombin time CCCCCCCCCCCCCCCCCCCCCCCCC. has a shorter duration o% action than lo& molecular &eight he"arin TTTFT AAAAAAAAAAAAAAAAAAAAAAAAAA. degree o% ioniHation BBBBBBBBBBBBBBBBBBBBBBBBBB. degree o% "rotein binding CCCCCCCCCCCCCCCCCCCCCCCCCC. "lacental blood %lo& DDDDDDDDDDDDDDDDDDDDDDDDDD. "K o% the drug EEEEEEEEEEEEEEEEEEEEEEEEEE.li"id solubility o% the drug TTFTT FFFFFFFFFFFFFFFFFFFFFFFFFF. Filtration ''''''''''''''''''''''''''. 4assive di%%usion )))))))))))))))))))))))))). Facilitated di%%usion . Active trans"ort **************************. 9econdary active trans"ort FTFFF KKKKKKKKKKKKKKKKKKKKKKKKKK. (he 9A node develo"s %rom the structures on the right side o% the embryo --------------------------. )is,"ur!in6e have the %astest conduction velocities in the heart ...........................Atrial conduction is slo&ed by a decrease in tem"erature 00000000000000000000000000. (he 48 interval re"resents the duration o% atrial de"olariHation 33333333333333333333333333. Final re"olariHation is due to activation o% calcium channels TTTFF 44444444444444444444444444. (he main blood su""ly to the A> node is %rom right coronary artery 77777777777777777777777777. .ean arterial "ressure is more determinant o% myocardial blood %lo& than arterial diastolic "ressure 88888888888888888888888888. .yocardial oxygen consum"tion and coronary blood %lo& bear a linear relationshi" 99999999999999999999999999. Coronary blood %lo& &ill be im"roved by slo&ing the heart rate ((((((((((((((((((((((((((.0ormal myocardial oxygen extraction ratio is E0 $.

, +2 ,

2=5. n normal resting 2=E. healthycondition man at rest F ain bradycardia the su"ine &ould "osition2=D.8egarding be 2=G.Acetylcholine ex"ected to occur the is autoregulatory %ollo&ing the neurotransmitter 2=?.Concerning mechanisms at2#0.(he glomerular in acute anion hy"ovolaemia %iltration ga" TFTTT ::::::::::::::::::::::::::. le%t ventricular end diastolic volume is about +0 mls. >>>>>>>>>>>>>>>>>>>>>>>>>>. the %irst heart sound coincides &ith the onset o% ventricular systole @@@@@@@@@@@@@@@@@@@@@@@@@@. cardiac out"ut is a""roximately E5mls/beat AAAAAAAAAAAAAAAAAAAAAAAAAA. le%t ventricular end diastolic "ressure ; ->ED4 . is about 5 mm)g BBBBBBBBBBBBBBBBBBBBBBBBBB. the second heart sound coincides &ith end o% ( &ave o% EC' FTTTT CCCCCCCCCCCCCCCCCCCCCCCCCC. an increase in sym"athetic activity AAAAAAAAAAAAAAAAAAAAAAAAAAA.an increase in ca"illary hydrostatic "ressure BBBBBBBBBBBBBBBBBBBBBBBBBBB. a decrease in barorece"tor activity CCCCCCCCCCCCCCCCCCCCCCCCCCC. an increase in arteriovenous oxygen content di%%erence DDDDDDDDDDDDDDDDDDDDDDDDDDD.an increase in angiotension . TFTFT EEEEEEEEEEEEEEEEEEEEEEEEEEE. increased carotid sinus "ressure FFFFFFFFFFFFFFFFFFFFFFFFFFF. increased right atrial "ressure '''''''''''''''''''''''''''.a""lication o% "ressure o% the eye ball ))))))))))))))))))))))))))).%ollo&ing the release o% a valsalva manoeuvre . ex"iration TTTTF ***************************. sym"athetic nerve terminal su""lying the heart KKKKKKKKKKKKKKKKKKKKKKKKKKK.sym"athetic nerve terminal at the adrenal medulla ---------------------------. "arasym"athetic nerve terminal su""lying the lacrimal gland ............................ sym"athetic nerve terminal su""lying s&eat gland 000000000000000000000000000.sym"athetic ganglia FTTTT 333333333333333333333333333.0ormally about +0$ o% renal "lasma %lo& 444444444444444444444444444. 'F8 is directly "ro"ortional to systemic arterial "ressure 777777777777777777777777777.(ubular %unction is more im"ortant than 'F8 in determining the rate o% urine "roduction 888888888888888888888888888. Blood in e%%erent arteriole is more viscous than that in a%%erent arteriole 999999999999999999999999999. 'lomerular %iltration is a ty"e o% ultra%iltration TFFFT (((((((((((((((((((((((((((. s calculated %rom "lasma concentration o% sodiumF bicarbonate and "hos"hate :::::::::::::::::::::::::::.(he normal value is bet&een 25,2G mmol/l >>>>>>>>>>>>>>>>>>>>>>>>>>>. s normal in renal tubular acidosis

, ++ ,

2#2.Concerning o% blood coagulation J2#+.8egarding 2#=.(hyroid hormones the "assage &ill2##. 2#5..otility o% glomerular nsulin secretion o% %iltrate the gastrointestinal through the renal tract tubules is increased J by @@@@@@@@@@@@@@@@@@@@@@@@@@@. )igh in as"irin overdose AAAAAAAAAAAAAAAAAAAAAAAAAAA. s decreased &hen "lasma albumin is decreased FFTTT BBBBBBBBBBBBBBBBBBBBBBBBBBB.Fibrinogen is "resent in lo& concentrations in "atients &ith liver disease CCCCCCCCCCCCCCCCCCCCCCCCCCC. Calcium ions are re/uired to convert %ibrin monomer to %ibrin threads AAAAAAAAAAAAAAAAAAAAAAAAAAAA. )e"arin is secreted by circulating eosino"hil cells. BBBBBBBBBBBBBBBBBBBBBBBBBBBB. )aemo"hiliacs have a lac! o% %actor > and A CCCCCCCCCCCCCCCCCCCCCCCCCCCC. 0ormal "rothrombin time is bet&een +0s and =0s. TTFTF DDDDDDDDDDDDDDDDDDDDDDDDDDDD. (hic! ascending limb o% loo" dilutes the %iltrates by its "o&er%ul sodium "um"s EEEEEEEEEEEEEEEEEEEEEEEEEEEE. A substance suitable %or measuring glomerular %iltration rate should be absorbed or secreted by tubules FFFFFFFFFFFFFFFFFFFFFFFFFFFF. Distal tubule is normally im"ermeable to &ater ''''''''''''''''''''''''''''. 'lucose is absent in the %iltrate in -oo" o% )enle )))))))))))))))))))))))))))). 9odium concentration in descending limb o% loo" is same as that in distal convulated tubule TFTTF . sensitiHe the myocardium to catecholamines ****************************. lo&er the "lasma cholesterol KKKKKKKKKKKKKKKKKKKKKKKKKKKK. increase the %ormation o% messenger 80As ----------------------------. reduce albumin synthesis ............................. iodine is absorbed %rom gastrointestinal tract in ioniHed %orm TTTFT 0000000000000000000000000000. is about 2,+ :/ hour in the basal state 3333333333333333333333333333. is increased 5,20 times %ollo&ing ingestion o% %ood 4444444444444444444444444444. is increased by glucagons 7777777777777777777777777777. is de"ressed in starvation 8888888888888888888888888888. is increased in "erio"erative "eriod TTTTF 9999999999999999999999999999. vagal bloc!ade ((((((((((((((((((((((((((((. mechanical obstruction ::::::::::::::::::::::::::::. stimulation o% s"lanchnic nerves >>>>>>>>>>>>>>>>>>>>>>>>>>>>. "regnancy @@@@@@@@@@@@@@@@@@@@@@@@@@@@. neostigmine FTFFT

, += ,

2#D.8egarding the neuromuscular 6unctionJ2#E.(he AAAAAAAAAAAAAAAAAAAAAAAAAAAA. liver2#G.8egarding 2#?.8egarding 250.A shi%t o% the cerebral cerebros"inal oxygen blood dissociation %luid %lo&;JC9F curve . J to the right AAAAAAAAAAAAAAAAAAAAAAAAAAAA. (he syna"tic cle%t is about 50,E0 nm &ide BBBBBBBBBBBBBBBBBBBBBBBBBBBB. (he "ost6unctional membrane is thro&n into %olds CCCCCCCCCCCCCCCCCCCCCCCCCCCC. Acetylcholine rece"tor has %ive "rotein subunits AAAAAAAAAAAAAAAAAAAAAAAAAAAAA. (&o al"ha subunits o% acetylcholine rece"tor have to be activated %or the channel to o"en BBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Acetylcholine is synthesiHed %rom choline and acetic acid TTTTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCC. receives most o% its blood su""ly %rom the "ortal vein DDDDDDDDDDDDDDDDDDDDDDDDDDDDD. involve in vaso"ressin metabolism and inactivation EEEEEEEEEEEEEEEEEEEEEEEEEEEEE. "roduces he"arin FFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has a normal "ortal venous "ressure o% greater than +0mm)g '''''''''''''''''''''''''''''. receives a""roximately +5$ o% the cardiac out"ut TTFFT ))))))))))))))))))))))))))))). Brain receives 25$ o% cardiac out"ut . Cerebral blood %lo& rises by +$ %or each mm rise in 4aC3+ *****************************. >olatile anaesthetics reduce cerebral blood %lo& KKKKKKKKKKKKKKKKKKKKKKKKKKKKK. >olatile anaesthetics can im"air the autoregulation o% cerebral blood %lo& -----------------------------. Cerebral blood %lo& is relatively constant bet&een C44 o% 50,250 mm)g. TTFTT .............................. 0ormal s"eci%ic gravity is bet&een 2.00= and 2.00? 00000000000000000000000000000. (he rate o% %ormation is increased i% the intracranial "ressure rises. 33333333333333333333333333333. (he "ressure normally alters &ith res"iration. 44444444444444444444444444444. C9F glucose level is inde"endent on "lasma glucose level 77777777777777777777777777777. C9F %lo& &ill "asses into dural venous sinuses via arachnoid villi. TFTFT 88888888888888888888888888888. is associated &ith Bohr e%%ect in hy"erca"nia. 99999999999999999999999999999. is %avoured by a rise in tem"erature (((((((((((((((((((((((((((((. %avours the "assage o% oxygen %rom blood to tissues :::::::::::::::::::::::::::::. occurs &hen %etal blood is re"laced by adult blood >>>>>>>>>>>>>>>>>>>>>>>>>>>>>. occurs in stored blood TTTTF

, +# ,

252. n cell metabolism25+..otility 25=.Com"ared 255.8egarding @@@@@@@@@@@@@@@@@@@@@@@@@@@@@. o% "ressures &ith the gastrointestinal that o% during a normal res"iratory tract adultF is increased the cycle ne&born J by25#.Concerning in%ant5s com"osition o% body %luids @@@@@@@@@@@@@@@@@@@@@@@@@@@@@. 2 molecule &ill yield =G molecules o% A(4. AAAAAAAAAAAAAAAAAAAAAAAAAAAAA. (he Kreb5s cycle can o"erate %or a limited time anaerobically BBBBBBBBBBBBBBBBBBBBBBBBBBBBB. (he com"onents o% the Kreb5s cycle are su""lied entirely %rom carbohydrate metabolism CCCCCCCCCCCCCCCCCCCCCCCCCCCCC. (he 87 is higher %or carbohydrates than %ats AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Aerobic glycolysis is a "rocess &hen "yruvate enters the citric acid cycle and "roduce C3+ and )+3 TFFFT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 9ym"athetic bloc! u" to (# CCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. ncreased circulating adrenaline DDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. stimulation o% s"lanchnic nerves EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. "regnancy FFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Anticholinesterase drug TFFFT ''''''''''''''''''''''''''''''. !idneys have less ability to excrete a concentrated urine )))))))))))))))))))))))))))))). blood , brain barrier is less "ermeable to bilirubin . heat regulation is more e%%icient because o% its ability to metabolise bro&n %at ******************************. blood has greater a%%inity %or oxygen at lo& oxygen "ressures KKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. carbohydrate reserve is greater TFFTF ------------------------------. 4lasma constitutes a /uarter o% extracellular %luid volume ...............................Extracellular volume grossly de"leted in intestinal obstruction 000000000000000000000000000000. 4rotein content o% interstitial %luid is higher com"ared to intracellular %luid and "lasma 333333333333333333333333333333. 8atio o% extracellular / intracellular volume is smaller in in%ants com"ared to adult 444444444444444444444444444444. 0ormal osmolality o% "lasma is +G0 mosmoles /!g. TTFFT 777777777777777777777777777777. Alveolar "ressre rises to allo& ins"iratory %lo& to occur 888888888888888888888888888888. ntra"leural "ressure is ,5cm )+3 be%ore ins"iration begins 999999999999999999999999999999. Alveolar "ressure is "ositive during ex"iration ((((((((((((((((((((((((((((((. Fall in intra"leural "ressure during ins"iration is due to a %all in the elastic recoil ::::::::::::::::::::::::::::::. @ith %orced ex"irationF the intra"leural "ressure exceeds Hero. FTTFT

, +5 ,

25D.Alveolar, arterial oxygen di%%erence ; A,a D3+ <25E.-ung 25?. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. n an a&a!e com"liance25G.8egarding u"right 2D0.8egarding s"ontaneously the coronary breathing carotid blood bodies "atient %lo& J >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. is normally 25,+5 mm)g &hile breathing room air @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. is increased under anaesthesia due to increased ventilation/ "er%usion mismatch AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is decreased in one lung ventilation BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is increased in the "resence o% right to le%t intracardiac shunts CCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is decreased in excessive exercise TTFTF AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is normally 0.+ -/ cm )+3 BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. reduces &ith loss o% "ulmonary sur%actant CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is increased in em"hysema DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. increases a%ter induction o% general anaesthesia EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is di%%erent at a"ical and basal o% the lungs TFTFT FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. )ave cells &hich res"onds to increase in arterial 4). '''''''''''''''''''''''''''''''. )ave the highest blood %lo& ; ml/ unit &eight < in the body ))))))))))))))))))))))))))))))). 9timulate maximally the res"iratory drive &hen 4a3+ =5,E0 mm)g . tLs discharge is increased by anaemia *******************************. (he a%%erent nerve is via glosso"haryngeal nerve. FTTFT KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. ventilation "er unit lung volume is smallest at the a"ex o% the lungs. -------------------------------. basal alveoli are bigger than a"ical alveoli ................................ basal alveoli ex"and more than a"ical alveoli during ins"iration 0000000000000000000000000000000. "leural "ressure is less negative at the base o% lungs 3333333333333333333333333333333. last "art o% the ex"ired air comes %rom the a"ical alveoli. TFTTT 4444444444444444444444444444444. 9ubendocardium is more vulnerable to ischaemia than e"icardium 7777777777777777777777777777777. Adenosine is a coronary vasodilator. 8888888888888888888888888888888. .yocardial oxygen consum"tion and coronary blood %lo& bear a linear relationshi" 9999999999999999999999999999999. Coronary blood %lo& &ill be im"roved by slo&ing the heart rate (((((((((((((((((((((((((((((((. 0ormal myocardial oxygen extraction ratio is E0 $. TTTTT

, +D ,

2D2. n normal resting 2D=. healthycondition man at rest F ain bradycardia the su"ine &ould "osition2D+.@ith be 2D5.(he ex"ected countercurrent re%erence to occur %ollo&ing2D#. to the concentrating normal human n the mechanism autonomic heart J in nervous !idney systemF :::::::::::::::::::::::::::::::. le%t ventricular end diastolic volume is about +0 mls. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. the %irst heart sound coincides &ith the onset o% ventricular systole @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. cardiac out"ut is a""roximately E5mls/beat AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. le%t ventricular end diastolic "ressure ; ->ED4 < is about 5 mm)g BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. the second heart sound coincides &ith end o% ( &ave o% EC' FTTTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. (he most ra"idly conducting %ibres in the heart are "ur!in6e %ibres AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.(he last "art o% the ventricle to be activated is the a"ex BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. (he duration o% an action "otential in the ventricular muscle %ibre is about the same as in a s!eletal muscle %ibre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. (he ( &ave o% the EC' occurs at the beginning o% the absolute re%ractory "eriod o% the ventricle DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.-e%t axis deviation leads to abnormally large 8 &ave in standard limb lead 2. TFFFF EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE.increased carotid sinus "ressure FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. increased right atrial "ressure ''''''''''''''''''''''''''''''''.a""lication o% "ressure o% the eye ball )))))))))))))))))))))))))))))))).%ollo&ing the release o% a valsalva manoeuvre . ex"iration TTTTF ********************************. the "arasym"athetic system is transmitted in cranial nerves and sacral %ibres %rom the s"inal cord KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK."arasym"athetic e%%ects are identical to those o% acetylcholine --------------------------------."ostganglionic sym"athetic %ibres release cathecolaminesF exce"t at s&eat and adrenal glandsF &here acetylcholine is released ................................. sym"athetic e%%ects are more localiHed than "arasym"athetic actions 00000000000000000000000000000000."arasym"athetic stimulation increases bladder em"tying TFTFF 33333333333333333333333333333333.de"ends on active trans"ort o% sodium and chloride out o% ascending loo" o% )enle 44444444444444444444444444444444. allo&s an osmolality o% 2+00 mosmoles/!g in distal tubules 77777777777777777777777777777777.occurs "redominantly in the cortical ne"hrons 88888888888888888888888888888888. relies on the %ree movement o% &ater and electrolytes across the &alls o% vasa recta

, +E ,

2DD.Factors determining 2DG.8egarding the "assage urinary o% glomerular sodium loss %iltrate include through J2DE.Concerning the renal tubules o% blood J coagulation J2E0. 2D?.(hyroid nsulin secretion hormones &ill 99999999999999999999999999999999. medullary interstitium TFFTF ((((((((((((((((((((((((((((((((.4lasma sodium concentration ::::::::::::::::::::::::::::::::.'lomerular %iltration rate >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>.Circulating renin levels @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. Distal tubular %luid anion concentration AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.4lasma hydrogen ion concentration TTTTF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB.Fibrinogen is "resent in lo& concentrations in "atients &ith liver disease CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC.Calcium ions are re/uired to convert %ibrin monomer to %ibrin threads AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. )e"arin is secreted by circulating eosino"hil cells. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. )aemo"hiliacs have a lac! o% %actor > and A CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 0ormal "rothrombin time is bet&een +0s and =0s. TTFTF DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. (hic! ascending limb o% loo" dilutes the %iltrates by its "o&er%ul sodium "um"s EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. A substance suitable %or measuring glomerular %iltration rate should be absorbed or secreted by tubules FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Distal tubule is normally im"ermeable to &ater '''''''''''''''''''''''''''''''''. 'lucose is absent in the %iltrate in -oo" o% )enle ))))))))))))))))))))))))))))))))). 9odium concentration in descending limb o% loo" is same as that in distal convulated tubule TFTTF . sensitiHe the myocardium to catecholamines *********************************. lo&er the "lasma cholesterol KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. increase the %ormation o% messenger 80As ---------------------------------. reduce albumin synthesis .................................. iodine is absorbed %rom gastrointestinal tract in ioniHed %orm TTTFT 000000000000000000000000000000000. is about 2,+ :/ hour in the basal state 333333333333333333333333333333333. is increased 5,20 times %ollo&ing ingestion o% %ood 444444444444444444444444444444444. is increased by glucagons 777777777777777777777777777777777. is de"ressed in starvation 888888888888888888888888888888888. is increased in "erio"erative "eriod de"ends on a lo& concentration o% urea in the

, +G ,

2E2..otility o% the gastrointestinal tract is increased by2E+.8egarding 2E#.8egarding cerebros"inal 2E5.8egarding the neuromuscular cerebral blood%luid %lo&6unctionJ2E=.(he ;JC9F < J liver TTTTF 999999999999999999999999999999999. vagal bloc!ade (((((((((((((((((((((((((((((((((. mechanical obstruction :::::::::::::::::::::::::::::::::. stimulation o% s"lanchnic nerves >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. "regnancy @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. neostigmine FTFFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. (he syna"tic cle%t is about 50, E0 nm &ide BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. (he "ost6unctional membrane is thro&n into %olds CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Acetylcholine rece"tor has %ive "rotein subunits AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. (&o al"ha subunits o% acetylcholine rece"tor have to be activated %or the channel to o"en BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Acetylcholine is synthesiHed %rom choline and acetic acid TTTTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. receives most o% its blood su""ly %rom the "ortal vein DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. involve in vaso"ressin metabolism and inactivation EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. "roduces he"arin FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has a normal "ortal venous "ressure o% greater than +0mm)g ''''''''''''''''''''''''''''''''''. receives a""roximately +5$ o% the cardiac out"ut TTFFT )))))))))))))))))))))))))))))))))). Brain receives 25$ o% cardiac out"ut . Cerebral blood %lo& rises by +$ %or each mm rise in 4aC3+ **********************************. >olatile anaesthetics reduce cerebral blood %lo& KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. >olatile anaesthetics can im"air the autoregulation o% cerebral blood %lo& ----------------------------------. Cerebral blood %lo& is relatively constant bet&een C44 o% 50,250 mm)g. TTFTT ................................... (otal volume is +50, =00ml. 0000000000000000000000000000000000. 4roduce by choroids "lexuses in the rate o% =ml/min 3333333333333333333333333333333333. 0ormal C9F "rotein level is 0.+,0.# g/ -. 4444444444444444444444444444444444. C9F glucose level is inde"endent on "lasma glucose level 7777777777777777777777777777777777. C9F %lo& &ill "asses into dural venous sinuses via arachnoid villi.

, +? ,

2ED.A shi%t o% the oxygen dissociation curve to the right2EE.9evere 2EG.Com"ared 2E?.During 2G0.(he %ollo&ing hy"er!alaemia intrauterine &ith increase thatli%eF o% is a during normal associated "regnancy adultF &ith theJne&born in%ant5s

FFTFT 8888888888888888888888888888888888. is associated &ith Bohr e%%ect in hy"erca"nia. 9999999999999999999999999999999999. is %avoured by a rise in tem"erature ((((((((((((((((((((((((((((((((((. %avours the "assage o% oxygen %rom blood to tissues ::::::::::::::::::::::::::::::::::. occurs &hen %etal blood is re"laced by adult blood >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. occurs in stored blood TTTTF @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. absent " &aves in EC' AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. chronic ACE inhibitor inta!e BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. decreased serum bicarbonate level CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. suxamethonium administration in immediate burn AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. aldosterone de%iciency TTTFT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. !idneys have less ability to excrete a concentrated urine CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. blood , brain barrier is less "ermeable to bilirubin DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. heat regulation is more e%%icient because o% its ability to metabolise bro&n %at EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. blood has greater a%%inity %or oxygen at lo& oxygen "ressures FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. carbohydrate reserve is greater TFFTF '''''''''''''''''''''''''''''''''''. all the %etal blood returning %rom the "lacenta %lo&s directly into in%erior vena cava ))))))))))))))))))))))))))))))))))). %etal blood carries more oxygen than maternal blood at lo& 43+ . umbilical venous blood has a 43+ o% =0,#0 mm)g ***********************************. blood on the right side o% the %etal heart is better oxygenated than that on the le%t side KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. "ulmonary vascular resistance is higher than a%ter birth FFTTF -----------------------------------. 4lasma volume .................................... Fibrinogen 00000000000000000000000000000000000. 'astric em"tying time 33333333333333333333333333333333333. 'lucose tolerance 44444444444444444444444444444444444. Arterial 4aC3+ TTTFF

, =0 ,

2G2.Atrial natriuretic "e"tide2G+.(he 77777777777777777777777777777777777. "ath&ays o% "ain sensation include2G=.8egarding 2G#.8egarding "rotein 2G5.First,order drug "rocesses administration binding o% drugs J in "lasma J 77777777777777777777777777777777777. s released via coronary sinus 88888888888888888888888888888888888. s "otent vasodilator 99999999999999999999999999999999999. m"roves renal blood %lo& (((((((((((((((((((((((((((((((((((. ncreases the glomerular %iltration rate :::::::::::::::::::::::::::::::::::. Augment the release o% AD) TTTTF >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. a,delta %ibres &hich terminate in lamina 2 o% the dorsal horn @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. second order neurons &hich ascend in the i"silateral s"inothalamic tra AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. c %ibres &hich release histamine and serotonin BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. syna"ses in the substantia nigra o% the s"inal cord CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. descending "ath&ays in the dorsolateral colums TFFFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 9ublingual route avoids %irst, "ass inactivation in the liver BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 9u""ositories ex"ose the drug to %irst,"ass metabolism CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Distribution o% nebulised drug in the res"iratory tree de"ends on the "article siHe DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. )ighly &ater soluble drugs are administered by transdermal route EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Drugs given by oral route should have a very high exraction ratio TFTFF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. )ighly "rotein bound drugs have a longer biological hal%,li%e ''''''''''''''''''''''''''''''''''''. 4rotein binding is di%%erent mar!edly in arterial and venous blood )))))))))))))))))))))))))))))))))))). Free drug concentration is not altered in hy"oalbuminaemics states . Al"ha,2 acid glyco"rotein "rinci"ally binds to basic drugs ************************************. 'reater the "rotein bindingF lesser is the volume o% distribution TFFTT KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. a""ly to enHyme, mediated reactions ------------------------------------. are characteriHed by high rates o% reaction &hen the concentrations o% reacting substances are high. ..................................... can "ro"erly be described in terms o% t2/+ 000000000000000000000000000000000000. are involved in elimination o% most drugs 333333333333333333333333333333333333. change to Hero,order !inetic at very high drug doses

, =2 ,

2GD.(he %ollo&ing 2G?.(he 2?0.Factors &hich a%%ect statements drugs are "ea! the excreted about e%%ect drug largely o% hal%,li%e intravenous unchanged are correct anaesthetics by the J2GE.8egarding 2GG.A !idney include com"etitive J o% bio,availability antagonist o% drugs J TTFTT 444444444444444444444444444444444444. )al%,li%e o% a drug is shorter than its time constant 777777777777777777777777777777777777. Drug given by in%usion &ithout a bolus reach a steady state in %ive hal%,lives 888888888888888888888888888888888888. Extent o% drug distribution into extracellular %luid is unli!ely to a%%ect t2/+. 999999999999999999999999999999999999. Context sensitive hal%,li%e can be use %or any drug ((((((((((((((((((((((((((((((((((((. About ?#$ o% a drug is cleared o% the body in %our hal%,lives TTFFT ::::::::::::::::::::::::::::::::::::. s indicated by area under the "lasma concentration , curve time >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Bio,availability o% intravenous drug must be less than 200$ @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. s reduced by destruction o% drug in the gut AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. s reduced by metabolism o% drug in the liver BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. s greater by sublingual route than enteral route. TFTTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. combines &ith the same rece"tor as the agonist drug AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.shi%t the log dose res"onse curve %or the agonist to the right BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. de"resses the maximum obtainable res"onse o% the agonist CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. &ill a%%ect the a%%inity o% the agonist %or its rece"tor DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.need not have a close structural similarity to the agonist TTFFT EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. -ignocaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. .or"hine '''''''''''''''''''''''''''''''''''''.4ro"o%ol ))))))))))))))))))))))))))))))))))))).-evo,bu"ivacaine .>ecuronium FFFFF *************************************. dose administered KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK.volume o% distribution -------------------------------------. he"atic clearance ...................................... rate o% in6ection 0000000000000000000000000000000000000.cardiac out"ut TFFTT

, =+ ,

2?2.8egarding "ro"o%ol J2?+.Ketamine2?=.8egarding .idaHolam J2?#.8egarding 2?5.(he s"eed o% inhalational induction agents &ith inhalational J agents 3333333333333333333333333333333333333. s insoluble in &ater 4444444444444444444444444444444444444. s bound to albumin u" to ?E,?G $ 7777777777777777777777777777777777777.8educes sodium channel o"ening times in neuronal membranes 8888888888888888888888888888888888888. s hy"ertonic 9999999999999999999999999999999999999. Does not cause tachycardia TTTFT (((((((((((((((((((((((((((((((((((((. has mar!ed analgesic "ro"erties mediated by its binding to 0.DA rece"tors :::::::::::::::::::::::::::::::::::::.causes a %all in cardiac out"ut and a rise in heart rate >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>.is contraindicated in "atients &ith raised intracranial "ressure @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. has active metabolites AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.causes "osto"erative dreaming and hallucinations &hich is less %re/uent in children TFTTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB.)as t 2/+ o% less than + hours CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. s &ater soluble at ") o% D AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. )as an active metabolite BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Can have a "rolonged e%%ect i% it given &ith erythromycin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Bioavailability %ollo&ing intramuscular in6ection is ?0 $ TFTTT DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. (he blood gas "artition co,e%%icient o% des%lurane is 0.#+ EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Des%lurane &ill cause sym"athetic stimulation FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. 9evo%lurane can degrade to com"ound A in soda lime ''''''''''''''''''''''''''''''''''''''. Des%lurane is suitable %or inhalational induction )))))))))))))))))))))))))))))))))))))). Des%lurane can be used in halothane va"oriHer TTTFF . s /uic!er in "atients &ith high F8C **************************************. s /uic!er i% the agent is very soluble in blood KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. s slo&er in the "resence o% right to le%t shunt --------------------------------------. s unchanged in the "resence o% le%t to right shunt &ith normal systemic %lo& ....................................... s /uic!er &hen used &ith nitrous oxide FFTTT

, == ,

2?D.0itrous oxide2?E.8egarding o"ioid rece"tors J2?G.4ethidine2??.8egarding narcotic antagonists J+00.8ocuronium 00000000000000000000000000000000000000. is stored as li/uid 33333333333333333333333333333333333333. is a gas above a tem"erature o% =D degree centigrade 44444444444444444444444444444444444444. cylinders should have %illing ratio o% 0.D5,0.E5 77777777777777777777777777777777777777. content in a cylinder is al&ays re%lected %rom its "ressure gauge 88888888888888888888888888888888888888. is =# times less soluble than 0+. TTTTF 99999999999999999999999999999999999999. .or"hine acts on !a""a rece"tors ((((((((((((((((((((((((((((((((((((((. (he e%%ect o% stimulation o% sigma rece"tors is dys"horia and hallucination ::::::::::::::::::::::::::::::::::::::. Eu"horia is due to stimulation o% delta rece"tors >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. 0alor"hine antagoniHes !a""a rece"tors @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. 4ent aHocine is "artial agonist TTFFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is structurally related to mor"hine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. onset o% analgesic activity a%ter intramuscular in6ection is =5 minutes CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. in e/uianalgesic dosesF "ethidine and mor"hine "roduce e/ual amount o% sedation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. res"iratory de"ression caused by it can be antagoniHed by nalor"hine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. about D0$ is bound to "lasma "roteins TFFTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 0alor"hine induces antidiuretic e%%ect DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. 0aloxone is one,%i%th as "otent as nalor"hine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. 0aloxone "reci"itates a &ithdra&al syndrome a%ter chronic doses o% "entaHocine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. 0aloxone is metaboliHed and excreted by the !idneys '''''''''''''''''''''''''''''''''''''''. 0aloxone is one,%i%th as "otent &hen given orally as com"ared &ith "arenteral administration FFTFF ))))))))))))))))))))))))))))))))))))))). is an aminostereroid . is stable in a/ueous solution ***************************************. undergoes "rinci"ally he"atic elimination KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has "rovide intubating conditions &ithin D0 seconds ---------------------------------------. t release histamine

, =# ,

+02.'lyco"yrrolate+0+.Adrenaline+0=.8egarding amiodarone+0#.@ith regard to local anaestheticsJ+05.8o"ivacaine

TTTTF ........................................ can act at central cholinergic rece"tors 000000000000000000000000000000000000000. can increase the "hysiological dead s"ace 333333333333333333333333333333333333333. dilate the "u"il 444444444444444444444444444444444444444. is e/ually e%%ective &hen given orally 777777777777777777777777777777777777777. is %ive times "otent as antisialagogue than atro"ine FTFFT 888888888888888888888888888888888888888. is a bronchodilator 999999999999999999999999999999999999999. is released in "ostsyna"tic sym"athetic nerve endings (((((((((((((((((((((((((((((((((((((((. di%%ers %rom noradrenaline by having an extra methyl grou" :::::::::::::::::::::::::::::::::::::::. is commonly used &ith local anesthetics in a concentration o% 2 J G0F00 >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. &ill elevate the blood sugar TFTFT @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. "rol ongs action "otential duration in 9A node AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. shorten re"olarisation in A> node BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. cause "hotosensitivity CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. &ill have e%%ect on thyroid %unction on long treatment AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. slo&s conduction velocity in )is,"ur!in6ee system TFTTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. act by "reventing sodium acces to the axon interior by occu"ying the transmembrane sodium channel CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Bu"ivacaine carbonate com"ared to bu"ivacaine hydrochloride has a longer onset o% action and less intense bloc! DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. (he shortest duration o% action o% local anaesthetics %ollo&s intrathecal in6ectionF the longest durations %ollo& ma6or "eri"heral nerve bloc!s EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. 4rilocaine is more toxic to the cardiovascular and central nervous systems than lignocaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. (he Cm o% lignocaine is less than o% bu"ivacaine TFTFF ''''''''''''''''''''''''''''''''''''''''. is a "ure 8 enantiomer )))))))))))))))))))))))))))))))))))))))). is more cardiotoxic than bu"ivacaine . "roduces a motor bloc! o% more "ronounced degree and duration than bu"ivacaine

, =5 ,

+0D.8egarding antiemetic drugs+0E.3% the sym"athomimetic drugs+0G.8egarding diuretics+0?.8egarding esmolol ****************************************. gives rise to a sensory bloc! that is similar to bu"ivacaine KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is more li"id soluble than bu"ivacaine FFFTF ----------------------------------------. (hose &hich act as antido"aminergic agents can cause extra"yramidal sym"toms ......................................... Do m"eridone reduces vomiting by an antiserotonin action 0000000000000000000000000000000000000000. Extra"yramidal sym"toms a%ter administration o% dro"eridol are unli!ely D hours a%ter administration 3333333333333333333333333333333333333333. 4henothiaHine reduce nausea and vomiting by anti do"aminergicF antihistamine and antimuscarinic actions 4444444444444444444444444444444444444444. .etoclo"ramide and cycliHine have "rimarily anticholinergic actions. TFFTF 7777777777777777777777777777777777777777. al"ha,+ adrenergic drugs stimulate noradrenaline release 8888888888888888888888888888888888888888. beta,+ adrenergic drugs stimulate glycogenolysis and gluconeogenesis 9999999999999999999999999999999999999999. al"ha,2 agonists decrease intracellular calcium ((((((((((((((((((((((((((((((((((((((((. adrenaline has al"ha,2 and al"ha ,+ actions and beta,2 and beta,+ actions ::::::::::::::::::::::::::::::::::::::::. beta,+ agonists cause uterine relaxation FTFTT >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Frusemide inhibits the chloride reabsor"tion in the distal tubules @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. (hiaHides causes hy"o!alaemic acidosis AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Ethacrynic acid increases the excretion o% "otassium and hydrogen ion BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Aanthines decrease the glomerular %iltration rate CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Duration o% action o% %rusamide &ill last %or # hours FFTFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is beta,2 selective bloc!er BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has an elimination hal%,li%e o% ? minutes CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is metabolise by "lasma "seudocholinesterase DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. has histamine release EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is use%ul in management o% su"raventicular arrhytmias TTFFT

, =D ,

+20.Drugs +2+.(he %actors actions a%%ecting on the cardiovascular the rate o% trans"ort system o% include+22.)e"arin a drug across the "lacenta are+2=.Concerning +2#.(he carotid sinuses the AB3 blood grou"sJ FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. adrenaline causes al"ha and beta,2 and beta,+ stimulationF &hile noradrenaline stimulates al"ha and beta,2 not beta,+ activity '''''''''''''''''''''''''''''''''''''''''. iso"renaline has more beta than al"ha e%%ect on the heart ))))))))))))))))))))))))))))))))))))))))). do"amine increases "eri"heral resistanceF dobutamine reduces it . do"examine causes dilatation o% renalF cerebralF coronary and mesenteric beds *****************************************. nitroglycerine causes mainly arterial vasodilatationF nitro"russide mainly venous dilatation TTTTF KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has molecular &eight bet&een =000,D0F000 daltons -----------------------------------------. acts by binding to antithrombin .......................................... has anti"latetelet activity 00000000000000000000000000000000000000000. "rolongs the "rothrombin time 33333333333333333333333333333333333333333. has a shorter duration o% action than lo& molecular &eight he"arin TTTFT 44444444444444444444444444444444444444444. degree o% ioniHation 77777777777777777777777777777777777777777. degree o% "rotein binding 88888888888888888888888888888888888888888. "lacental blood %lo& 99999999999999999999999999999999999999999. "K o% the drug (((((((((((((((((((((((((((((((((((((((((. li"id solubility o% the drug TTFTT :::::::::::::::::::::::::::::::::::::::::. A "erson o% grou" 3 is a universal reci"ient >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. A "erson o% grou" B al&ays has anti,A agglutinins in his "lasma @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. n an incom"atible blood trans%usion reactionF donor cells are lysed by reci"ient antibodies AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Disseminated intravascular coagulo"athy is one o% com"lication o% mis,matched trans%usion BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. For AB3 incom"atibilityF sam"les o% reci"ient and donor should be ta!en %or analysis. FTTTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. have stretch rece"tors in their &alls AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.give a%%erent im"ulses via the glosso"haryngeal nerve BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. stimulate the res"iratory centre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. contain chemorece"tors

, =E ,

+25.8egarding the autoregulatory mechanisms in acute hy"ovolaemia+2D.Coronary +2E.(he ( &ave +2G.Acetylcholine +2?.8egarding artery the o%is lung the %lo& the EC' volumes neurotransmitter in adult occurs and is ca"acities at J DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD.stimulate the vasomotor centre TTFFT EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. an increase in sym"athetic activity FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. an increase in ca"illary hydrostatic "ressure ''''''''''''''''''''''''''''''''''''''''''.a decrease in barorece"tor activity )))))))))))))))))))))))))))))))))))))))))).an incease in arteriovenous oxygen content di%%erence . an increase in angiotension . TFTFT ******************************************. a""roximately 5$ o% the cardiac out"ut KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK.has diastolic "ressure as its determinant ------------------------------------------. reduced in severe tachycardia ........................................... basi cally under humoral control 000000000000000000000000000000000000000000.reduced in hy"oxia. TTTFF 333333333333333333333333333333333333333333.at the time o% the second heart sound 444444444444444444444444444444444444444444. during ventricular diastole 777777777777777777777777777777777777777777.during atrial systole 888888888888888888888888888888888888888888. at the beginning o% the re%ractory "eriod 999999999999999999999999999999999999999999. during re"olariHation o% the ventricles TFFFT ((((((((((((((((((((((((((((((((((((((((((. sym"athetic nerve terminal su""lying the heart ::::::::::::::::::::::::::::::::::::::::::.sym"athetic nerve terminal at the adrenal medulla >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>."arasym"athetic nerve terminal su""lying the lacrimal gland @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. sym"athetic nerve terminal su""lying s&eat gland AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA.sym"athetic ganglia FTTTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB.(he air ins"ired &ith the a maximal ins"iratory e%%ort in excess o% tidal volume is ins"iratory reserve volume CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Air "resent in the lungs a%ter maximal ins"iratory e%%ort is the residual volume AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. >ital ca"acity is decreased in asthma

, =G ,

++0. n normal human lungsM++2.4ulmonary sur%actant ++=.8egarding +++. n %it adult 4ulmonary "ersonF anatomical circulation dead s"ace BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 0ormal maximal voluntary ventilation is +50,=00 -/min CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. >ital ca"acity includes tidal volumesF ex"iratory reserve volume and residual volume TFTFF DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. "ulmonary vascular resistance is decreased by nore"ine"hrine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. beta,+,agonists cause bronchoconstriction FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. "ulmonary vascular resistance is increased by serotonin '''''''''''''''''''''''''''''''''''''''''''. "ulmonary vascular resistance is decreased by histamine ))))))))))))))))))))))))))))))))))))))))))). "ulmonary vascular resistance is decreased by nore"ine"hrine FFTTF . is "roduced by the ty"e alveolar cells *******************************************. increases alveolar ciliary motion KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is decreased by increased Fi3+ -------------------------------------------. aids di%%usion %rom the alveolus to the "ulmonary ca"illary ............................................ a""ears at about +# &ee!s o% gestation. FFTFT 0000000000000000000000000000000000000000000. increases &ith increasing lung volumes 3333333333333333333333333333333333333333333. can be measured by %o&ler5s method 4444444444444444444444444444444444444444444. ncreases &ith hy"oventilation 7777777777777777777777777777777777777777777. s reduced &hen nec! is %lexed 8888888888888888888888888888888888888888888. s increased in "ulmonary embolism TTFTT 9999999999999999999999999999999999999999999. De"endent "arts o% the lung receive greater blood %lo& than nonde"endent lungs. (((((((((((((((((((((((((((((((((((((((((((. Amount o% blood in the "ulmonary circulation is bet&een 0.5 to 2.0 :::::::::::::::::::::::::::::::::::::::::::. 4ulmonary blood volume increases %rom erect to su"ine "osition >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Barbiturate administration causes a rise in a "ulmonary blood volume @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. 4ulmonary vascular "ressures are bet&een one,sixth to one,tenth o% the systemic arterial "ressure. TTTFT

, =? ,

++#.8egarding cerebral circulation++5.Cerebros"inal AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. %luid++D.Carbon ++E.8egarding dioxide nerveis %ibresJ carried in the blood ++G. n cell metabolism AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. cerebral metabolic rate %or oxygen is about =.5 ml/200g o% brain "er min. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. hy"oxia cause cerebral vasodilatation CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. autoregulation is im"aired in the "resence o% intracerebral tumor AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. chronic hy"ertension shi%t the autoregulatory curve to the le%t BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. volatile anaesthetics &ill increase cerebral blood %lo&. TTTFT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is %ormed by secretion and %iltration o% "lasma DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. total volume is =00,#00 ml EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. leaves the =rd vetricles via the %oramen o% .agendie FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. glucose level is de"endent on "lasma glucose level ''''''''''''''''''''''''''''''''''''''''''''. has higher sodium level com"are to "lasma sodium TFFTF )))))))))))))))))))))))))))))))))))))))))))). in the red blood cells . as carbonic acid F &hich is bu%%ered ********************************************. in direct combination &ith reduced haemoglobin KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. as "hos"hate esters --------------------------------------------. combined &ith "lasma "rotein TTTFF ............................................. 4ain %ibres ;A,I and C,%ibres. are unmylinated 00000000000000000000000000000000000000000000. (he larger %ibres are more susce"tible to local anaesthetics 33333333333333333333333333333333333333333333. conduction involves sodium and chloride "ermeability 44444444444444444444444444444444444444444444. Conduction is %astest in mylinated %ibres 77777777777777777777777777777777777777777777. 8esting membrane "otential is 1?0 millivolts FFFTF 88888888888888888888888888888888888888888888. 2 molecule &ill yield =G molecules o% A(4. 99999999999999999999999999999999999999999999. (he Kreb5s cycle can o"erate %or a limited time anaerobically ((((((((((((((((((((((((((((((((((((((((((((. (he com"onents o% the Kreb5s cycle are su""lied entirely %rom carbohydrate metabolism

, #0 ,

++?.(he "roximal +=0.Com"ared &ith convoluted extracellular tubules %luid +=2.Cardiac +=+.(he F the intracellular blood muscle su""ly %luid di%%ers o%contains the %rom liver+==.@ith s!eletal a greater muscle concentration regard into that "ain it o% J "ath&ay J ::::::::::::::::::::::::::::::::::::::::::::. (he 87 is higher %or carbohydrates than %ats >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Aerobic glycolysis is a "rocess &hen "yruvate enters the citric acid cycle and "roduce C3+ and )+3 TFFFT @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. Absorb most o% &ater and salt o% the glomerular %iltrate AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. reabsorb all the glucose in the glomerular %iltrate BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. contain 6uxtaglomerular cell &hich secret renin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. are the main target cells %or antidiuretic hormone ;AD). AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. it is res"onsible %or reducing the volume o% glomerular %iltrate by G0$ TTFFT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. sodium ions CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. magnesium ions DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. "roteins EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. hydrogen ions FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. bicarbonate ions FTTTF '''''''''''''''''''''''''''''''''''''''''''''. re%ractory "eriod ))))))))))))))))))))))))))))))))))))))))))))). s"ontaneously . has intercalated disc *********************************************. can only contract isometrically KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. extraction ratio %or oxygen TTTFF ---------------------------------------------. re"resents 25$ o% the total cardiac out"ut .............................................. the "ortal vein oxygen saturation is normally G5 $ 000000000000000000000000000000000000000000000. sym"hatetic activation results in a decrease he"atic blood %lo& 333333333333333333333333333333333333333333333. the "ortal vein "ressure is normally #0 mm)g 444444444444444444444444444444444444444444444. E0 $ o% the he"atic blood %lo& in adults is derived %rom the he"atic artery FTTFF 777777777777777777777777777777777777777777777. %ree nerve endings are the rece"tors that res"onds to "ain stimuli 888888888888888888888888888888888888888888888. shar" "ain is conducted in the C %ibers rather than the A,delta %ibers has longer de"olarises

has a lo&er

, #2 ,

+=#.@ith regard to tyroid hormones+=5.@ith +=D.(he %ollo&ing regard to "hysiological haemostasis +=E.A%ter changes occur the %etus during is born "regnancy (FFF( 999999999999999999999999999999999999999999999. enters the s"inal cord via the anterior horn cell (((((((((((((((((((((((((((((((((((((((((((((. travels u" the cord in the i"silateral s"inothalamic tract :::::::::::::::::::::::::::::::::::::::::::::. enters the thalamus through the reticular %ormation TFFFT >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. it is controlled by thyrotro"ine releasing hormone @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. it increases activity o% iodin "um" in thyroid gland AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. it reduced number o% thyroid cells BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. it is "roduced by somatotro"ic cell CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is a glyco"rotein &ith molecular &eight about +G000 FTTFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Factor > is common to both the intrinsic and extrinsic coagulation "ath&ays BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Calcium ions is a %actor in blood coagulation CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. )e"arin inhibit "latelets aggregation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. E%%ects o% &ar%arin may be monitored using activated "artial thrombo"lastin time EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. As"irin im"air the action o% "latelets FTFFT FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. a decreased "latelet count ''''''''''''''''''''''''''''''''''''''''''''''. hy"ercoagula ble state )))))))))))))))))))))))))))))))))))))))))))))). an increased minute volume due to an increased res"iratory rate . a rise in renal threshold %or glucose **********************************************. inhibition o% %ibrinolysis TTFFT KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. its systemic vascular resistance rises ----------------------------------------------. its "ulmonary vascular resistance rises ............................................... there is reversal o% %lo& in the ductus arteriosus 0000000000000000000000000000000000000000000000. the o"ening bet&een the t&o ventricles closes 3333333333333333333333333333333333333333333333. the o"ening bet&een the t&o atrial closes TTFFT

, #+ ,

+=G. nsulin +=?.Countercurrent mechanism +#+..otility +#0. n the autonomic o% the gastrointestinal nervous systemF+#2.(he tract is increased anion by ga" 4444444444444444444444444444444444444444444444. release is increased by sul"honyl urea ty"e o% hy"oglycemic drugs 7777777777777777777777777777777777777777777777. has a hal% li%e o% %ive minutes in circulation 8888888888888888888888888888888888888888888888. increases the number o% glucose trans"orters in the cells 9999999999999999999999999999999999999999999999. secretion is reduced by surgical stress res"onse ((((((((((((((((((((((((((((((((((((((((((((((. is normally secreted at a rate o% about #0,50:/day TTTTT ::::::::::::::::::::::::::::::::::::::::::::::. in the descending -oo" o% henle &ater moves into the interstitium >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. thin ascending limb is "ermeable to 0a1 and urea @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. thic! ascending limb contains a higher concentration o% A(4 ase AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. -oo" o% henle is countercurrent exchanger BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. >asa rectae is countercurrent multi"lier TTTTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. the "arasym"athetic system is transmitted in cranial nerves and sacral %ibres %rom the s"inal cord AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. "ara sym"athetic e%%ects are identical to those o% acetylcholine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 0oradrenalin e is not metaboliHed by C3.( CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 0icotinic rece"tors are "resent in the "arasym"athetic and sym"athetic ganglion DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Do &n regulation o% rece"tors is seen in chronic heart %ailure TFFTT EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. s calculated %rom "lasma concentration o% sodiumF bicarbonate and "hos"hate FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. (he normal value is bet&een 25,2G me//l '''''''''''''''''''''''''''''''''''''''''''''''. s normal in renal tubular acidosis ))))))))))))))))))))))))))))))))))))))))))))))). )ig h in as"irin overdose . s decreased &hen "lasma albumin is decreased FFTTT ***********************************************. 9ym"athetic bloc! u" to (# KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. eased circulating adrenaline -----------------------------------------------. stimulation o% s"lanchnic nerves ncr

, #= ,

+#=.8egarding the bio,availability o% drugsJ+##.A com"etitive antagonist+#5.8egarding "ro"o%olJ+#D.Ketamine ................................................ "regnancy 00000000000000000000000000000000000000000000000. Anti cholinesterase drug TFFFT 33333333333333333333333333333333333333333333333. s indicated by area under the "lasma concentration , curve time 44444444444444444444444444444444444444444444444. s a number o% unchanged drug that reaches the systemic circulation. 77777777777777777777777777777777777777777777777. s reduced by destruction o% drug in the gut 88888888888888888888888888888888888888888888888. s reduced by metabolism o% drug in the liver 99999999999999999999999999999999999999999999999. s greater by sublingual route than enteral route TFTTT (((((((((((((((((((((((((((((((((((((((((((((((. can be dis"laced by agonist &ith higher concentration :::::::::::::::::::::::::::::::::::::::::::::::. com bines &ith the same rece"tor as the agonist drug >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. shi%t the log dose res"onse curve %or the agonist to the right @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. de"resses the maximum obtainable res"onse o% the agonist AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. &ill a%%ect the a%%inity o% the agonist %or its rece"tor TTTFF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. s &ater soluble CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. s bound to albumin u" to ?E,?G $ AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. s not contraindicated to "atients &ith egg allergies. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. s hy"ertonic CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Con6ugates in liver to inactive metabolites. FTTFT DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. es a %all in cardiac out"ut EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is a "otent bronchodilator FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. has active metabolites ''''''''''''''''''''''''''''''''''''''''''''''''. es "osto"erative dreaming and hallucinations &hich is less common in children )))))))))))))))))))))))))))))))))))))))))))))))). mar!ed analgesic "ro"erties mediated by its binding to 0.DA rece"tors FTTTT caus

caus has

, ## ,

+#E.8egarding .idaHolamJ+#G.0itrous oxide+#?.Concerning muscle relaxantsF+50.'lyco"yrrolate+52.Amiodarone . . cause more signi%icant reduction o% blood "ressure com"are to diaHe"am ************************************************. s &ater soluble at ") o% D KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. )as an active metabolite ------------------------------------------------. Erythromycin inhibits the midaHolam metabolism ................................................. Bioavailability %ollo&ing intramuscular in6ection is ?0 $ TFTTT 000000000000000000000000000000000000000000000000. is stored as li/uid 333333333333333333333333333333333333333333333333. is a gas above a tem"erature o% =D degree centigrade 444444444444444444444444444444444444444444444444.is %lammable 777777777777777777777777777777777777777777777777. cont ent in a cylinder is al&ays re%lected %rom its "ressure gauge 888888888888888888888888888888888888888888888888. is =# times less soluble than 0itrogen TTFTF 999999999999999999999999999999999999999999999999.8ocuronium is a steroidal com"ound ((((((((((((((((((((((((((((((((((((((((((((((((. .ivacurium is not suitable %or intravenous in%usion ::::::::::::::::::::::::::::::::::::::::::::::::. 8oc uronium is metaboliHed by "seudo,cholinesterase >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. >ec uronium has signi%icant vagolytic e%%ects @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. .ivacurium has a %aster onset than rocuronium TFFFF AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. can act at central cholinergic rece"tors BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. can increase the "hysiological dead s"ace CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. dilate the "u"il AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is e/ually e%%ective &hen given orally BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is %ive times more "otent as antisialogogue than atro"ine FTFFT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. "rolonge action "otential duration in 9A node DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. shor ten re"olarisation in A> node EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. causes "hotosensitivity FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. a%%ect thyroid %unction on long term treatment

, #5 ,

+5+.@ith regard to local anaestheticsJ+5=..etoclo"ramide+5#.@ith +55.Antihy"ertensive regards to non drugs steroidal actions anti,in%lammatory includeJ drugsJ '''''''''''''''''''''''''''''''''''''''''''''''''. s conduction velocity in )is,"ur!in6ae system TFTTT ))))))))))))))))))))))))))))))))))))))))))))))))). t acts by "reventing sodium access to the axon interior by occu"ying the transmembrane sodium channel . Bu"ivacaine carbonate com"ared to bu"ivacaine hydrochloride has a longer onset o% action and less intense bloc! *************************************************. (he shortest duration o% action o% local anaesthetics %ollo&s intrathecal in6ection KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. 4ril ocaine is more toxic to the cardiovascular and central nervous systems than lignocaine -------------------------------------------------. (he Cm o% lignocaine is less than o% bu"ivacaine TFTFF .................................................. Bloc!s central do"amine rece"tors 0000000000000000000000000000000000000000000000000. E%%e ctive in treatment o% o"ioid induced gastric stasis. 3333333333333333333333333333333333333333333333333. )as no extra"yramidal side e%%ect. 4444444444444444444444444444444444444444444444444. Does not cross into breast mil!. 7777777777777777777777777777777777777777777777777. s e%%ective in high intravenous doses %or the emesis o% chemothera"y. TFFFT 8888888888888888888888888888888888888888888888888. (hey are e%%ective analgesics even &ithout "resence o% in%lammation. 9999999999999999999999999999999999999999999999999. (hey inhibit cyclo, oxygenase. (((((((((((((((((((((((((((((((((((((((((((((((((. 50$ o% asthmatics are allergic to as"irin. :::::::::::::::::::::::::::::::::::::::::::::::::. % the e%%ect on "latelet %unction is to be avoidedF as"irin needs to be sto""ed at least + &ee!s be%ore surgery. >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. 8en al damage is a !no&n com"lication. FTFTT @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. Clonidine reduces the blood "ressure by its agonist activity on al"ha,2 adrenoce"tors. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Dilti aHem is an angiotensin converting enHyme inhibitor BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 0i%e di"ine acts as a calcium channel entry bloc!er CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 9odium nitro"russide causes metabolic acidosis &ith "rolonged in%usion. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. Chr onic cough is a !no&n side e%%ect o% angiotensin inhibitors. slo&

, #D ,

+5D.8ecognised method o% "rologing the action o% ligocaine includesJ+5E.4henytoin +D0..ivacurium +5G.Distribution +5?.8egarding sym"athomimetics volume is FFTTF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Addition o% adrenaline CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Carbonation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. :sin g a more concentrated solution EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. .ixing &ith dextran in saline FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. ncreasing the volume o% drug in6ected. TFTTT ''''''''''''''''''''''''''''''''''''''''''''''''''. is the drug o% choice %or com"lete heart bloc! )))))))))))))))))))))))))))))))))))))))))))))))))). is bro!en do&n chie%ly by cholinesterase . is use%ul in treatment o% arrhytmias associated &ith digitals **************************************************. increases diastolic de"olariHation KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. incr eases automaticity FFTFF --------------------------------------------------. large in drugs &ith high li"id solubility. ................................................... small in drugs &ith lo& "lasma "rotein binding. 00000000000000000000000000000000000000000000000000. larg e in drugs &ith high tissue binding. 33333333333333333333333333333333333333333333333333. im" ortant %or calculation o% loading dose. 44444444444444444444444444444444444444444444444444. hel"%ul in assessing the suitability %or hemodialysis. TFTTT 77777777777777777777777777777777777777777777777777. deri ved %rom beta,"henylethylamine 88888888888888888888888888888888888888888888888888. all contain catechol ring 99999999999999999999999999999999999999999999999999. do"amine is a naturally occuring catecholamines ((((((((((((((((((((((((((((((((((((((((((((((((((. adrenaline is the most "otent activator o% al"ha adrenergic rece"tor ::::::::::::::::::::::::::::::::::::::::::::::::::. nora drenaline causes bronchodilatation and is good %or asthmatic "atient TFTTF >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. is a de"olariHing muscle relaxant @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. can trigger malignant hy"erthermia

, #E ,

+D2.4ancuronium J+D+.(hio"entone J+D=.Fentanyl +D#.. @ar%arin J AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. duration o% action t&ice that o% succinylcholine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. hydrolyHed by "lasma cholinesterase CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. causes histamine release FFTTT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. not cross the "lacenta in clinically signi%icant amounts BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. es tachycardia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. es hy"otension DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. cause "rolonged "aralysis in "atient ta!ing stre"tomycin EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. causes dilatation o% the "u"il TTFTF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. at normal "lasma ")F is 50 , E5$ bound to "lasma "roteins '''''''''''''''''''''''''''''''''''''''''''''''''''. is a thiosubstituted succinylurea ))))))))))))))))))))))))))))))))))))))))))))))))))). in +.5$ solution it has a ") greater than 20 . a%ter redistribution it is ra"idly metabolised in the liver ***************************************************. its excretion is use%ully accelerated by a %orced al!aline diuresis TFTFF KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is a synthetic o"ioid ---------------------------------------------------. its analgesic "otency is 2000 times o% al%entanil .................................................... sedative e%%ect is more than "ethidine 000000000000000000000000000000000000000000000000000. "las ma clearance is less than mo"hine 333333333333333333333333333333333333333333333333333. dura tion o% action is about +0 minute TFFTT 444444444444444444444444444444444444444444444444444. is an antagonist o% >it K 777777777777777777777777777777777777777777777777777. com "etes &ith "henylbutaHone at "lasma binding sites 888888888888888888888888888888888888888888888888888. does not a%%ect already synthesiHed clotting %actors 999999999999999999999999999999999999999999999999999. is contraindicated in severe hy"ertension does caus caus may has is

, #G ,

+D5.8egarding drug administrationJ+DD.4lasma +DE. ntracellular %luid +D?.Drugs +DG.Coronary readily blood cross %lo& the blood,brain barrier (((((((((((((((((((((((((((((((((((((((((((((((((((. %ibrinolysis TTTTF :::::::::::::::::::::::::::::::::::::::::::::::::::. 9ubl ingual route avoids %irst,"ass inactivation in the liver >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. 9u" "ositories ex"ose the drug to %irst,"ass metabolism @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@. Distribution o% nebulised drug in the res"iratory tree de"ends on the "article siHe AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. )ig hly &ater soluble drugs are administered by transdermal route BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Dru gs given by oral route should have a very high extraction ratio TFTFF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. #$ o% total body &eight AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. "rinci"al "lasma cation is 0a1 2#0 mmol/BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. also contain %ructoseFgalactose and mannose CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. albu min is the most abundant "lasma "rotein DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. total "lasma "rotein ranging %rom +0 , #0 g/TTTTF EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. #0$ o% body &eight FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. volume is measured directly &ith mar!ers ''''''''''''''''''''''''''''''''''''''''''''''''''''. inorganic "hos"hate is the most im"ortant anion )))))))))))))))))))))))))))))))))))))))))))))))))))). K1 concentration is a""roximately 250 mmol/. its "ro"ortion varies little bet&een tissues TFTTF ****************************************************. is about 500 ml/min at rest KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. su""lies muscle that ta!es u" #0 ml oxygen "er minute at rest ----------------------------------------------------. is altered directly by vagal activity ..................................................... ceases in systole 0000000000000000000000000000000000000000000000000000. is auroregulated FTFFT 3333333333333333333333333333333333333333333333333333. BenHyl"enicillin "revent

, #? ,

+E0. n %irst,order !inetics +E2.Carbon dioxide trans"ort in blood +E+.Dantrolene +E=.4rimary haemostasis de"ends u"on 4444444444444444444444444444444444444444444444444444. )yoscine hydrobromide 7777777777777777777777777777777777777777777777777777. 'lyco"yrollate 8888888888888888888888888888888888888888888888888888. Atra curium 9999999999999999999999999999999999999999999999999999. 4ro"o%ol FTFFT

((((((((((((((((((((((((((((((((((((((((((((((((((((. A constant "ro"ortion o% drug metabolised in a given time "eriod ::::::::::::::::::::::::::::::::::::::::::::::::::::. (he absolute amount eliminated is greatest &hen "lasma concentration is greatest >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. (he enHyme res"onsible %or the reaction is saturated @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ (he rate o% elimination and elimination hal%,li%e is constantFirres"ective o% "lasma concentration AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. (he reaction is re"resented by a linear relationshi" TTTFF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Carbonic anhydrase is "resent in "lasma CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. +5$ o% carbon dioxide is dissolved AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 50$ is carried as bicarbonate BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. (ran s"ort o% carbon dioxide is %acilitated by deoxygenated haemoglobin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 9om e o% the carbon dioxide reacts &ith haemoglobin to %orm carbamino FFFTT DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. s use%ul &hen given intramuscularly EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Contains = g mannitol in each +0 mg vial o% Dantrium FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. (he dose %or treayment o% malignant hy"erthermia should not exceed 2 mg/!g in +# hours '''''''''''''''''''''''''''''''''''''''''''''''''''''. nteracts &ith vera"amil ))))))))))))))))))))))))))))))))))))))))))))))))))))). Causes hy"er!alaemia FTFTF . blood coagulation *****************************************************. "latelet aggregation and adhesiveness KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. vascular %actors -----------------------------------------------------. "rostaglandin release ...................................................... serotonin

, 50 ,

+E#.8elaxation o% the "regnant uterus is "roduced by +EG.(he +E5.Abnormal +EE.(he %ollo&ing action high o% non,de"olarising interactions "lasma "otassium are antagonistic muscle causes relaxant +ED.0itrous is "rolonged oxide by

FTTTF 00000000000000000000000000000000000000000000000000000. E"idural anaesthesia 33333333333333333333333333333333333333333333333333333. 0itrous oxide 44444444444444444444444444444444444444444444444444444. 8itodrine 77777777777777777777777777777777777777777777777777777. )alothane 88888888888888888888888888888888888888888888888888888. Am yl nitrate FFTTT

99999999999999999999999999999999999999999999999999999. : &aves on the electrocardiogram (((((((((((((((((((((((((((((((((((((((((((((((((((((. increased am"litude o% the 4 &aves :::::::::::::::::::::::::::::::::::::::::::::::::::::. "rolonged 789 com"lexes >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. ventricular %ibrillation @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ increased digitalis toxicity FFTTT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. does not combine &ith haemoglobin BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is not a trigger o% malignant hy"er"yrexia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. induces bone marro& a"lasia AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is "artially metabolised by intestinal bacteria BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. caus es di%%usion hy"oxia at the termination o% anaesthesia TTTTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 0al oxone and dextro"ro"oxy"he DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Acetylcysteine and "aracetamol EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Atenolol and salbutamol FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. 4rotamine and &ar%arin ''''''''''''''''''''''''''''''''''''''''''''''''''''''. (ranexamic acid and stre"to!inase TTTFT )))))))))))))))))))))))))))))))))))))))))))))))))))))). )y"onatraemia . )y"er!alaemia

, 52 ,

+E?..agnesium +G0.Cardiac e%%ects o% hy"othermia include +G2.8o"ivacaine +G+. n the normal "ulmonary circulation ******************************************************. )y"ermagnesaemia KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. -ithium ------------------------------------------------------. 'entamycin FFTTT ....................................................... 0ormal "lasma concentration is =,5 mmol/000000000000000000000000000000000000000000000000000000. ??$ in the body is intracellular 333333333333333333333333333333333333333333333333333333. @hen de%icient may cause muscle &ea!ness and dysrhythmias 444444444444444444444444444444444444444444444444444444. 4otentiates the action o% Ca+1 at the neuromuscular 6unction 777777777777777777777777777777777777777777777777777777. t reduces "eri"heral vascular tone FTTFT 888888888888888888888888888888888888888888888888888888. Bra dycardia 999999999999999999999999999999999999999999999999999999. >entricular %ibrillation ((((((((((((((((((((((((((((((((((((((((((((((((((((((. * &aves on the EC' ::::::::::::::::::::::::::::::::::::::::::::::::::::::. Atrial %ibrillation >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. 8educed cardiac out"ut in res"onse to reduced tissue oxygen TTTTF

@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ is an ester,lin!ed local anaesthetic AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is more li"id soluble than bu"ivacaine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has a duration o% action similar to lignocaine at e/ui"otent doses CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is a vasoconstrictor at clinical concentrations AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. has convulsions in toxic dose FFFTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. ca"i llary "ressure is about 20 mm)g CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. angi otensin is inactivated DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. 4'F+I causes vasoconstriction EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. the velocity o% blood in the root o% the "ulmonary artery is the same as that in the aorta FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. o% the %etusFabout 25$ o% the cardiac out"ut goes to the lungs TFTTT

, 5+ ,

+G=.Alveolar minute ventilation +GE.(he +G#.Acetylcholine +G5.Al"ha,adrenergic velocity o% acting im"ulse stimulation at muscarinic "ro"agation "roduces rece"tors along +GD. nerve n an %ibres uncom"ensated res"iratory al!alosis '''''''''''''''''''''''''''''''''''''''''''''''''''''''. is e/ual to total minute ventilation minus the dead s"ace ventilation ))))))))))))))))))))))))))))))))))))))))))))))))))))))). can be calculated %rom the alveolar air e/uation . is e/ual to tidal volume multi"lied by res"iratory rate *******************************************************. is about #.5 -/min at rest KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. varies &ith "osture TFFTT

-------------------------------------------------------. stimulates adrenaline secretion in the adrenal medulla ....................................................... causes vasodilatation 0000000000000000000000000000000000000000000000000000000. decreases bronchial tone 3333333333333333333333333333333333333333333333333333333. increases ureteric tone 4444444444444444444444444444444444444444444444444444444. has "re6unctional e%%ects at the neuromuscular 6unction FTFTT 7777777777777777777777777777777777777777777777777777777. vasodilation 8888888888888888888888888888888888888888888888888888888. tach ycardia 9999999999999999999999999999999999999999999999999999999. uterine relaxation in "regnancy (((((((((((((((((((((((((((((((((((((((((((((((((((((((. a "ositive inotro"ic e%%ect :::::::::::::::::::::::::::::::::::::::::::::::::::::::. intestinal relaxation FFFFT

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. "atient &ill be hy"oventilating @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ base excess exceeded 20 mmol/AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. arterial ") is E.D5 or above BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. concentration o% ionised calcium in the "lasma is decreased CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. tetany is a com"lication FFTTT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. increases &ith diameter in myelinated %ibres BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is inde"endent o% diameter in unmyelinated %ibres

, 5= ,

+GG. n the renal5s regulation o% &ater and sodium +?0.(he +G?.(he treatment stress res"onse o% bu"ivacaine to surgeryinduced includes cardiac +?2.0itric arrest oxide ;03< CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is altered in hy"o!alaemia DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is %astest in AI %ibres E0,2+0 ms,2 EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is de"end u"on local oxygenation TFFTT FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. the ascending limb o% loo" o% )enle is im"ermeable to &ater ''''''''''''''''''''''''''''''''''''''''''''''''''''''''. sodium reabsor"tion %rom the loo" o% )enle occurs "assively )))))))))))))))))))))))))))))))))))))))))))))))))))))))). under conditions o% maximum antidiuresisF 5$ o% &ater reabsor"tion occurs in the distal tubule . sodium excretion a%%ected by blood %lo& in the vasa recta ********************************************************. "rolonged thirst induces aldosterone "roduction TFFTT

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. ncreases in AC()F cortisol and gro&th hormone --------------------------------------------------------. ncr eased li"olysis ....................................................... 4rotein catabolism 00000000000000000000000000000000000000000000000000000000. ncreased glucagon secretion 33333333333333333333333333333333333333333333333333333333. 8educed insulin secretion TFTTT 44444444444444444444444444444444444444444444444444444444. 8a"id reversal o% hy"oxia and metabolic acidosis 77777777777777777777777777777777777777777777777777777777. 4rolonged cardio"ulmonary resuscitation 88888888888888888888888888888888888888888888888888888888. -ign ocaine %or the treatment o% ventricular tachycardia 99999999999999999999999999999999999999999999999999999999. Control o% convulsions to decrease hy"oxia and lactic acidosis ((((((((((((((((((((((((((((((((((((((((((((((((((((((((. Bret ylium %or the treatment o% cardiac arrhythmias TTFTT

::::::::::::::::::::::::::::::::::::::::::::::::::::::::. s the active ingredient o% glyceryl trinitrate >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. m"roves "latelet %unctions @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ s usually administered in doses o% 20,50 ""m AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 0itrous oxide ;0+3< is it5s by "roduct causing toxicity

, 5# ,

+?+..or"hine +?=.Atro"ine and hyoscine +?#.4henoxybenHamine +?5. so%lurane and en%lurane +?D.(hyroid hormones BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. .ethaemoglobinemia is one o% it5s adverse e%%ects TFTTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is a "henanthrene derivative AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is the anagesic o% choice in biliary and renal collic BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has an anticholinergic e%%ect CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. decreases intracranial "ressure DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is a good anticonvulsant TFTFF EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. incr ease the ris! o% regurgitation FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. are contraindicated intravenously in glaucoma '''''''''''''''''''''''''''''''''''''''''''''''''''''''''. cause mild neuromuscular bloc!ade in large doses ))))))))))))))))))))))))))))))))))))))))))))))))))))))))). are e/ui"otent as drying agents . "roduce con%usional states TFFFF

*********************************************************. bloc!s both I2, and I+,rece"tors KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is a non,com"etative antagonist ---------------------------------------------------------. caus es re%lex tachycardia ....................................................... reduces su"ine blood "ressure in normal sub6ects 000000000000000000000000000000000000000000000000000000000. cause sedation and %atigue TTTTT 333333333333333333333333333333333333333333333333333333333. they have similar boiling "oints 444444444444444444444444444444444444444444444444444444444. iso%lurane has the higher molecular &eight 777777777777777777777777777777777777777777777777777777777. they are both contraindicated in ane"hric "atients 888888888888888888888888888888888888888888888888888888888. adrenaline in%iltration is sa%e 999999999999999999999999999999999999999999999999999999999. both give measurable %luoride ion in the serum TFFTT (((((((((((((((((((((((((((((((((((((((((((((((((((((((((. oxine ;(#< is the most active natural com"ound thyr

, 55 ,

+?E.Etomidate +?G.Amiodarone +??.8egarding steroid thera"y =00. n the stomach

:::::::::::::::::::::::::::::::::::::::::::::::::::::::::. more than ??$ o% active hormone is "rotein,bound >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. their actions are mediated via rece"tors on the cell sur%ace @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ an increase in metabolic rate occurs &ithin minutes o% increased hormone activity AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. they increase the number o% cardiac I,adrenoce"tors FTFFT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has no muscle,relaxing "ro"erties CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. inhi bits adrenal steroidogenesis AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. increases the tone o% "haryngeal muscle BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. does not cause hy"otension on induction o% anaesthesia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. "roduces a lo& incidence o% allergic,ty"e reactions TTFFT DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is a class B anti,arrhythmic drug EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. does not cause clinically im"ortant myocardial de"ression FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is unli!ely to cause side,e%%ects i% trouble %ree %or the %irst = months o% treatment ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. "ulmonary toxicity is one o% its side e%%ect )))))))))))))))))))))))))))))))))))))))))))))))))))))))))). inter%eres &ith tests o% thyroid %unction FTFTT

. hydrocortisone re"lacement alone is su%%icient in Addison5s disease **********************************************************. dexamethasone is suitable %or re"lacement thera"y KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. methyl"rednisolone is a more "otent anti,in%lammatory agent than hydrocortisone ----------------------------------------------------------. "rol onged steroid thera"y may cause osteo"orosis ....................................................... cortisone does not cause %luid retention FFTTF 0000000000000000000000000000000000000000000000000000000000. there is a""roximately = litres o% gastric secretion "er day 3333333333333333333333333333333333333333333333333333333333. the "arasym"athetic innervation is %rom the coeliac "lexus 4444444444444444444444444444444444444444444444444444444444. gastric em"tying is controlled by "eriodic relaxations o% the "yloric s"hincter

, 5D ,

=02.(achy"hylaxis occurs during short,term treatment &ith =0+.4eri"heral chemorece"tors =0=.0aloxone =0#.(he central chemorece"tors 7777777777777777777777777777777777777777777777777777777777. cathecolamines inhibit secretion 8888888888888888888888888888888888888888888888888888888888. the contents are normally sterile TFFTT

9999999999999999999999999999999999999999999999999999999999. e"hedrine ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. trim eta"han ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. suxamethonium >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. noradrenaline @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ sodium nitro"russide TTTFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. "resent in the carotid bodies BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. "resent in the adrenal medulla CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. "res ent in the aortic arch AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. "resent in the right atrium BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. are su""lied by the glosso"haryngeal nerve TFTFT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is a I,rece"tor antagonist DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is an analogue o% mor"hine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is a res"iratory stimulant in normal man FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. reverses the analgesic e%%ects o% "lacebo '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. has a duration o% action o% one to %our hours TFFTT ))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). are more sensitive to changes in the chemical com"osition o% cerebros"inal %luid than o% blood . are directly in%luenced by changes in arterial oxygen content ***********************************************************. are located &ithin the res"iratory centre o% the medulla KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. res"ond directly to changes in ") rather than to changes in carbon dioxide tension -----------------------------------------------------------. are bathed directly by cerebros"inal %luid TFFTF

, 5E ,

=05.(hio"entone has a short duration o% action because =0E.Extracellular =0D.Drugs that cause %luid local =0G.9odium =0?.E"ile"ti%orm venous thrombo"hlebitis nitro"russide EE' activity are induced by

....................................................... it is metabolised by the liver 00000000000000000000000000000000000000000000000000000000000. it is redistributed to muscle 33333333333333333333333333333333333333333333333333333333333. it is s"eci%ically bound to the reticular activating system 44444444444444444444444444444444444444444444444444444444444. it is usually given by ra"id intravenous in6ection 77777777777777777777777777777777777777777777777777777777777. it induces tachy"hylaxis FTFTF 88888888888888888888888888888888888888888888888888888888888. methohexitone 99999999999999999999999999999999999999999999999999999999999. "ancuronium (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. thio "entone :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. etomidate >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. diaHe"am FFTTT

@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ contains sodium and chloride as the "redominant ions AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. has the same osmotic concentration as sea &ater BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. accounts %or about #5$ o% body &eight in a normal adult CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. incl udes the "lasma volume AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is a higher "ro"otion o% body &eight in in%ancy than in old age TFFTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. the intrao"erative dose range is 0.5,D mg/!g/min CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. metabolism to cynide occurs non,enHymetically in blood DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. metabolism "roduces thiocynate &hich is excreted in urine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. it "roduces dilation "redominantly o% resistance vessels FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. reduces renal blood %lo& FTTFF ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. en%lurane )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). midaHolam . methohexitone

, 5G ,

=20.4ulmonary sur%actant =2=.(he =22.(he binding actions o% o%non,de"olarising a drug to "lasma neuromuscular "roteins bloc!ing drugs =2+. n human nutrition ************************************************************. etomidate KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. iso%lurane TFTFF

------------------------------------------------------------. incr eases sur%ace tension di%%erentially in di%%erently siHed alveoli ....................................................... hel"s "revent "ulmonary oedema 000000000000000000000000000000000000000000000000000000000000. increases alveolar ciliary motion 333333333333333333333333333333333333333333333333333333333333. aids di%%usion %rom the alveolus to the "ulmonary ca"illary 444444444444444444444444444444444444444444444444444444444444. is "roduced by the ty"e alveolar cells FTFFT 777777777777777777777777777777777777777777777777777777777777. are "otentiated by anaesthetic va"ours 888888888888888888888888888888888888888888888888888888888888. &hen given in re"eated doses can be described as dual bloc! 999999999999999999999999999999999999999999999999999999999999. are "otentiated by intra"eritoneal tobramycin ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. are "otentiated in "atients &ith multi"le neuro%ibromatosis ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. are "otentiated in hy"o"roteinaemia TFTTT

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Basic energy re/uirement %or a E0 !g man is about G#00 !* ;+000 !cal< @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ carbohydrates are the most com"act energy source AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. the res"iratory /uotient ;87< decreases &hen %at is the main energy source being utilised BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. essential amino acids are those &hich "artici"ate in metabolic reactions CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. a high "rotein diet raises the metabolic reactions TFTFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. "rolongs its biological hal%,li%e BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is li!ely to be di%%erent in arterial and venous blood CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is only o% im"ortance to albumin DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. slo&s glomerular %iltration o% the drug EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. "rev ents renal tubular secretion o% the drug TTFTF

, 5? ,

=2#.@hen considering the u"ta!e o% a volatile anaesthetic agent =25.Amino"hylline =2D.Clonidine =2E. ntracranial =2G. "ressure n the is liver increased by FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. the rate o% u"ta!e is increased i% ventilation increases '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. induction is more ra"id i% cardiac out"ut decreases ))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). induction is less ra"id &ith less soluble agent . the e%%ect o% changing cardiac out"ut on the rate o% u"ta!e &ill be greater &ith a more soluble agent *************************************************************. the second,gas e%%ect allo&s the maintenance concentration o% TTFTF

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. is a methylxanthine -------------------------------------------------------------. inter acts &ith adenosine rece"tors ....................................................... is a central res"iratory de"ressant 0000000000000000000000000000000000000000000000000000000000000. increases cardiac contractility 3333333333333333333333333333333333333333333333333333333333333. causes generalised e"ile"ti%orm seiHures TTFTT 4444444444444444444444444444444444444444444444444444444444444.is a "artial agonist at I+,adrenoce"tors 7777777777777777777777777777777777777777777777777777777777777. cause hy"ertension i% in%used intravenously 8888888888888888888888888888888888888888888888888888888888888. is &ell absorbed &hen ta!en orally 9999999999999999999999999999999999999999999999999999999999999.anxiety is an im"ortant side,e%%ect (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. redu ces cardiac contractility TFTFF

:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. halothane >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. suxamethonium @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ mor"hine AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. nitroglycerine BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. etomidate TTFTF CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. oxy genated blood is delivered by branches o% the he"atic artery AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. total blood %lo& is hal% the cardiac out"ut

, D0 ,

=2?.8ecognised non,res"iratory %unctions o% the lung include =++.(he =+0.4ulmonary volumevascular o% distribution resistance o% a=+2.Frusemide drug BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. %lo& is %rom the "eri"hery o% the acini to the he"atic vein at the centre CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. "ortal venous "ressure is about 20 mm)g DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. adenosine is im"ortant in local regulation o% blood %lo& TFFTT EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. activation o% angiotensin FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. met abolism o% circulating adenine nucleotides ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. the synthesis o% circulating !alli!rein )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). the inactivation o% circulating brady!inin . the inactivation o% circulating adrenaline TTTTF

**************************************************************. is increased in chronic hy"oxia KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has a value a""roximately one,sixth that o% the systemic circulation --------------------------------------------------------------. can be measured using a %lo&,directed balloon catheter &ith a thermistor ti" ....................................................... is increased by iso"renaline 00000000000000000000000000000000000000000000000000000000000000. is decreased by 5,hydroxytry"tamine ;5,)(< TTTFF 33333333333333333333333333333333333333333333333333333333333333. has its "rimary site o% action in the loo" o% )enle 44444444444444444444444444444444444444444444444444444444444444. com monly causes hy"eruricaemia 77777777777777777777777777777777777777777777777777777777777777. enhances the excretion o% calcium 88888888888888888888888888888888888888888888888888888888888888. hy"onatraemic acidosis is the adverse e%%ect 99999999999999999999999999999999999999999999999999999999999999. redu ces the e%%icacy o% concurrently "rescribed lithium TTTFF

((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. re%ers to the "eri"heral com"artment o% the t&o,com"artment model ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. ma!es the assum"tion that there is a uni%orm concentration o% drug >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. is calculated using the measured concentration in the blood or "lasma @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ is a%%ected by di%%erential regional blood %lo& AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. &ill be relatively lo& i% hydro"hilic and extensively bound to "lasma "roteins

, D2 ,

=+=.(he sul"honylureas =+#. n the metabolism o% these drugs =+5.Dextran solutions =+E.@ith =+D.Concerning regard s!eletal to "harmaco!inetics muscle FTTTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. rarely cause hy"oglycaemia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. act mainly by increasing the secretion o% insulin AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. are highly "rotein,bound BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. are sa%e to use in chronic renal %ailure CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. are used as a diagnostic test in the inci"ient diabetic FTTFF DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. mor"hine %orms a con6ugated glucuronide EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. "enicillin is mainly hydrolysed FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. one o% the ma6or metabolic "roducts o% halothane is mono%luoroacetic acid '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. "ethidine metabolism re/uires catechol,o,methyltrans%erase ))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). cocaine is hydrolysed TFFFT

. inter%ere &ith subse/uent cross, matching ***************************************************************. have use%ul oxygen,carrying ca"acity KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. serious ana"hylactoid reactions is a com"lication ---------------------------------------------------------------. decrease the "lasma ionised calcium i% in%used ra"idly ....................................................... acute renal %ailure is a com"lication TFTFT 000000000000000000000000000000000000000000000000000000000000000. each %ibre has one motor end"late 333333333333333333333333333333333333333333333333333333333333333. the motor end"late is at the "roximal end o% the %ibre 444444444444444444444444444444444444444444444444444444444444444. de" olarisation causes electrical changes only in the muscle %ibre near the end"late 777777777777777777777777777777777777777777777777777777777777777. the resting "otential di%%erence at the end"late is +0m> less than the rest o% the muscle 888888888888888888888888888888888888888888888888888888888888888. each %ibre is no longer than 2 mm TFFFF 999999999999999999999999999999999999999999999999999999999999999. Hero order !inetics indicates metabolism at a constant rate A

, D+ ,

=+G.(he clearance o% the drugs =+?..inimum alveolar concentration ==0. so%lurane ==2.9odium dantrolene

(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. First order !inetics can change to Hero order !inetics :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. A three com"artment model is a %eature o% %at soluble drugs >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. Drugs &ith large volumes o% distribution have long hal%,lives @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ Com"artments re%er to anatomical structures TTTTF AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 8e"resents the removal o% a givenamount o% the drug in unit time BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. re"resents the rate o% elimination "er unit concentration in blood CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. e/uals the volume o% distribution multi"lied by the ha!l% li%e AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. e/uals the volume o% distribution multi"lied by constant BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is inversely "ro"ortional to the hal% li%e TFFTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is an index o% "otency o% intravenous anaesthetics DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is measured in volumes $ EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. can be determined by "robit analysis FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is a%%ected by age ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. is a correlate o% oil/&ater solubility FTFTF )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). has the same molecular &eight as en%lurane . i% "ut in a calibrated halothane va"oriHerF it &ill deliver a dangerously high concentration o% iso%lurane ****************************************************************. reduces the blood "ressureF mainly by de"ressing cardiac out"ut KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. has a .AC o% 2.DG$ ----------------------------------------------------------------. causes minimal changes in cerebral blood %lo& at light levels o% anaesthesia TFFFT

....................................................... is a neuromuscular bloc!er 0000000000000000000000000000000000000000000000000000000000000000. may cause dangerous rise in serum calcium 3333333333333333333333333333333333333333333333333333333333333333. can be used "reo"eratively to reduce suxamethonium "ains

, D= ,

==+.)alothane decreases the blood "ressure as a result o% ===.Bu"ivacaine ==#.-evobu"ivacaine ==5.8o"ivacaine 4444444444444444444444444444444444444444444444444444444444444444. is use%ul in the treatment o% malignant hy"er"yrexia 7777777777777777777777777777777777777777777777777777777777777777. is a s!eletal muscle relaxant FFTTT 8888888888888888888888888888888888888888888888888888888888888888. direct myocardial de"ression 9999999999999999999999999999999999999999999999999999999999999999. "eri "heral vasodilatation ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. a central action on the vasomotor centre ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. ganglion bloc!ade >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. barorece"tor inhibition TTTTT

@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ "roduces de"olarisation in the neural membrane o% "eri"heral nerves AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is detoxi%ied in the liver BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. is an ester CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. can cause methaemoglobinemia AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. =0 ml o% 0.5$ is recommended dose in a E5!g man TTTTT BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. has an e%%icacy e/uivalent to bu"ivacaine %or both anaesthesia and analgesia CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. has enhanced sa%ety "ro%ile com"ared to bu"ivacaine DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. Chirocaine is an exam"le o% levobu"ivacaine EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Consists only o% the 9;,< enantiomer o% bu"ivacaine FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Excr eted mainly by the !idney TTTTT '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. is a racemic mixture ))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). is less cardiotoxic than bu"ivacaine . is more "otent than bu"ivacaine *****************************************************************. has the same "Ka as bu"ivacaine KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. "oduces greater motor bloc! than bu"ivacaine FTFTF

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==D.Ketamine hydrochloride ==E.BenHodiaHe"ines

==G.4ro"o%ol =#0.4hysiological ==?.-ung sur%actant dead s"ace

-----------------------------------------------------------------. is an arylcycloal!ylamine ....................................................... increases "ulmonary vascular resistance 00000000000000000000000000000000000000000000000000000000000000000. increases myocardial contractility in vivo 33333333333333333333333333333333333333333333333333333333333333333. has bronchodilatory "ro"erties 44444444444444444444444444444444444444444444444444444444444444444. incr eases tone in s!eletal muscles TFTTT 77777777777777777777777777777777777777777777777777777777777777777. are extensively excreted in the urine 88888888888888888888888888888888888888888888888888888888888888888. are highly "rotein bound 99999999999999999999999999999999999999999999999999999999999999999. &he n used chronicallyF induce he"atic microsomal enHymes (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. are antalgesic :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. cross the "lacenta FTFFT

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. is "resented in 20$ soya nean oil @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ decreases blood "ressure mainly by vasodilatation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. is bro!en do&n by "lasma cholinesterase BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. #,5 mg/!g is the standard induction dose in healthy adults CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. s more res"iratory de"ressant than thio"entone TTFFT AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. decreases com"liance BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. increases sur%ace tension CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. is released %rom the "ulmonary circulation DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. is made o% molecules that are "artly li"o"hilic and "artly hydro"hilic EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is "roduced in ty"e "neumocytes FFFTF FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. chan ges &ith "osture ''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. decreases &ith exercise

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=#2.Closing ca"acityJ =#+.During /uiet ins"iration =##.(he =#=.(he "hysiological "ulmonary circulation res"onse to haemorrhagic shoc! consists o% )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). includes anatomical dead s"ace . is res"onsible %or the di%%erence bet&een mixed ex"ired gas and alveolar gas ******************************************************************. is di%%usion de"endent TFTTF

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. ncreases &ith age ------------------------------------------------------------------. s measured using the single breath nitrogen &ashout techni/ue ....................................................... Decreases &ith obesity 000000000000000000000000000000000000000000000000000000000000000000. s smaller than closing volume 333333333333333333333333333333333333333333333333333333333333333333. Encroaches on tidal breathing at a mean age o% DD in su"ine sub6ects TTFFF 444444444444444444444444444444444444444444444444444444444444444444. Alv eolar volume increases by =0$ 777777777777777777777777777777777777777777777777777777777777777777. Abdominal muscle are active 888888888888888888888888888888888888888888888888888888888888888888. 9acros"inalis muscles are active 999999999999999999999999999999999999999999999999999999999999999999. ntra thoracic "ressure decreases by a %e& mm)g ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. (he ribcage does not move TFFFF

::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. Contains =0$ o% the blood volume >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. 4ulmonary vascular resistance increases &ith hy"oxia @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ 4ulmonary vascular resistance is mar!edly less than systemic vascular resistance AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 4ulmonary artery "ressure is +5/? mm)g BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 4ulmonary artery "ressure increases &ith exercise FTTTT CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. ncreased sym"athetic activity AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. 4roduction o% renin BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. ncreased "roduction o% erythro"oietin CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. ncreased barorece"tor activity DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD. ncreased chemorece"tor activity

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=#5.(he %ollo&ing =#D.(he oxy,haemoglobin ions have dissociation a higher intracellular curve =#?.(he =#E.8egarding thanaextracellular &ave"ressures o% the concentrationJ central during venous res"iratory =#G.>ariations "ressure cycle &ave%ormJ J in coronary blood %lo&

TTTFT EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. in healthy adults has a 450 value o% =.#!4a FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is moved to the le%t by a %all in ") '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''. is move to the right by a %all in tem"erature ))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))). in the %etus has a lo&er "50 than in adult . is moved to the right by an increase in th +F= D4' concentration in 8BC TFFTT

*******************************************************************. 9odium KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK. Calcium -------------------------------------------------------------------. 4otassium ....................................................... Chloride 0000000000000000000000000000000000000000000000000000000000000000000. Bicarbonate FFTFF 3333333333333333333333333333333333333333333333333333333333333333333. Alveolar "ressre rises to allo& ins"iratory %lo& to occur 4444444444444444444444444444444444444444444444444444444444444444444. ntra "leural "ressure is ,5cm )+3 be%ore ins"iration begins 7777777777777777777777777777777777777777777777777777777777777777777. Alveolar "ressure is "ositive during ex"iration 8888888888888888888888888888888888888888888888888888888888888888888. Fall in intra"leural "ressure during ins"iration is due to a %all in the elastic recoil 9999999999999999999999999999999999999999999999999999999999999999999. @it h %orced ex"irationF the intra"leural "ressure exceeds Hero. FTTFT

(((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. the heart extracts u" to ?5$ o% the oxygen %rom each unit o% blood delivered to it :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::. oxygen consum"tion can be increased signi%icantly only by increasing blood %lo& >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>. autoregulation is &ell develo"ed in the heart @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ the al"ha,adrenegic rece"tors o% the coronary arterioles mediate vasoconstriction AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. stimulation o% vagal %ibres to the heart constricts the coronaries FTTTF BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. s caused by atrial contraction

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=50.>agal stimulation "roducesJ =52.Alveolar, arterial oxygen di%%erence ; A,a D3+ < =5=.8egarding =5+.-ung com"liance the carotid bodies J

CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. s not seen in atrial %ibrillation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA s caused by atrial %illing during ventricular contraction BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Decreases &ith ins"iration CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. s %ollo&ed by the v &ave TTFFF

DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD %all in heart rate EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. decrease. in atrial contractility FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. An increase in ventricular contractility '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 9lo&ing o% A,> conduction )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))) A %all in stro!e volume TFFTF

. is normally 25,+5 mm)g &hile breathing room air ********************************************************************. is increased under anaesthesia due to increased ventilation/ "er%usion mismatch KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK is decreased in one lung ventilation --------------------------------------------------------------------. is increased in the "resence o% right to le%t intracardiac shunts ....................................................... is decreased in excessive exercise TTFTF

00000000000000000000000000000000000000000000000000000000000000000000 is normally 0.+ -/ cm )+3 33333333333333333333333333333333333333333333333333333333333333333333 reduces &ith loss o% "ulmonary sur%actant 44444444444444444444444444444444444444444444444444444444444444444444. is increased in em"hysema 77777777777777777777777777777777777777777777777777777777777777777777 increases a%ter induction o% general anaesthesia 88888888888888888888888888888888888888888888888888888888888888888888. is di%%erent at a"ical and basal o% the lungs TFTFT

99999999999999999999999999999999999999999999999999999999999999999999. )ave cells &hich res"onds to increase in arterial 4). ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. )ave the highest blood %lo& ; ml/ unit &eight < in the body :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 9timulate maximally the res"iratory drive &hen 4a3+ =5,E0 mm)g

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=5#. n an a&a!e u"right s"ontaneously breathing "atient =5E.(he =55.8egarding =5D. n normal res"iratory healthy coronary center man blood in at the rest %lo& brain in the stem su"ine receives "osition in"ut %rom

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> tLs discharge is increased by anaemia @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ (he a%%erent nerve is via glosso"haryngeal nerve. FTTFT

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA ventilation "er unit lung volume is smallest at the a"ex o% the lungs. BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB basal alveoli are bigger than a"ical alveoli CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. basal alveoli ex"and more than a"ical alveoli during ins"iration AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA "leural "ressure is less negative at the base o% lungs BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. last "art o% the ex"ired air comes %rom the a"ical alveoli. TFTTT

CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. 9ubendocardium is more vulnerable to ischaemia than e"icardium DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD Adenosine is a coronary vasodilator. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. .yocardial oxygen consum"tion and coronary blood %lo& bear a linear relationshi" FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Coronary blood %lo& &ill be im"roved by slo&ing the heart rate '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' 0ormal myocardial oxygen extraction ratio is E0 $. TTTTT

)))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))) le%t ventricular end diastolic volume is about +0 mls. . the %irst heart sound coincides &ith the onset o% ventricular systole *********************************************************************. cardiac out"ut is a""roximately E5mls/beat KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK le%t ventricular end diastolic "ressure ; ->ED4 < is about 5 mm)g ---------------------------------------------------------------------. the second heart sound coincides &ith end o% ( &ave o% EC' FTTTT

....................................................... (he aortic and carotid bodies 00000000000000000000000000000000000000000000000000000000000000000000 .echanorece"tors o% the larynxs 33333333333333333333333333333333333333333333333333333333333333333333 3xygen,sensitive chemorece"tors in the medulla 444444444444444444444444444444444444444444444444444444444444444444444. Bronchiolar strech rece"tors via sym"athetic stimulations 77777777777777777777777777777777777777777777777777777777777777777777 8ece"tors &hich res"ond to the hydrogen ion concentration in the C9F

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=5G.3xygen =D2.(he velocity is trans"ort o% conduction %rom the o%alveoli a nerve into action the "otential blood in "ulmonary =D+.4ulse "ressure ca"illaries increases by =D0. =5?.&ith n cell the an conducting metabolism increase insystem o% the heart TTFFT

888888888888888888888888888888888888888888888888888888888888888888888. Filtration 999999999999999999999999999999999999999999999999999999999999999999999. 4assive di%%usion (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. Facilitated di%%usion :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: Active trans"ort >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> 9econdary active trans"ort FTFFF

@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ (he 9A node develo"s %rom the structures on the right side o% the embryo AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 9ym"athetic innervation o% the right side su""ly to the A> node BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Atrial conduction is slo&ed by a decrease in tem"erature CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. (he 48 interval re"resents the duration o% atrial de"olariHation AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA (he action "otential in 9A and A> nodes are largely due to 0a1 TFTFF

BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. 2 molecule &ill yield =G molecules o% A(4. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. (he Kreb5s cycle can o"erate %or a limited time anaerobically DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD (he com"onents o% the Kreb5s cycle are su""lied entirely %rom carbohydrate metabolism EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. (he 87 is higher %or carbohydrates than %ats because extra oxygen is needed to burn carbohidrates FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Aerobic glycolysis is a "rocess &hen "yruvate enters the citric acid cycle and "roduce C3+ and )+3 TFFFT

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' s highest in "reganglionic autonomic nerve %ibres )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))) AI has a higher conduction velocity than AI . s %aster in unmyelinated %ibres than the myelinated one **********************************************************************. s inversely related to the cross,sectional area o% the axon KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK is decreased by cooling the nerve FTFFT ----------------------------------------------------------------------. 9tro!e volume

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=D=. n Cardiac cycle =D#. n the autonomic nervous systemF =DD.(he =D5.8egarding normal the Electrocardiogram neuromuscular 6unctionJ

....................................................... Blood viscosity 00000000000000000000000000000000000000000000000000000000000000000000 9ystemic vascular resistance 33333333333333333333333333333333333333333333333333333333333333333333 Arterial "artial "ressure o% oxygen 4444444444444444444444444444444444444444444444444444444444444444444444. -e%t ventricular end,diastolic volume TFFFT

77777777777777777777777777777777777777777777777777777777777777777777 .itral valve closure occurs be%ore tricus"id valve closure 8888888888888888888888888888888888888888888888888888888888888888888888. Carotid "ressure is highest at the start o% ventricular systole 9999999999999999999999999999999999999999999999999999999999999999999999. -e%t ventricular volume is lo&est &hen mitral valve o"ens ((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. Atrial contraction is o% more im"ortance to ventricular %illing i% heart rate increase :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: -ate in diastoleF the mitral and tricus"id valves are closed &hile the aortic and "ulmonary valves are o"en TFTTF

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> the "arasym"athetic system is transmitted in cranial nerves and sacral %ibres %rom the s"inal cord @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ "arasym"athetic e%%ects are identical to those o% acetylcholine AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 0oradrenaline is not metaboliHed by C3.( BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 0icotinic rece"tors are "resent in the "arasym"athetic and sym"athetic ganglion CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Do&n regulation o% rece"tors is seen in chronic heart %ailure TFFTT

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA (he syna"tic cle%t is about 50,E0 nm &ide BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. (he "ost6unctional membrane is thro&n into %olds CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Acetylcholine rece"tor has %ive "rotein subunits DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD (&o al"ha subunits o% acetylcholine rece"tor have to be activated %or the channel to o"en EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. Acetylcholine is synthesiHed %rom choline and acetic acid TTTTF

FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. Can give good in%ormation regarding myocardial contractility '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' (he electrodes are silver/silver chloride electrode )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))) C.5 is a modi%ication o% lead >5

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=DE.(he "ath&ays o% "ain sensation include =E0.(he =DG.8egarding %ollo&ing drug statements administration aboutJ drug =D?.First,order hal%,li%e are "rocesses correct J . Bet&een the ( &ave and the next 4 &aveF the myocardial "otential is Hero ***********************************************************************. 8e"olarisation ta!es "lace in the o""osite direction as de"olarisation FTTFT

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK a,delta %ibres &hich terminate in lamina 2 o% the dorsal horn -----------------------------------------------------------------------. second order neurons &hich ascend in the i"silateral s"inothalamic tra ....................................................... c %ibres &hich release histamine and serotonin 00000000000000000000000000000000000000000000000000000000000000000000 syna"ses in the substantia nigra o% the s"inal cord 33333333333333333333333333333333333333333333333333333333333333333333 descending "ath&ays in the dorsolateral colums TFFFT

44444444444444444444444444444444444444444444444444444444444444444444444. 9ublingual route avoids %irst,"ass inactivation in the liver 77777777777777777777777777777777777777777777777777777777777777777777 9u""ositories ex"ose the drug to %irst,"ass metabolism 88888888888888888888888888888888888888888888888888888888888888888888888. Distribution o% nebulised drug in the res"iratory tree de"ends on the "article siHe 99999999999999999999999999999999999999999999999999999999999999999999999. )ighly &ater soluble drugs are administered by transdermal route (((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. Drugs given by oral route should have a very high exraction ratio TFTFF

:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: a""ly to enHyme, mediated reactions >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> are characteriHed by high rates o% reaction &hen the concentrations o% reacting substances are high. @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ can "ro"erly be described in terms o% t2/+ AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA are involved in elimination o% most drugs BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB change to Hero,order !inetic at very high drug doses TTFTT

CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. )al%,li%e o% a drug is shorter than its time constant AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA Drug given by in%usion &ithout a bolus reach a steady state in %ive hal%,lives BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB. Extent o% drug distribution into extracellular %luid is unli!ely to a%%ect t2/+. CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC. Context sensitive hal%,li%e can be use %or any drug DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD About ?#$ o% a drug is cleared o% the body in %our hal%,lives

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=E2.0itrous oxide =E+.8egarding o"ioid rece"tors J =E=.4ethidine =E#.8ocuronium =E5.A drug that is strongly "rotein,boundJ TTFFT

EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE. is stored as li/uid FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF. is a gas above a tem"erature o% =D degree centigrade '''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''' cylinders should have %illing ratio o% 0.D5,0.E5 )))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))) content in a cylinder is al&ays re%lected %rom its "ressure gauge . is =# times less soluble than 0+. TTTTF

************************************************************************. .or"hine acts on !a""a rece"tors KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK (he e%%ect o% stimulation o% sigma rece"tors is dys"horia and hallucination ------------------------------------------------------------------------. Eu"horia is due to stimulation o% delta rece"tors ....................................................... 0alor"hine antagoniHes !a""a rece"tors 00000000000000000000000000000000000000000000000000000000000000000000 4entaHocine is "artial agonist TTFFT

33333333333333333333333333333333333333333333333333333333333333333333 is structurally related to mor"hine 444444444444444444444444444444444444444444444444444444444444444444444444. onset o% analgesic activity a%ter intramuscular in6ection is =5 minutes 77777777777777777777777777777777777777777777777777777777777777777777 in e/uianalgesic dosesF "ethidine and mor"hine "roduce e/ual amount o% sedation 888888888888888888888888888888888888888888888888888888888888888888888888. res"iratory de"ression caused by it can be antagoniHed by nalor"hine 999999999999999999999999999999999999999999999999999999999999999999999999. about D0$ is bound to "lasma "roteins TFFTF

((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((((. is an aminostereroid :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: is stable in a/ueous solution >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> undergoes "rinci"ally he"atic elimination @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ has "rovide intubating conditions &ithin D0 seconds AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA t release histamine TTTTF

BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB &ill be metabolised ra"idly

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