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Bone marrow depression is seen with. | B i.e. N2O | 2 | Halothene | N20 | Ether | Isoflurane | Anaesthesia | null | 34dd629e-5386-4dd0-8caf-a804e6fd0607 | single |
The regional anaesthesia technique that would not be expected to provide appropriate analgesic benefit during the first stage of labor is | Pudendal nerve block during delivery mitigates somatic pain during second stage of labor. | 2 | Lumbar epidural | Pudendal nerve block | Lumbar sympathetic block | Paracervical block | Anaesthesia | null | d43682d6-da0b-4579-a51b-0fb3cee61dc7 | single |
Recommended maximum dose of Lignocaine + adrenaline for peripheral nerve shock. | Local Anesthetic Maximum dose Over 24 hours Plain With Adrenaline Lidocaine 300mg 4.5mg/kg 500mg 7mg/kg Mepivacaine 300mg 4.5mg/kg 500mg 7mg/kg Prilocaine 600mg 8mg/kg 600mg 2-chloroprocaine 800mg 12mg/kg 1000mg Bupivacaine 175mg 3mg/kg 225mg 400mg Levobupivacaine 150mg 400mg Ropivacaine 225mg 3mg/kg 800mg maximum dose of plain lidocaine is mentioned differently in different anesthesia books - 3mg/kg BW ( Miller TEXT BOOK of Anesthesia) or 4.5 mg/kg BW (Morgan and Mikhail's Clinical Anesthesiology) | 1 | 7 mg/kg bw | 4.5 mg/kg bw | 2 mg/ kg bw | 3 mg/kg bw | Anaesthesia | Regional Anesthesia | 5920aa93-772c-4582-bded-9eed0f6a33eb | single |
Local anaesthetic with prolonged action | Dibucaine is the longest acting local anaestheticChlorprocaine is the shoest acting local anaestheticDecreasing order of duration: Dibucaine >Bupivacine= Tetracaine = Ropivacaine=Etidocaine > Prilocaine = lignocaine =Mepivacaine = Cocaine >Procaine >Chloprocaine(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.290,304) | 4 | Procaine | Cocaine | Lidocaine | Dibucaine | Anaesthesia | All India exam | 0b66813d-89c4-4089-8a81-9c5163907a66 | single |
In venturi mask maximum O2 concentration attained is | Maximum concentration delivered by ventimask (venturimask) is 60%. | 3 | 90% | 100% | 60% | 80% | Anaesthesia | null | cf4ca71d-373b-4e97-a5d1-758bf63b2ed1 | single |
Percentage of lidocaine in eutectic mixture | Eutectic mixture of local AnaestheticsThis is unique topical preparation which can anaesthetize the intact skinIt is a mixture of 2.5% lidocaine and 2.5 prilocaineIt acts slowly and the cream must held in contact with skin for at least 1 hourEMLA is used: to make venepuncture painless especially in children, and for the procedure like skin grafting & circumcision As systemic absorption of prilocaine can cause methemoglobinemia, EMLA should not be used on mucocutaneous membrane or in the very small child.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 754, 856) | 2 | 1% | 2.55 | 5% | 10% | Anaesthesia | All India exam | b1184e2d-1dc9-4997-907f-8fadece6bfe5 | single |
Following group of drugs is not the first line in the management of chronic | null | 3 | Opioids | Antiepileptics | Dopamine antagonist | Serotonergic drugs | Anaesthesia | null | be576689-98e0-4e4f-9fed-08eea325798b | single |
Most commonly used nerve for neuromuscular monitoring under anesthesia is | Monitoring of Neuromuscular block Done by nerve stimulator Different stimulation - Single Twitch Tetanus Train of four stimulus (most common) Double burst stimulation Post - tetanic count Nerves used - ulnar nerve (most common) (Adductor pollicis muscle ) Facial nerve Posterior tibial nerve External peroneal nerve Response of stimulation | 2 | Radial | Ulnar | Glossopharyngeal | Vagus | Anaesthesia | Monitoring in Anesthesia | 7ca524c7-8c12-4671-b59b-6eb9db002fc7 | single |
Anaesthesia used in microlaryngoscopy is | C i.e. Pollarad tube with infiltration block When fire breaks out during laser vocal cord surgery, oxygen should be turned off, ventilation stopped, tracheal tube removed and submerged in water and the patient should be ventilated with facemasK. Airway damage is assessed with bronchoscopy and bronchial lavage, steroids, can be used for treatment. Anesthesia for Endoscopic Surgeries of Airway Endoscopy includes laryngoscopy, microlaryngoscopy (i.e. aided by an operating microscope), bronchoscopy & oesophagoscopy. These procedures may be accompanied by laser surgery. Microlaryngoscopic surgeries include biopsy / surgery of laryngeal malignancy, vocal cord polyps etc. It is associated with some specific problems as - common field for anesthetist & surgeon, already reduced glottic opening d/t growth, laryngospasm (mediated by superior laryngeal nerve) d/t laryngeal stimulation, very high chances of aspiration and myocardial ischemia (- 4% due to sympethetic stimulation). Preoperative Considerations - Sedative premedication is contraindicated in any patient with any significant degree of upper airway obstructionQ, d/t fear of aspiration. Glycopyrrolate, 1 hour before surgery minimize secretions, thereby facilitate ventilation. Pethidine & promethazine are only given if there is no airway obstruction. Laser Precautions General laser precautions include wearing protective spectacles to prevent retinal damage and evacuation of toxic fumes (laser plume) from tissue vaporization which may have potential to transmit microbacterial diseases. Greatest fear during laser airway surgery is a tracheal tube fire. This can be avoided by using a technique of ventilation that does not involve a flammable tube or catheter (eg intermittent apnea or jet ventilation through the laryngoscope side po). The potential fuel source should have laser resistant propeies (laser tubes or wrapping a tracheal tube with metallic tape) or be removed (supraglottic jet ventilation technique). The only non inflammable, laser proof tube is the all metal. Noon tube, which has no cuff. Most laser tubes have laser resistant propeies around the shaft, but the cuff is not protected and can ignite. So there are double cuffs to seal the airway- if upper cuff is struck by laser and saline escapes, the lower cuff will continue to seal the airway. No cuffed tracheal tube, or any currently available tube protection is completely laser proof. Therefore, whenever laser airway surgery is being performed with a tracheal tube in place, the following precaution should be observed. - Inspired 02 conc. should be as low as possible may be upto 21% - N20 suppo combustion & should be replaced with air (N2) or heliumQ - Tracheal tube cuffs should be filled with saline dyed with methylene blue to dessipate heat & signal cuff rupture - A cuffed tube will minimize 02 conc. in the parynx. The addition of 2% lidocaine jelly (1:2 mixture with saline) can seal small laser induced cuff leaks, potentially preventing combustion - Laser intensity & duration should be limited as much as possible. - Saline soaked pledgets (completely saturated) should be placed in the airway to limit risk of ignition. - A source of water (60 ml) should be immediately available in case of fire. Muscle Relaxation Profound muscle relaxation is the aim to provide masseter muscle relaxation for introduction of suspension laryngoscope & an immobile surgical field. - Anesthesia is induced with IV induction agent followed by a non depolarizing muscle relaxant; the vocal cords are sprayed with 3 ml lidocaine 4% to assist smooth anesthesia & to minimize the possibility of postextubation laryngospasmQ - Alternatively the cords may be painted with 3% cocaine at the end of procedure, which has the added advantage of reducing bleeding from operative site. Oxygentation & Ventilation - Microlaryngoscopy tubes are long, have a small internal and external diameter, and are designed specifically for endoscopic procedures (but not suitable for laser surgery). Typically 4 to 5 mm internal diameter tubes with high volume, low pressure cuffs are used in nasal or oral versions. The most popular anesthetic technique use a Coplan's microlaryngoscopy tube (5mm ID, 31cm long, 10m1 cuff volume and constructed from soft plastic). It is designed for micro laryngeal surgery or for patient whose airway has been narrowed to such an extent that a normal sized tracheal tube cannot be inseed. The small tube diameter provides better visibility and access to surgical field but may lit incomplete exhalation and occlusion. - Most commonly the patients are intubated with small diameter (4 - 6 mm) tracheal tubesQ; - Standandard tracheal tubes of this size, however, are designed for pediatric patients. They tend to be too sho for adult trachea (in length)Q with a low volume cuff that will exe high pressure against it - A 4 - 6 mm microlaryngea tracheal (MLT) tubes (Mallinckrodt critical Care) is the same length as the adult tube, has dispropoionately large high volume low pressure cuff, and is stiffer and less prone to compression than a regular tracheal tube. - The advantages of intubation include - protection against aspiration, and the ability to administer inhalational anesthetics and enable monitoring of ventilation by capnography and spirometry, by measuring end tidal CO2Q - In some cases (eg those involving posterior commissure), intubation may interfere with surgeon's visualization and then alternatives are: 1.Insufflation of high flows of oxygen through small catheter placed in the trachea 2. Intermittent apnea technique. Jet ventilation through laryngoscope High frequency positive pressure ventilation (HFPPV) | 3 | Pollarad tube of 10 mm diameter with heavy sedation | Pollarad tube of 15 mm diameter with topical xylocaine | Pollarad tube with infiltration block | Heavy sedation on and Endotracheal intubation | Anaesthesia | null | 11b27d26-0b05-4dfe-bf68-4f8999b7192c | single |
Shortest acting muscle relaxant is | Ans) aSuccinylcholine is the only available depolarizing neuromuscular blocker. It is characterized by rapid onset of effect and ultrashort duration of ac-tion because of its rapid hydrolysis by butyryl cholinesterase.Classification of nondepolarizing neuromuscular blockers according to duration of action (time to T1 = 25% of control) after twice the ED95Class of BlockerLong-Acting (>50 min)Intermediate- Acting (20-50 min)Short-Acting (15-12 min)Ultrashort- acting (<10-12min)Steroidal compoundPancuronium pipecuroniumVecuronium Rocuronium Benzylisoquinolinium compoundsd-Tubocurarine Metocurine DoxacuriumAtracurium CisatrucuriumMivacurium Others Asymmetrical mixed-onium chlorofumarates GantacuriumPhenolic etherGallamine Diallyl derivative of toxiferineAlcuromum | 1 | Succinylcholine | Vecuronium | Pancuronium | Atracurium | Anaesthesia | Muscle Relaxant | d953d978-03c3-4903-87dd-e87b92319971 | single |
Muscle relaxant with ganglion blocker action are A/E | D i.e. Halothane | 4 | Pancuronium | Trimethaphan | Curare | Halothane | Anaesthesia | null | 4e8372ea-a052-4b14-b269-d86cd4d5a45a | single |
Anaesthetic without epileptogenic potential | Ans:A.)Desflurane. Sevoflurane,Enflurane and Isoflurane have Epileptogenic potential. | 1 | Desflurane | Sevoflurane | Isoflurane | Enflurane | Anaesthesia | null | 813ac636-730a-49c3-b348-f9a514cc77bb | single |
Induction agent of choice in day care surgery is | (Propofol) 585 - Lee's 13th) (375-KDT6th)* Geneal anaesthesia for day surgery should use agents that are rapidly eliminated and titratable* Most of those in common use are appropriate intravenous propofol or inhalation sevoflurane are both highly suitable for induction of anaesthesia in adults and childrenAdvantages of propofol over Thiopentone1. Rapid and smooth recovery2. Completely eliminated from body in 4 hours so patient is ambulatory early3. Antiemetic4. Antipruritic5. BronchodilatorDisadvantages of Day Surgery* Where day surgery is not well established, it may promote an over cautions attitude* May encourage poor management of operating list order* Surplus overnight capacity can attract emergency out liers and block beds* Antisocial hours may deter - day care nursing staff | 2 | Ketamine | Propofol | Methohexitone | Thiopentone sodium | Pharmacology | Anaesthesia | de6ab9af-a223-49b8-8ed6-3e25f065f0b3 | single |
Most appropriate mode of ventilation for head injury patient | null | 3 | CPAP | SIMV | CMV | AMV | Anaesthesia | null | e25d6843-1d97-458a-b2de-4a3d5a5ab58a | single |
Clayton is used in a close breathing system for the purpose of | D i.e. As an indicator | 4 | As a hardner | As an absorbent | As a softner | As an indicator | Anaesthesia | null | 10c5d751-b270-497d-82f1-937e4940c279 | single |
Least soluble anaesthetic agent is | Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. If an anesthetic has a high coefficient, then a large amount of it will have to be taken up in the body's blood before being passed on to the fatty (lipid) tissues of the brain where it can exe its effect. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 1 | Desflurane | Sevoflurane | Halothane | Methoxyflurane | Anaesthesia | General anaesthesia | 228a9c90-d6e9-4c90-ad11-b2c70b74d43b | single |
Supreme LMA characteristic is | LMA Supreme is one of the most advanced laryngeal mask airway (LMA)It has features of usual LMA with additional Built-in drain tube and a bite blockIt has high volume/ low-pressure cuff which generates higher seal pressureIt also provides a conduit for active suctioning of stomachIt can be used in infants as well as in adults.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 317, 318) | 4 | Has no bite block | Used in infants | High pressure, low volume | Has built in drain tube | Anaesthesia | All India exam | 8213f07f-ec90-4a1e-935e-020e96fadc90 | single |
A 65 year old man is scheduled for emergency laparoscopic appendectomy. He is a chronic smoker with history of severe COPD, diabetic and hypertensive, on insulin, metformin and antihypertensive medications, not on regular follow up. He also complains of dyspnea on walking more than a few meters. This patient would be assigned | Elderly male patient –poorly controlled diabetic and hypertensive, known smoker with COPD. His co-morbidities are constant threat to life. And since emergency appendectomy is done, it falls under ASA 4E. | 3 | ASA 3E | ASA 3 | ASA 4E | ASA 4 | Anaesthesia | null | 7fcf03e0-da09-4c53-895d-2f73171e69b7 | single |
Capnography is used for assessment of | Capnography is the method of determining CO2 levels in exhaled gases (PACO2) but NOT blood.It is the ideal confirmatory method of endotracheal intubation(VENTILATION OF LUNG AFTER INTUBATION) Aeral blood gas analysis is used to measure CO2 levels in Blood (PaCO2) Pulse oxymetry is used to measure oxygen saturation of blood and hea rate. | 3 | Oxygen saturation of blood | Amount of CO2 transpoed in blood | Ventilation of lung after intubation | Myocardial perfusion | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 875eb259-41a6-46a4-8b93-504ce23c7caa | single |
Contraindication for laryngeal mask airway is | LMA INDICATIONS : .Sho procedures where endotracheal tube is not necessary,Difficult airway , Cardiac arrest ,conduit for intubation, Contraindications Absolute :Complete Upper airway obstruction,Locked jaw relative : increased risk of aspiration like in full stomach, 2nd n 3rd trimester of pregnancy ,morbid obesity,Upper GI bleed, Hiatus hernia, Suspected or known Supraglottic anatomical abnormalities | 2 | Empty stomach | Hiatus hernia | Minor surgery | Young age | Anaesthesia | Anaesthetic equipments | f0251eb0-f3b6-4281-98c4-8494811a913d | single |
Most cardiostable among the following is | Thiopentone, propofol, ketamine cardio unstable Etomidate cardio stable Etomidate is the most cardiac stable intravenous agent due to its lack of effect on the sympathetic nervous system and on the function of the baroreceptor. The myocardial oxygen supply-to-demand ratio is well maintained. Hence, etomidate is the intravenous agent of choice in patients with coronary aery disease, cardiomyopathy and cerebral vascular disease. | 4 | Thiopentone sodium | Ketamine | Propofol | Etomidate | Anaesthesia | Intravenous Anesthetic Agents | ac20506a-ad14-451a-8623-b55f455b160d | single |
Hyperbaric Oxygen is not useful in | Hyperbaric oxygen is not useful in veigo. | 2 | CO poisining | Veigo | Gas gangrene | compament syndrome | Anaesthesia | Anaesthetic equipments | e3fff86a-f185-4175-8bea-3920f3a9b8fe | single |
Most common complication of celiac plexus block | Postural hypotension : due to lumbar sympathetic chain blockade leading to upper abdominal vessel dilation and venous pooling. So intravenous fluids are required preblock | 2 | Pneumothorax | Postural hypotention | Retroperitoneal hamorrhage | Intra_aerial injection | Anaesthesia | Regional anaesthesia | 69310e44-16fe-4022-9aee-2f27a81ccb0b | single |
The physiological dead space is decreased by | Dead space is defined as the volume of the airway that doesnot paicipate in gas exchange (It is nothing but ventilation occurs but perfusion doesnot occur) Anatomical Dead Space : from nasopharynx to respiratory bronchioles.average adult,normally 150ml Alveolar dead space : Alveoli that are ventilated but not perfused.usually it is absent Physiological or total dead space : Anatomical + Alveolar dead space Factors that increase dead space : upright position neck extension advanced age positive pressure ventilation decreased pulmonary perfusion (pulmonary emboli or pulmonary hypeension) lung diseases (emphysema or cystic fibrosis ) FACTORS THAT DECREASE DEAD SPACE : supine position , neck flexion , intubation Anatomical dead space is measured by single breath nitrogen test , physiological dead space is measured by modified bohr's equation. | 3 | Upright position | positive pressure ventilation | Neck flexion | Emphysema | Anaesthesia | Complications of anaesthesia | b22c2620-2de2-4a64-be80-6fab640e0360 | single |
In spinal anaesthesia the drug is deposited between | Ans. is 'b' i.e., Pia and arachnoid matter Spinal anaesthesia In spinal anaesthesia LA is injected into subarachnoid space (space between pia matter and arachnoid matter). Structure pierced during SA (from outside in) - Skin - Subcutaneous tissue --> Supraspinous & intraspinous ligament --> Ligamentum falvum --> Duramater -->Arachnoidmater. Site of spinal anaesthesia L2_3 or L3_4 interveebral space in adult (In adult spinal cord ends at lower border of Ll veebrae). L4_5 interveebral space in children (spinal cord ends at lower border of L3 veebrae in children). Spinal anaesthesia leads to creation of a zone of differential blockade, ie motor fibres are blocked two levels lower and autonomic fibres are blocked two levels higher than the sensory blockade due to different sensitivity of different fibres. | 2 | Dura and arachnoid | Pia and arachnoid | Dura and veebra | Into the cord substance | Anaesthesia | null | 88cc204a-0e34-4c91-b342-9bdf12e7d692 | single |
Muscle relaxant with ganglion blocker action is | Curare is an example of a non-depolarizing muscle relaxant that blocks the nicotinic acetylcholine receptor (nAChR), one of the two types of acetylcholine (ACh) receptors, at the neuromuscular junction | 3 | Pancuronium | Trimethoprim | Curare | Halothane | Anaesthesia | Muscle relaxants | 58d5b370-4d36-4a39-9034-b61aa5b454ac | single |
In Phrenic nerve block, it is best to infiltrate near | Phrenic nerve is blocked 3 cm above the clavicle at the posterior border of sternomastoid. Used for intractable hiccups | 3 | Scalenus anterior | Scalenus posterior | Posterior border of sternomastoid | Anterior border of sternomastoid | Anaesthesia | Anaesthesia of special situations | 73ee2bf3-4428-426a-9a06-97862a8e0f46 | single |
Pulse oximetry monitors | Pulse oxymetry monitors hea rate, oxygen saturation of hemoglobin and gives aerial waveform. It works on the principle of transmission spectrophotometry and optical plethysmography. It has 2light emitting diodes.one is red with the wavelength of 660nm and other one is infrared with the wavelength of 940nm. | 1 | Oxygen saturation of hemoglobin | Oxygen content of blood | Pulse pressure | Oxygen paial pressure | Anaesthesia | Anaesthetic equipments | b6fde986-dade-4aa6-8a36-3340a25c4f8e | single |
Most cardiotoxic local anesthetic | Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congenial with less cardiotoxicity).(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294) | 2 | Procaine | Bupivacaine | Cocaine | Lidocaine | Anaesthesia | All India exam | a533029b-defe-42ad-a7b5-946411f5111a | single |
Characteristic of an ideal gas is | D i.e. Obeys Charles, boyle's & avogadro's laws | 4 | Volume is directly propoional to change in pressure | Volume is inversely propoional to change in temperature | At absolute temp. volume of gas is 1 | Obeys Carles, Byles and Avagadro' laws | Anaesthesia | null | 60c041e8-c11a-4a39-b55c-3303aa1f4a6c | single |
For Foreign bodies are retained in the larynx causing choking, first line of management is | Hemilich manouvere | 2 | Airway inseion | Hemilich manouvere | Hemilich valve | Tracheostomy | Anaesthesia | null | 10b873ef-f50c-4ab5-8bda-4ba832d785ff | single |
Not a sign of stellate ganglion block | Horner syndrome is a sign of stellate ganglion block (miosis, enopthalmos,ptosis, anhydrosis and absence of cliospinal reflex | 2 | Miosis | exopthalomoss | Nasal congestion | Conjunctival redness | Anaesthesia | Regional anaesthesia | d2f82b22-2fc7-4ede-aa46-9b887e241002 | single |
This manouver helps to | This is BURP manouver . here thyroid cartilage is pushed back up with right pressure to improve laryngoscopic view. | 2 | Decrease risk of aspiration | Improve laryngoscopic view | Open the airway | Stabilize ET tube position | Anaesthesia | null | 08958bd9-ccd0-473d-b34c-cc6f2ead9b83 | single |
Arrange following according to increasing order of their total body water as percentage of body weight 1. 6 month baby 2. neonate 3. young female 4. young male | Age Total body water (%) ECF(%) Blood volume(%) Neonate 80 45 9 6 mo old 70 35 1 yr 60 28 5 yr 65 25 8 Young male 60 22 7 Young female 50 20 7 Elderly 50 20 | 3 | 1<2<3<4 | 1<3<4<2 | 3<4<1<2 | 4<3<2<1 | Anaesthesia | Anaesthesia Q Bank | 0e6559ce-8a0f-4540-8af4-2a5e19508815 | single |
Ether was first used by | Ether was used for frivolous purposes ("ether frolics"), but not as an anesthetic agent in humans until 1842, when Crawford W. Long and William E. Clark independently used it on patients for surgery and dental extraction, respectively. However, neither Long nor Clark publicized his discovery. Four years later, in Boston, on October 16, 1846, William T.G. Moon conducted the first publicized demonstration of general anesthesia for surgical operation using ether. The dramatic success of that exhibition led the operating surgeon to exclaim to a skeptical audience: "Gentlemen, this is no humbug!" Joseph Priestley produced nitrous oxide in 1772, and Humphry Davy first noted its analgesic propeies in 1800. Gardner Colton and Horace Wells are credited with having first used nitrous oxide as an anesthetic for dental extractions in humans in 1844. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 2 | Priestley | Moon | Wells | Simpson | Anaesthesia | General anaesthesia | 6eba1feb-f4f5-4d46-ae0b-897369dab138 | single |
High airway resistance is seen in | Resistance impedes airflow into (and out of) the lung. The major component of resistance is the resistance exeed by the airways (large and small), and a minor component is the sliding of the lung and the chest wall tissue elements during inspiration (and expiration). Resistance is overcome by (driving) pressure. In spontaneous breathing, Resistance (R) is calculated as driving pressure (DP) divided by the resultant gas flow (F): R = DP/F The value of airway resistance is approximately 1 cm H2O/L/sec, and is higher in obstructive lung disease (e.g., COPD, asthma); in severe asthma, it is elevated approximately tenfold. The presence of an endotracheal tube adds a resistance of 5 (or 8) cm H2O/L/min for a tube with an internal diameter of size 8 (or 7) cm. For any tube for which the airflow is laminar (smooth, streamlined), the resistance increases in direct propoion to the tube length and increases dramatically (to the fouh power) as the diameter of the tube is reduced. Two factors explain why most (approximately 80%) of the impedance to gas flow occurs in the large airways. First, as bronchi progressively branch, the resistances are arranged in parallel and the total cross-sectional area at the level of the terminal bronchioles adds up to almost tenfold that at the trachea. Second, in tubes that are large, irregular or branched, the flow is often turbulent, not laminar. When flow is laminar: F(lam) = DP/R In contrast, when the flow is turbulent: F(turb) = DP/R2 Therefore, for a given radius, far more pressure is required to achieve comparable flow where the flow is turbulent; thus, the effo required is greater, and if prolonged or severe, respiratory failure is more likely. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 4 | Respiratory bronchiole | Intermediate bronchiole | Terminal bronchiole | Main bronchus | Anaesthesia | Fundamental concepts | cfdb0644-0572-4bb3-92de-499607ec1305 | single |
Secondary action of Superior Rectus Muscle is | Ans. is c i.e., Adduction & intorsion Muscle Primary ction Secondary Action Superior rectus Elevation Adduction and intorsion Inferior rectus Depression Adduction and extorsion Medial rectus Adduction Lateral rectus Abduction Superior oblique Intorsion Abduction and depression Inferior oblique Extorsion Abduction and elevation | 3 | Abduction & extorsion | Adduction & extorsion | Adduction & intorsion | Adduction & extorsion | Anaesthesia | null | 46f092cd-fbd3-4389-b6d3-d186d528e8fe | single |
Optimum oxygenation is maintained by adjusting following parameters
a — Tidal volume,b — PEEP,c — FiO2,d — respiratory rate | PEEP and FiO2 determine optimum oxygenation. | 2 | a, b | b, c | c, d | d, a | Anaesthesia | null | 86c8c8c5-5db2-48c7-9d4f-3f2399e901df | single |
No effect on hea | B i.e. Ether | 2 | Chloroform | Ether | Methoxyflurane | Halothane | Anaesthesia | null | 1d9fb803-31b6-4c88-b8a3-ec2a7a806839 | single |
Local anaesthesia causing methemoglobinemia | Prilocaine Prilocaine is an amide local anaesthetic that is metabolized to ohotolidine. Ohotolidine is an oxidizing compound capable of conveing hemoglobin to methemoglobin. As methemoglobinemia reduces the amount of hemoglobin that is available for oxygen transpo this side effect is potentially life threatening. Therefore dose limits for prilocaine should be strictly observed. Drugs causing methemoglobinemia Anilines Aminophenois Aminoph enon es Chlorates/dapsone Prilocaine/benzocaine Nitrates/nitrites/naphthalene Nitrobenzene Phenazopyridine Primaquine and related antimalarials Sulfonamides | 2 | Procaine | Prilocaine | Etiodicaine | Ropivacaine | Anaesthesia | null | 81eac16b-f72a-4838-9262-272b0df14a2a | single |
The most potent synthetic opioid is | Sufentanil has a high affinity for the mu receptor, higher than that of any other opioid. | 2 | Remifentanil | Sufentanil | Alfentanil | Fentanyl | Anaesthesia | General anaesthesia | f388c0c1-5324-4954-a99d-7b61dafc1d14 | single |
Modality best utilized for neuromuscular monitoring during maintenance of anaesthesia is | Neuromuscular monitoring, also known as a train of four monitoring, is a technique used during recovery from the application of general anaesthesia to objectively determine how well a patient&;s muscles are able to function. | 1 | Train of four | Single twitch | Tetanic stimulation | Post-tetanic stimulation | Anaesthesia | General anaesthesia | 4f166a9a-a656-4653-ac4b-0c5b31f32383 | single |
In a patient with fixed respiratory obstruction Helium is used along with Oxygen instead of plain oxygen because | B i.e. It decreases turbulence | 2 | It increases the absorption of oxygen | It decreases turbulence | It decreases the dead space | For analgesia | Anaesthesia | null | 3a0ffbe4-a3c2-4a62-a9b2-ae3ff303b88b | single |
100 % Oxygen therapy used in | (A) Cluster headache # CLUSTER HEADACHES are rare, extremely painful, & debilitating headaches that occur in groups or clusters.> These headaches affect one side of the head (unilateral) & may involve tearing of the eyes & a stuffy nose.> Unlike migraines, more men experience this type of headache than women.> They can affect people of any age, but are most common between adolescence & middle age.> No discernable pattern can be found among families in the development of cluster headaches.> While no specific cause has been found for the disorder, it appears to be related to a sudden release of histamine or serotonin by the body tissue.> Onset is sudden & most commonly happens during the dreaming (REM) phase of sleep.> Headaches may occur daily for months, alternating with periods without the headaches (episodic), or they can recur for a year or more without stopping (chronic).> A person may experience alternating chronic & episodic phases.> Some people who experience cluster headaches are heavy smokers.> Alcohol, glare, stress, or certain foods may trigger an attack.> The goal of treatment is to relieve the symptoms.> Smoking, alcohol use, specific foods, and other factors that seem to trigger cluster headaches should be avoided.> A headache diary may be helpful in identifying triggers.> When a headache occurs, record the date and time it starts.> In addition, list all activities, substances used, and food/drink consumed within the previous 24 hours, as well as any other factors that seem significant.> HBOT seems to be useful in the treatment of cluster headaches, particularly for frequent headaches that occur at night.> Side effects of mild ear and sinus pressure have been reported | 1 | Cluster headache | Migraine | Congenital spherocytosis | COPD | Anaesthesia | Miscellaneous | 14b4e0a0-db11-434f-a13a-1657d0325ff0 | single |
Intravenous anaesthetic agent of choice in status epilepticus | Propofol produces coical EEG changes. Propofol appears to possess profound anticonvulsant propeies. CBF ICP CMRO2 Seizure Thiopentone ||| ||| ||| ||| Ketamine || || | | Halothane || || | | Nitrous oxide | | | | Previously thiopentone was used nowerdays propofol is used. | 1 | Propofol | Thiopentone | Ketamine | Etomidate | Anaesthesia | Intravenous Anesthetic Agents | 6e8fd92b-b3ae-4679-bd79-9f043350abff | single |
Critical temperature for liquid nitrogen is | Critical temperature (Tc) of substance is the temperature at and above which vapor of that substance cannot be liquefied, no matter how much pressure is applied (Note: Below critical temperature a substance can exist as a liquid or gas depending on pressure).Critical temperature of N2 is-146.9degC; that means N2 can b3e liquefied below -146.9degC - So, liquid nitrogen must be stored below -146.9degC(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no 11 -12) | 3 | 36.5degC | -20degC | -147degC | -242degC | Anaesthesia | All India exam | da6170ab-6a68-4a2c-bbf8-900eb0574402 | single |
Hepatotoxic inhalational agent | All inhalational agent cause maild hepatotoxicity by decreasing hepatic blood flowIsoflurane is the agent of choice in liver disease as it has least effect on Hepatic blood flowDirect hepatotoxicity (Hepatitis, hepatic necrosis) is caused by- halothane, chloroform, trilene, methoxyflurane(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 167-169) | 1 | Halothane | Enflurane | Desflurane | Sevoflurane | Anaesthesia | All India exam | 2aba8f3a-d451-4fb0-91eb-9e740836110a | single |
Shoest acting non depolarizing muscle relaxant is | Suxamethonium (succinylcholine) is the shoest acting skeletal muscle relaxantMivacurium is the shoest acting nondepolarizing skeletal muscle relaxant.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.139) | 1 | Mivacurium | Doxacuronium | Pipecurium | Vecuronium | Anaesthesia | All India exam | e89c60e7-82cf-4a17-bfd9-be302f7831a7 | single |
Anesthesia agent with least analgesic propey | B i.e. Halothane | 2 | N20 | Halothane | Ether | Propane | Anaesthesia | null | 718f54d3-cdd2-485c-8945-f764d6d471f2 | single |
Laudanosine is metabolic end product of | Laudanosine is metabolic end product of atracurium. | 4 | Mivacurium | Doxacurium | Rocuronium | Atracurium | Anaesthesia | null | 5e40f87b-3d60-45ab-b5dd-63e7df7e6b98 | single |
Not compatible with soda lime | C i.e. Trielene | 3 | Ether | Halothene | Trilene | N20 | Anaesthesia | null | 6b1af373-9cc6-4607-8ad5-483ce4f70432 | single |
Flat capnogram found in A/E | in bronchospasm,there is prolonged expiratory upstroke(abscence of phase 3 plateau). in tube displacement,disconnection,accidental extubation,ventilation failure,it is flat. | 4 | Disconnection of anesthetic tubing | Accidental extubation | Mechanjca1 ventilation failure | Bronchospasm | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | e5738549-f3c5-4247-9089-9ff519f30ca1 | single |
Spinal anesthesia should be injected into the space between | Spinal anesthesia is usually injected at L3-L4, L2-L3 | 3 | T12-L1 | L1-L2 | L3-L4 | L5-S1 | Anaesthesia | Regional anaesthesia | a1cb2b48-b7f8-456c-97c5-e17fe66027cd | single |
Maximum vital capacity decreased in | C i.e. Trendelenberg Trendelenburg (head down) position causes cephalad shift of abdominal viscera and diaphragm leading to marked decrease in lung capacities (i.e. vital capacity, functional residual capacity, total lung volume, lung compliance) Q Respiratory rate is not affected in any position.Q Physiological effects of patient position Trendelenburg Horizontal Lithotomy Prone Lateral decubitus * Cardiac : Activation of * Cardiac * Cardiac * Cardiac * Cardiac baroreceptors produce - Decreased hea rate - Increase in - Decrease - Cardiac output unchanged decrease in - Decreased peripheral circulating preload, cardiac unless venous return - Cardiac output resistance blood volume output, blood obstructed. - Hea output - Equalization of and preload. pressure due to - Aerial blood pressure - B.P. pressure through out - Effect on peripheral may fall as a result of - Peripheral vascular resistance the aerial system blood pooling of blood. decreased vascular * Respiratory : Cephalad shift of - Increased right sided pressure and * Respiratory resistance. abdominal viscera produces filling & cardiac cardiac - Decreases total * Respiratory - Marked decrease in lung output. output lung compliance - Decreased volume of capacities (VC, FRC, Total * Respiratory depends on and increases dependent lung. lung volume, lung - Diaphragm is volume work of - Increased perfusion of compliance)Q displaced cephalad status. breathing. dependent lung. - Atelactasis by abdominal viscus * Respiratory - Increased ventilation of - Increase ventilation perfusion - Increase perfusion of - Decreased dependent lung in awake mismatch dependent vital capacity. patient (No v/q mismatch) - Increase likelihood of (posterior) segment - Increase - Decreased ventilation of regurgitation - Functional residual likelihood of dependent lung in * Others - Increase intraocular pressure in glaucoma - Increase in intracranial Pressure & decrease in cerebral blood flow. capacity decreases aspiration anaesthetized patient (v/q mismatch) - Fuher decrease in dependent lung ventilation with paralysis and open chest. | 3 | Prone | Supine | Trendelenberg | Left lateral | Anaesthesia | null | 8521d3bf-35b8-4312-be43-d52f01f57e24 | single |
The term "balanced anaesthesia" has been given by | Term 'balanced anaesthesia' was introduced by Lundy in 1926Balanced anaestesiaThe cardinal feature of general anaesthetics are:-Loss of all sensations, especially painSleep (unconsciousness) and amnesiaImmobility and muscle relaxationAbolition of reflexesIn the modern practice of balanced anaesthesia these modalities are achieved by using the combination of inhaled and i.v. drugs. | 3 | Simpson | Fischer | Lundy | Moan | Anaesthesia | All India exam | e572f5b1-585a-47b0-8038-af45ad4ff2c2 | single |
Shoest acting nondepolarising muscle relaxant | Suxamethonium (succinylcholine) is the shoest acting skeletal muscle relaxantMivacurium is the shoest acting nondepolarizing skeletal muscle relaxant(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.214,218,219 ) | 2 | Succinylcholine | Mivacurium | Atracurium | Vecuronium | Anaesthesia | All India exam | e38f7b88-3a20-4d93-b903-95bfb12631dd | single |
Modern monitors to measure ETCO2 make use of | Measurements of variations in the respiratory cycle of expired carbon dioxide by displayed waveform and by absolute numerical values is defined as Capnography and Capnometry respectivelyMeasurement of the exhaled CO2 at the level of upper airway at the end of expiration (when CO2 is at its maximum) is referred to as 3end tidal CO2 (EtCO2)Modern monitors used to measure EtCO2 in the exhaled air make use of infrared absorption spectroscopy(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 126) | 1 | Infrared absorption spectroscopy | Ultra violet rays | Laser technology | Scatter technology | Anaesthesia | All India exam | 24e64e1a-15b0-4a9b-8ed0-1411b5cd02b2 | single |
Propofol infusion syndrome is characterized by | Propofol infusion syndrome occurs when propofol infusion is continued for more than 48 hours
Severe metabolic acidosis
Acute cardiacfailure
Hyperkalemia
Hyperlipidemia
Skeletal myopathy
Refractory bradycardia. | 3 | Hypokalemia | Hypolipidemia | Bradycardia | Tachycardia | Anaesthesia | null | 5032d293-19a2-48f2-b738-6f19154c2893 | single |
Fixed performance device is | venturi mask is a device used to deliver designated oxygen concentration to patients on controlled oxygen therapy. It is designed with wide bore tubes with various colour adapters. Each colour code responds to the precise oxygen concentration and specific litre flow. | 1 | Ventury mask | Nasal cannula | Simple mask | Non rebreathing mask | Anaesthesia | Anaesthetic equipments | 742eaa85-dd16-4b48-bd44-d65975b39aa2 | single |
A 25 year old male is undergoing incision and drainage of abscess under general anaesthesia with Spontaneous respiration. The most efficient anaesthetic circuit is | Mapelson breathing systems are classified as Mapelson A, B, C, D, E, F Mapelson A also known as Magill&;s circuit. Ranking of Mapelson&;s systems based on superiority as follows : Spontaneous ventilation : A>D,F,E>C,B Controlled ventilation : D, F, E>B,C>A Mapelson A is more efficient in spontaneous ventilation Mapelson D is more efficient in Controlled ventilation | 1 | Maplelson A | Mapleson B | Mapleson C | Mapleson D | Anaesthesia | Anaesthetic equipments | c8c0403f-2c1b-4c6b-aebe-846b4757a6f2 | single |
Sciatic nerve blockade provides sensory loss of the | Sciatic nerve blockade results in sensory loss to the posterior thigh by blocking the posterior cutaneous nerve along with everything below the knee, except for the medial lower leg, which is innervated by the saphenous nerve. | 2 | Anterior and lateral thigh | Posterior thigh and majority of the leg below the knee | Medial and posterior thigh | Medial leg below the knee | Anaesthesia | Regional anaesthesia | cb5f9066-dc57-414a-8172-501eef202218 | single |
A 23 years old male presents with ingrown nail. The ingrown nail was removed after administering a ring block. The mechanism of action of the local anesthetic used is | Answer: b) Blockage of activated sodium channelsLOCAL ANESTHETICSInterfere with the excitation process in a nerve membrane in one or more of the following ways:Altering the basic resting potential of the nerve membraneAltering the threshold potential (firing level)Decreasing the rate of depolarizationProlonging the rate of repolarizationLA's are weak bases carrying a positive charge at the tertiary amine group at physiological pH.MOA: Blocks voltage gated Na+ channels from inside of cell membrane by binding to a-subunit.Nerve block produced by local anesthetics is called a nondepolarizing nerve block.LA's are weak bases; they act by penetrating the axonal membrane in the unionized form.After penetration, they get ionized and block the activated sodium channels from within, thereby preventing the propagation of action potentials. | 2 | Opening of sodium channels | Blockage of activated sodium channels | Increased frequency of GABA activated chloride channels | Increased duration of GABA activated chloride channels | Anaesthesia | Local and Regional Anesthesia | c6b85368-d8fe-4c98-822a-b583a16add40 | single |
% of thiopentone used in induction | C i.e. 2.5% | 3 | 0.50% | 1.50% | 2.50% | 4.50% | Anaesthesia | null | 1ee29635-fb6c-4606-8292-cf5a04397794 | single |
Emergency oxygen flush in anaesthetic machine provides | Emergency oxygen flush delivers more than normal amount of oxygen at higher pressure to stabilize the patient. | 1 | 35-75L/min oxygen at 55 to 60 Psi pressure | 25-35L/min oxygen at 10 to 12 Psi pressure | 55-75L/min oxygen at 55 to 60 Psi pressure | 10-20L/min oxygen at 10 to 12Psi pressure | Anaesthesia | null | 851d06d5-3fe7-4461-89bd-a2d8b40b93ea | single |
Best anaesthetic agent for out patient anasthesia is | C i.e. Alfentanyl | 3 | Fentanyl | Morphine | Alfentanyl | Penthidine | Anaesthesia | null | ee86b126-91ed-41d4-9331-9ba7abf20155 | single |
Pseudocholinesterase acts on | Mivacurium is metabolised by pseudocholinesterase. Rest all are metabolisedby non specific esterase. | 3 | Esmolol | Atracurium | Mivacurium | Remifentanil | Anaesthesia | null | bcc36afa-7332-4b0e-83e3-53232d3cdef9 | single |
Commonly used in narcoanalysis | D i.e. Thiopentone | 4 | Atropine | Scopolamine | Opium | Thiopentone | Anaesthesia | null | 918d9528-7fb8-4b09-b363-b1b55ae85fad | single |
Least absorbed from mucous membrane are | Hydrophobicity is a primary determinant of intrinsic anesthetic potency because the anesthetic molecule must penetrate into the nerve membrane and bind at a paially hydrophobic site on the Na+ channel. Clinically, however, the correlation between hydrophobicity and anesthetic potency is not as precise as in an isolated nerve. Differences between in vitro and in vivo potency may be related to a number of factors, including local anesthetic charge and hydrophobicity (which influence paitioning into and transverse diffusion across biologic membranes) and vasodilator or vasoconstrictor propeies (which influence the initial rate of vascular uptake from injection sites into the central circulation). Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 3 | Lidocaine | Tetracaine | Procaine | Cocaine | Anaesthesia | General anaesthesia | a34f62b6-ba9f-4de3-971f-76198e94855f | single |
Mac Intosh curved blade laryngoscope is a type of | The Macintosh laryngoscope has a curved blade which allows exposure of the larynx by positioning the tip in the vallecula, anterior to the epiglottis, lifting it out of view. This laryngoscope is designed to lessen the difficulty of exposing the larynx to pass an endotracheal tube | 2 | Indirect laryngoscope | Direct laryngoscopc | Bronchoscope | Video laryngoscope | Anaesthesia | Anaesthetic equipments | fdbe6912-964c-47ec-be94-1b1efd057965 | single |
For a 78 yr old man for trans urethral resection of prostate, ideal anesthetic method is spinal anesthesia, this is because | TURP syndrome may occur at any time perioperatively and has been observed as early as few minutes after surgery has staed and as late as several hours after surgery has been completed. When under regional anesthesia, the patient characteristically complains of Dizziness Headache Nausea Tight feeling in the chest and throat Shoness of breath Restlessness Confusion Retching Abdominal paint thus regional anaesthesia is preferred. | 2 | General anesthesia causes more bleeding than spinal | Signs of hyponatremia can easily be detected under spinal | Spinal anesthesia abolishes the obturator nerve stimulation by electro cautery | Obstructive uropathy and renal failure may be associated with prostatic enlargement | Anaesthesia | Central Neuraxial Blockade | 33fdba55-187e-4fba-b943-34f805891bd7 | single |
In relation to the drug Sugammadex | There is currently no data available regarding the use of sugammadex for the 'immediate reversal' of vecuronium. However, sugammadex is recommended for reversal of vecuronium once spontaneous T2 twitch has been achieved, using a dose of 4mg/kg to reverse 0.1mg/kg of vecuronium.Sugammadex is not effective against benzyl-isoquinolinium muscle relaxants (e.g. cisatracurium and mivacurium).Phase I-IV trials have shown sugammadex to be effective for rapid reversal of rocuronium-induced neuromuscular blockade (16mg/kg).Sugammadex is a member of the g-cyclodextrin family, which encapsulates aminosteroid neuromuscular blocking agents (rocuronium, vecuronium, pancuronium). | 3 | It is recommended for immediate reversal of Vecuronium | It can effectively reverse Cisatracurium | 16mg/kg is recommended intravenously for the immediate reversal of Rocuronium | It is an a-cyclodextrin that encapsulates amino-steroid neuromuscular blocking agents | Anaesthesia | Miscellaneous | e6ddcc52-375d-4917-8f50-ea9d26b852f6 | single |
Index of potency of general anaesthesia | A i.e. Minimum alveolar concentration | 1 | Minimum alveolar concentration | Diffusion coefficient | Dead space concentration | Alveolar blood concentration | Anaesthesia | null | d7ad68d6-b31a-45b1-a153-e07a4e495f0e | single |
Induction agent of choice in bronchial asthma | Ketamine is a bronchial smooth muscle relaxant. When it is given to patients with reactive airway disease and bronchospasm, pulmonary compliance is improved. Ketamine is as effective as halothane or enflurane in preventing experimentally induced bronchospasm. The mechanism for this effect is probably a result of the sympathomimetic response to ketamine, but isolated bronchial smooth muscle studies showed that ketamine can directly antagonize the spasmogenic effects of carbachol and histamine. Because of its broncho-dilating effect, the administration of ketamine can treat status asthmaticus unresponsive to conventional therapy. A potential respiratory problem, especially in children, is the increased salivation that follows ketamine administration; this effect can be modulated by an anticholinergic drug such as atropine or glycopyrrolate. Racemic ketamine is a potent bronchodilator, making it a good induction agent for asthmatic patients; however, S(+) ketamine produces minimal bronchodilation. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e | 3 | Thiopentone | Methhexitone | Ketamine | Propofol | Anaesthesia | General anaesthesia | f5dc8e72-d1f0-46d3-83d4-995da57dbc1e | single |
Day care anesthesia is best achieved with | Propofol | 3 | Enflurane | Isoflurane | Propofol | Methoxyflurane | Anaesthesia | null | a1cd9953-168a-41fa-a948-9f6ef8dd9aca | single |
Vasponstricator L.A. is | All local anaesthetics are vasodilators except cociane which is a vasoconstrictor | 1 | Cocaine | Procaine | Lidocaine | Chlorprocain | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | bff27f23-a636-4d92-acc4-b4fc4781ee65 | single |
The recommended size of endotracheal tube for 1 year old child is | Tube diameter in mm
= Age in years/4 + 4
= 1/4 + 4
= 17/4
= 4.2 | 3 | 2.5 | 3 | 4 | 5 | Anaesthesia | null | 92736f6a-a3e7-41cb-b4dc-2e6edfb3f8da | single |
Nasal intubation is contra indicated in | A i.e. CSF Rhinorrhea Nasal (naso-tracheal) intubation is required when oral (orotracheal) tube will interfere with surgery (eg intraoral surgery) and may be indicated when oral intubation is difficult (eg inability to open month). It provides good oral hygiene and more secure fixation with less chances of displacement and extubation. But it is more commonly a/w significant nasaVmucosal bleeding, submucosal placement, transient bacteremia (infection), sinusitis and otitis mediaQ. These side effects make nasotracheal intubation contraindicated in base of skull fracture, CSF rhinorrheaQ, nasal abnormalities and trauma and coagulopathy. | 1 | CSF Rhinorrhea | Fracture cervical spine | Fracture mandible | Sho neck | Anaesthesia | null | a06ca870-cad9-4717-a950-3a5aad1e44e8 | single |
Visual analogue scale most widely used to measure | null | 4 | Sleep | Sedation | Depth of anaesthesia | Pain intensity | Anaesthesia | null | e1addaf9-cab8-4b28-9497-d74b5af32b8c | single |
Arrange following pas of Anesthesia machine according increasing pressure system wise i) Vaporize mounting devices ii) Hanger yoke assembly iii) Flow indicators iv) Pipe line indicator | Anesthesia machine according increasing pressure system iii) Flow indicators i) Vaporize mounting devices iv) Pipe line indicator ii) Hanger yoke assembly | 1 | (iii), (i), (iv), (ii) | (i), (iv), (iii), (ii) | (ii), (i), (iii), (iv) | (iii), (iv), (ii), (i) | Anaesthesia | Anesthesia Machine | 5a2a168a-f486-43b3-9e20-e08790893530 | single |
Intubation dose of pancuronium | D i.e. 0.08 mg/Kg Pancuronium is commonly used MR. d/t lack of S/E like flushing, bronchospasm as it causes less histamine release. It causes hypeension by releasing Noradrenaline and is safe in malignant hyperpyrexia. Dose for intubation is 0.08-0.12 mg/kgQ | 4 | 0.02 mg/Kg | 0.04 mg/Kg | 0.06 mg/Kg | 0.08 mg/Kg | Anaesthesia | null | 85ffaaa8-6bdf-4ddf-bdb1-a7c4d03658af | single |
Drug of choice for treating malignant hypehermia | Dantrolene sodiumis thedrug of choicefor malignant hypehermia but it is to be reconstituted withsterile distilled water, not saline as it can precipitate in saline or other salt solutions. It is given at a dose of2.5 mg/ kgintravenously and can be repeated every 5-10 minutes (upto 10mg/kg) till the attack subsides. All anesthetic agents should be cut off and the patient is given 100% oxygen. Bicarbonate at a dose of 1 to 4 mEq/kg IV can be used to treat metabolic acidosis. If the body temperature is high, it should be brought down using cold intravenous fluids, cooling body cavities with sterile iced fluids, surface cooling with ice packs and cooling blankets. | 1 | Dantrolene | Nikethamide | Baclofene | Propofol | Anaesthesia | Inhalational Anesthetic Agents | 28dc851b-82e3-4137-9499-71763192520d | single |
After hyperventilation for some time holding the breath is dangerous since | B i.e. Due to lack of stimulation by CO2, anoxia can go into dangerous level | 2 | It can lead to CO2 narcosis | due to lack of stimulation by CO2, anoxia can go into dangerous level | I-0O2 shift 0 dissociation curve to left. | Alkalosis can lead to tetany | Anaesthesia | null | f8d4bad9-26d8-48d5-bfdc-1adca17c43cc | single |
Size in < 6 years old child, of endotracheal tube is | A i.e. Age +3.5/3.5 | 1 | Age +3.5/3.5 | Age +2.5/2.5 | Age + 4.5/4.5 | Age -4.5/4.5 | Anaesthesia | null | f28eaa42-3795-4ba3-838c-4547798818c0 | single |
Least soluble anesthetic agent is | Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. It is inversely propoional to the induction rate. It determines the onset of induction and recovery. anesthetic blood gas solubility Nitrous oxide 0.47 Halothane 2.4 Isoflurane 1.4 Sevoflurane 0.65 Desflurane 0.45 Methoxyflurane 12 Enflurane 1.9 | 1 | Desflurane | Sevoflurane | Halothane | Methoxyflurane | Anaesthesia | General anaesthesia | 49090fa2-2ee0-4a32-b560-1b973f33cf93 | single |
Sodalime in breathing circuit is contraindicated with | Chloroform produces phosphogene gas with soda lime, so soda lime is contraindicated with it. | 2 | Sevoflurane | Chloroform | Desflurane | Methoxyflurane | Anaesthesia | null | cb2323ae-61d9-47c3-9955-47373f679cb0 | single |
Ketamine is useful as an anesthetic agent in | Ketamine is a potent bronchodilator and relieves bronchospasm -Intravenous anaesthetic agent of choice in asthmatic Ketamine increases ICT, IOP and cardiac oxygen demand, therefore contraindicated in other three conditionsNote-Inhalation anaesthetic agent of choice in asthmatics is halothane.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 182 - 184) | 3 | Ischemic hea disease | Intracranial hemorrhage | Hyperactive airways | Glaucoma | Anaesthesia | All India exam | 82b0a445-9a84-4231-b4c8-fa7205ff6c63 | single |
Coronary steal syndrome is associated with | Coronary steal phenomenonInpatient with coronary aery stenosis, isoflurane causes coronary aery vasodilatation in non-ischemic area, thereby diveing the blood away from ischemic zone.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.169) | 3 | Desflurane | Sevoflurane | Isoflurane | Halothane | Anaesthesia | All India exam | 8f1d7c98-909c-434a-8bdb-9518c9160f93 | single |
The proseal LMA has advantage over normal LMA | Advantage of proseal LMA over classical LMA is that it is comparable to ETT in preventing aspiration. The PLMA shows several modifications from the cLMA: The drain tube runs through the device from the tip to the proximal end. When the PLMA is correctly positioned, the tip of the device forms a high-pressure seal with the oesophageal inlet and the drain tube runs in continuity with the oesophageal lumen . oesophageal drain tube posterior inflatable cuff reinforced airway tube integral bite block introducer this reduces the risk of aspiration and hence may be suitable in non-supine positions (e.g., lateral, prone), in laparoscopic surgery (e.g., cholecystectomy, gynecological surgery), and in patients who are obese. | 2 | In being more easy to inse | Comparable to endotracheal tube in preventing aspiration | Can be inseed in concious patient. | Can be used for pulmonary toileting | Anaesthesia | Airway | 3d59a333-060b-40c9-bff7-a9b96c70142a | single |
Pudendal Nerve Block Involve | D i.e. S2 S3 S4 | 4 | LiL2L3 | L2L3L4 | SiS2S3 | S2S3S4 | Anaesthesia | null | e96b637f-8c74-449a-a9ad-e70925209f7b | single |
Minimal mandatory Percentage of oxygen used in general anaesthesia is | minimum mandatory is 30% oxygen. Less than 30 % can only is allowed in surgeries with high risk of fire hazard. There we decrease oxygen under strict monitoring. | 2 | 33% | 30% | 21% | 66% | Anaesthesia | Inhalational Anesthetic Agents | 0fbe3ddc-b37c-4cbb-be00-88efbacd906c | single |
Most common complication of spinal anesthesia is | A i.e. Hypotension | 1 | Hypotension | Headache | Meningitis | Arrythmia | Anaesthesia | null | 04dadaa1-1bfe-45a7-ab9d-0fc9636d0713 | single |
Preclampsia patient at 38 weeks of gestation is started on oxytocin to augment her labor and the patient is now requesting for epidural analgesia. Anaesthetic considerations include | Always ensure adequate hemostasis prior to epidural anaesthesia. Platelet count less than <50000/microliter is contraindicated to neuroxial interventions due to high risk epidural hematoma. | 2 | No work up is required prior to performing epidural anaesthesia, as this will treat her hypertension | The presence of hypertension and oedema requires further workup before proceeding. | Neuraxial anaesthesia should be avoided, as there is increased risk of bleeding | Avoid systemic opiates, as the risk of respiratory depression is too high | Anaesthesia | null | 81e1a070-0b0c-4237-bf0d-96ca842f24e0 | single |
Pain rating index is provided by | C i.e. Mc Gill questionnaire | 3 | Faces scale | Visual analogue scale | Mc Gill questionniare | CHEOP scale | Anaesthesia | null | 3e9dbc59-226d-4b33-b6d6-4d9faaee0200 | single |
During cesarean section under general endotracheal anaesthesia, venous air embolism | Expired Nitrogen is the most sensitive venous-air embolism detection method, as the largest component of air is nitrogen. | 3 | Is associated with high end-tidal CO2 | Should be treated with nitrous oxide | Is associated with expired nitrogen | Induces severe hypertension | Anaesthesia | null | 501c7143-2635-45e9-a370-40d908dfd2ba | single |
Most common complication of central venous catheter | C i.e. Catheter related infection | 3 | Local bleeding | Thrombosis | Catheter related infection | Pneumotherax | Anaesthesia | null | e0ef736f-4115-4fa1-9b48-3891bb54be93 | single |
If thiopentone is injected accidently into an aery the first symptom is | D i.e. Pain | 4 | Analgesia | Paralysis | Skin ulceration | Pain | Anaesthesia | null | 86799b51-64da-4c55-a02f-ab32d1504ec0 | single |
Percentage of adrenaline with lignocaine for local infilteration is | The most common concentrations of epinephrine combined with local anaesthetics are 1:50000 (0.02 mg/ml), 1:100,000 (0.01mg/ml) and 1:20000 (0.005 mg/dml)The 1:50000 concentration is manufactured in combination with 2% lidocaineThe 1:100,000 concentration is manufactured in combination with 2% lidocaine and 4% aicaineThe 1:200,000 concentration is manufacture in combination with 4% prilocaine, 4% aicaine and 0.5% bupivacaine.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.523,126,127) | 4 | 0.736111111 | 1:10000 | 0.111111111 | 1:50000 | Anaesthesia | All India exam | f6cb2e92-cb6d-4dfb-af1c-62ecf4693f68 | single |
Semiclosed circuit system | Semiclose breathing circuit is less economical, causes more environmental pollution. It is simple portable and no need of advanced monitoring. | 3 | Needs advanced monitoring | Complex | More environmental pollution | More economical | Anaesthesia | null | 32ec269a-db55-4f15-afc1-6910b6d77ff1 | single |
Post dural (spinal) puncture headache is due to | (Seepage of CSF) (517 - Lee's 13th) (360-KDT 6th)* Post spinal headache is due to seepage of CSF: can be minimised by using smaller bore needle (KDT)* Typical location is bifrontal and / or occipital* It is more common in Young pregnant patients and with accidental dural puncture rate during epidural anaesthesia using Touhyneedle (60 - 80%) Reduced by introduction of size 25 G and 27 - G whitacre pencil point needles. Which replaced cutting needles* Paralysis of cranial nerve. All cranial nerves except 1st, 9, 10th can be involved after spinal Anaesthesia. Most commonly (90%) 6th nerve is involved (Because of the longest course of 6th nerve) | 1 | Seepage of CSF | Fine needle | Toxic effects of the drugs | Traumatic damage to nerve roots | Pharmacology | Anaesthesia | 89f2b9da-cbe5-4816-a4c2-7ac6b11e26d7 | single |
Most common injection site infection in spinal anaesthesia | Streptococcal infection is most common in spinal anaesthesia. | 2 | Staphylococcus | Streptococcus | Pseudomonas | Bacteroides | Anaesthesia | null | d79211c5-f256-4296-9c01-8874aaa68c5d | single |
Adapting LLMs to Domains via Continual Pre-Training (ICLR 2024)
This repo contains the Biomedicine Knowledge Probing dataset used in our paper Adapting Large Language Models via Reading Comprehension.
We explore continued pre-training on domain-specific corpora for large language models. While this approach enriches LLMs with domain knowledge, it significantly hurts their prompting ability for question answering. Inspired by human learning via reading comprehension, we propose a simple method to transform large-scale pre-training corpora into reading comprehension texts, consistently improving prompting performance across tasks in biomedicine, finance, and law domains. Our 7B model competes with much larger domain-specific models like BloombergGPT-50B.
[2024/6/21] 🤗 We release the 2nd version of AdaptLLM at Instruction-Pretrain, effective for both pre-training from scratch and continual pre-training 🤗
**************************** Updates ****************************
- 2024/8/29: Updated guidelines on evaluating any 🤗Huggingface models on the domain-specific tasks
- 2024/6/22: Released the benchmarking code
- 2024/6/21: Released the 2nd version of AdaptLLM at Instruction-Pretrain
- 2024/4/14: Released the knowledge probing datasets at med_knowledge_prob and law_knowledge_prob
- 2024/4/2: Released the raw data splits (train and test) of all the evaluation datasets
- 2024/1/16: Our research paper has been accepted by ICLR 2024
- 2023/12/19: Released our 13B base models developed from LLaMA-1-13B
- 2023/12/8: Released our chat models developed from LLaMA-2-Chat-7B
- 2023/9/18: Released our paper, code, data, and base models developed from LLaMA-1-7B
1. Domain-Specific Models
LLaMA-1-7B
In our paper, we develop three domain-specific models from LLaMA-1-7B, which are also available in Huggingface: Biomedicine-LLM, Finance-LLM and Law-LLM, the performances of our AdaptLLM compared to other domain-specific LLMs are:
LLaMA-1-13B
Moreover, we scale up our base model to LLaMA-1-13B to see if our method is similarly effective for larger-scale models, and the results are consistently positive too: Biomedicine-LLM-13B, Finance-LLM-13B and Law-LLM-13B.
LLaMA-2-Chat
Our method is also effective for aligned models! LLaMA-2-Chat requires a specific data format, and our reading comprehension can perfectly fit the data format by transforming the reading comprehension into a multi-turn conversation. We have also open-sourced chat models in different domains: Biomedicine-Chat, Finance-Chat and Law-Chat.
LLaMA-3-8B (💡New!)
In our recent research on Instruction-Pretrain, we developed a context-based instruction synthesizer to augment the raw corpora with instruction-response pairs, enabling Llama3-8B to be comparable to or even outperform Llama3-70B: Finance-Llama3-8B, Biomedicine-Llama3-8B.
2. Domain-Specific Tasks
Pre-templatized Testing Splits
To easily reproduce our prompting results, we have uploaded the filled-in zero/few-shot input instructions and output completions of the test each domain-specific task: biomedicine-tasks, finance-tasks, and law-tasks.
Note: those filled-in instructions are specifically tailored for models before alignment and do NOT fit for the specific data format required for chat models.
Evaluating Any Huggingface LMs on Domain-Specific Tasks (💡New!)
You can use the following script to reproduce our results and evaluate any other Huggingface models on domain-specific tasks. Note that the script is NOT applicable to models that require specific prompt templates (e.g., Llama2-chat, Llama3-Instruct).
1). Set Up Dependencies
git clone https://github.com/microsoft/LMOps
cd LMOps/adaptllm
pip install -r requirements.txt
2). Evaluate the Model
# Select the domain from ['biomedicine', 'finance', 'law']
DOMAIN='biomedicine'
# Specify any Huggingface model name (Not applicable to chat models)
MODEL='instruction-pretrain/medicine-Llama3-8B'
# Model parallelization:
# - Set MODEL_PARALLEL=False if the model fits on a single GPU.
# We observe that LMs smaller than 10B always meet this requirement.
# - Set MODEL_PARALLEL=True if the model is too large and encounters OOM on a single GPU.
MODEL_PARALLEL=False
# Choose the number of GPUs from [1, 2, 4, 8]
N_GPU=1
# Whether to add a BOS token at the beginning of the prompt input:
# - Set to False for AdaptLLM.
# - Set to True for instruction-pretrain models.
# If unsure, we recommend setting it to False, as this is suitable for most LMs.
add_bos_token=True
# Run the evaluation script
bash scripts/inference.sh ${DOMAIN} ${MODEL} ${add_bos_token} ${MODEL_PARALLEL} ${N_GPU}
Raw Datasets
We have also uploaded the raw training and testing splits, for facilitating fine-tuning or other usages: ChemProt, RCT, ConvFinQA, FiQA_SA, Headline, NER, FPB
Domain Knowledge Probing
Our pre-processed knowledge probing datasets are available at: med_knowledge_prob and law_knowledge_prob
Citation
If you find our work helpful, please cite us:
@inproceedings{
cheng2024adapting,
title={Adapting Large Language Models via Reading Comprehension},
author={Daixuan Cheng and Shaohan Huang and Furu Wei},
booktitle={The Twelfth International Conference on Learning Representations},
year={2024},
url={https://openreview.net/forum?id=y886UXPEZ0}
}
and the original dataset:
@inproceedings{MedMCQA,
author = {Ankit Pal and
Logesh Kumar Umapathi and
Malaikannan Sankarasubbu},
title = {MedMCQA: {A} Large-scale Multi-Subject Multi-Choice Dataset for Medical
domain Question Answering},
booktitle = {{CHIL}},
series = {Proceedings of Machine Learning Research},
volume = {174},
pages = {248--260},
publisher = {{PMLR}},
year = {2022}
}
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Models trained or fine-tuned on AdaptLLM/med_knowledge_prob
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