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Practice Set of Anesthesia
1. Which muscle group is affected when there is active injury at S1 root level of spinal cord?
(1) Knee extensors
(2) Ankle dorsiflexors
(3) Long toe extensors
(4) Ankle plantar flexors
2. Which one is not a risk factor of Post-operative nausea & vomiting?
(1) Perioperative history of smoking
(2) First trimester pregnancy
(3) Volatile anaesthetic agent
(4) Strabismus surgery
3. Which parameter does not confirm the diagnosis of systemic inflammatory response syndrome?
(1) White blood cell count < 12,000/mm3 and > 4000/mm3
(2) Heart rate > 90 beats/min
(3) Temperature > 38 °C or < 36 °C
(4) Respiratory rate > 20 breaths/min or PaCO2 < 32 mm Hg
4. Which one is not a complication of total and peripheral parenteral nutrition?
(2) Hyperchloremic metabolic acidosis
(4) Decreased levels of liver enzyme
5. Which statement is not true for prevention from awareness?
(1) Consider administrating an amnestic premedication
(2) Prefer intravenous anaesthetic drug and minimise use of potent inhalation agent
(3) Avoid or minimize muscle relaxant
(4) Set an alarm for low anaesthetic gas concentration
6. What does polysomnography finding indicate for apnea longer than 10 seconds with a > 90% air flow reduction despite respiratory effort?
(2) Obstructive Apnea
(3) Central Apnea
7. Which is not a diagnostic parameter of metabolic syndrome ?
(1) Fasting plasma glucose level ≥ 110 mg/dl
(2) Abdominal obesity (waist girth > 40 inches in men and >35 inches in women)
(3) Serum triglyceride level ≥ 150 mg/dl
(4) Serum high-density lipoprotein cholesterol level > 40 mg/dl in men and >50 mg/dl in women
8. Which option is not the primary management of anaphylactic reactions during anaesthesia?
(1) Stop administration of all drugs, colloids, blood products.
(2) Intravenous hydrocortisone of methylprednisoione
(3) Maintain airway with 100% oxygen.
(4) Epinephrine administration titrate dose according to symptom severity and clinical response.
9. Choose the correct sequence for onset of drug-induced hyperthermia syndrome.
(1) Malignant hyperthermia > sympathomimetic syndrome > serotonin syndrome > neuroleptic malignant syndrome
(2) Sympathomimetic syndrome > malignant hyperthermia > serotonin syndrome >neuroleptic > malignant syndrome
(3) Sympathomimetic syndrome > neuroleptic malignant syndrome > serotonin syndrome > malignant hyperthermia
(4) Serotonin syndrome > malignant hyperthermia > sympathomimetic syndrome >neuroleptic malignant syndrome
10. A eutectic mixture of the local anesthetics cream is a mixture of which local anesthetics?
(1) Lidocaine and prilocaine
(2) Lidocaine and benzocaine
(3) Prilocaine and benzocaine
(4) Mepivacaine and lidocaine
11. How many hours should elapse before performing 4 single-shot spinal anesthetic in a patient who is receiving 1 mg/kg enoxaparin twice a day for the treatment of a deep vein thrombosis?
(1) 2 hours
(2) 6 hours
(3) 12 hours
(4) 24 hours
12. Which of the following is the earliest sign of lidocaine toxicity?
(3) Lightheadedness and dizziness
(4) Tonic-clonic seizures
13. In what sequence (First to Last) would the nerve fibers get blocked in a sciatic nerve block?
(1) Sympathetic, Proprioception, Pain, Motor
(2) Sympathetic, Pain, Proprioception, Motor
(3) Motor, Pain, Proprioception, Sympathetic
(4) Pain, Proprioception, Motor, Sympathetic
14. The correct arrangement of local anesthetics in order of their ability to produce cardiotoxicity from most to least is-
(1) Bupivacaine, lidocaine, ropivacaine
(2) Bupivacaine, ropivacaine, lidocaine
(3) Lidocaine, bupivacaine, ropivacaine
(4) Ropivacaine, bupivacaine, lidocaine
15. Select the imcorrect statement regarding spinal anatomy and spinal anesthesia.
(1) The addition of epinephrine to lidocaine will prolong spinal anesthesia
(2) The spinal cord extends to L3 in the infant and L1 in adults
(3) Taylor approach for spinal anesthesia uses a paramedian approach to the L5-S1 largest interspace of the vertebral column
(4) The Dural sac extends to the S4-S5 interspace
16. How much local anesthetic should be administered per spinal segment to patients between 20 and 40 years of age receiving a lumbar epidural anesthetic?
(1) 0.25 to 0.5 mL
(2) 0.5 to 1.0 mL
(3) 1 to 2mL
(4) 2 to 3 mL
17. Important landmarks for performing a sciatic nerve block (classic approach of Labat) include
(1) Iliac crest, sacral hiatus, greater trochanter
(2) Iliac crest, coccyx;, and greater trochanter
(3) Posterior superior iliac spine, coccyx, and greater trochanter
(4) Posterior superior iliac spine, greater trochanter and sacral hiatus
18. Which portions of the upper extremity is not innervated by the brachial plexus?
(1) Posterior medial portion of the
(3) Lateral portion of the forearm
(4) Anterolateral portion of the arm
19. Which of following factor does not change minimum alveolar concentration?
20. Drug induced allergic reactions occurring during the immediate perioperative period are most commonly attributed to administration of:
(1) Muscle relaxants
(4) Local Anesthetic
21. Which disease does resistance to the response of non-depolarizing blockage?
(1) Guillain-barre syndrome
(2) Myasthenia gravis
(3) Cerebral palsy
(4) Duchenne muscle dystrophy
22. A 24-year-old primiparous woman is undergoing an elective caesarean section. After pre hydration with 1500 mL of saline, a spinal anesthetic is performed and 5 minutes later the blood pressure is noted to be 80/40 and the heart rate is 100. The best treatment after assuring that adequate left uterine displacement is performed would be
(3) 1000 mL Ringer lactate
(4) 1000 mL Hetastarch
23. Apnea hypopnea index 30 indicates-
(1) Episodes of hypopnea are 30 times more common than apnea
(2) Episodes of apnea are 30 times more common than hypopnea
(3) Episodes of apnea and hypopnea occur at a rate of 30 per hour
(4) Apnea/hypopnea episodes in last 30 seconds
24. Stainless steel tube with a smooth plastic surface and matte finish tracheal tube designed for use with CO2 and KTP laser is
(1) Laser flex tracheal tube
(2) Laser shield 2 tracheal tube
(3) Laser resistant tracheal tube
(4) Sheridan laser tracheal tube
25. Which distribution of blood flow does not match with its pulmonary zone?
(1) Zone 1—pA> pa> pv
(2) Zone 2—pa>pA> pv
(3) Zone 3-—pa>pv=pA
(4) Zone 4—pa>pis>pv>pA
26. Which is not a common indication for lung transplantation?
(1) Chronic obstructive pulmonary disease
(2) cystic fibrosis
(3) pulmonary cyst
(4) primary pulmonary hypertension
27. Which statement is not true for berlin definition of acute respiratory distress syndrome?
(1) Lung injury of acute onset with week of an apparent clinical insult
(2) Progression of pulmonary symptoms, bilateral opacities on lung imaging not explainable by other lung pathology
(3) Respiratory failure not explained by heart failure or volume overload
(4) Arterial PaO2/FiO2 ratio is > 200 in severe ARDS
28. Compression only life support (COLS) is an effective management for cardiopulmonary arrest in adults. Which statement is false?
(1) Early recognition of cardiac arrest and activation
(2) 30 effective chest compression without any interruption
(3) Mouth to mouth breathing
(4) Early transfer to medical facility
29. Which is not a property of Fospropofol?
(1) Is prodrug of propofol indicated for monitored anesthesia care
(2) More painful at the site of intravenous administration
(3) Less potential for hyperlipidemia with long term administration.
(4) Administrated in conjunction with opioid such as fentanyl
30. Which statement is true for streamlined pharynx airway liner supra glottic device?
(1) Silicone reusable supra glottic device
(2) Uncuffed device that is anatomically pre shaped to line the pharynx
(3) Difficult to insert even in experienced hands
(4) Cannot be used in controlled ventilation
31. Which statement is incorrect for Dexmedetomidine?
(1) More selective alpha 2 receptor agonist.
(2) Can be used in ICU for more than 24 hour.
(3) Ability to produce cooperative sedation
(4) Does not interfere with the respiratory drive
32. Which statement is incorrect for Sugammadex?
(1) Modified gamma cyclodextrin selective relaxant binding agent
(2) Used to reverse amino steroid non depolarizing neuromuscular blocking agent
(3) Recommended for reversal of rocuronium and vecuronium induced neuro muscular blockage in adult patients
(4) Anticholinergic coadministration is required
33. As per WHO guidelines, which lung protective ventilation setting is not advisable for COVID patients with persistent severe hypoxemia?
(1) Tidal volume- 6 ml/kg
(2) Plateau airway pressure >40 cm H2O
(3) SpO2-88-93 or PaO2 55-80 mmHg
(4) Allow permissive hypercapnia and adequate PEEP
34. What type of data do you need for a chi-square test?
35. Bullard laryngoscopes would not be helpful in
(1) Limited mouth opening
(2) Treacher Collins syndrome
(3) Morbid obesity
(4) Anesthesia provider who has limited use of the left arm
36. The operator can visualize in a laryngoscopy (II) b view of a Modified Cormack-Lehane grading system
(1) More than 50% of the glottic opening
(2) Posterior part of the glottis and arytenoids, but not the glottis
(3) The epiglottis only, which can be lifted from the posterior pharyngeal wall
(4) The epiglottis only, which cannot be lifted from the posterior pharyngeal wall.
37. Which of the following has not been predictors of difficult face mask ventilation ?
(1) Lack of teeth
(2) Presence of beard
(3) History of snoring
(4) Male sex
38. American heart association 2010 guideline discouraged — Sellleck’s maneuver
(1) During routine intubation of cardiac arrest victim.
(2) Improve laryngoscope view by applying backward, upward and rightward pressure
(3) Occlude the esophagus against the cervical vertebra
(4) Reduce risk of regurgitation
39. Negative-pressure pulmonary edema can occur at or around the time of extubation. All of the following statements are correct except
(1) It may occur in spontaneously breathing patients.
(2) The inciting factor is inspiratory effort against closed glottis, generating a negative intrathoracic pressure in excess of 100 cm H2O.
(3) Rib retraction, laryngospasm and stridor may lead to this condition.
(4) First step of treatment is rapid administration of furosemide to facilitate fluid removal.
40. Retrograde intubation can be a useful technique for the difficult airway. It would be reasonable to consider it in all of the following situations except :
(2) Ankylosis of the mandible
(3) Pathology in the area of cricothyroid
(4) Maxillofacial surgery
41. According to the difficult airway algorithm which actions should be considered after initial intubation attempts are unsuccessful ?
(1) Proceed without intubating trachea
(2) Returning to spontaneous ventilation
(3) Supraglottic airway device insertion
(4) Awakening the patient
42. Which of the following is not a suggested use for the laryngeal mask airway ?
(1) Emergency ventilation when tracheal intubation has failed.
(2) Assisting a tracheal intubation
(3) Providing an airway with minimal changes in blood pressure and heart rate.
(4) To protect against aspiration.
43. Remifentanil is metabolized primarily by
(2) Non-specific esterase
44. Which option is not correct for opioid receptor ?
(1) Mu receptor — Supraspinal analgesia and respiratory depression
(2) Kappa receptor — Spinal analgesia and sedation
(3) Delta receptor — Behavioral and epileptogenic
(4) Sigma receptor — Analgesia and respiratory depression
45. Which of the following opioid receptor agonists has anticholinergic properties ?
46. Which of the following choices is not consistent with a limb affected by complex regional pain syndrome ?
(1) Cool, red, clammy skin and hair loss in the involved extremity.
(2) Associated with trauma burning and continuous pain exacerbated by normal movement.
(3) Pain that is greater than would be expected from the injury.
(4) Atrophy and osteoporosis of the involved extremity.
47. The main advantage of neurolytic nerve blockade with phenol versus alcohol is
(1) Denser blockade
(2) Blockade is permanent
(3) The effects of the block can be evaluated immediately.
(4) The block is less painful
48. Allodynia is defined as
(1) Spontaneous pain in an area of region that is anesthetic.
(2) Pain initiated or caused by a primary lesion or dysfunction in the nervous system.
(3) An unpleasant abnormal sensation, whether spontancous or evoked.
(4) Pain caused by a stimulus that does not normally provoke pain.
49. A celiac-plexus block would not effectively treat pain resulting from a malignancy involving which of the following organs ?
(2) Adrenal gland
50. Transcutaneous Electric Nerve Stimulation (TENS) is low-intensity electrical stimuli mechanism of the TENS unit in relieving pain is
(1) Direct electrical inhibition of type A-delta and C fibers
(2) Depletion of neutotransmitter in nociceptors
(3) Hyperpolarization of spinothalamic tract neurons
(4) Inhibitory effect at the neurons spinal cord level and augment descending inhibitory pathways
51. Which lamina of the spinal cord has predominant sympathetic function ?
(2) Lamina VII
(3) Lamina II
(4) Lamina V
52. Which neurotransmitter has an excitatory effect on nociception ?
53. Disorder having physical symptoms of a medical condition that cannot be explained, resulting in involuntary distress and physical impairment is termed as
(1) Conversion disorder
(2) Somatization disorder
(3) Substance related disorder
54. Which syndrome is not matched with following entrapment neuropathies ?
(1) Pronator syndrome — Radial nerve
(2) Tarsal tunnel syndrome — Posterior tibial nerve
(3) Cubital tunnel syndrome — Ulnar nerve
(4) Carpal tunnel syndrome — Median nerve
55. William T.G. Morten conducted the first publicized demonstration of general anaesthesia for surgical operation using ether in
(1) 16 October, 1847
(2) 16 October, 1846
(3) 16 October, 1848
(4) 16 October, 1845
56. Who gave the demonstration of cocaine in topical anaesthesia and is also credited with original application of modern local anaesthesia ?
(1) Albert Niemann
(2) Carl Koller
(3) Alfred Einhorn
(4) William Halsted
57. Following all are the effects of laryngeal nerve injury on the voice Except :
(1) Hoarseness and tiring of voice due to bilateral superior laryngeal nerve injury.
(2) Stridor of voice and distress due to acute bilateral recurrent laryngeal nerve injury.
(3) Aphonia of voice due to bilateral vagus nerve injury.
(4) Stridor of voice due to unilateral superior laryngeal nerve injury.
58. What is the pathophysiological cause of hypoxic hypoxia ?
(1) Alveolar hypoventilation
(2) Inability of cell to utilize oxygen
(3) Microvascular dysfunction
(4) Increased oxygen consumption
59. Which of the following treatment might not be useful in restoring a prolonged prothrombin time to the normal range ?
(1) Vitamin K
(2) Recombinant factor VIII
(3) Fresh frozen plasma