37 - AIIMS may 2006 anaesthesia mcqs

1q: a 20 year old patient presented with early pregnancy for medical termination of pregnancy ( MTP) in daycare facility. What will be anaesthetic induction agent of choice?

a. thiopentone
b. ketamine
c. propofol
d. diazepam

answer c. propofol

2q: in general , the last muscle to be rendered akinetic with a retrobulbar anaesthetic block is ?

a. superior rectus
b. superior oblique
c. inferior oblique
d. levator palpebrae superioris

answer b. superior oblique

3q: which of the following is the neuromuscular blocking agent with the shortest onset of action ?

a. mivacurium
b. vecuronium
c. rapacuronium
d. succinyl choline

answer d. succinyl choline

4q: which of the following fluorinated anaesthetics corrodes metal in vaporizers and breathing systems ?

a. sevoflurane
b. enflurane
c. isoflurane
d. halothane

answer d. halothane

5q: which of the following inhalational agents has the minimum blood gas solubility coefficient ?

a. isoflurane
b. sevoflurane
c. desflurane
d. nitrous oxide

answer c. desflurane

6q: the following anaesthetic drug causes pain on intravenous administration ?

a. midazolam
b. propofol
c. ketamine
d. thiopentone sodium

answer b. propofol

7q: which of the following drugs is contraindicated in a patient with raised intracranial pressure ?

a. thiopentone
b. propofol
c. midazolam
d. ketamine

answer d. ketamine

8q: which one of the common side effects is seen with fentanyl ?

a. chest wall rigidity
b. tachycardia
c. pain in abdomen
d. hypertension

answer a. chest wall rigidity

9q: which one of the following is the description used for the term allodynia during pain management ?

a. absence of pain perception
b. complete lack of pain sensation
c. unpleasant sensation with or without stimulus
d. perception of an ordinary non noxious stimulus as severe pain

answer d. perception of an ordinary non noxious stimulus as severe pain

30 - AIIMS november 2002 anaesthesia mcqs

1q: rapid induction of anaesthesia occurs with which of the following inhalational anaesthetics ?

a. isoflurane
b. halothane
c. desflurane
d. sevoflurane

answer c. desflurane

2q: a 5 year old child is scheduled for strabismus ( squint ) correction . induction of anaesthesia is uneventful. After conjunctival incision as the surgeon grasps the medial rectus the anaesthesiologist looks at the cardiac monitor. Why do u think he did that ?

a. he wanted to check the depth of anaesthesia
b. he wanted to be sure that the BP did not fall
c. he wanted to see if there was an oculocardiac reflex
d. he wanted to make sure there was no ventricular arrythmias which normally accompany incision

answer c. he wanted to see if there was an oculocardiac reflex

3q: which muscle relaxant increases intracranial pressure ?

a. mivacurium
b. atracurium
c. suxamethonium
d. vecuronium

answer c. suxamethonium or succinyl choline or scoline

4q: which of the following inhaled gases is used to decrease pulmonary artery pressure in adults and infants ?

a. nitrous oxide
b. nitrogen dioxide
c. nitric oxide
d. nitrogen

answer c . nitric oxide

5q: the use of succinyl choline is not contraindicated in ?

a. tetanus
b. closed head injury
c. cerebral stroke
d. hepatic failure

answer d. hepatic failure

6q: a 6 year old boy is scheduled for examination of the eye under anaesthesia . the father informed that for the past six months , the child is developing progressive weakness of both legs. His elder sibling had died at age of 14 years. Which drug would you definitely avoid during the anaesthetic management ?

a. succinyl choline
b. thiopentone
c. nitrous oxide
d. vecuronium

answer a. succinyl choline

7q: which of the following statement is not correct for vancuronium ?

a. it has high incidence of cardiovascular side effects
b. it has short duration of neuromuscular block
c. in usual doses the dose adjustment is not required in kidney disease
d. it has high lipophilic property

answer a. it has high incidence of cardiovascular side effects

8q: the topical use of which of the following local anaesthetics is not recommended ?

a. lignocaine
b. bupivacaine
c. cocaine
d. dibucaine

answer b. bupivacaine

9q: during surgery for aortic arch aneurysm under deep hypothermic circulatory arrest which of the following anaesthetic agent administered prior to circulatory arrest that also provides cerebral protection ?

a. etomidate
b. thiopental sodium
c. propofal
d. ketamine

answer b. thiopental sodium

10q: in volume cycled ventilation the inspiratory flow rate is set at ?

a. 140-160 L/min
b. 110-130 L/min
c. 60-100 L/min
d. 30-50 L/min

answer c. 60-100 L/min

20 - AIIMS december 1997 anaesthesia mcqs

1q: malignant hyperthermia is caused by ?

a. halothane
b. cyclopropane
c. suxamethonium
d. ether

answer both a and c . halothane and suxamethonium

2q: anaesthetic agent causing hallucination is ?

a. ketamine
b. ether
c. nitrous oxide
d. cyclopropane

answer a. ketamine

3q: vasoconstriction is seen with ?

a. lignocaine
b. cocaine
c. idiotocaine
d. bupivacaine

answer b. cocaine

4q: sallick’s manouvre is used for ?

a. to reduce dead space
b. to prevent alveolar collapse
c. to prevent gastric aspiration
d. to facilitate assisted respiration

answer c. to prevent gastric aspiration

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

11 - AIIMS may 1993 anaesthesia mcqs

1q: malignant hyperthermia is seen with ?

a. gallamine
b. lignocaine
c. succinyl choline
d. bupivacaine

answer c. succinyl choline .

2q: d-TC ( d-Tubocurarine ) is a ?

a. ganglion blocker
b. depolarizing blocker
c. competitive neuromuscular block
d. both a and c

answer d. both a and c .

10 - succinyl choline or suxamethonium mcqs

1q: which muscle relaxant increases intracranial pressure ?

a. mivacurium
b. atracurium
c. suxamethonium
d. vecuronium

answer c. suxamethonium also called succinyl choline

-- succinyl choline or suxamethonium causes increases in

1.intracranial pressure, 2.intraocular pressure, 3.intragastric pressure . this question was asked in AIIMS November 2002 paper .

2q: the use of succinyl choline is not contraindicated in ?

a. tetanus
b. closed head injury
c. cerebral stroke
d. hepatic failure

answer d. hepatic failure

 succinyl choline is short acting muscle relaxant as it is rapidly metabolized by pseudocholinesterase secreted both by liver and plasma . in liver failure this enzyme is reduced ,so succinyl choline concentration is increased during liver failure and is also maintained for greater periods .
 but this does not mean that succinyl choline should be contraindicated in liver failure. The duration of paralysis produced by succinyl choline is increased during liver failure but this does not require succinyl choline to be contraindicated in liver failure .

conditions where succinyl choline use is contraindicated due to hyperkalemia caused by succinyl choline are :

1. tetanus
2. stroke
3. closed head injury
4. myopathy
5. burns
6. acidosis
7. massive trauma
8. prolonged body immobilization
9. guillian barre syndrome
10. spinal cord injury
11. paraplegia
12. severe intraabdominal infection

-- this question was also asked in AIIMS November 2002 paper .

3q: a six year old boy is scheduled for examination of the eye under anaesthesia. The father informed that for the past six months , the child is developing progressive weakness of both legs. His elder sibling had died at age of 14 years. Which drug would you definitely avoid during the anaesthetic management ?

 

1. succinyl choline
2. thiopentone
3. nitrous oxide
4. vecuronium

answer a. succinyl choline

-- weakness of the legs indicate that the boy is suffering from myopathy ( most probably duchenes muscular dystrophy ). Succinyl choline is contraindicated in myopathy due to increased risk of hyperkalemia .

-- this question was also asked in the november 2002 AIIMS paper .

7 - muscle relaxants - onset and duration of action list

Muscle relaxants	Onset ( minutes )	Duration ( minutes )
Succinyl choline	1-1.5	3-6
Mivacurium	2-4	12-20
Rocuronium	1-2	25-40
Vecuronium	2-4	30-60
Atracurium	2-4	20-35
Cisatracurium	3-6	20-40
Piperacuronium	2-4	50-100
d-tubocurarine	4-6	30-60
Pancuronium	4-6	40-80
Doxacurium	4-8	60-120

So if the question is ?

Q: what is the shortest acting muscle relaxant ?

Answer : succinyl choline .

Q: what is the shortest acting non-depolarising muscle relaxant ?

Answer: mivacurium

Q: what is the longest acting muscle relaxant ?

Answer: doxacurium .

Q: what is the longest acting non-depolarising muscle relaxant ?

Answer: doxacurium .

TRY USING THIS MNEMONIC TO REMEMBER : Suck Me Rosy Victoria's Attractive Sister , Prepare To Please Doctors.

( in PREPARE = Two P s indicate piperacuronium and please indicates pancuronium )

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.