12 - AIIMS november 1993 anaesthesia mcqs

1q: intraarterial thiopentone injection causes :

a. cardiac arrest
b. respiratory arrest
c. convulsion
d. pain

answer d. pain

2q: post anaesthetic muscle soreness is caused by ?

a. gallamine
b. d-tubocurarine
c. suxamethonium
d. xylocaine

answer c. suxamethonium

3q: regarding myasthenia , what is true about sensitivity to curare and succinyl choline ?

Curare succinyl choline
a. decreased increased
b. decreased normal
c. increased increased
d. increased decreased

answer d. curare increased and succinyl choline decreased

4q: method of anaesthetic induction in children is by ?

a. intramuscular
b. inhalation
c. intravenous
d. oxygen tent

answer c. intravenous

5q: quantitative estimation of air embolism is done by ?

a. ECG
b. End tidal CO2 estimation
c. Pulmonary capillary wedge pressure
d. Doppler study

answer b. end tidal CO2 estimation

6q: oxygen delivery is regulated by all except ?

a. oxygen tent
b. noval catheter
c. venti mask
d. polymask

answer b. noval catheter

6 - anaesthesia cases mcqs - 1

If malignant hyperthermia is
suspected intraoperatively

a. Complete the procedure but pretreat
with dantrolene prior to future
elective surgery
b. Administer inhalational anesthetic
agents
c. Administer succinylcholine
d. Hyperventilate with 100% oxygen
e. Acidify the urine to prevent myoglobin
precipitation in the renal
tubules

The answer is d. (Schwartz, 7/e, pp 448, 499.)

The cause of malignant
hyperthermia is unknown, but it is associated with inhalational anesthetic
agents and succinylcholine. It may develop in an otherwise healthy person
who has tolerated previous surgery without incident. It should be suspected
in the presence of a history of unexplained fever, muscle or connective
tissue disorder, or a positive family history (evidence suggests an
autosomal dominant inheritance pattern). In addition to fever during anesthesia,
the syndrome includes tachycardia, increased O2 consumption,
increased CO2 production, increased serum K+, myoglobinuria, and acidosis.
Rigidity rather than relaxation following succinylcholine injection may
be the first clue to its presence. Treatment of malignant hyperthermia
should include prompt conclusion of the operative procedure and cessation
of anesthesia, hyperventilation with 100% oxygen, and administration
of intravenous dantrolene. The urine should be alkalinized to protect the
kidneys from myoglobin precipitation. If reoperation is necessary, one
should premedicate heavily, alkalinize the urine, and avoid depolarizing
agents such as succinylcholine. Pretreatment for 24 h with dantrolene is
helpful; it is thought to act directly on muscle fiber to attenuate calcium
release.