Download PGI PG 2020 May Anesthesia Solved Question Paper

1.Inophthalmologyapatientisallergicto
aminoesters.Whatcanbeused?
a)Cocaine
b)Procaine
c)Prilocaine

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d)Bupivacaine
e)Tetracaine
CorrectAnswer-C:D
Ans.is'c'i.e.,Prilocaine&'d'i.e.,Bupivacaine
[Ref:Lee's13th/ep.486]

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Prilocaine&bupivacaineareamides(amcinonide).Otherthreeare
aminoesters.

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2.TRUEstatementregardinginhalational
anesthesiais/are?
a)Sevofluraneistheagentofchoiceforchildrenandasthma

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patients
b)Sevofluraneshouldnotbeusedwherethegasflowrateisless
than2L/min
c)Desfluraneshouldnotbeusedforinductioninchildren
d)Isofluraneismorepotentthansevoflurane

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e)Halothaneistheagentofchoicefordaycaresurgery
CorrectAnswer-A:B:C:D
Ans.is'a'i.e.,Sevofluraneistheagentofchoiceforchildrenand
asthmapatients,'b'i.e.,Sevofluraneshouldnotbeusedwhere
thegasflowrateislessthan2Llmin,'c'i.e.,Desfluraneshould

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notbeusedforinductioninchildren&'d'i.e.,Isofluraneis
morepotentthansevoflurane
[Ref:AjayYadavSth/ep.70-87;MorganSth/ep.163-70]
"InJune1995'theFoodandDrugAdministration(FDAIapproved
theclinicaluseofsevoflurane.butwithawarningthatnotsuedat

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freshgasflowslessthan2l/minbecausesufficientdatahadnot
beenpresentedtoestablishitssafetyinthatcircumstance.
TheFDAwasconcernedthatsevofluranemaycauseadverserenal
effectsatlowflowsbecauseitisdegradedbythestrongbasesin
CO2absorbentstofluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl

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ether(compoundA).
-http://anesthesiologlt,pubs.asahq.org/article.aspx?
articleid=2026924

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3.Ifyouareaskedtocollect4serialsamples
fromlumbarpuncture.Whatshouldbe

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donewithfirstsample?
a)Cellcountslikedifferentialcounts
b)Biochemicaltests[protein&glucoseetc
c)Bacterialcultureandgramstaining
d)Mycobacterial&fungalcultureandstaining

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e)Noneoftheabove-discardthesample
CorrectAnswer-A
Ans.is'a'i.e.,Cellcountslikedifferentialcounts
Ref:https://emedicine.medscape.com/article/80773-technique
Theclassicapproachistosendthe4CSFtubesforthe

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followingstudies:
1. TubeI-Cellcountanddifferential
2. Tube2-Glucoseandproteinlevels
3. Tube3-Gramstain,cultureandsensitivity(C&S)
4. Tube4-Cellcountanddifferential

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4.Trueregardinglocalanesthaticsis/are?
a)Prilocaineislongeractingthenbupivacaine
b)Tetracaineismorepotentthanlignocaine
c)Dibucaineisthelongestactinglocalanesthetic
d)Bupivacainecanproducecardiotoxicity

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e)Cocainecanproducehypotension
CorrectAnswer-B:C:D
Ans.is'b'i.e.,Tetracaineismorepotentthanlignocaine,'c'i.e.,
Dibucaineisthelongestactinglocalanesthetic&'d'i.e.,
Bupivacainecanproducecardiotoxicity

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[Ref:Morgan4th/ep.266-270,926;AjayYadav4'h/ep.118;
Essentialofanaesthesia4th/ep.116;Goodman&GilmanLLth/ep.
375]
ChloroprocaineistheshortestactingLA.
Dibucaineisthelongestacting.mostpotentandmosttoxicLA.

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Procaine&chloroprocaineareleastpotentLAs.
BuQivacaindisthemostcardiotoxicLA(Ropivacaineisanewer
bupivacainecongenerwithlesscardiotoxicity).
Levobupivacaine(TheS(-)enantiomerofbupivacaine)isless
cardiotoxicandlesspronetocauseseizure.

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PrilocaineandBenzocainecancauseMethemoglobinemia.
LignocaineisthemostcommonlyusedLA.
Bupivacainehasthehighestlocaltissueirritancy
Chloroprocaineiscontraindicatedinspinalanaesthesiaasitcan
causeparaplegiaduetothepresenceofneurotoxicpreservative

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sodiummetabisulphite.
ProcaineistheLAofchoiceinmalignanthyperthermia.

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5.Whichofthefollowinganestheticshould
notbeusedinapatientofchronicrenal
failure?

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a)Methoxyflurane
b)Ketamine
c)Pancuronium
d)Succinylcholine
e)Desflurane

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CorrectAnswer-A:B:C
Ans.is'a'i.e.,Methoxyflurane,'b'i.e.,Ketamine&'c'i.e.,
Pancuronium
[Ref:Morgan4th/ep.219]
Musclerelaxants

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Atracurium/cisatracuriumarethemusclerelaxantofchoiceasthere
eliminationisnotdependentonkidney.
Mivacuriumisanalternativeasitseliminationisalsoindependentof
kidney.
Gallamineandmetocurineareentirelydependentonrenalexcretion

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forelimination)Contraindicatedinrenaldisease.
Pancuronium.pipecuranium,Alcuroniumanddoxacuriumare
Primarilydependentonrcontraindicated,howeverneuromuscular
functionshouldbecloselymonitoredr.ftheseagentsareusedin
Patientswithabnormalrenalfunction.

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VecuroniumandRocuroniumareprimarilyexcretedinBile(hepatic
elimination)butsomeamountiseliminatedinurinealso.
So,onlythreenon-depolarizingblockershavenoeliminationthrough

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kidney:-Atracurium,Cisatracurium,Mivacurium
Succinylcholine(delnlarizingblockerlisalsoindependentofrenal

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excretionforelimination.
ItcanbesafetyusedinthePresenceofrenalfailure.provided
serumpotassiumconcentrationislessthan5mg/L.

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6.IncomparisontoIJVcannulation,true
aboutsubclavianveincannulationis/are?

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a)Morechancesofpneumothorax
b)Moreincidenceofcathetermalposition
c)Moreinfectiouscomplications
d)Moresafetyinultrasoundguidedtechnique
e)Alloftheabove

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CorrectAnswer-A:B
Ans.is'a'i.e.,Morechancesofpneumothorax&'b'i.e.,More
incidenceofcathetermalposition
[Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMCi270925
/17]

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Subclavianveincannulation
Goodexternallandmarks
Largeradius
Practicalmethodofcentrallineincardio-respiratoryarrest
Blindprocedure

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Ultrasoundnotmuchuseful
Shouldnotbeattemptedinchildren<2years
Unabletocompressbleedingvessels
Morecommon&frequent:Cathetermalposition,Pneumothorax,
hemothorax,Pinch-offsy:rdrome.

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Lesscommon&frequent:Arterialpuncture,Thrombosis,
infectiouscomplications.

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7.Apatient,plannedforcesareansection,
developshypotension8minutesafterthe
spinalanesthesia.Drugswhichcanbe

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usedtotreatthisare?
a)Ephedrine
b)Mephenteramine
c)Adrenaline
d)Dopamine

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e)Steroids
CorrectAnswer-A:B:C:D
Ans.is'a'i.e.,Ephedrine,'b'i.e.,Mephenteramine,'c'i.e.,
Phenylephrine&'d'i.e.Dopamine
[Ref:MillerVh/ep.1617]

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Managinghypotensioninducedbyspinalanesthesiafor
caesareansection:
Treatment
Inspiteofusingalltheprophylacticmeasures,40o/oto60%of
patientswillstillneedtreatmentforhypotension:-

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i)Fluidloadingissuperiortono-fluidregimen;however,the
incidenceofPSHisstillhighwithallfluidloadingprotocols
ii)Vasopressors:-
Phenylephrine(PE)ispreferredvasopressor.
PreventionandtreatmentofPSHbecauseoffasteronset.

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Ephedrinemaybemorebeneficialinpatientswithbradycardia.
Norepinephrineinfusionwasrecentlyinvestigatedasanalternative
forprophylaxisofPSH.

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OndansetronwasreportedasaprophylacticdrugfromPSH
Othersympathomimeticdrugsusedaremephentermine.

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metaraminol,methoxamine,dopamineand,angiotensinII
Atropineshouldbegivenforbradycardia

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8.Endotrachealintubationis/areassessed
by:
a)Mallampatigrading

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b)ASAphysicalstatusgrading
c)Thyromentaldistance
d)Teetharrangement
e)None
CorrectAnswer-A:C:D

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Ans.A,MallampatigradingC,Thyromentaldistance&D,Teeth
arrangement
Ref:ManipalSurgery4th/1072-73;AjayYadav5th/53'124;Morgan
5th/312-13
ASAphysicalstatusgradingisforgeneralhealthstatusofpatient

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(notforassessingintubation)
AssessmentofDifficultIntubation:
Mallampatigrading:ItisdonetoassessmouthoPening
Thyromentaldistance(distanceb/wthyroidnotchtomental
prominencewithfullyextendedneck)

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Mentohyoiddistance:normal>5cm
AssessmentofTMjointfunction:Interincisorgap(mouthopening)
shouldbeatleast5cm(2fingerbreadth)
NeckMovement

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9.Drug(s)notgivenastransdermalpatch:

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a)Fentanyl
b)Diclofenac
c)Morphine
d)Clonidine
e)Buprenorphine

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CorrectAnswer-B:C
Ans.B,Diclofenac&C,Morphine
[Ref:KDT7th/476
Transdermalfentanyl(Durogesic)hasbecomeavailableforusein
cancer/terminalillness.

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Butransskinpatchescontainbuprenorphineanopioidpain
medication.
Clonidinetransdermaldelivery(patch)systemshavebeenavailable
sincethe1980

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10.Trueaboutdesflurane:

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a)Boilingpointis<230C
b)ChemicallyitisFlourinatedmethylethylether
c)Itincreasestheeffectofmusclerelaxant
d)Canbegivensafelytopatientsusceptibletomalignant
hyperthermia

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e)Morepotentthanisoflurane
CorrectAnswer-A:B:C
Ans.A,Boilingpointis<230CB,ChemicallyitisFlourinated
methylethyletherC,Itincreasestheeffectofmusclerelaxant
[RefAjeyYadavSth/82;MorganSth/170&71)

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Desflurane:
Fluorinatedmethylethylether
Boilingpointislessthan20C.
Producesmaximummusclerelaxationamongtheagents.
5timeslesspotentthanisoflurane.

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Lossofpotency(theMACofdesfluraneis5timeshigherthan
isoflurane)
Immunemediatedhepatitisarareoccurrence.
hasthelowestblood:gassolubilityofthepotentvolatileanesthetics

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11.Trueabouttracheostomy:

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a)Tracheostomytubemayclosedbymucoussecretion&crust
formation
b)Copioussecretionfromtubeisalwaysduepulmonaryinfection
c)X-raychestshouldbedoneforconfirmationineverycase
d)Improperpositioningmayleadtofatalhaemorrhage

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e)Displacingoftubeafter2weekismedicalemergency
CorrectAnswer-A:D
Ans.A,Tracheostomytubemayclosedbymucoussecretion&
crustformationD,Improperpositioningmayleadtofatal
haemorrhage

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RefSchwartz9th/59-Iqhttp://www.nurses.com/;pL.Dhingra6th/
3I6-20;AjayYadav5th/48-49;MilloAnaesthaiaZth/232&IBit-72
Reintubationinthefirst36hoursaftertracheostomyIson
emergency.
TracheostomytubeshouldnotbedisturbedForthefirst48-72hr,

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butthereafterthetubeischangeddaily&cleanedatregularinterval.
Recentstudydonotsupportobtainingaroutineposttracheostomy
chestX-ray.
Themostdramaticcomplicationistracheo-innominatearteryfistula
(TIAF).

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Palpabletubepulsationsuggestimpendingerosionofanartery,
Trachealdeviationmaysignalabdomenbleeding

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12.CnrnnonentofAdvancedcardiovascular
lifesupport(ACLS)inaccordancetoAHA
2015guideline:

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a)Chestcompression100-150perminute
b)Chestcompressionatleast5cm/2inch
c)VasopressorsisusedtomaintainMAP>70mmHginnon-
responsivetofluids
d)1Breathevery8seconds

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e)Vasopressinisusedasvasopressor
CorrectAnswer-B
Ans.B.Chestcompressionatleast5cm/2inch
Basiclifesupport(BLS),advancedcardiovascularlifesupport
(ACLS),andpost-cardiacarrestcarealldescribeasetofskillsand

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knowledgeappliedsequentiallyduringthetreatmentofpatientswho
haveacardiacarrest.
ACLScomprisesthelevelofcarebetweenBLSandpost-cardiac
arrestcare
Updaterecommendationsforadvancedcardiaclifesupport

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2015:
Thecombinedusevasopressinandepinephrineoffersnoadvantage
tousingstandard-doseepinephrineincardiacarrest.
VasopressinhasbeenremovedfromtheAdultCardiacArrest
Algorithm-2015update.

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AdvancedCardiacLifeSupport:
Continuouschestcompressionsatarateoflil)/rninto120/min,
vnthoutpausesforventilation.Theproviderdeliveringventilation

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shouldprovide1breathevery6seconds(10breathsperminute).
Itmaybereasonabletoavoidandimmediate$rcorrecthypotension

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(SBp<90mmHg,MAp<65mmHg)duringpost-cardiacarrest
care.

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13.Anaestheticagents(s)having
epileptogenicpotential:
a)Atracurium

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b)Etomidate
c)Enflurane
d)Pethidine
e)Propofol
CorrectAnswer-A:C:D

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Ans.(A)Atracurium(C)Enflurane(D)Pethidine
Etomidate:Doesnothaveepileptogenicpotential.
Enflurane:Athighdosesitproducesspikeandwavepatternin
EEGwhichculminatesintofranktonic-clonicseizure.
Atracurium:Itsmetabolicproductlaudanosine(Laudanosine

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Toxicity)-seizuresprecipitated.
Ketamlnecanelicitseizuresinpatientswithanepilepticdiathesis.
Propofol:Significantanticonvulsantactivity.

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14.Trueaboutxenonisare:
a)Environmentfriendly

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b)Cheap
c)Lowbloodsolubility
d)Inert
e)Stable
CorrectAnswer-A:C:D:E

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Ans.(A)Environmentfriendly(C)Lowbloodsolubility(D)Inert
(E)Stable
Advantagesanddisadvantagesofxenon(Xe)anesthesia:
Advantages:
Inert(probablynontoxicwithnometabolism).

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Minimalcardiovasculareffects.
LowbloodsolubilitY.
Rapidinductionandrecovery
Doesnottriggermalignanthyperthermia
Environmentalfriendly.

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Nonexplosive
Disadvantages:
Highcost
Lowpotency{MAC=70%)

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15.Ingastubing,rateofturbulentflow

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dependsupon:
a)Viscosityofgas
b)Pressuregradient
c)Lengthoftube
d)Radiusoftube

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e)Densityofgas
CorrectAnswer-B:E
Ans.(B)Pressuregradient(E)Densityofgas
Turbulent
Turbulentflowisproducedifflowrateisveryhighorifgaspasses

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throughbends,constrictions.
Flowisrough.
Reynold'snumbermustexceedto2000forturbulence.
Turbulentflowismoredependondensity

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16.Gasstoredinliquidstateincylinders:

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a)Nitrogen
b)Helium
c)CO2
d)Cyclopropane
e)Nitrousoxide

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CorrectAnswer-C:D:E
Ans,(C)CO2(D)Cyclopropane(E)Nitrousoxide
Oxygen,nitrogen,airandheliumarestoredincylindersasgases.
Nitrousoxide,carbondioxideandcyclopropanearestoredinas
liquidinequilibriumwithsaturatedvapour.

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ColourofCylinders:
O2-Blackbodywithwhiteshoulder
N2O-Blue
CO2-Grey
Cyclopropane-orange

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Helium-Brown
Air-Greybodywithblackandwhiteshoulders
Entonox-Bluebodywithblueandwhiteshoulders(50%O2.+50%
N2O).

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17.Trueaboutcaudalanesthesiainchildren:

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a)Averagedistancefromtheskintotheanteriorwallofthesacral
canalis21mm
b)0.5mL/kgdoseofbupivacaineissufficientforlumberand
sacraldermatomesblock
c)Beyond6-7yearsofage,itisdifficulttogiveandisless

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successfulincomparisontoyoungerchildren
d)2-3cmofepiduralcatheterisadvancesthroughepiduralspace
incontinuosinfusion
e)Distancefromtheupperborderofthesacralhiatustothedural
sacis30?10.4mm

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CorrectAnswer-A:C:D:E
Ans.(A)Averagedistancefromtheskintotheanteriorwallof
thesacralcanalis21mm(C)Beyond6-7yearsofage,itis
difficulttogiveandislesssuccessfulincomparisonto
youngerchildren(D)2-3cmofepiduralcatheterisadvances

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throughepiduralspaceincontinuosinfusion(E)Distancefrom
theupperborderofthesacralhiatustotheduralsacis
30?10.4mm
CaudalAnesthesia
Normallengthofcathetertobeintroducedintotheepiduralspacels

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2to3cm,asforanyepiduralblock.
Dosageprescriptionscheme:
1. With0.5mL/kg,allsacraldermatomesareblocked.
2. With1.0ml/kgallsacralandlumbardermatomesareblocked.
3. With1.25ml/kg,theupperlimitofanesthesiaisatleastmidthoracic.

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Drugused:Thedoseof0.25%bupivacainets0.5-O.75ml/kg

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Extraduralspacebelowsacralhiatusmayrangefrombeingdeepto
excessivelyshallow-itsaveragelengthls10-15cm.
ItsanatomyismoreeasilyappreciatedininfantsandchilDren
Indications:

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Useforpattants<8yearsoldtoprovideintraoperativeand
postoperativeanalgesiaforabdominalandlowerextremitysurgery.
Technique:
Advanceneedleandcatheter2to4mm.

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18.

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Anaestheticusedforinductionin
pediatricsurgeryis?
a)Propofol
b)Thiopentone
c)Ketamine

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d)Diazepam
e)Etomidate
CorrectAnswer-A:B:E
Ans.(A)Propofol(B)Thiopentone(E)Etomidate
AnaestheticsinPediatricpatients:

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Induction
Inhalationalinduction:
Inhalationalagentwithmask-Inductionmethodofchoicein
children.
Sevoflurane-Inductionagentofchoiceinchildren.

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UsedinN2O+O2gasmixture.
Halothane-2ndInductionagentofchoice.
Intravenousinduction:
THiopental/propofol(Outpatientsurgery).
Ketamine-preferredinchildrenwithhypovolemia.

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Etomidate-preferredinchildrenwithunstablecardiovascularstatus

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19.Atracuriumismetabolizedby-
a)Conjugation
b)Hoffmandegradation
c)Pseudocholineaterase

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d)Methylation
e)None
CorrectAnswer-B
Ans.B.Hoffmandegradation
Theuniquefeatureofatracuriumisinactivationinplasmaby

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spontaneousnonenzymaticdegradation(Hofmannelimination).
Consequentlyitsdurationofactionisnotalteredinpatientswith
hepatic/renalinsufficiencyorhyperdynamiccirculation--->Hence,
preferredmusclerelaxantforsuchpatientsaswellasforneonates
andtheelderly.

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Atracurtumismetabolisedtolaudanosinethatisresponsiblefor
seizures.
Causehistaminerelease>Hypotension,bronchoconstriction&
flushing.

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20.Ventilatorassociatedcomplication(s)

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is/are?
a)Barotrauma
b)Subglotticstenosis
c)Pneumoperitoneum
d)Paralyticileus

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e)Increasedcardiacoutput
CorrectAnswer-A:B:C:D
Ans.(A)Barotrauma(B)Subglotticstenosis
(C)Pneumoperitoneum(D)Paralyticileus
[RefEssentialsofanestheticemergenciesp.123]

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Complicationsofmechanicalventilator:
Barotrauma-Causepneumothorax,pneumomediastinum,
bronchopleuralfistula,pneumopericardium/cardiactamponade,
Pneumoperitoneum,systemicairembolismandpulmonary
embolism.

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Hemodynamiccomplications
Nosocomialinfections:Pneumonia,UTI
Acid-basedisturbances-RespiratoryalkalosisduetoCO2washout.
Waterretention.
GIT-Mainlyparalyticileus.

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21.Headachefollowingduralpuncture,
treatmentis:
a)ACTH
b)Clonidine
c)Steroids

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d)Blood
e)Caffeine
CorrectAnswer-A:C:E
Ans.(A)ACTH(C)Steroids(E)Caffeine
Ref:Morgan's4,h/ep.297,Lee's13h/ep.509,

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510;www.cochrane.org
Postduralpunctureheadache:
DuetoCSFleakfromaduraldefect&decreasedICT.
Mostcommoncomplicationofspinalanesthesia.
Typicallocationisbifrontaloroccipital.

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Onset
Usually12-72hotrsfollowingtheprocedure.
Lastsfor7-10days.
Management:
UseofsmallboreneedlecanpreventpDpH.

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Conservativetreatment:
Analgesics(NSAIDs),oralori.v.fluids.
Drugs:Cosyntropin,caffeine,hydrocortisone,gabapentin,
theophylline,sumatriptan,pregabalinandACTH.

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22.Pre-anaestheticmedicationisgivento?

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a)Reduceanxietyandfear
b)Reductionofsecretionofsaliva
c)Toproduceamnesia
d)Topreventundesirablereflexes
e)Preventvomiting

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CorrectAnswer-A:B:C:D
Ans.(A)Reduceanxietyandfear(B)Reductionofsecretionof
saliva(C)Toproduceamnesia(D)Topreventundesirable
reflexes
[RelKDT6h/ep.378]

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Preanaestheticmedication:
Aims:
1. Reliefofanxietyandapprehensionpreoperativelyandtofacilitate
smoothinduction.
2. Amnesiaforpreoperativeandpostoperativeevents.

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3. Supplementanalgesicactionofanaestheticsandpotentiatethem.
4. Decreasesecretionsandvagalstimulation(undesirablereflex).
5. Antiemeticeffectextendingintopostoperativeperiod.
6. Decreaseacidityandvolumeofgastricjuicesothatitisless
damagingifaspirated.

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23.Methodsofregionalanaesthesiais/are?
a)Bier'sblock
b)Spinalanaesthesia
c)Rapidsequenceinduction
d)Conscioussedation

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e)Surfaceanaesthesia
CorrectAnswer-A:B:E
Ans.(A)Bier'sblock(B)Spinalanaesthesia(E)Surface
anaesthesia
[Ref:Morgan4/ep.269-270]

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Regionalanaesthesia(Localanaesthesia):
Methodsare:
1. Topicalanaesthesia(surfaceanaesthesia)
2. Infiltrationanaesthesia
3. Intravenousregionalanaesthesia(Bier'sblock)

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4. Conductionblock(eitherfieldblockornerveblock)
5. Spinalanaesthesia
6. Epiduralanaesthesia

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24.Ifweincreasethedepthofchest
compressioninCPR,itcauses-

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a)Decreasedmortality
b)Increasedbrainperfusion
c)Increasedaorticpressure
d)Ribfracture
e)Hemothorax

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CorrectAnswer-A:B:C:D:E
Ans.(A)Decreasedmortality(B)Increasedbrainperfusion
(C)Increasedaorticpressure(D)Ribfracture(E)Hemothorax
Increasingthedepthofchestcompressionalsocarryanincreased
riskofcomplicationslike:-

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Riband/orsternalfracture
InjurYtodiaPhragmorlung
Pneumothorax,pneumomediastinum,pneumopericardium
Hemothorax

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25.Hypotensiveshockrefractorytofluid,

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whatiscontraindicated?
a)Ketamine
b)Atropine
c)Fentanyl
d)Thopentone

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e)Etomidate
CorrectAnswer-C:D
Ans.(C)Fentanyl(D)Thopentone
[Ref:Wroerleetextbookofanaesthesiap.54]
Inhypotensivepatients,nosedative,hypnoticoropiateshouldbe

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given.
FentanylisanopiateandthioPentoneisasedative(barbiturate).
Ketamineincreasescardiacoutputandbloodpressure-Intravenous
anaestheticofchoiceinshock.
Etomidateproduceslittlecardi-ovascularanilrespiratorydepression

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Agentofchoiceforcardiovascularsurgeries(bypassaneurysms,
valvesurgery).
Etomidateismostcardiostableinducingagent.
Ifhypotensionisduetobradycardia-->Atropineisthedrugof
choice.

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26.Drugsknowntotriggermalignant
hyperthermia-
a)Halothane
b)Succinylcholine
c)Pancuronium

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d)Fentanyl
e)Propofol
CorrectAnswer-A:B
Ans.(A)Halothane(B)Succinylcholine
[RefMorganAnaesthesia5th/ep.1187-9A;AiayYadavp.13j-35;

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Miterp.1187-89;Leel3'h/ep.353;Wylle'sAflaesthesiflVh/cp.I65-
67]
DrugscausingMalignanthyperthermia(MH):
Succinylcholine
Halothane

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Isoflurane
Enflurane
Sevoflurane
Desflurane
Methoxyflurane

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MAOinhibitors
TCA
Phenothiazines
Lignocaine

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27.Whenwillyoususpectmalignant

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hyperthermiainpostappendectomy
patientshiftedtoICUwithhighfever&-
a)Hypotonia
b)Seizure
c)Masseterspasm

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d)Metabolicacidosis
e)Hypokalemia
CorrectAnswer-B:C:D
Ans.(B)Seizure(C)Masseterspasm(D)Metabolicacidosis
[Ref:MorganAnaesthesia5'h/ep.1187-90;AjayYadavSe/ep.133-

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35;MillerThlep,1187-89;Leel3'h/ep.35i;Wylie'sAnesthesiaVh/e
p.j65,367]
Malignanthyperthermia:
Theconditionoccursduringorimmediatelyafteranaesthesiaand
maybeprecipitatedbypotentinhalationagents(enflurane,

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halothane,isoflurane),orsuxamethonium.
Clinicalfeaturesare:-
MassetersPasmIfapatientdevelopsseveremasseterspasm
aftersuxamethonium,thereisasignificantpossibilityofmalignant
hyperthermia.

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Tachycardiaandarrhythmias
Riseinend-tidalCO,(firstsign)
Increasedtemperature&unexpectedchangeinBP.
Seizuresagitationandmusclerigidity

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28.Whichofthefollowingis/areusedin

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bupivacainetoxicity-
a)CaC12
b)Bretylium
c)Intralipids
d)Esmolol

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e)Epinephrine
CorrectAnswer-B:C:E
Ans.(B)Bretylium(C)Intralipids(E)Epinephrine
[Re!.MorganAnaesthesiaSth/ep.273-74;Ajayyadav5'h/ep.144;
Miller6th/ep.933;Leel3th/ep.384;BarashAnaesthesia6,h/ep.

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545]
Managementofbupivacainetoxicity
Ensureadequateoxygenation,whetherbyfacemaskorby
intubation.
Anticonvulsantssuchasbenzodiazepinesandbarbituratesarethe

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drugofchoiceforseizurecontrol.
Propofolcanalsobeused.
Succinylcholineissometimesalsousedtoterminatethe
neuromusculareffectsofseizures.
ForunresPonsivebupivacainetoxicity,intravenouslipidor

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cardiopulmonarybypassmaybeconsidered.
Forarrhythmias,amiodaroneistheDOC.Bretyliumandesmololcan
alsobeused.

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29.Anaesthesiausedforinductionis/are-
a)Propofol

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b)Thiopentone
c)Ketamine
d)Diazepam
e)Midazolam
CorrectAnswer-A:B:C:E

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Ans.(A)Propofol(B)Thiopentone(C)Ketamine(E)Midazolam
[Ref:MorganAnaesthesia5th/ep.175-82;AjayYadavS,h/ep.92;
Leel3th/ep.155]
Intravenousinducingagents:
Thiopentone

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Methohexitone
Propofol
Etomidate
Ketamine
Benzodiazepines

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---

30.Whichofthefollowingcriteriais/areused
forsettingmechanicalventilatorforadult
inICU-
a)Age
b)Gender

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c)Weight
d)Height
e)Underlyingconditionofpatient
CorrectAnswer-B:C:D:E
Ans.(B)Gender(C)Weight(D)Height(E)Underlyingcondition

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ofpatient
[Ref:MorganAnaesthesia5th/ep.1288;emedicine.medscape.com]
Mainlydependsonidealbodyweight(IBW),whichiscalculated
basedongenderandheight.
WomenIBW(lbs)=105+5(Heightininches-60)

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MenIBW(lbs)=106+6(Heightininches-60)
Settingsalsodependatypesoflungdisease,i.e.whetherthe
patientisnormalorwithrestrictivediseaseorwithobstructivelung
disease

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31.Trueaboutendotrachealtube-

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a)Noncuffedtubeisusedinpediatricagegroup
b)MadeofPVC&disposable
c)Canbeputeitheroralornasalaccordingtodifferentsituations
d)CuffedPVCtubes-lowpressure,lowvolume
e)Moretendencytogotorightbronchusthereby

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CorrectAnswer-A:B:C:E
Ans.(A)Noncuffedtubeisusedinpediatricagegroup
(B)MadeofPVC&disposable(C)Canbeputeitheroralor
nasalaccordingtodifferentsituations(E)Moretendencytogo
torightbronchusthereby

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[Ref:MorganAnaesthesiap.320-25;AjayYedav5'h/ep.43-46;Lee
l3th/ep.205-09]
Endotrachealtubesaremainlyoftwotypes.
CuffedEndotrachealTube:
CuffPressureshouldnotexceed30cmH2O(22mmHg)toprevent

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ischemicdamagetotrachealmucosa.
Twotypes,basedoncuffpressureandvolume.
LowPressure,Highvolume:-
Inthiscuffhashighvolume&lowpressure.
Becauseoflowpressurethesetubesproducelesstrachealinjury,

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thereforesuitableforprolongedsurgeries.0
Morecommonlyusedthanhighpressurelowvolumetube.
Thesetubesaremadeupofpolyvinylchloride
Highpressure,lowvolume:
Madeupofredrubber.

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UncuffedEndotrachealTube:

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Inchildren(lessthanl0yearsofage)uncuffedtubesshouldbeused
andthereshouldbeslightteakoninspiratorypressureof30cmIIrO

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32.Trueaboutendotrachealintubation-
a)HeadtraumapatientpresentingwithaGCSscore8orless

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shouldbeintubated
b)Doneinpatientswithincreasedriskofaspiration
c)Canbeusedinpatientwithfullstomach
d)Incervicalinjury,patientneckisstabilizedbeforeintuvation
e)Doneinpatientswhoneedanaesthesia

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CorrectAnswer-A:B:C:D:E
Ans.(A)HeadtraumapatientpresentingwithaGCSscore8or
lessshouldbeintubated(B)Doneinpatientswithincreased
riskofaspiration(C)Canbeusedinpatientwithfullstomach
(D)Incervicalinjury,patientneckisstabilizedbeforeintuvation

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(E)Doneinpatientswhoneedanaesthesia
[RefLeel3tt'/ep.208;MillerVh/ep./586;CSDTl4th/ep.814]
Endotrachealintubationisusedtomaintainapatentairwayin
operationtheateraswellasoutsidetheoperationtheater:-
IndicationsforEndotrachealIntubationintheoperatingroom

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include:
Theneedtodeliverpositivepressureventilation.
Protectionofrespiratorytractfromaspirationofgastriccontents.
Surgicalprocedureinvolvingtheheadandneckorinnon-supine
positionsthatprecludemanualairwaysupport.

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Almostallsituationsinvolvingneuromuscularparalysis.
Somenon-operativeindicationsare:
Tracheobronchialtoilet(pulmonarytoilet).
Profounddisturbanceinconsciousnesswiththeinabilitytoprotect
theairways.

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---

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33.Whichofthefollowingis/arefeature(s)of
epiduralanaesthesiathanspinal
anaesthesia-
a)Smallersizeofneedleisused
b)Drugusedislessinconcentration

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c)Lesschanceofspinalheadache
d)Onsetofactionisdelayed
e)Densityofanaestheticagentislessinepiduralthanspinal
CorrectAnswer-B:C:D:E
Ans.(B)Drugusedislessinconcentration(C)Lesschanceof

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spinalheadache(D)Onsetofactionisdelayed(E)Densityof
anaestheticagentislessinepiduralthanspinal
[RefMorganAnaesthesiap.959,969;AjayYadav5'h/ep.162;
MillerVh/ep.1626]
Epiduralanaesthesia:

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Sloweronsetofaction
Lessreliable
Difficult
DurationcanbeprolongedbyrepeatedlyinjectingLAbyanepidural
catheter.

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Canbeusedforupperabdominal,thoracic&necksurgeryaswellin
additiontosurgeriesperformedbyspinalanaesthesia.
PDPHisunlikelybecauseduraisnotpierced->so,thereisnoCSF
leakage.
Epiduralneedlesarelargerthanspinalneedles.

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34.Whichofthefollowingstatement(s)is/are
correctregardingmanagementof
malignanthyperthermiaexcept:
a)Discontinueallanaestheticsimmediately
b)DantroleneismainstayoftherapyforMH

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c)Hyperventilationwith100%oxygenishelpful
d)Sodiumbicarbonateisgiventocorrectalkalosis
e)Correcthyperkalemiabygivingdextrose&insulin
CorrectAnswer-D
Ans.D.Sodiumbicarbonateisgiventocorrectalkalosis

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MalignantHyperthermia:
DuetoabnormalityoftypeIRyanodinereceptorwhichiscalcium
releasechannelofsarcoplasmicreticulum.
Geneticdiseaseusuallyautosomaldominantbutcanberecessive
also.

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PatientwithnormalCKlevelsshouldundergomusclebiopsystudies
(wheremuscleissubjectedtotriggeringfactors(likehalothane&
suxamethonium).
TreatmentofMH:
Dantrolene-

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MainstayoftherapyofMH.
DirectlybindstoRyanodinereceptorinhibitingcalciumrelease

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35.Whichofthefollowingis/aretrueabout
pre-anaestheticcheckup(PAC):
a)Notnecessaryinchildren

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b)Usedtoassesspatientconditiontotolerateanaesthesia&
surgery
c)Canbeperformedbysurgicalfaculty
d)Relievesanxietyofpatient
e)Helpinplanninganaesthesiatechnique

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CorrectAnswer-B:D:E
Ans.(B)Usedtoassesspatientconditiontotolerate
anaesthesia&surgery(D)Relievesanxietyofpatient(E)Helpin
planninganaesthesiatechnique
PACisequallynecessaryininfant&children(infact,evenmore

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thanadults).
Infantsareatamuchgreaterriskofanestheticmorbidity&mortality
thanolderchildren;riskisgenerallyinverselyproportionaltoage.
Pre-anaestheticCheckup(PAC):Goals:
Toreduceanxiety&educatethepatientaboutanaesthesia

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Toobtaininformationaboutpatient\medicalhistory
ToPerformPhysicalexamination
Todeterminewhichtestsarerequired
Toplonanaesthetictechnique.
Toobtaininformedconsent

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Togiveanypreoperativeinstructions

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36.Whichofthefollowingstatementis/are
trueregardingintravenousfluid:
a)Ringerlactateiscrystalloidofchoiceforbloodlossreplacement
b)Colloidisfluidofchoiceinsevereshock

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c)5%Dextroseshouldbeavoidedinheadinjury
d)0.45%salinecontains154mEq/LNa+&154mEq/LCi?
e)Dextrosenormalsaline(DNS)ishypotonic
CorrectAnswer-A:B:C
Ans.(A)Ringerlactateiscrystalloidofchoiceforbloodloss

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replacement(B)Colloidisfluidofchoiceinsevereshock
(C)5%Dextroseshouldbeavoidedinheadinjury
[Ref:MorganAnaesthesiaSth/1163-66;Ajayyadav5th/12-15;Lee
Anaesthesia13th/232-33;Miller7th/2799]
Colloidsareonlyreservedforsevereshock.

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Bloodglucosecontrol:
Hyperglycaemiaisknowntoexacerbatecerebrallacticacidosisand
consequentlyaggravatescerebralischaemiainheadinjury.
Thereforeglucosesolutionsshouldbeavoided.
Dextrose:

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Aggregateischemicneurologicinjury
Hyperglycemiamayalsoconstituteahormonallymediatedresponse
tomoresevereinjury.
Ringerlactate:
Crystalloidofchoiceforbloodlossreplacement.

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NormalSaline:
0.9%NaClisotonicsolution

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DextroseNormalSaline:
Hypertonic

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37.

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Whichofthefollowingis/aretrue
regardinganaestheticgas:
a)N20-increasesefficacyofotherinhalationalagents
b)Halothane-agentofchoiceinchildren
c)Sevofluraneisagentofchoiceinchildren

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d)Isoflurane-smoothinduction
e)None
CorrectAnswer-A:C
Ans.(A)N20-increasesefficacyofotherinhalationalagents
(C)Sevofluraneisagentofchoiceinchildren

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NitrousOxide:
Goodanalgesia
Itisnotcompleteanaesthesia(usedasasupplementtoanesthesia)
Whengivenalongwithotherinhalationalagentitincreasesthe
alveolarconcentrationofthatagent(secondgaseffect)

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Notamusclerelaxant
Sevoflurane:
Odourissweetsoinductionissmooth
Faster,pleasant&smoothinductionwithnosignificantsystemic
toxicitymakessevofluraneistheagentofchoiceforinductionin

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children

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38.TrueaboutEndotrachealtube:
a)Mostcommonusedsizeforadultmaleis8-8.5
b)Mostcommonusedsizeforadultfemaleis7-7.5
c)PVCtubeisreusablebycleaning

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d)Inchildrencuffedtubeisnotused
e)Cuffisforaspirationofsecretions
CorrectAnswer-A:B:D
Ans.(A)Mostcommonusedsizeforadultmaleis8-8.5
(B)Mostcommonusedsizeforadultfemaleis7-7.5(D)In

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childrencuffedtubeisnotused
[RefAjayYadav5th/43-46;Lee13th/209;Miller7th/Chap10;
Morgansclinicalanesthesia5th/321]
Thesizeofthetrachealtubeisnormallydescribedastheinternal
diameter(ID)inmillimeters.

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Trachealtubesizeof8mm(ID)formolesand7.5mm(ID)for
femalesareoftenused.
Twotypes-redrubber(reusable,costlier,non-transParent)&PVC
(disposable,cheap,transparent).
CuffpreventleakagebetweentheETT&thetrachea-bothleakage

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ofgasoutwardsduringIPPV&ofgastriccontents,blood&mucus
intothelungs.
Inchildrenlessthan10yearsofageuncuffedtubeshouldbeused
&-thereshouldbeslightleaktoavoidbarotraumasifinspiratory
pressureexceedsabove30cmH2O.

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39.Trueaboutsubarachnoidblock(spinal
anesthesia):
a)Cannotbeusedininfant&children
b)Canbegivenbyunskilleddoctor
c)MaybeusedwhenI.Vaccessisnotpossibleforintravenous

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drugs
d)Hypotensionismostcommonside-effect
e)None
CorrectAnswer-D
Ans.D.Hypotensionismostcommonside-effect

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[RefAjayYailav5th/155-61;Lee13th/479;OxfordHandbookof
Anesthesia3rd/832]
Subarachnoidblock:
Mostcommonlyusedanaesthetictechnique
AdultlevelisusuallyL3-4

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Indications:
Orthopaedicssurgerygeneralsurgery(pelvic&perineal),
gynecological&obstetricalsurgery'urologicalsurgeriesetc.,
MostcommonlydrugsusedinIndiaare-xylocaine(lignocaine)&
Sensoricaine(bupivacaine)

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Hypotensionismostcommonside-effect:
Managedbypreloading&intraoperativefluidsvasopressors.For
thisgoodi.VaccessisveryimPortant.

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40.IndicationofCVPlineis/are:
a)CVPmonitoringinshockpatient

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b)Priortomajorsurgery
c)ForadministeringinotropicsthroughCVPlineinshockpatients
d)Ineverycaseofcaesareansection
e)Forgivingbloodinpatientwithseverehaemorrhage
CorrectAnswer-A:B:C:E

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Ans.(A)CVPmonitoringinshockpatient(B)Priortomajor
surgery(C)ForadministeringinotropicsthroughCVPlinein
shockpatients(E)Forgivingbloodinpatientwithsevere
haemorrhage
[RefAjayYadav5th/59;Morgan'sclinicalanesthesia5th/100]

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IndicationofCVP:
Majorsurgerieswherelargefluctuationsinhaemodynamicsare
expected
Openheartsurgeries
Fluidmanagementinshock

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Asvenousaccessinpatientswithpoorperipheralveins
Parenteralnutrition
Aspirationofairembolism
Cardiacpacing

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41.APatienthashypersensitivityto

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neostigmine.Hehastoundergoupper
abdominalsurgery.Musclerelaxantof
choiceis:
a)Pancuronium
b)Ropacuronium

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c)Vecuronium
d)Atracurium
e)Piperacurium
CorrectAnswer-D
Ans.D.Atracurium

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[Ref:AjayYadav5th/116-17;Lee13th/189-95]
Atracuriumundergospontaneousdegradationinplasmacalledas
Hoffmandegradation.
Atracuriumisrelaxantofchoiceifreversalagentiscontraindicated.
Othermusclerelaxants:

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(mentionedinquestion)requirereversalwithneostigmine(butNe
cannotuseneostigmineduetohypersensitivity),socannotusein
thispatient

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42. Whichofthefollowingcondition(s)can
causeexaggeratedhyperkalemiain

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patientswithuseofsuccinylcholine:
a)Burn
b)Spinalcordinjury
c)Musculardystrophy
d)Tetanus

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e)Abdominalorganinjury
CorrectAnswer-A:B:C:D
Ans.(A)Burn(B)Spinalcordinjury(C)Musculardystrophy
(D)Tetanus
[RefAjayYaday5th/112-13;Lee13th/190;KDT7th/355;Barash

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ClinicalAnesthesia6th/MR]
Succinylcholine&hyperkalemia:
Inpatientswithextensiveburn&softtissueinjuries.
Alsointetanus&spinalcordinjuries,neurological&muscular
disorders(stroke,cerebralpalsy&musculardystrophy).

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Aftermajordenervationinjuries,spinalcordtransection,peripheral
denervation,stroke,trauma,extensiveburns,andprolonged
immobilitywithdisease

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43.Whichofthefollowingdoesnotincrease
intracranialpressure:

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a)Sodiumthiopentone
b)Desflurane
c)Mannitol
d)Sevoflurane
e)Propofol

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CorrectAnswer-A:C:E
Ans.(A)Sodiumthiopentone(C)Mannitol(E)Propofol
[RefAjayYadavp.86,109;Lee/643-45]
Mannitolisusedinthetreatmentofincreasedintracranialtension.

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44.Mechanismofactionofgeneral

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anesthesiais/are:
a)GABA-Areceptor
b)GABA-Breceptor
c)NMDAreceptor
d)Na+channelblockage

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e)None
CorrectAnswer-A:C
Ans.(A)GABA-Areceptor(C)NMDAreceptor
[Ref:KDT7th/372-73;AjayYadav5th/71;Lee13th/149;Miller
6th/721-22]

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MechanismofGeneralAnaesthesia:
TheGABA-AreceptorgatedCl-channelisthemostimportantof
these.
Manyinhalationalagents,barbiturates,benzodiazepinesepropofol
Actionofglycineinthespinalcord&medullaisaugmentedby

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barbiturate,Propofol&manyinhalationalanaesthetics.
InhibitionofexcitatorytypeofNMDAtypeofglutamatereceptor:
Ketamine&N2O.

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45.Whichofthefollowingstatementis
correctregardingmechanismofactionof

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localanaesthesia:
a)Blockageofrestingsodiumchannelmoreisthanactivated
sodiumchannel
b)Fasterconductingfibersblockedeasily
c)BlockNa-KATPasechannel

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d)Finetouchgoesbeforepain
e)Inregionalblocki.vinjectionisused
CorrectAnswer-E
Ans.E.Inregionalblocki.vinjectionisused
[Ref,AjayYadav5th/138-140,149;Lee13th/369-374]

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MOA:
Thekeytargetoflocalanestheticsisthevoltage-gatedsodium
channel.
Thebindingisintracellularandismediatedbyhydrophobic
interactions.

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Localanestheticsblockvoltage-gatedsodiumchannelsandinterrupt
initiationandpropagationofimpulsesinaxons.
Localanestheticsreversiblyinhibitperipheralnerveconductionby
blockingvoltagegatedsodium&potassiumchannel.
Theaffinityofthesodiumreceptorishigherinopenorinactivated

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statesthanintherestingstate.
Blockadesequenceis-sympathetic>temperature(cold)>pain(prick)
>proprioception(Lighttouchwithcotton).

---

46.AllaretrueregardingLaryngealMask
Airwayexcept:

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a)Bigoraltumoriscontraindicationforitsuse
b)MaybeusedwhenintubationwithETTisnotpossible
c)Canbeusedinchild'seyesurgery
d)MaybeusedinCPR
e)None

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CorrectAnswer-E
Ans.(E)NONE
[RefAjayYadav5th/42-43;LeeAnaesthesia13th/206-08;Morgo4
Anesthesia4th/97;DorschDorschanesthesiaequipment5th/488;
Miller\anesthesia6th/I627]

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Advancedcardiaclifesupport(PartofCPR):
Forbreathing-Advancedmethodlikeendotrachealtube,LMA,
combitubeortracheostomytube.
LaryngealMaskAirway(LMA):
Asanalternativetointubationwheredifficultintubationisanticipated

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Anelectivemethodforminorsurgerieswhereanesthetistwantsto
avoidintubation(Likeeyesurgeryinchildren).
Contraindication:oropharyngealmass.
LMAprovidesanalternativetoventilationthroughafacemaskor
endotrachealtube(ETT).

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LMAhasprovenparticularlyhelpfulasatemporarymeasureif
patientswithdifficultairways(thosewhocannotbeventilatedor
intubated)becauseofitseaseofinsertion&relativelyhighsuccess
rate(95-99%).

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C/IforLMAincludes:patientwithpharyngealpathology(e.g.,

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abscess),pharyngealobstruction,fullstomach(e.g.,pregnancy,
hiatalhernia)orlowpulmonarycompliance

---

47.Whichofthefollowingcircuitispreferred
inchildforspontaneousrespiration:
a)MaplesonA

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b)Jackson&Reescircuit
c)MaplesonC
d)MaplesonE
e)MaplesonF
CorrectAnswer-A

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Ans.(A)MaplesonA
[RefAjayYadav5th/35;DorschAnesthesiaEquipment5th/213-215;
MorganAnesthesia5th/i3;4th/35-37]
PediatricBreathingCircuits:
TypeEMaplesonCircuit:

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ItisAyre'sTpiecewithcorrugatedtubing.
Itisapediatriccircuit
Asitdoesnothavebreathingbagsoitisnotacompletecircuit(It
wasmadecompletebyattachingabreathingbagbyattachinga
breathingbagbyJackson&Rees).

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TypeEisbasicallyacircuitonlyforspontaneousrespiration(asit
doesnotcontainbreathingbag)butcanbeutilizedforcontrolled
ventilationbyintermittentlyoccludingtheendofexpiratorylimb

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48.Weaningisgenerallydoneby:
a)SIMV

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b)Controlledmodeventilation(CMV)
c)CPAP
d)PressurecontrolledVentilation
e)AssistedcontrolledVentilation
CorrectAnswer-A:C

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Ans.A,SIMV&C,CPAP
[RefAjayYadav5th/239-40;Morgan5th/1298;Milleranesthesia6th]
Weaning:
Meansdiscontinuingtheventilatorsupport.
WeaningprocessmayvaryfromPatienttoPatient,hospitalto

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hospital(dependingonthetypeofventilatoravailable)6clinicianto
clinician4ispossibletoweanpatientinanymodeofventilation
exceptcontrolmodeventilation
TechniquesforWeaning:
Thecommontechniquestoweanapatientfromtheventilator

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includeSIMVpressuresupport,orperiodsofspontaneousbreathing
aloneonaT-pieceoronlowlevelsOfCPAP
Mandatoryminuteventilationhasalsobeensuggestedasanideal
weaningtechniques,butexperiencewithitislimited.
MostoftenaPPLiedapproachisthatpatientfromcontrol/assist

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controlmodeventilationisshiftedtoSIMV&thenkeepon
decreasingtherateofbreathdeliveredbyventilatorgraduallytillit
becomes1to2breath/min

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49.Achildonimmediatepostoperative,is
complainingofnausea&vomitingafter

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squintsurgery.Whichofthefollowing
drugsmaybenotusedduringoperation
incontrollingthissymptom:
a)Propofol
b)Ketamine

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c)Dexamethasone
d)Ondansetron
e)Palonosetron
CorrectAnswer-A:C:D
Ans.A,PropofolC,Dexamethasone&D,Ondansetron

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[RefAjayYadavSth/132;LeeAnaesthesial3th/630]
StrabismusSurgeryinPaediatricPatient:
Keyfeaturesinrelationtostrabismusareoculocardiacreflexin
responsetosurgicalmovementofglobe,postoperativenausea&
vomiting(PONV)&theassociationofstrabismuswithoccult

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myopathies&possiblymalignanthyperthermia.
Antiemesisisimprovedbyuseofpropofoloninduction&
maintenance&bythepreemptiveuseofboth5-hydroxy-tryptamine
inhibitors&dexamethasone,
OpioidsshouldbeavoidedbecauseregularNSAIDSareas

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effective.
TopicalNSAIDS(Ketorolac0.5%oo/o,diclofenacl%)havebeen
usedwithsomesuccess.

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Theincidenceofoculocardiacreflexcanbereducedbytheuseof
ketamineatinduction&bytheuseofmedialcanthalinjectionof

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localanaesthetic(lidocaine),whichalsoreducestheneedfor
postoperativeanalgesia

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50.Whichofthefollowingfluidusedin
perioperativeperiodisisotonic:
a)RL

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b)DNS
c)5%Dextrose
d)HES
e)NS
CorrectAnswer-A:C:D:E

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Ans.A,RLC,5%DextroseD,HES&E,NS
[RefAjayYadav5th/12-15;LeeAnaesthesiap.232-33;Morgan
5th/1164]
RingerLactateSolution(RL,Hartmansolution):
Lactateismetabolizedtobicarbonateinliver

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RingerlactateiscrystalloidofchoiceforbloodlossrePlacement.
RLisslightlyhypotonic.
NormalSaline:
0.99%NaClisotonicsolution.
PreferredoverRLfortreating:hypochloremicmetabolicalkalosis,

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braininjury(Catinlactatecanincreasetheneuronalinjury)&
hyponatremia
DextroseNormalSaline:
Hypertonic.
bestusedasmaintenancefluid.

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HydroxyethylStarch(Colloid):
Types:Hetastarch&Pentastarch

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