| Post Name | Assistant professor in Anaesthesiology (NCA- Muslim) - Medical Education |
|---|---|
| Question Paper Code | 032/2022/OL |
| Category Code | 234/2021 |
| Date of Test | 29 June 2022 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
According to the National Institute for Occupational Safety and Health (NIOSH), the operating room concentration of Nitrous oxide and volatile anaesthetics should be limited to ______ and _______ppm.
Answer
A. 25, 0.5
2
While setting up anaesthesia in an MRI suite, decision was made to double the extension tube length from the ventilator to the patient table. What is the effect of this act on dead space ventilation of the patient under anaesthesia?
Answer
D. No charge
3
A female baby is delivered with vacuum assistance. The amniotic fluid is meconium stained. Initial evaluation reveals a cyanotic limp newborn with a heart rate of 80 bpm, poor respiratory effort and grimacing in response to suctioning. The APGAR score for this baby is
Answer
C. 3
4
Successful transition from foetal to neonatal circulation depends primarily on these factors except
Answer
B. Decreased systemic vascular resistance
5
A 30 year old G3P2 parturient with suspected placental abruption is being taken up for emergency caesarean section. Suddenly she develops breathlessness and hypotension. All these findings suggest amniotic fluid embolism except
Answer
C. Increased maternal pH
6
A 35 year old G5P4 with irregular ante natal check up presents to labour room for safe confinement. As the labour progresses, her blood pressure was noted to be 166/110 mm Hg and HR sustained over 100 bpm. Which is the most appropriate option for acute treatment of preeclampsia in this patient?
Answer
C. Labetalol
7
Regarding placental exchange and foetal uptake of drugs, all statements are true except
Answer
B. Placental exchange of substances occurs principally via ion transport form maternal circulation to foetus
8
Alkalinization of local anasthetics by adding sodium bicarbonate can result in faster onset of action with all except
Answer
C. Levobupivacaine
9
Allodynia means
Answer
C. Exaggerated response to a non-noxious stimulus
10
All the following statements are true regarding post operative shivering except
Answer
B. Thiopentone is more commonly associated with shivering than propofol
11
A patient who was received asleep in PACU after general anaesthesia develops desaturation. You are called in to assess the patient. You feel it is laryngospasm. The most appropriate first step in the management would be
Answer
D. Jaw thrust manoeuvre with CPAP
12
A 44 year old female is posted for elective laparoscopic cholecystectomy. She gives history of Obstructive Sleep Apnoea. Post operative plan should include all except
Answer
C. Administration of benzodiazepines in place of Opioids to reduce anxiety
13
The most reliable indicator of pharyngeal muscle tone while assessing the reversal of neuro muscular blockade is
Answer
C. Ability to oppose incisor teeth strongly against a tongue depressor
14
Which of the following intra operative factors is predictive of post operative delirium?
Answer
B. Haematocrit < 30%
15
Considering the variable "Circulation" in Modified Aldrete Score, a score of 1 means
Answer
C. Systemic Blood pressure is 20-50% of pre anaesthetic level
16
Each Litre/min of oxygen flow through a nasal cannula increase the FiO2 by
Answer
B. 0.04
17
CO2 diffuses through the cell membrane more rapidly than oxygen because
Answer
A. CO2 is more soluble
18
Regarding temperature loss from the body
Answer
C. Both 1 and 2
19
Regarding surgical diathermy, all the following statements are true except
Answer
C. There is risk of burning the patient at the place since the same current passes through the plate, as through the patient
20
Regarding the expired CO2, as measured by capnography, the wrong statement is
Answer
C. Increases in air embolism
21
The true statement regarding medical gas cylinder is
Answer
D. All of the above
22
Entonox (i) Entonox is a 50:50 mixture of oxygen and nitrous oxide with a filling ratio of 0.75 (ii) Cylinders are blue with black/white shoulders (iii) Cylinders should be kept vertical (iv) Exhibits pointing effect True are
Answer
B. i, iii, iv
23
Soda lime
Answer
B. contains 1% Potassium Hydroxide to harden the granules
24
According to Hagen Poiseuille equation, laminar flow is directly related to
Answer
D. Pressure difference across the length of the tube
25
All of the following are measures of dispersion except
Answer
A. Mean
26
Statistical power is defined as the probability of
Answer
B. Rejecting a null hypothesis when it is false
27
Which of the following helps to minimize the random error in a research study?
Answer
D. Adequate sample size
28
Submitting a manuscript to more than one journal the same time is known as
Answer
C. Simultaneous publication
29
Which among the following has a dual effect of increasing the gastric pH and decreasing the gastric volume to minimize the risk associated with aspiration?
Answer
A. Ranitidine
30
All of the following are contraindication to immersion extra corporeal shock wave lithotripsy except
Answer
A. Harrington rod implants
31
A 42 year old female is posted for extra corporeal shock wave lithotripsy for a very painful ureteric stone. The patient is requesting epidural anaesthesia for the procedure. Which of the following steps in epidural catheter placement should be avoided in this patient?
Answer
A. Loss of resistance to air
32
A 40 year old woman with a history of hypertension, headache, palpitation and nephrolithiasis is undergoing a parathyroidectomy for parathyroid adenoma. During induction of general anaesthesia, she develops severe hypertension and tachycardia. The most likely diagnosis is
Answer
D. Pheochromocytoma
33
Regarding hypothemia during cardio pulmonary bypass, all statements are true except
Answer
B. Intentional hypothermia is always used following the initiation of CPB
34
Which among the following inhalational anaesthetics causes the least coronary vasodilatation?
Answer
D. Sevoflurane
35
The mechanism of 'y descent' in central venous pressure waveform is
Answer
A. Atrial emptying when tricuspid valve opens
36
Adverse effects of hypothermia include all of the following except
Answer
B. Irreversible coagulopathy
37
Coronary perfusion pressure is
Answer
C. Arterial diastolic pressure minus left ventricular end diastolic pressure
38
Use of a pneumatic tourniquet can lead to following complications except
Answer
A. Tourniquet pain that is relieved by performing a peripheral nerve block
39
A 55 year old female with a medical history of hypertension, Diabetes Mellitus and recent transient ischaemic attack is posted for right shoulder replacement in the beach chair position. The surgeon is requesting for a hypotensive technique for reducing intra operative blood loss. Where is the location for placing the arterial transduce?
Answer
B. Level of the external meatus
40
While positioning a patient for spine surgery in the prone position, all the statements are true except
Answer
B. The abdomen must be supported (Never permitted to hang freely)
41
All of the following intra venous fluids are isotonic except
Answer
D. D5 Normal Saline
42
Transfusion related sepsis occur most commonly with the transfusion of
Answer
A. Platelets
43
Types of autologous blood transfusion include all of the following except
Answer
D. Donor directed transfusion
44
Administration of Succinyl Choline can lead to hyperkalaemia in all of the following conditions except
Answer
B. Cerebral Palsy
45
A bleeding patient was transfused 3 units of O negative packed RBCs as there was no time for blood typing and cross matching. Later the patient's blood group was found to be A+. If the patient requires further transfusion, which of the following should be transfused?
Answer
D. O negative PRC
46
The estimated maintenance fluid requirement of a 10 year old child, weighing 35 kg is
Answer
B. 75 ml/hr
47
The correct statement regarding the appropriate use of Ultrasound equipment during performance of regional anaesthesia is
Answer
B. Higher frequency transducers provide higher image resolution
48
A patient undergoing right mastectomy with axiliary lymph node dissection was given T3-T5 paravertebral block for post operative analgesia. This patient was an alcoholic and in the PACU she develops right arm paraesthesia. Her vitals are stable and bilateral upper extremity pulse volumes are equal. The most likely diagnosis is
Answer
B. Surgery related brachial plexus injury
49
An absolute contra indication for electro convulsive therapy is
Answer
B. Recent MI less than 3 months
50
The most sensitive monitor to detect air embolism is
Answer
A. Trans oesophageal ECHO
51
All of the following decrease cerebral blood flow except
Answer
D. Ketamine
52
Electrophysiological monitor which is most resistant to anaesthetic agents
Answer
C. Brain stem auditory evoked potentials
53
All of the following drugs can be give through endotracheal tube except
Answer
D. Calcium
54
The earliest and the most pathognomonic feature of malignant hyperthermia is
Answer
B. increased EtCO2
55
Inadvertent intra thecal injection of 0.25% Bupivacaine following the placement of a caudal epidural in a 1-year-old child will present as
Answer
D. Oxygen desaturation
56
A 3 year old child weighing 16 kg is posted for inguinal hernia under caudal epidural block. The calculated dose of 0.25% Bupivacaine for the procedure will be
Answer
B. 8 mL
57
A 6 year old is undergoing a squint surgery with a Laryngeal Mask Airway (LMA) in place. 30 minutes into the procedure his heart rate is 60 per min, Blood Pressure is 90/60 mm Hg and the pulsoximeter reads 98%. The next step in the management is
Answer
B. Administer Inj Atropine after informing the surgeon
58
In Pressure Support Ventilation (PSV), inspiration ends and expiration begins when
Answer
C. Flow decreases to a pre-set level
59
A 40 year old man is on ventilator for Acute Respiratory Distress Syndrome (ARDS). The plateau pressure for the patient should ideally be kept below
Answer
A. 30 cm of 𝐻2 𝑂
60
The most common cause of death in the post operative period following Whipple's procedure is
Answer
B. Intra peritoneal Haemorrhage
61
The following is not a component of Prothrombin Complex Concentrate (PCC)
Answer
B. Prothrombin
62
Regarding Carbetocin, all are true except
Answer
D. Should be stored at 2-8° Centigrade
63
Choose the correct statement
Answer
B. Heart rate and ventricular filling are inversely related
64
Inhalational induction is faster in paediatric population because
Answer
D. All of the above
65
Which among the following drugs show context insensitivity?
Answer
C. Remifentanil
66
Regarding pharmacokinetics of propofol, all of the following statements are true except
Answer
B. It is not a CYP3A4 inhibitor
67
Regarding Ryanodex all are true except
Answer
D. Warming increase the solubility
68
Historically, Letheon was a name given to
Answer
A. Ether
69
IPPV may benefit patients with
Answer
C. Cardiac failure
70
Advantage of neuraxial blockade over general anaesthesia in elderly undergoing orthopaedic surgery include
Answer
D. All of the above
71
To maintain perfusion of spinal cord, the MAP must be at least
Answer
B. 75 mm Hg
72
A patient with Duchenne muscular dystrophy is posted for scoliosis correction. Anaesthetic consideration include all except
Answer
B. Left ventricular ejection fraction <75% of the predicted is a contraindication for elective surgery
73
In a patient with Scoliosis, respiratory function is compromises when Cobb's angle is more than
Answer
A. 65°
74
Following are essential components of damage control resuscitation except
Answer
D. Immediate definitive surgery
75
Lethal triad does not include
Answer
A. Hypovolemia
76
Traumatic Brain Injury (TBI) can be clinically assessed by all of the following scales except
Answer
C. Marshall classification
77
Cerebral Perfusion Pressure (CPP) is
Answer
B. Mean arterial pressure-intracranial pressure
78
The ideal position of the tip of the endotracheal tube should be
Answer
A. T4 vertebral body
79
What should be the target ETAC (End Tidal Anaesthesia Concentration) to prevent awareness?
Answer
A. 0.7 age adjusted MAC
80
Which among the following is an EEG based monitor to assess the intra operative awareness?
Answer
D. All of the above
81
What charges is EEG pattern is expected as the depth of anaesthesia increases?
Answer
A. beta-alpha-theta-delta
82
Which of the following reflexes may be preserved in a brain-dead patient?
Answer
B. Knee jerk
83
'Rule of 100' in the management of brain dead donor include all of the following parameters except
Answer
D. Diastolic BP < 100 mm Hg
84
The lower oesophagus sphincter tone is reduced following administration of
Answer
C. Sellick's manoeuvre
85
The temperature of the chemo perufsion used in Hyperthemic Intra Peritoneal Chemotherapy (HIPEC) is
Answer
A. 41-43 Degree Centigrade
86
While treating chronic hyponatremia, the desired increase in Plasma Sodium per day is
Answer
D. 4-8 mmol/L
87
A 33 year old second gravida, previously diagnosed to have large ASD with moderate PAH was undergoing caesarean section under GA. During the procedure, tachycardia was noted and an ECG was taken (given below). She soon developed hemodynamic compromise with blood pressure of 70 systolic and spO2 of 80%. What will be your treatment of choice?
Answer
C. DC Version - 50 Joules
88
A 65- year old male patient has h/o old Anterior wall MI and has previously undergone CABG. He has LV dysfunction with LV EF of 35%. He is on Aspirin, Statin, Ivabradine, Frusemide, Spironolactone, Sacubitril-Valsartan and Digoxin. He also has h/o COPD and is on Metered dose inhalation. He underwent a Radical neck dissection and had an uneventful surgery. He developed severe dyspnoea while in post OP ICU. He had bilateral rhonchi and crepitations. His ECG did not show any fresh ECG changes other than sinus tachycardia. Which test will be most helpful for diagnosis?
Answer
B. NT Pro BNP
89
A 76-year old lady with Chronic AF, and history of previous TIA and was on Dabigatran 150 mg twice daily. She also has h/o Diabetes Mellitus and Hypertension. She developed a large sub dural haematoma and is being planned for emergency surgery. Which agent will you chose for reversal of anticoagulation?
Answer
C. Idarucizumab
90
A 60 year old male diabetic patient was undergoing a total Hip replacement and developed bradycardia and hypotension during procedure. His ECG was taken and is shown below. What will be the appropriate choice of treatment?
Answer
D. Primary Angioplasty
91
A 58 year old gentleman was brought to critical care ICU with probable cardiac arrest. He had VF on ECG monitor and was DC verted and CPR was given. He is still having VF after multiple attempts at DC version. Which will be the first drug you will consider in this scenario?
Answer
C. IV Epinephrine
92
You have been asked to do a pre operative evaluation for a 48 year old lady was being planned for Open Cholecystectomy. She does not have DM, Hypertension, CAD, or any other risk factors. She has good effort tolerance and can climb 3 flights of stairs without any symptoms. Her ECG and CXR are within normal limits. What will be your strategy for preoperative cardiac risk assessment?
Answer
D. Proceed to surgery
93
Who coined the term Anaesthesia in 1846 to describe the insensibility due to inhalation of Ether?
Answer
D. Oliver Wendell Holmes
94
Regarding Thromboelastography the incorrect statement is
Answer
D. Elevated A60 is a measure of coagulation factor deficiency
95
A 45 year old lady is being planned for Abdomino Perineal Resection. She has Rheumatic heart disease-Severe Mitral Regurgitation, Moderate Mitral Stenosis, Mild Aortic regurgitation and is in sinus rhythm. What will be your strategy regarding infective endocarditis prophylaxis?
Answer
D. Antibiotic prophylaxis is not indicated
96
Regarding fluid management of neonates, all are true except
Answer
B. A minimum haematocrit of 60% has to be maintained
97
What is the order of efficacy provided by the various circuits when planning for controlled ventilation in a patient under general anaesthesia?
Answer
A. D>B>C>A
98
Recommendations for endotracheal intubations in Covid 19 patients include all except
Answer
C. Awake fibre optic intubation is the technique of choice
99
A 40 year old pregnant lady has history of unprovoked DVT and is on 20 mg Rivaroxaban once daily for DVT prophylaxis. She is being planned for Caesarean section under spinal anaesthesia. When will you stop Rivaroxaban prior to surgery?
Answer
B. 2 day
100
Regarding sterilization of supra glottic airway devices, the true statement is
Answer
A. LMA used for tonsillectomy should not be reused
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