AIIMS NOV 2019 – ANAESTHESIA & CRITICAL CARE MCQ

As these are recalled questions.. Slight change in wording can change answer-
read question and I tried giving explanation too ( ref :miller 8th edn)

1) Post operative pulmonary complications are seen in all of the following

except :
a) BMI>30 – INCREASES RISK
b) Upper abdominal surgery – yes – during surgical procedures – retraction
leads to atelectasis of lower segments also due to pain VC is reduced –
pooling of secretions - infections
c) Patient with 7 pack years of smoking – defiantly risk factor modifiable
stop 6-8 weeks prior but as per text book current smoker or >40 pack
years
d) Age > 70 – old age reduces pulmonary compliance decreases ciliary
motility and increases chances of resp problems

Other factors: patient: age >60, ASA2, heart failure, partial or total
functional dependence(cannot walk 2blocks/1 flight of stairs), copd,
delirium, cigratte, weight loss, alcohol, abnormal chest findings like crepts
wheeze

Procedure: thoracic surgery, abdominal neurosurg,head and neck and

emergency surgery, vascular surg, any GA, blood transfusion intraop
prolong surgery

Lab values: albumin<3.5, abnormal cxr blood urea >21

2) Assertion: FLEXION OF NECK HELPS IN VENTILATION FALSE (I am

not sure what wordings they have used )
Neck flexion - u can see in this image how neck flexion doesn’t help
ventilation
Good ventilation occurs with atlanto occipital extension and
jawthrust(textbook lines)
Reason: jaw thrust removes tounge from posterior tounge wall : TRUE see
image

Image: students said image given- what is given ????is this the same
3) CPR true and false:
a) Can be given irrespective of rib # (true)
b) Adults chest compression 30:2 with 2 rescuer (true)
c) Compression rate 100-120/min (true)
d) AED if available give compressions and shock every 3 minutes (false)
Check rhythm after 2 minutes and give shock if it shock able only
e) Infants change to 15:2 in case of second rescuer (true)

4) Steps of intubation sequence:

a) Neck flexion head extension – flexion of lower cervical spine and
extension of AO joint
b) Introduce laryngoscope from left –generally laryngoscopes are hold in
left hand and introduced from right side of the mouth – to push the
tounge to one side
c) Inflate cuff – pass ett and inflate cuff – or else there will be leak
d) Check air entry – capnography is surest sign along with chest lift mist
formation etc

5) Image of AED
6) Role of glycopyrrolate in premedication – reduce secretions-standard MCQ

7) In a post op patient they used to give 3 mg morphine epidurally, one day

increased dose to 12mg accidentallywhich is not true statement
a) C/o itching CORRECT
b) Supplement o2 by mask CORRECT
c) Complains of urinary retention CORRECT
d) ????

8) Tramadol metabolitesact by:

a) anticholinergic
b) antihistaminic
c) block reuptake of dopamine and serotonin
d) block reuptake of serotonin and NE correct

9) A solider was bought from siachen suffering from hypothermia. Which of

the following temperature closely rreflects core temperature
a) Oral
b) Rectal
c) Infra red temperature
d) ????

Core temperature monitoring site : lower esophagus = tympanic

membrane=nasopharynx=pulmonary artery > rectal=bladder > oral >skin
surface

10) A patient had svt unconsciousness – what is next step?

Unstable svt – sync cardioversion not dc shock