Anesthesia
Anesthesia
b) Procaine
c) Prilocaine
d) Bupivacaine
e) Tetracaine
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2. TRUE statement regarding inhalational
anesthesia is/ are?
a) Sevoflurane is the agent of choice for children and asthma
patients
b) Sevoflurane should not be used where the gas flow rate is less
than 2 L/min
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3. If you are asked to collect 4 serial samples
from lumbar puncture. What should be
done with first sample?
a) Cell counts like differential counts
Correct Answer - A
Ans. is'a'i.e., Cell counts like differential counts
Ref: https://emedicine.medscape.com/article/80773-technique
The classic approach is to send the 4 CSF tubes for the
following studies:
1. Tube I - Cell count and differential
2. Tube 2 - Glucose and protein levels
3. Tube 3 - Gram stain, culture and sensitivity (C&S)
4. Tube 4 - Cell count and differential
4. True regarding local anesthatics is/are?
a) Prilocaine is longer acting then bupivacaine
b) Ketamine
c) Pancuronium
d) Succinylcholine
e) Desflurane
b) Mephenteramine
c) Adrenaline
d) Dopamine
e) Steroids
c) Thyromental distance
d) Teeth arrangement
e) None
b) Diclofenac
c) Morphine
d) Clonidine
e) Buprenorphine
Correct Answer - B
Ans. B. Chest compression at least 5 cm/2 inch
Basic life support (BLS), advanced cardiovascular life support
(ACLS), and post-cardiac arrest care all describe a set of skills and
knowledge applied sequentially during the treatment of patients who
have a cardiac arrest.
ACLS comprises the level of care between BLS and post-cardiac
arrest care
Update recommendations for advanced cardiac life support
2015:
The combined use vasopressin and epinephrine offers no advantage
to using standard-dose epinephrine in cardiac arrest.
Vasopressin has been removed from the Adult Cardiac Arrest
Algorithm-2015 update.
Advanced Cardiac Life Support:
Continuous chest compressions at a rate of lil)/rnin to 120/min,
vnthout pauses for ventilation. The provider delivering ventilation
should provide 1 breath every 6 seconds (10 breaths per minute).
It may be reasonable to avoid and immediate$r correct hypotension
(SBp < 90 mm Hg, MAp < 65 mmHg) during post-cardiac arrest
care.
13. Anaesthetic agents(s) having
epileptogenic potential:
a) Atracurium
b) Etomidate
c) Enflurane
d) Pethidine
e) Propofol
b) Cheap
d) Inert
e) Stable
b) Pressure gradient
c) Length of tube
d) Radius of tube
e) Density of gas
b) Helium
c) CO2
d) Cyclopropane
e) Nitrous oxide
e) Distance from the upper border of the sacral hiatus to the dural
sac is 30±10.4mm
b) Thiopentone
c) Ketamine
d) Diazepam
e) Etomidate
b) Hoffman degradation
c) Pseudocholineaterase
d) Methylation
e) None
Correct Answer - B
Ans. B. Hoffman degradation
The unique feature of atracurium is inactivation in plasma by
spontaneous non enzymatic degradation (Hofmann elimination).
Consequently its duration of action is not altered in patients with
hepatic/renal insufficiency or hyperdynamic circulation ---> Hence,
preferred muscle relaxant for such patients as well as for neonates
and the elderly.
Atracurtum is metabolised to laudanosine that is responsible for
seizures.
Cause histamine release > Hypotension, bronchoconstriction &
flushing.
20. Ventilator associated complication(s)
is/are ?
a) Barotrauma
b) Subglottic stenosis
c) Pneumoperitoneum
d) Paralytic ileus
b) Clonidine
c) Steroids
d) Blood
e) Caffeine
c) To produce amnesia
e) Prevent vomiting
b) Spinal anaesthesia
d) Conscious sedation
e) Surface anaesthesia
d) Rib fracture
e) Hemothorax
b) Atropine
c) Fentanyl
d) Thopentone
e) Etomidate
b) Succinylcholine
c) Pancuronium
d) Fentanyl
e) Propofol
b) Seizure
c) Masseter spasm
d) Metabolic acidosis
e) Hypokalemia
b) Bretylium
c) Intralipids
d) Esmolol
e) Epinephrine
b) Thiopentone
c) Ketamine
d) Diazepam
e) Midazolam
b) Gender
c) Weight
d) Height
Correct Answer - D
Ans. D. Sodium bicarbonate is given to correct alkalosis
Malignant Hyperthermia:
Due to abnormality of type I Ryanodine receptor which is calcium
release channel of sarcoplasmic reticulum.
Genetic disease usually autosomal dominant but can be recessive
also.
Patient with normal CK levels should undergo muscle biopsy studies
(where muscle is subjected to triggering factors (like halothane &
suxamethonium).
Treatment of MH:
Dantrolene -
Mainstay of therapy of MH.
Directly binds to Ryanodine receptor inhibiting calcium release
35. Which of the following is/are true about
pre-anaesthetic checkup (PAC):
a) Not necessary in children
d) 0.45% saline contains 154 mEq/L Na+ & 154 mEq/L Ci?
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37. Which of the following is/are true
regarding anaesthetic gas:
a) N20- increases efficacy of other inhalational agents
e) None
e) None
Correct Answer - D
Ans. D. Hypotension is most common side-effect
[Ref Ajay Yailav 5th/155-61; Lee 13th/479; Oxford Handbook of
Anesthesia 3rd/832]
Subarachnoid block:
Most commonly used anaesthetic technique
Adult level is usually L3-4
Indications:
Orthopaedics surgery general surgery (pelvic & perineal),
gynecological & obstetrical surgery' urological surgeries etc.,
Most commonly drugs used in India are- xylocaine (lignocaine) &
Sensoricaine (bupivacaine)
Hypotension is most common side-effect:
Managed by preloading & intraoperative fluids vasopressors. For
this good i.V access is very imPortant.
40. Indication of CVP line is/are:
a) CVP monitoring in shock patient
b) Ropacuronium
c) Vecuronium
d) Atracurium
e) Piperacurium
Correct Answer - D
Ans. D. Atracurium
[Ref: Ajay Yadav 5th/116-17; Lee 13th/189-95]
Atracurium undergo spontaneous degradation in plasma called as
Hoffman degradation.
Atracurium is relaxant of choice if reversal agent is contraindicated.
Other muscle relaxants:
(mentioned in question) require reversal with neostigmine (but Ne
can not use neostigmine due to hypersensitivity), so can not use in
this patient
42. Which of the following condition (s) can
cause exaggerated hyperkalemia in
patients with use of succinylcholine:
a) Burn
c) Muscular dystrophy
d) Tetanus
b) Desflurane
c) Mannitol
d) Sevoflurane
e) Propofol
b) GABA-B receptor
c) NMDA receptor
e) None
Correct Answer - E
Ans. E. In regional block i.v injection is used
[Ref, Ajay Yadav 5th/138-140, 149; Lee 13th/369-374]
MOA:
The key target of local anesthetics is the voltage-gated sodium
channel.
The binding is intracellular and is mediated by hydrophobic
interactions.
Local anesthetics block voltage-gated sodium channels and interrupt
initiation and propagation of impulses in axons.
Local anesthetics reversibly inhibit peripheral nerve conduction by
blocking voltage gated sodium & potassium channel .
The affinity of the sodium receptor is higher in open or inactivated
states than in the resting state.
Blockade sequence is-sympathetic> temperature (cold)> pain (prick)
>proprioception (Light touch with cotton).
46. All are true regarding Laryngeal Mask
Airway except:
a) Big oral tumor is contraindication for its use
e) None
Correct Answer - E
Ans. (E) NONE
[Ref Ajay Yadav 5th/42-43; Lee Anaesthesia 13th/206-08; Morgo4
Anesthesia 4th/97; Dorsch Dorsch anesthesia equipment 5th/488;
Miller\ anesthesia 6th/ I 6 27]
Advanced cardiac life support (Part of CPR):
For breathing- Advanced method like endotracheal tube, LMA,
combitube or tracheostomy tube.
Laryngeal Mask Airway (LMA):
As an alternative to intubation where difficult intubation is anticipated
An elective method for minor surgeries where anesthetist wants to
avoid intubation (Like eye surgery in children).
Contraindication: oropharyngeal mass.
LMA provides an alternative to ventilation through a face mask or
endotracheal tube (ETT).
LMA has proven particularly helpful as a temporary measure if
patients with difficult airways (those who cannot be ventilated or
intubated) because of its ease of insertion & relatively high success
rate (95-99%).
C/I for LMA includes: patient with pharyngeal pathology (e.g.,
abscess), pharyngeal obstruction, full stomach (e.g., pregnancy,
hiatal hernia) or low pulmonary compliance
47. Which of the following circuit is preferred
in child for spontaneous respiration:
a) Mapleson A
c) Mapleson C
d) Mapleson E
e) Mapleson F
Correct Answer - A
Ans. (A) Mapleson A
[Ref Ajay Yadav 5th/35; Dorsch Anesthesia Equipment 5th/213-215;
Morgan Anesthesia 5th/ i3; 4th/ 35-37]
Pediatric Breathing Circuits:
Type E Mapleson Circuit:
It is Ayre's T piece with corrugated tubing.
It is a pediatric circuit
As it does not have breathing bag so it is not a complete circuit (It
was made complete by attaching a breathing bag by attaching a
breathing bagby Jackson & Rees).
Type E is basically a circuit only for spontaneous respiration (as it
does not contain breathing bag) but can be utilized for controlled
ventilation by intermittently occluding the end of expiratory limb
48. Weaning is generally done by:
a) SIMV
c) CPAP
b) Ketamine
c) Dexamethasone
d) Ondansetron
e) Palonosetron
b) DNS
c) 5% Dextrose
d) HES
e) NS