7. Anaesthetic agent contraindicated in hypertensives is?
B. Thiopentone sodium
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:
- 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:
- 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 ?
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:
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:
B. Thiopentone sodium
Correct answer : A. Sevoflurane
Some anaesthetic agents which increase Intracranial pressure
- Nitrous oxide
18. Which one of the following is the fastest acting inhalational agent?
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
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?
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?
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?
Correct answer : D. Thiopentone
Anesthetic agents implicated in malignant hyperthermia:
- Succinyl choline
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?
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:
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?
Correct answer : A. Procaine
Other ester linked local anaesthetics:
27. Which one of the following antibacterials should not be used with d-tubocurarine?
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?
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?
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
Correct answer : D. Pneumothorax
Pneumothorax should be treated with intercostal drainage / needle thoracocentesis.
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