{"question": "Bone marrow depression is seen with.", "exp": "B i.e. N2O", "cop": 2, "opa": "Halothene", "opb": "N20", "opc": "Ether", "opd": "Isoflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "34dd629e-5386-4dd0-8caf-a804e6fd0607", "choice_type": "single"}
{"question": "The regional anaesthesia technique that would not be expected to provide appropriate analgesic benefit during the first stage of labor is", "exp": "Pudendal nerve block during delivery mitigates somatic pain during second stage of labor.", "cop": 2, "opa": "Lumbar epidural", "opb": "Pudendal nerve block", "opc": "Lumbar sympathetic block", "opd": "Paracervical block", "subject_name": "Anaesthesia", "topic_name": null, "id": "d43682d6-da0b-4579-a51b-0fb3cee61dc7", "choice_type": "single"}
{"question": "Recommended maximum dose of Lignocaine + adrenaline for peripheral nerve shock.", "exp": "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)", "cop": 1, "opa": "7 mg/kg bw", "opb": "4.5 mg/kg bw", "opc": "2 mg/ kg bw", "opd": "3 mg/kg bw", "subject_name": "Anaesthesia", "topic_name": "Regional Anesthesia", "id": "5920aa93-772c-4582-bded-9eed0f6a33eb", "choice_type": "single"}
{"question": "Local anaesthetic with prolonged action", "exp": "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)", "cop": 4, "opa": "Procaine", "opb": "Cocaine", "opc": "Lidocaine", "opd": "Dibucaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "0b66813d-89c4-4089-8a81-9c5163907a66", "choice_type": "single"}
{"question": "In venturi mask maximum O2 concentration attained is", "exp": "Maximum concentration delivered by ventimask (venturimask) is 60%.", "cop": 3, "opa": "90%", "opb": "100%", "opc": "60%", "opd": "80%", "subject_name": "Anaesthesia", "topic_name": null, "id": "cf4ca71d-373b-4e97-a5d1-758bf63b2ed1", "choice_type": "single"}
{"question": "Percentage of lidocaine in eutectic mixture", "exp": "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)", "cop": 2, "opa": "1%", "opb": "2.55", "opc": "5%", "opd": "10%", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "b1184e2d-1dc9-4997-907f-8fadece6bfe5", "choice_type": "single"}
{"question": "Following group of drugs is not the first line in the management of chronic", "exp": null, "cop": 3, "opa": "Opioids", "opb": "Antiepileptics", "opc": "Dopamine antagonist", "opd": "Serotonergic drugs", "subject_name": "Anaesthesia", "topic_name": null, "id": "be576689-98e0-4e4f-9fed-08eea325798b", "choice_type": "single"}
{"question": "Most commonly used nerve for neuromuscular monitoring under anesthesia is", "exp": "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", "cop": 2, "opa": "Radial", "opb": "Ulnar", "opc": "Glossopharyngeal", "opd": "Vagus", "subject_name": "Anaesthesia", "topic_name": "Monitoring in Anesthesia", "id": "7ca524c7-8c12-4671-b59b-6eb9db002fc7", "choice_type": "single"}
{"question": "Anaesthesia used in microlaryngoscopy is", "exp": "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)", "cop": 3, "opa": "Pollarad tube of 10 mm diameter with heavy sedation", "opb": "Pollarad tube of 15 mm diameter with topical xylocaine", "opc": "Pollarad tube with infiltration block", "opd": "Heavy sedation on and Endotracheal intubation", "subject_name": "Anaesthesia", "topic_name": null, "id": "11b27d26-0b05-4dfe-bf68-4f8999b7192c", "choice_type": "single"}
{"question": "Shortest acting muscle relaxant is", "exp": "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", "cop": 1, "opa": "Succinylcholine", "opb": "Vecuronium", "opc": "Pancuronium", "opd": "Atracurium", "subject_name": "Anaesthesia", "topic_name": "Muscle Relaxant", "id": "d953d978-03c3-4903-87dd-e87b92319971", "choice_type": "single"}
{"question": "Muscle relaxant with ganglion blocker action are A/E", "exp": "D i.e. Halothane", "cop": 4, "opa": "Pancuronium", "opb": "Trimethaphan", "opc": "Curare", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "4e8372ea-a052-4b14-b269-d86cd4d5a45a", "choice_type": "single"}
{"question": "Anaesthetic without epileptogenic potential", "exp": "Ans:A.)Desflurane. Sevoflurane,Enflurane and Isoflurane have Epileptogenic potential.", "cop": 1, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Isoflurane", "opd": "Enflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "813ac636-730a-49c3-b348-f9a514cc77bb", "choice_type": "single"}
{"question": "Induction agent of choice in day care surgery is", "exp": "(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", "cop": 2, "opa": "Ketamine", "opb": "Propofol", "opc": "Methohexitone", "opd": "Thiopentone sodium", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "de6ab9af-a223-49b8-8ed6-3e25f065f0b3", "choice_type": "single"}
{"question": "Most appropriate mode of ventilation for head injury patient", "exp": null, "cop": 3, "opa": "CPAP", "opb": "SIMV", "opc": "CMV", "opd": "AMV", "subject_name": "Anaesthesia", "topic_name": null, "id": "e25d6843-1d97-458a-b2de-4a3d5a5ab58a", "choice_type": "single"}
{"question": "Clayton is used in a close breathing system for the purpose of", "exp": "D i.e. As an indicator", "cop": 4, "opa": "As a hardner", "opb": "As an absorbent", "opc": "As a softner", "opd": "As an indicator", "subject_name": "Anaesthesia", "topic_name": null, "id": "10c5d751-b270-497d-82f1-937e4940c279", "choice_type": "single"}
{"question": "Least soluble anaesthetic agent is", "exp": "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", "cop": 1, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Halothane", "opd": "Methoxyflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "228a9c90-d6e9-4c90-ad11-b2c70b74d43b", "choice_type": "single"}
{"question": "Supreme LMA characteristic is", "exp": "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)", "cop": 4, "opa": "Has no bite block", "opb": "Used in infants", "opc": "High pressure, low volume", "opd": "Has built in drain tube", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "8213f07f-ec90-4a1e-935e-020e96fadc90", "choice_type": "single"}
{"question": "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", "exp": "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.", "cop": 3, "opa": "ASA 3E", "opb": "ASA 3", "opc": "ASA 4E", "opd": "ASA 4", "subject_name": "Anaesthesia", "topic_name": null, "id": "7fcf03e0-da09-4c53-895d-2f73171e69b7", "choice_type": "single"}
{"question": "Capnography is used for assessment of", "exp": "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.", "cop": 3, "opa": "Oxygen saturation of blood", "opb": "Amount of CO2 transpoed in blood", "opc": "Ventilation of lung after intubation", "opd": "Myocardial perfusion", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "875eb259-41a6-46a4-8b93-504ce23c7caa", "choice_type": "single"}
{"question": "Contraindication for laryngeal mask airway is", "exp": "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", "cop": 2, "opa": "Empty stomach", "opb": "Hiatus hernia", "opc": "Minor surgery", "opd": "Young age", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "f0251eb0-f3b6-4281-98c4-8494811a913d", "choice_type": "single"}
{"question": "Most cardiostable among the following is", "exp": "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.", "cop": 4, "opa": "Thiopentone sodium", "opb": "Ketamine", "opc": "Propofol", "opd": "Etomidate", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "ac20506a-ad14-451a-8623-b55f455b160d", "choice_type": "single"}
{"question": "Hyperbaric Oxygen is not useful in", "exp": "Hyperbaric oxygen is not useful in veigo.", "cop": 2, "opa": "CO poisining", "opb": "Veigo", "opc": "Gas gangrene", "opd": "compament syndrome", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "e3fff86a-f185-4175-8bea-3920f3a9b8fe", "choice_type": "single"}
{"question": "Most common complication of celiac plexus block", "exp": "Postural hypotension : due to lumbar sympathetic chain blockade leading to upper abdominal vessel dilation and venous pooling. So intravenous fluids are required preblock", "cop": 2, "opa": "Pneumothorax", "opb": "Postural hypotention", "opc": "Retroperitoneal hamorrhage", "opd": "Intra_aerial injection", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "69310e44-16fe-4022-9aee-2f27a81ccb0b", "choice_type": "single"}
{"question": "The physiological dead space is decreased by", "exp": "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.", "cop": 3, "opa": "Upright position", "opb": "positive pressure ventilation", "opc": "Neck flexion", "opd": "Emphysema", "subject_name": "Anaesthesia", "topic_name": "Complications of anaesthesia", "id": "b22c2620-2de2-4a64-be80-6fab640e0360", "choice_type": "single"}
{"question": "In spinal anaesthesia the drug is deposited between", "exp": "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.", "cop": 2, "opa": "Dura and arachnoid", "opb": "Pia and arachnoid", "opc": "Dura and veebra", "opd": "Into the cord substance", "subject_name": "Anaesthesia", "topic_name": null, "id": "88cc204a-0e34-4c91-b342-9bdf12e7d692", "choice_type": "single"}
{"question": "Muscle relaxant with ganglion blocker action is", "exp": "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", "cop": 3, "opa": "Pancuronium", "opb": "Trimethoprim", "opc": "Curare", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "58d5b370-4d36-4a39-9034-b61aa5b454ac", "choice_type": "single"}
{"question": "In Phrenic nerve block, it is best to infiltrate near", "exp": "Phrenic nerve is blocked 3 cm above the clavicle at the posterior border of sternomastoid. Used for intractable hiccups", "cop": 3, "opa": "Scalenus anterior", "opb": "Scalenus posterior", "opc": "Posterior border of sternomastoid", "opd": "Anterior border of sternomastoid", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia of special situations", "id": "73ee2bf3-4428-426a-9a06-97862a8e0f46", "choice_type": "single"}
{"question": "Pulse oximetry monitors", "exp": "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.", "cop": 1, "opa": "Oxygen saturation of hemoglobin", "opb": "Oxygen content of blood", "opc": "Pulse pressure", "opd": "Oxygen paial pressure", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "b6fde986-dade-4aa6-8a36-3340a25c4f8e", "choice_type": "single"}
{"question": "Most cardiotoxic local anesthetic", "exp": "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)", "cop": 2, "opa": "Procaine", "opb": "Bupivacaine", "opc": "Cocaine", "opd": "Lidocaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "a533029b-defe-42ad-a7b5-946411f5111a", "choice_type": "single"}
{"question": "Characteristic of an ideal gas is", "exp": "D i.e. Obeys Charles, boyle's & avogadro's laws", "cop": 4, "opa": "Volume is directly propoional to change in pressure", "opb": "Volume is inversely propoional to change in temperature", "opc": "At absolute temp. volume of gas is 1", "opd": "Obeys Carles, Byles and Avagadro' laws", "subject_name": "Anaesthesia", "topic_name": null, "id": "60c041e8-c11a-4a39-b55c-3303aa1f4a6c", "choice_type": "single"}
{"question": "For Foreign bodies are retained in the larynx causing choking, first line of management is", "exp": "Hemilich manouvere", "cop": 2, "opa": "Airway inseion", "opb": "Hemilich manouvere", "opc": "Hemilich valve", "opd": "Tracheostomy", "subject_name": "Anaesthesia", "topic_name": null, "id": "10b873ef-f50c-4ab5-8bda-4ba832d785ff", "choice_type": "single"}
{"question": "Not a sign of stellate ganglion block", "exp": "Horner syndrome is a sign of stellate ganglion block (miosis, enopthalmos,ptosis, anhydrosis and absence of cliospinal reflex", "cop": 2, "opa": "Miosis", "opb": "exopthalomoss", "opc": "Nasal congestion", "opd": "Conjunctival redness", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "d2f82b22-2fc7-4ede-aa46-9b887e241002", "choice_type": "single"}
{"question": "This manouver helps to", "exp": "This is BURP manouver . here thyroid cartilage is pushed back up with right pressure to improve laryngoscopic view.", "cop": 2, "opa": "Decrease risk of aspiration", "opb": "Improve laryngoscopic view", "opc": "Open the airway", "opd": "Stabilize ET tube position", "subject_name": "Anaesthesia", "topic_name": null, "id": "08958bd9-ccd0-473d-b34c-cc6f2ead9b83", "choice_type": "single"}
{"question": "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", "exp": "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", "cop": 3, "opa": "1<2<3<4", "opb": "1<3<4<2", "opc": "3<4<1<2", "opd": "4<3<2<1", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia Q Bank", "id": "0e6559ce-8a0f-4540-8af4-2a5e19508815", "choice_type": "single"}
{"question": "Ether was first used by", "exp": "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", "cop": 2, "opa": "Priestley", "opb": "Moon", "opc": "Wells", "opd": "Simpson", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "6eba1feb-f4f5-4d46-ae0b-897369dab138", "choice_type": "single"}
{"question": "High airway resistance is seen in", "exp": "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", "cop": 4, "opa": "Respiratory bronchiole", "opb": "Intermediate bronchiole", "opc": "Terminal bronchiole", "opd": "Main bronchus", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "cfdb0644-0572-4bb3-92de-499607ec1305", "choice_type": "single"}
{"question": "Secondary action of Superior Rectus Muscle is", "exp": "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", "cop": 3, "opa": "Abduction & extorsion", "opb": "Adduction & extorsion", "opc": "Adduction & intorsion", "opd": "Adduction & extorsion", "subject_name": "Anaesthesia", "topic_name": null, "id": "46f092cd-fbd3-4389-b6d3-d186d528e8fe", "choice_type": "single"}
{"question": "Optimum oxygenation is maintained by adjusting following parameters\na — Tidal volume,b — PEEP,c — FiO2,d — respiratory rate", "exp": "PEEP and FiO2 determine optimum oxygenation.", "cop": 2, "opa": "a, b", "opb": "b, c", "opc": "c, d", "opd": "d, a", "subject_name": "Anaesthesia", "topic_name": null, "id": "86c8c8c5-5db2-48c7-9d4f-3f2399e901df", "choice_type": "single"}
{"question": "No effect on hea", "exp": "B i.e. Ether", "cop": 2, "opa": "Chloroform", "opb": "Ether", "opc": "Methoxyflurane", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "1d9fb803-31b6-4c88-b8a3-ec2a7a806839", "choice_type": "single"}
{"question": "Local anaesthesia causing methemoglobinemia", "exp": "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", "cop": 2, "opa": "Procaine", "opb": "Prilocaine", "opc": "Etiodicaine", "opd": "Ropivacaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "81eac16b-f72a-4838-9262-272b0df14a2a", "choice_type": "single"}
{"question": "The most potent synthetic opioid is", "exp": "Sufentanil has a high affinity for the mu receptor, higher than that of any other opioid.", "cop": 2, "opa": "Remifentanil", "opb": "Sufentanil", "opc": "Alfentanil", "opd": "Fentanyl", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f388c0c1-5324-4954-a99d-7b61dafc1d14", "choice_type": "single"}
{"question": "Modality best utilized for neuromuscular monitoring during maintenance of anaesthesia is", "exp": "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.", "cop": 1, "opa": "Train of four", "opb": "Single twitch", "opc": "Tetanic stimulation", "opd": "Post-tetanic stimulation", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "4f166a9a-a656-4653-ac4b-0c5b31f32383", "choice_type": "single"}
{"question": "In a patient with fixed respiratory obstruction Helium is used along with Oxygen instead of plain oxygen because", "exp": "B i.e. It decreases turbulence", "cop": 2, "opa": "It increases the absorption of oxygen", "opb": "It decreases turbulence", "opc": "It decreases the dead space", "opd": "For analgesia", "subject_name": "Anaesthesia", "topic_name": null, "id": "3a0ffbe4-a3c2-4a62-a9b2-ae3ff303b88b", "choice_type": "single"}
{"question": "100 % Oxygen therapy used in", "exp": "(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", "cop": 1, "opa": "Cluster headache", "opb": "Migraine", "opc": "Congenital spherocytosis", "opd": "COPD", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "14b4e0a0-db11-434f-a13a-1657d0325ff0", "choice_type": "single"}
{"question": "Intravenous anaesthetic agent of choice in status epilepticus", "exp": "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.", "cop": 1, "opa": "Propofol", "opb": "Thiopentone", "opc": "Ketamine", "opd": "Etomidate", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "6e8fd92b-b3ae-4679-bd79-9f043350abff", "choice_type": "single"}
{"question": "Critical temperature for liquid nitrogen is", "exp": "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)", "cop": 3, "opa": "36.5degC", "opb": "-20degC", "opc": "-147degC", "opd": "-242degC", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "da6170ab-6a68-4a2c-bbf8-900eb0574402", "choice_type": "single"}
{"question": "Hepatotoxic inhalational agent", "exp": "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)", "cop": 1, "opa": "Halothane", "opb": "Enflurane", "opc": "Desflurane", "opd": "Sevoflurane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "2aba8f3a-d451-4fb0-91eb-9e740836110a", "choice_type": "single"}
{"question": "Shoest acting non depolarizing muscle relaxant is", "exp": "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)", "cop": 1, "opa": "Mivacurium", "opb": "Doxacuronium", "opc": "Pipecurium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e89c60e7-82cf-4a17-bfd9-be302f7831a7", "choice_type": "single"}
{"question": "Anesthesia agent with least analgesic propey", "exp": "B i.e. Halothane", "cop": 2, "opa": "N20", "opb": "Halothane", "opc": "Ether", "opd": "Propane", "subject_name": "Anaesthesia", "topic_name": null, "id": "718f54d3-cdd2-485c-8945-f764d6d471f2", "choice_type": "single"}
{"question": "Laudanosine is metabolic end product of", "exp": "Laudanosine is metabolic end product of atracurium.", "cop": 4, "opa": "Mivacurium", "opb": "Doxacurium", "opc": "Rocuronium", "opd": "Atracurium", "subject_name": "Anaesthesia", "topic_name": null, "id": "5e40f87b-3d60-45ab-b5dd-63e7df7e6b98", "choice_type": "single"}
{"question": "Not compatible with soda lime", "exp": "C i.e. Trielene", "cop": 3, "opa": "Ether", "opb": "Halothene", "opc": "Trilene", "opd": "N20", "subject_name": "Anaesthesia", "topic_name": null, "id": "6b1af373-9cc6-4607-8ad5-483ce4f70432", "choice_type": "single"}
{"question": "Flat capnogram found in A/E", "exp": "in bronchospasm,there is prolonged expiratory upstroke(abscence of phase 3 plateau). in tube displacement,disconnection,accidental extubation,ventilation failure,it is flat.", "cop": 4, "opa": "Disconnection of anesthetic tubing", "opb": "Accidental extubation", "opc": "Mechanjca1 ventilation failure", "opd": "Bronchospasm", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "e5738549-f3c5-4247-9089-9ff519f30ca1", "choice_type": "single"}
{"question": "Spinal anesthesia should be injected into the space between", "exp": "Spinal anesthesia is usually injected at L3-L4, L2-L3", "cop": 3, "opa": "T12-L1", "opb": "L1-L2", "opc": "L3-L4", "opd": "L5-S1", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "a1cb2b48-b7f8-456c-97c5-e17fe66027cd", "choice_type": "single"}
{"question": "Maximum vital capacity decreased in", "exp": "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.", "cop": 3, "opa": "Prone", "opb": "Supine", "opc": "Trendelenberg", "opd": "Left lateral", "subject_name": "Anaesthesia", "topic_name": null, "id": "8521d3bf-35b8-4312-be43-d52f01f57e24", "choice_type": "single"}
{"question": "The term \"balanced anaesthesia\" has been given by", "exp": "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.", "cop": 3, "opa": "Simpson", "opb": "Fischer", "opc": "Lundy", "opd": "Moan", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e572f5b1-585a-47b0-8038-af45ad4ff2c2", "choice_type": "single"}
{"question": "Shoest acting nondepolarising muscle relaxant", "exp": "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 )", "cop": 2, "opa": "Succinylcholine", "opb": "Mivacurium", "opc": "Atracurium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e38f7b88-3a20-4d93-b903-95bfb12631dd", "choice_type": "single"}
{"question": "Modern monitors to measure ETCO2 make use of", "exp": "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)", "cop": 1, "opa": "Infrared absorption spectroscopy", "opb": "Ultra violet rays", "opc": "Laser technology", "opd": "Scatter technology", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "24e64e1a-15b0-4a9b-8ed0-1411b5cd02b2", "choice_type": "single"}
{"question": "Propofol infusion syndrome is characterized by", "exp": "Propofol infusion syndrome occurs when propofol infusion is continued for more than 48 hours\n\nSevere metabolic acidosis\nAcute cardiacfailure\nHyperkalemia\nHyperlipidemia\nSkeletal myopathy\nRefractory bradycardia.", "cop": 3, "opa": "Hypokalemia", "opb": "Hypolipidemia", "opc": "Bradycardia", "opd": "Tachycardia", "subject_name": "Anaesthesia", "topic_name": null, "id": "5032d293-19a2-48f2-b738-6f19154c2893", "choice_type": "single"}
{"question": "Fixed performance device is", "exp": "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.", "cop": 1, "opa": "Ventury mask", "opb": "Nasal cannula", "opc": "Simple mask", "opd": "Non rebreathing mask", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "742eaa85-dd16-4b48-bd44-d65975b39aa2", "choice_type": "single"}
{"question": "A 25 year old male is undergoing incision and drainage of abscess under general anaesthesia with Spontaneous respiration. The most efficient anaesthetic circuit is", "exp": "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", "cop": 1, "opa": "Maplelson A", "opb": "Mapleson B", "opc": "Mapleson C", "opd": "Mapleson D", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "c8c0403f-2c1b-4c6b-aebe-846b4757a6f2", "choice_type": "single"}
{"question": "Sciatic nerve blockade provides sensory loss of the", "exp": "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.", "cop": 2, "opa": "Anterior and lateral thigh", "opb": "Posterior thigh and majority of the leg below the knee", "opc": "Medial and posterior thigh", "opd": "Medial leg below the knee", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "cb5f9066-dc57-414a-8172-501eef202218", "choice_type": "single"}
{"question": "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", "exp": "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.", "cop": 2, "opa": "Opening of sodium channels", "opb": "Blockage of activated sodium channels", "opc": "Increased frequency of GABA activated chloride channels", "opd": "Increased duration of GABA activated chloride channels", "subject_name": "Anaesthesia", "topic_name": "Local and Regional Anesthesia", "id": "c6b85368-d8fe-4c98-822a-b583a16add40", "choice_type": "single"}
{"question": "% of thiopentone used in induction", "exp": "C i.e. 2.5%", "cop": 3, "opa": "0.50%", "opb": "1.50%", "opc": "2.50%", "opd": "4.50%", "subject_name": "Anaesthesia", "topic_name": null, "id": "1ee29635-fb6c-4606-8292-cf5a04397794", "choice_type": "single"}
{"question": "Emergency oxygen flush in anaesthetic machine provides", "exp": "Emergency oxygen flush delivers more than normal amount of oxygen at higher pressure to stabilize the patient.", "cop": 1, "opa": "35-75L/min oxygen at 55 to 60 Psi pressure", "opb": "25-35L/min oxygen at 10 to 12 Psi pressure", "opc": "55-75L/min oxygen at 55 to 60 Psi pressure", "opd": "10-20L/min oxygen at 10 to 12Psi pressure", "subject_name": "Anaesthesia", "topic_name": null, "id": "851d06d5-3fe7-4461-89bd-a2d8b40b93ea", "choice_type": "single"}
{"question": "Best anaesthetic agent for out patient anasthesia is", "exp": "C i.e. Alfentanyl", "cop": 3, "opa": "Fentanyl", "opb": "Morphine", "opc": "Alfentanyl", "opd": "Penthidine", "subject_name": "Anaesthesia", "topic_name": null, "id": "ee86b126-91ed-41d4-9331-9ba7abf20155", "choice_type": "single"}
{"question": "Pseudocholinesterase acts on", "exp": "Mivacurium is metabolised by pseudocholinesterase. Rest all are metabolisedby non specific esterase.", "cop": 3, "opa": "Esmolol", "opb": "Atracurium", "opc": "Mivacurium", "opd": "Remifentanil", "subject_name": "Anaesthesia", "topic_name": null, "id": "bcc36afa-7332-4b0e-83e3-53232d3cdef9", "choice_type": "single"}
{"question": "Commonly used in narcoanalysis", "exp": "D i.e. Thiopentone", "cop": 4, "opa": "Atropine", "opb": "Scopolamine", "opc": "Opium", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": null, "id": "918d9528-7fb8-4b09-b363-b1b55ae85fad", "choice_type": "single"}
{"question": "Least absorbed from mucous membrane are", "exp": "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", "cop": 3, "opa": "Lidocaine", "opb": "Tetracaine", "opc": "Procaine", "opd": "Cocaine", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "a34f62b6-ba9f-4de3-971f-76198e94855f", "choice_type": "single"}
{"question": "Mac Intosh curved blade laryngoscope is a type of", "exp": "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", "cop": 2, "opa": "Indirect laryngoscope", "opb": "Direct laryngoscopc", "opc": "Bronchoscope", "opd": "Video laryngoscope", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "fdbe6912-964c-47ec-be94-1b1efd057965", "choice_type": "single"}
{"question": "For a 78 yr old man for trans urethral resection of prostate, ideal anesthetic method is spinal anesthesia, this is because", "exp": "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.", "cop": 2, "opa": "General anesthesia causes more bleeding than spinal", "opb": "Signs of hyponatremia can easily be detected under spinal", "opc": "Spinal anesthesia abolishes the obturator nerve stimulation by electro cautery", "opd": "Obstructive uropathy and renal failure may be associated with prostatic enlargement", "subject_name": "Anaesthesia", "topic_name": "Central Neuraxial Blockade", "id": "33fdba55-187e-4fba-b943-34f805891bd7", "choice_type": "single"}
{"question": "In relation to the drug Sugammadex", "exp": "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).", "cop": 3, "opa": "It is recommended for immediate reversal of Vecuronium", "opb": "It can effectively reverse Cisatracurium", "opc": "16mg/kg is recommended intravenously for the immediate reversal of Rocuronium", "opd": "It is an a-cyclodextrin that encapsulates amino-steroid neuromuscular blocking agents", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "e6ddcc52-375d-4917-8f50-ea9d26b852f6", "choice_type": "single"}
{"question": "Index of potency of general anaesthesia", "exp": "A i.e. Minimum alveolar concentration", "cop": 1, "opa": "Minimum alveolar concentration", "opb": "Diffusion coefficient", "opc": "Dead space concentration", "opd": "Alveolar blood concentration", "subject_name": "Anaesthesia", "topic_name": null, "id": "d7ad68d6-b31a-45b1-a153-e07a4e495f0e", "choice_type": "single"}
{"question": "Induction agent of choice in bronchial asthma", "exp": "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", "cop": 3, "opa": "Thiopentone", "opb": "Methhexitone", "opc": "Ketamine", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f5dc8e72-d1f0-46d3-83d4-995da57dbc1e", "choice_type": "single"}
{"question": "Day care anesthesia is best achieved with", "exp": "Propofol", "cop": 3, "opa": "Enflurane", "opb": "Isoflurane", "opc": "Propofol", "opd": "Methoxyflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "a1cd9953-168a-41fa-a948-9f6ef8dd9aca", "choice_type": "single"}
{"question": "Vasponstricator L.A. is", "exp": "All local anaesthetics are vasodilators except cociane which is a vasoconstrictor", "cop": 1, "opa": "Cocaine", "opb": "Procaine", "opc": "Lidocaine", "opd": "Chlorprocain", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "bff27f23-a636-4d92-acc4-b4fc4781ee65", "choice_type": "single"}
{"question": "The recommended size of endotracheal tube for 1 year old child is", "exp": "Tube diameter in mm\n= Age in years/4 + 4\n= 1/4 + 4\n= 17/4\n= 4.2", "cop": 3, "opa": "2.5", "opb": "3", "opc": "4", "opd": "5", "subject_name": "Anaesthesia", "topic_name": null, "id": "92736f6a-a3e7-41cb-b4dc-2e6edfb3f8da", "choice_type": "single"}
{"question": "Nasal intubation is contra indicated in", "exp": "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.", "cop": 1, "opa": "CSF Rhinorrhea", "opb": "Fracture cervical spine", "opc": "Fracture mandible", "opd": "Sho neck", "subject_name": "Anaesthesia", "topic_name": null, "id": "a06ca870-cad9-4717-a950-3a5aad1e44e8", "choice_type": "single"}
{"question": "Visual analogue scale  most widely used to measure", "exp": null, "cop": 4, "opa": "Sleep", "opb": "Sedation", "opc": "Depth of anaesthesia", "opd": "Pain intensity", "subject_name": "Anaesthesia", "topic_name": null, "id": "e1addaf9-cab8-4b28-9497-d74b5af32b8c", "choice_type": "single"}
{"question": "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", "exp": "Anesthesia machine according increasing pressure system iii) Flow indicators i) Vaporize mounting devices iv) Pipe line indicator ii) Hanger yoke assembly", "cop": 1, "opa": "(iii), (i), (iv), (ii)", "opb": "(i), (iv), (iii), (ii)", "opc": "(ii), (i), (iii), (iv)", "opd": "(iii), (iv), (ii), (i)", "subject_name": "Anaesthesia", "topic_name": "Anesthesia Machine", "id": "5a2a168a-f486-43b3-9e20-e08790893530", "choice_type": "single"}
{"question": "Intubation dose of pancuronium", "exp": "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", "cop": 4, "opa": "0.02 mg/Kg", "opb": "0.04 mg/Kg", "opc": "0.06 mg/Kg", "opd": "0.08 mg/Kg", "subject_name": "Anaesthesia", "topic_name": null, "id": "85ffaaa8-6bdf-4ddf-bdb1-a7c4d03658af", "choice_type": "single"}
{"question": "Drug of choice for treating malignant hypehermia", "exp": "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.", "cop": 1, "opa": "Dantrolene", "opb": "Nikethamide", "opc": "Baclofene", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "28dc851b-82e3-4137-9499-71763192520d", "choice_type": "single"}
{"question": "After hyperventilation for some time holding the breath is dangerous since", "exp": "B i.e. Due to lack of stimulation by CO2, anoxia can go into dangerous level", "cop": 2, "opa": "It can lead to CO2 narcosis", "opb": "due to lack of stimulation by CO2, anoxia can go into dangerous level", "opc": "I-0O2 shift 0 dissociation curve to left.", "opd": "Alkalosis can lead to tetany", "subject_name": "Anaesthesia", "topic_name": null, "id": "f8d4bad9-26d8-48d5-bfdc-1adca17c43cc", "choice_type": "single"}
{"question": "Size in < 6 years old child, of endotracheal tube is", "exp": "A i.e. Age +3.5/3.5", "cop": 1, "opa": "Age +3.5/3.5", "opb": "Age +2.5/2.5", "opc": "Age + 4.5/4.5", "opd": "Age -4.5/4.5", "subject_name": "Anaesthesia", "topic_name": null, "id": "f28eaa42-3795-4ba3-838c-4547798818c0", "choice_type": "single"}
{"question": "Least soluble anesthetic agent is", "exp": "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", "cop": 1, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Halothane", "opd": "Methoxyflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "49090fa2-2ee0-4a32-b560-1b973f33cf93", "choice_type": "single"}
{"question": "Sodalime in breathing circuit is contraindicated with", "exp": "Chloroform produces phosphogene gas with soda lime, so soda lime is contraindicated with it.", "cop": 2, "opa": "Sevoflurane", "opb": "Chloroform", "opc": "Desflurane", "opd": "Methoxyflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "cb2323ae-61d9-47c3-9955-47373f679cb0", "choice_type": "single"}
{"question": "Ketamine is useful as an anesthetic agent in", "exp": "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)", "cop": 3, "opa": "Ischemic hea disease", "opb": "Intracranial hemorrhage", "opc": "Hyperactive airways", "opd": "Glaucoma", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "82b0a445-9a84-4231-b4c8-fa7205ff6c63", "choice_type": "single"}
{"question": "Coronary steal syndrome is associated with", "exp": "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)", "cop": 3, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Isoflurane", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "8f1d7c98-909c-434a-8bdb-9518c9160f93", "choice_type": "single"}
{"question": "The proseal LMA has advantage over normal LMA", "exp": "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.", "cop": 2, "opa": "In being more easy to inse", "opb": "Comparable to endotracheal tube in preventing aspiration", "opc": "Can be inseed in concious patient.", "opd": "Can be used for pulmonary toileting", "subject_name": "Anaesthesia", "topic_name": "Airway", "id": "3d59a333-060b-40c9-bff7-a9b96c70142a", "choice_type": "single"}
{"question": "Pudendal Nerve Block Involve", "exp": "D i.e. S2 S3 S4", "cop": 4, "opa": "LiL2L3", "opb": "L2L3L4", "opc": "SiS2S3", "opd": "S2S3S4", "subject_name": "Anaesthesia", "topic_name": null, "id": "e96b637f-8c74-449a-a9ad-e70925209f7b", "choice_type": "single"}
{"question": "Minimal mandatory Percentage of oxygen used in general anaesthesia is", "exp": "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.", "cop": 2, "opa": "33%", "opb": "30%", "opc": "21%", "opd": "66%", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "0fbe3ddc-b37c-4cbb-be00-88efbacd906c", "choice_type": "single"}
{"question": "Most common complication of spinal anesthesia is", "exp": "A i.e. Hypotension", "cop": 1, "opa": "Hypotension", "opb": "Headache", "opc": "Meningitis", "opd": "Arrythmia", "subject_name": "Anaesthesia", "topic_name": null, "id": "04dadaa1-1bfe-45a7-ab9d-0fc9636d0713", "choice_type": "single"}
{"question": "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", "exp": "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.", "cop": 2, "opa": "No work up is required prior to performing epidural anaesthesia, as this will treat her hypertension", "opb": "The presence of hypertension and oedema requires further workup before proceeding.", "opc": "Neuraxial anaesthesia should be avoided, as there is increased risk of bleeding", "opd": "Avoid systemic opiates, as the risk of respiratory depression is too high", "subject_name": "Anaesthesia", "topic_name": null, "id": "81e1a070-0b0c-4237-bf0d-96ca842f24e0", "choice_type": "single"}
{"question": "Pain rating index is provided by", "exp": "C i.e. Mc Gill questionnaire", "cop": 3, "opa": "Faces scale", "opb": "Visual analogue scale", "opc": "Mc Gill questionniare", "opd": "CHEOP scale", "subject_name": "Anaesthesia", "topic_name": null, "id": "3e9dbc59-226d-4b33-b6d6-4d9faaee0200", "choice_type": "single"}
{"question": "During cesarean section under general endotracheal anaesthesia, venous air embolism", "exp": "Expired Nitrogen is the most sensitive venous-air embolism detection method, as the largest component of air is nitrogen.", "cop": 3, "opa": "Is associated with high end-tidal CO2", "opb": "Should be treated with nitrous oxide", "opc": "Is associated with expired nitrogen", "opd": "Induces severe hypertension", "subject_name": "Anaesthesia", "topic_name": null, "id": "501c7143-2635-45e9-a370-40d908dfd2ba", "choice_type": "single"}
{"question": "Most common complication of central venous catheter", "exp": "C i.e. Catheter related infection", "cop": 3, "opa": "Local bleeding", "opb": "Thrombosis", "opc": "Catheter related infection", "opd": "Pneumotherax", "subject_name": "Anaesthesia", "topic_name": null, "id": "e0ef736f-4115-4fa1-9b48-3891bb54be93", "choice_type": "single"}
{"question": "If thiopentone is injected accidently into an aery the first symptom is", "exp": "D i.e. Pain", "cop": 4, "opa": "Analgesia", "opb": "Paralysis", "opc": "Skin ulceration", "opd": "Pain", "subject_name": "Anaesthesia", "topic_name": null, "id": "86799b51-64da-4c55-a02f-ab32d1504ec0", "choice_type": "single"}
{"question": "Percentage of adrenaline with lignocaine for local infilteration is", "exp": "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)", "cop": 4, "opa": "0.736111111", "opb": "1:10000", "opc": "0.111111111", "opd": "1:50000", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "f6cb2e92-cb6d-4dfb-af1c-62ecf4693f68", "choice_type": "single"}
{"question": "Semiclosed circuit system", "exp": "Semiclose breathing circuit is less economical, causes more environmental pollution. It is simple portable and no need of advanced monitoring.", "cop": 3, "opa": "Needs advanced monitoring", "opb": "Complex", "opc": "More environmental pollution", "opd": "More economical", "subject_name": "Anaesthesia", "topic_name": null, "id": "32ec269a-db55-4f15-afc1-6910b6d77ff1", "choice_type": "single"}
{"question": "Post dural (spinal) puncture headache is due to", "exp": "(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)", "cop": 1, "opa": "Seepage of CSF", "opb": "Fine needle", "opc": "Toxic effects of the drugs", "opd": "Traumatic damage to nerve roots", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "89f2b9da-cbe5-4816-a4c2-7ac6b11e26d7", "choice_type": "single"}
{"question": "Most common injection site infection in spinal anaesthesia", "exp": "Streptococcal infection is most common in spinal anaesthesia.", "cop": 2, "opa": "Staphylococcus", "opb": "Streptococcus", "opc": "Pseudomonas", "opd": "Bacteroides", "subject_name": "Anaesthesia", "topic_name": null, "id": "d79211c5-f256-4296-9c01-8874aaa68c5d", "choice_type": "single"}
{"question": "Diffusion hypoxia is a type of ...............hypoxia", "exp": "Hypoxic hypoxia also called aerial hypoxiais a result of insufficient oxygen available to the lungs. Diffusion hypoxia occurs during recovery from nitrous oxide anesthesia when nitrous oxide is suddenly cut off. Nitrous oxide diffuses from the blood to the alveoli and replaces the oxygen which reduces alveolar O2 concentration, resulting in relative hypoxemia. This can be avoided by providing supplemental O2 for the first 10 minutes of recovery. Diffusion hypoxia is less common with xenon because its rate of diffusion from the blood to the alveoli is slower.", "cop": 4, "opa": "Anemic", "opb": "Histotoxic", "opc": "Stagnant", "opd": "Hypoxic", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "f2fd4448-3405-41e6-bc72-3ebaf63db8b1", "choice_type": "single"}
{"question": "Muscle relaxant of choice in patient suffering from chronic liver disease", "exp": "Atracurium is preferred in CLD patients since it is metabolised by Hoffmann elimination.", "cop": 2, "opa": "Pancuronium", "opb": "Atracurium", "opc": "Mivacurium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": null, "id": "cda02f98-ba04-488a-b315-7ff0faa4938c", "choice_type": "single"}
{"question": "The cardiovascular side effect of Dexmedetomidine is following", "exp": "Dexmetetomidine is a highly selective alpha2 - adrenoceptor against thus can cause hypotension and Bradycardia. Dexmedetomidine * Highly selective alpha - 2 adrenoreceptor agonist * Used mainly as IV adjunct during induction and /or maintenance of general anesthetics * Minimal respiratory and cardiovascular depression * Good sedation , good analgesic, sympatholytic effects * Selectivity for alpha1: alpha 2 receptors is 1:1640", "cop": 1, "opa": "Hypotension and Bradycardia", "opb": "Hypeension and Tachycardia", "opc": "Hypotension and Tachycardia", "opd": "Hypeension and Bradycardia", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "f7e3daf1-ab6d-4e72-a2a7-26d182d3386e", "choice_type": "single"}
{"question": "Merits of nasotracheal intubation is", "exp": "Good oral hygine Intubation can be done in two ways : Orotracheal intubation Nasotracheal intubation Orotracheal intubation is the preferred technique in most cases. It is most suited to emergency situation (nasotracheal intubation requires a little extra time. Orotracheal intubation under direct laryn goscopy is generally the easier route and the one of choice in unstable patients when rapid re-establishment of the airway is essential. Nasatracheal intubation is better tolerated during pralonged mechanical ventilation. Nasotracheal intubation has ceain drawbacks :? - Increased risk of nosocomial sinusitis - Increased risk of mensal damage and bleeding therefore nasotracheal intubation should be avoided in coagulopathies - Restricted movement of the endotracheal tube Complications of orotracheal tube occurs due to - Occlusion or displacement of the tube and airway trauma.", "cop": 1, "opa": "Good oral hygiene", "opb": "Less infection", "opc": "Less miscosal damage and bleeding", "opd": "More movement or displacement of endotracheal t ube", "subject_name": "Anaesthesia", "topic_name": null, "id": "0b14a1a1-0b3a-4326-b3d0-64df105b9b1d", "choice_type": "single"}
{"question": "Most cardiotoxic local anaesthetic is", "exp": "Bupivacaine (Sensoricaine, Marcaine)Bupivacaine is 2nd most commonly used local anaesthetic (after lidocaine)Bupivacaine has the highest local tissue irritancy amongst local anaestheticsIt is the most cardiotoxic local anaestheticLevobupivacaine (The S(-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizureConcentrations used for bupivacaine are:- Nerve block: 0.5%, epidural: 0.25 -0.5%, and spinal: 0.5%Maximum safe dose is 2mg/kg without adrenaline and 3mg/kg with epinephrine (Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 1, "opa": "Bupivacaine", "opb": "Procaine", "opc": "Prilocaine", "opd": "Dibucaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "45f7b6f1-f97c-4588-83c5-697b8887d662", "choice_type": "single"}
{"question": "Pin index system for oxygen", "exp": "Ans: (b) 2,5Ref: Miller's Anaesthesia 7th ed. / 675* Pin index for oxygen is 2, 5.* Cylinder of oxygen is black body with white shoulder.GasColor CodePin index positionBodyShoulderOxygenBlackWhite2,5Nitrous oxideBlueBlue3, 5CO2GrayGray1,6HeliumBrownBrown2,5AirGreyWhite/black quartered1,5", "cop": 2, "opa": "1,5", "opb": "2,5", "opc": "4,5", "opd": "3,5", "subject_name": "Anaesthesia", "topic_name": "Local and Regional Anesthesia", "id": "027707f3-c54a-47d9-ac0f-8faea34dfb9f", "choice_type": "single"}
{"question": "The site of action of local anaesthetic in epidural anesthesia is", "exp": "Local anaesthetic in maximal blockade is believed to act in spinal nerve root. Mechanism of action of central neuraxial blockade. The mechanisms of spinal and epidural are believed to be the nerve roots. Blockade of neural transmission in the posterior nerve root fibers interrupt somatic and visceral sensation, whereas blockade of anterior nerve root fibers prevent efferent motor & autonomic outflow.", "cop": 1, "opa": "Spinal nerve root", "opb": "Spinal cord", "opc": "Epidural neural tissue", "opd": "Anterior root of spinal nerve", "subject_name": "Anaesthesia", "topic_name": "Central Neuraxial Blockade", "id": "8a78e1a6-f97e-4726-9caa-ec1b9a063438", "choice_type": "single"}
{"question": "The treatment of choice in diagnosed ventricular fibrillation is", "exp": "Defibrillation.The delivery of an electrical shock through the chest wall to the hea momentarily stops the hea and the chaotic rhythm. This often allows the normal hea rhythm to resume. If a public-use automated external defibrillator (AED) is available, anyone can administer it. Most public-use AEDs voice instructions as you use them. Public-use AEDs are programmed to recognize ventricular fibrillation and send a shock only when needed.", "cop": 3, "opa": "Amiodarone", "opb": "External cardiac massage", "opc": "DC shock", "opd": "Adrenaline", "subject_name": "Anaesthesia", "topic_name": "Cardiopulmonary Cerebral Resuscitation", "id": "0ca66de7-02f3-4b3d-b7b3-dc517d51e463", "choice_type": "single"}
{"question": "Index of potency of general anesthesia", "exp": "Minimal alveolar concentrationIt is the lowest concentration of the anaesthetic in pulmonary alveoli needed to produce immobility in response to a painful stimulus (surgical incision) in 50% individualsIt is the measure of potency of inhalation Gas.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 162 - 163)", "cop": 1, "opa": "Minimum alveolar concentration", "opb": "Diffusion coefficient", "opc": "Dead space concentration", "opd": "Alveolar blood concentration", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e336226b-1657-490c-b691-354961a21794", "choice_type": "single"}
{"question": "A intravenous anesthetic agent that is associated with hemodynamic stability, maintenence of CPP with post operative nausea, vomiting and myoclonus", "exp": "B i.e. Etomidate", "cop": 2, "opa": "Ketamine", "opb": "Etomidate", "opc": "Propofol", "opd": "Opioids.", "subject_name": "Anaesthesia", "topic_name": null, "id": "d671fa37-a30c-40a8-990c-1ce0b42a4c83", "choice_type": "single"}
{"question": "A child with bladder exstrophy and chronic renal failure. The Anesthesia of choice for the child while operating exstrophy is aEUR'", "exp": "Atracurium \"Atracurium and cisatracurium are muscle relaxants of choice for both liver and kidney failure\".", "cop": 1, "opa": "Atracurium", "opb": "Mivacurium", "opc": "Pancuronium", "opd": "Rocuronium", "subject_name": "Anaesthesia", "topic_name": null, "id": "1980e7d1-d5ab-4782-8ca8-6690452220e3", "choice_type": "single"}
{"question": "Sodium Thiopentone is ultra sho acting d/t", "exp": "Barbiturate pharmacokinetics has been described in physiologic and compament models. Both these pharmacokinetic models describe rapid redistribution as the primary mechanism that terminates the action of a single induction dose. Physiologic models of barbiturates describe a rapid mixing of the drug within the central blood volume followed by a quick distribution of the drug to highly perfused, low-volume tissues (i.e., brain), with a slower redistribution of the drug to lean tissue (muscle), which terminates the effect of the initial (induction of anesthesia) dose. In these models, adipose tissue uptake and metabolic clearance (elimination) play only minor roles in the termination of the effects of the induction dose. The reasons are the minimal perfusion ratio of adipose tissue compared with other tissues and the slow rate of removal. Ref: Miller's anesthesia 8th edition", "cop": 3, "opa": "Rapid absorption", "opb": "Rapid metabolism", "opc": "Rapid redistribution", "opd": "Rapid excretion", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "7fca4e73-c0d6-4059-ae8c-80dd95c9098a", "choice_type": "single"}
{"question": "Complete neuromuscular blocking agent with shortest duration of action", "exp": "Ans. c (Mivacurium) (Ref. Anaesthesia by Ajay Yadav, 2nd/pg. 90)Mivacurium is a nondepolarizing neuromuscular blocking agent with a short duration of action. Mivacurium is indicated as an adjunct to anesthesia to facilitate endotracheal intubation and to induce skeletal muscle relaxation in the surgical field.Neuromuscular blocking agentsAcetylcholineNicotinic Cholinergic Receptor# Release- Mechanism: Ca2+ entry and halting of K+ exit at presynaptic terminal -ACh release- Inhibitors of ACh release: Mg2+ blocks Ca2+ channels of presynaptic neurons in heart | ACh release- Promoters of ACh release: |-aminopyridine blocks K+ channels of presynaptic neurons | ACh release# Metabolism - In Blood: Butyrylcholinesterase, pseudocholinesterase or plasma cholinesterase (identical enzymes)- In neuromuscular cleft: Acetylcholinesterase- Dibucaine : Dibucaine acts to inhibit normal acety Icholinesterase, and therefore will be unable to inhibit abnormal acetylcholinesterase. Persons w/abnl acetylcholinesterases have dibucaine value at approx 50, instead of 80-90 for normal acetylcholinesterases# Structrure- Composed of b subunits, where ACh binds the a subunits# Location- Presynaptic neuron in neuromuscular junction: causes positive feedback on ACh release, usually constitutes a negative feedback mechanism. Postsynaptic neuron in neuromuscular junction: causes propagation of action potential to myofibrilsOverview of Neuromuscular Blocking Agents# Depolarizing drugs - Noncompetitive depolarization of nicotinic cholinergic receptor - Not effective in Myasthenia Gravis pts since there is a |in postsyn ACh receptors & therefore not enough receptors to activate# Non-depolarizing Drugs- Competitive blockade of nicotinic-cholinergic receptors- Not effective in Eaton-Lambert pts since there is an | in postsyn ACh receptors & not enough non-depolarizing drug to inhibit all# Reversal of Muscle Relaxant Activity- AChesterase inhibitors only for non-depolarizing drugs, but inhibitors have no selectivity for NMJ & will inhibit AChesterases in heart & plasma -| non depolarizing in plasma must give an anti-muscarinic to prevent heart effects- Recombinant pseudocholinesterase for pts w/atypical cholinesteraseMivacurium & rocuronium can be used as muscle relaxant in 'rapid sequence induction'.Skeletal Muscle RelaxantsSubclassMechanism of actionEffectsClinical applicationsPharmacokinetics, toxicities, interactionsDepolarizing neuromuscular blocking agentSuccinylcholineAgonist at nicotinic acetylcholine (ACh) receptors, especially at neuromuscular junction depolarizes may stimulate ganglionic nicotinic ACh and cardiac muscarinic ACh receptorsInitial depolarization causes transient contractions, followed by prolonged flaccid paralysis depolarization is then followed by repolarization that is also accompanied by paralysisPlacement of tracheal tube at start of anesthetic procedure rarely, control of muscle contractions in status epilepticusRapid metabolism by plasm cholinesterase normal duration, 5 min arrhythmias hyperkalemia transient increased intrabdominal, intraocular pressure postoperative muscle painNondepolarizing neuromuscular blocking agentsd-TubocurarineCompetitive antagonist at ACh receptors, especially at neuromuscular junctionsPrevents depolarization by ACh, causes flaccid paralysis can cause histamine release with hypotension weak block of cardiac muscarinic Ach receptorsProlonged relaxation for surgical procedures superseded by newer nondepolarizing agentsRenal excretion duration, 40-60 min toxicities: histamine release hypotension prolonged agentsCisatracuriumSimilar to tubocurarineLike tubocurarine but locks histamine release and antimuscarnic effectsProlonged relaxation of surgical procedures relaxation of respiratory muscles to facilitate mechanical ventilation in intensive care unitNot dependent on renal or hepatic function duration 25-45 min toxicities: Prolonged apnea but less to than atacuriumRocuroniumSimilar to cisatracuriumLike cisatracurium but slight antimuscarinic effectLike cisatracurium useful in patients with renal impairmentHepatic metabolism duration 20-35 min Toxicities: like cisatracuriumMivacurium: Rapid onset, short duration (10-20 min); metabolized by plasma cholinesteraseVecuronium: Intermediate duration; metabolized in liverCentrally acting spasmolytic drugsBaclofenGABA agonist, facilitates spinal inhibition of motor neuronsPre- and postsynaptic inhibition of motor outputSevere spasticity due to cerebral palsy, multiple sclerosis, strokeOral, intrathecal toxicities: sedation, weaknessCyclobenzaprinePoorly understood inhibition of muscle stretch reflex in spinal cordReduction in hyperactive muscle reflexes antimuscarinic effectsAcute spasm due to muscle injury inflammationHepatic metabolism duration 4-6 h toxicities: strong antimuscarinic effectsChlorphenesin, methocarbamol, orphenadrine, other: Like cyclobenzaprine with varying degrees of antimuscarinic effectDiazepamFacilitates GABAergic transmission in central nervous systemIncreases interneuron inhibition of primary motor afferents in spinal cord central sedationChronic spasm due to cerebral palsy, stroke, spinal cord injury acute spasm due to muscle injuryHepatic metabolism duration 12-24 hTizanidinea2-Adrenoceptor agonist in the spinal cordPresynaptic and postsynaptic inhibition of reflex motor outputSpasm due to multiple sclerosis, stroke, amyotrophic lateral sclerosisRenal and hepatic elimination duration, 3-6 h toxicities: Weakness, sedation hypotensionDirect-acting muscle relaxantsDantroleneBlocks RyRl Ca2+ release channels in the sarcoplasmic reticulum of skeletal muscleReduces actin-myosin interaction weakness skeletal muscle contractionIV: Malignant hyperthermia Oral spasm due to cerebral palsy spinal cord injury multiple sclerosisIV, oral duration, 4-6 h Toxicities: Muscle weakness.Mivacurium. another isoquinoline compound, has the shortest duration of action of all nondepolarizing muscle relaxants. However, its onset of action is significantly slower than that of succinylcholine. In addition, the use of a larger dose to speed the onset can be associated with profound histamine release leading to hypotension, flushing, and bronchospasm. Clearance of mivacurium by plasma cholinesterase is rapid and independent of the liver or kidney. However, because patients with renal failure often have decreased levels of plasma cholinesterase, the short duration of action of mivacurium may be prolonged in patients with impaired renal function. Although mivacurium is no longer in widespread clinical use, an investigational ultra-short-acting isoquinoline nondepolarizing muscle relaxant, gantacurium, is currently in phase III clinical testing. This novel compound has a very rapid onset and short duration of action", "cop": 3, "opa": "Rocuronium", "opb": "Pipecuronium", "opc": "Mivacurium", "opd": "Pancuronium", "subject_name": "Anaesthesia", "topic_name": "Muscle Relaxant", "id": "912ee9b6-932c-4364-8168-eb1b8aab45ff", "choice_type": "single"}
{"question": "Rebreathing systems are WE", "exp": "D i.e. Mapleson F - Calcium hydroxide is the main component of both sodalime (94%) and baralimeQ (80%). - Ba(OH)2 is not a constituent of soda lime, it is used in baralime. Water (of crystalization) is used to produce hardening in baralimeQ. - Clayton, mimosaQ, ethyl violet, phenolphthalein & ethyl orange are indicators.", "cop": 4, "opa": "To & fro system", "opb": "Circle system", "opc": "Water's system", "opd": "Mapleson F", "subject_name": "Anaesthesia", "topic_name": null, "id": "639d007f-cf48-4ab5-b868-bf49a3d94637", "choice_type": "single"}
{"question": "Chest compression to ventilation ratio in resuscitation of children with 2 rescuers is", "exp": "In CPR of children compression to ventilation ratio if single rescuer is 30:2 and if double rescuer is 15:2.", "cop": 3, "opa": "30:02:00", "opb": "3:01", "opc": "15:02", "opd": "30:02:00", "subject_name": "Anaesthesia", "topic_name": null, "id": "09c511d0-c5e3-4832-88d1-a8e4a3ae8617", "choice_type": "single"}
{"question": "Maximum does of lidocaine as local anesthesia is", "exp": "D i.e. 500 mg", "cop": 4, "opa": "100 mg", "opb": "200 mg", "opc": "300 mg", "opd": "500 mg", "subject_name": "Anaesthesia", "topic_name": null, "id": "a8349217-41c1-4510-837a-87cec0d8d380", "choice_type": "single"}
{"question": "Thiopentone is absolutely contraindicated in", "exp": "(Porphyria): (381 -- KDT 7th edition; 536- Goodman 12th7or variegate)Thiopentone can precipitate acut intermittent or variegate porphyria in susceptible individuals therefore contraindicated. The abnormal synthesis of protoporphyrin (important in hemoglobin production) results in excess porphobilinogen. Barbiturates induce amino levulinic acid synthase, an enzyme responsible for phosphobilinogen synthesis, This leads to excessive porphobilinogen levels and can precipitate acute porphyric crises, that are manifested by severe abdominal pain, nausea, vomiting, psychiatric disorders and neurologic abnormalities", "cop": 1, "opa": "Porphyria", "opb": "Moribund patients", "opc": "Increased intracranial pressure", "opd": "Meningitis", "subject_name": "Pharmacology", "topic_name": "Anaesthesia", "id": "e1a6bd20-0da6-47b4-9f16-bca48ed0f609", "choice_type": "single"}
{"question": "MAC stands for", "exp": "Minimum alveolar concentration is defined as the alveolar concentration of an inhaled anesthetic agent that prevents movement in 50% of patients in response to a standardized surgical stimulus. Low MAC - High potency MAC values of adult Halothane: 0.75 Sevoflurane: 2.0 Isoflurane: 1.2 Desflurane: 6.0 Enflurane: 1.7 Xenon: 70 N2O: 104 Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 1, "opa": "Minimum alveolar concentration", "opb": "Minimal analgesic concentration", "opc": "Minimal anaesthetic concentration", "opd": "Maximum alveolar concentration", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f6ef2d56-11af-45d1-8954-e505a3dd9800", "choice_type": "single"}
{"question": "The potency of an inhalational anaesthetic agent depends upon", "exp": "Meyer-Oveon correlation of anesthetic potency with solubility in olive oil interpreted by the majority of researchers as an indicator that lipids are likely the anesthetic target. This interpretation focused attention on anesthetic effects on the bulk physical propeies of cell membranes, which were known at that time to consist primarily of lipid molecules. Such nonspecific or \"lipoid-based\" anesthetic theories dominated the field from the 1960s to the 1980s. Moreover, the simple elegance of the relationship between MAC and lipid solubility graphically illustrated Meyer and Oveon's conclusion that \"All chemically indifferent substances that are soluble in fat are anesthetics ... their relative potency as anesthetics will depend on their affinity to fat on the one hand and water on the other hand, that is, on the fat/water paition coefficient\". This was interpreted as oring lipids as the primary targets of anesthetics and a single nonspecific theory to explain anesthesia. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 2, "opa": "blood gas paition coefficient", "opb": "Oil-gas paition coefficient", "opc": "Gas pressure", "opd": "Blood pressure", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "f94d737e-3ed1-483f-8c30-fcb1ae47438e", "choice_type": "single"}
{"question": "Drug used to prolong the action of LA in Hypeensive pts", "exp": "Vasoconstrictor are used along with local anaestheticsAdrenaline is the most commonly used vasoconstrictor. Less commonly phenylephrine is also used. Felypressin (synthetic vasopressin) does not affect BP & HR - Preferred in patients with cardiovascular disease(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.270-271)", "cop": 2, "opa": "Clonidine", "opb": "Felypressin", "opc": "Dexmeditomidate", "opd": "Noradrenalin", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "01a61937-4e59-4020-8794-3004c5e23e48", "choice_type": "single"}
{"question": "Capnography is useful for", "exp": "capnography is the ideal method of determining the correct placemet of endotracheal tube. Identification : loss of waveform of capnogram.decline in End tidal CO2 levels.", "cop": 3, "opa": "Determining Vaporizer malfunction or contamination", "opb": "Determining circuit hypoxia", "opc": "Determining the appropriate placement of endotracheal", "opd": "Detecting concentration of oxygen in the anesthetic circuit.", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "216b1c0a-18f1-4126-b8e0-d53ac9037bd5", "choice_type": "single"}
{"question": "Intravenous anesthetic agent of choice in this below given procedure", "exp": "Methohexitone is IV anesthetic agent of choice for electroconvulsive therapy because, compared to thiopental and propofol, methohexitone produces less depression of EEG activity. intravenous injection is painful.", "cop": 4, "opa": "Thiopentone", "opb": "Propofol", "opc": "Etomidate", "opd": "Methohexitone", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "8cf9dee3-7bc5-4dcf-bd44-b6ea8188fb4b", "choice_type": "single"}
{"question": "The following combination of agents are the most preferred for sho day care surgeries", "exp": "A i.e. Propofol, Fentanyl, isoflurane", "cop": 1, "opa": "Propofol, fentanyl, isoflurane", "opb": "Thiopentone sodium, morphine, halothane", "opc": "Ketamine, pethidine, halothane", "opd": "Propofol, morphine, halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "386a1f9c-0c72-41dd-8c15-b105e6967cac", "choice_type": "single"}
{"question": "For high pressure storage of compressed gases cylinders are made up of.", "exp": "A i.e. Molybdenum Steel", "cop": 1, "opa": "Molybdenum steel", "opb": "Iron + Mo", "opc": "Steel + Cu", "opd": "Cast iron", "subject_name": "Anaesthesia", "topic_name": null, "id": "7421914f-f23e-409b-a816-63495a6aa44b", "choice_type": "single"}
{"question": "Most potent cerebral vasodilator is", "exp": "C i.e. Hyper carbia", "cop": 3, "opa": "B blocker", "opb": "Nitro-glycerine", "opc": "Hyper carbia", "opd": "Nitroprusside", "subject_name": "Anaesthesia", "topic_name": null, "id": "60061103-7cbe-4c3b-aaa1-179e688e2c64", "choice_type": "single"}
{"question": "Inducing agent with maximum incidence of vomiting", "exp": "Postoperative nausea and vomiting are more common following etomidate than following propofol or barbiturate induction. Propofol also possesses significant antiemetic activity with small (sub hypnotic) doses (i.e., 10 mg in adults). The median concentration of propofol with an antiemetic effect was 343 ng/mL, which also causes a mild sedative effect. This concentration can be achieved by an initial dose of propofol infusion of 10 to 20 mg followed by 10 ug/kg/minute. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 2, "opa": "Ketamine", "opb": "Etomidate", "opc": "Thiopentone", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "4df8da90-d1ae-4f0d-a5ae-db86ccc18e90", "choice_type": "single"}
{"question": "The Heidbrink meter in Boyle&;s machine", "exp": "Heidbrink is a flowmeter used in past. It consists of a metal tapered tube with inveed black float. The upper-end projects in the glass tube. Other type of flowmeter used in past was Connell which has round bobin.", "cop": 2, "opa": "Reduces pressure of gases", "opb": "Indicates flow of gases", "opc": "Indicates humidity of gases", "opd": "It a fixed orifice meter", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "6e194de7-1ea5-4f92-a061-14e59b30c70c", "choice_type": "single"}
{"question": "Atracurium is metabolized and excreted by", "exp": "Ans. d (Hoffman's elimination). (Ref. Harrisons, Medicine, 18th/735)ATRACURIUM BESYLATE# Long acting and non-depolarising muscle relaxant.# Muscle relaxant of choice in renal failure or anephric patients.# pH of solution is 3.5.# Stored at 4degC.# Duration of action doubled at 25degC.# Metabolism mainly by Hofmann elimination (a chemical degradation) and hydrolysis in plasma and elsewhere in body.# Major metabolite is laudanosine, which is CNS- stimulant.", "cop": 4, "opa": "Kidney", "opb": "Liver", "opc": "Brain", "opd": "Hoffman's elimination", "subject_name": "Anaesthesia", "topic_name": "Muscle Relaxant", "id": "17ff3db2-cb07-4f02-88bf-54bdc1c2a12b", "choice_type": "single"}
{"question": "Maximum dose of lignocaine with adrenaline (in mg/kg)", "exp": "Maximum safe dose of plain lidocaine - 300 mg (4.5 mg/kg)Maximum safe dose of lidocaine with epinephrine- 500 mg (7mg/kg)(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 754, 856)", "cop": 3, "opa": "4", "opb": "5", "opc": "7", "opd": "10", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "77d7cdd4-7f5b-468d-93b6-8b8dcbe866ee", "choice_type": "single"}
{"question": "Maximum interval between bare metal cardiac stent and elective surgery is", "exp": "1 month is ideal interval between bare metal cardiac stent and any elective surgery.", "cop": 3, "opa": "1 year", "opb": "2 month", "opc": "1 month", "opd": "2 year", "subject_name": "Anaesthesia", "topic_name": null, "id": "c6f05ec6-13d1-40a4-a4f5-781cd36936ff", "choice_type": "single"}
{"question": "The definite contraindication of Thiopentone", "exp": "(D) Acute intermittant porphyria # Barbiturates are Contraindicated in -- H/O Barbiturate hypersensitivity H/O Acute intermittent porphyria (cause LMN paralysis or CVS collapse);Anticipated airway obstruction> Care: Fixed cardiac output states; Shock states; Hepatic/Renal dysfunction; Asthmatic/Myxoedema; Adrenocortical failure; Myotonia dystrophia; Extremes of age.", "cop": 4, "opa": "Diabetic patient", "opb": "ECT", "opc": "Sarcoidosis", "opd": "Acute intermittant porphyria", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "75b547e8-2aa3-4f9f-a5db-44ea259a5fa6", "choice_type": "single"}
{"question": "Bronchospasm is not caused by", "exp": "D i.e. Halothane", "cop": 4, "opa": "Regurgitation", "opb": "Aspiration", "opc": "Intubation", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "9ab192eb-ae4e-4eb2-9e64-362b704d2588", "choice_type": "single"}
{"question": "Sodalime circuit is not used with", "exp": "D i.e. Trilene", "cop": 4, "opa": "Enflurane", "opb": "Isoflurane", "opc": "Methoxyflurane", "opd": "Trilene", "subject_name": "Anaesthesia", "topic_name": null, "id": "f3d414a5-66da-43aa-a1f8-9bdc33f4492c", "choice_type": "single"}
{"question": "Minimum Alveolar concentration of halothane is", "exp": "Halothane is a potent anesthetic with a MAC of 0.74%. Its blood/gas paition coefficient of 2.4 makes it an agent with moderate induction and recovery time. It is not a good analgesic and its muscle relaxation effect is moderate.", "cop": 1, "opa": "0.74%", "opb": "1-2%", "opc": "6%", "opd": "2%", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "d8c15424-0ed5-4757-81be-2758b8475def", "choice_type": "single"}
{"question": "In epidural anaesthesia drug is injected", "exp": "Epidural (extradural anaesthesia)Local anaesthetic is injected in epidural space, i.e., outside the dura mater with Tuohy&;s needleIn extradural space, LA acts on the nerve rootsIt is used in thoracic, lumbar and sacral (caudal) regions (in contrast to spinal anaesthesia which is given in lumbar region)Continuous analgesia is achieved by mixing the LA with an opioid, eg fentanylIt is mainly used to control postoperative pain (by continuous epidural anaesthesia)It can also b used for all surgeries which can be performed under spinal anaesthesia.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.189)", "cop": 1, "opa": "Outside the dura", "opb": "Inside the duramater", "opc": "Inside arachnoidamater", "opd": "inside piamater", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "92f9db21-4c0c-4f3f-b46e-c4de7bd89b29", "choice_type": "single"}
{"question": "Minimum Alveolar concentration  of halothane is", "exp": "Halothane is a potent anesthetic with a MAC of 0.74%. Its blood/gas partition coefficient of 2.4 makes it an agent with moderate\ninduction and recovery time. It is not a good analgesic and its muscle relaxation effect is moderate.", "cop": 1, "opa": "0.74%", "opb": "1-2%", "opc": "6%", "opd": "2%", "subject_name": "Anaesthesia", "topic_name": null, "id": "b54da3ac-d32d-43c3-8221-6e3b8cb5142d", "choice_type": "single"}
{"question": "In venturi mask maximum 02 concentration attained is", "exp": "In Venturi mask normal O2 concentration is between 24 and 60% . In non breathing masks oxygen saturation is between 80 and 90%.", "cop": 3, "opa": "90%", "opb": "100%", "opc": "60%", "opd": "80%", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "9708c475-537c-4ce0-aba8-90dc2f02e2be", "choice_type": "single"}
{"question": "Adiministration of Scoline (Sch) produces dangerous hyperkalamia in", "exp": "D i.e. Paraplegia", "cop": 4, "opa": "Acute Renal Failure (A.R.F.)", "opb": "Raised ICT", "opc": "Fracture femur", "opd": "Paraplegia", "subject_name": "Anaesthesia", "topic_name": null, "id": "ccd6b291-4cea-4c89-88ed-4aae95f732a3", "choice_type": "single"}
{"question": "Emergence delirium is associated with", "exp": "Ketamine causes postoperative delirium and hallucinations. It is also contraindicated in delirium tremens and head injury. Ketamine increases cerebral metabolism, CBF, and ICP. So contraindicated in neurosurgeries. Ketamine, like other phencyclidines, produces undesirable psychological reactions, which occur during awakening from ketamine anesthesia and are termed emergence reactions. The common manifestations of these reactions, which vary in severity and classification, are vivid dreaming, extracorporeal experiences (sense of floating out of body), and illusions (misinterpretation of a real, external sensory experience). These incidents of dreaming and illusion are often associated with excitement, confusion, euphoria, and fear. They occur in the first hour of emergence and usually abate within 1 to several hours. These psychic emergence reactions are secondary to ketamine-induced depression of auditory and visual relay nuclei, thus leading to misperception or misinterpretation of auditory and visual stimuli. The incidence of the psychic emergence reactions ranges from 3% to 100%. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 2, "opa": "Pentothal sodium", "opb": "Ketamine", "opc": "Droperidol", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "76d6e8ef-8da2-4b82-b3ee-82b15b44159e", "choice_type": "single"}
{"question": "Minimum alveolar concentration (MAC) is a measure of", "exp": "Minimum alveolar concentration (MAC) - Measure of potencyBlood: Gas paition coefficient -Blood solubility of anaesthetic agent and determines the speed of induction & recoveryOil: Gas paition coefficient - Lipid solubility of anaesthetic agent and is related to potency of anaesthetic agent.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 160, 268, 510)", "cop": 1, "opa": "Potency of anaesthetic agent", "opb": "Speed of induction and recovery", "opc": "Lipid solubility of agent", "opd": "Toxicity of agent", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "795e8eba-887f-4da8-af8d-f908df4aa954", "choice_type": "single"}
{"question": "Most potent antiemetic agent used in preoperative period", "exp": "the most potent anti-emetic used is hyoscine . the most commonly used anti-emetics are metochlopramide,ondensetron.", "cop": 2, "opa": "Glycopyrolate", "opb": "Hyoscine", "opc": "Atropine", "opd": "Metochlorpromide", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "cf8e5fea-3f10-4bdb-a1d2-d8d7257b2e1d", "choice_type": "single"}
{"question": "The most important determinant of carbon dioxide elimination is", "exp": "Fresh gas flow is important determinant of carbon dioxide elimination in breathing circuits.", "cop": 2, "opa": "Minute ventilation", "opb": "Fresh gas flow", "opc": "Expiratory reserve volume", "opd": "Vital capacity", "subject_name": "Anaesthesia", "topic_name": null, "id": "595e5db9-609d-426a-a77d-18463db79c68", "choice_type": "single"}
{"question": "In a 2 months old infant undergoing surgery for biliary atresia, you would avoid one of the following anaesthetic", "exp": "B i.e. Halothane Among all these options only halothane is hepatotoxic so it should be avoided Lets revise some impoant facts. All coagulation factors with exception of factor VIII (8) & von wille brand factor are produced by liverQ Vit K is necessary for synthesis of prothrombin (factor II) and factor VII, IX and XQ. PT is normally 11-14 seconds, mesures the activity of fibrinogen, prothrombin and factors, V, VII, and XQ All opioids cause spasm of sphincter of oddi & increase biliary pressure Halothane hepatitis is more common in middle age, obese, female sex, and a repeated exposure (esp with in 28 days)", "cop": 2, "opa": "Thiopentone", "opb": "Halothane", "opc": "Propofol.", "opd": "Sevoflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "89f1fc8f-a728-4ccf-aa39-31bee8fa38aa", "choice_type": "single"}
{"question": "In volume controlled ventilation, the inspiratory flow rate is", "exp": "In most patients, inspiratory flow rates is 60 L/min are adequate. Higher flow rates are required in patients with higher ventilator demands.", "cop": 4, "opa": "140-160 L/min", "opb": "110-130 L/min", "opc": "60-100 L/min", "opd": "30-50 L/min", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "339ac4b7-9136-4688-8efd-a92a5e628cae", "choice_type": "single"}
{"question": "Shoest acting NDMR", "exp": "Rapacuronium Among the given options Rapacuronium is the shoest ating drug. Rapacuronium has been withdrawn from the market because it produces intense bronchospasm in a significant number of patients. Alcuronium is a relatively sho acting muscle relaxant. Always remember this", "cop": 2, "opa": "Succinyl choline", "opb": "Rapac uroni um", "opc": "Atracurium", "opd": "Pancuronium", "subject_name": "Anaesthesia", "topic_name": null, "id": "9e8b40da-669b-47ff-97f9-268e1f3a4999", "choice_type": "single"}
{"question": "Following group of drugs is the first line in the management of schizophrenia", "exp": "Most antipsychotics are dopamine antagonists, and as such they have found use in treatingschizophrenia, bipolar disorder, and stimulant psychosis.", "cop": 4, "opa": "Opioids", "opb": "Antiepileptics", "opc": "Serotonergic drugs", "opd": "Dopamine antagonist", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "4c7f4c37-7b2e-40e4-aa5f-92f172245234", "choice_type": "single"}
{"question": "Most potent bronchodilator among inhalational anesthetic agents is", "exp": "Effect of inhalational agents on respiratory systemAll inhalational agents are bronchodilators -Halothane cause maximum bronchodilatation. The inhalational agent of choice in asthmatics (intravenous anaesthtic of choice is ketamine).All inhalational agents cause respiratory depression to some extent - Maximum depression of respiration is seen with enflurane, on the other hand, maximum inhibition of ventilator response to increased CO2 and hypoxia is caused by halothaneAll inhalational agents vasodilate pulmonary vascular bed by blunting the hypoxic pulmonary vasoconstriction (HPV) response. Halothane has maximum effect: Isoflurane, Enflurane, desflurane, sevoflurane have similar effect.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 167 - 169)", "cop": 3, "opa": "Isoflurane", "opb": "Sevoflurane", "opc": "Halothane", "opd": "Desflurane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "48c5a2e3-2e0c-4a3f-a28f-b90edd413c82", "choice_type": "single"}
{"question": "Anesthetic agent (s) safe to use in ICP", "exp": "Anesthetic agents safe to use in raised intracranial pressure (ICP) are thiopentone, propofol & etomidate. Ref: Manuel C Pardo Jr and Ronaldo D Miller 7th Ed.", "cop": 2, "opa": "Halothane", "opb": "Thiopentone", "opc": "Ketamine", "opd": "Ether", "subject_name": "Anaesthesia", "topic_name": null, "id": "862ee773-a036-49ad-a84d-1144e7eebf25", "choice_type": "single"}
{"question": "Concentration of adrenaline used with local anaesthetic", "exp": "Concentration of adrenaline used for local anaesthetic is 1 in 2 lakhs, (that of phenylephrine is 1 in 20,000).", "cop": 4, "opa": "1:1,000", "opb": "1:10,000", "opc": "1:1,00000", "opd": "1:2,00000", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "084749cf-de2e-44b4-b849-e412e8f5cef9", "choice_type": "single"}
{"question": "Anaesthetic of choice for day care surgery is", "exp": "“Propofol is parcularly suitable for day care surgery’ because residual impairment is less marked and shorter lasng Propofol\n Propofol is a milky white powder that is preservave free; therefore, it must be used within 6 hours. It is an oil based preparaon, therefore injecon is painful.\n Propofol is the most frequently used intravenous anaesthec today. — Miller 6 th /e-3l8  It can be used for both inducon as well as maintenace.\n It does not possess anconvulsive acon (unlike thiopentone),\n It causes fall in BP and bradycardia, o Like thiopental it does not possess muscle relaxant acon.\n Propofol possess significant anemec and anpruric acon. — Miller 6 th /e - 324\n Propofol decreases polymorphonuclear leukocyte chemotoxis but not aherence, phagocytosis and killing (Thiopentone blocks all these) increased life threatning infecons.\n Propofol is parcularly suitable for outpaent surgery. Intermient injecon or connuous infusion of propofol is frequently used for total iv. anaesthesia (TIVA) when supplemented by fentanyl.\n It is anaesthecs of choice for intubaon in ICU and for paents with malignant hyperthermia.  Side effects - pain on injecon, myoclonus, apnea, X BP and rarely thrombophlebis,\n Propofol infusion syndrome A lethal syndrome, associated with infusion of propofol for 48 hours or longer.\nOccurs in children and crically ill It occurs as a result of failure of free fay acid metabolism and failure of the mitochondrial respiratory chain. Features are -\ncardiomyopathy with acute cardiac failure, metabolic acidosis, skeletal myopathy, hyperkalemia, hepatomegaly and lipemia", "cop": 3, "opa": "Thiopentone", "opb": "Nitrous oxide", "opc": "Propofol", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "1c7656bb-4e9e-4072-9dc5-43cd15e7eea5", "choice_type": "single"}
{"question": "Fluoride content is least in", "exp": "(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.170-171)", "cop": 4, "opa": "Enflurane", "opb": "Isoflurane", "opc": "Sevoflurane", "opd": "Desflurane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e5bb2ea7-947c-4378-8f75-bfd92cbfd523", "choice_type": "single"}
{"question": "Fasciculation are caused by", "exp": "Fasciculations are the characteristic feature of depolarising block. Succinylcholine is the depolarising muscle relaxant. d-tubocurare, vecuronium and pancuronium are the non-depolarising muscle relaxants.", "cop": 1, "opa": "Suxamethonium", "opb": "Pancuronium", "opc": "d-TC", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "64900aa6-187d-416d-b9a3-72130b15da19", "choice_type": "single"}
{"question": "Induction agent that may cause adrenal coex suppression is", "exp": "The specific endocrine effects manifested by etomidate consist of a dose-dependent reversible inhibition of the enzyme 11b-hydroxylase, which results in decreased biosynthesis of coisol. Blockade of the cytochrome P450-dependent enzyme 11b-hydroxylase also results in decreased mineralocoicoid production and increased formation of intermediaries (11-deoxycoicosterone). Subsequent research has shown that etomidate is far more potent as an inhibitor of steroid synthesis than as a sedative-hypnotic agent. The etomidate concentrations associated with adrenocoical suppression are less than 10 ng/mL, which are much lower than the concentrations needed for hypnosis (>200 ng/mL). Ref: Miller's anesthesia 8th edition", "cop": 2, "opa": "Ketamine", "opb": "Etomidate", "opc": "Propofol", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "980aa12c-a592-4e38-924d-b84839c4943d", "choice_type": "single"}
{"question": "Reynolds number is related to", "exp": "Flow through a tube can be described by the modified Bernoulli Equation, which states: Po = P + 1/2 r*U^2 Where Po is a constant called the \"stagnation pressure,\" P is pressure, r is density, U and is equal to fluid velocity. Pressure does not always decrease in the direction of flow - if one assumes friction is negligible (and thus the total energy of the system remains constant), any change in the kinetic energy of a fluid (ex. a reduction as U^2 falls) must be accompanied by an oppositional change in potential energy increases(P rises) Whether flow is laminar or turbulent is dependent on the Reynolds Number (Re), defined as: Re = rUL/u Where r is density, U is equal to fluid velocity, L is the length of the tubing, and u is the viscosity of the fluid. Note that the modified Bernoulli Equation applies to laminar flow (ReD < 2300, parabolic flow profile), but not to turbulent flow (ReD > 4000, blunted flow profile) Flowmeters based on a Venturi tube (circular tube with a gradual contraction and expansion in diameter, ex. those used in aircraft) maintain laminar flow at normal flow rates - since conservation of mass and energy is assumed to apply, restriction of the diameter leads to increased speed of gas flow and a corresponding decrease in the pressure on the walls The floating bobbin rotameter that is familiar to anesthesiologists is known as the Thorpe tube - the sudden restriction caused by the bobbin leads to a propoional increase in velocity and the Bernoulli equation does not apply (flow is propoionate to the square root of the pressure drop). Because the pressure drop across the orifice is inversely propoional to orifice area squared, the pressure change across the bobbin will decrease as the bobbin rises (and the area of the tube increases). The bobbin reaches a steady state when the pressure drop exactly opposes the gravitational force on the bobbin - at this steady state the pressure drop is always the same (because gravitational forces are constant), however as flow rates increase, the bobbin will move higher because this critical pressure drop will occur over a larger cross-sectional area (since velocity is higher)", "cop": 1, "opa": "Laminar flow", "opb": "Ventimask", "opc": "Dissolved oxygen in blood", "opd": "Intraalveolar tension", "subject_name": "Anaesthesia", "topic_name": "Airway", "id": "44f342ce-085b-4c37-ad81-8121d3d79cc8", "choice_type": "single"}
{"question": "Most potent bronchodilator among inhalational anesthetic agent is", "exp": "Halothane is considered a potent bronchodilator, as it often reverses asthma-induced bronchospasm. This action is not inhibited by b-adrenergic blocking agents. Halothane attenuates airway reflexes and relaxes bronchial smooth muscle by inhibiting intracellular calcium mobilization. Halothane also depresses clearance of mucus from the respiratory tract (mucociliary function), promoting postoperative hypoxia and atelectasis. Morgan clinical anesthesia 5e pg: 16", "cop": 2, "opa": "Isoflurane", "opb": "Halothane", "opc": "Sevoflurane", "opd": "Desflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "88eb84c9-98ad-4578-8d50-eb392a00d0d7", "choice_type": "single"}
{"question": "In infant (full term) diameter (mm) length (cm) of ETT used are", "exp": "C i.e. 3.5 mm, 12 cm Endotracheal Intubation Endotracheal tube is sterilized by boilingQ and cuffed E.T. tube is inflated at pressure 15-22 mmHg In neurosurgical operations Armoured Endotracheal tubeQ is used. For quick intubation, DOC is Suxamethonium.Q", "cop": 3, "opa": "3.5, 16", "opb": "7,12", "opc": "3.5, 12", "opd": "7,10", "subject_name": "Anaesthesia", "topic_name": null, "id": "21e15a25-1253-4f54-bdb4-ce630278b014", "choice_type": "single"}
{"question": "Upper Lid Retractors include", "exp": "Ans. is 'd' i.e., Levator palpabrae superioris & muller muscle The levator palpebrae superioris is the impoant upper eye lid retractor. Injury or weakness to this muscle leads to ptosis. This muscle is supplied by occulomotor (3') nerve. Deep pa of the elevator muscle is the Muller's muscle, which is sympathetically innvervated. In hypehyroidism, sensitization of the Muller muscle leads to upper eyelid retraction and pseudoproptosis. On the other hand, in Horner's syndrome loss of this muscle action leads to ptosis. The capsulopalpebral fascia assists in lower eyelid retraction and coordinates with eyeball movement. It arises as an extension of the inferior rectus and inses into the lower edge of the lower tarsus and the adjacent orbital septum.", "cop": 4, "opa": "Muller muscle and superior rectus", "opb": "Levator palpabrae superioris and superior oblique", "opc": "Superior oblique and superior rectus", "opd": "Levator palpabrae superioris & muller muscle", "subject_name": "Anaesthesia", "topic_name": null, "id": "317462f8-9a21-4882-bd73-df080b0c178b", "choice_type": "single"}
{"question": "The triad of general anaesthesia includes", "exp": "The triad of general anesthesia : Unconsciousness (narcosis) analgesia muscle relaxation The pentad of anesthesia: Loss of consciousness loss of reflex response amnesia muscle relaxation analgesia Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 1, "opa": "Unconsciousness, analgesia and muscle relaxation", "opb": "Anxiolysis, analgesia and unconsciousness", "opc": "Muscle relaxation, sedation and analgesia", "opd": "Dissociation, analgesia and muscle relaxation", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f57d4468-4022-4e61-acc1-675e53df01f2", "choice_type": "single"}
{"question": "In renal failure, IV anesthetic used", "exp": "Ans. D Cis-Atracurium Atracurium & cisatracurium both undergo Hoffman elimination & therefore both are safe in liver and kidney compromise. Additionally cisatracurium has lesser risk of causing seizures, so it's preferred over atracurium", "cop": 4, "opa": "Atracurium", "opb": "Vivacurium", "opc": "Pancuronium", "opd": "Cistracurium", "subject_name": "Anaesthesia", "topic_name": "Non-depolarising Neuromuscular Blocking Agents", "id": "732a704b-ced2-4b08-8f69-8f0e7f1dcb13", "choice_type": "single"}
{"question": "Amount of K+ in ringer lactate is", "exp": "Ringer lactate solution include a concentration of 4mEq/L.", "cop": 2, "opa": "2", "opb": "4", "opc": "5", "opd": "6", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "9a6d42bd-106e-44ba-9ee5-2df00638194c", "choice_type": "single"}
{"question": "Drug used in treatment of malignant hypehermia is", "exp": "MH is a pharmacogenetic clinical syndrome that, in its classic form occurs during anesthesia with a volatile halogenated alkane such as halothane and/or the administration of the depolarizing muscle relaxant succinylcholine.The fulminant MH episode observed clinically produces rapidly increasing body temperature (by as much as 1deg C in 5 minutes) and extreme acidosis as a result of an acute loss of control of intracellular calcium levels and compensatory uncontrolled increases in skeletal muscle metabolism that may proceed to severe rhabdomyolysis. Although MH was initially associated with a moality rate of 60%, earlier diagnosis and the use of dantrolene have reduced the moality to less than 1.4%. Current cases of MH are restricted in severity because of diagnostic awareness, early detection through end-expired carbon dioxide (CO2), the use of less potent anesthetic triggers, and the administration of drugs that attenuate the progression of the fulminant episode. The incidence of fulminant MH was repoed to be 1 case per 62,000 anesthetics administered when triggering agents were not used, but the number of suspected cases was 1 case per 4500 anesthetics administered when triggering agents were administered. Clinical signs of malignant hypehermia: Treatment of malignant hypehermia: Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 1, "opa": "Dantrolene", "opb": "Diazepam", "opc": "Paracetamol", "opd": "Phenobarbitone", "subject_name": "Anaesthesia", "topic_name": "Complications of anaesthesia", "id": "68fad2d9-c7c4-44f2-9005-0c80339c1694", "choice_type": "single"}
{"question": "High air way resistance is seen in", "exp": "D i.e. Main bronchus Medium size airways like main bronchus has maximum resistanceQ", "cop": 4, "opa": "Respiratory bronchiole", "opb": "Terminal bronchiole", "opc": "Intermediate bronchiole", "opd": "Main bronchus", "subject_name": "Anaesthesia", "topic_name": null, "id": "a1bb2e9d-06e4-444a-bac0-253c3f2ea052", "choice_type": "single"}
{"question": "This pattern of capnograph is seen in", "exp": "The shark finn pattern capnograph is seen in endotracheal tube obstruction", "cop": 2, "opa": "Spontaneous breathing", "opb": "Endotracheal tube obstruction", "opc": "Malignant hyperthermia", "opd": "Unidirectional valve malfunction", "subject_name": "Anaesthesia", "topic_name": null, "id": "8e51a5b2-8426-4efd-b81b-02e6631a29f9", "choice_type": "single"}
{"question": "Dextrose is added to the spinal anesthetic drugs to", "exp": "By adding dextrose we maKe local anaesthetic hyperbaric and prevent uncontrolled ascending of local anaesthetics The local anesthetic solutions can be made hyperbaric by the addition of glucose or hypobaric by the addition of sterile water or fentanyl. A hyperbaric solution of local anesthetic is denser (heavier) than CSF, whereas a hypobaric solution is less dense (lighter) than CSF. Significance: Hyperbaric solutions tend to move to the most dependent area of the spine. With the patient in a head-down position, a hyperbaric solution spreads cephalad, and a hypobaric anesthetic solution moves caudal. A head-up position causes a hyperbaric solution to settle caudally and a hypobaric solution to ascend cephalad. An isobaric solution tends to remain at the level of injection.", "cop": 3, "opa": "Increase duration of action", "opb": "Reduce plasma levels of local anesthetic to prevent toxicity", "opc": "Increase specific gravity", "opd": "Hasten onset of action", "subject_name": "Anaesthesia", "topic_name": "Regional Anesthesia", "id": "8ec29b0d-a3cf-4073-b8e9-b04ad686a44b", "choice_type": "single"}
{"question": "Repeated use of halothane causes", "exp": "A i.e. Hepatitis", "cop": 1, "opa": "Hepatitis", "opb": "Pancreatitis", "opc": "Encephalitis", "opd": "Meningitis", "subject_name": "Anaesthesia", "topic_name": null, "id": "3dd7650c-4cd2-4db5-8b13-95dce45ac640", "choice_type": "single"}
{"question": "With a fixed performance mask such as a ventimask", "exp": "Dead space in ventimask is low and rebreathing is not possible because of high flow of gas.", "cop": 3, "opa": "Rebreathing is possible", "opb": "Plugging side holes increases the oxygen concentration", "opc": "Total gas flow is higher than the patient’s peak inspiratory flow", "opd": "There is high equipment dead space", "subject_name": "Anaesthesia", "topic_name": null, "id": "66c14f54-5f89-4097-80d4-35bdbaa42c55", "choice_type": "single"}
{"question": "Stages of anesthesia were established by", "exp": "A i.e. Ether", "cop": 1, "opa": "Ether", "opb": "N20", "opc": "Halothane", "opd": "Chloroform", "subject_name": "Anaesthesia", "topic_name": null, "id": "937ce7a7-b9b1-4dce-970f-e062331b5b4d", "choice_type": "single"}
{"question": "This is used in treatment of", "exp": "This is autologous epidural blood patch, used in treatment of post dural puncture headache.", "cop": 2, "opa": "Migraine", "opb": "Post dural puncture headache", "opc": "Spondylolisthesis", "opd": "Disc prolapse", "subject_name": "Anaesthesia", "topic_name": null, "id": "6f67ad41-3b24-47f4-8fab-cfd887fae301", "choice_type": "single"}
{"question": "For high pressure Storage of compressed gases cylinders are made up of", "exp": "To withstand high pressure cylinders are made up of molybdenum and steel.", "cop": 1, "opa": "Molybdenum steel", "opb": "Iron + Mo", "opc": "Steel + Cu", "opd": "Cast iron", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "f7636d6b-6358-4439-aaaf-f575962ddbcb", "choice_type": "single"}
{"question": "Minimum Alveolar Concentration of sevoflurane in % is", "exp": "Minimum alveolar concentration is defined as alveolar concentration of an inhaled anesthetic agent that prevents movement in 50% of patients in response to a standardized surgical stimulus. Low MAC - High potency MAC values of adult Halothane : 0.75 Sevoflurane : 2.0 Isoflurane : 1.2 Desflurane : 6.0 Enflurane : 1.7", "cop": 4, "opa": "0.75", "opb": "0.42", "opc": "1.15", "opd": "2", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "4863193b-edb1-4227-8fc3-79a704f318a0", "choice_type": "single"}
{"question": "If a patient starts getting convulsions following the use of Lignocaine as local anaesthetic, the Drug of choice for the control of convulsions would be", "exp": "(A) Diazepam > If a patient starts getting convulsions following the use of Lignocaine as local anaesthetic, the Drug of choice for the cortrol of convulsions is the> diazepam# DIAZEPAM> Relatively lipid soluble, water insoluble; crosses placenta.> Should be administered orally or i.v. as i.v. route is slow, incomplete, erratic.> Elimination half life 20-40 hours. (Enterohepatic recirculation),> Its metabolite N-desmethyldiazepam is pharmacologically active with half life of 100 hours; Age tends to reduce clearance of Diazepam> Complications of Diazepam: i.v. Injection causes high incidence of thrombophlebitis and pain.", "cop": 1, "opa": "Diazepam", "opb": "Chlorpromazine", "opc": "Scoline", "opd": "Any", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "aa51643c-0006-4001-9dcf-6c2f9ab56f85", "choice_type": "single"}
{"question": "The most suitable agent for IV induction and maintenance in a day care surgery", "exp": "PROPOFOL The active ingredient in propofol, 2,6-diisopropylphenol, is essentially insoluble in aqueous solutions and is formulated only for IV administration as a 1% (10 mg/ml) emulsion in 10% soybean oil, 2.25% glycerol, and 1.2% purified egg phosphatide. In the United States, disodium EDTA (0.05 mg/ml) or sodium metabisulfite (0.25 mg/ml) is added to inhibit bacterial growth. The induction dose of propofol in a healthy adult is 1.5 to 2.5 mg/kg and it has an onset and duration of anesthesia similar to thiopental. As with barbiturates, dosages should be reduced in the elderly and in the presence of other sedatives and increased in young children. Because of its reasonably sho elimination half-life, propofol often is used for maintenance of anesthesia as well as for induction. For sho procedures, small boluses (10% to 50% of the induction dose) every 5 minutes or as needed are effective. An infusion of propofol produces a more stable drug level (100 to 300 mg/kg per minute) and is better suited for longer-term anesthetic maintenance. Infusion rates should be tailored to patient response and the levels of other hypnotics. Sedating doses of propofol are 20% to 50% of those required for general anesthesia. However, even at these lower doses, caregivers should be vigilant and prepared for all of the side effects of propofol discussed below, paicularly airway obstruction and apnea. Propofol elicits pain on injection that can be reduced with lidocaine and the use of larger arm and antecubital veins. Excitatory phenomena during induction with propofol occur at about the same frequency as with thiopental, but much less frequently than with methohexital. Side Effects: Nervous System: The CNS effects of propofol are similar to those of barbiturates. Propofol decreases CMRO2, cerebral blood flow, and intracranial and intraocular pressures by about the same amount as thiopental. Like thiopental, propofol has been used in patients at risk for cerebral ischemia; however, no human outcome studies have been performed to determine its efficacy as a neuroprotectant. Results from studies on the anticonvulsant effects of propofol have been mixed; some data even suggest it has proconvulsant activity when combined with other drugs. Thus, unlike thiopental, propofol is not a proven acute intervention for seizures. Cardiovascular. Propofol produces a dose-dependent decrease in blood pressure that is significantly greater than that produced by thiopental. The fall in blood pressure can be explained by both vasodilation and mild depression of myocardial contractility. Propofol appears to blunt the baroreceptor reflex or is directly vagotonic because smaller increases in hea rate are seen for any given drop in blood pressure after doses of propofol. As with thiopental, propofol should be used with caution in patients at risk for or intolerant of decreases in blood pressure. Respiratory and Other Side Effects: At equipotent doses, propofol produces a slightly greater degree of respiratory depression than thiopental. Patients given propofol should be monitored to ensure adequate oxygenation and ventilation. Propofol appears to be less likely than barbiturates to provoke bronchospasm. It has no clinically significant effects on hepatic, renal, or endocrine organ systems. Unlike thiopental, propofol appears to have significant anti-emetic action and is a good choice for sedation or anesthesia of patients at high risk for nausea and vomiting. Propofol provokes anaphylactoid reactions and histamine release at about the same low frequency as thiopental. Although propofol does cross placental membranes, it is considered safe for use in pregnant women, and like thiopental, only transiently depresses activity in the newborn.", "cop": 3, "opa": "Etomidate", "opb": "Ketamine", "opc": "Propofol", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "0fb56149-fcb7-485c-aad4-4d2d8eed1647", "choice_type": "single"}
{"question": "Success of Block 1 is assessed by", "exp": "Westphal's sign (Block 1 is Epidural block)", "cop": 1, "opa": "Westphal's sign", "opb": "Gutierrez sign", "opc": "Loss of resistance", "opd": "Crawford sign", "subject_name": "Anaesthesia", "topic_name": "Spinal, Epidural, & Caudal Blocks", "id": "c9fd38f3-12da-4492-a4cf-19a26d79484f", "choice_type": "single"}
{"question": "Inducing agent contraindicated in asthma is", "exp": "D i.e. Althesin Contraindications Steroidal agent (Althesin) is contraindicated in Porphyria and AsthamaQ Adernaline is C/I with Halothane and Ring block is C/I in finger Ether and Cylopropane are C/I with cauery Trilene is C/I with sodalime In pregnancy Gallamine and Morphine In Diabetics Ether (better answer) & Chloroform as both causes hyperglycemia In liver damage Choloroform (1st ) & Halothane In renal damageMethoxyflurane & Morphine as both leads to High Output renal failure. Gallamine is also C/I Thiopentone is C/I in acute intermittent porphyria", "cop": 4, "opa": "Ketamine", "opb": "Thiopentone", "opc": "Propofol", "opd": "Althesin", "subject_name": "Anaesthesia", "topic_name": null, "id": "5d709eff-852f-4f8c-8f78-4b2c163d7496", "choice_type": "single"}
{"question": "Colour code of oxygen cylinder is", "exp": "Color coding of cylinders is introduced to prevent accidental misplacement of cylinders.", "cop": 1, "opa": "Black cylinder with white shoulders", "opb": "Black cylinder with grey shoulders", "opc": "White cylinder with black shoulders", "opd": "Grey cylinder with white shoulders", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "c32b231a-bed5-4aa9-8c74-ae4381431e6b", "choice_type": "single"}
{"question": "As compared to a 10 year old child, a 1 year old child will have higher", "exp": "Metabolic rate and oxygen consumption are higher in infants than in older children. Rest of the parameters in question remain the same.", "cop": 1, "opa": "Oxygen consumption", "opb": "Functional residual capacity", "opc": "Tidal volume", "opd": "Vital capacity", "subject_name": "Anaesthesia", "topic_name": null, "id": "57caa800-66a3-4cd4-8e25-b472d324ae79", "choice_type": "single"}
{"question": "Non depolarizing neuromuscular blocker is", "exp": "Non depolarising neuromuscular blocker is competitive antagonist at nicotinic cholinergic receptor. It doesn’t cause fasciculations . it is reversed by neostigmine.", "cop": 2, "opa": "Non competitive neuromuscular blocker", "opb": "Reversed by neostigmine", "opc": "Persistent stimulator of nicotinic cholinergic receptors", "opd": "Induces fasciculations", "subject_name": "Anaesthesia", "topic_name": null, "id": "87212064-fe05-47a9-a8d9-4a0b6953e830", "choice_type": "single"}
{"question": "VAS is most widely used to measure", "exp": "The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between \"no pain\" and \"worst pain.\"", "cop": 3, "opa": "Sleep", "opb": "Sedation", "opc": "Pain intensity", "opd": "Depth of anaesthesia", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "bfee869c-a7ba-4707-a8e0-bbfe3561d187", "choice_type": "single"}
{"question": "Gas used in rapid airbag inflation", "exp": "Chemistry of airbagsThe inclusion of airbags in the modern automobiles has led to decrease in the automobile injuries The term airbag is a misnomer as air is not involved in the inflation processRather an airbag inflates rapidly (in about 30ms) due to explosive production of N2 gas. Sodium azide is used which rapidly decomposed to nitrogen gas(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition)", "cop": 1, "opa": "Sodium azide", "opb": "Nitrocellulose", "opc": "Mercuric nitrate", "opd": "Potassium nitrate", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "409447c6-ce02-4f0d-a49c-3c22a7d940f9", "choice_type": "single"}
{"question": "Anaphylaxis is caused by", "exp": "AlthesinAlthesis is a neurosteroidIt was used as a parenteral anaestheticIt was withdrawn from the market because of several severe anaphylactic reactions(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition)", "cop": 2, "opa": "N2O", "opb": "Althesin", "opc": "Halothane", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "60d61a52-1467-4a16-a371-cacb91ea4276", "choice_type": "single"}
{"question": "Most common site of Curling's ulcer", "exp": "Duodenum [Ref Robbins 7/e p819; Curling's ulcer is acute peptic ulcer of the duodenum described in 1842 by Curling as a complication of burns. Cushing's ulcer is acute peptic ulcer of stomach, duodenum and esophagus seen in intracranial injury, operations or tumor.", "cop": 3, "opa": "Ileum", "opb": "Stomach", "opc": "Duodenum", "opd": "Esophagus", "subject_name": "Anaesthesia", "topic_name": null, "id": "d6ff563c-5f17-4d39-9def-b1f672e809f6", "choice_type": "single"}
{"question": "Bradycardia during anaesthesia seen ina) Pancuronium b) Vecuronium c) Atracuriumd) Propofole) Succinylcholine", "exp": "Bradycardia is caused by → Succinylcholine, propofol, opioids anaesthetics (Morphine, fentanyl and its cogneres).\nTachycardia is caused by → Gallamine, Pancuronium, Rocuronium, Ketamine, Thiopentone, Methohexitone.", "cop": 4, "opa": "ab", "opb": "bc", "opc": "cd", "opd": "de", "subject_name": "Anaesthesia", "topic_name": null, "id": "cd2ec856-9903-4a91-9116-3572caba7019", "choice_type": "single"}
{"question": "Second gas effect is", "exp": "The increase in the paial pressures of the other gases in the alveolar mixture resulting from the rapid uptake of high concentrations of nitrous oxide during inhalational anesthesia induction is known as the second gas effect. The second gas effect is also evident in this example: the rapid uptake of N2O and reduced alveolar gas volume sustains Piso near its original inspired value and increases alveolar PO2, thereby augmenting uptake of these gases. Note also that the rapid uptake of N2O into blood results in an effective increase in minute ventilation, because more circuit gas is passively drawn into alveoli as alveolar gas is absorbed rapidly. These effects have been demonstrated in humans and animals, and theoretically, are sho-lived and peain only to the period of initial rapid transfer of N2O from alveoli to blood. The second gas effect may persist beyond the initial rapid phase of N2O uptake. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "Displacement of N20 by Oxygen", "opb": "Displacement of oxygen by N20", "opc": "Facilitation of inhalation of Halothane by N20", "opd": "Removal of oxygen by N20 from alveoli during recovery from general anaesthesia", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "536e0ba3-fc58-4a2b-965f-b12c1c1171b2", "choice_type": "single"}
{"question": "Intravenous regional anaesthesia is contraindicated in", "exp": "As tourniquet application can precipitate sickling and hypoxia, IVRA is contraindicated in sickle cell anemia.", "cop": 1, "opa": "Sickle cell disease", "opb": "Thalassemia", "opc": "Hereditary spherocytosis", "opd": "G6PD deficiency", "subject_name": "Anaesthesia", "topic_name": null, "id": "d86a75a0-2453-4cf4-a309-330d5a3bbdc3", "choice_type": "single"}
{"question": "The opioid contraindicated in patients on MAO inhibitor is", "exp": "Some opioid analgesics are associated with a risk of serotonin syndrome in combinations with MAOIs due to their serotonergic propeies. 1. Dextromethorphan, 2. methadone, 3. pethidine, 4. tramadol or 5. fentanyl should be avoided in patients on MAO inhibitor.", "cop": 3, "opa": "codeine", "opb": "Morphine", "opc": "Fentanyl", "opd": "Buprenorphine", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "b01fa96b-7976-4a71-a709-10429d551a02", "choice_type": "single"}
{"question": "Inhalation agent incompatable with sodaline", "exp": "B i.e. Trichloro ethylene Sodalime with trilene forms phosgene (neurotoxic) gas.Q So this combination is contraindicated. Sodalime is a mixture of 94% (Ca(OH)2 + 5% NaOH as catalyst + 1% KOHQ; with granule size of 4-8 meshQ. It should not be used with : The drier the sodalime, the more likely it will degrade & absorb volatile anesthetics. It produces compound A with sevofluraneQ (clinically significant) and carbon monoxide with desflurane, isoflurane & enflurane (clinically insignificant). However, desflurae can be broken down to CO by dry barium hydroxide lime to such an extent that it is capable of causing clinically significant CO poisoning.", "cop": 2, "opa": "Isoflurane", "opb": "Trichloro Ethylene", "opc": "Methoxy flurane", "opd": "Enflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "4e1a2c22-52d9-4128-9627-4289f407100e", "choice_type": "single"}
{"question": "Malampatti grading is for", "exp": "D i.e. Inspection of oral cavity before intubation Malampatti grading is for assessment of difficult air way (inspection of oral cavity for intubation)Q", "cop": 4, "opa": "Mobility of cervical spine", "opb": "Mobility of atlanto axial joint", "opc": "Assessment of free rotation of neck before intubation", "opd": "Inspection of oral cavity before intubation", "subject_name": "Anaesthesia", "topic_name": null, "id": "6fbf3579-c236-44bf-82a2-8031caced3bd", "choice_type": "single"}
{"question": "O2 delivery is regulated by WE", "exp": "D i.e. Noval Catheter - Nasal catheter is used for 02 delivery not novel catheter. O2 is delivered through various devices. The common used methods are.", "cop": 4, "opa": "O2 tent", "opb": "Venti mask", "opc": "Poly mask", "opd": "Noval Catheter", "subject_name": "Anaesthesia", "topic_name": null, "id": "f403dd2d-9cc8-4011-8449-2c57eb9b91d5", "choice_type": "single"}
{"question": "Hepatotoxic agent is", "exp": "The first modern halogenated volatile anesthetic, halothane, was introduced in 1955. Clinical exposure to halothane is associated with two distinct types of hepatic injury. Subclinical hepatotoxicity occurs in 20% of adults who receive halothane. It is characterized by mild postoperative elevations in alanine aminotransferase and aspaate aminotransferase, but is reversible and innocuous. Anaerobic halothane reduction by CYP2A6 to a 2-chloro-1,1,1-trifluoroethyl radical is thought to mediate this mild hepatic injury. The fulminant form of hepatotoxicity, commonly known as halothane hepatitis, It is characterized by elevated alanine aminotransferase, aspaate aminotransferase, bilirubin, and alkaline phosphatase levels, and massive hepatic necrosis following the administration of halothane. Halothane hepatitis is rare (1 in 5000 to 35,000 administrations in adults), but is fatal in 50% to 75% of these cases. Because of the potential for fatal hepatitis, halothane is no longer used in adult patients in many countries. Halothane hepatitis is caused by a hypersensitivity reaction associated with the oxidative metabolism of halothane. The highly reactive trifluoroacetyl chloride metabolite of halothane oxidation can react with nearby liver proteins. In most patients who developed hepatic necrosis after halothane anesthesia, antibodies against TFA-modified proteins were detected, suggesting that the hepatic damage is linked to an immune response against the modified protein, which acts as a neoantigen. Accordingly, patients who develop halothane hepatitis often have a history of prior exposures to halothane or other volatile anesthetics, together with symptoms suggestive of immune reactivity, such as fever, rash, ahralgia, and eosinophilia. A current hypothesis is that TFA-protein adducts induce a cytotoxic T cell reaction in sensitized individuals, which leads to liver damage. However, the immune responses observed in halothane hepatitis might not mediate liver injury. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 4, "opa": "Ketamine", "opb": "Ether", "opc": "N2O", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "703f2b92-6af3-4913-9b47-16514c0fd94a", "choice_type": "single"}
{"question": "Only anticholinergic commonly used to reverse the action of neuromuscular blocker", "exp": "All the given drugs are used for neuromuscular blockade reversal, However neostigmine is the most commonly used one.", "cop": 4, "opa": "Edrophonium", "opb": "Physostigmine", "opc": "Pyridostigmine", "opd": "Neostigmine", "subject_name": "Anaesthesia", "topic_name": null, "id": "336ac5d6-6edb-4854-bb17-f48af14099d6", "choice_type": "single"}
{"question": "Local anaesthetics act on", "exp": "Local anaesthetics act on open state > inactivated state > resting state, votage gated sodium channels.", "cop": 1, "opa": "Inactivated voltage gated sodium channels", "opb": "Inactivated ligand gated potassium channels", "opc": "Resting ligand gated potassium channels", "opd": "Resting voltage gated sodium channels", "subject_name": "Anaesthesia", "topic_name": null, "id": "5cabd296-3cea-42f1-885f-b27a2df1307b", "choice_type": "single"}
{"question": "Risk of adverse effects of SCOLINE is greater in", "exp": "Ans. a (Spinal cord injury) (Ref. Lee Anesthesia 12th/pg. 223 & Anaesthesia by Ajay Yadav 2nd/pg. 86-88)Potassium release following use of scoline is especially seen in patients with the following, hence the risk of adverse effects greater in them:# Burns# Cerebral palsy# Duchenne's muscular dystrophy# Spinal cord trauma# Severe abdominal sepsis# Tetanus# UMN and LMN lesions# Wasting secondary to chronic arterial insufficiency.", "cop": 1, "opa": "Spinal cord injury", "opb": "Thoracic injury", "opc": "Bone injury", "opd": "Head injury", "subject_name": "Anaesthesia", "topic_name": "Complications Of Anaesthesia", "id": "712757c5-380d-4260-8e66-53d7143af7e6", "choice_type": "single"}
{"question": "Percentage of thiopentone used for induction is", "exp": "The usual concentration of thiopental is 2.5%. The usual doses of thiopental (3 to 4 mg/kg) and thiamylal (3 to 4 mg/kg) are approximately twice the dose of methohexital (1 to 2 mg/kg). In dose-response studies, the ED50 for thiopental ranged from 2.2 to 2.7 mg/kg, and the ED50 for methohexital was 1.1 mg/kg. Less interpatient variability is seen in the dose-response to barbiturates than to benzodiazepines when used for anesthesia induction, but significant variability remains in the dose of thiopental required to induce anesthesia. Interpatient dose variability is related to the presence of hemorrhagic shock, cardiac output, lean body mass, obesity, gender, and age. Hemorrhagic shock, lean body mass, age, and obesity explain the variability of patients' responses resulting from a decrease in the central volume of distribution. Finally, patients who have severe anemia, burns, malnutrition, widespread malignant disease, uremia, ulcerative colitis, or intestinal obstruction also require smaller induction doses of barbiturates. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "0.50%", "opb": "1.50%", "opc": "2.50%", "opd": "4.50%", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "eb3ab30d-b3ec-4b1d-8edf-f4afb083479c", "choice_type": "single"}
{"question": "Fastest route of absorption of local anaesthetic is", "exp": "The fastest route for absorption of LA is intercostal block, due to close location of blood vessel around the nerve, so that is why LA are rapidly taken by in intercostal block.", "cop": 1, "opa": "Intercostal", "opb": "Epidural", "opc": "Brachial", "opd": "Caudal", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "53fea5dc-2dbd-4e2e-8b3f-f4bbea10293c", "choice_type": "single"}
{"question": "Post Spinal Headache can last for", "exp": "C i.e. 7-10 days", "cop": 3, "opa": "Upto 10 min", "opb": "Upto 10 hours", "opc": "7 - 10 days", "opd": "Upto 10 months", "subject_name": "Anaesthesia", "topic_name": null, "id": "a117d7e8-6051-4b33-a0ab-ab8a8c36168a", "choice_type": "single"}
{"question": "The cuff used in Endotracheal tube is following", "exp": "Low pressure - high volume type cuffs have a comparatively large volumes and consequently large contact areas between cuff and trachea. Advantage of high volume, low pressure cuff is lesser incidence of tracheal mucosal damage. Disadvantages of high volume, low pressure cuff include: Sore throat (due to larger mucosal contact area) Aspiration Spontaneous extubation Difficulty in inseion (because of the floppy cuff)", "cop": 1, "opa": "Low pressure - high volume", "opb": "High pressure - low volume", "opc": "Variable pressure - low volume", "opd": "Low pressure - low volume", "subject_name": "Anaesthesia", "topic_name": "Airway", "id": "fc8f2d7d-59bf-4895-a8c0-ee13964fef12", "choice_type": "single"}
{"question": "Mendelson's syndrome is", "exp": "D i.e. Aspiration of gastric content - Mendelson's syndrome is d/t aspiration of gastric contentQ - It is prevented by Sellick's maneuver i.e. backward pressure on cricoid cailageQ.", "cop": 4, "opa": "Air leak", "opb": "Tracheal rupture during intubation", "opc": "Oesophageal rupture", "opd": "Aspiration of gastric content", "subject_name": "Anaesthesia", "topic_name": null, "id": "fa4b5206-1b5e-4263-87b1-5d8c562d26eb", "choice_type": "single"}
{"question": "Sellick's maneuver is used for", "exp": "Ans. (b) To prevent gastric aspirationRef : Miller's Anaesthesia 7th ed. 12430* Sellick s manuever is a method of preventing regurgitation of an anesthesized patient during endotracheal intubation by applying pressure to the cricoid cartilage.* Or in other words, Sellicks maneuver is application of backward pressure on cricoid cartilage to prevent gastric aspiration (Mandelson s syndrome).", "cop": 2, "opa": "To prevent alveolar collapse", "opb": "To prevent gastric aspiration", "opc": "To facilitate Respiration", "opd": "To reduce dead space", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous General Anesthesia", "id": "0dcf4c5d-206f-4e8a-b92a-94e322b6f7a7", "choice_type": "single"}
{"question": "Local anesthetic that can cause Methemoglobinemia", "exp": "Ans. b (Prilocaine) (Ref. KDT 5th ed., 325; Anaesthsia by Ajay Yadav 3rd ed., 218-appendix; 114)Local anesthetic is associated with the risk of Methemoglobinemia- Prilocaine.PRILOCAINE# Prilocaine is an amide type local anesthetic agent.# Safest Local Anesthetic# Metabolized in liver, kidney and lung# Maximum safest dose is 5 mg/kg with adrenaline 8 mg/kg# Most suitable for Bier's block (0.5%)# Methemoglobinemia occurs at higher dose (prilocaine is unique amongst the local anesthetic agents for its ability to reduce the blood's oxygen carrying capacity to cause clinically detectable cyanosis.)# Stored in cool place# Metabolized by pseudocholine esterase# Agent of choice in patients with history of malignant hyperthermia.# It is the first synthetic local anesthetic introduced in 1905.# Practically, it is not used today.# Prilocaine can however be used for Bier's block (or intravenous regional anaesthesia--IVRA). No serious complications have been documented.# Equipotent with lignocaine, but its duration of action is longer and it is less toxic.# It is not a surface anesthetic.Chart 1: Drug capable of inducing methemoglobinemia AcetaminophenAnti malaria drugsNitratesNitric oxidep-Aminislicylic acidChloroquineAmmonum nitrateNitrous oxideLocal anestheticsPrimaquineSilver nitratePiperazineBenzocaineQuinacrineSodium nitrateRifampinBupivacaineMethylene blueNitroglycerineRiluzoleLidocaineDapsoneNitroprussideSulfonamidesPolocainePhenacetinsBismuth subnitrateSulfasalazineEMLA*PhenazopyndineNitntesSulfamethoxazoleAnticonvusantsFlutamideAmyl nitrateSulfadiazineVaiproic acidHydroxylamineIsobutyl nitrateSulfapyridinePhenytoinOral hypoglycemicMetochlopramideNitrofurantoinSulfonesSulfanilamide", "cop": 2, "opa": "Ropivacaine", "opb": "Prilocaine", "opc": "Amethocaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": "Local and Regional Anesthesia", "id": "736c4393-2b23-4527-ba3f-3194526cefac", "choice_type": "single"}
{"question": "Bradycardia is common after injection of", "exp": "Succinylchole is the only muscle relaxant, which stimulates vague nerve - BRADYCARDIA.(attenuates tachycardia and hypeension) This effect is more predominant in the pediatric age group. Therefore, I. V. Atropine is given prior to the first dose of scholine in the children and prior to the second dose in the adults. Ref.morgan 5th/e", "cop": 2, "opa": "Midazolam", "opb": "Succinylcholine", "opc": "Dopamine", "opd": "Isoprenaline", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "b6c2b95a-aea7-4c81-bbfb-821302c85bf1", "choice_type": "single"}
{"question": "Laughing gas is", "exp": "Humphry Davy coined the name \"laughing gas\" for nitrous oxide. Nitrous oxide, commonly known as laughing gas or nitrous, is a chemical compound, an oxide of nitrogen with the formula N2O. At room temperature, it is a colourless, non-flammable gas, with a slight metallic scent and taste. At elevated temperatures, nitrous oxide is a powerful oxidiser similar to molecular oxygen. It is soluble in water. Nitrous oxide is a weak general anaesthetic, and so is generally not used alone in general anaesthesia, but used as a carrier gas (mixed with oxygen) for more powerful general anaesthetic drugs such as sevoflurane or desflurane. It has a minimum alveolar concentration of 105% and a blood/gas paition coefficient of 0.46. The use of nitrous oxide in anaesthesia, however, can increase the risk of postoperative nausea and vomiting. Recreational inhalation of nitrous oxide, with the purpose of causing euphoria and/or slight hallucinations, began as a phenomenon for the British upper class in 1799, known as \"laughing gas paies\". In rats, N2O stimulates the mesolimbic reward pathway by inducing dopamine release and activating dopaminergic neurons in the ventral tegmental area and nucleus accumbens, presumably through antagonistic of NMDA receptors localised in the system. This action has been implicated in its euphoric effects and, notably, appears to augment its analgesic propeies as well. It is remarkable, however, that in mice, N2O blocks amphetamine-induced carrier-mediated dopamine release in the nucleus accumbens and behavioural sensitisation, abolishes the conditioned place preference (CPP) of cocaine and morphine, and does not produce reinforcing (or aversive) effects of its own. Effects of CPP of N2O in rats are mixed, consisting of reinforcement, aversion and no change. In contrast, it is a positive reinforcer in squirrel monkeys, and is well known as a drug of abuse in humans. These discrepancies in response to N2O may reflect species variation or methodological differences. In human clinical studies, N2O was found to produce mixed responses, similarly to rats, reflecting high subjective individual variability.", "cop": 1, "opa": "Nitrous oxide", "opb": "Halothane", "opc": "Chloroform", "opd": "Diethylether", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "37d49c49-8b4d-4d46-9c9b-a3233fa32ea5", "choice_type": "single"}
{"question": "Anaesthetic circuit that prevents rebreathing of CO2", "exp": "Different anaesthetic breathing circuits are Mapleson circuits and circle system. Circle system is a closed circuit, so called because it has inbuilt CO2 absorbers. It prevents rebreathing of exhaled air", "cop": 4, "opa": "Magil's circuit", "opb": "Mapleson D circuit", "opc": "Ayre's piece", "opd": "Circle system", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "978accf4-8843-4840-82cd-69818910d389", "choice_type": "single"}
{"question": "Drug contraindicated in renal failure is", "exp": "B i.e. Pethidine Meperidine (pethidine, demerol), a phenylpiperidine is metabolized chiefly in liver to nonmeperidine, which is eliminated by the kidney and liver. In patients or addicts who are tolerant to the depressant effects of meperidine, large doses repeated at sho interval may produce an excitatory syndrome including hallncination, tremors, muscle twitches, dilated pupils, hyperactive reflexes and convulsions. These excitatory symptoms are d/t accumulation of normeperidine, which has a half life of 15-20 hours, compared to 3 hours for meperidine. In patients with cirrhosis, the bioavailability of meperidine is --80% increased and t1/2 of both meperidine and normeperidine are prolonged. Since normeperidine is eleminated by kidney and liver, decreased renal or hepatic function predispose to neurotoxic effects of nor-meperidineQ. Meperidine is also not recommended for the treatment of chronic pain b/o concerns of metabolite toxicity. It should not be used for longer than 48 hours or in doses > 600 mg/day. Major pathway for morphine metabolism is conjugation with glucuronic acid forming morphine -6- glucuronide and morphine -3- glucuronide. Morphine-6-glucuronide is twice as potent as morphine with somewhat longer t1/2. (t1/2 of morphine is 2 hours) and pharmacological actions indistinguishable from those of morphine. With chronic morphine administration, the 6-glucuronide accounts for most of analgesia and its blood levels exceed those of morphine. Morphine-6-glucuronide is excreted by kidney, so its levels increase in renal failure, perhaps explaining morphine's potency and long action in compromised renal function. So in patients with renal failure decreased protein binding of morphine (resulting in higher plasma free drug level) and accumulation of morphine -6- glucuronide predispose them to respiratory depression. So morphine is given cautiously in low doses in renal failure. Respiratory depression is also repoed in patients with CRF receiving sufentanyl. Except for slightly decreased protein binding, the free drug volume of distribution and clearance of alfentanil appears to be unaffected by renal failure. Fentanyl, has sho half life and its metabolites are inactive. Therefore, it is a good choice in patients with renal diseaseQ. In renal disease (renal failure) remifentanil > fentanyl > alfentanil > sufentanil are safe. Whereas morphine (d/t morphine 6 glucoronide) 1/t respiratory depression is used very cautiously in low dose and meperidine (pethidine) is contraindicated d/t very long acting metabolite nor-meperidine causing neurotoxic excitatory syndrome.", "cop": 2, "opa": "Morphine", "opb": "Pethidine", "opc": "Fentanyl", "opd": "Alfentanil", "subject_name": "Anaesthesia", "topic_name": null, "id": "f5fac5f4-1023-4ba1-a8cd-80625f86d2dd", "choice_type": "single"}
{"question": "Lumbar puncture was done in a patient with raised intracranial tension. The patient died suddenly on the table. The cause of the death is most likely to be", "exp": "(B) Tentorial herniation # Lumbar puncture was done in a patient with raised intracranial tension. The patient died suddenly on the table. The cause of the death is most likely to be:- Tentorial herniation", "cop": 2, "opa": "Middle cerebral artery hemorrhage", "opb": "Tentorial herniation", "opc": "Rupture of an aneurysm", "opd": "Loss of CSF", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "9cfd5ca4-6af8-4235-ab10-3455e93e345b", "choice_type": "single"}
{"question": "During induction of general anesthesia, administration of oxygen with high concentration of nitrous oxide and halothane hastens the uptake of halothane, this is known as", "exp": "During induction ofgeneral anesthesia, when a large volume of a gas (nitrous oxide) is taken up from alveoli into pulmonary capillary blood, the concentration of gases remaining in the alveoli is increased. This results in effects known as the second gas effect. These effects occur because of the contraction of alveolar volume associated with the uptake of the nitrous oxide. this effect makes speed of induction fast", "cop": 3, "opa": "Fink effect", "opb": "Concentration effect", "opc": "Second gas effect", "opd": "Third gas effect", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "40d4a2bf-0dd6-4978-85ec-81bcafa94b0f", "choice_type": "single"}
{"question": "During G.A. shivering is abolished by suppression of", "exp": "A i.e. Hypothalmus Temperature regulation during G.A. OWI Normally hypothalmus maintain core body temperatureQ (central blood temperature) within very narrow range (intehreshold range). Temperature of patient undergoing G.A. should be monitored (except for < 15 minutes procedure) by thermistor or thermocouple with a probe placed over tympanic membrane, rectum, nasopharynx, esophagus, bladder & skin. Hypothermia (ie body temperatureprotective during times of cerebral or cardiac ischemiaQ Raising body temperature induces vasodialation & sweating while hypothermia triggers vasoconstriction & shivering as compensatory mechanism. During G.A. body cannot compensate for hypothermia because anesthetics inhibit central thermoregulation by interfering with hypothalamic function.Q Spinal & epidural anesthesia also lead to hypothermia by vasodialation & internal redistribution of heat. The accompanying thermoregulatory impairment from regional anesthesia is due to an altered perception of temperature in bloacked dermatomes by hypothalmus as opposed to central effect of G.A. Postanesthetic shivering or shaking that is not related to hypehermia can be abolished by ceain opioids e.g. meperidine, butrophanol & tramadol (but not morphine).", "cop": 1, "opa": "Hypothalmus", "opb": "Thalmus", "opc": "Cerebral Coex", "opd": "Medulla", "subject_name": "Anaesthesia", "topic_name": null, "id": "7b975b29-6a00-47c0-922f-52691d26da57", "choice_type": "single"}
{"question": "Shoest acting skeletal muscle relaxant is", "exp": "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.205-211)", "cop": 1, "opa": "Suxamethonium", "opb": "Mivacurium", "opc": "Pancuronium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "41503c68-c34f-4ea0-b58a-6f023a0264ed", "choice_type": "single"}
{"question": "Most commonly used local anaesthetics", "exp": "BupivacaineBupivacaine is 2nd most commonly used local anaesthetic (after lidocaine)Bupivacaine has the highest local tissue irritancy amongst local anaestheticsIt is the most cardiotoxic local anaestheticLevobupivacaine (The S(-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizureConcentrations used for bupivacaine are:- Nerve block :0.5%, epidural: 0.25-0.5% and spinal: 0.5% Maximum safe dose is 2mg/kg without adrenaline and 3mg/kg with epinephrine(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 2, "opa": "Dibucaine", "opb": "Bupivacaine", "opc": "Prilocaine", "opd": "Tetracaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "b030f822-ba34-43cc-98c2-f250975541c7", "choice_type": "single"}
{"question": "Nephrotoxic agent is", "exp": "A i.e. Methoxy flurane", "cop": 1, "opa": "Methoxy flurone", "opb": "Isoflurone", "opc": "Halothane", "opd": "N20", "subject_name": "Anaesthesia", "topic_name": null, "id": "ae0c08d1-8f64-49a0-8928-e03d32c53b3a", "choice_type": "single"}
{"question": "Gas cylinder with single pin index", "exp": "Entonox has an pin index number of 7 . Air - 1 , 5 ; Oxygen- 2 , 5 ; N20 - 3 , 5 . CO2 - 1 ,6 ; Cyclopropane - 3 , 6 ; Heliox - 4 , 6 . PIN index number is developed to prevent incorect cylinder attachment .", "cop": 4, "opa": "Oxygen", "opb": "Air", "opc": "Titrogen", "opd": "Entonox", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "cbea2c66-a701-499a-86c1-13a055a062f8", "choice_type": "single"}
{"question": "Levosimendan is approved in", "exp": "Levosimendan is a calcium sensitizer -- it increases the sensitivity of the hea to calcium, thus increasing cardiac contractility without a rise in intracellular calcium.Has been approved for use in acute cardiac failure in EuropeKatzung 13e pg: 220", "cop": 1, "opa": "Hea failure", "opb": "Kidney failure", "opc": "Liver failure", "opd": "Endocrine crisis", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "e2456f9a-7470-4e13-99fe-3176866d0a57", "choice_type": "single"}
{"question": "Malignant hyperthermia is", "exp": "Malignant hyperthermia is autosomal dominant disease. It is characterized by metabolic acidosis and hyperkalemia.\ni.v dantrolene infusion is used for treatment.", "cop": 2, "opa": "Autosomal recessive pharamacogenetic disease", "opb": "Succinylcholine is a triggering agent", "opc": "Metabolic alkalosis and hypokalemia", "opd": "Calcium infusion is used for treatment.", "subject_name": "Anaesthesia", "topic_name": null, "id": "00d9efd9-cc33-4f14-8e6c-76eefaa1f408", "choice_type": "single"}
{"question": "Commonly used route of administration for general anaesthesia is", "exp": "Ans. b (Intravenous). (Ref: Anesthesia by Ajay Yadav 2nd/pg. 71; KD Tripathi, 5th/pg. 342)INTRAVENOUS ANAESTHESIA# The most commonly used route of administration used for general anesthesia is IV for induction of anesthesia and inhalational agents are preferred for maintenance.# The most commonly used IV anesthetic agent for induction is thiopentone,# Ideal characteristics of IV anesthetics are- Compatible with other dugs- High therapeutic index- Inexpensive- Independent of liver/kidneys for metabolism/excretion- No toxic metabolites- Long shelf life and resistance to microbial contamination- Non-cumulative- Non-allergenic- No cardiopulmonary depression- No effect on cerebral blood flow- No endocrinologic effect- No pain on injection- Quick and smooth induction-recovery- Reversible with specific antagonist- Potent, so small volume is required for anesthetic induction/maintenanceIV Anesthetic agents:BarbituratesNon-barbituratesDissociatives- Oxybarbiturate - pentobarbital and methohexital- Thiobarbiturates - thiopental and thiamylal- Propofol- Etomidate- Alphaxalone- PropanididKetamineTiletamine", "cop": 2, "opa": "Inhalational", "opb": "Intravenous", "opc": "Intraarterial", "opd": "Subcutaneous", "subject_name": "Anaesthesia", "topic_name": "General Anesthesia", "id": "d5c6d1c1-f794-4e57-9417-1be5128111aa", "choice_type": "single"}
{"question": "Duration of action of Lidocaine with adrenaline", "exp": "Duration of action of lidocaine with adrenaline is 2-3 hours. Adrenaline enhances both speed and quality of block, It also prolong effect of lignocaine and reduce the peak blood level and toxicity by reducing the local blood supply duration of action of lidocaine whithout adrenaline is 30-90min", "cop": 3, "opa": "15-30 minutes", "opb": "30-60 minutes", "opc": "2-3 hours", "opd": "3-6 hours", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "8d960f53-4590-43f8-835a-6f776efc76fa", "choice_type": "single"}
{"question": "Percentage of hepatitis after halothane use", "exp": "The first modern halogenated volatile anesthetic, halothane, was introduced in 1955. Clinical exposure to halothane is associated with two distinct types of hepatic injury. Subclinical hepatotoxicity occurs in 20% of adults who receive halothane. It is characterized by mild postoperative elevations in alanine aminotransferase and aspaate aminotransferase, but is reversible and innocuous. Anaerobic halothane reduction by CYP2A6 to a 2-chloro-1,1,1-trifluoroethyl radical is thought to mediate this mild hepatic injury. The fulminant form of hepatotoxicity, commonly known as halothane hepatitis, It is characterized by elevated alanine aminotransferase, aspaate aminotransferase, bilirubin, and alkaline phosphatase levels, and massive hepatic necrosis following the administration of halothane. Halothane hepatitis is rare (1 in 5000 to 35,000 administrations in adults), but is fatal in 50% to 75% of these cases. Because of the potential for fatal hepatitis, halothane is no longer used in adult patients in many countries. Halothane hepatitis is caused by a hypersensitivity reaction associated with the oxidative metabolism of halothane. The highly reactive trifluoroacetyl chloride metabolite of halothane oxidation can react with nearby liver proteins. In most patients who developed hepatic necrosis after halothane anesthesia, antibodies against TFA-modified proteins were detected, suggesting that the hepatic damage is linked to an immune response against the modified protein, which acts as a neoantigen. Accordingly, patients who develop halothane hepatitis often have a history of prior exposures to halothane or other volatile anesthetics, together with symptoms suggestive of immune reactivity, such as fever, rash, ahralgia, and eosinophilia. A current hypothesis is that TFA-protein adducts induce a cytotoxic T cell reaction in sensitized individuals, which leads to liver damage. However, the immune responses observed in halothane hepatitis might not mediate liver injury. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "20%", "opb": "40%", "opc": "1 in 30000", "opd": "1 in 3000", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f39377ef-8c1e-40b6-b421-ce9075dd95b6", "choice_type": "single"}
{"question": "Dissociative anaesthesia is produced by", "exp": "Dissociative anaesthesia is characterized by profound analgesia, immobility, amnesia with light sleep and feeling of dissociation from once own body and the surroundings - Cataleptic stateKetamine (phencyclidine) induces dissociative anaesthesia.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 1, "opa": "Ketamine", "opb": "Etomidate", "opc": "Propofol", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "8e5d7def-3e49-47b7-83ca-bc1d5aff248c", "choice_type": "single"}
{"question": "Maximum global warming is by", "exp": "Desflurane is a greenhouse gasIt causes maximum global warmingGlobal warming potential (as an equal amount of CO2)Isoflurane210 timesSevoflurane510 timesDesflurane 1620 times (Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 170)", "cop": 1, "opa": "Desflurane", "opb": "Isoflurane", "opc": "Sevoflurane", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "667a7c0d-40f9-4a33-81ee-6a03148ee24b", "choice_type": "single"}
{"question": "Maximum safe dose of bupivacaine", "exp": "Maximum safe dose of bupivacaine is 2 mg/kg with or without adrenaline.", "cop": 2, "opa": "1 mg/kg", "opb": "2 mg/kg", "opc": "3 mg/kg", "opd": "5 mg/kg", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "082767e6-e33b-471e-b8df-1446467a032f", "choice_type": "single"}
{"question": "Anaesthetic agent of choice in congenital heart disease with right to left shunt is", "exp": "Ketamine being sympathomimetic causes raised left sided pressures, which obstructs shunt flow.", "cop": 4, "opa": "Thiopentone", "opb": "Propofol", "opc": "Etomidate", "opd": "Ketamine", "subject_name": "Anaesthesia", "topic_name": null, "id": "a701f10b-ba4f-4512-8fa2-92629238a880", "choice_type": "single"}
{"question": "Best antagonist of Morphine", "exp": "Ans. is 'c' Naloxone T/t of choice for morphine poisoning is Naloxone (6 mg. IV) repeated every 3 min till respiration picks up) It is preferred due to no agonistic action and no respiratory depression. Nalorphine is given only when Naloxone not available", "cop": 3, "opa": "Pentazocine", "opb": "Buprenorphine", "opc": "Naloxone", "opd": "Nalorphine", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous General Anesthesia", "id": "00f2a2ee-23ec-40d6-a80a-c6059c3292dc", "choice_type": "single"}
{"question": "Least Cardiotoxic anaesthetic agent", "exp": "B i.e. Isoflurane Isoflurane increases ICT but less than halothane & enflurane; which can be reversed by hyperventilation. So isoflurane is a preferable agent in raised ICT. Isoflurane is anaesthesia of choice (AOC) for neurosurgical procedureQ as it does not increase cerebral blood flow & CSF pressure. Of various inhalation agents available, isoflurane has the advantage of providing stability of cardiac rhythm & lack of sensitizention of the hea to exogenous & endogenous adrenalineQ. In coronary aery disease isoflurane should be avoided Wt coronary steel phenomenonQ. In ischemia of cardiac muscle selective vasodialation of vessels of Ischemic zone and maintained tone of non ischemic zone //t selective increase of blood supply to ischemic areas. But in coronary steal phenomenon (Isoflurane & Dipyridomole) there is dialation of vessels of non ischemic zone also so there is decrease of flow in ischemic zone.Q That is why isoflurane is avoided in ischemic hea disease. In Myocardial Infarction operation should be with held for 6 monthsQ. Goldman Index is for cardiac risk factor and when it is > 13 it is associated with poor prognosis. In hypeension, halothane is AOC (for hypotensive surgery) In hypovolumia, Light G.A. (preferably Ether and Cyclopropane) with IPPV is method of choice Isoflurane increases ICT but less than halothane & enflurane; which can be reversed by hyperventilation. So isoflurane is a preferable agent in raised ICT. Isoflurane is anaesthesia of choice (AOC) for neurosurgical procedureQ as it does not increase cerebral blood flow & CSF pressure. Of various inhalation agents available, isoflurane has the advantage of providing stability of cardiac rhythm & lack of sensitizention of the hea to exogenous & endogenous adrenalineQ. In coronary aery disease isoflurane should be avoided Wt coronary steel phenomenonQ. In ischemia of cardiac muscle selective vasodialation of vessels of Ischemic zone and maintained tone of non ischemic zone //t selective increase of blood supply to ischemic areas. But in coronary steal phenomenon (Isoflurane & Dipyridomole) there is dialation of vessels of non ischemic zone also so there is decrease of flow in ischemic zone.Q That is why isoflurane is avoided in ischemic hea disease. In Myocardial Infarction operation should be with held for 6 monthsQ. Goldman Index is for cardiac risk factor and when it is > 13 it is associated with poor prognosis. In hypeension, halothane is AOC (for hypotensive surgery) In hypovolumia, Light G.A. (preferably Ether and Cyclopropane) with IPPV is method of choice", "cop": 2, "opa": "Enflurane", "opb": "Isoflurane", "opc": "Sevoflurane", "opd": "Halothane, Trilene, ketamine", "subject_name": "Anaesthesia", "topic_name": null, "id": "78604203-d384-446d-826c-e701bd41c001", "choice_type": "single"}
{"question": "Longest acting L.A", "exp": "B i.e. Tetracaine", "cop": 2, "opa": "Bupivacaine", "opb": "Tetracaine", "opc": "Xylocaine", "opd": "Procaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "7c1db26f-e677-442a-95f1-f872ded8cfc4", "choice_type": "single"}
{"question": "Local anaesthetic acts by inhibition of", "exp": "The nerve resting membrane potential is little affected by local anesthetics. As the concentration of local anesthetic applied to the nerve is increased, a decrease in the rate of depolarization and in the peak amplitude of the action potential occurs until the impulse is abolished. It is not possible, however, to derive data on the binding of local anesthetics to Na+ channels from measurement of the changes in nerve impulses. By using a \"voltage-clamp\" procedure, Na+ currents and their inhibition by local anesthetics can be directly assayed. When the membrane of isolated neurons is rapidly depolarized to a constant value, the time course of ionic currents is observed. Sodium currents during one initial depolarization are reduced by subclinical doses of local anesthetic (e.g., 0.2mM lidocaine) and totally abolished by clinical doses (e.g., 1% lidocaine, [?]40mM). If the test depolarization is applied repeatedly, for example, at frequencies higher than 5Hz (five pulses per second), the paially depressed (tonically inhibited) Na+ current is fuher reduced incrementally for each pulse until a new steady-state level of inhibition is reached. This frequency-dependent inhibition, also called phasic inhibition. Local anesthetics bind in the inner vestibule of the closed Na+ channel. Amino acid mutations in the S6 segments of D-1, D-3, and D-4 all modify local anesthetic action, thus suggesting either that these regions form a pharmacophore small enough to simultaneously contact the drug at three surfaces or that the local anesthetic molecule moves rapidly among these three segments. X - binding site of LA. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 1, "opa": "Na channels", "opb": "Mg channels", "opc": "Ca channels", "opd": "K channels", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "5e72fa22-530d-45a1-bc4b-b73c7cc1353e", "choice_type": "single"}
{"question": "The inhalational agent of choice in children is", "exp": "An inhaled induction of anesthesia with sevoflurane in oxygen with or without nitrous oxide is a common method used in children because it does not require IV access. IV induction is selected in children who already have IV access, who request an IV induction, or for whom an IV induction is indicated (full stomach, persistent gastroesophageal reflux disease, significant potential for cardiopulmonary compromise). The most common induction anesthetic in children is propofol 2 to 3 mg/kg Basics of Anaesthesia 7e pg: 603", "cop": 2, "opa": "Methoxyflurane", "opb": "Sevoflurane", "opc": "Desflurane", "opd": "Isoflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "379287f7-a871-4ca6-98d1-8e8d14649b9a", "choice_type": "single"}
{"question": "Colour coding of halothane , isoflurane, sevoflurane and desflurane is respectively", "exp": null, "cop": 2, "opa": "red, purple, blue , yellow", "opb": "red , purple, yellow , blue", "opc": "red , yellow, purple, blue", "opd": "red, blue , purple, yellow", "subject_name": "Anaesthesia", "topic_name": "Anesthesia Machine", "id": "625228a2-8b47-4a48-8f37-5c6de40bde78", "choice_type": "single"}
{"question": "For anesthesiology mild Systemic disease Included in ASA grade", "exp": null, "cop": 4, "opa": "1", "opb": "3", "opc": "4", "opd": "2", "subject_name": "Anaesthesia", "topic_name": null, "id": "90f31f42-a9bb-4c39-9328-c527ed333b26", "choice_type": "single"}
{"question": "Maximum dose of lignocaine with adrenaline is (in mg/ kg)", "exp": "Ans. c (7). (Ref. Harrisons Medicine, 18th/735)LIGNOCAINE# Maximum safest dose 3 mg/kg or 200 mg and with adrenaline 7 mg/kg or 500 mg.# Duration of effect 45 to 60 min and with adrenaline it is 2-3 hours.# Should not be given in patients with history of malignant hyperthermia.# Concentration usedo Surface topical analgesia- 4%o As jelly, for urethra- 2%o Nerve blocks/epidural/infiltration block-- 1-2%o Spinal- 5%# Lignocaine is an amide# It is 4 times less potent than bupivacaine# Drug of choice for lignocaine-induced arrhythmia is bretylium tosylate (SGPGI 2002)# Repeated doses of 4-5 mL of 0.5% bupivacaine or 1% lignocaine are used to maintain epidural analgesia.# 'Transient neurological symptoms' is an disntinct side-effect of LignocaineEducational point:The baricity of the local anesthetic solution. Baricity is defined by the ratio of the density of the local anesthetic solution to the density of CSF. A solution with a ratio > 1 is hyperbaric and tends to sink with gravity within the CSF. An isobaric solution has a baricity of 1 and tends to remain in the immediate area of injection. A ratio < 1 is a hypobaric solution, which rises in the CSF.", "cop": 3, "opa": "4", "opb": "2", "opc": "7", "opd": "10", "subject_name": "Anaesthesia", "topic_name": "Local and Regional Anesthesia", "id": "d86b98eb-c7ef-4052-ab4e-2b0c78dcdd58", "choice_type": "single"}
{"question": "Second gas effect is seen with", "exp": "The second gas effect is a distinct phenomenon that occurs independently of the concentration effect. The ability of the large-volume uptake of one gas (first gas) to accelerate the rate of increase of the Pa of a concurrently administered companion gas (second gas) is known as the second gas effect. For example, the initial large volume uptake of nitrous oxide accelerates the uptake of companion gases such as volatile anesthetics and oxygen. Basics of Anaesthesia 7e pg: 99", "cop": 2, "opa": "Ether", "opb": "Nitrous oxide", "opc": "Halothane", "opd": "Isoflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "63e96e4e-910a-4a9c-aee3-fda2dbd05ac0", "choice_type": "single"}
{"question": "Concentration of adrenaline used with lignocaine", "exp": "local anaesthetic + adrenaline (1:200000) \n\nFast onset\nLess systemic toxicity \nProlonged duration", "cop": 4, "opa": "0.180555556", "opb": "1.430555556", "opc": "1:20000", "opd": "1:200000", "subject_name": "Anaesthesia", "topic_name": null, "id": "20f8fae9-b3ad-4c99-9253-accfbff91537", "choice_type": "single"}
{"question": "For reduction of shoulder one of the following technique is appropriate", "exp": "Interscalene approach: most intense at C5-C7 dermatomes and least intense at C8-T1(ulnar nerve area), most optimal for procedures on shoulderAxillary approach: most optimal for a procedure from elbow to hand", "cop": 2, "opa": "Spinal anesthesia", "opb": "Interscalene block", "opc": "Axillary brachial block", "opd": "Bier block", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "997217e9-3ce6-4588-a4a3-37abbb5c7249", "choice_type": "single"}
{"question": "Anesthetic agent (s) safe to use in TICP", "exp": "B i.e. Thiopentone Anesthetic agents safe to use in raised intracranial pressure (ICP) are thiopentone, propofol & etomidateQ", "cop": 2, "opa": "Halothane", "opb": "Thiopentone", "opc": "Ketamine", "opd": "Ether", "subject_name": "Anaesthesia", "topic_name": null, "id": "270e8637-7e7e-4078-a65a-6138e5e5bcdc", "choice_type": "single"}
{"question": "Eutectic mixture of local anaesthetic (EMLA) cream is", "exp": "Eutectic mixture of local anaesthetic (EMLA)This 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 head in contact with the skin for at least 1 hourEMLA is used: to make venepuncture painless especially for children, and for the procedure like skin grafting & circumcisionAs systemic absorption of prilocaine can cause methemoglobinemia, EMLA should not be used on the mucocutaneous membrane or in very small child.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 754, 856)", "cop": 2, "opa": "Bupivacaine 2.0 + Prilocaine 2.5%", "opb": "Lidocaine 2.5%+Prilocaine 2.5%", "opc": "Lidocaine 2.5% + Prilocaine 5%", "opd": "Bupivacaifne 0.5% + Lidocaine 2.55", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "64967f5d-1d02-44f5-84cd-db884b4c49f0", "choice_type": "single"}
{"question": "The most impoant constituent in soda lime for reabsorption of CO2 in a closed circuit", "exp": "Sodalime is most common Co2 absorbant . Indicators added to sodalime changes the color of sodalime . It contains 94% Ca(OH)2 , 5%NaOH,1% KOH.", "cop": 3, "opa": "Sodium hydroxide", "opb": "Barium hydroxide", "opc": "Calcium hydroxide", "opd": "Potassium hydroxide", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "88e2cf55-87a1-4d8f-ad51-97f3be6759e3", "choice_type": "single"}
{"question": "Commonest complication of subclan venous puncture is", "exp": "Pleura being in close proximity subclan cannulation has high incidence of pneumothorax other common problem is malposition of catheter due to its touous course.", "cop": 2, "opa": "Infection", "opb": "Pneumothorax", "opc": "Carotid aery puncture", "opd": "Atrial perforation", "subject_name": "Anaesthesia", "topic_name": "Monitoring in Anesthesia", "id": "492867fe-ec5c-46ee-84ac-ba1c389e5060", "choice_type": "single"}
{"question": "Cis atracurium is prefferd over atracurium due to advantage of aEUR'", "exp": "No histamine release Cisatracurium is a stereoisomer of Atracurium Unlike atracurium cisatracurium does not produce a consistent dose dependent increase in plasma histamine -Atracurium triggers dose dependent histamine release that becomes significant at dose above 5mg/kg. - The release is dose dependent such that with increasing dose administered at the same rate there is greater propensity for eliciting histamine release. The histamine release resulted in:- - Flushing - Hypotension - Reflex tachycardia These effects are transient and the extent of hypotensive effect and reflex tachycardia were rarely of clinical significance. - Cisatracurium does not cause increase in histamine secretion, does not affect hea rate or blood pressure nor does it produce autonomic effects. Cisatracurium does not cause bronchospasmQ Atracurium use has been associated with bronchospasm and it should be avoided in patients with Asthma. To date cisatracurium has not been repoed to elicit bronchospasm at doses that are clinically prescribed Cisatracurium produces less laudanosineQ Laudanosine results from Hoffman elimination of Atracurium and cisatracurium Laudanosine may cause C.N.S. toxicity Cisatracurium produces less laudanosine Cisatracurium is 4 times as potent as Atracurium and produces less Laudanosine and has longer duration of intubation dose", "cop": 3, "opa": ">Rapid onset", "opb": ">Sho duration of action", "opc": ">No histamine release", "opd": "Less cardiodepressant", "subject_name": "Anaesthesia", "topic_name": null, "id": "35c85a06-2289-4a6e-81fa-57d0605ffa19", "choice_type": "single"}
{"question": "Dexmedetomidine is", "exp": "Dexmedetomidine is alpha 2 agonist, more sensitive than clonidine. It is used to produce conscious sedation.", "cop": 2, "opa": "Selective alpha 2 blocker", "opb": "Agent of choice for conscious sedation", "opc": "Less sensitive to alpha 2 receptors than clonidine", "opd": "Good analgesic", "subject_name": "Anaesthesia", "topic_name": null, "id": "79e99245-a83c-4586-ad85-9503956afc34", "choice_type": "single"}
{"question": "Percentage of tetracaine used in eye surgery", "exp": "Cataract surgery can be performed using topical anaesthesia alone. Tetracaine 0.5% and Lidocaine 4% can be used. Advantages of this method are that it avoids the potential complications with retrobulbar and peribulbar injections. Disadvantages include the potential for eye movement during surgery, increased patient anxiety, and discomfo from the microscope light.(Refer: stoelting's pharmacology and physiology in anaesthetic practice ,5th edition ,pg no.282-283)", "cop": 1, "opa": "0.50%", "opb": "1%", "opc": "2%", "opd": "4%", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "5ef243be-ae7a-4771-b3f9-d0fdf12e3f22", "choice_type": "single"}
{"question": "In spinal anaesthesia the needle pierced upto", "exp": "Ans. d (Subarachnoid space). (Ref. Harrisons, Medicine, 18th/735)SPINAL ANESTHESIA# The term \"spinal anesthesia\" was coined in 1885 by Leonard Corning.Technique of spinal anesthesia:# In spinal anaesthesia the spinal needle is pierced upto subarachnoid space where the anaesthetic agent is injected to produce the anaesthesia.# The selected level should be below LI in an adult and L3 in a child to avoid needle trauma to the spinal cord. As an anatomic landmark, the L3-L4 interspace is located at the line intersecting the top of the iliac crests. Either a midline or paramedian approach can be used.# The anatomic layers passed through include skin, subcutaneous structures, supraspinous ligament, interspinous ligament, ligamentum flavum, dura mater, and arachnoid membrane.# Once the needle tip is believed to be in the subarachnoid space, the stylet is removed to see if CSF appears at the needle hub. With small diameter needles (26 to 29 gauge) this generally requires 5 to 10 seconds, but may require >1 minute in some patients. Gentle aspiration may speed the appearance of CSF. If CSF does not appear, the needle orifice may be obstructed by a nerve root and rotating the needle 90 degrees may result in CSF flow. Alternatively, the needle orifice may not be completely in the subarachnoid space and advancing an additional 1 to 2 mm may result in brisk CSF flow. This is particularly true of pencil-point needles, which have their orifice on the side of the needle shaft proximal to the needle tip.# Finally, failure to obtain CSF suggests that the needle orifice is not in the subarachnoid space and the needle should be reinserted.# Common complications include hypotension, bradycardia, increased sensitivity to sedative medications, nausea and vomiting (possibly secondary to hypotension), postdural puncture headache, nerve injury, total spinal, and hematoma/abscess formation at the site of puncture.# Total spinal anesthesia results from local anesthetic depression of the cervical spinal cord and brain stem. Signs and symptoms include dysphonia, dyspnea, upper extremity weakness, loss of consciousness, pupillary dilation, hypotension, bradycardia, and cardiopulmonary arrest. Eaily recognition is the key to management. Treatment includes securing the airway, mechanical ventilation, volume infusion, and pressor support.# Absolute contraindications include local infection at the puncture site, bacteremia, severe hypovolemia, coagulopathy, severe stenotic valvular disease, infection at the site of the procedure, and intracranial hypertension. Relative contraindications include progressive degenerative (demyelinating) neurologic disease (multiple sclerosis), low back pain, and sepsis.# Intrathecal opioids:- Opioids produce intense visceral analgesia and may prolong sensory blockade without affecting motor or sympathetic function.- Fentanyl and sufentanil have a rapid onset of action and an effective duration greater than 6 hours.- Morphine lasts 6-24 hours.- Side effects include respiratory depression (which may occur late with hydrophilic agents), nausea, vomiting, pruritus, and urinary retention.", "cop": 4, "opa": "Subdural space", "opb": "Extradural space", "opc": "Epidural space", "opd": "Subrachnoid space", "subject_name": "Anaesthesia", "topic_name": "Local and Regional Anesthesia", "id": "5c230271-f1c6-4a71-9ccf-2955c8d5456c", "choice_type": "single"}
{"question": "Total cerebral metabolic failure occurs at blood flow of", "exp": "A i.e. 10 ml/100 gm/min", "cop": 1, "opa": "10 m1/100 gm/min", "opb": "20 m1/100 gm/m1", "opc": "30 m1/100 gm/min", "opd": "40 m1/100 gm/ml", "subject_name": "Anaesthesia", "topic_name": null, "id": "a1ad0acf-01b2-4a86-8f0e-384d9355fb38", "choice_type": "single"}
{"question": "Anaesthetic agent that predisposes to maximum arrhhmias", "exp": "Halothane-catecholamine sensitization also promotes abnormal automaticity of dominant and latent atrial pacemakers. These effects may produce premature ventricular contractions and arrhythmias originating from the His bundle. Intact sinoatrial node function reduces the incidence of epinephrine induced ventricular escape during halothane anesthesia and is protective against His bundle arrhythmias. Halothane and, to a lesser extent, other volatile anesthetics sensitize the myocardium to the arrhythmogenic effects of epinephrine. Sensitization is the interaction between volatile anesthetics and catecholamines that leads to reductions in the threshold for both atrial and ventricular arrhythmias. Halothane and, to a lesser extent, isoflurane may be arrhythmogenic in Purkinje fibers in experimental myocardial infarction by facilitating reentrant activity or increasing temporal dispersion of the refractory period recovery. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "Isoflurance", "opb": "Enflurane", "opc": "Halothane", "opd": "Ether", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f9f0eabb-d2a5-4f24-b509-93ecc05371e4", "choice_type": "single"}
{"question": "Least analgesic", "exp": "C i.e. Halothane", "cop": 3, "opa": "N20", "opb": "Ether", "opc": "Halothane", "opd": "Cyclopropane", "subject_name": "Anaesthesia", "topic_name": null, "id": "ca7d52c7-5259-4683-ba35-62d39247dcf8", "choice_type": "single"}
{"question": "Thiopentone is contraindicated in", "exp": "Being an enzyme inducer (ALA synthetase)  thiopentone precipitates porphyria.", "cop": 3, "opa": "Narcoanalysis", "opb": "Neurosurgery", "opc": "Acute intermittent porphyria", "opd": "Induction of anaesthesia", "subject_name": "Anaesthesia", "topic_name": null, "id": "cb504581-4769-4188-90b0-8a4b2e20f95f", "choice_type": "single"}
{"question": "A 30 yr old man with paraplegia, the muscle relaxant should be avoided for tracheal intubation will be", "exp": "Succinylcholine can cause hyperkalemia in paraplegic patients due to proliferation of extrajunctional receptor. Conditions causing susceptibility to succinylcholine-induced hyperkalemia in an order. Myopathies (eg, Duchenne's dystrophy) Spinal cord injury Encephalitis Stroke Guillain-Barre syndrome Severe Parkinson's disease Burn injury Massive trauma Severe intraabdominal infection Tetanus Hence the use of succinyl choline is avoided in all the above conditions.", "cop": 1, "opa": "Suxamethonium", "opb": "Vecuronium", "opc": "Rocuronium", "opd": "Mivacurium", "subject_name": "Anaesthesia", "topic_name": "Neuromuscular Blocker", "id": "c59f9f2f-6101-419e-b6b4-9e466d96255e", "choice_type": "single"}
{"question": "site of action of vecuronium is", "exp": "Vecuronium is the non-depolarising neuromuscular blocker, acts on nicotinic receptors(Nm) at myoneural junction.", "cop": 4, "opa": "Cerebrum", "opb": "Reticular formation", "opc": "Motor neuron", "opd": "Myoneural junction", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "877c0db2-dba0-4d41-aec4-ea0984853b96", "choice_type": "single"}
{"question": "Depth of anaesthesia can be best assessed by", "exp": "Monitors used to assess depth of anesthesia: Electroencephalography (EEG) Bispectral index (BIS) Entropy Evoked responses (EP) - Motor EP, sensory EP (Auditory, visual, brain stem evoked potential) Patient safety index Narcotrend", "cop": 4, "opa": "Pulse oximeter", "opb": "End tidal Pco2", "opc": "ABG analysis", "opd": "Bispectral index", "subject_name": "Anaesthesia", "topic_name": "Monitoring in Anesthesia", "id": "25a3189a-14ec-4748-89e1-68cfcdf35325", "choice_type": "single"}
{"question": "Anti pruritic property is seen with", "exp": "Propofol has anti pruritic property.", "cop": 2, "opa": "Thiopentone", "opb": "Propofol", "opc": "Etomidate", "opd": "Ketamine", "subject_name": "Anaesthesia", "topic_name": null, "id": "108e5590-53b9-4d43-83b3-6d06e55ab312", "choice_type": "single"}
{"question": "Safe inducing agent in malignant hyperpyrexia is", "exp": "Propofol", "cop": 4, "opa": "Thiopentone", "opb": "Etomidate", "opc": "Halothane", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": null, "id": "8e07e0a0-cb16-46cc-aea9-c870878b84ca", "choice_type": "single"}
{"question": "Local Anesthetic first used", "exp": "Cocaine was the earliest used local anaesthesia(1st time used by Carl Koller in 1884 for occular surgery) cocaine is a naturaly occuring ester linked local anesthetic", "cop": 4, "opa": "Procaine", "opb": "Lignocaine", "opc": "Bupivacaine", "opd": "Cocaine", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "7b1edff7-f9d7-419a-8052-8445d99304f8", "choice_type": "single"}
{"question": "Aschners reflex is seen in", "exp": "Aschners reflex is also called occulocardiac reflex. Aschners reflex is called oculocardiac reflex. The Oculocardiac reflex, also known as Aschner phenomenon, Aschner reflex, or Aschner-Dagnini reflex, is a decrease in pulse rate associated with traction applied to extraocular muscles and/or compression of the eyeball. The reflex is mediated by nerve connections between the ophthalmic branch of the trigeminal cranial nerve the ciliary ganglion, and the vagus nerve of the parasympathetic nervous system. Nerve fibres from the maxillary and mandibular divisionsof the trigeminal nerve have also been documented. These afferents synapse with the visceral motor nucleus of the vagus nerve, located in the reticular formation of the brain stem. The efferent poion is carried by the vagus nerve from the cardiovascular centerof the medulla to the hea, of which increased stimulation leads to decreased output of the sinoatrial node. This reflex is especially seen children, paicularly during strabismus correction surgery.However, this reflex may also occur with adults. Bradycardia,junctional rhythm and asystole, all of which may be life-threatening, can be induced through this reflex. This reflex has been seen to occur during many pan facial trauma surgeries due to stimulation of any of the three branches of trigeminal nerve.", "cop": 4, "opa": "Cardiac surgery", "opb": "Neurosurgery", "opc": "Spinal anesthesia", "opd": "Squint surgery", "subject_name": "Anaesthesia", "topic_name": "Monitoring in Anesthesia", "id": "e8e28138-0885-45ad-9bab-b6af859623d0", "choice_type": "single"}
{"question": "Maximum duration of action is seen with", "exp": "Non-depolarising blockers : Long acting (>50mins) : d-Tubocurare, Pancuronium, Doxacurium, Pipecuronium. Intermediate acting (20-50mins) : Vecuronium, Atracurium ,Cisatracurium, Rocuronium . Sho acting (<20mins) : Mivacurium,Rapacuronium.", "cop": 3, "opa": "Atracurium", "opb": "Rocurium", "opc": "Pancuronium", "opd": "Rapacurium", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "bb0ab310-66e7-4641-8d8c-07a572432390", "choice_type": "single"}
{"question": "Colour of O2 cylinder", "exp": "D i.e. Black & White", "cop": 4, "opa": "Gray", "opb": "Orange", "opc": "Blue", "opd": "Black & White", "subject_name": "Anaesthesia", "topic_name": null, "id": "dd0513da-29b8-4054-8749-637bcf06e81a", "choice_type": "single"}
{"question": "High air flow oxygen enriched devices", "exp": "High air flow oxygen enriched devices are fixed performance devices and deliver constant concentration of oxygen. They require face masks with holes to enable high volumes of air to entrained.", "cop": 2, "opa": "Are variable performance devices", "opb": "Deliver constant concentrations of oxygen", "opc": "Require oxygen entrainment", "opd": "Require closed face masks.", "subject_name": "Anaesthesia", "topic_name": null, "id": "070645fa-2c6c-456c-9850-3712cff82c17", "choice_type": "single"}
{"question": "Afferent nerve fibre affected by local anesthesia first", "exp": "C i.e. Type C", "cop": 3, "opa": "Type A", "opb": "Type Il - B", "opc": "Type C", "opd": "Type II", "subject_name": "Anaesthesia", "topic_name": null, "id": "fa402eca-0d02-4396-b307-0d32ea825c70", "choice_type": "single"}
{"question": "Bone marrow depression is seen with chronic administration of", "exp": "(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.163-168)", "cop": 2, "opa": "Isoflurane", "opb": "N2O", "opc": "Ether", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "a223166e-c26f-480b-9450-980a9395053f", "choice_type": "single"}
{"question": "The most appropriate circuit for ventilating a spontaneously breathing infant during anaesthersia is", "exp": "(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.33)", "cop": 1, "opa": "Jackson rees modification of Ayre's t piece", "opb": "Mapleson a or magill'scircuint", "opc": "Mapleson c or Waters to and fro canister", "opd": "Bains circuit", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "8ae22f97-2d54-405a-a8a3-90574798f1a1", "choice_type": "single"}
{"question": "Anaesthesia breathing circuit recommended for spontaneous breathing is", "exp": "TypeA or Magills circuit is used in Spontaneous ventilation. Type D is used in controlled ventilation. TypeB and Type C are obselete nowadays", "cop": 1, "opa": "Mapleson A", "opb": "Mapleson B", "opc": "Mapleson C", "opd": "Mapleson D", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "c403aa56-c462-44e1-af85-3a42285d2252", "choice_type": "single"}
{"question": "Hoffman's elimination is feature of", "exp": "Ans. d (Atracurium) (Ref KDT 6th !345; Anaesthesia by Ajay yadav, 2nd ed., p. 90)The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofmann elimination) in addition to that by cholinesterases. Consequently its duration of action is not altered in patients with hepatic/renal insufficiency or hypodynamic circulation. It is the preferred muscle relaxant for such patients as well as for neonates and the elderly. Hypotension may occur due to histamine release.Cisatracurium, R-Cis, R-Cis enantiomer of atracurium is nearly 4 times more potent, slower in onset, but similar in duration of action. Like atracurium it undergoes Hofmann elimination, but in contrast it is not hydrolysed by plasma cholinesterase. Most importantly, it does not provoke histamine release.ATRACURIUM BESYLATE# Long acting and non-depolarising muscle relaxant.# Muscle relaxant of choice in renal failure or anephric patients.# pH of solution is 3.5.; Stored at 4degC.; Duration of action doubled at 25degC.# Metabolism mainly by Hofmann elimination (chemical degradation) and hydrolysis in plasma and elsewhere in body.# Major metabolite is laudanosine, which is CNS stimulant.# Cisatracurium is one of the ten isomers of atracurium and its active metabolites contain less laudanosine which causeless hypotension, central nervous system excitement, and seizures than that of atracurium.# It is considered an intermediate-acting agent in terms of duration of action.Notable features of Few muscle relaxantsPropertyMuscle relaxant (MR)Rapid onset of ActionShortest ActingLongest ActingSch (overall); Rocuronium (non-depolarising)Sch (overall); Mivacurium (non-depolarising)DoxacuriumExcreted in LiverRocuronium; VecuroniumNo placenta crossingd -TCHistamine released-TC (maximum) Atracuronium Mivacuronium SchLeast Histamine releaseVecuroniumMost CardiostableVecuroniumM.R. used to decrease BPd -TCM.R. Used to maintain BPPancuroniumM.R. Safe in asthmaVecronium; CisatracuroniumM.R. Causing epilepsyAtracurium; secondary LaunodocinM.R. Causing epilepsyCisatracurium; Atracurium", "cop": 4, "opa": "Pancuronium", "opb": "Thiopentone", "opc": "Vecuronium", "opd": "Atracurium", "subject_name": "Anaesthesia", "topic_name": "Muscle Relaxant", "id": "38b3a4c3-97cf-4503-a241-f0097fd5dbd5", "choice_type": "single"}
{"question": "Dose of Thiopentone used for induction is", "exp": "C i.e. 5 mg/kg", "cop": 3, "opa": "1 mg/kg", "opb": "2 mg/ kg", "opc": "5 mg/ kg", "opd": "10 mg/kg", "subject_name": "Anaesthesia", "topic_name": null, "id": "5629f0a7-e6ea-415f-9e9a-6cd2a0c236bf", "choice_type": "single"}
{"question": "The most common cranial nerve involved in spinal anesthesia", "exp": "cranial nerve VI is most commonly affected during spinal Anaesthesia. Dural puncture - a critical step in performing spinal anesthesia - was first introduced by Quinke in 1891, and sholy thereafter, Bier repoed the first case of post-dural puncture headache (PDPH). Bier proposed that ongoing leakage of cerebrospinal fluid (CSF) causes the headache, ie, leakage of CSF through the dural puncture site exceeds the rate of CSF production and results in low CSF pressure. Magnetic resonance imaging has confirmed that this leads to intracranial hypotension with descent of the brain, thereby causing traction of the sixth cranial nerve and pain-sensitive structures. The stretching of the nerve is thought to cause local ischemia as well as nerve dysfunction and can be seen in association with other signs of intracranial hypotension such as veigo, nausea, and vomiting.", "cop": 2, "opa": "1", "opb": "6", "opc": "9", "opd": "10", "subject_name": "Anaesthesia", "topic_name": "Central Neuraxial Blockade", "id": "1b45fcfd-7056-477e-a298-1c8da0d20d30", "choice_type": "single"}
{"question": "Foleys catheter 16 F means", "exp": "16 mm outer diameter", "cop": 2, "opa": "16 mm inner diameter", "opb": "16 mm outer diameter", "opc": "16 mm circumference", "opd": "16 mm for 16 years old", "subject_name": "Anaesthesia", "topic_name": null, "id": "d53beb4c-aa5d-4a52-b85f-7a5c6c1c2bbe", "choice_type": "single"}
{"question": "Maternal supine hypotension syndrome can be minimized by", "exp": "Removal of aortocaval compression with left-uterine displacement in patients undergoing general or regional anaesthesia, can minimize maternal supine hypotension.", "cop": 2, "opa": "Left-Hip elevation", "opb": "Left-Uterine displacement", "opc": "Regional anaesthesia", "opd": "General anaesthesia", "subject_name": "Anaesthesia", "topic_name": null, "id": "84bb066b-b824-4fef-a5af-f95c54b93d40", "choice_type": "single"}
{"question": "An 8 year old child is brought to the emergency room with testicular torsion. The parents tell you that he ate sandwich 6 hours ago. Surgeon wants to operate immediately. Your response should be", "exp": "Testicular torsion requires immediate investigation and possible surgery to preserve viable testis.", "cop": 2, "opa": "Wait for 2 more hours, deem it urgent, do rapid-sequence intubation", "opb": "Take him to the OT, deem it emergent, do rapid-sequence intubation", "opc": "He is adequately fasting, consider elective intubation", "opd": "Wait for 2 hours, consider elective intubation", "subject_name": "Anaesthesia", "topic_name": null, "id": "27556f28-cce3-45a1-b569-d9e8a4c0c76b", "choice_type": "single"}
{"question": "Shoest acting local anesthetic agent is", "exp": "Classification Amide type Long acting * Bupivacaine * Levo-Bupivacaine * Ropivacaine * Dibucaine Intermediate acting * Lidocaine (lignocaine) * Mepivacaine * Prilocaine * Aicaine Ester type Long acting * Tetracaine (amethocaine) Intermediate acting * Cocaine Sho acting * Procaine * Chloroprocaine * Benzocaine * Proparacaine i.e. Procaine Ref: willer 10th ed.", "cop": 1, "opa": "Procaine", "opb": "Lidocaine", "opc": "Tetracaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "1e2cea51-869e-40d5-a7d3-0c3e7af948d1", "choice_type": "single"}
{"question": "Arrange following structures as pierced by spinal needle during spinal block (from outside to inside) i) Interspinous ligaments ii) Ligamentum flavum iii) Supra spinous ligament iv) Epidural space", "exp": "Structures as pierced by spinal needle during spinal block (from outside to inside): iii)Supra spinous ligament i) Interspinous ligaments ii) Ligamentum flavum iv) Epidural space", "cop": 3, "opa": "(i), (ii), (iii), (iv)", "opb": "(ii), (iv), (i), (iii)", "opc": "(iii), (i), (ii), (iv)", "opd": "(ii), (iii), (i), (iv)", "subject_name": "Anaesthesia", "topic_name": "Regional Anesthesia", "id": "46a54b7e-55b6-45f1-a18a-4643f96b2c28", "choice_type": "single"}
{"question": "A five year old is scheduled for strabismus surgery. As the surgeon grasps medial rectus muscle anesthesiologist carefully monitors the pulse. This is for", "exp": "Aschners reflex is called oculocardiac reflex. TheOculocardiac reflex, also known asAschner phenomenon, Aschner reflex, or Aschner-Dagnini reflex, is a decrease in pulse rate associated with traction applied to extraocular muscles and/or compression of the eyeball. The reflex is mediated by nerve connections between the ophthalmic branch of the trigeminal cranial nerve the ciliary ganglion, and the vagus nerve of the parasympathetic nervous system. Nerve fibres from the maxillary and mandibular divisions of the trigeminal nerve have also been documented. These afferents synapse with the visceral motor nucleus of the vagus nerve, located in the reticular formation of the brain stem. The efferent poion is carried by the vagus nerve from the cardiovascular centerof the medulla to the hea, of which increased stimulation leads to decreased output of the sinoatrial node. This reflex is especially sensitive in neonates and children, paicularly during strabismus correction surgery.However, this reflex may also occur with adults. Bradycardia, junctional rhythm and asystole all of which may be life-threatening,can be induced through this reflex. This reflex has been seen to occur during many pan facial trauma surgeries due to stimulation of any of the three branches of trigeminal nerve.", "cop": 2, "opa": "Assessing the depth of anesthesia", "opb": "Detecting Aschners reflex", "opc": "Rule out ventricular dysrrhythmias", "opd": "Detecting hypotension", "subject_name": "Anaesthesia", "topic_name": "Monitoring in Anesthesia", "id": "90c2a5df-b166-41ef-a06a-b765b35389ae", "choice_type": "single"}
{"question": "Indication for nasotracheal intubation is", "exp": "It is the most common method used for giving anaesthesia in oral surgeries as it provides a good field for surgeons to operate.Other options are contraindications.", "cop": 1, "opa": "Oral surgeries", "opb": "Coagulopathy", "opc": "Basilar skull fractures", "opd": "Maxillary fractures", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "112e2061-52cc-40aa-9f4b-e0d66f9ad086", "choice_type": "single"}
{"question": "Site of action of epidural analgesia", "exp": "C i.e. Substantia gelatinosa Opoid receptors are maximum in Lamina 2 (substantia gelatinosa) Lamina 5 of spinal cord. So Epidural Narcotics acts mainly on substantia gelatinosa Common side effects of intraspinal/ epidural opioids are pruritis (itching), nausea - vomiting; urinary retention, sedation, ileus and dose dependent respiratory depression (most serious)Q", "cop": 3, "opa": "Sensory nerve endings", "opb": "Ventral horn", "opc": "Substantia gelatinosa", "opd": "Coex", "subject_name": "Anaesthesia", "topic_name": null, "id": "11d019a4-5f67-45b1-9aba-7fe494a0991e", "choice_type": "single"}
{"question": "The following combination of agents are the most preferred for short day care surgeries", "exp": "Ans. is 'a' i.e. Propofol, fentanyl, isoflurane For day care surgery patients are sent back home the same day. Therefore you need agents which are rapidly eliminated so that no after effects are left. The agents used are-PropofolAlfentanilRemifentanilN2OIsofluraneSevofluraneDesflurane", "cop": 1, "opa": "Propofol, fentanyl, isoflurane", "opb": "Thiopentone sodium, morphine, halothane", "opc": "Ketamine, pethidine, halothane", "opd": "Propofol, morphine, halothane", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous General Anesthesia", "id": "a1cf6329-0e6c-43ef-8e03-1e63b7d04dfd", "choice_type": "single"}
{"question": "Respiratory irritation is seen with", "exp": "Trichloroethlyene", "cop": 3, "opa": "Ether", "opb": "Halothane", "opc": "Trichloroethlyene", "opd": "Cyclopropane", "subject_name": "Anaesthesia", "topic_name": null, "id": "f458a077-8a1d-4cd1-ad2c-350d39d2c25d", "choice_type": "single"}
{"question": "Seen after tracheostomy", "exp": "Tracheostomy decreases all three :- V/P ratio, dead space, resistance to air flow.", "cop": 3, "opa": "Inversion of V/P ratio", "opb": "Increased V/P ratio", "opc": "Decreased in dead space", "opd": "Increased resistance of air flow", "subject_name": "Anaesthesia", "topic_name": null, "id": "9454c825-0c6d-4b01-93ef-982a74e433b2", "choice_type": "single"}
{"question": "Circuit of choice for controlled ventilation", "exp": "Bains co-axial system is used in controlled ventilation.Fresh gas flow required to prevent rebreathing is 1.6MV.", "cop": 3, "opa": "Magill circuit", "opb": "Type C", "opc": "Type D", "opd": "Type E", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "33f8abac-ca6f-4216-b76a-648faa231a2c", "choice_type": "single"}
{"question": "Emergency tracheostomy is not indicated in", "exp": "Emergency tracheostomy is not indicated in asthma.", "cop": 4, "opa": "Foreign body larynx", "opb": "Bilateral vocal cord paralysis", "opc": "Stridor due to laryngeal growth", "opd": "Acute severe asthma", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "49c16a5a-0cb3-48cb-877c-b1fbe84f0298", "choice_type": "single"}
{"question": "The penaz technique", "exp": "Penaz technique is a continuous non-invasive method of BP monitoring. Infra-red plethysmograph is mounted on the pneumatic cuff.", "cop": 2, "opa": "Is invasive", "opb": "Uses plethysmography", "opc": "Does not require a pneumatic cuff", "opd": "Is suitable in presence of peripheral vascular disease", "subject_name": "Anaesthesia", "topic_name": null, "id": "2502c9b0-89d1-4bd3-be38-eded5311e5ed", "choice_type": "single"}
{"question": "Gas stored in liquid form is", "exp": "N20 is stored in blue steel cylinders as a colorless liquid under 745 psi pressure and is in equilibrium with the gas phase (approximately 50 atmospheres at room temperature). The tank maintains that pressure until it is empty.", "cop": 2, "opa": "Carbon dioxide", "opb": "Nitrous oxide", "opc": "Cyclopropane", "opd": "Oxygen", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "f9699360-8d93-45e2-9bcf-5328f354190d", "choice_type": "single"}
{"question": "Person with RYR1 receptor mutation should avoid", "exp": "(A) Succinylcholine# Malignant Hyperthermia (MH) or Malignant Hyperpyrexia is a rare life-threatening condition that is usually triggered by exposure to certain drugs used for general anesthesia -- specifically the volatile anesthetic agents and succinylcholine, a neuromuscular blocking agent.> In susceptible individuals, these drugs can induce a drastic and uncontrolled increase in oxidative metabolism in skeletal muscle, which overwhelms the body's capacity to supply oxygen, remove carbon dioxide, and regulate body temperature, eventually leading to circulatory collapse and death if not immediately treated.> Susceptibility to MH is often inherited as an autosomal dominant disorder, for which there are at least 6 genetic loci of interest, most prominently the ryanodine receptor gene (RYR1).> MH susceptibility is phenotypically and genetically related to central core disease (CCD), an autosomal dominant disorder characterized both by MH signs and myopathy.> MH is usually revealed upon or shortly after exposure to certain general anesthetic agents.> There is no simple, straightforward test to diagnose the condition.> Treatment with Dantrolene and other drugs is usually initiated when MH is strongly suspected.> Dantrolene and the avoidance of triggering agents in susceptible people have markedly reduced the mortality from this condition.", "cop": 1, "opa": "Succinylcholine", "opb": "Nitrous oxide", "opc": "Lidocaine", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "8c875261-3ba6-43ab-9d74-c26a3a7cbb47", "choice_type": "single"}
{"question": "Pain Assessment Tool is best done by", "exp": "(B) TachycardiaPAT - Pain Assessment ToolParameters012Posture/tone ExtendedDigits widespreadShoulders raised off bedFlexed and/or tenseFists clenchedTrunk guardingLimbs drawn to midlineHead and shoulder resist posturingCryNo YesWhen disturbedDoesn't settle after handlingLoudWhimperingWhiningSleep patternRelaxed Agirated or withdrawnWakes with startleEasily wokenRestlessSquirmingNo clear sleep/wake patternEye aversion \"shut out\"Expression FrownShallow furrowsEyes lightly closedGrimaceDeep furrowsEyes tightly closedPupils dilatedColorPink, well perfused Pale/dusky/flushed, Palmar swearingRespirations TachypneaArt restApneaAt rest or with handlingHeart rate TachycardiaAt restFluctuatingSpontaneous or at restOxygen saturationNormal Desaturation with or without handlingBlood pressureNormal Hypo-/hypertension at restNurse's perceptionNo pain perceived by me I think the baby is in painNote: Infants are assessed and scores obtained every 2 to 4 hours. An infant with a score > 5 requires comfort measures; >10 requires analgesia dose adjustment# Pain causes stress. The endocrine system reacts by releasing an excessive amount of hormones, ultimately resulting in carbohydrate, protein, and fat catabolism (destruction); poor glucose use; and other harmful effects. This reaction combined with inflammatory processes can produce weight loss, tachycardia, increased respiratory rate, fever, shock, and death. Unrelieved pain prolongs the stress response, adversely affecting the patient's recovery.> Cardiovascular system responds to stress of pain by activating the sympathetic nervous system, which produces a variety of unwanted effects.> In the postoperative period, these include hypercoagulation and increased heart rate, blood pressure, cardiac work load, and oxygen demand.> Aggressive pain control is required to reduce these effects and prevent thromboembolic complications.> Cardiac morbidity is the primary cause of death after anesthesia and surgery", "cop": 2, "opa": "Ask patient", "opb": "Tachycardia", "opc": "Tachypnea", "opd": "Bradypnea", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "abe79175-df99-4942-98bc-9a5532ee3f70", "choice_type": "single"}
{"question": "Hepatitis can be a complication of ......", "exp": "Metabolic byproduct of halothane can cause autoimmune hepatitis. Halothane hepatitisis rare with an incidence of 1 per 35,000 cases but very fatal, with amoality of 50-75%. It is an immune mediated due to antibodies against highly reactive trifluoroacetyl chloride which is a metabolite of halothane. Risk factors for halothane hepatitis: Multiple exposures to halothane at sho intervals middle-aged obese women - because halothane undergo extensive metabolism in obese patients familial predisposition to halothane Another theory for halothane hepatitis is that it is caused by a hypersensitivity reaction associated with oxidative metabolism of halothane. The liver in halothane hepatitis shows centrilobular necrosis. In a patient with prior history of halothane hepatitis, inhalational induction agent of choice is Sevoflurane. Other points related to effect of halothane on hepatic system : Disrupts dual blood supply of liver ( Among all volatile anesthetic agent , it cause max decrease in hepatic flow) Contraindicated in Pre-existing liver days function C/I in hepatic surgery", "cop": 1, "opa": "Halothane", "opb": "Enflurane", "opc": "Methoxyflurane", "opd": "Enflurane", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "1f2fbb5b-80d2-4437-a44e-c794a8681a78", "choice_type": "single"}
{"question": "Intraocular Pressure is lowered by A/E (or increased by)", "exp": "A i.e. Ketamine", "cop": 1, "opa": "Ketamine", "opb": "Morphine", "opc": "Halothane", "opd": "Thiopentane", "subject_name": "Anaesthesia", "topic_name": null, "id": "d967e9ec-9d24-4638-bca4-a17d84cc4b21", "choice_type": "single"}
{"question": "The given device is used for", "exp": "The device shown is a peripheral nerve stimulator, which delivers train of four stimulus to peripheral nerve (ulnar nerve) to assess adequacy of muscle relaxation.", "cop": 2, "opa": "To monitor depth of anaesthesia", "opb": "To monitor adequacy of paralysis", "opc": "To monitor temperature", "opd": "To monitor expired carbon dioxide", "subject_name": "Anaesthesia", "topic_name": null, "id": "9fef8245-8333-4e66-8fe0-4478a2781bea", "choice_type": "single"}
{"question": "Vasoconstriction is seen with", "exp": "Ans. is 'b' i.e. cocaine All local anaesthetic cause vasodilation except for cocaine which causes vasoconstriction.", "cop": 2, "opa": "Lignocaine", "opb": "Cocaine", "opc": "Idiotocaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous (Local and Regional Anesthesia)", "id": "0f8cf124-90af-4008-ac1a-fc46ac08894a", "choice_type": "single"}
{"question": "The anaesthetic agent that causes maximum increase in intracranial pressure is", "exp": "By dilating cerebral vessels, halothane lowers cerebral vascular resistance and increases cerebral blood volume and CBF. Autoregulation, the maintenance of constant CBF during changes in aerial blood pressure, is blunted. Concomitant rises in intracranial pressure can be prevented by establishing hyperventilation before the administration of halothane. Cerebral activity is decreased, leading to electroencephalographic slowing and modest reductions in metabolic oxygen requirements. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 2, "opa": "Isoflurane", "opb": "Halothane", "opc": "Enflurane", "opd": "Desflurane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "6e5f7d29-7193-4fcb-b145-9ab9f453760e", "choice_type": "single"}
{"question": "Best anaesthesia for status asthamaticus", "exp": "B i.e. Ketamine", "cop": 2, "opa": "Thiopentone", "opb": "Ketamine", "opc": "Ether", "opd": "N20", "subject_name": "Anaesthesia", "topic_name": null, "id": "c2d56954-1df3-4740-b92b-b33da9fd9707", "choice_type": "single"}
{"question": "Arrange the following the anticoagulant drug's last dose to be stopped before surgery in ascending order{time} 1)Clopidogrel 2)Ticlopidine 3)low molecular wt heparin 4)Warfarin", "exp": "The following drugs has tobe continued on the day of surgery: Antihypeensive medications Cardiac medications (e.g.,b-blockers, digoxin) Antidepressants, anxiolytics, and other psychiatric medications Thyroid medications Anticonvulsantmedications Asthma medications. Steroids (oral and inhaled) Drugs that should be discontinued on the day of surgery Oral hypoglycemic agents NSAIDs - Discontinue 48 hours before the day of surgery Warfarin - Discontinue 4 days before surgery, except for patients having cataract surgery without a bulbar block. Sho acting Insulins except when given by a continuous pump Thienopyridines (e.g., clopidogrel, ticlopidine) except in cataract surgery, patients with metallic/drug eluting stents Aspirin in selected cases where reversal of platelet inhibition is necessary MAO Inhibitors - 2 weeks prior (MAO Inhibitors are usually continued.They should be discontinued if the patient and anesthesiologist factors are not orable to continue them)", "cop": 2, "opa": "2>1>3>4", "opb": "3>4>1>2", "opc": "4>3>2>1", "opd": "3>4>2>1", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia Q Bank", "id": "2ce1c9e1-5bb9-426a-b350-bbc28cf9e02e", "choice_type": "single"}
{"question": "The pulse oximetry reading is affected in", "exp": "Pulse oximetry values can be erroneous in dark skin. But in all other cases it is normal.", "cop": 4, "opa": "Anemia", "opb": "Jaundice", "opc": "Red nail polish", "opd": "Dark skin", "subject_name": "Anaesthesia", "topic_name": null, "id": "2770f161-919a-43df-bee9-e2132123e79c", "choice_type": "single"}
{"question": "Malignant hypehermia is caused by", "exp": "Ans. is 'a' i.e., Succinylcholine + halothane", "cop": 1, "opa": "Succinylcholine + halothane", "opb": "Propranolol", "opc": "Lidocaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "86d28be8-e596-467b-ad3b-f9fd9a4d4496", "choice_type": "single"}
{"question": "Fulminant hepatic failure can be caused by", "exp": "The first modern halogenated volatile anesthetic, halothane, was introduced in 1955. Clinical exposure to halothane is associated with two distinct types of hepatic injury. Subclinical hepatotoxicity occurs in 20% of adults who receive halothane. It is characterized by mild postoperative elevations in alanine aminotransferase and aspaate aminotransferase, but is reversible and innocuous. Anaerobic halothane reduction by CYP2A6 to a 2-chloro-1,1,1-trifluoroethyl radical is thought to mediate this mild hepatic injury. The fulminant form of hepatotoxicity, commonly known as halothane hepatitis, is characterized by elevated alanine aminotransferase, aspaate aminotransferase, bilirubin, and alkaline phosphatase levels, massive hepatic necrosis following the administration of halothane. Halothane hepatitis is rare (1 in 5000 to 35,000 administrations in adults), but is fatal in 50% to 75% of these cases. Because of the potential for fatal hepatitis, halothane is no longer used in adult patients in many countries. Halothane hepatitis is caused by a hypersensitivity reaction associated with the oxidative metabolism of halothane. The highly reactive trifluoroacetyl chloride metabolite of halothane oxidation can react with nearby liver proteins. In most patients who developed hepatic necrosis after halothane anesthesia, antibodies against TFA-modified proteins were detected, suggesting that the hepatic damage is linked to an immune response against the modified protein, which acts as a neoantigen. Accordingly, patients who develop halothane hepatitis often have a history of prior exposures to halothane or other volatile anesthetics, together with symptoms suggestive of immune reactivity, such as fever, rash, ahralgia, and eosinophilia. A current hypothesis is that TFA-protein adducts induce a cytotoxic T cell reaction in sensitized individuals, which leads to liver damage. However, the immune responses observed in halothane hepatitis might not mediate liver injury. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 1, "opa": "Halothane", "opb": "Isoflurane", "opc": "Nitrous oxide", "opd": "Phenobarbitone", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "8ca00678-1009-45dd-8419-a32a0735505c", "choice_type": "single"}
{"question": "Absolute contraindication for Thiopentone sodium is\\", "exp": "(B) Acute intermittent porphyria # ThiOPENTONE SODIUM - Contraindications: Thiopentone sodium is contraindicated in history of Barbiturate hypersensitivity.> Acute intermittent porphyria (cause LMN paralysis or CVS collapse); Anticipated airway obstruction.> Fixed cardiac output states> Shock, Hepatic/Renal dysfunction> Asthmatic/Myxoedema> Adrenocortical failure> Myotonia dystrophia> Extremes of age", "cop": 2, "opa": "Respiratory depression", "opb": "Acute intermittent porphyria", "opc": "Liver failure", "opd": "Pregnancy", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "ec888df2-00b3-4843-bc06-eca2b21861e7", "choice_type": "single"}
{"question": "Ketamine is safe in", "exp": "D i.e. Severe Shock", "cop": 4, "opa": "Raised ICT", "opb": "Open eye injury", "opc": "Ischemic hea disease", "opd": "Severe shock", "subject_name": "Anaesthesia", "topic_name": null, "id": "5246fb47-b7f8-42d5-9c97-58816b386352", "choice_type": "single"}
{"question": "Position for orotracheal intubation", "exp": "Flexing of cervical joint at neck approx. 25-30degrees and extension of atlanto -occipital joint (head) approx. 85-110degrees enables oropharyngeal, pharyngolaryngeal and laryngotracheal axis in one line that allows easy intubation -This position is called as SNIFFING POSITION.", "cop": 4, "opa": "Extension of neck and atlanto-occipital joint", "opb": "Extension of only neck", "opc": "Flexion of neck only", "opd": "Flexion of neck and extension of atlanto-occipital joint", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "9d2d70b3-9ef0-43f9-9d09-005ff279d8fd", "choice_type": "single"}
{"question": "Helium is used along with oxygen instead of plain oxygen because", "exp": "Helium is used because it decreases the turbulence.", "cop": 2, "opa": "It increases the absorption of oxygen", "opb": "It decreases turbulence", "opc": "It decreases the dead space", "opd": "For analgesia", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "d574d9f6-903f-458c-a310-5d611f7a98cf", "choice_type": "single"}
{"question": "Local anaesthetics act by", "exp": "Effecting the Na+ channel", "cop": 2, "opa": "Effecting the spinal level", "opb": "Effecting the Na+ channel", "opc": "Effecting the K+ channel", "opd": "Blocking axonal transpo", "subject_name": "Anaesthesia", "topic_name": null, "id": "bf8a8361-42f1-4670-935b-e4bc39c2c2d5", "choice_type": "single"}
{"question": "A severely ill patient was maintained on an infusional anaesthetic agent. On the 2nd day he staed detiorating. The probable culprit may be", "exp": "A i.e. Etomidate; B i.e. Propofol Increased infection and moality in a group of patients sedated with etomidate infusion in an ICU was associated with low coisol levelsQ and is attributed to etomidate induced supression of adrenal coisal synthesisQ. Etomidate is a dose dependent but reversible inhibitor of 11 - hydroxylase in the adrenal coex and is more potent than metyrapone. This enzyme is required for both mineralocoicoid and coicosteroid production. Minor adrenocoical supressive effects (i.e. impaired response to ACTH) follow induction doses or sho infusion doses. Propofol is not recommended for sedation of critically ill pediatric patients in ICU. The drug has been associated with higher moality d/t propofol infusion syndrome. Its essential features are metabolic acidosis, multiple organ failure, hemodynamic instability, hepatomegaly, and rhabdomyolysis. Very rarely, it may occur in adults, and in patients undergoing long term propofol infusion (> 48 hours) for sedation at high doses (>5 mg/ kg/ hr).", "cop": 1, "opa": "Etiomidate", "opb": "Propofol", "opc": "Opioid", "opd": "Barbiturate", "subject_name": "Anaesthesia", "topic_name": null, "id": "e962ef84-10de-4473-a0b5-8f0f013f6408", "choice_type": "single"}
{"question": "Plan C of anesthetic airway management is", "exp": "C i.e. Inseion of laryngeal mask airway& fibrotic bronchoscopy American Society of Anesthsiologist (ASA) developed practice guidelines & an algorithm that involves four plans: Plans A, B, C, and D, which go in sequence.", "cop": 3, "opa": "Standard laryngoscopy & intubation", "opb": "Intubation catheter guided intubation", "opc": "Inseion of laryngeal mask airway & fiberoptic bronchoscopy", "opd": "Cancel the surgery or perform tracheostony", "subject_name": "Anaesthesia", "topic_name": null, "id": "238970c8-609d-42bb-a37b-45b2b9c6be81", "choice_type": "single"}
{"question": "Not an intravenous anaesthetic", "exp": "Ans. is 'd' i.e., Cyclopropane", "cop": 4, "opa": "Etomidate", "opb": "Thiopentone", "opc": "Ketamine", "opd": "Cyclopropane", "subject_name": "Anaesthesia", "topic_name": null, "id": "33bda780-b06c-4af4-b00a-8960c9ac3535", "choice_type": "single"}
{"question": "Shoest acting muscle relaxant", "exp": "MivacuriumMivacurium is the shoest acting competitive blockersIt does not need reversal -can be used as an alternative to SCh for endotracheal intubationIt is metabolized rapidly by plasma cholinesterases -prolonged paralysis can occur in pseudocholinesterase deficiency Mivacurium is the only nondepolarising (competitive) blocker that is metabolized by plasma cholinesterase (pseudocholinesterase).(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.328)", "cop": 3, "opa": "Pancuronium", "opb": "Atracurium", "opc": "Mivacurium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "a4470496-0877-4c50-8993-0ab8233a80fd", "choice_type": "single"}
{"question": "Depth of anesthesia can be best assessed by", "exp": "Ans. d (Bispectral Index) (Ref. CSDT 12th/pg. Chapter 11 & Anaesthesia by Ajay Yadav, 2nd/pg. 45)MONITORING THE DEPTH OF ANESTHESIA# The Bispectral Index is a monitor that can be used in many cases to assess anesthetic depth.# It is measured from superficial scalp electrodes and is a processed electroencephalogram.# It is possible that this type of monitoring approach will be increasingly used to assess anesthetic depth.# A Bispectral index (BIS) monitor is a modern neurophysiological monitoring device which continually analyses a patient's electroencephalogram during general anesthesia to assess the level of consciousness during anesthesia.# The \"depth of anesthesia\" is commonly used as a surrogate for \"the likelihood of forming experiences or memory.\"# BIS is therefore best described as a monitor of the depth of the hypnotic component of anesthesia or sedation.# BIS demonstrates a dose-response relationship with inhalational and hypnotic intravenous agents, such as propofol and midazolam, which is independent of the agent(s) being used and correlates with clinical assessments of the level of consciousness.# Ketamine, however, causes EEG activation, complicating BIS interpretation.", "cop": 4, "opa": "Pulse oximeter", "opb": "End-tidal PCO2", "opc": "Acid blood gas analysis", "opd": "Bispectral index", "subject_name": "Anaesthesia", "topic_name": "Fundamental Concepts", "id": "e8cf3e05-02fd-4219-8f2a-71fed5681eed", "choice_type": "single"}
{"question": "Pin index for Air is", "exp": "PIN index number prevents wrong fitting of the cylinders . AIR - 1 ,5 02 - 2 ,5 N20 - 3 ,5 CO2 - 1 ,6 ; 2,6(Liquid) Cyclopropane 3 ,6 Entonox 7", "cop": 4, "opa": "1,4", "opb": "2,5", "opc": "5", "opd": "1,5", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "2478f7b6-12f0-4611-90fe-e6a94f7c6995", "choice_type": "single"}
{"question": "Best to monitor intraoperative myocardial ischemia (infarction) is", "exp": "C i.e. Transesophageal echocardiography Tranoesophageal echocardiography provides a real time picture of all 4 cardiac chambers and valves. It can identify any malfunctioning valves in addition to any wall motion abnormalities related to myocardia ischemia. It is very useful during anesthesia. Abnormal motion of ventricular wall detected in this way is a reliable index of myocardial ischemia and may guide drug therapy, can identify if therapy has successfully treated the ischemia or indicate the need for fuher surgical revascularization CVP (catheer in central vein) measures right sided filling pressure whereas pulmonary aery catheter measures/monitors left hea filling pressure. Aerial cannulation measures direct systemic aerial pressure and facilitate sampling of aerial blood for analysis.", "cop": 3, "opa": "ECG", "opb": "CVP monitoring", "opc": "Transesophageal echocardiography", "opd": "Invasive intracarotid aerial pressure", "subject_name": "Anaesthesia", "topic_name": null, "id": "2dad33e6-9207-4b2d-9b86-9aeff829c381", "choice_type": "single"}
{"question": "Administration of scoline (Sch) produces dangerous hyperkalemia in", "exp": "Sch can cause dangerous hyperkalemia in burn, massive trauma, Crush injury ,Severe intraabdominal infection(sepsis),spinal cord injury, hemiplegia / paraplegia, muscular dystrophy ,GB syndrome, Rhabdomyolysis, Myasthenia Gracia, tetanus, severe parkinsonism,polyneuropathy,closed head injury, stroke ,encephalitis. Ref: Morgan 4th/e p214.", "cop": 4, "opa": "Acute renal failure (ARF)", "opb": "Raised ICT", "opc": "Fracture femur", "opd": "Paraplegia", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "1ff2de69-e66e-481c-9df0-96595855c010", "choice_type": "single"}
{"question": "Fasciculations are caused by", "exp": "Ans. a (Scoline). (Ref. KD Tripathi, Pharamacology, 6th ed., 150)SUXAMETHONIUM CHLORIDE OR SUCCINYL CHOLINE (SCOLINE)Introduction- It is a short acting muscle relaxant.- It is a phase II blocker.- Depolarising muscle i.e. depolarising block at motor end-plate.- It is dichlor ester of succinic acid.- The action lasts for 3-5 minutes.- Action is prolonged in liver disease.- Metabolised by pseudocholinesterase.- It gives good intubating condition in shortest time (less than one minute).Uses- Endotracheal intubation in dose of 1 to 2 mg/kg body weight.- To modify electroconvulsive therapy.- For procedures requiring short duration relaxation.- Excellent for operative abet and caesaerian section.Side effects(Mnemonic=ABRHAM on FTV)- Apnoea (Prolonged),- Bradycardia,- Raised intraocular pressure- Hyperkalemia- Ache (Myalgia/ Post-operative muscle ache)- Malignant hyperpyrexia- Fasciculation,- Tachyphylaxis- Ventricular fibrillationIts S/E can be prevented by- Self-taming with 10 mg suxamethonium given a minute before induction of an anaesthesia.PrecurarizationAlso remember:# Malignant hyperpyrexia:- It is due to release of Ca++ from sarcoplasmic reticulum in sensitive person- It can be caused also bya) Halothane,b) Methoxyflurane andc) Isoflurane- Rx- dantrolene.- Dantrolene is muscle relaxant acting directly on muscle. {MH 2006)", "cop": 1, "opa": "Scoline", "opb": "Ketamine", "opc": "Halothane", "opd": "Atracurium", "subject_name": "Anaesthesia", "topic_name": "Muscle Relaxant", "id": "889d7522-a081-4024-ad90-38873c42d2c8", "choice_type": "single"}
{"question": "Amount of water that constitutes soda lime in carbon dioxide absorber is", "exp": "Water constitute 14-19% in soda lime.", "cop": 2, "opa": "20-24%", "opb": "14-19%", "opc": "10-14%", "opd": "25-30%", "subject_name": "Anaesthesia", "topic_name": null, "id": "f320607c-a968-4a3b-8072-ba4e7fe5d297", "choice_type": "single"}
{"question": "The second gas effect is", "exp": null, "cop": 4, "opa": "Displacement of N20 by Oxygen", "opb": "Displacement of oxygen by N20", "opc": "Removal of oxygen by N20 from alveoli during recovery from general anaesthesia", "opd": "Facilitation of inhalation of Halothane by N20", "subject_name": "Anaesthesia", "topic_name": null, "id": "7d286fbe-ffae-4413-bfdb-6f4d3e8cf994", "choice_type": "single"}
{"question": "A mid tracheostomy is done over", "exp": "a mid tracheostomy is done at 2nd and 3rd tracheal rings behind the isthumus,it is the operation of choice .", "cop": 2, "opa": "1st and 2nd tracheal ring", "opb": "2nd and 3rd tracheal ring", "opc": "3rd and 4th tracheal ring", "opd": "5th and 6th tracheal ring", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "21d0ddc8-2f04-40eb-9495-1ff0aa41f2cb", "choice_type": "single"}
{"question": "Drug of choice in cardiogenic shock is", "exp": "Dopamine or dobutamine are positive inotropic drugs with the prompt onset and sho duration of action; they are most useful in patients with failure complicated by severe hypotension.Katzung 13e pg: 220", "cop": 1, "opa": "Dopamine", "opb": "Phenylalanine", "opc": "Noradrenaline", "opd": "Adrenaline", "subject_name": "Anaesthesia", "topic_name": "Complications of anaesthesia", "id": "6358335c-4acc-4bf4-bac5-c543e20c8df8", "choice_type": "single"}
{"question": "Most common complication seen after Block 2 is", "exp": "Hypotension (Block 2 is Spinal block)", "cop": 2, "opa": "Bradycardia", "opb": "Hypotension", "opc": "Nausea", "opd": "Anxiety", "subject_name": "Anaesthesia", "topic_name": "Spinal, Epidural, & Caudal Blocks", "id": "390bd39a-efd7-4012-acd5-b13b08be652c", "choice_type": "single"}
{"question": "Surest indicator of reversal of anaesthesia is", "exp": "After reversal * good muscle tone - as assessed clinically .being able to cough, raise his or her head from the pillow for at least 5 s, protrude the tongue and have good grip strength", "cop": 1, "opa": "Head lift for 5 seconds", "opb": "Hand grip for 5 seconds", "opc": "TOF > 0.9", "opd": "Tongue depression", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "1ff4667d-ebcb-4414-a71c-3266b6bb14b9", "choice_type": "single"}
{"question": "The current mode of analgesia best for intrapaum pain relief is", "exp": "Bupivacaine as the most commonly used local anesthetic for epidural anesthesia during labor and for postoperative pain management. Given at level of L2-L5Basics of anesthesia 7e pg: 280", "cop": 1, "opa": "Epidural analgesia", "opb": "Spinal anaesthesia", "opc": "Inhalational", "opd": "Local analgesia", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia of special situations", "id": "2f342d4a-b1c5-45cf-8e26-a4a4d0863722", "choice_type": "single"}
{"question": "Cis atracurium is preferred over atracurium due to advantage of", "exp": "Cisatracurium is preferred over atracurium as it does not release histamine. Onset of action is same for both atracurium and cisatracurium. Cis-atracurium has longer duration of action.", "cop": 3, "opa": "Rapid onset", "opb": "Sho duration of action", "opc": "No histamine release", "opd": "Less cardiodepressant", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "2c33a7ae-e6a6-4402-b650-6fd3a0a81b0f", "choice_type": "single"}
{"question": "Pudendal nerve block involves", "exp": "S2, S3, S4", "cop": 4, "opa": "Ll, L2, L3", "opb": "L3, L4,L5", "opc": "Sl, S2, S3", "opd": "S2, S3, S4", "subject_name": "Anaesthesia", "topic_name": null, "id": "ffbbf62c-c095-4679-9f9d-f901119f3c6a", "choice_type": "single"}
{"question": "This law of plethysmography explains principle of working in", "exp": "The  law of plethysmography explains working of pulse oximeter.", "cop": 2, "opa": "Capnography", "opb": "Oximetry", "opc": "CVP monitor", "opd": "Entropy", "subject_name": "Anaesthesia", "topic_name": null, "id": "85653cea-0e58-4fef-9bc5-ceaed11485eb", "choice_type": "single"}
{"question": "Induction agent of choice in a child with cyanotic hea disease", "exp": "In cyanotic hea disease (right to left shunt), systemic vascular resistance should be increased by anaesthetics - ketamine is the anaesthetic of choiceIn acyanotic hea disease (left to right shunt), systemic vascular resistance should be decreased - volatile anaesthetics (isoflurane, sevoflurane or desflurane) should be used.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 2, "opa": "Thiopentone", "opb": "Ketamine", "opc": "Halothane", "opd": "Midazolam", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "93c16f78-b687-4636-b69b-f3607259803c", "choice_type": "single"}
{"question": "Foster Kennedy syndrome is", "exp": "Ans. is 'c ib., I/L Optic atrophy C/L papilloedema Foster-Kennedy syndrome : - The frontal lobe, pituitary and middle-ear tumor such as meningiomata of the oflactory groove are sometimes associated with Ipsilateral pressure atrophy of the optic nerve and contralateral papilledema. Pseudo-Foster-kennedy syndrome : - It is characterized by occurence of unilateral papilloedema associated with raised ICT (due to any cause) and a pre-existing optic atrophy (due to any cause) on the other side.", "cop": 2, "opa": "I/L Papilloedema CiL optic atrophy", "opb": "I/L Optic atrophy C/L papilloedema", "opc": "I/L Optic atrophy and papilloedema", "opd": "UL Papilloedema C/L papilitis", "subject_name": "Anaesthesia", "topic_name": null, "id": "e6996f40-8b77-4247-af0c-f082f74d7048", "choice_type": "single"}
{"question": "Ideal intubating position (modified chevalier Jackson position) is", "exp": "It is also called morning sniffing position or barking dog position. Explanation Prior to direct laryngoscopy and intubation, the patient is placed in the sniffing position which consists of cervical flexion with atlantooccipital extension. This is to ensure a line of sight from the mouth to the larynx so that intubation can be performed with ease. Cervical flexion of 35 degrees is provided by elevating the patient's head by 7-9 cm (folded sheet under the head). This aligns the pharyngeal and laryngeal axes. Atlantooccipital extension is provided by the head tilt. This brings into alignment the visual axis of the mouth with that of pharyngeal and laryngeal axes. Adequacy of head elevation can be estimated by checking the horizontal alignment between external auditory meatus and sternal notch.", "cop": 1, "opa": "Flexion of neck and extension of head", "opb": "Extension neck and extension of head", "opc": "Flexion of neck and neutral position of head", "opd": "Extension of head and neutral position of head", "subject_name": "Anaesthesia", "topic_name": "Airway", "id": "8f652ed9-000b-451f-9d4f-aa2a80fb5048", "choice_type": "single"}
{"question": "Best indicator of Endotracheal tube Extubation is", "exp": "(D) Negative inspiratory pressure # Mechanical function indicators of Extubation:1. FEV>10-15 ml/Kg2. Tidal volume >/= 4-6 ml/Kg3. FVC IN 1 SEC >10 ml/KG4. Negative inspiratory force >20 cm H205. Vital capacity >/=15 ml/KG6. Dead space ventilation or tidal volume ratio <0.67. Rapid shallow breating index", "cop": 4, "opa": "Tin box index", "opb": "Minute volume", "opc": "Respiratory rate", "opd": "Negative inspiratory pressure", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "9a6858bd-a321-4e88-b056-be5f8e97adbc", "choice_type": "single"}
{"question": "Phase II block is seen in", "exp": "Ans. is 'd' i.e. . Suxamethonium Suxamethonium causes Biphasic Block, with dose more than 500mg. Phase I block - Features of classical depolarization block Phase II block - Results from desensitization of receptor to acetylcholine and resembles competitive block and partially antagonized by anticholinesterase.Other frequently asked facts about SuccinylcholineIt is a non-competitive muscle relaxant and has overall shortest duration of action d/t rapid hydrolysis by Pseudocholinesterase.It causes malignant hyperthermia*.It increases muscle tone and causes muscle rigidity.It causes hyperkalemia* in * ParaplegiaTetanusBumIt increases intraocular pressure and intra-abdominal pressure.", "cop": 4, "opa": "Halothane", "opb": "Ether", "opc": "D-tubocurare", "opd": "Suxamethonium", "subject_name": "Anaesthesia", "topic_name": "Depolarising Neuromuscular Blocking Agents", "id": "b587e88d-a12c-477e-baa2-302a471e0e8e", "choice_type": "single"}
{"question": "Earliest and most pathognomic feature of malginant hyperthermia is", "exp": "Increased CO2 production is earliest sign of malignant hyperthermia.", "cop": 2, "opa": "Increased temperature", "opb": "Increased end-tidal CO2", "opc": "Increased heart rate", "opd": "Increased respiratory rate", "subject_name": "Anaesthesia", "topic_name": null, "id": "7778ff40-cf86-4a3d-8de2-acb2fa6a2b53", "choice_type": "single"}
{"question": "Lowest concentration of anesthetic agent in aveoli needed to produce immobility in response to painful stimulus in 50% of individual is termed as", "exp": "A i.e. Minimum alveolar concentration", "cop": 1, "opa": "Minimum alveolar concentration", "opb": "Minimal analgesic concentration", "opc": "Minimal analgesic concentration", "opd": "Maximum alveolar concentration", "subject_name": "Anaesthesia", "topic_name": null, "id": "78b0a79c-b2d9-4c5f-a7f6-93529238f70f", "choice_type": "single"}
{"question": "Size of the laryngeal mask airway  for normal adults", "exp": "Voyagis have proposed an alternative method of size selection for the laryngeal mask airway (LMA) based on a common misconception that the No. 3 is for females and the No. 4 for males.\nIn fact, their new proposal strongly reflects current European practice, which is to use a No. 4 for normal adults and a No. 5 for large adults and to use the No. 3 rarely. We consider, however, that\nfurther conclusive trials are required before the manufacturer's weight-based recommendations are altered.\nJudging the correct size of LMA can be difficult since the relationship between gender, weight, height, and upper airway geometry appears inconsistent.\nNo factors have yet been identified that give an easy measurement of potential pharyngeal volume directly correlating with appropriate LMA size, and certainly, there is no known anatomical difference between the male and the female adult or child pharynx at a given weight.\nSome practitioners consider that the smaller sizes are satisfactory for spontaneous ventilation since a less effective seal is required. However, too small a mask may still result in local soft tissue damage due to poor fit around the laryngeal inlet or misplacement into the upper oesophagus or the glottic inlet.\nThe problems associated with insertion of too large a mask (airway obstruction, airway reflex activation) are probably fewer than those associated with insertion of too small a mask.", "cop": 4, "opa": "2.5", "opb": "3", "opc": "1.5", "opd": "4", "subject_name": "Anaesthesia", "topic_name": null, "id": "c8357f98-f736-45de-81aa-cd32af74e9cb", "choice_type": "single"}
{"question": "The current mode of analgesia best for intrapaum pain relief", "exp": "Continous lumbar epidural analgesia is the procedure of choice for pain relief during normal labour and vaginal delivery (Intrapaum pain)(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.953-960 )", "cop": 1, "opa": "Epidural analgesia", "opb": "Spinal anaesthesia", "opc": "Inhalational", "opd": "Local analgesia", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "e53455ae-0c5e-46bb-a176-a6f2ba9ed32b", "choice_type": "single"}
{"question": "Murphy&;s eye is seen in", "exp": "* The \"Murphy eye\" is the eponymous name for a hole on the side of most endotracheal tubes (ETTs) that functions as a vent, and prevents the complete obstruction of the patient&;s airway, should the primary distal opening of an ETT become occluded. REF : WILLEY 10TH ED", "cop": 2, "opa": "Macintosh laryngoscope", "opb": "Endotracheal tube", "opc": "LMA", "opd": "Flexible laryngoscope", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "9a704cf0-7f28-4093-a663-3e9f73c4205c", "choice_type": "single"}
{"question": "Position with least vital capacity in G.A.", "exp": "A i.e. Trendelenburg In trendelenburg position, head end is lowered so due to gravity and weight of intra-abdominal viscera, diaphragm is at its highest level causing compression of lungs; so vital capacity is lowered.", "cop": 1, "opa": "Trendelenburg", "opb": "Lithotomy", "opc": "Prone", "opd": "Lateral", "subject_name": "Anaesthesia", "topic_name": null, "id": "0bdad56c-46db-4de9-bb2a-d2d5a0ce5106", "choice_type": "single"}
{"question": "Maximum safe dose of lignocaine for spinal anesthesia is", "exp": "25-100 mg", "cop": 2, "opa": "5-15 mg", "opb": "25-100 mg", "opc": "100-200 mg", "opd": "150-300 mg", "subject_name": "Anaesthesia", "topic_name": null, "id": "31691dfa-ff2b-4c2c-8352-1e6a3645505f", "choice_type": "single"}
{"question": "Estimation of FiO2 calculation during the use of nasal cannula in a child is", "exp": "Answer: c) 21% + (Nasal Cannula flow (L/min) X 3)Oxygen delivery systems for infants and childrenSystemPercent oxygen deliveredIndicationsCommentsBlow byLess than 30 percentUse for spontaneously breathing children who require low doses of oxygen and do not tolerate a maskMonitor pulse oximetryNasal cannula25 to 40 percentUse to deliver low dose oxygen to spontaneously breathing patientsPercent oxygen delivered affected by respiratory rate, tidal volume, and extent of mouth breathing. Flow rate 2L/min or less for infants Fio2=21% + (Nasal Cannula flow (L/min) X 3)Simple mask35 to 50 percentUse to deliver low dose oxygen to spontaneously breathing patientsPercent oxygen delivered affected by mask fit and respiratory ratePartial rebreather Mask50 to 60 percentUse to conserve oxygen Non rebreather maskUp to 95 percentUse to deliver high dose oxygen to spontaneously breathing patientsTight mask fit required to deliver higher concentrations of oxygenHood80 to 90 percentInfants less than one year of ageNoisy for patientTentLess than 50 percentUse for children who require 30 percent oxygen or lessMist may obscure view of patient. Noisy for patient.Self-inflating ventilation bag95 to 100 percent, with reservoirUse to provide assisted ventilation and oxygenDo not use to provide blow by. Must use with a reservoir to provide higher oxygen concentrations.Flow-inflating ventilation bag100 percentUse to provide assisted ventilation and oxygenMay use to provide blow by. Requires experience to use reliably.", "cop": 3, "opa": "21% + (Nasal Cannula flow (L/min) X 1)", "opb": "21% + (Nasal Cannula flow (L/min) X 2)", "opc": "21% + (Nasal Cannula flow (L/min) X 3)", "opd": "21% + (Nasal Cannula flow (L/min) X 4)", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "4311820a-fc33-4db0-9d6d-270556683faf", "choice_type": "single"}
{"question": "Most potent analgesic agent among following", "exp": "Ans. a. Nitrous oxide above options, most potent analgesic agent is Nitrous oxide. \"Nitrous oxide- 50:50 nitrous oxide and oxygen has revolutionized it as analgesic agent; it has been used as an analgesic agent in obstetric surgeries; dental procedures; in acute trauma; burn dressings and cardiac pain as well.\"- Wiley and Churchill-Davidson A Practice of Anesthesia 7/e p536 Miller says \"Nitrous oxide produce analgesia that is in pa because of release of proenkephalin derived family of endogenous opioids Physical propeies of N20 It is colourless, non-irritating and sweet smelling Boiling point is -89degC. Critical temperature is 36.5degCdeg which is a.bove room temperature, therefore it can be kept in liquefied state. Stored as liquid in blue color cylindersQ 35 times more soluble than nitrogen Remember: Anesthesia with No analgesia HalothaneQ Only analgesia N20Q Profound analgesia KetamineQ Best/maximum analgesia TrileneQ", "cop": 1, "opa": "Nitrous oxide", "opb": "Nitric oxide", "opc": "CO2", "opd": "Oxygen", "subject_name": "Anaesthesia", "topic_name": null, "id": "3b332f26-5d8e-4b75-8eb5-aeddeed72dd1", "choice_type": "single"}
{"question": "A 5 year old Child is suffering from patent ductus aeriosus (PDA) with congestive cardiac failure.Ligatio of ductus aeriosus was decided for surgical management.The most apropriate inhalation anaesthetic agent of the choice with minimal haemodynamic alteration for induction of anaethesia is", "exp": "Sevoflurane is the inducing agent of choice in children . Cardiovascular stability in decreasing order : Isoflurane(nost stable)>desflurane>Sevoflurane>Halothane>Enflurane. Halothane suppresses baroreceptor reflex and causes tachycardia (Arrythmogenic -by sensitising the hea to catecholamines) Enflurane is most cardiovascular unstable agent Isoflurane is the most cardiostable inhalational agent as cardiac output is best maintained by reflex tachycardia as protective baroreceptor reflex is minimally inhibited. Among Isoflurane and sevoflurane, sevoflurane is the agent of choice in children. Ref.:Morgan 4th/e p 929", "cop": 1, "opa": "Sevoflurane", "opb": "Isoflurane", "opc": "Enflurane", "opd": "Halothen", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia of special situations", "id": "c1660987-c0ff-44c1-8284-b9fc985c3e36", "choice_type": "single"}
{"question": "Dose of thiopentone used is", "exp": "2.50%", "cop": 2, "opa": "2%", "opb": "2.50%", "opc": "3%", "opd": "5%", "subject_name": "Anaesthesia", "topic_name": null, "id": "539a5209-2684-43b9-9280-2b70071495a0", "choice_type": "single"}
{"question": "As per ISO, color of N20 cylinder is", "exp": "To differentiate color coding is given to the cylinders . Blue - N20 Black - N2 Orange - Cyclopropane Grey - Co2 Black body with white shoulder - O2 Black body with brown shoulder - Heliox ( Helium + 02 )", "cop": 1, "opa": "Blue", "opb": "Black", "opc": "White", "opd": "Red", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "dec5bf39-22c4-45de-9a03-ace17ac8fdc2", "choice_type": "single"}
{"question": "Wooden chest rigidity is seen with", "exp": "Fentanyl induced chest wall rigidity seen with high bolus dose of fentanyl. CWR related to opiate administration was first described by Hamilton and Cullen in 1953 . Following opiate administration, clinicians may observe significant difficulty with mask ventilation, respiratory arrest, and a rigid chest wall; this phenomenon has been noted with various opioid substances. The majority of repoed cases and physiologic studies focus on CWR occurring with high opioid doses --administeredas pa of anesthetic induction", "cop": 2, "opa": "Morphine", "opb": "Fentanyl", "opc": "Remifentanyl", "opd": "Pentazocine", "subject_name": "Anaesthesia", "topic_name": "Intravenous Anesthetic Agents", "id": "eee014b3-6728-41f8-b313-e593df46b490", "choice_type": "single"}
{"question": "Laundosine is a toxic metabolite of", "exp": "Atracurium The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofman elimination) in addition to that by alkaline ester hydrolysisConsequently, its duration of action is not altered in patients with hepatic/renal insufficiency or hyperdynamic circulation - Preferred muscle relaxant for such patients as well as for neonates and the elderlyAtracurium is metabolized to laudanosine that is responsible for seizuresIt can cause histamine release - Hypotension & bronchoconstriction(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.216)", "cop": 1, "opa": "Atracurium", "opb": "Pancuronium", "opc": "Mivacurium", "opd": "Vecuronium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "5e49223c-56ac-419d-9eb2-da0d6cc1e280", "choice_type": "single"}
{"question": "Inducing agent of choice in asthma", "exp": "Ans. is 'b' i.e., Ketamine Inducing agent of choice in Asthma & COPD --> Ketamine. Inhalational agent of choice in Asthma & COPD ---> Halothane. Propofol and etomidate are alternates to ketamine for indcution in asthmatic patients. Drugs considered safe for asthmatics Induction Propofol, etomidate, ketamine Opioids Pethidine, Fentanyl, alfentanil Muscle relaxants Vecuronium, rocuronium, Pancuronium Volatile agents Halothane, Isoflurane, Sevoflurane, Desflurane, N20 Other Benzodiazepines (Amongst hypnotics, BZD are safe)", "cop": 2, "opa": "Etomidate", "opb": "Ketamine", "opc": "Propofol", "opd": "Induction", "subject_name": "Anaesthesia", "topic_name": null, "id": "fd2c94cb-e69f-4754-9ae6-f40ada02f426", "choice_type": "single"}
{"question": "In a patient with multiple injuries, first thing is to be done is", "exp": null, "cop": 1, "opa": "Patency of airway", "opb": "Maintenance of B.P.", "opc": "Immobilize cervical spine", "opd": "Lateral position with mouth gas", "subject_name": "Anaesthesia", "topic_name": null, "id": "0ed94f1f-462e-46e1-aac4-7f5bc2b1b563", "choice_type": "single"}
{"question": "A patient of alcohlic liver faliure requires general anesthesia AOC is", "exp": "C i.e. Isoflurane - IsofluraneQ is volatile anesthetic agent of choiceQ in patients with liver disease because it has the least effect on hepatic blood flow. - CisatracuriumQ is neuromuscular blocking agent of choiceQ owing to its unique non hepatic metabolism.", "cop": 3, "opa": "Ether", "opb": "Halothane", "opc": "Isoflurane", "opd": "Methoxyflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "b83a2d85-f499-4a91-90d2-df77443654fa", "choice_type": "single"}
{"question": "Following A, a patient suffered splenic ruture. His BP is 90/60 mmHg, PR 126/min and Sp02 92%. Induction agent of choice is", "exp": "D i.e. Etomidate Ketamine and etomidate are most commonly used induction agents for (non head injury) trauma patientsQ. Ketamine is beneficial in patients with acute hypovolemic shock (d/t indirect sympathetic stimulatory effects). Whereas etomidate provides greater cardiovascular stability (ie no or minimal effects on myocardial contractility, cardiac output and cardiovascular system, mild reduction in peripheral vascular resistance and BP, and no histamine release).", "cop": 4, "opa": "Remifentanyl", "opb": "Halothane", "opc": "Midazolam", "opd": "Etomidate", "subject_name": "Anaesthesia", "topic_name": null, "id": "6a0341cd-0fbb-4039-bbbf-0977c51365e4", "choice_type": "single"}
{"question": "Pneumothorax is a complication of", "exp": "B i.e. Brachial Plexus block Brachial plexus block with interscalene approach provides most intense anesthesia in C5-C7 dermatomes and least intense in C8-T1 (ulnar nerve) area.", "cop": 2, "opa": "Axillary block", "opb": "Brachial plexus block", "opc": "Epidural block", "opd": "High Spinal block", "subject_name": "Anaesthesia", "topic_name": null, "id": "837376a3-065c-441c-95c0-cb56f918c9b1", "choice_type": "single"}
{"question": "Local Anaesthetic in wound/ulcer management", "exp": "For management of wound/ulcer, local anaesthetic with topical anaesthetic action is usedAmong the given options, only benzocaine has topical action.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 271)", "cop": 3, "opa": "Prilocaine", "opb": "Chlorprocaine", "opc": "Benzocaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "de77739b-8e2f-4293-a0f9-c1d127704b0e", "choice_type": "single"}
{"question": "A 40 year old female underwent surgery.Postoperatively she told the anesthetist that she was aware of preoperative events.Intraoperative awareness is evaluated by", "exp": "A bispectral index (BIS) monitor is commonly utilized to assess depth of sedation when administering sedative, hypnotic, or anesthetic agents during surgical and medical procedures. The depth of sedation is calculated by measuring cerebral electric activity an electroencephalogram (EEG). The BIS algorithm processes the frontal EEG and conves the signal to a waveform on the BIS monitor 100 to 90-awake and responding appropriately to verbal stimulation 80 to 70-responsive to loud commands or mild shaking 70 to 60-intense tactile stimulation is needed for a response 60 to 40-unresponsive to verbal stimulus; general anesthesia obtained with a low chance for explicit recall less than 40-deep hypnotic state; possible protective responses still intact. less than 20-burst suppression (EEG pattern characterized by cycles of high-voltage electrical movement alternating with cycles of no activity in the brain); respiratory drive is limited, but possible protective responses still intact. 0-totally suppressed EEG (flat line). Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "Pulse oximetry", "opb": "Colour doppler", "opc": "Bispectral imaging", "opd": "End tidal CO2", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "7a930bf5-f9e0-41a7-aa6c-6e04e1182476", "choice_type": "single"}
{"question": "Size of LMA used for 25kg child is", "exp": "Size of LMA used for a 25 kg child is 2.5 LMA size 6 is used in adults weighing over 100 kg", "cop": 3, "opa": "1", "opb": "1.5", "opc": "2.5", "opd": "4", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "35aee0fa-bf88-4045-bbee-49bfe499e302", "choice_type": "single"}
{"question": "Machine used noninvasively to monitor an external chest compression during cardiopulmonary resuscitation is", "exp": null, "cop": 4, "opa": "Zoll depth synchronizer", "opb": "Zoll strength sensor", "opc": "Zoll pAO2 monitor", "opd": "Zoll AED -plus automatic external defibrillator", "subject_name": "Anaesthesia", "topic_name": null, "id": "37b53d29-5baf-4fd4-944b-3677d5b57795", "choice_type": "single"}
{"question": "ASA classification is done for", "exp": null, "cop": 2, "opa": "Fasting", "opb": "Risk", "opc": "Pain", "opd": "Lung capacity", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "455b453b-4227-4294-8aa6-8537ed40f54f", "choice_type": "single"}
{"question": "Local anaesthesia causing metheaEUR' moglobinemia", "exp": "Prilocaine", "cop": 2, "opa": "Procaine", "opb": "Prilocaine", "opc": "Etiodicaine", "opd": "Ropivacaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "e697b4de-883b-4fe0-a518-9c7e4af4917c", "choice_type": "single"}
{"question": "Arrange following inhalational anesthetic agents according to increasing MAC values i) Isoflurane ii) Desflurane iii) Sevoflurane iv) Halothane", "exp": "MAC: Minimum alveolar concentration of inhalational agent required to produce no movement on surgical stimulus in 50% of test patients. Eg: N2O - 104 Halothane - 0.75 Isoflurane - 1.28 Sevoflurane- 2 Desflurane- 6 Less MAC- high potency High MAC- low potency Most potent inhalational agent- Methoxyflurane Least potent inhalational agent- N2O", "cop": 1, "opa": "(iv), (i), (iii), (ii)", "opb": "(iv), (iii), (i), (ii)", "opc": "(ii), (iv), (iii), (i)", "opd": "(i), (ii), (iii), (iv)", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "8dcc24e7-672c-4ad0-96ea-669f8f6f8184", "choice_type": "single"}
{"question": "Best site for going spinal anaesthesia is interveebral space between.", "exp": "The spinal canal contains the spinal cord with its covering (the meninges), fatty tissue and venous plexus. The meninges are composed of three layers: the pia mater, the arachnoid mater and the Dura meter. The spinal subdural space is poorly demarcated. The epidural space is a better defined potential space within the spinal canal that is bounded by the Dura meter and ligamentum flavum. There is cerebrospinal fluid between pia meter and Archnoid meter and this space is called sub arachnoid space. The spinal cord normally extends from the foramen magnum to the level of L1 in adults. so in adults we can give spinal anesthesia below this level in L2/L3, L3/L4. L2/L3 IS BETTER SPACE In children the spinal cord ends at L3 and moves up with age. The blood supply to the spinal cord and nerve roots is derived from a single anterior spinal aery and pair posterior aeries.", "cop": 1, "opa": "L2 - L3", "opb": "L3 - L4", "opc": "L1 - L2", "opd": "L5 - S1", "subject_name": "Anaesthesia", "topic_name": "Central Neuraxial Blockade", "id": "f0069ca2-03ef-44fa-b0d4-33712f4b2e5d", "choice_type": "single"}
{"question": "Arrange Mapelson circuit for spontaneous ventilation in an adult from best to worst", "exp": "During spontaneous ventilation, alveolar gas containing Co2 will be exhaled into the breathing tube or directly vented through an open APL valve. Before inhalation occurs, if the fresh gas flow exceeds alveolar minute ventilation, the in flow of fresh gas will force the alveolar gas remaining in the breathing tube to exit from the APL valve. Because a fresh gas flow equal to minute ventilation is sufficient to prevent rebreathing, the Mapelson a design is the most efficient for spontaneous ventilation", "cop": 3, "opa": "D>B>C>A", "opb": "A>C>B>D", "opc": "A>D>C>B", "opd": "B>C>D>A", "subject_name": "Anaesthesia", "topic_name": "Anesthesia Circuit", "id": "c7c4eb02-4070-44cf-a156-d0e2a209e2d1", "choice_type": "single"}
{"question": "Best local anaesthetic for ophthalmic surgery is", "exp": "The choice of local anaesthetic for ocular surgery variesBut lidocaine (2%) and bupivacaine (0.5-0.75%) are used most commonlyGenerally the use of 1:1 mixture of 2% lidocaine (Xylocaine) and 0.50% bupivacaine along with adrenaline and hyaluronidase in facial, retrobulbar and peribulbar blocks is common(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 4, "opa": "Tetracaine", "opb": "Prilocaine", "opc": "Procaine", "opd": "Bupivacaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "59cc9467-e05b-48d0-8b9b-e131c736963d", "choice_type": "single"}
{"question": "Best Scale to measure pain in children of 5 years age would be", "exp": "D i.e. CHEOPS", "cop": 4, "opa": "VAS", "opb": "Mc Gill Scale", "opc": "Faces Scale", "opd": "CHEOPS", "subject_name": "Anaesthesia", "topic_name": null, "id": "b4c904dc-b15c-4006-8a21-5e85f241d325", "choice_type": "single"}
{"question": "Dibucaine number is", "exp": "Dibucaine number gives percentage of abnormal pseudocholinesterase.", "cop": 2, "opa": "Gives percentage of lignocaine levels in blood", "opb": "Gives percentage of abnormal pseudocholinesterase  in blood.", "opc": "Gives percentage of metabolised lignocaine levels", "opd": "Gives percentage of succinylcholine in blood.", "subject_name": "Anaesthesia", "topic_name": null, "id": "86c77b48-c605-4b22-acad-1224ae9e9c89", "choice_type": "single"}
{"question": "The Blade of the laryngoscope used in intubation of newborn is", "exp": "The Macintosh blade is the most widely used of the curved laryngoscope blades, while the Miller blade is the most popular style of straight blade. The Miller blades are commonly used for infants.Uncuffed tubes are limited mostly to pediatric patients (in small children, the cricoid cailage, the narrowest poion of the pediatric airway, often provides an adequate seal for mechanical ventilation).", "cop": 3, "opa": "Curved blade with uncuffed tube", "opb": "Straight blade with Cuffed tube", "opc": "Straight blade with uncuffed tube", "opd": "Curved blade with cuffed tube", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "66e19c7b-f86c-4e29-a0c7-f38690ad90d8", "choice_type": "single"}
{"question": "Colour of Entonox cylinder is", "exp": "Entonox cylinder has blue body and white shoulder.", "cop": 4, "opa": "Black body, white shoulder", "opb": "Grey body, black and white shoulder", "opc": "Black body, brown and white shoulder", "opd": "Blue body, white shoulder", "subject_name": "Anaesthesia", "topic_name": null, "id": "5699e4fd-c484-4c21-8c9f-94f971140334", "choice_type": "single"}
{"question": "5 yr old child going to sitting craniotomy while positioning in O.T. developed End Tidal CO2 0mm Hg P02 80 mm Hg implies", "exp": "C i.e. Venous Air embolism A patient undergoing lapro/thoraco-scopyQ or procedure (eg craniotomy) in sitting, head upQ, park-bench, knee-chest positions that place the operative site above the right atrium carry an increased risk of VAE. Sudden decrease in end-tidal CO2 concentration (ETCO?), sudden hypotension/circulatory arrest and Mill wheel murmur indicate the diagnosisQ.", "cop": 3, "opa": "Endotracheal tube in oesophagus", "opb": "E.T. blocked with secretion", "opc": "Venous air Embolism", "opd": "Left lung collapse", "subject_name": "Anaesthesia", "topic_name": null, "id": "46b0898f-5ec6-4fee-807a-d11a5b2ee9d8", "choice_type": "single"}
{"question": "Induction agent that may cause adrenal cortex suppression is", "exp": "Synthesis of adrenal steroids (both mineral and glucocorticoids) is inhibited by etomidate.", "cop": 2, "opa": "Ketamine", "opb": "Etomidate", "opc": "Propofol", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": null, "id": "61d5dcb7-22f4-46e4-b2a4-044b7897d26e", "choice_type": "single"}
{"question": "The probe is used for", "exp": "This image shows TEE probe, which is used for intraoperative cardiovascular monitoring.", "cop": 2, "opa": "Enteroclysis", "opb": "Transesophageal echo", "opc": "Oesophageal temperature monitor", "opd": "ERCP probe", "subject_name": "Anaesthesia", "topic_name": null, "id": "4b29fe2c-4406-4401-a2ef-9113196522ca", "choice_type": "single"}
{"question": "Conc. of Lidocaine used in spinal anesthesia", "exp": "A i.e. 5%", "cop": 1, "opa": "5%", "opb": "3%", "opc": "2%", "opd": "1%", "subject_name": "Anaesthesia", "topic_name": null, "id": "61d9b7fb-1416-48d1-95f0-cef07d63b07d", "choice_type": "single"}
{"question": "The maximum safe dose of bupivacaine is", "exp": "Maximum safe dose of bupivacaine is 2 mg/kg with or without adrenaline", "cop": 2, "opa": "1 mg/kg", "opb": "2 mg/kg", "opc": "3 mg/kg", "opd": "5 mg/kg", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "df4d8a44-7376-4352-a04e-f2f0d88c092c", "choice_type": "single"}
{"question": "Systemic absorption of local anaesthetic is better with", "exp": "Intravenous > tracheal > intercostal is order of systemic absorption of local anaesthetic drug.", "cop": 3, "opa": "Subcutaneous route", "opb": "Epidural route", "opc": "Tracheal route", "opd": "Intercostal route", "subject_name": "Anaesthesia", "topic_name": null, "id": "c2126b8e-e587-40e1-92df-8a837114d053", "choice_type": "single"}
{"question": "Duration of action of paraprocaine is", "exp": "Procaine acts for around 20 minutes, althought it’s onset of action is within 10 seconds.", "cop": 1, "opa": "20 minutes", "opb": "10 minutes", "opc": "20 seconds", "opd": "10 seconds", "subject_name": "Anaesthesia", "topic_name": null, "id": "172570ca-6da4-46cc-a508-0e37ea5f28aa", "choice_type": "single"}
{"question": "Least effect on myocardial contractility", "exp": "Ans:D i.e. Isoflurane. CARDIAC EFFECTS OF ANESTHETIC AGENTS :Anticholinergic agents - Atropine/glycopyrrolate: will cause an increase in hea rate, contractility, cardiac output and myocardial oxygen consumption. Often there will be no changein blood pressure and a decrease in right atrial pressure.Thiopental - BarbiturateReduction in blood pressure - peripheral vasodilation is the main action. Compensatory rise in hea rate - barorecptor response. Commonly associated with ventricular arrhythmias .BenzodiazepinesMidazolam and diazepam: Cause little or no direct myocardial depressant effects.Hypnotics- Etomidate: no direct myocardial depression. Safe to use with cardiac, critical and septic patients. .Mu opioids- Fentanyl is a pure mu agonist causes dose dependant bradycardia (increase in vagal tone). Mixed agonist/antagonist agents= Buprenorphine: a paial mu agonist/antagonist. Slow onset of action, duration of 6-8 hours. Cardiovascular depression and respiratory depression not as profound as pure mu agonists. Butorphanol: paial agonist/antagonist. Similar to buprenorphine in cardiovascular/respiratory effects. Dissociative Agents:Ketamine- Hea rate and aerial pressure increase due to an increase in sympathetic tone .Inhalational Anesthetics: Isoflurane and sevoflurane preserved cardiac index, and isoflurane and fentanyl-midazolam preserved myocardial contractility at baseline levels in this group of patients with congenital hea disease. Halothane depressed cardiac index and myocardial contractility.", "cop": 4, "opa": "Ether", "opb": "Halothane", "opc": "Trilene", "opd": "Isoflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "9ccdedd7-51d5-4b3b-ab78-bf3cfa041894", "choice_type": "single"}
{"question": "Shoest acting non depolarizing muscle relaxant", "exp": "Non depolarising (competitive) 1)Long Acting - pancuronium,pipecuronium 2) Intermediate Acting-vecuronium,rocuronium,atracurium 3) Sho Acting - Mivacurium", "cop": 1, "opa": "Mivacurium", "opb": "Vercuromium", "opc": "Atracurium", "opd": "Succinyl choline", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "4512c4eb-6995-41ea-bb53-fd394ad204e8", "choice_type": "single"}
{"question": "Increased Cardiac Oxygen demand is caused by", "exp": "D i.e. Ketamine", "cop": 4, "opa": "Halothane", "opb": "Thiopentone", "opc": "N20", "opd": "Ketamine", "subject_name": "Anaesthesia", "topic_name": null, "id": "28193437-8522-479f-8fed-e8eb5fc1e08f", "choice_type": "single"}
{"question": "Minimum &;starvation time&; required in general anaesthesia", "exp": "Traditionally, patients are considered to be at risk if their gastric volume is greater than 25 mL (0.4 mL/kg) and their gastric pH is less than 2.5. Some investigators believe that controlling acidity is more impoant than volume and that the criteria should be revised to a pH less than 3.5 with a volume greater than 50 mL. Patients who have eaten immediately prior to emergency surgery are obviously at risk. Traditionally, \"NPO after midnight\" implied a preoperative fast of at least 6 h. The current opinion allows clear liquids until 2 h before the induction of anesthesia. According to the American Society of Anesthesiologists (ASA) guideline, breast milk is permitted up to 4 h before anesthesia. Infant formula, nonhuman milk, and a light meal are permitted up to 6 h before induction. Patients consuming a heavy meal including meat, fats, and fried foods should fast for 8 h. Ceain patient populations are paicularly likely to have large volumes of acidic gastric fluid: patients with an acute abdomen or peptic ulcer disease, children, the elderly, diabetic patients, pregnant women, and obese patients. Fuhermore, pain, anxiety, or opioids may delay gastric emptying. Note that pregnancy and obesity place patients in double jeopardy by increasing the chance of aspiration (increased intraabdominal pressure and distoion of the lower esophageal sphincter) and the risk of aspiration pneumonia (increased acidity and volume of gastric contents). Aspiration is more common in patients undergoing esophageal, upper abdominal, or emergency laparoscopic surgery. Ref: Morgan & Mikhail&;s clinical anesthesiology 6e", "cop": 2, "opa": "4 hours", "opb": "8 hours", "opc": "12 hours", "opd": "24 hours", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "6bdca4f6-538f-4948-8b7b-15529c94d486", "choice_type": "single"}
{"question": "Intraoperative wheezing can be managed by", "exp": "Among IV induction agents,ketamine has a bronchodilator action.", "cop": 2, "opa": "Thiopentane", "opb": "Ketamine", "opc": "Methohexitone", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "Complications of anaesthesia", "id": "b0030ae3-5aae-47e9-87cb-69274554d590", "choice_type": "single"}
{"question": "A 25 year old G2P, at 39 weeks gestation is electing to have spinal anaesthesia for a repeat cesarean section. 5 minutes after bupivacaine spinal injection, the patient becomes hypotensive and is complaining of tingling in her fingers with subjective difficulty breathing. Her oxygen saturation remains 100% and blood pressure in 90/60 mmHg The most likely etiology is.", "exp": "In pregnancy, CSF volume is decreased, thereby decreasing dose requirement of local anaesthetic. This facilitates spread of local anaesthetic when spinal anaesthesia is given.\nOption D would have been correct, if question mentioned Epidural anaesthesia.", "cop": 3, "opa": "Severe patient anxiety", "opb": "Increased peripheral nerve sensitization to local anaesthetics", "opc": "Decrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics", "opd": "Engorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic", "subject_name": "Anaesthesia", "topic_name": null, "id": "24876de2-e604-4932-9965-65f811d42f2d", "choice_type": "single"}
{"question": "Management of prolonged Scoline apnea is by", "exp": "Suxamethonium apnea and phase 2 block both are managed with mechanical ventilation till recovery. The mainstay treatment for succinylcholine apnea due to atypical pseudocholinesterase is to continue mechanical ventilation until muscle function returns to normal by clinical signs. Administration of neostigmine is controversial as the effects may be transient, possibly followed by intensified neuromuscular blockade. Fresh frozen plasma can augment the patient's endogenous plasma pseudocholinesterase activity but is not recommended because of the risk of iatrogenic viral infectious complications. If human plasma cholinesterase is available, it can be given to reverse neuromuscular blockade. Hence, the best option here would be to continue mechanical ventilation.", "cop": 3, "opa": "Exchange transfusion", "opb": "Estimation of plasma cholinesterase", "opc": "Continuation of aificial ventilation", "opd": "Reversal with neostigmine", "subject_name": "Anaesthesia", "topic_name": "Neuromuscular Blocker", "id": "d62c126f-7c09-4083-830d-38e465108f26", "choice_type": "single"}
{"question": "After suxamethonium 50mg, apnea persists for one hour", "exp": "Cholinesterase is a family of enzymes present in the central nervous system, particularly in  of this enzyme in any tissue most likely has no significance in terms of health.\nDiscriminates three phenotypes: Normal, intermediate, and atypical.", "cop": 2, "opa": "Treatment with cholnesterase is indicated", "opb": "Probab1y an atypical cholinesterase is present", "opc": "Treatment with stored blood is indicated", "opd": "Apnea may be due to low serum potassium concentration", "subject_name": "Anaesthesia", "topic_name": null, "id": "d83d38f8-d84c-442d-8bca-4c67bc9f3e29", "choice_type": "single"}
{"question": "In rapid sequence intubation", "exp": "Pre-oxygenation is mandatory in rapid sequence intubation. Succinylcholine, depolarizing muscle relaxant is the preferred agent. Short acting opioids can be administered prior to induction.", "cop": 2, "opa": "Non-depolarizing muscle relaxants are used", "opb": "Cricoid pressure of 30N is required", "opc": "Opioids are contraindicated", "opd": "Pre-oxygenation is not mandatory", "subject_name": "Anaesthesia", "topic_name": null, "id": "c13f4167-e6a9-4863-ab4d-592e3977a342", "choice_type": "single"}
{"question": "Intra ocular pressure rises in", "exp": "Laryngoscopy and intubation of trachea can dramatically increase intraocular pressure to a value as high as 40mm Hg.Administration of intravenous lignocaine prior to intubation has been found to prevent an increase in IOPIOP changes with LMA inseion are less than those following tracheal intubation.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no 325-331)", "cop": 1, "opa": "Intubation & laryngoscopy", "opb": "LMA", "opc": "Infusion of IV propofol", "opd": "Bag and mask ventilation", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "f51b7d52-7bcc-4a89-9730-5f0154303f81", "choice_type": "single"}
{"question": "Most potent antiemitic agent used in preoperative period", "exp": "D i.e. Metochlopromide Metochlopramide increases lower esophageal sphinter tone, speeds gastric emptying & lowers gastric fluid volume & decreases risk for aspiration pneumonia due to antiemetic effect", "cop": 4, "opa": "Glycopyrolate", "opb": "Hyoscine", "opc": "Atropine", "opd": "Metochlorpromide", "subject_name": "Anaesthesia", "topic_name": null, "id": "15109a1e-ed23-4af7-ac1f-6a11c52211c3", "choice_type": "single"}
{"question": "The disease with known association with malignant hyperthermia is", "exp": "KDS-King Denborough syndrome, Muscular dystrophy (DMD),myotonia are musculoskeletal disease associated with malignant hyperthermia.", "cop": 4, "opa": "Huntington chorea", "opb": "Fabry disease", "opc": "Burns", "opd": "Denborough syndrome", "subject_name": "Anaesthesia", "topic_name": null, "id": "79de7e9c-d898-4454-bcfd-4bcbb65e2d4e", "choice_type": "single"}
{"question": "Muscle most resistant to non depolarizing block is", "exp": "C i.e. Diaphragm", "cop": 3, "opa": "Intercostal", "opb": "Abdominal", "opc": "Diaphragm", "opd": "Adductors.", "subject_name": "Anaesthesia", "topic_name": null, "id": "26ee8800-e102-4eec-a793-bedce517e349", "choice_type": "single"}
{"question": "Xylocaine heavy in subarachnoid space has concentration of", "exp": "D i.e. 5%", "cop": 4, "opa": "1%", "opb": "2%", "opc": "3%", "opd": "5%", "subject_name": "Anaesthesia", "topic_name": null, "id": "0fb20e43-3a03-417c-8ece-49349e9b63d3", "choice_type": "single"}
{"question": "Malignant hypehermia is a rare complication following the administration of Not a complication of epidural anesthesia", "exp": "DIC", "cop": 3, "opa": "Headache", "opb": "Hypotension", "opc": "DIC", "opd": "Hematoma", "subject_name": "Anaesthesia", "topic_name": null, "id": "eba0c4fc-64fc-457d-aad7-33b73302875d", "choice_type": "single"}
{"question": "Dose of Ketamine is", "exp": "B i.e. 2mg/Kg IV", "cop": 2, "opa": "0.5 mg/Kg l/m", "opb": "2 mg/kg I/v", "opc": "5mg/kg I/v", "opd": "10mg / kg I/m", "subject_name": "Anaesthesia", "topic_name": null, "id": "b61173ab-4c9c-4b20-872f-65adbdcfa566", "choice_type": "single"}
{"question": "Tec 6 vaporizer is used with.........", "exp": "The most common such vaporizer is the Ohmeda Tec 6, designed specifically for use with desflurane. Desflurane has two physical propeies, making it unsuitable for use with a conventional vaporizer. First, it has a very high SVP (88.5 kPa at 20degC). A conventional vaporizer would require high fresh gas flows to dilute it to within clinically useful concentrations, making it uneconomical. Secondly, it has a low boiling point (23.5degC). At room temperature, it will intermittently boil resulting in large fluctuations in agent delivery. When boiling, there will be excessive agent delivery; however, it will then cool due to a large loss of latent heat of vaporization, resulting in an exponential decrease in SVP and under-delivery of agent. The Ohmeda Tec 6 overcomes these problems by using an electrical filament that heats the desflurane to 39degC, raising its SVP to 194 kPa, that is, nearly 2 atm. In addition to providing a stable SVP, this high pressure removes the need for a pressurized carrier gas--instead, the fresh or diluent gas is entirely separate from the vaporizing chamber", "cop": 2, "opa": "Halothane", "opb": "Desflurane", "opc": "Isoflurane", "opd": "Trielene", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "cb230989-d36c-4d72-9a23-f2f5f94cddee", "choice_type": "single"}
{"question": "A 65 year old male patient with history of coronary aery disease was diagnosed with hemorroides. The anaesthesia modality of choice for haemorrhoidectomy", "exp": "Saddle anaesthesia is spinal anaesthesia given in sitting position. After giving the drug patient is kept inthis position for 5-10 mins. Drugs only blocks sacral nerve roots and perineal anaesthesia is achieved.Since thoracic and lumbar spinal nerves are not blocked it has is no haemodynamic alteration. Caudal is the other name of sacral epidural anaesthesia commonly done in < 7 yrs old children since it is easy to approach is sacral epidural space because of unfused sacral hiatus. Caudal anesthesia requires identification of the sacral hiatus.", "cop": 3, "opa": "Spinal anaesthesia", "opb": "General anaesthesia", "opc": "Saddle anaesthesia", "opd": "Caudal anaesthesia", "subject_name": "Anaesthesia", "topic_name": "Central Neuraxial Blockade", "id": "45cacb4f-e6c0-4083-bd1c-0b477b3fed36", "choice_type": "single"}
{"question": "Inducing dose of Propofol in adults", "exp": "(B) 2 mg/kg > The dose of Propofol is 2-2.5 mg/kg for induction.> The lower dose should be used in the elderly.> The effective blood concentration for anaesthesia (ED 90 - the dose at which the effect is seen for 90% of patients) is 3.4 mg/mL when used with 67% nitrous oxide.> Sedation may be produced with a 0.2 mg/kg bolus dose intravenously or an infusion of 2 mg/kg/h, which produces a blood concentration of about 2 mg/mL.> Co-induction with either an opioid or midazolam enables the induction dose and initial target level for TCI to be reduced.> Myoclonic movements are common on induction, especially with slow injection. Emergence is more rapid than with thiopentc , with less 'hangover'.", "cop": 2, "opa": "1 mg/kg", "opb": "2 mg/kg", "opc": "3 mg/kg", "opd": "5 mg/kg", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "690bf569-27a7-4ae6-8db1-9172178d758f", "choice_type": "single"}
{"question": "Malampati grading is for", "exp": "Mallampati classification: a frequently performed test that examines the size of the tongue in relation to the oral cavity. The more the tongue obstructs the view of the pharyngeal structures, the more difficult intubation maybe Class I: The entire palatal arch, including the bilateral faucial pillars, is visible down to the bases of the pillars. Class II: The upper pa of the faucial pillars and most of the uvula are visible. Class III: Only the soft and hard palates are visible. Class IV: Only the hard palate is visible. Ref: Miller&;s anesthesia 8th edition Ref: Morgan & Mikhail&;s clinical anesthesiology 6e", "cop": 4, "opa": "Mobility of cervical spine", "opb": "Mobility of atlantoaxial joint", "opc": "Assesment of free rotation of neck before intubation", "opd": "Inspection of oral cavity before intubation", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "4cec9149-1712-4d29-bd0f-ad1b76a3b0b6", "choice_type": "single"}
{"question": "Rotameters", "exp": "Rotameters are constant pressure drop-variable orifice devices. They are accurate at values as low as 200mL/min both laminar and turbulent flow determine their accuracy .", "cop": 2, "opa": "Depend on laminar low for their accuracy", "opb": "Will only function when upright", "opc": "Are constant pressure drop-constant orifice devices", "opd": "Are not accurate below 1L/min", "subject_name": "Anaesthesia", "topic_name": null, "id": "eec09aec-46e6-477d-bed3-4872b61f97fd", "choice_type": "single"}
{"question": "The most appropriate inhalational agent for pediatric patients", "exp": "Sevoflurane fast acting with pleasant smell , most appropriate for pediatric patients. Sevoflurane is the most commonly used inhalational agent for induction. This is because of its lack of pungency and low blood: gas solubility of 0.65 which allows for a smooth induction of anesthesia.", "cop": 1, "opa": "Sevoflurane", "opb": "Desflurane", "opc": "Isoflurane", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "Inhalational Anesthetic Agents", "id": "9d88e723-bbd6-4093-b4f7-9d7f17c1de24", "choice_type": "single"}
{"question": "Cuff pressure in endotracheal intubation with prolonged ventilation should be less than", "exp": "Cuff pressure in the endotracheal intubation is in between 25 to 30 mmHg.", "cop": 2, "opa": "20 mmHg", "opb": "30 mmHg", "opc": "40 mmHg", "opd": "50 mmHg", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "3fd3d1e6-c150-43ad-be18-82665af82e65", "choice_type": "single"}
{"question": "Anaesthetic gas with maximum respiratory irritation", "exp": "* Desflurane, unlike halothane or sevoflurane has a pungent smell which makes it unpleasant for inhalational induction. * When more than 6% desflurane is used, the pungency produces salivation, airway irritation, breath holding and coughing. Ref:- Stoelting's Pharmacology and Physiology in Anesthetic Practice 5th edition; pg num:- 101", "cop": 1, "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Enflurane", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "78fb2bf8-3ce3-4f0f-bff7-9f455f8a7d89", "choice_type": "single"}
{"question": "The optimal granule size of soda lime is", "exp": "The size of the soda lime granules is 4-8 mesh (i.e. will pass through a mesh of 4-8 strands per inch in each axis or 2.36-4.75 mm). Soda lime consists of 4% NaOH, 1% KOH, 14-19% H2O, and the remainder Ca (OH)2. In addition, small amounts of silica or kieselguhr are added for hardening, and to reduce the formation of dust. Absorbents are supplied in pellets or granules. Small granules provide greater surface area but at the cost of increased resistance The most frequently used size of soda lime granule is 4-8 mesh (i.e., 0.25-inch to 0.125-inch diameter). In theory, 100 g of CO2absorbent (soda lime) can absorb 26 L of CO2.", "cop": 1, "opa": "4- 8 mesh", "opb": "8- 10 mesh", "opc": "10- 12 mesh", "opd": "12- 16 mesh", "subject_name": "Anaesthesia", "topic_name": "Anesthesia Circuit", "id": "f656952c-5275-495f-a026-1e2aa98e648c", "choice_type": "single"}
{"question": "Most commonly involved segment of Lungs in Foreign body aspiration (Supine position)", "exp": "3 (Lobe: Right lower lobe lung)", "cop": 3, "opa": "1", "opb": "2", "opc": "3", "opd": "4", "subject_name": "Anaesthesia", "topic_name": "Cardiopulmonary Resuscitation And Mechanical Ventilation", "id": "fa6ecb50-d667-4e48-acf4-443031e45a99", "choice_type": "single"}
{"question": "Methemoglobinemia is seen with", "exp": "Methemoglobinemia is seen with benzocaine, prilocaine and with EMLA.", "cop": 2, "opa": "Tetracaine", "opb": "Prilocaine", "opc": "Bupivacaine", "opd": "Procaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "459a3562-0631-4c95-8a22-8ef2d2c447fc", "choice_type": "single"}
{"question": "In increased ICT, agent used for anesthesia", "exp": "D i.e. Isoflurane", "cop": 4, "opa": "N20", "opb": "Trilene", "opc": "Ether", "opd": "Isoflurane", "subject_name": "Anaesthesia", "topic_name": null, "id": "fed5ff77-cd5a-4dae-8521-d40fb27022c9", "choice_type": "single"}
{"question": "Laryngeal mask Airway (LMA) is used for;", "exp": "A i.e. Maintenance of airway", "cop": 1, "opa": "Maintenance of the airway", "opb": "Facilitating laryngeal surgery", "opc": "Prevention of aspiration", "opd": "Removing oral secretions", "subject_name": "Anaesthesia", "topic_name": null, "id": "9f3c052b-ecc7-4ece-a4ab-3c4dc207e909", "choice_type": "single"}
{"question": "Muscle relaxant of choice in hepatic and renal failure", "exp": "A i.e. Cisatracurium", "cop": 1, "opa": "Cisatracurium", "opb": "Rocuronium", "opc": "Vecuronium", "opd": "Rapacuronium", "subject_name": "Anaesthesia", "topic_name": null, "id": "da16443e-c6ea-421d-b13c-dc046df52e18", "choice_type": "single"}
{"question": "Post dural puncture headache is", "exp": "Post dural puncture headache is occipital > frontal > retroorbital.", "cop": 3, "opa": "Retro-orbital", "opb": "Frontal", "opc": "Occipital", "opd": "Temporal", "subject_name": "Anaesthesia", "topic_name": null, "id": "442e54fa-95dd-4f59-a1d1-0a1af73e9b0f", "choice_type": "single"}
{"question": "Concentration of Local anesthetic agent used for Bier's block is", "exp": "0.5% (Bier's block: Intravenous regional anesthesia)", "cop": 1, "opa": "0.50%", "opb": "1-2%", "opc": "4%", "opd": "5%", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous (Local and Regional Anesthesia)", "id": "df073c04-a7d7-46e5-ab99-c7259d8b2fc8", "choice_type": "single"}
{"question": "Maximum uterine relaxation", "exp": "C i.e. Halothane", "cop": 3, "opa": "Ether", "opb": "N20", "opc": "Halothane", "opd": "Chloroform", "subject_name": "Anaesthesia", "topic_name": null, "id": "783ada23-5b81-4f82-9e6e-48ab2ca57134", "choice_type": "single"}
{"question": "A patient in ICU was on invasive monitoring with intra aerial canulation through right radial aery for last 3 days. Later he developed swelling and discolouration of right hand. The next line of management is", "exp": "A i.e. Stellate ganglion block The patient has developed vasospasm (reflex sympathetic dystrophy) as indicated by development of swelling & discolouration of hand Stellate (Cervicothoracic) Block in reality blocks upper thoracic and cervical ganglion. It is indicated in : - Reflex sympathetic dystrophyQ - Vasospastic disorder of upper extremityQ - Head, Neck, Arm & Upper chest pain", "cop": 1, "opa": "Stellate ganglion block", "opb": "Brachial Block", "opc": "Radial Nerve block", "opd": "Celiac plexus block", "subject_name": "Anaesthesia", "topic_name": null, "id": "58aefee3-847d-48da-8918-4ffbf02434c2", "choice_type": "single"}
{"question": "Post operative shivering is treated with", "exp": "Shivering is the response of the body because of Hypothermia(32-35oC) Can happen in Intra operative patient with Normothermia, because their Thermoregulation is disturbed because of Anesthesia (GA/Local) According to ASA guideline in the management of Shivering Non pharmacological - Active warming of the patient Pharmacological- Pethidine (meperidine), Best drug for managing shivering - Tramadol Other drugs used for shivering- Ondansetron- Ketamine- Clonidine & dexmedetomidine- Anticholinergic drugs", "cop": 4, "opa": "Diazepam", "opb": "Antihistaminics", "opc": "Anticholinergics", "opd": "Pethidine", "subject_name": "Anaesthesia", "topic_name": "JIPMER 2018", "id": "9fd563f0-3024-4213-8eea-e21d48d9626f", "choice_type": "single"}
{"question": "The most significant change in maternal lung volume that occurs in the third trimester of pregnancy includes.", "exp": "With enlargement of uterus, diaphragm is forced cephalad that decreases FRC.", "cop": 3, "opa": "Decrease in vital capacity", "opb": "Increase in residual volume", "opc": "Decrease in functional residual capacity", "opd": "Decrease in closing capacity", "subject_name": "Anaesthesia", "topic_name": null, "id": "41c64644-135d-40bf-ba58-d477404a69bf", "choice_type": "single"}
{"question": "Safety pin index for oxygen cylinder is", "exp": null, "cop": 3, "opa": "3,5", "opb": "1,5", "opc": "2,5", "opd": "1,4", "subject_name": "Anaesthesia", "topic_name": null, "id": "f24222ca-02ce-49c6-acfd-fba96e146677", "choice_type": "single"}
{"question": "Local anaesthetic of choice for IVRA", "exp": "Lignocaine is preferred for IVRA.", "cop": 2, "opa": "Bupivacaine", "opb": "Lignocaine", "opc": "Tetracaine", "opd": "Procaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "259b06ec-3713-4e4e-8542-7f6682a5e2c6", "choice_type": "single"}
{"question": "Armoured enforcement of ET tube is used in", "exp": "Their distinctive feature of armoured or reinforced tubes has is a metal wire coil embedded in the wall of the tube shaft. Reinforced tubes have ceain advantages over standard endotracheal tubes in several situations due to their resistance to occlusion when bent and their overall greater flexibility:Many practitioners prefer using armoured tubes in head & neck and neurosurgical cases, i.e. when access to the airway is limited and bulky equipment in front of the patient&;s mouth and face can get in the way of the surgeon.", "cop": 1, "opa": "Neurosurgery", "opb": "Cardiac surgery", "opc": "Liver surgery", "opd": "Intestinal Surgery", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "8918b994-2cbc-4534-855f-938abdc53bf5", "choice_type": "single"}
{"question": "A patient after undergoing thoracotomy complains of severe pain. He can be managed by", "exp": "Orotracheal intubation Patients with severe maxillofacial trauma and with low Sp02 even on oxygen suggests severe airway compromise or obstruction. In these cases emergency airway management is essential. The patient require immediate oxygen. - These patients needs to be intubated immediately. - But an impoant point to note is that severe maxillofacial trauma makes intubation very difficult. -Some believe that nasotracheal intubation is contraindicated in patients with severe maxillofacial injury because nasotracheal intubation in these patients can result in nasocranial intubation or severe nasal hemorrhage. - Nasotracheal intubation is absolutely contraindicated in patients with midfacial injury and C.S.F. rhinorrhoea. Orotracheal intubation in patients with severe maxillofacial injury In patients with severe maxillofacial injuries orotracheal intubation is also difficult. Presence of blood clots, .fractures make the passage of the tube quite difficult. Moreover when the surgeons perform operation for mandibular or maxillary fractures they wires both these together. If surgery is required with severe maxillofacial injury surgeons usually prefer nasotracheal intubation or tracheostomy. Tracheostomy in patient with severe maxillofacial injury : ? Tracheostomy does not have much role in \"emergency airways management\". - Tracheostomy is a time taking procedure compared to intubation. - If the airways of the patient is severely compromised and he requires immediate oxygenation, tracheostomy has no role. - Immediate oxygenation can only be delivered by rapid intubation. In case, intubation is impossible, cricothyroidotomy is an alternative. -In emergency management of the airway, cricothyroidotomy is done if intubation is not possible. Tracheostomy is only done when immediate oxygen requirements are taken care of and a surgical procedure is planned. In the question the Sp02 of the patient is 80% when on oxygen. He requires immediate emergency management of the airway which can be achieved through intubation, If intubation is impossible, cricothyroidotomy is an alternative. The better option of intubation in this patient is orotracheal intubation. The ideal management in this patient is cricothyroidotomy. Since that is not mentioned in the question intubation in the next best option. \"Orotracheal intubation would be preferred over nasotracheal intubation in these cases\"", "cop": 2, "opa": "Intercostal cryoanalgesia", "opb": "I.V fentanyl", "opc": "Oral morphine", "opd": "Oral brufen", "subject_name": "Anaesthesia", "topic_name": null, "id": "589afc2d-d307-4e86-b7ee-dcbadd0d3666", "choice_type": "single"}
{"question": "Inducing agent of choice in DIC", "exp": "The cardiovascular stimulatory effects make ketamine a desirable drug for the induction of anesthesia in unstable cardiovascular patients suffering from hypovolemia, hemorrhagic shock, or cardiovascular depression in sepsis. Ketamine bronchodilation and profound analgesia allowing the use of high oxygen concentrations make ketamine an excellent choice for induction of anesthesia in patients with reactive airway disease. Patients who have sustained trauma with extensive blood loss are typical candidates for rapid-sequence anesthesia induction with ketamine. Patients with septic shock also may benefit from ketamine. The intrinsic myocardial depressant effect of ketamine may manifest in this situation if trauma or sepsis has caused depletion of catecholamine stores before the patient's arrival in the operating room. The use of ketamine in these patients does not obte the need for appropriate preoperative preparation, including restoration of intravascular blood volume. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 2, "opa": "Thiopentone", "opb": "Ketamine", "opc": "Methohexitone", "opd": "Propofol", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "a570cb73-175d-4d3f-90b6-3e41be69444c", "choice_type": "single"}
{"question": "Eutectic mixture of local anaesthetic (EMLA) cream", "exp": "EMLA is eutectic mixture of local anesthetics (2.5% lidocaine and 2.5% prilocaine)", "cop": 2, "opa": "Bupivacaine 2.0% +Prilocaine 2.5%", "opb": "Lidocaine 2.5% + Priocaine 2.5%", "opc": "Lidocaine 2.5% + Prilocaine 5%", "opd": "Bupivacaine 0.5% + Lidocaine 2.5%", "subject_name": "Anaesthesia", "topic_name": "Regional anaesthesia", "id": "516e4cb5-71df-4342-80b1-339e9c79f0f1", "choice_type": "single"}
{"question": "Most impoant factor determining the affect of anaesthetic agent on fetus", "exp": "All the given options determined the effect of anaesthetic on fetus. But, duration of pregnancy is the most impoantAlmost all anaesthetic agents can be potentially teratogenicDay 15th to day 60 is the most critical period.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 846)", "cop": 1, "opa": "Duration of pregnancy", "opb": "MAC", "opc": "Protein binding", "opd": "Route of anaesthetic", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "9e07937d-55ae-446d-90b9-9105b4c8d190", "choice_type": "single"}
{"question": "Drug of choice or differential blockade is", "exp": "Ropivacaine is pure S- isomer of bupivacaine,so less cardiotoxic than bupivacaine. It is drug of choice for differential block.", "cop": 2, "opa": "Lignocaine", "opb": "Ropivacaine", "opc": "Bupivacaine", "opd": "Dibucaine", "subject_name": "Anaesthesia", "topic_name": null, "id": "6d04ecaa-ca67-4126-8ad9-51ecb97b68f8", "choice_type": "single"}
{"question": "The substance is soda lime that acts as catalyst is", "exp": "Potassium hydroxide acts as catalyst for generation of sodium carbonate.", "cop": 2, "opa": "Sodium hydroxide", "opb": "Potassium hydroxide", "opc": "Calcium hydroxide", "opd": "Silica", "subject_name": "Anaesthesia", "topic_name": null, "id": "ae3d7422-0a40-4412-8c37-7036b7df7aa6", "choice_type": "single"}
{"question": "M.C. nerve used for monitoring during anaesthesia", "exp": "Ans. is 'a' i.e. Ulnar nerve Most common nerve used for monitoring during anaesthesia is ulnar nerve.Ulnar nerve supplies adductor pollicis, and this muscle is most commonly observed during perioperative period.Adductor pollicis muscle is monitored for neuromuscular blockade. If adductor pollicis is showing no activity it means laryngeal muscles have already been blocked and intubation can be performed. At the reversal, if there is activity in adductor pollicis it means that diaphragmatic activity has already returned and the patient will be able to maintain tidal volume even after extubation.Also knowThe muscle to show earliest reversal is orbicularis oculi, supplied by the facial nerve.Common peroneal nerve can also be used for monitoring.", "cop": 1, "opa": "Ulnar nerve", "opb": "Facial nerve", "opc": "Radial nerve", "opd": "Median nerve", "subject_name": "Anaesthesia", "topic_name": "Fundamental Concepts", "id": "04684bf0-0934-40b2-b791-e4ae7fc6e4d9", "choice_type": "single"}
{"question": "Pin code index of N2O is", "exp": "PIn index provides prevention of wrong attachments of cylinders . N20 - 3 ,5 O2 - 2 , 5 C02 (Gas) - 1 ,6 . ( Liquid below 88F ) 2 , 6 ; Cyclopropane 3 , 6 .", "cop": 4, "opa": "1,6", "opb": "2,5", "opc": "2,6", "opd": "3,5", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "820d98b2-28ec-4190-821f-84f776a06648", "choice_type": "single"}
{"question": "'Pityriasis Versicolor' is caused by", "exp": "Pityriasis versicolor are tinea versicolor is a superficial fungal infection caused by dimorphic fungi belonging to genus Malassezia. M.globosa and M.furfur are two main species causing it. Most common site affected is upper trunk, but can also affect face and flexural areas. Clinical manifustations are in te form of hypo or hypo pigmented macules with fine, branni scales. Scrapping the surface accentuate the scarring known as scratch sign or coup d'ongle sign or besniers sign Woodslamp-golden yellow fluorescense KOH-Both yeast and hyphal forms giving Spaghetti and meat ball appearance. Ref Harrison 20th edition pg 1233", "cop": 1, "opa": "Malassezia furfur", "opb": "Trichophyton rubrum", "opc": "Aspergillus fumigatus", "opd": "Nocardia versicolor", "subject_name": "Anaesthesia", "topic_name": "Anaesthesia of special situations", "id": "53b8064c-a0aa-4894-bb93-8efe061cd910", "choice_type": "single"}
{"question": "Sudden decreasd end tidal CO2 in GA causes", "exp": "Complications of Anaesthesia During anaesthesia: > Respiratory depression - Salivation, respiratory secretions > Cardiac arrhythmias > Fall in BP >Aspiration >Laryngospasm and >asphyxia >Awareness > Delirium and convulsion > Fire and explosion", "cop": 1, "opa": "Cardiac arrest", "opb": "Pulmonary hypeension", "opc": "Malignant hypehermia", "opd": "Malignant extubation", "subject_name": "Anaesthesia", "topic_name": "Preoperative assessment and monitoring in anaesthesia", "id": "2db1c2e5-b953-4cee-9242-a5a3d02ad2e0", "choice_type": "single"}
{"question": "A very high PEEP results in", "exp": "Hypotension is due to diminished central venous blood return to the heart secondary to elevated intrathoracic pressures.", "cop": 3, "opa": "Hypertension", "opb": "Hypothermia", "opc": "Hypotension", "opd": "Hyperthermia", "subject_name": "Anaesthesia", "topic_name": null, "id": "fee5ff1b-6dbd-4a79-a223-b22fffe657c0", "choice_type": "single"}
{"question": "Best antagonist of morphine is", "exp": "B i.e. Naloxone", "cop": 2, "opa": "Nalorphine", "opb": "Naloxone", "opc": "Buprenorphine", "opd": "Pentazocine", "subject_name": "Anaesthesia", "topic_name": null, "id": "090a4816-c3f1-48ca-bc32-acf9749a2022", "choice_type": "single"}
{"question": "The bronchoscope is best sterilized with", "exp": "A fiberoptic scope like bronchoscope, the flexible laryngoscope should be sterilized with 2% glutaraldehyde.", "cop": 2, "opa": "Ethylene oxide", "opb": "2% Glutaraldehyde", "opc": "Betadine", "opd": "Infrared radiation", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "5933d065-db0a-4e2d-bc71-69df5d9290aa", "choice_type": "single"}
{"question": "Landmark for superior laryngeal nerve block", "exp": "- Larynx is supplied by vagus- Upper larynx above vocal cord - supplied by internal branch of superior laryngeal nerve- Below vocal cord - recurrent laryngeal nerve- Feel the hyoid and try to palpate greater cornua of hyoid bone and take the needle on the side of the neck, taking the needle lateral to the greater cornua of hyoid bone, and hit in the hyoid bone, then we pass our needle just below the hyoid bone, we either give local anesthetic there, or we take needle few cms inside and pierce the membrane b/w hyoid bone and thyroid and give the drug or at superior cornua of thyroid cailage instead of caudally we give cranially 2ml of 2% lignocaine Anesthetize lower pa of vocal cord - 4ml of 2% lignocaine Injecting local anesthetic solution bilaterally, in the vicinity of the superior laryngeal nerves where they lie between the greater cornua of the hyoid bone and the superior cornua of the thyroid cailage as they traverse the thyrohyoid membrane to the submucosa of the piriform sinus, blocks the internal branch of the superior laryngeal nerve. The overlying skin is cleaned with alcohol or povidone-iodine (Betadine). The cornua of the hyoid bone or the thyroid cailage can be used as landmark", "cop": 4, "opa": "Angle of mandible", "opb": "C7 transverse process", "opc": "Cricoid cailage", "opd": "Great cornua hyoid bone", "subject_name": "Anaesthesia", "topic_name": "JIPMER 2018", "id": "53127722-9677-4ea2-9656-976b7a5c620a", "choice_type": "single"}
{"question": "In a typical blood gas analyser", "exp": "Oxygen tension falls with hypothermia. The pH electrode directly measure pH. The standard bicarbonate measured in sample titrated to pCO2 of 5.3 kPa, which eliminates respiratory component.", "cop": 4, "opa": "Oxygen tension will be overstimulated in hypothermia", "opb": "pH is a derived measurement", "opc": "Standard bicarbonate can be used to indicate the respiratory component", "opd": "The oxygen tension can be measured using Clarke electrode.", "subject_name": "Anaesthesia", "topic_name": null, "id": "b5037b8f-8b3b-4937-849b-8c0d7a509503", "choice_type": "single"}
{"question": "The following is the anesthetic of choice in status asthamaticus", "exp": "Ketamine", "cop": 3, "opa": "Thiopentone", "opb": "Althesin", "opc": "Ketamine", "opd": "Barbiturate", "subject_name": "Anaesthesia", "topic_name": null, "id": "8e7c25fb-54fb-4999-8d6d-48a431192008", "choice_type": "single"}
{"question": "Color of nitrous oxide cylinder is", "exp": "Ans. d (Blue). (Ref. Short textbook of anesthesia by Ajay Yadav, 2nd ed., 21)Colour and pressure of cylindersSr. No.Anaesthetic gasColorPressure (bar) CyclopropaneOrange52.N2OBlue543.CO2Grey504.HalothaneAmber--5.EthyleneRed--6.HeliumBrown1377.O2Black body with white shoulder1378.Entonox (50%O2+50%N2O)Blue with white shoulder1379.AirGrey with white shoulder137Colour code for vaporizer of anaesthetic agents1. Red for /ralothane} 2. Orange for enflurane(HINT: ROPY HE-IS)3. Purple for isoflurane4. Yellow for sevoflurane", "cop": 4, "opa": "Black with white shoulders", "opb": "White with black shoulders", "opc": "Grey", "opd": "Blue", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic Equipments", "id": "2ac10b4f-5334-439a-a90f-39c283ec8a19", "choice_type": "single"}
{"question": "The circled part of given capnograph reflects", "exp": "This is phase 3 which represents only alveolar air.", "cop": 2, "opa": "Inspiration", "opb": "Alveolar air", "opc": "Mixed air", "opd": "Dead space air", "subject_name": "Anaesthesia", "topic_name": null, "id": "afc3320f-dc16-42bc-90d4-0ba5f14e8bab", "choice_type": "single"}
{"question": "Pudendal nerve block", "exp": "Pudendal Nerve BlockIt is a peripheral nerve block that provides local anesthesia over S2-4 dermatomes (majority of perineum and inferior quaer of vagina)It does not block the superior bih canal so the mother is able to feel the uterine contractions(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.847)", "cop": 2, "opa": "S1-3", "opb": "S2-4", "opc": "S3-5", "opd": "S4,5", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "410b0c7a-c75d-4391-a224-7b3290f350b4", "choice_type": "single"}
{"question": "The pin index code of nitrous oxide is", "exp": "The Pin Index Safety System, or PISS, is a means of connecting high-pressure cylinders containing medical gases to a regulator or other utilization equipment. It uses geometric features on the valve and yoke to prevent mistaken use of the wrong gas. This system is widely used worldwide for anesthesia machines, poable oxygen administration sets, and inflation gases used in surgery. Cylinders attach to the machine hanger-yoke assemblies that utilize a pin index safety system to prevent accidental connection of a wrong gas cylinder. The yoke assembly includes index pins, a washer, a gas filter, and a check valve that prevents retrograde gas flow. PIN INDICES OF COMMONLY USED GASES: O2: 2,5 N2O: 3,5 Mixture of O2 and N2O (50% / 50%), commonly called Entonox: 7 (a single pin, located in the center) Air: 1,5 Mixtures of CO2 and O2 with more than 7% CO2: 1,6 Mixtures of CO2 and O2 with less than 7% CO2: 2,6 He: No pin Mixtures of O2 and He with less than 80% He, commonly called Heliox: 2,4 Mixtures of O2 and He with more than 80% He: 4-6 Cyclopropane: 3,6 Ethylene: 1,3 Nitrogen: 1,4 Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "cop": 3, "opa": "2, 5", "opb": "1, 5", "opc": "3, 5", "opd": "2, 6", "subject_name": "Anaesthesia", "topic_name": "Fundamental concepts", "id": "8e02ddd3-7f83-4d2d-aa1e-4da2403c621f", "choice_type": "single"}
{"question": "Optimum minute ventilation is ensured by adjusting the following ventilation parameters", "exp": "Minute ventilation is tidal volume multiplied by respiratory rate.so these parameters must be adjusted to maintain optimum ventilation.", "cop": 2, "opa": "PEEP and FiO2", "opb": "Tidal volume and respiratory rate", "opc": "PEEP and respiratory rate", "opd": "Tidal volume and PEEP", "subject_name": "Anaesthesia", "topic_name": null, "id": "a10231ff-3aa3-4fb6-9021-bcb47e35d857", "choice_type": "single"}
{"question": "Local anaesthetic with maximum ionized form at physiological pH", "exp": "Local anaesthetics with pKa value closest at physiological pH (7.4) will have a higher concentration of nonionized (unionized) base. Thus, the agent with pKa value away from physiological pH will have more concentration of ionized formChloroprocaine has highest pKa value, hence maximum ionized form at physiological pH.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.268-270)", "cop": 4, "opa": "Lignocaine", "opb": "Etidocaine", "opc": "Bupivacaine", "opd": "Chloroprocaine", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "c10dae90-b293-4bbd-af23-abd32cec4170", "choice_type": "single"}
{"question": "Use of dexemditomidine", "exp": "DexmedetomidineIt is a centrally acting a-2 adrenergic agonistIt is approved by f.D.A for sho-term (<24 hours) continuous IV sedation of adults who are tracheally intubatedIts use as an anaesthetic agent is not recommended but it is useful in patients with brain injury and ongoing sedation needs.(Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no. 288)", "cop": 2, "opa": "Prolong action of LA in hypeensive patients", "opb": "Sedative agent for intubated patients", "opc": "Increases bioavailability of regional anaesthetic drug", "opd": "Helps in reducing bispictral index of general anaesthetic drug with low potency", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "68b69fb2-ae71-4d99-974f-ae7a13e137d9", "choice_type": "single"}
{"question": "A patient on atracurium develops seizures due to accumulation of", "exp": "Hoffman's degradation of atracurium produces a teiary metabolite,laudanosine , which can cross blood brain barrier and produce convulsions .", "cop": 2, "opa": "Didanosine", "opb": "Laudanosine", "opc": "Methylated Atracurium", "opd": "Sulfated Atracurium", "subject_name": "Anaesthesia", "topic_name": "Muscle relaxants", "id": "40b73a47-7f51-4376-8d64-581eda90be65", "choice_type": "single"}
{"question": "Epidural narcotic is preferred over epidural LA because it causes", "exp": "C i.e. No motor paralysis", "cop": 3, "opa": "Less respiratory depression", "opb": "Less dose is required", "opc": "No motor paralysis", "opd": "No retention of urine", "subject_name": "Anaesthesia", "topic_name": null, "id": "2b9d7d5b-69d1-456d-a217-37a956b4c34c", "choice_type": "single"}
{"question": "Curare notch seen in capnograph is due to", "exp": "With return of spontaneous ventilation, curare notch is seen in capnograph.", "cop": 3, "opa": "Carbon dioxide rebreathing", "opb": "Bronchospasm", "opc": "Spontaneous breathing", "opd": "Valve malfunction", "subject_name": "Anaesthesia", "topic_name": null, "id": "7cf0a407-01b8-4a50-aa7d-bf6d33c58c25", "choice_type": "single"}
{"question": "Intracranial pressure is increased by", "exp": "(C) Ketamine # KETAMINE causes an increase in all pressure viz: intracranial pressure intraocular pressure; Blood pressure> It does not cause muscle relaxation> Ketamine induces dissociative anaesthesia profound analgesia, immobility amnesia with light sleep ad feeling of dissociation from ones own body and the surrounding.> Anaesthesia of choice in shock/hypotension: ketamine> Anaesthetic associated with increase in muscle tone: ketamine> Anaesthetic which does not abolish reflexes: ketamine> Anaesthetic of choice in bronchial asthma: Ketamine> Anaesthetic which is associated with emergence delirium and hallucinations : ketamine", "cop": 3, "opa": "Ether", "opb": "Halothane", "opc": "Ketamine", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": "Miscellaneous", "id": "5defeaaf-45bb-44a1-b6e7-6157c19df3f9", "choice_type": "single"}
{"question": "Inner diameter of adult male endotracheal tube is", "exp": "Internal diameter of the endotracheal tube used usually for an adult male ranges from 8.0 to 9.5 ID for an adult female ranges from 6.5 to 7.5", "cop": 4, "opa": "2 mm", "opb": "4 mm", "opc": "6 mm", "opd": "9 mm", "subject_name": "Anaesthesia", "topic_name": "Anaesthetic equipments", "id": "3e5c59bd-8c72-44d5-b2d9-3f0bdba8d9ad", "choice_type": "single"}
{"question": "Most common local anaesthetic used for intravenous regional anesthesia (Bier block).", "exp": "Lidocaine is the most - frequently selected amide local anesthetic for producing this type of regional anesthesia. Lidocaine has been the drug used most frequently for intravenous regional anesthesia. Prilocaine, mepivacaine, chloroprocaine, procaine and etidocaine have also been used successfully. Intravenous regional anesthesia or Bier's block involves the intravenous administration of a local anesthetic into a tourniquet- occluded limb. It is used to provide anesthesia for sho surgical procedures (<90 minutes) on the limbs. Note : Bupivacaine and its congeners is not used for Biers block. It is the most cardiotoxic local anesthetic. Accidental early deflation of the tourniquet can lead to massive systemic doses of bupivacaine resulting in cardiac arrhythmias and cardiovascular collapse.", "cop": 2, "opa": "Bupivacaine", "opb": "Lignocaine", "opc": "Prilocaine", "opd": "Chloroprocaine", "subject_name": "Anaesthesia", "topic_name": "Regional Anesthesia", "id": "02d1c019-862d-4660-9122-7c3be9fdca0c", "choice_type": "single"}
{"question": "The following is not the differential diagnosis of an anterior mediastinal mass.", "exp": "B i.e. Neurogenic tumor Neurogenic tumors (arising in posterior nerve structues) are the most common posterior mediastinal tumor but these do not occur in anterior mediastinumQ. And posterior mediastinum is the most common location for neurogenic tumors.", "cop": 2, "opa": "Teratoma", "opb": "Neurogenic tumor", "opc": "Thymoma", "opd": "Lymphoma", "subject_name": "Anaesthesia", "topic_name": null, "id": "853d2b37-b798-43c2-9068-b0d6af805153", "choice_type": "single"}
{"question": "Commonest complication of celiac plexus block is", "exp": "Celiac plexus is a sympathetic ganglion thus blocking it will always cause hypotension. The celiac plexus is the largest plexus of the sympathetic nervous system. It contains preganglionic sympathetic fibers from greater and lesser splanchnic nerves (emerge from the thoracic sympathetic ganglia, T5 to T12) as well as postganglionic sympathetic and preganglionic parasympathetic fibers. It provides sensory innervation and sympathetic outflow to stomach, liver, spleen, pancreas, kidney and GI tract up to splenic flexure. Plexus is located at the level of T12-L2 (usually L1) and lies anterior to aoa in the retroperitoneal space. Indications Most common indication is treatment of pain caused by pancreatic cancer. Occasionally used in the treatment of pain from chronic pancreatitis (controversial). Can be used for pain from other GI malignancies from LES to splenic flexure, as well as liver, spleen and kidneys. Complications Ohostatic hypotension (most common, can be minimized with fluid hydration) and diarrhea (secondary to blockade of sympathetic fibers). Less common complications include paraplegia (from damage to aery of Adamkiewicz), local anesthetic toxicity, spinal or epidural injection, aoic or vena cava puncture and bleeding, retroperitoeneal hemorrhage, visceral organ injury, and pneumothorax (if needle is placed too cephalad) Anatomical Considerations: preganglionic SNS (greater/lesser splanchnic nerves), postganglionic SNS, preganglionic PNS, sensory Indications: pancreatic cancer (common); sometimes pancreatitis (controversial) Common Side Effects: ohostatic hypotension, diarrhea Rare Side Effects: paraplegia, LA toxicity, spinal/epidural injection, aoic or vena cava puncture, retroperitoeneal hemorrhage, visceral organ injury, pneumothorax", "cop": 2, "opa": "Bradycardia", "opb": "Hypotension", "opc": "Seizures", "opd": "Retroperitoneal hematoma", "subject_name": "Anaesthesia", "topic_name": "Regional Anesthesia", "id": "47c4dc77-e3a6-4a0a-bdfb-2304dda958c4", "choice_type": "single"}
{"question": "Anaesthetic agent causing analgesia", "exp": "\"Ketamine is different from most other anaesthetic induction agents inthat it has significant analgesic action\"(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "cop": 1, "opa": "Ketamine", "opb": "Propofol", "opc": "Etomidate", "opd": "Thiopentone", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "3bb97968-79d9-446d-9ee5-7db914c9b60c", "choice_type": "single"}
{"question": "Primary mechanism responsible for cerebral protection effect of thiopentone is", "exp": "C i.e. Decreased (lowered) cerebn metabolism Barbiturates (thiopental), primarily decreases cerebral metabolismQ resulting in a dose related depression of cevebral metabolic oxygen consumption (CMR02).Reduced CMRO2 causes progressive slowing of EEG, a reduction in rate of ATP consumption, cerebral vasoconstriction (reducing cerebral blood flow and intracranial tension) and protection from incomplete cerebral ischemiaQ. Thiopentone Sodium* Thiopentone is a yellow coloured powder used as 2.5 % solution at 5 mg/kg dose for smooth induction. It is ultrasho actingQ due to rapid redistributionQ. It is contraindicated in porphyria.Q.", "cop": 3, "opa": "GABA action, calcium channel block and free radicle removal", "opb": "Increased cerebral blood flow", "opc": "Decreased (lowered) cerebn metabolism", "opd": "Reduces cerebral 02 demand by limiting CBF", "subject_name": "Anaesthesia", "topic_name": null, "id": "65e809f2-86cd-48d4-9f63-5ed398e1ddc5", "choice_type": "single"}
{"question": "Stages of anaesthesia were described by Guedel with", "exp": "Ether", "cop": 1, "opa": "Ether", "opb": "Chloroform", "opc": "N20", "opd": "Halothane", "subject_name": "Anaesthesia", "topic_name": null, "id": "507230a0-5323-4180-87d7-bc57b5ab1f0a", "choice_type": "single"}
{"question": "Not intravenous Anasthetic agent", "exp": "D i.e. Cyclopropane", "cop": 4, "opa": "Ketamine", "opb": "Thiopantone", "opc": "Etomidate", "opd": "Cyclopropane", "subject_name": "Anaesthesia", "topic_name": null, "id": "7f2cf9d8-4c80-4c60-a04d-a515fdbebe0c", "choice_type": "single"}
{"question": "Anaesthesia of choice for manual removal of placenta", "exp": "A i.e. GA Obstetric Anesthesia N20 can be given in Early pregnancy Anesthesia is dangerous in all three trimesters but comparatively 2\" trimester is safestQ. Supine Hypotensive Syndrome : In late pregnancy (IIIrd Trim) circulatory depression occurs due to diminished venous return because of pressure of gravid uterus over inferior venacava in supine position.Q Best uterine relaxant is halothane, so uterine tetanic contractions are most rapidly treated by halothane.Q M.C. cause of death during G.A. in obstetrics is Mendelson's syndromeQ i.e. Aspiration of gastric content during anesthesia. On X-Ray, butterfly motteling in hilar area is seen. This is prevented by: - Empty stomach and H2 blockers - Esophageal Intubation - Secillik's maneuver i.e. backward pressure on cailage.Q Contraindications - Gallimanie is C/I as it crosses placenta. - Morphine is C/I until delivery as it causes respiratory depression in mother and baby. For respiratory depression of morphine or pathidine. Naloxane 0.01 mg/Kg is given through umbilical vein.", "cop": 1, "opa": "GA", "opb": "Spinal", "opc": "Epidural", "opd": "Para Cervical", "subject_name": "Anaesthesia", "topic_name": null, "id": "df8f5d0d-f1a0-44c7-beaa-2f3f58a9f420", "choice_type": "single"}
{"question": "The following anaesthetic drug causes pain on intravenous administration", "exp": "Induction of anesthesia with propofol is often associated with pain on injection, apnea, hypotension, and, rarely, thrombophlebitis of the vein into which propofol is injected. Pain on injection is reduced by using a large vein, avoiding veins in the dorsum of the hand, and adding lidocaine to the propofol solution or changing the propofol formulation. Multiple other drugs and distraction techniques have been investigated to reduce the pain on injection of propofol. Pretreatment with a small dose of propofol, opiates, nonsteroidal antiinflammatory drugs, ketamine, esmolol or metoprolol, magnesium, a flash of light, a clonidine-ephedrine combination, dexamethasone, and metoclopramide all have been tested with variable efficacy. Ref: Millers anesthesia 8th edition.", "cop": 2, "opa": "Midazolam", "opb": "Propofol", "opc": "Ketamine", "opd": "Thiopentone sodium", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "8ecb2f2e-4f2e-43be-a622-52842c4fcc28", "choice_type": "single"}
{"question": "Longest acting among muscle relaxant is", "exp": "Among the given options, only doxacurium is long acting(Refer: stoelting's pharmacology and physiology in anaesthetic practice ,5th edition ,pg no.139)", "cop": 1, "opa": "Doxacurium", "opb": "Rocuronium", "opc": "Vecuronium", "opd": "Atracurium", "subject_name": "Anaesthesia", "topic_name": "All India exam", "id": "fc4eb6f4-e1d1-41ff-8792-193d4fcf9e97", "choice_type": "single"}
{"question": "Stage of surgical anesthesia during ether administration is", "exp": "Guedel's classification is a means of assessing of depth of general anesthesia introduced by Ahur Ernest Guedel for Ether in1937. Stage I (stage of analgesia or disorientation) Stage II (stage of excitement or delirium) Stage III (stage of surgical anesthesia) plane I to IV Stage IV: from stoppage of respiration till death Stage III (stage of surgical anesthesia): from onset of automatic respiration to respiratory paralysis. It is divided into four planes: Plane I - from onset of automatic respiration to cessation of eyeball movements Plane II - from cessation of eyeball movements to beginning of paralysis of intercostal muscles Plane III - from beginning to completion of intercostal muscle paralysis. Plane IV - from complete intercostal paralysis to diaphragmatic paralysis Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e.", "cop": 3, "opa": "Loss of Consciousness", "opb": "failure of circulation", "opc": "Regular respiration to cessation of breathing", "opd": "Loss of Consciousness to beginning of regular respiration", "subject_name": "Anaesthesia", "topic_name": "General anaesthesia", "id": "05efacf2-26c7-4fc5-acb0-75a922638a3b", "choice_type": "single"}