Practice Paper of NEET PG: Important Questions of ANAESTHESIA

The Important Questions of Anaesthesia for NEET PG exam:

1. Complications of stellate ganglion block are all except?
A. Mediastinitis
B. Cardiac arrest
C. Pneumothorax
D. Mueller’s syndrome

Correct answer : D. Mueller’s syndrome

  • Mueller’s syndrome is a sign of successful stellate ganglion block in which there is warmth of the face and injection of the tympanic membrane.
  • Other signs of successful stellate ganglion block include:
    • Horner’s syndrome
    • lacrimation
    • flushing of conjunctiva and sclera
    • increase in skin temperature
    • engorged veins of the arm
    • flushing of cheek, face, neck and arm
    • anhidrosis of the face and neck
    • stuffiness of the nostril
  • Complications of stellate ganglion block include:
    • perforation of oesophagus
    • pneumothorax
    • cardiac arrest
    • mediastinitis
    • intercostal neuralgia.

 

2. Anaesthetic implication in Gaisbock’s syndrome is?
A. Postoperative respiratory failure
B. Risk of deep vein thrombosis
C. Renal dysfunction
D. Risk of aspiration

Correct answer : B. Risk of deep vein thrombosis

  • Gaisbock’s syndrome is polycythemia due to reduction in plasma volume.
  • It is usually seen in smokersobese individuals and in patients with hypertension.
  • Anaesthetic implications include cardiovascular problems and risk of deep vein thrombosis.
  • May require venesection.

 

3. Guttmann’s sign is?
A. Flushing of the conjunctiva
B. Engorged veins of the arm
C. Stuffiness of the nostril
D. Warmth of the face

Correct answer: C. Stuffiness of the nostril

  • Guttmann’s sign is stuffiness of the nostril which is a sign of successful stellate ganglion block.
  • The other signs of successful stellate ganglion block include Horner’s syndrome, engorged veins of the arm, flushing of the conjunctiva and sclera, increase in skin temperature and anhydrosis of the face and neck.

 

4. Thiopental is contraindicated in all of the following except?
A. Porphyria
B. Status asthmaticus
C. Pericardial tamponade
D. Penetrating eye injury

Correct answer: D. Penetrating eye injury

  • Thiopental is contraindicated in porphyria, status asthmaticus, pericardial tamponade, and severe shock.
  • It causes centrally mediated respiratory depression.
  • It can cause laryngeal spasm and bronchoconstriction in asthmatics.
  • Thiopental causes depression of myocardial contractility.
  • Peripheral vascular resistance falls and it can lead to hypotension, which can be exaggerated if there is hypovolemia.

 

5. Which of the following anaesthetic agents can induce epilepsy?
A. Sevoflurane
B. Isoflurane
C. Desflurane
D. Methoxyflurane

Correct answer: A. Sevoflurane

Structure of sevoflurane

  • Enflurane and Sevoflurane can induce epilepsy.
  • The effect is much more pronounced with Enflurane.
  • Tip to remember: Enflurane = Epilepsy (both start with E).
  • Enflurane can also increase the intracranial pressure.
  • Isoflurane can cause coronary steal syndrome.
  • Methoxyflurane is nephrotoxic and can cause high output renal failure.

 

6. Which of the following is not a definitive airway?
A. Tracheostomy
B. Orotracheal tube
C. Nasotracheal tube
D. Laryngeal mask airway

Correct answer : D. Laryngeal mask airway

Double lumen endotracheal tube

DEFINITIVE AIRWAYS

  • Definitive airways prevents aspiration of gastric content, allows for control of ventilation and permits delivery of higher concentrations of oxygen.
  • They include endotracheal tubes (nasotracheal / orotracheal), tracheostomy and cricothyroidotomy.

NON DEFINITIVE AIRWAYS

  • They do not protect the patient from gastric aspiration.
  • The concentration of oxygen delivered to the patient is lower.
  • But they have the advantage of being easier to insert.
  • They can even facilitate insertion of definitive airways. (Certain laryngeal mask airways are designed to facilitate insertion of endotracheal tubes.)
  • e.g. Laryngeal mask airway, Oropharyngeal airway, Nasopharyngeal airway
 7. Anaesthetic agent contraindicated in hypertensives is?

A. Propofol
B. Thiopentone sodium
C. Diazepam
D. Ketamine

Correct answer : D. Ketamine

ANAESTHETIC AGENT CONTRAINDICATED IN HYPERTENSIVES

  • Ketamine increases heart rate, cardiac output and blood pressure
  • These effects are due to stimulation of the sympathetic nervous system and decrease in reuptake of noradrenaline
  • Hence it is contraindicated in:
    • Hypertensives
    • Ischemic  heart disease
    • Congestive cardiac failure
    • Arterial aneurysms
  • It is also contraindicated in patients with increased intracranial tension
  • It produces dissociative anaesthesia

 

8. Contraindications to vasoconstrictors in local anaesthesia?

A. Spinal anaesthesia
B. Epidural anaesthesia
C. Digital nerve block
D. Regional anaesthesia

Correct answer : C. Digital nerve block

CONTRAINDICATIONS TO VASOCONSTRICTORS IN LOCAL ANAESTHESIA

  • Vasoconstrictors like adrenaline are used with local anaesthetics for decreasing the systemic absorption and to increase the local anaesthetic concentration and duration of nerve block
  • But adrenaline should not be used with lignocaine when infiltrating areas of end arterial supply
  • These sites include:
    • Fingers
    • Toes
    • Pinna
    • Penis
    • Nose
  • The use of adrenaline is these areas can compromise the blood flow and result inischaemic injury

 

9. Which of the following is correct regarding colour coding of anaesthetic gases?

A. Oxygen – Black with grey shoulders
B. Nitrous oxide – Blue
C. Cyclopropane – Red
D. Helium – Orange

Correct answer : B. Nitrous oxide – Blue

COLOUR CODING OF ANAESTHETIC GASES

  • Oxygen – Black with white shoulders
  • Nitrous oxide – Blue
  • Cyclopropane – Orange
  • Carbon Dioxide – Grey
  • Nitrogen – Black
  • Helium – Brown
  • Air – Grey body with white & black quartered shoulder

 

10. Which anaesthetic agent is preferred in a patient taken for surgery with bilirubin of 8.6 mg/dl and serum creatinine of 2.1 mg/dl ?

A. Atracurium

B. Vecuronium

C. Pancuronium

D. Rocuronium

Correct answer : A. Atracurium

  • Atracurium is the preferred muscle relaxant in a patient with liver dysfunction / renal failure
  • It undergoes non specific ester hydrolysis and non enzymatic degradation ( Hoffman degradation )
  • It does not depend on the liver / kidney for its deactivation
  • Other muscle relaxants that can be given in liver / renal disease are Cisatracurium and Mivacurium

 

11. A Lower Segment Caesarean section (LSCS) can be carried out under all the following techniques of anaesthesia except:
A. General anaesthesia
B. Spinal anaesthesia
C. Caudal anaesthesia
D. Combined Spinal Epidural anaesthesia

Correct answer : C. Caudal anaesthesia

Caudal anaesthesia is used only for perineal surgery.

 

12. The following modes of ventilation may be used for weaning off patients from mechanical ventilation except:
A. Controlled Mechanical ventilation (CMV)
B. Synchronized intermittent mandatory ventilation (SIMV)
C. Pressure support ventilation (PSV)
D. Assist-control ventilation (ACV)

Correct answer : A. Controlled Mechanical ventilation (CMV)

In CMV, the ventillator delivers the tidal volume. The patient effort is not present. Hence it is not used for weaning off patients from ventillator.

 

13. The most appropriate circuit for ventilating spontaneously breathing infant during anaesthesia
A. Jackson Rees modification of Ayre T piece
B. Mapleson A or MgiIl’s circuit
C. Mapleson C or Waters’ to and fro canister
D. Bains circuit

Correct answer : A. Jackson Rees modification of Ayre T piece

 

14. The laryngeal mask airway used for securing the airway of a patient in all of the following conditions except:
A. In a difficult intubation
B. In cardiopulmonary resuscitation
C. In a child undergoing an elective/routine eye surgery
D. ln a patient with a large tumour in the oral cavity

Correct answer : D. ln a patient with a large tumour in the oral cavity

Use of laryngeal mask airway is contraindicated in case of oropharyngeal mass.

 

15. The following are used for treatment of postoperative nausea and vomiting following squint surgery in children except:
A. Ketamine
B. Ondansetron
C. Propofol
D. Dexamethasone

Correct answer : A. Ketamine

Ketamine can cause nausea and vomiting following administration.

 

16. All of the following are the disadvantages of anesthetic ether, except:
A. Induction is slow
B. Irritant nature of ether increases salivary and bronchial secretions
C. Cautery cannot be used
D. Affects blood pressure and is liable to produce arrhythmias

Correct answer : D. Affects blood pressure and is liable to produce arrhythmias

 

17. Which one of the following anaesthetic agents causes a rise in the Intracranial pressure:
A. Sevoflurane
B. Thiopentone sodium
C. Lignocaine
D. Propofol

Correct answer : A. Sevoflurane

Some anaesthetic agents which increase Intracranial pressure

  • Sevoflurane
  • Isoflurane
  • Halothane
  • Nitrous oxide
  • Ketamine

18. Which one of the following is the fastest acting inhalational agent?
A. Halothane
B. Isoflurane
C. Ether
D. Sevoflurane

Correct answer : D. Sevoflurane

Sevoflurane is the fastest acting among the options given. Desflurane is THE fastest acting inhalational agent.

 

19. Which of the following agents is not used to provide induced hypotension during surgery?
A. Sodium nitroprusside
B. Hydralazine
C. Mephentermine
D. Esmolol

Correct answer : C. Mephentermine

Mephentermine is acts as an agonist on alpha and beta adrenergic receptors. This causes increased in cardiac output and blood pressure. Hence it cannot be used to induce hypotension.

 

20. Which of the following agents is used for the treatment of postoperative shivering?
A. Thiopentone
B. Suxamethonium
C. Atropine
D. Pethidine

Correct answer : D. Pethidine

Management of postoperative shivering:

  • Drug of choice – Tramadol
  • Alternate drugs – pethidine, pentazocine
  • Supportive treatment – oxygen inhalation (there is increased oxygen consumption during shivering)

 

21. Which of the following intravenous induction agents is the most suitable for day care surgery?
A. Morphine
B. Ketamine
C. Propofol
D. Diazepam

Correct answer : C. Propofol

Propofol is the induction agent of choice in day care surgery

  • Early induction
  • Smooth recovery
  • Decreased incidence of post operative nausea and vomiting

 

22. Which of the following anesthetic agents does not trigger malignant hyperthermia?
A. Halothane
B. Isoflurane
C. Suxamethonium
D. Thiopentone

Correct answer : D. Thiopentone

Anesthetic agents implicated in malignant hyperthermia:

  • Succinyl choline
  • Halothane
  • Isoflurane

23. Which of the following statements is not true about etomidate?
A. It is an intravenous anesthetic
B. It precipitates coronary insufficiency
C. It inhibits cortisol synthesis
D. It causes pain at site of injection

Correct answer : B. It precipitates coronary insufficiency

Disadvantages of etomidate:

  • Decrease cortisol synthesis
  • Painful injection
  • Nausea and vomiting during recovery period
  • Produce restlessness and rigidity

 

24. Which one of the following agents sensitizes the myocardium to catecholamines?
A. Isoflurane
B. Ether
C. Halothane
D. Propofol

Correct answer : C. Halothane

Halothane sensitizes the myocardium to the action of catecholamines and can produce severe ventricular arrhythmia.

 

25. Which of the following inhalational agents is the induction agent of choice in children:
A. Methoxyflurane
B. Sevoflurane
C. Desflurane
D. Isoflurane

Correct answer : B. Sevoflurane

Sevoflurane has a fast, smooth and pleasant induction. Hence it is preferred in children. Sevoflurane reacts with soda lime to produce toxic products. Hence it cannot be used in a closed circuit.

 

26. Which one of the following local anesthetics belongs to the ester group?
A. Procaine
B. Bupivacaine
C. Lignocaine
D. Mepivacaine

Correct answer : A. Procaine

Other ester linked local anaesthetics:

  • Cocaine
  • Tetracaine
  • Benzocaine
  • Chlorprocaine

27. Which one of the following antibacterials should not be used with d-tubocurarine?
A. Norfloxacin
B. Streptomycin
C. Doxycycline
D. Cefotaxime

Correct answer : B. Streptomycin

Streptomycin can potentiate the action of d-tubocurarine and cause prolonged apnoea.

d-tubocurarine is a muscle relaxant. All aminoglycosides including streptomycin reduce ACh release from motor nerve endings. This is usually not manifested clinically. But the effect is more pronounced when given along with curare like muscle relaxants

 

28. Which of the following is the muscle relaxant of choice in renal failure?
A. Rapacurium
B. Pancuronium
C. Atracurium
D. Rocuronium

Correct answer : C. Atracurium

Atracurium undergoes Hoffman degradation. So elimination does not depend upon liver or kidney function

 

29. Which one of the following muscle relaxant has the maximum duration of action?
A. Atracurium
B. Vecuronium
C. Rocuronium
D. Doxacurium

Correct answer : D. Doxacurium

 

30. Which of the following is not an indication for endotracheal intubation?
A. Maintenance of a patent airway
B. To provide positive pressure ventilation
C. Pulmonary toilet
D. Pneumothorax

Correct answer : D. Pneumothorax

Pneumothorax should be treated with intercostal drainage / needle thoracocentesis.

 

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