ANAESTHESIOLOGY

END OF POSTING ASSESSMENT

Batch 20 Year 4
Group B
5.12.2017

Dr.T.Praba
AIMST
1.A 30 years old unknown polytrauma victim was brought to casuality unconscious and he needs to
undergo emergency laparotomy for severe intra-abdominal injury with haemorrhagic shock.
Regarding the consent:

A. The surgery can be delayed until his family members are identified.
B. The surgery must be cancelled since he can’t give consent.
C. One surgeon and one physician can jointly sign the consent form.
D. An anaesthetist and the surgeon can sign the consent form.

2. The reason for suxamethonium chloride being used in Rapid Sequence Induction in patients at risk of
Mendelson’s Syndrome is because of it’s:

A. Haemodynamic stability.
B. Less potential for anaphylaxis
C. Rapid onset of muscle relaxation
D. Doesn’t need reversal agent.

3. Regarding ASA classification of patients scheduled for surgery:

A. Patients with uncontrolled hypertension are ASA 111 patients.

B. Controlled diabetic patients are ASA 1 patients.
C. Morbidly obese patients with BMI of 41 are ASA IV group.
D. Neonates are ASA III since they have immature organ systems.
4. Regarding General anaesthesia, the correct statement is:

A. There is irreversible loss of consciousness.

B. Muscle relaxants are mandatory.
C. Spontaneous ventilation can be allowed.
D. Analgesic drugs are not required since patients are unconscious and won’t be able to complain.

5.Which of the following anaesthetic option is not possible for patients scheduled for herniorrhapy?

A. General anaesthesia with spontaneous ventilation using LMA.

B. Subarachnoid block.
C. Ileoinguinal and ileohypogastric nerve block.
D. Femoral nerve & Sciatic nerve block.

6. The correct answer with regards to spinal and epidural anaesthesia is :

A. Lower segment caesarian section can only be done under spinal anaesthesia.
B. Patients with coagulopathy shouldn’t undergo epidural anaesthesia.
C. Spinal anaesthesia can be done even if patient refuse since it doesn’t cause unconsciousness.
D. Epidural anaesthesia cannot be combined with general anaesthesia.
7. The immediate common cause of postoperative hypoxia occurring at recovery bay is most likely due to:

A. Nosocomial pneumonia.
B. Poor reversal from general anaesthesia
C. Total spinal block.
D. Anaphylaxis.

8. Regarding postoperative pain management, the true statement is :

A. PCA using opioids can cause normally adequate pain relive for thyroid surgery.
B. Non-steroidal anti-inflammatory agents can be given safely for diabetic patients.
C. Intravenous COX2 antagonists is safe in patients with hypertension.
D. Morphine should not be used intrathaecally.

9. Which of the following medical condition does not require intensive care management since with
appropriate treatment, it can be well controlled in general wards:

A. Acute asthma.
B. Severe Leptospirosis
C. Dengue haemorrhagic fever with shock.
D. Head injury.
10. Which of the following airway device offers hands free ventilatory support ?

A. Oropharyngeal airway.
B. Laryngeal airway mask.
C. Ambu facemask.
D. Nasopharyngeal airway.

11. Regarding Rapid sequence induction, the best true response is :

A. Patients shouldn’t be given any premedication.

B. Cricoid pressure should be released immediately after tracheal intubation.
C. Preoxygenation should be omitted in mothers posted for emergency caesarian section for fetal
distress since it delays surgery.
D. Only intravenous induction should be used.

12. Regarding Advanced Cardiac Life Support, which of the following drug is not advised during
resuscitation for cardiac arrest?

A. Amiadarone.
B. Atropine.
C. Adrenaline.
D. Vasopressin.
13. During postoperative period following laparotomy, the common cause of atrial fibrillation is:

A. Hypertension.
B. Hypernatraemia.
C. Hypocalcaemia.
D. Hypokalaemia.

14. Regarding Intensive care management, which is the true statement?

A. Only pharmacological method should be used for deep venous thrombosis prophylaxis.
B. All patients managed in ICU should be ventilated.
C. Antibiotics can be started without taking culture in severe sepsis with multi-organ failure to avoid
delay in treatment.
D. Multi drug resistant organisms will increase mortality rate.

15. Which of the following fluid is a colloid solution and can be used safely in patients with
coagulopathy?
A. Stereofundin.
B. Hydroxyethyl starch.(coloid)
C. Gelofuscine. (coloid best )
D. 10% Amino acids solution.
16. Regarding muscle relaxants, the true statement is:

A. Suxamethonium needs to be reversed with Neostigmine.

B. Rocuronium is a non-depolarizing muscle relaxant.
C. Relaxants must be used during general anesthesia.
D. Suxamethonium can be given safely for patients with malignant hyperpyrexia.

17. Which of the following statement is true with regards to day care surgery?
,
A. Only ASA 1 patients should be scheduled for daycare surgery.
B. Any surgery can be performed as day care surgery.
C. Preoperative assessment can be omitted.
D. Clear fluids can be taken until 2 hours prior to surgery.

18. Regarding central neuronal block, the correct statement is :

A. They only cause unilateral lower limb paralysis.

B. For spinal anaesthesia ,commonly 0.5% plain bupivacaine is used.
C. For epidural anaesthesia, heavy bupivacaine is used.
D. They can be called as Regional anaesthetic techniques.
19. During CPR and ACLS:

A. The chest compression should be at least 2 inches in adults.

B. Chest compression: ventilation ratio is 30:1
C. Defibrillation should be carried out even in asystole.
D. Trachea must be intubated for adequate ventilator support.

20. Which of the following investigation is a routine preoperative investigation for all surgeries?

A. Thyroid function test.

B. CXR.
C. Electrocardiogram.
D. Full blood count.
 OSCE
pen and paper + clinical scenario
 No. (1)

A female patient in an OT has

the above probe
attached to her index finger.

1. Name the monitor

2. State any two parameters measured by this monitor
3. State two cause of inaccurate measurements
4. State two clinical indications for its use .
 No.(2)

An anaesthetist was preparing general anaesthesia

for a herniorraphy using the equipment shown
in the picture .
1 Name the equipment
2 State the advantage of it’s use during cardiac arrest
3 State two clinical indications for it’s use
Clinical scenario
A 35 y/o G4 P3 patient is in the preanaesthetic clinic for preoperative
assessment. She has no co-morbidities. Indication for surgery is placenta
previa type 2 anterior. Antenatal check up is uneventful. She also gave history
of previous LSCS done under spinal anaesthesia for breech presentation
during her 3rd pregnancy. The obstetrician also planned to do bilateral tubal
ligation as per her request. With regards to her perioperative management

1 indicate her ASA status and the justifications for it

2 Indicate the consents necessary for her proceduer
3. What is the preferred type of anaesthesia
(spinal )
4 indicate any three preoperative medications necessary for her
(med for mandelson syndrome ppi, sodium citrate)
5 what are the specific complications associated with general anaesthesi?
(mandelson syndrome , malignant hyperthermia )