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Diffusion hypoxia is a type of ...............hypoxia | 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. | 4 | Anemic | Histotoxic | Stagnant | Hypoxic | Anaesthesia | Inhalational Anesthetic Agents | f2fd4448-3405-41e6-bc72-3ebaf63db8b1 | single |
Muscle relaxant of choice in patient suffering from chronic liver disease | Atracurium is preferred in CLD patients since it is metabolised by Hoffmann elimination. | 2 | Pancuronium | Atracurium | Mivacurium | Vecuronium | Anaesthesia | null | cda02f98-ba04-488a-b315-7ff0faa4938c | single |
The cardiovascular side effect of Dexmedetomidine is following | 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 | 1 | Hypotension and Bradycardia | Hypeension and Tachycardia | Hypotension and Tachycardia | Hypeension and Bradycardia | Anaesthesia | Intravenous Anesthetic Agents | f7e3daf1-ab6d-4e72-a2a7-26d182d3386e | single |
Merits of nasotracheal intubation is | 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. | 1 | Good oral hygiene | Less infection | Less miscosal damage and bleeding | More movement or displacement of endotracheal t ube | Anaesthesia | null | 0b14a1a1-0b3a-4326-b3d0-64df105b9b1d | single |
Most cardiotoxic local anaesthetic is | 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) | 1 | Bupivacaine | Procaine | Prilocaine | Dibucaine | Anaesthesia | All India exam | 45f7b6f1-f97c-4588-83c5-697b8887d662 | single |
Pin index system for oxygen | 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 | 2 | 1,5 | 2,5 | 4,5 | 3,5 | Anaesthesia | Local and Regional Anesthesia | 027707f3-c54a-47d9-ac0f-8faea34dfb9f | single |
The site of action of local anaesthetic in epidural anesthesia is | 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. | 1 | Spinal nerve root | Spinal cord | Epidural neural tissue | Anterior root of spinal nerve | Anaesthesia | Central Neuraxial Blockade | 8a78e1a6-f97e-4726-9caa-ec1b9a063438 | single |
The treatment of choice in diagnosed ventricular fibrillation is | 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. | 3 | Amiodarone | External cardiac massage | DC shock | Adrenaline | Anaesthesia | Cardiopulmonary Cerebral Resuscitation | 0ca66de7-02f3-4b3d-b7b3-dc517d51e463 | single |
Index of potency of general anesthesia | 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) | 1 | Minimum alveolar concentration | Diffusion coefficient | Dead space concentration | Alveolar blood concentration | Anaesthesia | All India exam | e336226b-1657-490c-b691-354961a21794 | single |
A intravenous anesthetic agent that is associated with hemodynamic stability, maintenence of CPP with post operative nausea, vomiting and myoclonus | B i.e. Etomidate | 2 | Ketamine | Etomidate | Propofol | Opioids. | Anaesthesia | null | d671fa37-a30c-40a8-990c-1ce0b42a4c83 | single |
A child with bladder exstrophy and chronic renal failure. The Anesthesia of choice for the child while operating exstrophy is aEUR' | Atracurium "Atracurium and cisatracurium are muscle relaxants of choice for both liver and kidney failure". | 1 | Atracurium | Mivacurium | Pancuronium | Rocuronium | Anaesthesia | null | 1980e7d1-d5ab-4782-8ca8-6690452220e3 | single |
Sodium Thiopentone is ultra sho acting d/t | 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 | 3 | Rapid absorption | Rapid metabolism | Rapid redistribution | Rapid excretion | Anaesthesia | General anaesthesia | 7fca4e73-c0d6-4059-ae8c-80dd95c9098a | single |
Complete neuromuscular blocking agent with shortest duration of action | 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 | 3 | Rocuronium | Pipecuronium | Mivacurium | Pancuronium | Anaesthesia | Muscle Relaxant | 912ee9b6-932c-4364-8168-eb1b8aab45ff | single |
Rebreathing systems are WE | 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. | 4 | To & fro system | Circle system | Water's system | Mapleson F | Anaesthesia | null | 639d007f-cf48-4ab5-b868-bf49a3d94637 | single |
Chest compression to ventilation ratio in resuscitation of children with 2 rescuers is | In CPR of children compression to ventilation ratio if single rescuer is 30:2 and if double rescuer is 15:2. | 3 | 30:02:00 | 3:01 | 15:02 | 30:02:00 | Anaesthesia | null | 09c511d0-c5e3-4832-88d1-a8e4a3ae8617 | single |
Maximum does of lidocaine as local anesthesia is | D i.e. 500 mg | 4 | 100 mg | 200 mg | 300 mg | 500 mg | Anaesthesia | null | a8349217-41c1-4510-837a-87cec0d8d380 | single |
Thiopentone is absolutely contraindicated in | (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 | 1 | Porphyria | Moribund patients | Increased intracranial pressure | Meningitis | Pharmacology | Anaesthesia | e1a6bd20-0da6-47b4-9f16-bca48ed0f609 | single |
MAC stands for | 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 | 1 | Minimum alveolar concentration | Minimal analgesic concentration | Minimal anaesthetic concentration | Maximum alveolar concentration | Anaesthesia | General anaesthesia | f6ef2d56-11af-45d1-8954-e505a3dd9800 | single |
The potency of an inhalational anaesthetic agent depends upon | 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 | 2 | blood gas paition coefficient | Oil-gas paition coefficient | Gas pressure | Blood pressure | Anaesthesia | Fundamental concepts | f94d737e-3ed1-483f-8c30-fcb1ae47438e | single |
Drug used to prolong the action of LA in Hypeensive pts | 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) | 2 | Clonidine | Felypressin | Dexmeditomidate | Noradrenalin | Anaesthesia | All India exam | 01a61937-4e59-4020-8794-3004c5e23e48 | single |
Capnography is useful for | 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. | 3 | Determining Vaporizer malfunction or contamination | Determining circuit hypoxia | Determining the appropriate placement of endotracheal | Detecting concentration of oxygen in the anesthetic circuit. | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 216b1c0a-18f1-4126-b8e0-d53ac9037bd5 | single |
Intravenous anesthetic agent of choice in this below given procedure | 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. | 4 | Thiopentone | Propofol | Etomidate | Methohexitone | Anaesthesia | Intravenous Anesthetic Agents | 8cf9dee3-7bc5-4dcf-bd44-b6ea8188fb4b | single |
The following combination of agents are the most preferred for sho day care surgeries | A i.e. Propofol, Fentanyl, isoflurane | 1 | Propofol, fentanyl, isoflurane | Thiopentone sodium, morphine, halothane | Ketamine, pethidine, halothane | Propofol, morphine, halothane | Anaesthesia | null | 386a1f9c-0c72-41dd-8c15-b105e6967cac | single |
For high pressure storage of compressed gases cylinders are made up of. | A i.e. Molybdenum Steel | 1 | Molybdenum steel | Iron + Mo | Steel + Cu | Cast iron | Anaesthesia | null | 7421914f-f23e-409b-a816-63495a6aa44b | single |
Most potent cerebral vasodilator is | C i.e. Hyper carbia | 3 | B blocker | Nitro-glycerine | Hyper carbia | Nitroprusside | Anaesthesia | null | 60061103-7cbe-4c3b-aaa1-179e688e2c64 | single |
Inducing agent with maximum incidence of vomiting | 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 | 2 | Ketamine | Etomidate | Thiopentone | Propofol | Anaesthesia | General anaesthesia | 4df8da90-d1ae-4f0d-a5ae-db86ccc18e90 | single |
The Heidbrink meter in Boyle&;s machine | 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. | 2 | Reduces pressure of gases | Indicates flow of gases | Indicates humidity of gases | It a fixed orifice meter | Anaesthesia | Anaesthetic equipments | 6e194de7-1ea5-4f92-a061-14e59b30c70c | single |
Atracurium is metabolized and excreted by | 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. | 4 | Kidney | Liver | Brain | Hoffman's elimination | Anaesthesia | Muscle Relaxant | 17ff3db2-cb07-4f02-88bf-54bdc1c2a12b | single |
Maximum dose of lignocaine with adrenaline (in mg/kg) | 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) | 3 | 4 | 5 | 7 | 10 | Anaesthesia | All India exam | 77d7cdd4-7f5b-468d-93b6-8b8dcbe866ee | single |
Maximum interval between bare metal cardiac stent and elective surgery is | 1 month is ideal interval between bare metal cardiac stent and any elective surgery. | 3 | 1 year | 2 month | 1 month | 2 year | Anaesthesia | null | c6f05ec6-13d1-40a4-a4f5-781cd36936ff | single |
The definite contraindication of Thiopentone | (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. | 4 | Diabetic patient | ECT | Sarcoidosis | Acute intermittant porphyria | Anaesthesia | Miscellaneous | 75b547e8-2aa3-4f9f-a5db-44ea259a5fa6 | single |
Bronchospasm is not caused by | D i.e. Halothane | 4 | Regurgitation | Aspiration | Intubation | Halothane | Anaesthesia | null | 9ab192eb-ae4e-4eb2-9e64-362b704d2588 | single |
Sodalime circuit is not used with | D i.e. Trilene | 4 | Enflurane | Isoflurane | Methoxyflurane | Trilene | Anaesthesia | null | f3d414a5-66da-43aa-a1f8-9bdc33f4492c | single |
Minimum Alveolar concentration of halothane is | 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. | 1 | 0.74% | 1-2% | 6% | 2% | Anaesthesia | General anaesthesia | d8c15424-0ed5-4757-81be-2758b8475def | single |
In epidural anaesthesia drug is injected | 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) | 1 | Outside the dura | Inside the duramater | Inside arachnoidamater | inside piamater | Anaesthesia | All India exam | 92f9db21-4c0c-4f3f-b46e-c4de7bd89b29 | single |
Minimum Alveolar concentration of halothane is | 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
induction and recovery time. It is not a good analgesic and its muscle relaxation effect is moderate. | 1 | 0.74% | 1-2% | 6% | 2% | Anaesthesia | null | b54da3ac-d32d-43c3-8221-6e3b8cb5142d | single |
In venturi mask maximum 02 concentration attained is | In Venturi mask normal O2 concentration is between 24 and 60% . In non breathing masks oxygen saturation is between 80 and 90%. | 3 | 90% | 100% | 60% | 80% | Anaesthesia | Anaesthetic equipments | 9708c475-537c-4ce0-aba8-90dc2f02e2be | single |
Adiministration of Scoline (Sch) produces dangerous hyperkalamia in | D i.e. Paraplegia | 4 | Acute Renal Failure (A.R.F.) | Raised ICT | Fracture femur | Paraplegia | Anaesthesia | null | ccd6b291-4cea-4c89-88ed-4aae95f732a3 | single |
Emergence delirium is associated with | 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 | 2 | Pentothal sodium | Ketamine | Droperidol | Halothane | Anaesthesia | General anaesthesia | 76d6e8ef-8da2-4b82-b3ee-82b15b44159e | single |
Minimum alveolar concentration (MAC) is a measure of | 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) | 1 | Potency of anaesthetic agent | Speed of induction and recovery | Lipid solubility of agent | Toxicity of agent | Anaesthesia | All India exam | 795e8eba-887f-4da8-af8d-f908df4aa954 | single |
Most potent antiemetic agent used in preoperative period | the most potent anti-emetic used is hyoscine . the most commonly used anti-emetics are metochlopramide,ondensetron. | 2 | Glycopyrolate | Hyoscine | Atropine | Metochlorpromide | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | cf8e5fea-3f10-4bdb-a1d2-d8d7257b2e1d | single |
The most important determinant of carbon dioxide elimination is | Fresh gas flow is important determinant of carbon dioxide elimination in breathing circuits. | 2 | Minute ventilation | Fresh gas flow | Expiratory reserve volume | Vital capacity | Anaesthesia | null | 595e5db9-609d-426a-a77d-18463db79c68 | single |
In a 2 months old infant undergoing surgery for biliary atresia, you would avoid one of the following anaesthetic | 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) | 2 | Thiopentone | Halothane | Propofol. | Sevoflurane | Anaesthesia | null | 89f1fc8f-a728-4ccf-aa39-31bee8fa38aa | single |
In volume controlled ventilation, the inspiratory flow rate is | In most patients, inspiratory flow rates is 60 L/min are adequate. Higher flow rates are required in patients with higher ventilator demands. | 4 | 140-160 L/min | 110-130 L/min | 60-100 L/min | 30-50 L/min | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 339ac4b7-9136-4688-8efd-a92a5e628cae | single |
Shoest acting NDMR | 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 | 2 | Succinyl choline | Rapac uroni um | Atracurium | Pancuronium | Anaesthesia | null | 9e8b40da-669b-47ff-97f9-268e1f3a4999 | single |
Following group of drugs is the first line in the management of schizophrenia | Most antipsychotics are dopamine antagonists, and as such they have found use in treatingschizophrenia, bipolar disorder, and stimulant psychosis. | 4 | Opioids | Antiepileptics | Serotonergic drugs | Dopamine antagonist | Anaesthesia | Miscellaneous | 4c7f4c37-7b2e-40e4-aa5f-92f172245234 | single |
Most potent bronchodilator among inhalational anesthetic agents is | 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) | 3 | Isoflurane | Sevoflurane | Halothane | Desflurane | Anaesthesia | All India exam | 48c5a2e3-2e0c-4a3f-a28f-b90edd413c82 | single |
Anesthetic agent (s) safe to use in ICP | 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. | 2 | Halothane | Thiopentone | Ketamine | Ether | Anaesthesia | null | 862ee773-a036-49ad-a84d-1144e7eebf25 | single |
Concentration of adrenaline used with local anaesthetic | Concentration of adrenaline used for local anaesthetic is 1 in 2 lakhs, (that of phenylephrine is 1 in 20,000). | 4 | 1:1,000 | 1:10,000 | 1:1,00000 | 1:2,00000 | Anaesthesia | All India exam | 084749cf-de2e-44b4-b849-e412e8f5cef9 | single |
Anaesthetic of choice for day care surgery is | “Propofol is parcularly suitable for day care surgery’ because residual impairment is less marked and shorter lasng Propofol
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.
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.
It does not possess anconvulsive acon (unlike thiopentone),
It causes fall in BP and bradycardia, o Like thiopental it does not possess muscle relaxant acon.
Propofol possess significant anemec and anpruric acon. — Miller 6 th /e - 324
Propofol decreases polymorphonuclear leukocyte chemotoxis but not aherence, phagocytosis and killing (Thiopentone blocks all these) increased life threatning infecons.
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.
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,
Propofol infusion syndrome A lethal syndrome, associated with infusion of propofol for 48 hours or longer.
Occurs 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 -
cardiomyopathy with acute cardiac failure, metabolic acidosis, skeletal myopathy, hyperkalemia, hepatomegaly and lipemia | 3 | Thiopentone | Nitrous oxide | Propofol | Halothane | Anaesthesia | null | 1c7656bb-4e9e-4072-9dc5-43cd15e7eea5 | single |
Fluoride content is least in | (Refer: Morgan and Mikhail's Clinical Anaesthesiology, 5th edition, pg no.170-171) | 4 | Enflurane | Isoflurane | Sevoflurane | Desflurane | Anaesthesia | All India exam | e5bb2ea7-947c-4378-8f75-bfd92cbfd523 | single |
Fasciculation are caused by | 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. | 1 | Suxamethonium | Pancuronium | d-TC | Vecuronium | Anaesthesia | Muscle relaxants | 64900aa6-187d-416d-b9a3-72130b15da19 | single |
Induction agent that may cause adrenal coex suppression is | 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 | 2 | Ketamine | Etomidate | Propofol | Thiopentone | Anaesthesia | General anaesthesia | 980aa12c-a592-4e38-924d-b84839c4943d | single |
Reynolds number is related to | 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) | 1 | Laminar flow | Ventimask | Dissolved oxygen in blood | Intraalveolar tension | Anaesthesia | Airway | 44f342ce-085b-4c37-ad81-8121d3d79cc8 | single |
Most potent bronchodilator among inhalational anesthetic agent is | 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 | 2 | Isoflurane | Halothane | Sevoflurane | Desflurane | Anaesthesia | General anaesthesia | 88eb84c9-98ad-4578-8d50-eb392a00d0d7 | single |
In infant (full term) diameter (mm) length (cm) of ETT used are | 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 | 3 | 3.5, 16 | 7,12 | 3.5, 12 | 7,10 | Anaesthesia | null | 21e15a25-1253-4f54-bdb4-ce630278b014 | single |
Upper Lid Retractors include | 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. | 4 | Muller muscle and superior rectus | Levator palpabrae superioris and superior oblique | Superior oblique and superior rectus | Levator palpabrae superioris & muller muscle | Anaesthesia | null | 317462f8-9a21-4882-bd73-df080b0c178b | single |
The triad of general anaesthesia includes | 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 | 1 | Unconsciousness, analgesia and muscle relaxation | Anxiolysis, analgesia and unconsciousness | Muscle relaxation, sedation and analgesia | Dissociation, analgesia and muscle relaxation | Anaesthesia | General anaesthesia | f57d4468-4022-4e61-acc1-675e53df01f2 | single |
In renal failure, IV anesthetic used | 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 | 4 | Atracurium | Vivacurium | Pancuronium | Cistracurium | Anaesthesia | Non-depolarising Neuromuscular Blocking Agents | 732a704b-ced2-4b08-8f69-8f0e7f1dcb13 | single |
Amount of K+ in ringer lactate is | Ringer lactate solution include a concentration of 4mEq/L. | 2 | 2 | 4 | 5 | 6 | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | 9a6d42bd-106e-44ba-9ee5-2df00638194c | single |
Drug used in treatment of malignant hypehermia is | 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 | 1 | Dantrolene | Diazepam | Paracetamol | Phenobarbitone | Anaesthesia | Complications of anaesthesia | 68fad2d9-c7c4-44f2-9005-0c80339c1694 | single |
High air way resistance is seen in | D i.e. Main bronchus Medium size airways like main bronchus has maximum resistanceQ | 4 | Respiratory bronchiole | Terminal bronchiole | Intermediate bronchiole | Main bronchus | Anaesthesia | null | a1bb2e9d-06e4-444a-bac0-253c3f2ea052 | single |
This pattern of capnograph is seen in | The shark finn pattern capnograph is seen in endotracheal tube obstruction | 2 | Spontaneous breathing | Endotracheal tube obstruction | Malignant hyperthermia | Unidirectional valve malfunction | Anaesthesia | null | 8e51a5b2-8426-4efd-b81b-02e6631a29f9 | single |
Dextrose is added to the spinal anesthetic drugs to | 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. | 3 | Increase duration of action | Reduce plasma levels of local anesthetic to prevent toxicity | Increase specific gravity | Hasten onset of action | Anaesthesia | Regional Anesthesia | 8ec29b0d-a3cf-4073-b8e9-b04ad686a44b | single |
Repeated use of halothane causes | A i.e. Hepatitis | 1 | Hepatitis | Pancreatitis | Encephalitis | Meningitis | Anaesthesia | null | 3dd7650c-4cd2-4db5-8b13-95dce45ac640 | single |
With a fixed performance mask such as a ventimask | Dead space in ventimask is low and rebreathing is not possible because of high flow of gas. | 3 | Rebreathing is possible | Plugging side holes increases the oxygen concentration | Total gas flow is higher than the patient’s peak inspiratory flow | There is high equipment dead space | Anaesthesia | null | 66c14f54-5f89-4097-80d4-35bdbaa42c55 | single |
Stages of anesthesia were established by | A i.e. Ether | 1 | Ether | N20 | Halothane | Chloroform | Anaesthesia | null | 937ce7a7-b9b1-4dce-970f-e062331b5b4d | single |
This is used in treatment of | This is autologous epidural blood patch, used in treatment of post dural puncture headache. | 2 | Migraine | Post dural puncture headache | Spondylolisthesis | Disc prolapse | Anaesthesia | null | 6f67ad41-3b24-47f4-8fab-cfd887fae301 | single |
For high pressure Storage of compressed gases cylinders are made up of | To withstand high pressure cylinders are made up of molybdenum and steel. | 1 | Molybdenum steel | Iron + Mo | Steel + Cu | Cast iron | Anaesthesia | Anaesthetic equipments | f7636d6b-6358-4439-aaaf-f575962ddbcb | single |
Minimum Alveolar Concentration of sevoflurane in % is | 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 | 4 | 0.75 | 0.42 | 1.15 | 2 | Anaesthesia | General anaesthesia | 4863193b-edb1-4227-8fc3-79a704f318a0 | single |
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 | (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. | 1 | Diazepam | Chlorpromazine | Scoline | Any | Anaesthesia | Miscellaneous | aa51643c-0006-4001-9dcf-6c2f9ab56f85 | single |
The most suitable agent for IV induction and maintenance in a day care surgery | 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. | 3 | Etomidate | Ketamine | Propofol | Thiopentone | Anaesthesia | General anaesthesia | 0fb56149-fcb7-485c-aad4-4d2d8eed1647 | single |
Success of Block 1 is assessed by | Westphal's sign (Block 1 is Epidural block) | 1 | Westphal's sign | Gutierrez sign | Loss of resistance | Crawford sign | Anaesthesia | Spinal, Epidural, & Caudal Blocks | c9fd38f3-12da-4492-a4cf-19a26d79484f | single |
Inducing agent contraindicated in asthma is | 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 | 4 | Ketamine | Thiopentone | Propofol | Althesin | Anaesthesia | null | 5d709eff-852f-4f8c-8f78-4b2c163d7496 | single |
Colour code of oxygen cylinder is | Color coding of cylinders is introduced to prevent accidental misplacement of cylinders. | 1 | Black cylinder with white shoulders | Black cylinder with grey shoulders | White cylinder with black shoulders | Grey cylinder with white shoulders | Anaesthesia | Fundamental concepts | c32b231a-bed5-4aa9-8c74-ae4381431e6b | single |
As compared to a 10 year old child, a 1 year old child will have higher | Metabolic rate and oxygen consumption are higher in infants than in older children. Rest of the parameters in question remain the same. | 1 | Oxygen consumption | Functional residual capacity | Tidal volume | Vital capacity | Anaesthesia | null | 57caa800-66a3-4cd4-8e25-b472d324ae79 | single |
Non depolarizing neuromuscular blocker is | Non depolarising neuromuscular blocker is competitive antagonist at nicotinic cholinergic receptor. It doesn’t cause fasciculations . it is reversed by neostigmine. | 2 | Non competitive neuromuscular blocker | Reversed by neostigmine | Persistent stimulator of nicotinic cholinergic receptors | Induces fasciculations | Anaesthesia | null | 87212064-fe05-47a9-a8d9-4a0b6953e830 | single |
VAS is most widely used to measure | 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." | 3 | Sleep | Sedation | Pain intensity | Depth of anaesthesia | Anaesthesia | Preoperative assessment and monitoring in anaesthesia | bfee869c-a7ba-4707-a8e0-bbfe3561d187 | single |
Gas used in rapid airbag inflation | 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) | 1 | Sodium azide | Nitrocellulose | Mercuric nitrate | Potassium nitrate | Anaesthesia | All India exam | 409447c6-ce02-4f0d-a49c-3c22a7d940f9 | single |
Anaphylaxis is caused by | 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) | 2 | N2O | Althesin | Halothane | Propofol | Anaesthesia | All India exam | 60d61a52-1467-4a16-a371-cacb91ea4276 | single |
Most common site of Curling's ulcer | 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. | 3 | Ileum | Stomach | Duodenum | Esophagus | Anaesthesia | null | d6ff563c-5f17-4d39-9def-b1f672e809f6 | single |
Bradycardia during anaesthesia seen ina) Pancuronium b) Vecuronium c) Atracuriumd) Propofole) Succinylcholine | Bradycardia is caused by → Succinylcholine, propofol, opioids anaesthetics (Morphine, fentanyl and its cogneres).
Tachycardia is caused by → Gallamine, Pancuronium, Rocuronium, Ketamine, Thiopentone, Methohexitone. | 4 | ab | bc | cd | de | Anaesthesia | null | cd2ec856-9903-4a91-9116-3572caba7019 | single |
Second gas effect is | 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 | 3 | Displacement of N20 by Oxygen | Displacement of oxygen by N20 | Facilitation of inhalation of Halothane by N20 | Removal of oxygen by N20 from alveoli during recovery from general anaesthesia | Anaesthesia | General anaesthesia | 536e0ba3-fc58-4a2b-965f-b12c1c1171b2 | single |
Intravenous regional anaesthesia is contraindicated in | As tourniquet application can precipitate sickling and hypoxia, IVRA is contraindicated in sickle cell anemia. | 1 | Sickle cell disease | Thalassemia | Hereditary spherocytosis | G6PD deficiency | Anaesthesia | null | d86a75a0-2453-4cf4-a309-330d5a3bbdc3 | single |
The opioid contraindicated in patients on MAO inhibitor is | 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. | 3 | codeine | Morphine | Fentanyl | Buprenorphine | Anaesthesia | Intravenous Anesthetic Agents | b01fa96b-7976-4a71-a709-10429d551a02 | single |
Inhalation agent incompatable with sodaline | 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. | 2 | Isoflurane | Trichloro Ethylene | Methoxy flurane | Enflurane | Anaesthesia | null | 4e1a2c22-52d9-4128-9627-4289f407100e | single |
Malampatti grading is for | 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 | 4 | Mobility of cervical spine | Mobility of atlanto axial joint | Assessment of free rotation of neck before intubation | Inspection of oral cavity before intubation | Anaesthesia | null | 6fbf3579-c236-44bf-82a2-8031caced3bd | single |
O2 delivery is regulated by WE | 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. | 4 | O2 tent | Venti mask | Poly mask | Noval Catheter | Anaesthesia | null | f403dd2d-9cc8-4011-8449-2c57eb9b91d5 | single |
Hepatotoxic agent is | 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 | 4 | Ketamine | Ether | N2O | Halothane | Anaesthesia | General anaesthesia | 703f2b92-6af3-4913-9b47-16514c0fd94a | single |
Only anticholinergic commonly used to reverse the action of neuromuscular blocker | All the given drugs are used for neuromuscular blockade reversal, However neostigmine is the most commonly used one. | 4 | Edrophonium | Physostigmine | Pyridostigmine | Neostigmine | Anaesthesia | null | 336ac5d6-6edb-4854-bb17-f48af14099d6 | single |
Local anaesthetics act on | Local anaesthetics act on open state > inactivated state > resting state, votage gated sodium channels. | 1 | Inactivated voltage gated sodium channels | Inactivated ligand gated potassium channels | Resting ligand gated potassium channels | Resting voltage gated sodium channels | Anaesthesia | null | 5cabd296-3cea-42f1-885f-b27a2df1307b | single |
Risk of adverse effects of SCOLINE is greater in | 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. | 1 | Spinal cord injury | Thoracic injury | Bone injury | Head injury | Anaesthesia | Complications Of Anaesthesia | 712757c5-380d-4260-8e66-53d7143af7e6 | single |
Percentage of thiopentone used for induction is | 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 | 3 | 0.50% | 1.50% | 2.50% | 4.50% | Anaesthesia | General anaesthesia | eb3ab30d-b3ec-4b1d-8edf-f4afb083479c | single |
Fastest route of absorption of local anaesthetic is | 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. | 1 | Intercostal | Epidural | Brachial | Caudal | Anaesthesia | All India exam | 53fea5dc-2dbd-4e2e-8b3f-f4bbea10293c | single |
Post Spinal Headache can last for | C i.e. 7-10 days | 3 | Upto 10 min | Upto 10 hours | 7 - 10 days | Upto 10 months | Anaesthesia | null | a117d7e8-6051-4b33-a0ab-ab8a8c36168a | single |
The cuff used in Endotracheal tube is following | 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) | 1 | Low pressure - high volume | High pressure - low volume | Variable pressure - low volume | Low pressure - low volume | Anaesthesia | Airway | fc8f2d7d-59bf-4895-a8c0-ee13964fef12 | single |
Mendelson's syndrome is | 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. | 4 | Air leak | Tracheal rupture during intubation | Oesophageal rupture | Aspiration of gastric content | Anaesthesia | null | fa4b5206-1b5e-4263-87b1-5d8c562d26eb | single |
Sellick's maneuver is used for | 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). | 2 | To prevent alveolar collapse | To prevent gastric aspiration | To facilitate Respiration | To reduce dead space | Anaesthesia | Miscellaneous General Anesthesia | 0dcf4c5d-206f-4e8a-b92a-94e322b6f7a7 | single |
Local anesthetic that can cause Methemoglobinemia | 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 | 2 | Ropivacaine | Prilocaine | Amethocaine | Bupivacaine | Anaesthesia | Local and Regional Anesthesia | 736c4393-2b23-4527-ba3f-3194526cefac | single |
Bradycardia is common after injection of | 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 | 2 | Midazolam | Succinylcholine | Dopamine | Isoprenaline | Anaesthesia | Muscle relaxants | b6c2b95a-aea7-4c81-bbfb-821302c85bf1 | single |