Download PGIMER (Post Graduate Institute of Medical Education & Research, Chandigarh) 2020 May Anesthesia Solved Question Paper
aminoesters.Whatcanbeused?
a)Cocaine
b)Procaine
c)Prilocaine
d)Bupivacaine
e)Tetracaine
CorrectAnswer-C:D
Ans.is'c'i.e.,Prilocaine&'d'i.e.,Bupivacaine
[Ref:Lee's13th/ep.486]
Prilocaine&bupivacaineareamides(amcinonide).Otherthreeare
aminoesters.
2.TRUEstatementregardinginhalational
anesthesiais/are?
a)Sevofluraneistheagentofchoiceforchildrenandasthma
patients
b)Sevofluraneshouldnotbeusedwherethegasflowrateisless
than2L/min
c)Desfluraneshouldnotbeusedforinductioninchildren
d)Isofluraneismorepotentthansevoflurane
e)Halothaneistheagentofchoicefordaycaresurgery
CorrectAnswer-A:B:C:D
Ans.is'a'i.e.,Sevofluraneistheagentofchoiceforchildrenand
asthmapatients,'b'i.e.,Sevofluraneshouldnotbeusedwhere
thegasflowrateislessthan2Llmin,'c'i.e.,Desfluraneshould
notbeusedforinductioninchildren&'d'i.e.,Isofluraneis
morepotentthansevoflurane
[Ref:AjayYadavSth/ep.70-87;MorganSth/ep.163-70]
"InJune1995'theFoodandDrugAdministration(FDAIapproved
theclinicaluseofsevoflurane.butwithawarningthatnotsuedat
freshgasflowslessthan2l/minbecausesufficientdatahadnot
beenpresentedtoestablishitssafetyinthatcircumstance.
TheFDAwasconcernedthatsevofluranemaycauseadverserenal
effectsatlowflowsbecauseitisdegradedbythestrongbasesin
CO2absorbentstofluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl
ether(compoundA).
-http://anesthesiologlt,pubs.asahq.org/article.aspx?
articleid=2026924
3.Ifyouareaskedtocollect4serialsamples
fromlumbarpuncture.Whatshouldbe
donewithfirstsample?
a)Cellcountslikedifferentialcounts
b)Biochemicaltests[protein&glucoseetc
c)Bacterialcultureandgramstaining
d)Mycobacterial&fungalcultureandstaining
e)Noneoftheabove-discardthesample
CorrectAnswer-A
Ans.is'a'i.e.,Cellcountslikedifferentialcounts
Ref:https://emedicine.medscape.com/article/80773-technique
Theclassicapproachistosendthe4CSFtubesforthe
followingstudies:
1. TubeI-Cellcountanddifferential
2. Tube2-Glucoseandproteinlevels
3. Tube3-Gramstain,cultureandsensitivity(C&S)
4. Tube4-Cellcountanddifferential
4.Trueregardinglocalanesthaticsis/are?
a)Prilocaineislongeractingthenbupivacaine
b)Tetracaineismorepotentthanlignocaine
c)Dibucaineisthelongestactinglocalanesthetic
d)Bupivacainecanproducecardiotoxicity
e)Cocainecanproducehypotension
CorrectAnswer-B:C:D
Ans.is'b'i.e.,Tetracaineismorepotentthanlignocaine,'c'i.e.,
Dibucaineisthelongestactinglocalanesthetic&'d'i.e.,
Bupivacainecanproducecardiotoxicity
[Ref:Morgan4th/ep.266-270,926;AjayYadav4'h/ep.118;
Essentialofanaesthesia4th/ep.116;Goodman&GilmanLLth/ep.
375]
ChloroprocaineistheshortestactingLA.
Dibucaineisthelongestacting.mostpotentandmosttoxicLA.
Procaine&chloroprocaineareleastpotentLAs.
BuQivacaindisthemostcardiotoxicLA(Ropivacaineisanewer
bupivacainecongenerwithlesscardiotoxicity).
Levobupivacaine(TheS(-)enantiomerofbupivacaine)isless
cardiotoxicandlesspronetocauseseizure.
PrilocaineandBenzocainecancauseMethemoglobinemia.
LignocaineisthemostcommonlyusedLA.
Bupivacainehasthehighestlocaltissueirritancy
Chloroprocaineiscontraindicatedinspinalanaesthesiaasitcan
causeparaplegiaduetothepresenceofneurotoxicpreservative
sodiummetabisulphite.
ProcaineistheLAofchoiceinmalignanthyperthermia.
5.Whichofthefollowinganestheticshould
notbeusedinapatientofchronicrenal
failure?
a)Methoxyflurane
b)Ketamine
c)Pancuronium
d)Succinylcholine
e)Desflurane
CorrectAnswer-A:B:C
Ans.is'a'i.e.,Methoxyflurane,'b'i.e.,Ketamine&'c'i.e.,
Pancuronium
[Ref:Morgan4th/ep.219]
Musclerelaxants
Atracurium/cisatracuriumarethemusclerelaxantofchoiceasthere
eliminationisnotdependentonkidney.
Mivacuriumisanalternativeasitseliminationisalsoindependentof
kidney.
Gallamineandmetocurineareentirelydependentonrenalexcretion
forelimination)Contraindicatedinrenaldisease.
Pancuronium.pipecuranium,Alcuroniumanddoxacuriumare
Primarilydependentonrcontraindicated,howeverneuromuscular
functionshouldbecloselymonitoredr.ftheseagentsareusedin
Patientswithabnormalrenalfunction.
VecuroniumandRocuroniumareprimarilyexcretedinBile(hepatic
elimination)butsomeamountiseliminatedinurinealso.
So,onlythreenon-depolarizingblockershavenoeliminationthrough
kidney:-Atracurium,Cisatracurium,Mivacurium
Succinylcholine(delnlarizingblockerlisalsoindependentofrenal
excretionforelimination.
ItcanbesafetyusedinthePresenceofrenalfailure.provided
serumpotassiumconcentrationislessthan5mg/L.
6.IncomparisontoIJVcannulation,true
aboutsubclavianveincannulationis/are?
a)Morechancesofpneumothorax
b)Moreincidenceofcathetermalposition
c)Moreinfectiouscomplications
d)Moresafetyinultrasoundguidedtechnique
e)Alloftheabove
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]
Subclavianveincannulation
Goodexternallandmarks
Largeradius
Practicalmethodofcentrallineincardio-respiratoryarrest
Blindprocedure
Ultrasoundnotmuchuseful
Shouldnotbeattemptedinchildren<2years
Unabletocompressbleedingvessels
Morecommon&frequent:Cathetermalposition,Pneumothorax,
hemothorax,Pinch-offsy:rdrome.
Lesscommon&frequent:Arterialpuncture,Thrombosis,
infectiouscomplications.
7.Apatient,plannedforcesareansection,
developshypotension8minutesafterthe
spinalanesthesia.Drugswhichcanbe
usedtotreatthisare?
a)Ephedrine
b)Mephenteramine
c)Adrenaline
d)Dopamine
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]
Managinghypotensioninducedbyspinalanesthesiafor
caesareansection:
Treatment
Inspiteofusingalltheprophylacticmeasures,40o/oto60%of
patientswillstillneedtreatmentforhypotension:-
i)Fluidloadingissuperiortono-fluidregimen;however,the
incidenceofPSHisstillhighwithallfluidloadingprotocols
ii)Vasopressors:-
Phenylephrine(PE)ispreferredvasopressor.
PreventionandtreatmentofPSHbecauseoffasteronset.
Ephedrinemaybemorebeneficialinpatientswithbradycardia.
Norepinephrineinfusionwasrecentlyinvestigatedasanalternative
forprophylaxisofPSH.
OndansetronwasreportedasaprophylacticdrugfromPSH
Othersympathomimeticdrugsusedaremephentermine.
metaraminol,methoxamine,dopamineand,angiotensinII
Atropineshouldbegivenforbradycardia
8.Endotrachealintubationis/areassessed
by:
a)Mallampatigrading
b)ASAphysicalstatusgrading
c)Thyromentaldistance
d)Teetharrangement
e)None
CorrectAnswer-A:C:D
Ans.A,MallampatigradingC,Thyromentaldistance&D,Teeth
arrangement
Ref:ManipalSurgery4th/1072-73;AjayYadav5th/53'124;Morgan
5th/312-13
ASAphysicalstatusgradingisforgeneralhealthstatusofpatient
(notforassessingintubation)
AssessmentofDifficultIntubation:
Mallampatigrading:ItisdonetoassessmouthoPening
Thyromentaldistance(distanceb/wthyroidnotchtomental
prominencewithfullyextendedneck)
Mentohyoiddistance:normal>5cm
AssessmentofTMjointfunction:Interincisorgap(mouthopening)
shouldbeatleast5cm(2fingerbreadth)
NeckMovement
9.Drug(s)notgivenastransdermalpatch:
a)Fentanyl
b)Diclofenac
c)Morphine
d)Clonidine
e)Buprenorphine
CorrectAnswer-B:C
Ans.B,Diclofenac&C,Morphine
[Ref:KDT7th/476
Transdermalfentanyl(Durogesic)hasbecomeavailableforusein
cancer/terminalillness.
Butransskinpatchescontainbuprenorphineanopioidpain
medication.
Clonidinetransdermaldelivery(patch)systemshavebeenavailable
sincethe1980
10.Trueaboutdesflurane:
a)Boilingpointis<230C
b)ChemicallyitisFlourinatedmethylethylether
c)Itincreasestheeffectofmusclerelaxant
d)Canbegivensafelytopatientsusceptibletomalignant
hyperthermia
e)Morepotentthanisoflurane
CorrectAnswer-A:B:C
Ans.A,Boilingpointis<230CB,ChemicallyitisFlourinated
methylethyletherC,Itincreasestheeffectofmusclerelaxant
[RefAjeyYadavSth/82;MorganSth/170&71)
Desflurane:
Fluorinatedmethylethylether
Boilingpointislessthan20C.
Producesmaximummusclerelaxationamongtheagents.
5timeslesspotentthanisoflurane.
Lossofpotency(theMACofdesfluraneis5timeshigherthan
isoflurane)
Immunemediatedhepatitisarareoccurrence.
hasthelowestblood:gassolubilityofthepotentvolatileanesthetics
11.Trueabouttracheostomy:
a)Tracheostomytubemayclosedbymucoussecretion&crust
formation
b)Copioussecretionfromtubeisalwaysduepulmonaryinfection
c)X-raychestshouldbedoneforconfirmationineverycase
d)Improperpositioningmayleadtofatalhaemorrhage
e)Displacingoftubeafter2weekismedicalemergency
CorrectAnswer-A:D
Ans.A,Tracheostomytubemayclosedbymucoussecretion&
crustformationD,Improperpositioningmayleadtofatal
haemorrhage
RefSchwartz9th/59-Iqhttp://www.nurses.com/;pL.Dhingra6th/
3I6-20;AjayYadav5th/48-49;MilloAnaesthaiaZth/232&IBit-72
Reintubationinthefirst36hoursaftertracheostomyIson
emergency.
TracheostomytubeshouldnotbedisturbedForthefirst48-72hr,
butthereafterthetubeischangeddaily&cleanedatregularinterval.
Recentstudydonotsupportobtainingaroutineposttracheostomy
chestX-ray.
Themostdramaticcomplicationistracheo-innominatearteryfistula
(TIAF).
Palpabletubepulsationsuggestimpendingerosionofanartery,
Trachealdeviationmaysignalabdomenbleeding
12.CnrnnonentofAdvancedcardiovascular
lifesupport(ACLS)inaccordancetoAHA
2015guideline:
a)Chestcompression100-150perminute
b)Chestcompressionatleast5cm/2inch
c)VasopressorsisusedtomaintainMAP>70mmHginnon-
responsivetofluids
d)1Breathevery8seconds
e)Vasopressinisusedasvasopressor
CorrectAnswer-B
Ans.B.Chestcompressionatleast5cm/2inch
Basiclifesupport(BLS),advancedcardiovascularlifesupport
(ACLS),andpost-cardiacarrestcarealldescribeasetofskillsand
knowledgeappliedsequentiallyduringthetreatmentofpatientswho
haveacardiacarrest.
ACLScomprisesthelevelofcarebetweenBLSandpost-cardiac
arrestcare
Updaterecommendationsforadvancedcardiaclifesupport
2015:
Thecombinedusevasopressinandepinephrineoffersnoadvantage
tousingstandard-doseepinephrineincardiacarrest.
VasopressinhasbeenremovedfromtheAdultCardiacArrest
Algorithm-2015update.
AdvancedCardiacLifeSupport:
Continuouschestcompressionsatarateoflil)/rninto120/min,
vnthoutpausesforventilation.Theproviderdeliveringventilation
shouldprovide1breathevery6seconds(10breathsperminute).
Itmaybereasonabletoavoidandimmediate$rcorrecthypotension
(SBp<90mmHg,MAp<65mmHg)duringpost-cardiacarrest
care.
13.Anaestheticagents(s)having
epileptogenicpotential:
a)Atracurium
b)Etomidate
c)Enflurane
d)Pethidine
e)Propofol
CorrectAnswer-A:C:D
Ans.(A)Atracurium(C)Enflurane(D)Pethidine
Etomidate:Doesnothaveepileptogenicpotential.
Enflurane:Athighdosesitproducesspikeandwavepatternin
EEGwhichculminatesintofranktonic-clonicseizure.
Atracurium:Itsmetabolicproductlaudanosine(Laudanosine
Toxicity)-seizuresprecipitated.
Ketamlnecanelicitseizuresinpatientswithanepilepticdiathesis.
Propofol:Significantanticonvulsantactivity.
14.Trueaboutxenonisare:
a)Environmentfriendly
b)Cheap
c)Lowbloodsolubility
d)Inert
e)Stable
CorrectAnswer-A:C:D:E
Ans.(A)Environmentfriendly(C)Lowbloodsolubility(D)Inert
(E)Stable
Advantagesanddisadvantagesofxenon(Xe)anesthesia:
Advantages:
Inert(probablynontoxicwithnometabolism).
Minimalcardiovasculareffects.
LowbloodsolubilitY.
Rapidinductionandrecovery
Doesnottriggermalignanthyperthermia
Environmentalfriendly.
Nonexplosive
Disadvantages:
Highcost
Lowpotency{MAC=70%)
15.Ingastubing,rateofturbulentflow
dependsupon:
a)Viscosityofgas
b)Pressuregradient
c)Lengthoftube
d)Radiusoftube
e)Densityofgas
CorrectAnswer-B:E
Ans.(B)Pressuregradient(E)Densityofgas
Turbulent
Turbulentflowisproducedifflowrateisveryhighorifgaspasses
throughbends,constrictions.
Flowisrough.
Reynold'snumbermustexceedto2000forturbulence.
Turbulentflowismoredependondensity
16.Gasstoredinliquidstateincylinders:
a)Nitrogen
b)Helium
c)CO2
d)Cyclopropane
e)Nitrousoxide
CorrectAnswer-C:D:E
Ans,(C)CO2(D)Cyclopropane(E)Nitrousoxide
Oxygen,nitrogen,airandheliumarestoredincylindersasgases.
Nitrousoxide,carbondioxideandcyclopropanearestoredinas
liquidinequilibriumwithsaturatedvapour.
ColourofCylinders:
O2-Blackbodywithwhiteshoulder
N2O-Blue
CO2-Grey
Cyclopropane-orange
Helium-Brown
Air-Greybodywithblackandwhiteshoulders
Entonox-Bluebodywithblueandwhiteshoulders(50%O2.+50%
N2O).
17.Trueaboutcaudalanesthesiainchildren:
a)Averagedistancefromtheskintotheanteriorwallofthesacral
canalis21mm
b)0.5mL/kgdoseofbupivacaineissufficientforlumberand
sacraldermatomesblock
c)Beyond6-7yearsofage,itisdifficulttogiveandisless
successfulincomparisontoyoungerchildren
d)2-3cmofepiduralcatheterisadvancesthroughepiduralspace
incontinuosinfusion
e)Distancefromtheupperborderofthesacralhiatustothedural
sacis30?10.4mm
CorrectAnswer-A:C:D:E
Ans.(A)Averagedistancefromtheskintotheanteriorwallof
thesacralcanalis21mm(C)Beyond6-7yearsofage,itis
difficulttogiveandislesssuccessfulincomparisonto
youngerchildren(D)2-3cmofepiduralcatheterisadvances
throughepiduralspaceincontinuosinfusion(E)Distancefrom
theupperborderofthesacralhiatustotheduralsacis
30?10.4mm
CaudalAnesthesia
Normallengthofcathetertobeintroducedintotheepiduralspacels
2to3cm,asforanyepiduralblock.
Dosageprescriptionscheme:
1. With0.5mL/kg,allsacraldermatomesareblocked.
2. With1.0ml/kgallsacralandlumbardermatomesareblocked.
3. With1.25ml/kg,theupperlimitofanesthesiaisatleastmidthoracic.
Drugused:Thedoseof0.25%bupivacainets0.5-O.75ml/kg
Extraduralspacebelowsacralhiatusmayrangefrombeingdeepto
excessivelyshallow-itsaveragelengthls10-15cm.
ItsanatomyismoreeasilyappreciatedininfantsandchilDren
Indications:
Useforpattants<8yearsoldtoprovideintraoperativeand
postoperativeanalgesiaforabdominalandlowerextremitysurgery.
Technique:
Advanceneedleandcatheter2to4mm.
18.
Anaestheticusedforinductionin
pediatricsurgeryis?
a)Propofol
b)Thiopentone
c)Ketamine
d)Diazepam
e)Etomidate
CorrectAnswer-A:B:E
Ans.(A)Propofol(B)Thiopentone(E)Etomidate
AnaestheticsinPediatricpatients:
Induction
Inhalationalinduction:
Inhalationalagentwithmask-Inductionmethodofchoicein
children.
Sevoflurane-Inductionagentofchoiceinchildren.
UsedinN2O+O2gasmixture.
Halothane-2ndInductionagentofchoice.
Intravenousinduction:
THiopental/propofol(Outpatientsurgery).
Ketamine-preferredinchildrenwithhypovolemia.
Etomidate-preferredinchildrenwithunstablecardiovascularstatus
19.Atracuriumismetabolizedby-
a)Conjugation
b)Hoffmandegradation
c)Pseudocholineaterase
d)Methylation
e)None
CorrectAnswer-B
Ans.B.Hoffmandegradation
Theuniquefeatureofatracuriumisinactivationinplasmaby
spontaneousnonenzymaticdegradation(Hofmannelimination).
Consequentlyitsdurationofactionisnotalteredinpatientswith
hepatic/renalinsufficiencyorhyperdynamiccirculation--->Hence,
preferredmusclerelaxantforsuchpatientsaswellasforneonates
andtheelderly.
Atracurtumismetabolisedtolaudanosinethatisresponsiblefor
seizures.
Causehistaminerelease>Hypotension,bronchoconstriction&
flushing.
20.Ventilatorassociatedcomplication(s)
is/are?
a)Barotrauma
b)Subglotticstenosis
c)Pneumoperitoneum
d)Paralyticileus
e)Increasedcardiacoutput
CorrectAnswer-A:B:C:D
Ans.(A)Barotrauma(B)Subglotticstenosis
(C)Pneumoperitoneum(D)Paralyticileus
[RefEssentialsofanestheticemergenciesp.123]
Complicationsofmechanicalventilator:
Barotrauma-Causepneumothorax,pneumomediastinum,
bronchopleuralfistula,pneumopericardium/cardiactamponade,
Pneumoperitoneum,systemicairembolismandpulmonary
embolism.
Hemodynamiccomplications
Nosocomialinfections:Pneumonia,UTI
Acid-basedisturbances-RespiratoryalkalosisduetoCO2washout.
Waterretention.
GIT-Mainlyparalyticileus.
21.Headachefollowingduralpuncture,
treatmentis:
a)ACTH
b)Clonidine
c)Steroids
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,
510;www.cochrane.org
Postduralpunctureheadache:
DuetoCSFleakfromaduraldefect&decreasedICT.
Mostcommoncomplicationofspinalanesthesia.
Typicallocationisbifrontaloroccipital.
Onset
Usually12-72hotrsfollowingtheprocedure.
Lastsfor7-10days.
Management:
UseofsmallboreneedlecanpreventpDpH.
Conservativetreatment:
Analgesics(NSAIDs),oralori.v.fluids.
Drugs:Cosyntropin,caffeine,hydrocortisone,gabapentin,
theophylline,sumatriptan,pregabalinandACTH.
22.Pre-anaestheticmedicationisgivento?
a)Reduceanxietyandfear
b)Reductionofsecretionofsaliva
c)Toproduceamnesia
d)Topreventundesirablereflexes
e)Preventvomiting
CorrectAnswer-A:B:C:D
Ans.(A)Reduceanxietyandfear(B)Reductionofsecretionof
saliva(C)Toproduceamnesia(D)Topreventundesirable
reflexes
[RelKDT6h/ep.378]
Preanaestheticmedication:
Aims:
1. Reliefofanxietyandapprehensionpreoperativelyandtofacilitate
smoothinduction.
2. Amnesiaforpreoperativeandpostoperativeevents.
3. Supplementanalgesicactionofanaestheticsandpotentiatethem.
4. Decreasesecretionsandvagalstimulation(undesirablereflex).
5. Antiemeticeffectextendingintopostoperativeperiod.
6. Decreaseacidityandvolumeofgastricjuicesothatitisless
damagingifaspirated.
23.Methodsofregionalanaesthesiais/are?
a)Bier'sblock
b)Spinalanaesthesia
c)Rapidsequenceinduction
d)Conscioussedation
e)Surfaceanaesthesia
CorrectAnswer-A:B:E
Ans.(A)Bier'sblock(B)Spinalanaesthesia(E)Surface
anaesthesia
[Ref:Morgan4/ep.269-270]
Regionalanaesthesia(Localanaesthesia):
Methodsare:
1. Topicalanaesthesia(surfaceanaesthesia)
2. Infiltrationanaesthesia
3. Intravenousregionalanaesthesia(Bier'sblock)
4. Conductionblock(eitherfieldblockornerveblock)
5. Spinalanaesthesia
6. Epiduralanaesthesia
24.Ifweincreasethedepthofchest
compressioninCPR,itcauses-
a)Decreasedmortality
b)Increasedbrainperfusion
c)Increasedaorticpressure
d)Ribfracture
e)Hemothorax
CorrectAnswer-A:B:C:D:E
Ans.(A)Decreasedmortality(B)Increasedbrainperfusion
(C)Increasedaorticpressure(D)Ribfracture(E)Hemothorax
Increasingthedepthofchestcompressionalsocarryanincreased
riskofcomplicationslike:-
Riband/orsternalfracture
InjurYtodiaPhragmorlung
Pneumothorax,pneumomediastinum,pneumopericardium
Hemothorax
25.Hypotensiveshockrefractorytofluid,
whatiscontraindicated?
a)Ketamine
b)Atropine
c)Fentanyl
d)Thopentone
e)Etomidate
CorrectAnswer-C:D
Ans.(C)Fentanyl(D)Thopentone
[Ref:Wroerleetextbookofanaesthesiap.54]
Inhypotensivepatients,nosedative,hypnoticoropiateshouldbe
given.
FentanylisanopiateandthioPentoneisasedative(barbiturate).
Ketamineincreasescardiacoutputandbloodpressure-Intravenous
anaestheticofchoiceinshock.
Etomidateproduceslittlecardi-ovascularanilrespiratorydepression
Agentofchoiceforcardiovascularsurgeries(bypassaneurysms,
valvesurgery).
Etomidateismostcardiostableinducingagent.
Ifhypotensionisduetobradycardia-->Atropineisthedrugof
choice.
26.Drugsknowntotriggermalignant
hyperthermia-
a)Halothane
b)Succinylcholine
c)Pancuronium
d)Fentanyl
e)Propofol
CorrectAnswer-A:B
Ans.(A)Halothane(B)Succinylcholine
[RefMorganAnaesthesia5th/ep.1187-9A;AiayYadavp.13j-35;
Miterp.1187-89;Leel3'h/ep.353;Wylle'sAflaesthesiflVh/cp.I65-
67]
DrugscausingMalignanthyperthermia(MH):
Succinylcholine
Halothane
Isoflurane
Enflurane
Sevoflurane
Desflurane
Methoxyflurane
MAOinhibitors
TCA
Phenothiazines
Lignocaine
27.Whenwillyoususpectmalignant
hyperthermiainpostappendectomy
patientshiftedtoICUwithhighfever&-
a)Hypotonia
b)Seizure
c)Masseterspasm
d)Metabolicacidosis
e)Hypokalemia
CorrectAnswer-B:C:D
Ans.(B)Seizure(C)Masseterspasm(D)Metabolicacidosis
[Ref:MorganAnaesthesia5'h/ep.1187-90;AjayYadavSe/ep.133-
35;MillerThlep,1187-89;Leel3'h/ep.35i;Wylie'sAnesthesiaVh/e
p.j65,367]
Malignanthyperthermia:
Theconditionoccursduringorimmediatelyafteranaesthesiaand
maybeprecipitatedbypotentinhalationagents(enflurane,
halothane,isoflurane),orsuxamethonium.
Clinicalfeaturesare:-
MassetersPasmIfapatientdevelopsseveremasseterspasm
aftersuxamethonium,thereisasignificantpossibilityofmalignant
hyperthermia.
Tachycardiaandarrhythmias
Riseinend-tidalCO,(firstsign)
Increasedtemperature&unexpectedchangeinBP.
Seizuresagitationandmusclerigidity
28.Whichofthefollowingis/areusedin
bupivacainetoxicity-
a)CaC12
b)Bretylium
c)Intralipids
d)Esmolol
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.
545]
Managementofbupivacainetoxicity
Ensureadequateoxygenation,whetherbyfacemaskorby
intubation.
Anticonvulsantssuchasbenzodiazepinesandbarbituratesarethe
drugofchoiceforseizurecontrol.
Propofolcanalsobeused.
Succinylcholineissometimesalsousedtoterminatethe
neuromusculareffectsofseizures.
ForunresPonsivebupivacainetoxicity,intravenouslipidor
cardiopulmonarybypassmaybeconsidered.
Forarrhythmias,amiodaroneistheDOC.Bretyliumandesmololcan
alsobeused.
29.Anaesthesiausedforinductionis/are-
a)Propofol
b)Thiopentone
c)Ketamine
d)Diazepam
e)Midazolam
CorrectAnswer-A:B:C:E
Ans.(A)Propofol(B)Thiopentone(C)Ketamine(E)Midazolam
[Ref:MorganAnaesthesia5th/ep.175-82;AjayYadavS,h/ep.92;
Leel3th/ep.155]
Intravenousinducingagents:
Thiopentone
Methohexitone
Propofol
Etomidate
Ketamine
Benzodiazepines
30.Whichofthefollowingcriteriais/areused
forsettingmechanicalventilatorforadult
inICU-
a)Age
b)Gender
c)Weight
d)Height
e)Underlyingconditionofpatient
CorrectAnswer-B:C:D:E
Ans.(B)Gender(C)Weight(D)Height(E)Underlyingcondition
ofpatient
[Ref:MorganAnaesthesia5th/ep.1288;emedicine.medscape.com]
Mainlydependsonidealbodyweight(IBW),whichiscalculated
basedongenderandheight.
WomenIBW(lbs)=105+5(Heightininches-60)
MenIBW(lbs)=106+6(Heightininches-60)
Settingsalsodependatypesoflungdisease,i.e.whetherthe
patientisnormalorwithrestrictivediseaseorwithobstructivelung
disease
31.Trueaboutendotrachealtube-
a)Noncuffedtubeisusedinpediatricagegroup
b)MadeofPVC&disposable
c)Canbeputeitheroralornasalaccordingtodifferentsituations
d)CuffedPVCtubes-lowpressure,lowvolume
e)Moretendencytogotorightbronchusthereby
CorrectAnswer-A:B:C:E
Ans.(A)Noncuffedtubeisusedinpediatricagegroup
(B)MadeofPVC&disposable(C)Canbeputeitheroralor
nasalaccordingtodifferentsituations(E)Moretendencytogo
torightbronchusthereby
[Ref:MorganAnaesthesiap.320-25;AjayYedav5'h/ep.43-46;Lee
l3th/ep.205-09]
Endotrachealtubesaremainlyoftwotypes.
CuffedEndotrachealTube:
CuffPressureshouldnotexceed30cmH2O(22mmHg)toprevent
ischemicdamagetotrachealmucosa.
Twotypes,basedoncuffpressureandvolume.
LowPressure,Highvolume:-
Inthiscuffhashighvolume&lowpressure.
Becauseoflowpressurethesetubesproducelesstrachealinjury,
thereforesuitableforprolongedsurgeries.0
Morecommonlyusedthanhighpressurelowvolumetube.
Thesetubesaremadeupofpolyvinylchloride
Highpressure,lowvolume:
Madeupofredrubber.
UncuffedEndotrachealTube:
Inchildren(lessthanl0yearsofage)uncuffedtubesshouldbeused
andthereshouldbeslightteakoninspiratorypressureof30cmIIrO
32.Trueaboutendotrachealintubation-
a)HeadtraumapatientpresentingwithaGCSscore8orless
shouldbeintubated
b)Doneinpatientswithincreasedriskofaspiration
c)Canbeusedinpatientwithfullstomach
d)Incervicalinjury,patientneckisstabilizedbeforeintuvation
e)Doneinpatientswhoneedanaesthesia
CorrectAnswer-A:B:C:D:E
Ans.(A)HeadtraumapatientpresentingwithaGCSscore8or
lessshouldbeintubated(B)Doneinpatientswithincreased
riskofaspiration(C)Canbeusedinpatientwithfullstomach
(D)Incervicalinjury,patientneckisstabilizedbeforeintuvation
(E)Doneinpatientswhoneedanaesthesia
[RefLeel3tt'/ep.208;MillerVh/ep./586;CSDTl4th/ep.814]
Endotrachealintubationisusedtomaintainapatentairwayin
operationtheateraswellasoutsidetheoperationtheater:-
IndicationsforEndotrachealIntubationintheoperatingroom
include:
Theneedtodeliverpositivepressureventilation.
Protectionofrespiratorytractfromaspirationofgastriccontents.
Surgicalprocedureinvolvingtheheadandneckorinnon-supine
positionsthatprecludemanualairwaysupport.
Almostallsituationsinvolvingneuromuscularparalysis.
Somenon-operativeindicationsare:
Tracheobronchialtoilet(pulmonarytoilet).
Profounddisturbanceinconsciousnesswiththeinabilitytoprotect
theairways.
33.Whichofthefollowingis/arefeature(s)of
epiduralanaesthesiathanspinal
anaesthesia-
a)Smallersizeofneedleisused
b)Drugusedislessinconcentration
c)Lesschanceofspinalheadache
d)Onsetofactionisdelayed
e)Densityofanaestheticagentislessinepiduralthanspinal
CorrectAnswer-B:C:D:E
Ans.(B)Drugusedislessinconcentration(C)Lesschanceof
spinalheadache(D)Onsetofactionisdelayed(E)Densityof
anaestheticagentislessinepiduralthanspinal
[RefMorganAnaesthesiap.959,969;AjayYadav5'h/ep.162;
MillerVh/ep.1626]
Epiduralanaesthesia:
Sloweronsetofaction
Lessreliable
Difficult
DurationcanbeprolongedbyrepeatedlyinjectingLAbyanepidural
catheter.
Canbeusedforupperabdominal,thoracic&necksurgeryaswellin
additiontosurgeriesperformedbyspinalanaesthesia.
PDPHisunlikelybecauseduraisnotpierced->so,thereisnoCSF
leakage.
Epiduralneedlesarelargerthanspinalneedles.
34.Whichofthefollowingstatement(s)is/are
correctregardingmanagementof
malignanthyperthermiaexcept:
a)Discontinueallanaestheticsimmediately
b)DantroleneismainstayoftherapyforMH
c)Hyperventilationwith100%oxygenishelpful
d)Sodiumbicarbonateisgiventocorrectalkalosis
e)Correcthyperkalemiabygivingdextrose&insulin
CorrectAnswer-D
Ans.D.Sodiumbicarbonateisgiventocorrectalkalosis
MalignantHyperthermia:
DuetoabnormalityoftypeIRyanodinereceptorwhichiscalcium
releasechannelofsarcoplasmicreticulum.
Geneticdiseaseusuallyautosomaldominantbutcanberecessive
also.
PatientwithnormalCKlevelsshouldundergomusclebiopsystudies
(wheremuscleissubjectedtotriggeringfactors(likehalothane&
suxamethonium).
TreatmentofMH:
Dantrolene-
MainstayoftherapyofMH.
DirectlybindstoRyanodinereceptorinhibitingcalciumrelease
35.Whichofthefollowingis/aretrueabout
pre-anaestheticcheckup(PAC):
a)Notnecessaryinchildren
b)Usedtoassesspatientconditiontotolerateanaesthesia&
surgery
c)Canbeperformedbysurgicalfaculty
d)Relievesanxietyofpatient
e)Helpinplanninganaesthesiatechnique
CorrectAnswer-B:D:E
Ans.(B)Usedtoassesspatientconditiontotolerate
anaesthesia&surgery(D)Relievesanxietyofpatient(E)Helpin
planninganaesthesiatechnique
PACisequallynecessaryininfant&children(infact,evenmore
thanadults).
Infantsareatamuchgreaterriskofanestheticmorbidity&mortality
thanolderchildren;riskisgenerallyinverselyproportionaltoage.
Pre-anaestheticCheckup(PAC):Goals:
Toreduceanxiety&educatethepatientaboutanaesthesia
Toobtaininformationaboutpatient\medicalhistory
ToPerformPhysicalexamination
Todeterminewhichtestsarerequired
Toplonanaesthetictechnique.
Toobtaininformedconsent
Togiveanypreoperativeinstructions
36.Whichofthefollowingstatementis/are
trueregardingintravenousfluid:
a)Ringerlactateiscrystalloidofchoiceforbloodlossreplacement
b)Colloidisfluidofchoiceinsevereshock
c)5%Dextroseshouldbeavoidedinheadinjury
d)0.45%salinecontains154mEq/LNa+&154mEq/LCi?
e)Dextrosenormalsaline(DNS)ishypotonic
CorrectAnswer-A:B:C
Ans.(A)Ringerlactateiscrystalloidofchoiceforbloodloss
replacement(B)Colloidisfluidofchoiceinsevereshock
(C)5%Dextroseshouldbeavoidedinheadinjury
[Ref:MorganAnaesthesiaSth/1163-66;Ajayyadav5th/12-15;Lee
Anaesthesia13th/232-33;Miller7th/2799]
Colloidsareonlyreservedforsevereshock.
Bloodglucosecontrol:
Hyperglycaemiaisknowntoexacerbatecerebrallacticacidosisand
consequentlyaggravatescerebralischaemiainheadinjury.
Thereforeglucosesolutionsshouldbeavoided.
Dextrose:
Aggregateischemicneurologicinjury
Hyperglycemiamayalsoconstituteahormonallymediatedresponse
tomoresevereinjury.
Ringerlactate:
Crystalloidofchoiceforbloodlossreplacement.
NormalSaline:
0.9%NaClisotonicsolution
DextroseNormalSaline:
Hypertonic
37.
Whichofthefollowingis/aretrue
regardinganaestheticgas:
a)N20-increasesefficacyofotherinhalationalagents
b)Halothane-agentofchoiceinchildren
c)Sevofluraneisagentofchoiceinchildren
d)Isoflurane-smoothinduction
e)None
CorrectAnswer-A:C
Ans.(A)N20-increasesefficacyofotherinhalationalagents
(C)Sevofluraneisagentofchoiceinchildren
NitrousOxide:
Goodanalgesia
Itisnotcompleteanaesthesia(usedasasupplementtoanesthesia)
Whengivenalongwithotherinhalationalagentitincreasesthe
alveolarconcentrationofthatagent(secondgaseffect)
Notamusclerelaxant
Sevoflurane:
Odourissweetsoinductionissmooth
Faster,pleasant&smoothinductionwithnosignificantsystemic
toxicitymakessevofluraneistheagentofchoiceforinductionin
children
38.TrueaboutEndotrachealtube:
a)Mostcommonusedsizeforadultmaleis8-8.5
b)Mostcommonusedsizeforadultfemaleis7-7.5
c)PVCtubeisreusablebycleaning
d)Inchildrencuffedtubeisnotused
e)Cuffisforaspirationofsecretions
CorrectAnswer-A:B:D
Ans.(A)Mostcommonusedsizeforadultmaleis8-8.5
(B)Mostcommonusedsizeforadultfemaleis7-7.5(D)In
childrencuffedtubeisnotused
[RefAjayYadav5th/43-46;Lee13th/209;Miller7th/Chap10;
Morgansclinicalanesthesia5th/321]
Thesizeofthetrachealtubeisnormallydescribedastheinternal
diameter(ID)inmillimeters.
Trachealtubesizeof8mm(ID)formolesand7.5mm(ID)for
femalesareoftenused.
Twotypes-redrubber(reusable,costlier,non-transParent)&PVC
(disposable,cheap,transparent).
CuffpreventleakagebetweentheETT&thetrachea-bothleakage
ofgasoutwardsduringIPPV&ofgastriccontents,blood&mucus
intothelungs.
Inchildrenlessthan10yearsofageuncuffedtubeshouldbeused
&-thereshouldbeslightleaktoavoidbarotraumasifinspiratory
pressureexceedsabove30cmH2O.
39.Trueaboutsubarachnoidblock(spinal
anesthesia):
a)Cannotbeusedininfant&children
b)Canbegivenbyunskilleddoctor
c)MaybeusedwhenI.Vaccessisnotpossibleforintravenous
drugs
d)Hypotensionismostcommonside-effect
e)None
CorrectAnswer-D
Ans.D.Hypotensionismostcommonside-effect
[RefAjayYailav5th/155-61;Lee13th/479;OxfordHandbookof
Anesthesia3rd/832]
Subarachnoidblock:
Mostcommonlyusedanaesthetictechnique
AdultlevelisusuallyL3-4
Indications:
Orthopaedicssurgerygeneralsurgery(pelvic&perineal),
gynecological&obstetricalsurgery'urologicalsurgeriesetc.,
MostcommonlydrugsusedinIndiaare-xylocaine(lignocaine)&
Sensoricaine(bupivacaine)
Hypotensionismostcommonside-effect:
Managedbypreloading&intraoperativefluidsvasopressors.For
thisgoodi.VaccessisveryimPortant.
40.IndicationofCVPlineis/are:
a)CVPmonitoringinshockpatient
b)Priortomajorsurgery
c)ForadministeringinotropicsthroughCVPlineinshockpatients
d)Ineverycaseofcaesareansection
e)Forgivingbloodinpatientwithseverehaemorrhage
CorrectAnswer-A:B:C:E
Ans.(A)CVPmonitoringinshockpatient(B)Priortomajor
surgery(C)ForadministeringinotropicsthroughCVPlinein
shockpatients(E)Forgivingbloodinpatientwithsevere
haemorrhage
[RefAjayYadav5th/59;Morgan'sclinicalanesthesia5th/100]
IndicationofCVP:
Majorsurgerieswherelargefluctuationsinhaemodynamicsare
expected
Openheartsurgeries
Fluidmanagementinshock
Asvenousaccessinpatientswithpoorperipheralveins
Parenteralnutrition
Aspirationofairembolism
Cardiacpacing
41.APatienthashypersensitivityto
neostigmine.Hehastoundergoupper
abdominalsurgery.Musclerelaxantof
choiceis:
a)Pancuronium
b)Ropacuronium
c)Vecuronium
d)Atracurium
e)Piperacurium
CorrectAnswer-D
Ans.D.Atracurium
[Ref:AjayYadav5th/116-17;Lee13th/189-95]
Atracuriumundergospontaneousdegradationinplasmacalledas
Hoffmandegradation.
Atracuriumisrelaxantofchoiceifreversalagentiscontraindicated.
Othermusclerelaxants:
(mentionedinquestion)requirereversalwithneostigmine(butNe
cannotuseneostigmineduetohypersensitivity),socannotusein
thispatient
42. Whichofthefollowingcondition(s)can
causeexaggeratedhyperkalemiain
patientswithuseofsuccinylcholine:
a)Burn
b)Spinalcordinjury
c)Musculardystrophy
d)Tetanus
e)Abdominalorganinjury
CorrectAnswer-A:B:C:D
Ans.(A)Burn(B)Spinalcordinjury(C)Musculardystrophy
(D)Tetanus
[RefAjayYaday5th/112-13;Lee13th/190;KDT7th/355;Barash
ClinicalAnesthesia6th/MR]
Succinylcholine&hyperkalemia:
Inpatientswithextensiveburn&softtissueinjuries.
Alsointetanus&spinalcordinjuries,neurological&muscular
disorders(stroke,cerebralpalsy&musculardystrophy).
Aftermajordenervationinjuries,spinalcordtransection,peripheral
denervation,stroke,trauma,extensiveburns,andprolonged
immobilitywithdisease
43.Whichofthefollowingdoesnotincrease
intracranialpressure:
a)Sodiumthiopentone
b)Desflurane
c)Mannitol
d)Sevoflurane
e)Propofol
CorrectAnswer-A:C:E
Ans.(A)Sodiumthiopentone(C)Mannitol(E)Propofol
[RefAjayYadavp.86,109;Lee/643-45]
Mannitolisusedinthetreatmentofincreasedintracranialtension.
44.Mechanismofactionofgeneral
anesthesiais/are:
a)GABA-Areceptor
b)GABA-Breceptor
c)NMDAreceptor
d)Na+channelblockage
e)None
CorrectAnswer-A:C
Ans.(A)GABA-Areceptor(C)NMDAreceptor
[Ref:KDT7th/372-73;AjayYadav5th/71;Lee13th/149;Miller
6th/721-22]
MechanismofGeneralAnaesthesia:
TheGABA-AreceptorgatedCl-channelisthemostimportantof
these.
Manyinhalationalagents,barbiturates,benzodiazepinesepropofol
Actionofglycineinthespinalcord&medullaisaugmentedby
barbiturate,Propofol&manyinhalationalanaesthetics.
InhibitionofexcitatorytypeofNMDAtypeofglutamatereceptor:
Ketamine&N2O.
45.Whichofthefollowingstatementis
correctregardingmechanismofactionof
localanaesthesia:
a)Blockageofrestingsodiumchannelmoreisthanactivated
sodiumchannel
b)Fasterconductingfibersblockedeasily
c)BlockNa-KATPasechannel
d)Finetouchgoesbeforepain
e)Inregionalblocki.vinjectionisused
CorrectAnswer-E
Ans.E.Inregionalblocki.vinjectionisused
[Ref,AjayYadav5th/138-140,149;Lee13th/369-374]
MOA:
Thekeytargetoflocalanestheticsisthevoltage-gatedsodium
channel.
Thebindingisintracellularandismediatedbyhydrophobic
interactions.
Localanestheticsblockvoltage-gatedsodiumchannelsandinterrupt
initiationandpropagationofimpulsesinaxons.
Localanestheticsreversiblyinhibitperipheralnerveconductionby
blockingvoltagegatedsodium&potassiumchannel.
Theaffinityofthesodiumreceptorishigherinopenorinactivated
statesthanintherestingstate.
Blockadesequenceis-sympathetic>temperature(cold)>pain(prick)
>proprioception(Lighttouchwithcotton).
46.AllaretrueregardingLaryngealMask
Airwayexcept:
a)Bigoraltumoriscontraindicationforitsuse
b)MaybeusedwhenintubationwithETTisnotpossible
c)Canbeusedinchild'seyesurgery
d)MaybeusedinCPR
e)None
CorrectAnswer-E
Ans.(E)NONE
[RefAjayYadav5th/42-43;LeeAnaesthesia13th/206-08;Morgo4
Anesthesia4th/97;DorschDorschanesthesiaequipment5th/488;
Miller\anesthesia6th/I627]
Advancedcardiaclifesupport(PartofCPR):
Forbreathing-Advancedmethodlikeendotrachealtube,LMA,
combitubeortracheostomytube.
LaryngealMaskAirway(LMA):
Asanalternativetointubationwheredifficultintubationisanticipated
Anelectivemethodforminorsurgerieswhereanesthetistwantsto
avoidintubation(Likeeyesurgeryinchildren).
Contraindication:oropharyngealmass.
LMAprovidesanalternativetoventilationthroughafacemaskor
endotrachealtube(ETT).
LMAhasprovenparticularlyhelpfulasatemporarymeasureif
patientswithdifficultairways(thosewhocannotbeventilatedor
intubated)becauseofitseaseofinsertion&relativelyhighsuccess
rate(95-99%).
C/IforLMAincludes:patientwithpharyngealpathology(e.g.,
abscess),pharyngealobstruction,fullstomach(e.g.,pregnancy,
hiatalhernia)orlowpulmonarycompliance
47.Whichofthefollowingcircuitispreferred
inchildforspontaneousrespiration:
a)MaplesonA
b)Jackson&Reescircuit
c)MaplesonC
d)MaplesonE
e)MaplesonF
CorrectAnswer-A
Ans.(A)MaplesonA
[RefAjayYadav5th/35;DorschAnesthesiaEquipment5th/213-215;
MorganAnesthesia5th/i3;4th/35-37]
PediatricBreathingCircuits:
TypeEMaplesonCircuit:
ItisAyre'sTpiecewithcorrugatedtubing.
Itisapediatriccircuit
Asitdoesnothavebreathingbagsoitisnotacompletecircuit(It
wasmadecompletebyattachingabreathingbagbyattachinga
breathingbagbyJackson&Rees).
TypeEisbasicallyacircuitonlyforspontaneousrespiration(asit
doesnotcontainbreathingbag)butcanbeutilizedforcontrolled
ventilationbyintermittentlyoccludingtheendofexpiratorylimb
48.Weaningisgenerallydoneby:
a)SIMV
b)Controlledmodeventilation(CMV)
c)CPAP
d)PressurecontrolledVentilation
e)AssistedcontrolledVentilation
CorrectAnswer-A:C
Ans.A,SIMV&C,CPAP
[RefAjayYadav5th/239-40;Morgan5th/1298;Milleranesthesia6th]
Weaning:
Meansdiscontinuingtheventilatorsupport.
WeaningprocessmayvaryfromPatienttoPatient,hospitalto
hospital(dependingonthetypeofventilatoravailable)6clinicianto
clinician4ispossibletoweanpatientinanymodeofventilation
exceptcontrolmodeventilation
TechniquesforWeaning:
Thecommontechniquestoweanapatientfromtheventilator
includeSIMVpressuresupport,orperiodsofspontaneousbreathing
aloneonaT-pieceoronlowlevelsOfCPAP
Mandatoryminuteventilationhasalsobeensuggestedasanideal
weaningtechniques,butexperiencewithitislimited.
MostoftenaPPLiedapproachisthatpatientfromcontrol/assist
controlmodeventilationisshiftedtoSIMV&thenkeepon
decreasingtherateofbreathdeliveredbyventilatorgraduallytillit
becomes1to2breath/min
49.Achildonimmediatepostoperative,is
complainingofnausea&vomitingafter
squintsurgery.Whichofthefollowing
drugsmaybenotusedduringoperation
incontrollingthissymptom:
a)Propofol
b)Ketamine
c)Dexamethasone
d)Ondansetron
e)Palonosetron
CorrectAnswer-A:C:D
Ans.A,PropofolC,Dexamethasone&D,Ondansetron
[RefAjayYadavSth/132;LeeAnaesthesial3th/630]
StrabismusSurgeryinPaediatricPatient:
Keyfeaturesinrelationtostrabismusareoculocardiacreflexin
responsetosurgicalmovementofglobe,postoperativenausea&
vomiting(PONV)&theassociationofstrabismuswithoccult
myopathies&possiblymalignanthyperthermia.
Antiemesisisimprovedbyuseofpropofoloninduction&
maintenance&bythepreemptiveuseofboth5-hydroxy-tryptamine
inhibitors&dexamethasone,
OpioidsshouldbeavoidedbecauseregularNSAIDSareas
effective.
TopicalNSAIDS(Ketorolac0.5%oo/o,diclofenacl%)havebeen
usedwithsomesuccess.
Theincidenceofoculocardiacreflexcanbereducedbytheuseof
ketamineatinduction&bytheuseofmedialcanthalinjectionof
localanaesthetic(lidocaine),whichalsoreducestheneedfor
postoperativeanalgesia
50.Whichofthefollowingfluidusedin
perioperativeperiodisisotonic:
a)RL
b)DNS
c)5%Dextrose
d)HES
e)NS
CorrectAnswer-A:C:D:E
Ans.A,RLC,5%DextroseD,HES&E,NS
[RefAjayYadav5th/12-15;LeeAnaesthesiap.232-33;Morgan
5th/1164]
RingerLactateSolution(RL,Hartmansolution):
Lactateismetabolizedtobicarbonateinliver
RingerlactateiscrystalloidofchoiceforbloodlossrePlacement.
RLisslightlyhypotonic.
NormalSaline:
0.99%NaClisotonicsolution.
PreferredoverRLfortreating:hypochloremicmetabolicalkalosis,
braininjury(Catinlactatecanincreasetheneuronalinjury)&
hyponatremia
DextroseNormalSaline:
Hypertonic.
bestusedasmaintenancefluid.
HydroxyethylStarch(Colloid):
Types:Hetastarch&Pentastarch
This post was last modified on 11 August 2021