Last 5 year PYQs in Anesthesia for FMGE

Q1. Intravenous induction agent of choice for day care anesthesia is?

1. Ketamine
2. Propofol
3. Etomidate
4. Thiopentone

Correct Answer 2 : Propofol

• Propofol is an intravenous anesthetic agent of choice for day care surgery because it does not have a residual effect.
• Propofol has rapid onset of action and smooth recovery, hence preferred for day care surgeries.

Q2. During recovery from anesthesia, a patient started experiencing hallucinations and vivid dreams. Which inducing agent is most likely responsible?

1. Ketamine
2. Propofol
3. Thiopentone
4. Etomidate

Correct Answer 1 : Ketamine

• Ketamine is a non opioid intravenous anesthetic agent that causes emergence delirium/ hallucinations and vivid dreams due to thalamo-cortical disassociation.
• The most common side effect of ketamine is hallucinations.

Q3. How do local anesthetics work?

1. Block sodium channels
2. Block potassium channels
3. Block calcium channels
4. Block chloride channels

Correct Answer 1 : Block sodium channels

• Local anesthetics block the initiation and propagation of action potentials by preventing the voltage-dependent increase in sodium conductance.

Q4. In the case of a patient who has experienced a road traffic accident and is currently experiencing significant bleeding, along with hypotension, what gauge of cannula would you select for administering large volume intravenous fluid replacement?

1. 14 G
2. 13 G
3. 16 G
4. 18 G

Correct Answer 1 : 14 G

• The 14G cannula has the thickest diameter with flow rate of 250-300ml is orange color coded cannula,which is used when large volume replacement with iv fluids is needed.

Q5. Which is the anesthesia of choice in a daycare dental surgery?

1. General anesthesia
2. Spinal anesthesia
3. Epidural anesthesia
4. Infiltration anesthesia

Correct Answer 4  -Infiltration anesthesia :

• Infiltration anesthesia is a form of local anesthetic giving anesthesia only to the applied region and the patient is fully awake. This type of anesthesia is preferred for dental / minor procedures.

Q6.  The mask given below works on which of the following principles?

1. Bohr effect
2. Boyle’s principle
3. Bernoulli principle
4. Mapleson’s circuit

Correct Answer 3  - Bernoulli’s principle

• The picture depicts a High Flow Venturi mask that uses Bernoulli’s principle to deliver a predetermined and fixed oxygen concentration to the patient.

Q7. When assessing a patient before anesthesia, the oral cavity should be examined. The image provided below displays the examined cavity. It illustrates:

1. Mallampati class IV
2. Mallampati Class II
3. Mallampati class III
4. Mallampati class I

 Correct Answer 3  - Mallampati class III:

The picture shows Mallampati Class III as only the base of the uvula is visible.

Q8. During subclavian venous catheterization, the patient experienced a sudden drop in oxygen levels and upon examining the chest, increased resonance was observed in the upper part of the right lung. What is the most probable diagnosis in this case?​

1. Arterial puncture
2. Pneumothorax
3. Cardiac tamponade
4. Chylothorax

Correct Answer 2 - Pneumothorax

• Pneumothorax is a complication that occurs during Subclavian Catheterization due to either the use of a large bore needle or repeated attempts at insertion of the needle. Hyperresonance in the chest is a diagnostic feature of Pneumothorax, emphysema, and COPD.

Q9. Which of the following induction agents is most appropriate for a patient with cardiac disease?

1. Ketamine
2. Etomidate
3. Propofol
4. Thiopentone

Correct Answer 2  - Etomidate

• It is also an α2-receptors agonist therefore it maintains the vascular tone and myocardial contractility, thus maintaining cardiovascular haemodynamics which makes it an anesthetic of choice in cardiac disease.

Q10. An unresponsive patient in an ambulance on attachment of monitors showed the following rhythm. What should be done immediately?

1. Check for pulse and breathing
2. Chest compressions and defibrillation
3. Put the patient in left lateral position
4. Cardioversion

Correct Answer 2  - Chest compressions and defibrillation:

• Chest compressions and defibrillation are the appropriate immediate actions to take when a patient in cardiac arrest is unresponsive and shows an abnormal rhythm on the attached monitors. Chest compressions help maintain blood circulation to vital organs, while defibrillation delivers an electric shock to the heart to restore its normal rhythm.

Q11. What is the appropriate preoperative fasting recommendation?​

1. 4 hours for solids in adults
2. 2 hours for liquids in adults
3. 2 hours for breast milk in infants
4. 4 hours for solids in infants

Correct Answer 2 - 2 hours for liquids in adults

• A preoperative fasting period is a time prescribed before any procedure that involves general anesthesia, sedation, or regional anesthesia.
• The collective fasting recommendation is two hours for clear and light liquids, four hours for breast milk, and six hours for solid foods, infant formula, light meals, and non-human milk.

​Q12. In the operating theater, you observe the utilization of a particular vaporizer. Which of the listed gases would you anticipate it to comprise?

1. Desflurane
2. Sevoflurane
3. Halothane
4. Isoflurane

Correct Answer 1  - Desflurane

Anesthesia vaporizers are employed to vaporize a liquid anesthetic agent so that a controlled amount of it can be delivered to the patient. Three types of vaporizers or concentration-calibrated vaporizers are available in the market such as variable bypass, electronically controlled vaporizers, and heated blenders. These instruments are used in the emergency departments, trauma departments, operating rooms, delivery rooms, ambulatory surgical centers and any needy areas that require inhalation agent administration. Some-times it is mounted on the anesthesia machines.

Heated-blender vaporizers are now only required for desflurane. It is marketed under the trade name “SupraneTM” by Baxter Pharmaceutical Products Division.

​Q13. Which method is considered the most effective for evaluating the extent of muscle relaxation?

1. Tetanic stimulation
2. Double-burst stimulation
3. Train of four
4. Electromyography

Correct Answer 3 : Train-of-four:

By comparing the amplitude of the fourth twitch to the first, anesthesiologists can accurately quantify neuromuscular blockade and tailor drug dosages to achieve optimal relaxation while minimizing the risk of residual paralysis..

The train-of-four (TOF) method is considered the gold standard for assessing the degree of muscle relaxation during anesthesia.

It involves stimulating a motor nerve at a high frequency and observing the resulting muscle twitch responses.

Q14. What should be done after immediate defibrillation is performed on a young male patient who was brought to the emergency department unconscious after collapsing at a railway station, with no pulse felt and a monitor showing ventricular fibrillation?

1. Check for a pulse
2. Resume chest compressions
3. Epinephrine 1 mg IV
4. Amiodarone 300 mg IV bolus

Correct Answer 2  - Resume chest compressions:

• Ventricular fibrillation (V-fib) is a dangerous heart rhythm condition that can cause cardiac arrest. Hence, it is necessary to stop V-fib immediately to restore pulse and blood pressure. The second focus should be on reducing the development of V-fib in the future.  
• The treatment for ventricular fibrillation(V-fib) includes cardiopulmonary resuscitation, i.e., (CPR). Recent consensus guidelines for CPR advocate that chest compression immediately resumes after the defibrillation process.
• Pulse checks and rhythm checks can be postponed until the completion of five compressions, minimally for two minutes.

Q15. A known case of asthmatic bronchitis was reported to the hospital with breathlessness, palpitations, and oxygen saturation of 88%. The hospital does not have a ventilator. All the following can be given to the patient, except?

1. Hydrocortisone
2. Theophylline
3. Oxygen with oxygen mask, and reservoir
4. Leukotriene antagonist

Correct Answer 3  - Oxygen with oxygen mask, and reservoir:

• Bronchial asthma is an inflammatory chronic disease condition of airways that is characterized by paroxysmal wheezing, cough, and chest tightness.
• Asthma causes tightening of muscles around the airways and causes airways to narrow. Hence, when both acute bronchitis and asthma occur together, this situation is called asthmatic bronchitis. 
• Currently, nasal cannula, non-breathing bag face mask reservoir, venturi masks, are used in the clinical settings as conventional oxygen therapies. However, non-invasive ventilation (NIV) in airways causes trauma, need for sedation, infections.
• Conventional oxygen therapy (COT) involves a simple face mask that delivers oxygen.
• COT is not able to provide sufficient respiratory support to the patients that are suffering from bronchial asthma. As it needs an extra attempt to breathe and work for the breathing process to maintain oxygenation. 

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