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Amount of water that constitutes soda lime in carbon dioxide absorber is | Water constitute 14-19% in soda lime. | 2 | 20-24% | 14-19% | 10-14% | 25-30% | Anaesthesia | null | f320607c-a968-4a3b-8072-ba4e7fe5d297 | single |
The second gas effect is | null | 4 | Displacement of N20 by Oxygen | Displacement of oxygen by N20 | Removal of oxygen by N20 from alveoli during recovery from general anaesthesia | Facilitation of inhalation of Halothane by N20 | Anaesthesia | null | 7d286fbe-ffae-4413-bfdb-6f4d3e8cf994 | single |
A mid tracheostomy is done over | a mid tracheostomy is done at 2nd and 3rd tracheal rings behind the isthumus,it is the operation of choice . | 2 | 1st and 2nd tracheal ring | 2nd and 3rd tracheal ring | 3rd and 4th tracheal ring | 5th and 6th tracheal ring | Anaesthesia | Fundamental concepts | 21d0ddc8-2f04-40eb-9495-1ff0aa41f2cb | single |
Drug of choice in cardiogenic shock is | 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 | 1 | Dopamine | Phenylalanine | Noradrenaline | Adrenaline | Anaesthesia | Complications of anaesthesia | 6358335c-4acc-4bf4-bac5-c543e20c8df8 | single |
Most common complication seen after Block 2 is | Hypotension (Block 2 is Spinal block) | 2 | Bradycardia | Hypotension | Nausea | Anxiety | Anaesthesia | Spinal, Epidural, & Caudal Blocks | 390bd39a-efd7-4012-acd5-b13b08be652c | single |
Surest indicator of reversal of anaesthesia is | 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 | 1 | Head lift for 5 seconds | Hand grip for 5 seconds | TOF > 0.9 | Tongue depression | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 1ff4667d-ebcb-4414-a71c-3266b6bb14b9 | single |
The current mode of analgesia best for intrapaum pain relief is | 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 | 1 | Epidural analgesia | Spinal anaesthesia | Inhalational | Local analgesia | Anaesthesia | Anaesthesia of special situations | 2f342d4a-b1c5-45cf-8e26-a4a4d0863722 | single |
Cis atracurium is preferred over atracurium due to advantage of | 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. | 3 | Rapid onset | Sho duration of action | No histamine release | Less cardiodepressant | Anaesthesia | Muscle relaxants | 2c33a7ae-e6a6-4402-b650-6fd3a0a81b0f | single |
Pudendal nerve block involves | S2, S3, S4 | 4 | Ll, L2, L3 | L3, L4,L5 | Sl, S2, S3 | S2, S3, S4 | Anaesthesia | null | ffbbf62c-c095-4679-9f9d-f901119f3c6a | single |
This law of plethysmography explains principle of working in | The law of plethysmography explains working of pulse oximeter. | 2 | Capnography | Oximetry | CVP monitor | Entropy | Anaesthesia | null | 85653cea-0e58-4fef-9bc5-ceaed11485eb | single |
Induction agent of choice in a child with cyanotic hea disease | 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) | 2 | Thiopentone | Ketamine | Halothane | Midazolam | Anaesthesia | All India exam | 93c16f78-b687-4636-b69b-f3607259803c | single |
Foster Kennedy syndrome is | 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. | 2 | I/L Papilloedema CiL optic atrophy | I/L Optic atrophy C/L papilloedema | I/L Optic atrophy and papilloedema | UL Papilloedema C/L papilitis | Anaesthesia | null | e6996f40-8b77-4247-af0c-f082f74d7048 | single |
Ideal intubating position (modified chevalier Jackson position) is | 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. | 1 | Flexion of neck and extension of head | Extension neck and extension of head | Flexion of neck and neutral position of head | Extension of head and neutral position of head | Anaesthesia | Airway | 8f652ed9-000b-451f-9d4f-aa2a80fb5048 | single |
Best indicator of Endotracheal tube Extubation is | (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 | 4 | Tin box index | Minute volume | Respiratory rate | Negative inspiratory pressure | Anaesthesia | Miscellaneous | 9a6858bd-a321-4e88-b056-be5f8e97adbc | single |
Phase II block is seen in | 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. | 4 | Halothane | Ether | D-tubocurare | Suxamethonium | Anaesthesia | Depolarising Neuromuscular Blocking Agents | b587e88d-a12c-477e-baa2-302a471e0e8e | single |
Earliest and most pathognomic feature of malginant hyperthermia is | Increased CO2 production is earliest sign of malignant hyperthermia. | 2 | Increased temperature | Increased end-tidal CO2 | Increased heart rate | Increased respiratory rate | Anaesthesia | null | 7778ff40-cf86-4a3d-8de2-acb2fa6a2b53 | single |
Lowest concentration of anesthetic agent in aveoli needed to produce immobility in response to painful stimulus in 50% of individual is termed as | A i.e. Minimum alveolar concentration | 1 | Minimum alveolar concentration | Minimal analgesic concentration | Minimal analgesic concentration | Maximum alveolar concentration | Anaesthesia | null | 78b0a79c-b2d9-4c5f-a7f6-93529238f70f | single |
Size of the laryngeal mask airway for normal adults | 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.
In 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
further conclusive trials are required before the manufacturer's weight-based recommendations are altered.
Judging the correct size of LMA can be difficult since the relationship between gender, weight, height, and upper airway geometry appears inconsistent.
No 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.
Some 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.
The 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. | 4 | 2.5 | 3 | 1.5 | 4 | Anaesthesia | null | c8357f98-f736-45de-81aa-cd32af74e9cb | single |
The current mode of analgesia best for intrapaum pain relief | 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 ) | 1 | Epidural analgesia | Spinal anaesthesia | Inhalational | Local analgesia | Anaesthesia | All India exam | e53455ae-0c5e-46bb-a176-a6f2ba9ed32b | single |
Murphy&;s eye is seen in | * 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 | 2 | Macintosh laryngoscope | Endotracheal tube | LMA | Flexible laryngoscope | Anaesthesia | Anaesthetic equipments | 9a704cf0-7f28-4093-a663-3e9f73c4205c | single |
Position with least vital capacity in G.A. | 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. | 1 | Trendelenburg | Lithotomy | Prone | Lateral | Anaesthesia | null | 0bdad56c-46db-4de9-bb2a-d2d5a0ce5106 | single |
Maximum safe dose of lignocaine for spinal anesthesia is | 25-100 mg | 2 | 5-15 mg | 25-100 mg | 100-200 mg | 150-300 mg | Anaesthesia | null | 31691dfa-ff2b-4c2c-8352-1e6a3645505f | single |
Estimation of FiO2 calculation during the use of nasal cannula in a child is | 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. | 3 | 21% + (Nasal Cannula flow (L/min) X 1) | 21% + (Nasal Cannula flow (L/min) X 2) | 21% + (Nasal Cannula flow (L/min) X 3) | 21% + (Nasal Cannula flow (L/min) X 4) | Anaesthesia | Miscellaneous | 4311820a-fc33-4db0-9d6d-270556683faf | single |
Most potent analgesic agent among following | 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 | 1 | Nitrous oxide | Nitric oxide | CO2 | Oxygen | Anaesthesia | null | 3b332f26-5d8e-4b75-8eb5-aeddeed72dd1 | single |
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 | 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 | 1 | Sevoflurane | Isoflurane | Enflurane | Halothen | Anaesthesia | Anaesthesia of special situations | c1660987-c0ff-44c1-8284-b9fc985c3e36 | single |
Dose of thiopentone used is | 2.50% | 2 | 2% | 2.50% | 3% | 5% | Anaesthesia | null | 539a5209-2684-43b9-9280-2b70071495a0 | single |
As per ISO, color of N20 cylinder is | 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 ) | 1 | Blue | Black | White | Red | Anaesthesia | Anaesthetic equipments | dec5bf39-22c4-45de-9a03-ace17ac8fdc2 | single |
Wooden chest rigidity is seen with | 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 | 2 | Morphine | Fentanyl | Remifentanyl | Pentazocine | Anaesthesia | Intravenous Anesthetic Agents | eee014b3-6728-41f8-b313-e593df46b490 | single |
Laundosine is a toxic metabolite of | 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) | 1 | Atracurium | Pancuronium | Mivacurium | Vecuronium | Anaesthesia | All India exam | 5e49223c-56ac-419d-9eb2-da0d6cc1e280 | single |
Inducing agent of choice in asthma | 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) | 2 | Etomidate | Ketamine | Propofol | Induction | Anaesthesia | null | fd2c94cb-e69f-4754-9ae6-f40ada02f426 | single |
In a patient with multiple injuries, first thing is to be done is | null | 1 | Patency of airway | Maintenance of B.P. | Immobilize cervical spine | Lateral position with mouth gas | Anaesthesia | null | 0ed94f1f-462e-46e1-aac4-7f5bc2b1b563 | single |
A patient of alcohlic liver faliure requires general anesthesia AOC is | 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. | 3 | Ether | Halothane | Isoflurane | Methoxyflurane | Anaesthesia | null | b83a2d85-f499-4a91-90d2-df77443654fa | single |
Following A, a patient suffered splenic ruture. His BP is 90/60 mmHg, PR 126/min and Sp02 92%. Induction agent of choice is | 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). | 4 | Remifentanyl | Halothane | Midazolam | Etomidate | Anaesthesia | null | 6a0341cd-0fbb-4039-bbbf-0977c51365e4 | single |
Pneumothorax is a complication of | 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. | 2 | Axillary block | Brachial plexus block | Epidural block | High Spinal block | Anaesthesia | null | 837376a3-065c-441c-95c0-cb56f918c9b1 | single |
Local Anaesthetic in wound/ulcer management | 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) | 3 | Prilocaine | Chlorprocaine | Benzocaine | Bupivacaine | Anaesthesia | All India exam | de77739b-8e2f-4293-a0f9-c1d127704b0e | single |
A 40 year old female underwent surgery.Postoperatively she told the anesthetist that she was aware of preoperative events.Intraoperative awareness is evaluated by | 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 | 3 | Pulse oximetry | Colour doppler | Bispectral imaging | End tidal CO2 | Anaesthesia | General anaesthesia | 7a930bf5-f9e0-41a7-aa6c-6e04e1182476 | single |
Size of LMA used for 25kg child is | Size of LMA used for a 25 kg child is 2.5 LMA size 6 is used in adults weighing over 100 kg | 3 | 1 | 1.5 | 2.5 | 4 | Anaesthesia | Anaesthetic equipments | 35aee0fa-bf88-4045-bbee-49bfe499e302 | single |
Machine used noninvasively to monitor an external chest compression during cardiopulmonary resuscitation is | null | 4 | Zoll depth synchronizer | Zoll strength sensor | Zoll pAO2 monitor | Zoll AED -plus automatic external defibrillator | Anaesthesia | null | 37b53d29-5baf-4fd4-944b-3677d5b57795 | single |
ASA classification is done for | null | 2 | Fasting | Risk | Pain | Lung capacity | Anaesthesia | Fundamental concepts | 455b453b-4227-4294-8aa6-8537ed40f54f | single |
Local anaesthesia causing metheaEUR' moglobinemia | Prilocaine | 2 | Procaine | Prilocaine | Etiodicaine | Ropivacaine | Anaesthesia | null | e697b4de-883b-4fe0-a518-9c7e4af4917c | single |
Arrange following inhalational anesthetic agents according to increasing MAC values i) Isoflurane ii) Desflurane iii) Sevoflurane iv) Halothane | 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 | 1 | (iv), (i), (iii), (ii) | (iv), (iii), (i), (ii) | (ii), (iv), (iii), (i) | (i), (ii), (iii), (iv) | Anaesthesia | Inhalational Anesthetic Agents | 8dcc24e7-672c-4ad0-96ea-669f8f6f8184 | single |
Best site for going spinal anaesthesia is interveebral space between. | 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. | 1 | L2 - L3 | L3 - L4 | L1 - L2 | L5 - S1 | Anaesthesia | Central Neuraxial Blockade | f0069ca2-03ef-44fa-b0d4-33712f4b2e5d | single |
Arrange Mapelson circuit for spontaneous ventilation in an adult from best to worst | 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 | 3 | D>B>C>A | A>C>B>D | A>D>C>B | B>C>D>A | Anaesthesia | Anesthesia Circuit | c7c4eb02-4070-44cf-a156-d0e2a209e2d1 | single |
Best local anaesthetic for ophthalmic surgery is | 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) | 4 | Tetracaine | Prilocaine | Procaine | Bupivacaine | Anaesthesia | All India exam | 59cc9467-e05b-48d0-8b9b-e131c736963d | single |
Best Scale to measure pain in children of 5 years age would be | D i.e. CHEOPS | 4 | VAS | Mc Gill Scale | Faces Scale | CHEOPS | Anaesthesia | null | b4c904dc-b15c-4006-8a21-5e85f241d325 | single |
Dibucaine number is | Dibucaine number gives percentage of abnormal pseudocholinesterase. | 2 | Gives percentage of lignocaine levels in blood | Gives percentage of abnormal pseudocholinesterase in blood. | Gives percentage of metabolised lignocaine levels | Gives percentage of succinylcholine in blood. | Anaesthesia | null | 86c77b48-c605-4b22-acad-1224ae9e9c89 | single |
The Blade of the laryngoscope used in intubation of newborn is | 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). | 3 | Curved blade with uncuffed tube | Straight blade with Cuffed tube | Straight blade with uncuffed tube | Curved blade with cuffed tube | Anaesthesia | General anaesthesia | 66e19c7b-f86c-4e29-a0c7-f38690ad90d8 | single |
Colour of Entonox cylinder is | Entonox cylinder has blue body and white shoulder. | 4 | Black body, white shoulder | Grey body, black and white shoulder | Black body, brown and white shoulder | Blue body, white shoulder | Anaesthesia | null | 5699e4fd-c484-4c21-8c9f-94f971140334 | single |
5 yr old child going to sitting craniotomy while positioning in O.T. developed End Tidal CO2 0mm Hg P02 80 mm Hg implies | 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. | 3 | Endotracheal tube in oesophagus | E.T. blocked with secretion | Venous air Embolism | Left lung collapse | Anaesthesia | null | 46b0898f-5ec6-4fee-807a-d11a5b2ee9d8 | single |
Induction agent that may cause adrenal cortex suppression is | Synthesis of adrenal steroids (both mineral and glucocorticoids) is inhibited by etomidate. | 2 | Ketamine | Etomidate | Propofol | Thiopentone | Anaesthesia | null | 61d5dcb7-22f4-46e4-b2a4-044b7897d26e | single |
The probe is used for | This image shows TEE probe, which is used for intraoperative cardiovascular monitoring. | 2 | Enteroclysis | Transesophageal echo | Oesophageal temperature monitor | ERCP probe | Anaesthesia | null | 4b29fe2c-4406-4401-a2ef-9113196522ca | single |
Conc. of Lidocaine used in spinal anesthesia | A i.e. 5% | 1 | 5% | 3% | 2% | 1% | Anaesthesia | null | 61d9b7fb-1416-48d1-95f0-cef07d63b07d | single |
The maximum safe dose of bupivacaine is | Maximum safe dose of bupivacaine is 2 mg/kg with or without adrenaline | 2 | 1 mg/kg | 2 mg/kg | 3 mg/kg | 5 mg/kg | Anaesthesia | Regional anaesthesia | df4d8a44-7376-4352-a04e-f2f0d88c092c | single |
Systemic absorption of local anaesthetic is better with | Intravenous > tracheal > intercostal is order of systemic absorption of local anaesthetic drug. | 3 | Subcutaneous route | Epidural route | Tracheal route | Intercostal route | Anaesthesia | null | c2126b8e-e587-40e1-92df-8a837114d053 | single |
Duration of action of paraprocaine is | Procaine acts for around 20 minutes, althought it’s onset of action is within 10 seconds. | 1 | 20 minutes | 10 minutes | 20 seconds | 10 seconds | Anaesthesia | null | 172570ca-6da4-46cc-a508-0e37ea5f28aa | single |
Least effect on myocardial contractility | 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. | 4 | Ether | Halothane | Trilene | Isoflurane | Anaesthesia | null | 9ccdedd7-51d5-4b3b-ab78-bf3cfa041894 | single |
Shoest acting non depolarizing muscle relaxant | Non depolarising (competitive) 1)Long Acting - pancuronium,pipecuronium 2) Intermediate Acting-vecuronium,rocuronium,atracurium 3) Sho Acting - Mivacurium | 1 | Mivacurium | Vercuromium | Atracurium | Succinyl choline | Anaesthesia | Muscle relaxants | 4512c4eb-6995-41ea-bb53-fd394ad204e8 | single |
Increased Cardiac Oxygen demand is caused by | D i.e. Ketamine | 4 | Halothane | Thiopentone | N20 | Ketamine | Anaesthesia | null | 28193437-8522-479f-8fed-e8eb5fc1e08f | single |
Minimum &;starvation time&; required in general anaesthesia | 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 | 2 | 4 hours | 8 hours | 12 hours | 24 hours | Anaesthesia | Fundamental concepts | 6bdca4f6-538f-4948-8b7b-15529c94d486 | single |
Intraoperative wheezing can be managed by | Among IV induction agents,ketamine has a bronchodilator action. | 2 | Thiopentane | Ketamine | Methohexitone | Propofol | Anaesthesia | Complications of anaesthesia | b0030ae3-5aae-47e9-87cb-69274554d590 | single |
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. | In pregnancy, CSF volume is decreased, thereby decreasing dose requirement of local anaesthetic. This facilitates spread of local anaesthetic when spinal anaesthesia is given.
Option D would have been correct, if question mentioned Epidural anaesthesia. | 3 | Severe patient anxiety | Increased peripheral nerve sensitization to local anaesthetics | Decrease in volume of CSF in subarachnoid space facilitated higher spread of local anaesthetics | Engorgement of epidural veins contributed to inadvertent intravascular injection of local anaesthetic | Anaesthesia | null | 24876de2-e604-4932-9965-65f811d42f2d | single |
Management of prolonged Scoline apnea is by | 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. | 3 | Exchange transfusion | Estimation of plasma cholinesterase | Continuation of aificial ventilation | Reversal with neostigmine | Anaesthesia | Neuromuscular Blocker | d62c126f-7c09-4083-830d-38e465108f26 | single |
After suxamethonium 50mg, apnea persists for one hour | 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.
Discriminates three phenotypes: Normal, intermediate, and atypical. | 2 | Treatment with cholnesterase is indicated | Probab1y an atypical cholinesterase is present | Treatment with stored blood is indicated | Apnea may be due to low serum potassium concentration | Anaesthesia | null | d83d38f8-d84c-442d-8bca-4c67bc9f3e29 | single |
In rapid sequence intubation | 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. | 2 | Non-depolarizing muscle relaxants are used | Cricoid pressure of 30N is required | Opioids are contraindicated | Pre-oxygenation is not mandatory | Anaesthesia | null | c13f4167-e6a9-4863-ab4d-592e3977a342 | single |
Intra ocular pressure rises in | 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) | 1 | Intubation & laryngoscopy | LMA | Infusion of IV propofol | Bag and mask ventilation | Anaesthesia | All India exam | f51b7d52-7bcc-4a89-9730-5f0154303f81 | single |
Most potent antiemitic agent used in preoperative period | 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 | 4 | Glycopyrolate | Hyoscine | Atropine | Metochlorpromide | Anaesthesia | null | 15109a1e-ed23-4af7-ac1f-6a11c52211c3 | single |
The disease with known association with malignant hyperthermia is | KDS-King Denborough syndrome, Muscular dystrophy (DMD),myotonia are musculoskeletal disease associated with malignant hyperthermia. | 4 | Huntington chorea | Fabry disease | Burns | Denborough syndrome | Anaesthesia | null | 79de7e9c-d898-4454-bcfd-4bcbb65e2d4e | single |
Muscle most resistant to non depolarizing block is | C i.e. Diaphragm | 3 | Intercostal | Abdominal | Diaphragm | Adductors. | Anaesthesia | null | 26ee8800-e102-4eec-a793-bedce517e349 | single |
Xylocaine heavy in subarachnoid space has concentration of | D i.e. 5% | 4 | 1% | 2% | 3% | 5% | Anaesthesia | null | 0fb20e43-3a03-417c-8ece-49349e9b63d3 | single |
Malignant hypehermia is a rare complication following the administration of Not a complication of epidural anesthesia | DIC | 3 | Headache | Hypotension | DIC | Hematoma | Anaesthesia | null | eba0c4fc-64fc-457d-aad7-33b73302875d | single |
Dose of Ketamine is | B i.e. 2mg/Kg IV | 2 | 0.5 mg/Kg l/m | 2 mg/kg I/v | 5mg/kg I/v | 10mg / kg I/m | Anaesthesia | null | b61173ab-4c9c-4b20-872f-65adbdcfa566 | single |
Tec 6 vaporizer is used with......... | 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 | 2 | Halothane | Desflurane | Isoflurane | Trielene | Anaesthesia | Inhalational Anesthetic Agents | cb230989-d36c-4d72-9a23-f2f5f94cddee | single |
A 65 year old male patient with history of coronary aery disease was diagnosed with hemorroides. The anaesthesia modality of choice for haemorrhoidectomy | 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. | 3 | Spinal anaesthesia | General anaesthesia | Saddle anaesthesia | Caudal anaesthesia | Anaesthesia | Central Neuraxial Blockade | 45cacb4f-e6c0-4083-bd1c-0b477b3fed36 | single |
Inducing dose of Propofol in adults | (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'. | 2 | 1 mg/kg | 2 mg/kg | 3 mg/kg | 5 mg/kg | Anaesthesia | Miscellaneous | 690bf569-27a7-4ae6-8db1-9172178d758f | single |
Malampati grading is for | 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 | 4 | Mobility of cervical spine | Mobility of atlantoaxial joint | Assesment of free rotation of neck before intubation | Inspection of oral cavity before intubation | Anaesthesia | Fundamental concepts | 4cec9149-1712-4d29-bd0f-ad1b76a3b0b6 | single |
Rotameters | 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 . | 2 | Depend on laminar low for their accuracy | Will only function when upright | Are constant pressure drop-constant orifice devices | Are not accurate below 1L/min | Anaesthesia | null | eec09aec-46e6-477d-bed3-4872b61f97fd | single |
The most appropriate inhalational agent for pediatric patients | 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. | 1 | Sevoflurane | Desflurane | Isoflurane | Halothane | Anaesthesia | Inhalational Anesthetic Agents | 9d88e723-bbd6-4093-b4f7-9d7f17c1de24 | single |
Cuff pressure in endotracheal intubation with prolonged ventilation should be less than | Cuff pressure in the endotracheal intubation is in between 25 to 30 mmHg. | 2 | 20 mmHg | 30 mmHg | 40 mmHg | 50 mmHg | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 3fd3d1e6-c150-43ad-be18-82665af82e65 | single |
Anaesthetic gas with maximum respiratory irritation | * 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 | 1 | Desflurane | Sevoflurane | Enflurane | Halothane | Anaesthesia | General anaesthesia | 78fb2bf8-3ce3-4f0f-bff7-9f455f8a7d89 | single |
The optimal granule size of soda lime is | 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. | 1 | 4- 8 mesh | 8- 10 mesh | 10- 12 mesh | 12- 16 mesh | Anaesthesia | Anesthesia Circuit | f656952c-5275-495f-a026-1e2aa98e648c | single |
Most commonly involved segment of Lungs in Foreign body aspiration (Supine position) | 3 (Lobe: Right lower lobe lung) | 3 | 1 | 2 | 3 | 4 | Anaesthesia | Cardiopulmonary Resuscitation And Mechanical Ventilation | fa6ecb50-d667-4e48-acf4-443031e45a99 | single |
Methemoglobinemia is seen with | Methemoglobinemia is seen with benzocaine, prilocaine and with EMLA. | 2 | Tetracaine | Prilocaine | Bupivacaine | Procaine | Anaesthesia | null | 459a3562-0631-4c95-8a22-8ef2d2c447fc | single |
In increased ICT, agent used for anesthesia | D i.e. Isoflurane | 4 | N20 | Trilene | Ether | Isoflurane | Anaesthesia | null | fed5ff77-cd5a-4dae-8521-d40fb27022c9 | single |
Laryngeal mask Airway (LMA) is used for; | A i.e. Maintenance of airway | 1 | Maintenance of the airway | Facilitating laryngeal surgery | Prevention of aspiration | Removing oral secretions | Anaesthesia | null | 9f3c052b-ecc7-4ece-a4ab-3c4dc207e909 | single |
Muscle relaxant of choice in hepatic and renal failure | A i.e. Cisatracurium | 1 | Cisatracurium | Rocuronium | Vecuronium | Rapacuronium | Anaesthesia | null | da16443e-c6ea-421d-b13c-dc046df52e18 | single |
Post dural puncture headache is | Post dural puncture headache is occipital > frontal > retroorbital. | 3 | Retro-orbital | Frontal | Occipital | Temporal | Anaesthesia | null | 442e54fa-95dd-4f59-a1d1-0a1af73e9b0f | single |
Concentration of Local anesthetic agent used for Bier's block is | 0.5% (Bier's block: Intravenous regional anesthesia) | 1 | 0.50% | 1-2% | 4% | 5% | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | df073c04-a7d7-46e5-ab99-c7259d8b2fc8 | single |
Maximum uterine relaxation | C i.e. Halothane | 3 | Ether | N20 | Halothane | Chloroform | Anaesthesia | null | 783ada23-5b81-4f82-9e6e-48ab2ca57134 | single |
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 | 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 | 1 | Stellate ganglion block | Brachial Block | Radial Nerve block | Celiac plexus block | Anaesthesia | null | 58aefee3-847d-48da-8918-4ffbf02434c2 | single |
Post operative shivering is treated with | 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 | 4 | Diazepam | Antihistaminics | Anticholinergics | Pethidine | Anaesthesia | JIPMER 2018 | 9fd563f0-3024-4213-8eea-e21d48d9626f | single |
The most significant change in maternal lung volume that occurs in the third trimester of pregnancy includes. | With enlargement of uterus, diaphragm is forced cephalad that decreases FRC. | 3 | Decrease in vital capacity | Increase in residual volume | Decrease in functional residual capacity | Decrease in closing capacity | Anaesthesia | null | 41c64644-135d-40bf-ba58-d477404a69bf | single |
Safety pin index for oxygen cylinder is | null | 3 | 3,5 | 1,5 | 2,5 | 1,4 | Anaesthesia | null | f24222ca-02ce-49c6-acfd-fba96e146677 | single |
Local anaesthetic of choice for IVRA | Lignocaine is preferred for IVRA. | 2 | Bupivacaine | Lignocaine | Tetracaine | Procaine | Anaesthesia | null | 259b06ec-3713-4e4e-8542-7f6682a5e2c6 | single |
Armoured enforcement of ET tube is used in | 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. | 1 | Neurosurgery | Cardiac surgery | Liver surgery | Intestinal Surgery | Anaesthesia | Anaesthetic equipments | 8918b994-2cbc-4534-855f-938abdc53bf5 | single |
A patient after undergoing thoracotomy complains of severe pain. He can be managed by | 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" | 2 | Intercostal cryoanalgesia | I.V fentanyl | Oral morphine | Oral brufen | Anaesthesia | null | 589afc2d-d307-4e86-b7ee-dcbadd0d3666 | single |
Inducing agent of choice in DIC | 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 | 2 | Thiopentone | Ketamine | Methohexitone | Propofol | Anaesthesia | General anaesthesia | a570cb73-175d-4d3f-90b6-3e41be69444c | single |
Eutectic mixture of local anaesthetic (EMLA) cream | EMLA is eutectic mixture of local anesthetics (2.5% lidocaine and 2.5% prilocaine) | 2 | Bupivacaine 2.0% +Prilocaine 2.5% | Lidocaine 2.5% + Priocaine 2.5% | Lidocaine 2.5% + Prilocaine 5% | Bupivacaine 0.5% + Lidocaine 2.5% | Anaesthesia | Regional anaesthesia | 516e4cb5-71df-4342-80b1-339e9c79f0f1 | single |
Most impoant factor determining the affect of anaesthetic agent on fetus | 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) | 1 | Duration of pregnancy | MAC | Protein binding | Route of anaesthetic | Anaesthesia | All India exam | 9e07937d-55ae-446d-90b9-9105b4c8d190 | single |
Drug of choice or differential blockade is | Ropivacaine is pure S- isomer of bupivacaine,so less cardiotoxic than bupivacaine. It is drug of choice for differential block. | 2 | Lignocaine | Ropivacaine | Bupivacaine | Dibucaine | Anaesthesia | null | 6d04ecaa-ca67-4126-8ad9-51ecb97b68f8 | single |
The substance is soda lime that acts as catalyst is | Potassium hydroxide acts as catalyst for generation of sodium carbonate. | 2 | Sodium hydroxide | Potassium hydroxide | Calcium hydroxide | Silica | Anaesthesia | null | ae3d7422-0a40-4412-8c37-7036b7df7aa6 | single |