multiple choice questions

MCQs
The MCQ section in Anaesthesia and intensive care medicine is designed to
test your knowledge of selected topics in this issue of the journal. The correct
answers are given at the foot of the page.
Henry G W Paw is Consultant in Anaesthesia and Intensive Care at York Hospital, and
Clinical Senior Lecturer at the Hull York Medical School, UK.

Vijayanand Nadella is SHO in Anaesthesia at York Hospital.

Questions

1 Applied anatomy for upper limb nerve blocks 4 Local anaesthetic agents
(pages 144–147) (pages 159–162)
Regarding the brachial plexus: Regarding the properties and uses of local anaesthetics:
A T
 he trunks of the brachial plexus lie in the A S
 peed of onset of the local anaesthetic block depends
anterior triangle of the neck on the dissociation constant (pKa) of the agent
B Injury to the roots of brachial plexus results in B P
 rocaine is the recommended drug for intravenous
Horner’s syndrome regional anaesthesia
C M
 usculocutaneous nerve is a continuation of the C E
 ster local anaesthetics undergo rapid hydrolysis by
medial cord plasma pseudocholinesterases
D T
 he interscalene approach of brachial plexus block D Lidocaine is classified as a class 1a anti-arrhythmic agent
is less effective for hand surgery E C
 ocaine acts directly on synaptic transmission by
E In the wrist, the median nerve lies to the ulnar blocking catecholamine reuptake
side of flexor carpi radialis
5 Local anaesthetic agents
2 The nerves of the leg and foot (pages 159–162)
(pages 148–150) Regarding the properties of local anaesthetics:
Regarding the applied anatomy of nerves of lower limb:
A C
 ocaine undergoes significant metabolism by ester
A T
 ibial nerve is one of the terminal branches of hydrolysis
femoral nerve B P
 otency of local anaesthetic agents is quantified as
B Injury to the common peroneal nerve at the neck octanol partition coefficient
of the fibula results in foot drop C A
 cidic environment of an abscess decreases the
C S
 aphenous nerve is the only nerve below the knee non- ionized proportion of local anaesthetic
not derived from the sciatic nerve D A
 t lower concentrations, the block produced by
D S
 ural nerve supplies the postero-medial part of the ropivacaine may be motor sparing
lower third of the calf E L
 evobupivacaine is the r-enantiomer of racemic
E T
 he deep peroneal nerve supplies a small patch of bupivacaine
skin on the dorsum of the hallux and the second toe
6 Cell biology and gene expression
3 Systemic toxic effects of local anaesthetics (pages 163–167)
(pages 155–158) Regarding the physiology of a cell:
Regarding the toxicity of local anaesthetics:
A In muscle cells, the endoplasmic reticulum is
A Hypothermia is a feature of cocaine toxicity important for the storage of calcium ions
B T
 he enzyme carnitine acylcarnitine translocase B T
 he process of DNA transcription is carried out by the
may be a target to impact on cardiac toxicity enzyme RNA polymerase
C M
 ethylene blue 1–2 mg/kg intravenously is used C O
 xidative phosphorylation takes place in the
to treat methaemoglobinaemia mitochondrial matrix
D P
 rilocaine toxicity is the result of extensive D R
 egulation of gene expression occurs at the level of
pulmonary uptake translation
E T
 he risk of local anaesthetic toxicity is increased E In an RNA strand, introns are the sequences of
by hypercarbia nucleotides that have no useful information

Correct answers: 1    (B, D, E)   2    (B, C, E)   3    (B, C, E)   4    (A, C, E)   5    (B, C, D)   6    (A, B, E)

Anaesthesia and intensive care medicine 8:4 168 © 2007 Published by Elsevier Ltd.