Assistant Professor in Anaesthesiology Question Paper and Answer Key

 PROVISIONAL ANSWER KEY
Question Paper Code: 43/2024/OL
Category Code: 343/2023
Exam: Assistant Professor in Anaesthesiology
Date of Test 20-04-2024
Department Medical Education

Question1:-All of the following nerves are blocked in an ankle block, except
        A:-Sural Nerve
        B:-Deep Peroneal Nerve
        C:-Anterior tibial Nerve
        D:-Superficial Peroneal Nerve
        Correct Answer:- Option-C

Question2:-Which of the following drug causes increase in amplitude of somato sensory evoked potential during intra operative monitoring ?
        A:-Etomidate
        B:-Propofol
        C:-Midazolam
        D:-Sevoflurane
        Correct Answer:- Option-A

Question3:-Which of the following is NOT associated with PRIS (Propofol Related Infusion Syndrome) ?
        A:-Metabolic acidosis
        B:-Rhabdomyolysis
        C:-Hyperlipidemia
        D:-Hypokalemia
        Correct Answer:- Option-D

Question4:-Which of the following drug is safe in patients with acute intermittent Porphyria ?
        A:-Etomidate
        B:-Thiopental Sodium
        C:-Propofol
        D:-Ketamine
        Correct Answer:- Option-C

Question5:-False statement regarding blood gas partition coefficient is
        A:-Affected by temperature
        B:-Low blood gas partition coefficient in obesity and haemodilution
        C:-Also known as Ostwald coefficient
        D:-BG partition coefficient is least for Nitrous oxide
        Correct Answer:- Option-D

Question6:-Comparing Lignocaine with Prilocaine, which of the following is true ?
        A:-Lignocaine and prilocaine has the same potency
        B:-Prilocaine is more protein bound
        C:-Lignocaine has high Pka than prilocaine
        D:-Both drugs produce methaemoglobinimia
        Correct Answer:- Option-A

Question7:-Who performed the first spinal anaesthesia ?
        A:-John Snow
        B:-John Lundy
        C:-Karl Koller
        D:-August Bier
        Correct Answer:- Option-D

Question8:-Which artery accompanies the ilioinguinal and ilio hypogastric nerve ?
        A:-Superficial epigastric artery
        B:-Deep circumflex artery
        C:-Inferior epigastric artery
        D:-Superficial circumflex artery
        Correct Answer:- Option-B

Question9:-Under anaesthesia which is the most common method used to evaluate intra operative awareness ?
        A:-Capnography
        B:-BIS
        C:-EEG
        D:-TEE
        Correct Answer:- Option-B

Question10:-Which of the following is NOT a sign of stellate ganglion block ?
        A:-Horner's syndrome
        B:-Guttmann's sign
        C:-Vasodilation in arm and forearm
        D:-Bradycardia
        Correct Answer:- Option-D

Question11:-Supra sternal notch compression test is done to confirm the position of
        A:-Endoracheal tube
        B:-Tracheostomy tube
        C:-Proseal LMA (PLMA)
        D:-i-gel
        Correct Answer:- Option-C

Question12:-Volatile anesthetic agent least metabolised in body is
        A:-Halothane
        B:-Isoflurane
        C:-Enflurane
        D:-Desflurane
        Correct Answer:- Option-D

Question13:-A preoperative assessment should include all the following except
        A:-Current medication and drugs
        B:-Psychological aspects of patient
        C:-Patient knowledge of rehabilitation
        D:-Age, weight and height
        Correct Answer:- Option-C

Question14:-One of the method to measure changes in the levels of consciousness during anaesthesia is
        A:-Auditory evoked potential
        B:-Visual evoked potential
        C:-Tactile evoked potential
        D:-Speech evoked potential
        Correct Answer:- Option-A

Question15:-Recommended selection criteria for SCS (Spinal Cord Stimulator) placement in patients with chronic pain are all except
        A:-Confirmed diagnosis of neuropathic pain
        B:-Chronic pain, > 6 months
        C:-Failed trial of polypharmacy
        D:-Nociceptive pain syndrome
        Correct Answer:- Option-D

Question16:-Select wrong statement about preoxygenation
        A:-100% oxygen used
        B:-It prevents hypercarbia
        C:-Anaesthetic circuit is used
        D:-Aim is to fill FRC
        Correct Answer:- Option-B

Question17:-Gassserian Gnaglion block is most commonly used for neuropathic pain located in which of the following nerve distribution ?
        A:-VII Nerve
        B:-V Nerve
        C:-IX Nerve
        D:-X Nerve
        Correct Answer:- Option-B

Question18:-Who coined the term "Anaesthesia" ?
        A:-John S Lundy
        B:-WTG Morton
        C:-Oliver Vendel Homes
        D:-August Bier
        Correct Answer:- Option-C

Question19:-A patient on Ticlopidine is posted for hernia repair. Select the correct statement.
        A:-Ticlopidine can be continued on the day of Surgery
        B:-Ticlopidine is to be stopped on the day of surgery
        C:-Ticlopidine is to be stopped 7 days prior to surgery
        D:-Ticlopidine is to be stopped 14 days prior to surgery
        Correct Answer:- Option-D

Question20:-A 34 year old man suffered severe head injury with extensive intra cerebral bleed, he is declared brain dead and prepared for organ harvesting. His preoperative BP is 90 systolic and is on Noradrenaline support. ASA(PS) classification for him would be
        A:-Class 5
        B:-Class 4
        C:-Class 6
        D:-Class 3
        Correct Answer:- Option-C

Question21:-Minimum Alveolar concentration of an inhalational agent is decreased in the following conditions except
        A:-Pregnancy
        B:-Chronic Alcoholism
        C:-Hyponatremia
        D:-Anaemia
        Correct Answer:- Option-B

Question22:-Inhalational agent which causes primary cardiac arrest due to ventricular fibrillation is
        A:-Diethyl ether
        B:-Trichloroethylene
        C:-Entonox
        D:-Chloroform
        Correct Answer:- Option-D

Question23:-A patient undergoing hyperbaric oxygen therapy with 3 atmospheres develops convulsions. This is known as
        A:-Paul Bert effect
        B:-Lorraine Smith effect
        C:-Bohr effect
        D:-Valtis Kennedy effect
        Correct Answer:- Option-A

Question24:-Select the appropriate statement about Sugammadex.
        A:-It can reverse the effect of succinyl choline and atracurium
        B:-It forms tight complexes with vecuronium
        C:-It hydrolyses rocuronium
        D:-It is always used in combination with atropine or glycopyrrolate
        Correct Answer:- Option-B

Question25:-Modified Aldrete Score for discharge criteria include assessment of all except
        A:- O₂ Saturation
        B:-Post OP nausea and vomiting
        C:-Consciousness
        D:-Activity
        Correct Answer:- Option-B

Question26:-A size E compressed gas cylinder completely filled with N₂O contains how many litres of gas ?
        A:-1160 L
        B:-1470 L
        C:-1590 L
        D:-1640 L
        Correct Answer:- Option-C

Question27:-Which of the following methods can be used to detect all leaks in the low-pressure system in anaesthesia machine ?
        A:- O₂ flush test
        B:-Common gas outlet occlusion test
        C:-Positive pressure leak test
        D:-Negative pressure leak test
        Correct Answer:- Option-D

Question28:-The CO₂ Pa₂ measured by Capnometer is less than the arterial value measured simultaneously is due to
        A:-Use of ion specific electrode for blood gas determination
        B:-Alveolar capillary gradient
        C:-Alveolar dead space
        D:-Intrapulmonary shunt
        Correct Answer:- Option-C

Question29:-Which of the following alpha-antagonist produces an irreversible blockade ?
        A:-Phentolamine
        B:-Prazosin
        C:-Phenoxybenzamine
        D:-Yohimbine
        Correct Answer:- Option-C

Question30:-Which of the following drug should not be used in the treatment of severe bradycardia induced by an excess of beta-adrenergic receptor blockade ?
        A:-Atropine
        B:-Dobutamine
        C:-Dopamine
        D:-Glucagon
        Correct Answer:- Option-C

Question31:-Concentration of lignocaine used for spinal anaesthesia is
        A:-2.5%
        B:-3%
        C:-4%
        D:-5%
        Correct Answer:- Option-D

Question32:-Breathing circuit of choice for spontaneous ventilation is
        A:-Mapleson A
        B:-Mapleson D
        C:-Mapleson B
        D:-Mapleson E
        Correct Answer:- Option-A

Question33:-The law which states that for a fixed mass of gas at constant temperature, the product of pressure and volume is constant is
        A:-Charles's law
        B:-Boyle's law
        C:-Graham's law
        D:-Dalton's law
        Correct Answer:- Option-B

Question34:-Which of the following intravenous anaesthetic agent is associated with the highest incidence of nausea and vomiting ?
        A:-Ketamine
        B:-Thiopentone sodium
        C:-Etomidate
        D:-Propofol
        Correct Answer:- Option-C

Question35:-The pressure gauge on size E compressed cylinder containing reads 1600 psi. How long could the be delivered from the cylinder at a rate of 2L/min ?
        A:-90 mins
        B:-140 mins
        C:-250 mins
        D:-320 mins
        Correct Answer:- Option-C

Question36:-The highest trace concentration of allowed in the OR atmosphere by the National Institute for Occupational Safety and Helth (NIOSH) is
        A:-1 ppm
        B:-5 ppm
        C:-25 ppm
        D:-50 ppm
        Correct Answer:- Option-C

Question37:-At high altitude the flow of a gas through a rotameter will be
        A:-Greater than expected
        B:-Greater than expected at higher flows and less than expected at low flows
        C:-Less than expected
        D:-Greater than expected at higher flows but accurate at low flows
        Correct Answer:- Option-D

Question38:-Mechanism of action of local anaesthetic is
        A:- K₊channel inhibition
        B:- Na₊channel inhibition
        C:- Na₊channel activation
        D:- Ca₊₊channel inhibition
       Correct Answer:- Option-B

Question39:-Granule size of soda lime in canister is
        A:-6-8 mesh
        B:-4-8 mesh
        C:-8-10 mesh
        D:-4-6 mesh
        Correct Answer:- Option-B

Question40:-Most cardiotoxic local anaesthetic is
        A:-Lignocaine
        B:-Bupivacaine
        C:-Ropivacaine
        D:-Levobupivacaine
        Correct Answer:- Option-B

Question41:-Percentage loss of vital capacity in lithotomy position is
        A:-12.5%
        B:-18%
        C:-14.5%
        D:-10%
        Correct Answer:- Option-B

Question42:-I/V induction agent which comes under classification of steroid derivative is
        A:-Propofol
        B:-Ketamine
        C:-Propanidid
        D:-Althesin
        Correct Answer:- Option-D

Question43:-The most important single factor controlling cerebral blood flow
        A:-Arterial oxygen tension
        B:-Arterial carbon dioxide tension
        C:-Hypoxia
        D:-Arterial pH
        Correct Answer:- Option-B

Question44:-The half-life of carboxyhaemoglobin in a patient breathing 100%
        A:-5 minutes
        B:-1 hour
        C:-2 hours
        D:-12 hours
        Correct Answer:- Option-B

Question45:-The term azeotrope refers to
        A:-A mixture of two volatile anaesthetic agents
        B:-A mixture of volatile anaesthetic agent and
        C:-A mixture of volatile anaesthetic agent and
        D:-Radioactively labelled
        Correct Answer:- Option-A

Question46:-Normal intracranial pressure is
        A:-5-10 mm of Hg
        B:-5-15 mm of Hg
        C:-10-20 mm of Hg
        D:-15-30 mm of Hg
        Correct Answer:- Option-B

Question47:-A patient has oxygen saturation of 96% on pulse oximetry but 88% on arterial blood gas analysis, what is the most likely cause for this discrepancy ?
        A:-Indocyanine green dye
        B:-Methemoglobinemia
        C:-Carboxyhaemoglobin
        D:-Presence of nail polish
        Correct Answer:- Option-C

Question48:-The blood gas solubility coefficient of Isoflurane is
        A:-0.47
        B:-13
        C:-1.4
        D:-2.3
        Correct Answer:- Option-C

Question49:-In a cannot intubate cannot ventilate scenario the patient is oxygenated via a cricothyroidotomy. In an adult, what is the largest size of tracheostomy tube that can be inserted through the cricothyroid membrane ?
        A:-Size 8
        B:-Size 7
        C:-Size 6
        D:-Size 5
        Correct Answer:- Option-C

Question50:-A deep-sea SCUBA diver is treated in a hyperbaric chamber for acute decompression sickness. The improvement in symptoms is best explained by
        A:-Dalton's law
        B:-Charles's law
        C:-Henry's law
        D:-Boyle's law
        Correct Answer:- Option-D

Question51:-The situation in which medical personnel do not provide a sufficient dosage of medication thereby provoking repetative demand from the patient for analgesics during perioperative management of patient with chronic pain
        A:-Addiction
        B:-Pseudoaddiction
        C:-Physical dependance
        D:-Adaptation
        Correct Answer:- Option-B

Question52:-Which is not a complication of spinal cord stimulation in failed back syndrome ?
        A:-Hypotension
        B:-Electrode displacement
        C:-Infection
        D:-Battery failure
        Correct Answer:- Option-A

Question53:-Optimal timing for initiation of epidural labour analgesia
        A:-3 cm cervical dilation
        B:-Cervix fully effaced
        C:-Patient in active labour
        D:-Maternal request for labour pain relief
        Correct Answer:- Option-D

Question54:-Which nerve fibres transmit the noxious stimuli from the periferal receptors in the periferal visceral and somatic site to the dorsal horn of spinal cord ?
        A:-A delta and C
        B:-A beta
        C:-A alpha
        D:-A alpha and C
        Correct Answer:- Option-A

Question55:-Ideal epidural catheter insertion site for upper abdominal surgeries like cholecystectomy, gastrectomy and Whipple procedure is
       A:- T₈-T₁₁
       B:-T₂-T₅
       C:-T₆-T₈
       D:-L₁-L₄
       Correct Answer:- Option-C

Question56:-Which of the following is 'FALSE' regarding Patient Controlled Analgesia (PCA) ?
        A:-A lock out interval that is too short will not contribute to an increase in medication related side effects
        B:-An optimal demand or bolus dose is integral to the efficacy of PCA
        C:-A longer lock out interval may result in inadequate analgesia
        D:-Continuous or background infusion provides improved analgesia during sleep
        Correct Answer:- Option-A

Question57:-Acoustic Window used for Transcranial Doppler Monitoring of components of Code of Willis, include all except
        A:-Ophthalmic
        B:-External auditory meatus
        C:-Temporal
        D:-Foramen Magnum
        Correct Answer:- Option-B

Question58:-As per the current recommendation regarding Resuscitation during haemorrhagic shock in trauma is aimed at
        A:-Bringing back the blood pressure to normal value with crystalloids
        B:-Bringing the blood pressure about the normal value with crystalloids
        C:-Bringing the blood pressure to normal values with whole blood
        D:-Bringing up the blood pressure to maintain deliberate hypotension by limitation of crystalloids infusion and by early transfusion of blood components
        Correct Answer:- Option-D

Question59:-Goals for Late resuscitation in trauma included all except
        A:-Maintain systolic blood pressure less than 100 mm Hg
        B:-Normalise coagulation status
        C:-Normalise body temperature
        D:-Reverse systemic acidosis
        Correct Answer:- Option-A

Question60:-Which of the following is an INCORRECT statement in the care of a patient transported by Helicopter, following a major head trauma ?
        A:-Provide adequate oxygen to avoid hypoxemia
        B:-Maintain Cerebral perfusion pressure below 50 mm Hg
        C:-Institute endotracheal intubation for patients with GCS lower than 9
        D:-Maintain normal ventilation
        Correct Answer:- Option-B

Question61:-During treatment of nerve agent poisoning like sarin (SARIN), with intravenous Pralidoxime, the target therapeutic blood concentration should be
        A:-10 microgram/ml
        B:-14 microgram/ml
        C:-4 microgram/ml
        D:-0.5 microgram/ml
        Correct Answer:- Option-C

Question62:-The lethal exposure level of phosgene in humans
        A:-800 ppm for 2 minutes
        B:-25 ppm for 2 minutes
        C:-1500 ppm for 2 minutes
        D:-2500 ppm for 2 minutes
        Correct Answer:- Option-A

Question63:-Current fasting guidelines for non-operating room anaesthesia is
        A:-8 hours fasting for fluids and solids
        B:-2 hours fasting for light breakfast
        C:-8 hours fasting for full meal, 6 hours fasting for light meal and 2 hours fasting for clear fluids
        D:-4 hours fasting for light meal
        Correct Answer:- Option-C

Question64:-Indication for Inferior Vena Cava (IVC) filter placement include all except
        A:-Allergy to antiplatelets
        B:-High risk of pulmonary embolism
        C:-Contra indication for anticoagulation
        D:-Failure of anticoagulation
        Correct Answer:- Option-A

Question65:-As per the American Heart Association guidelines, cardiac resynchronisation therapy is the class I indication for those patients with the following set of parameters except
        A:-Atrial fibrillation
        B:-Left ventricular Ejection fraction 35% or less
        C:-QRS duration 120 m sec or greater
        D:-Drug refractory NYHA class III or ambulant class IV heart failure
        Correct Answer:- Option-A

Question66:-Machanism of action of antidepressents like AMITRIPTYLINE, IMIPRAMINE used in the treatment of Neuropathic pain are through
        A:-Cyclooxygenase
        B:-G-Protein coupled Kappa receptors
        C:-GABA receptors
        D:-Norepinephrine/5-Hydroxy tryptamine receptors
        Correct Answer:- Option-D

Question67:-Which ganglion neurolysis is performed in patients with unresectable pancreatic cancer ?
        A:-Coeliac plexus
        B:-Superior hypogastric
        C:-Ganglion impar
        D:-Lumbar sympathetic ganglia
        Correct Answer:- Option-A

Question68:-Which of the following is NOT a role of social worker in palliative care team ?
        A:-Participates in diagnosis and treatment of the patient and their families
        B:-Address the psychosocial needs of the patient and their families
        C:-Participates in meetings with the medical team, patients and families
        D:-Assist in complex discharge needs and communicates with community resources
        Correct Answer:- Option-A

Question69:-Which of the following sequence of six-step protocol for breaking bad news is correct ?
        A:-Setting → Perception → Invitation → Knowledge → Empathy → Sequelae
        B:-Setting → Invitation → Perception → Knowledge → Empathy → Sequelae
        C:-Setting → Perception → Invitation → Empathy → Knowledge → Sequelae
        D:-Setting → Invitation → Perception → Empathy → Knowledge → Sequelae
        Correct Answer:- Option-A

Question70:-Normal Brain tissue PO₂(P_btO₂) is A:-60-70 mm Hg
        B:-40-45 mm Hg
        C:-50-55 mm Hg
        D:-20-25 mm Hg
        Correct Answer:- Option-D

Question71:-The most commonly targetted nuclei for the treatment of movement disorders are
        A:-Caudate
        B:-Sub thalamic nuclei
        C:-Putamen
        D:-Globus pallidus
        Correct Answer:- Option-B

Question72:-Most common infection in post kidney transplant patient is
        A:-Pneumococcus
        B:-Cyto megalo vrius
        C:-Parvo virus
        D:-Retro virus
        Correct Answer:- Option-B

Question73:-The diagnostic criteria of Hepato pulmonary syndrome include all except
        A:-Portal hypertension
        B:- PaO₂ less than 80 mm Hg on room air
        C:-Evidence of intropulmonary vascular dilation
        D:- more than 40 mm Hg
        Correct Answer:- Option-D

Question74:-Which is the excellent marker of synthetic function of liver transplant patient in post operative period ?
        A:-Prothrombin time or INR
        B:-Serum albumin
        C:-ALT
        D:-Gamma Glutamyl transferase
        Correct Answer:- Option-A

Question75:-What is the dose of recombinant activated factor VII a in the management of severe obstetric haemorrhage ?
        A:-70-90 Microgram/kg
        B:-10-15 Microgram/kg
        C:-200-225 microgram/kg
        D:-1000-1250 microgram/kg
        Correct Answer:- Option-A

Question76:-A 14 year old man with a medical history of non-small cell lung cancer presents to the ED with new-onset shortness of breath. A chest Computed Tomography (CT) scan reveals a Pulmonary Embolism (PE) at the bifurcation of the right and left pulmonary arteries. The patient is initiated on parenteral anticoagulation and transferred to the medical ICU. On admission to the medical ICU, the patient develops pulseless electrical activity. He is intubated and mechanically ventilated, with recovery of spontaneous circulation after one round of chest compressions and administration of epinephrine 1 mg. Which is the next best step to evaluate and/or treat this patient's PE ?
        A:-Administer alteplase 100 mg infused over 2 hours
        B:-Check a troponin T concentration
        C:-Check a brain natriuretic peptide concentration
        D:-Do a Transthoracic Echocardiogram (TTE)
        Correct Answer:- Option-D

Question77:-Loss of 'a' wave in CVP waveform is seen in
        A:-Tricuspid stenosis
        B:-Pericardial effusion
        C:-Atrial fibrillation
        D:-Atrioventricular dissociation
        Correct Answer:- Option-C

Question78:-A 24 year old man is admitted to the medical ICU for hypotension after being stung by a bee. He was given intramuscular epinephrine by emergency medical services and transferred to the Emergency Department (ED). On arrival at the ED, his blood pressure was 78/42 mm Hg; he was given 1 L of 0.9% sodium chloride, diphenhydramine, famotidine, and methylprednisolone. The patient remained hypotensive but responded to an additional 2 L of 0.9% sodium chloride. He was transferred to the medical ICU for further treatment. On arrival in the medical ICU, his MAP is 62 mm Hg. A right internal jugular central venous catheter is placed, which reveals CVP 3 mm Hg,SPO₂ 61%, venous lactage concentration 4.4 mmol/L, and haemoglobin (Hb) 9.6 g/dL. Together with further fluid resuscitation, which agent would be best to initiate or administer ?
        A:-Packed Red Blood Cells (PRBCs)
        B:-Dobutamine
        C:-Milrinone
        D:-Norepinephrine
        Correct Answer:- Option-D

Question79:-Typically the Sterility Assurance Level (SAL) for terminal sterilization is
        A:-10^-3
        B:-10^-6
        C:-10^-7
        D:-10^-5
        Correct Answer:- Option-B

Question80:-Indications for Central venous cannulation include all except
        A:-Temporary hemodialysis
        B:-Central venous pressure monitoring
        C:-Aspiration of air emboli
        D:-Continuous, beat to beat blood pressure monitoring
        Correct Answer:- Option-D

Question81:-Intra operative awareness is monitored by
        A:-Bispectral imaging
        B:-Pulse oximetry
        C:-Colour Doppler
        D:-End tidal CO₂
        Correct Answer:- Option-A

Question82:-Which best describes the category of Acute Respiratory Distress Syndrome (ARDS) that most benefits from prone positioning and cisatracurium administration ?
        A:-Acute lung injury
        B:-Moderate to severe
        C:-Mild to moderate
        D:-Mild
        Correct Answer:- Option-B

Question83:-False statement regrading Fibre Optic Bronchoscopy in a mechanically ventilated patient is
        A:-Will reduce alveolar ventilation upto 75%
        B:-Can cause hypoxia which can last for hours
        C:-Cannot be used for retrieving small foreign body
        D:-Has no effect on PEEP delivered
        Correct Answer:- Option-D

Question84:-A 55 year old man (weight 75 kg) is admitted to the burns ICU after sustaining a 65% total body surface area burn to the abdomen, back, and lower extremities from a house fire. He is unconscious and unable to protect his airway. His medical history is significant for hypertension and hyperlipidemia. He is currently receiving high-dose norepinephrine and vasopressin to maintain a MAP of 65 mm Hg. His current laboratory data show the following : sodium 130 mEq/L, potassium 5.9 mEq/L, chloride 122 mEq/L, carbon dioxide 15 mg/dL, Blood Urea Nitrogen (BUN) 10 mg/dL, and SCr 1.3 mg/dL. Which medications would be most appropriate to use for RSI ?
        A:-Propofol, fentanyl, rocuronium
        B:-Ketamine, fentanyl, succinylcholine
        C:-Etomidate, fentanyl, rocuronium
        D:-Propofol, fentanyl, succinylcholine
        Correct Answer:- Option-C

Question85:-What is the best design to study the efficacy of an intervention ?
        A:-Cross sectional study
        B:-Case control study
        C:-Cohort study
        D:-RCT
        Correct Answer:- Option-D

Question86:-Which is the best trial design to study the prognosis of a disease ?
        A:-Cross-sectional study
        B:-Case-control study
        C:-Cohort study
        D:-RCT
        Correct Answer:- Option-C

Question87:-Informed consent should included all except
        A:-Comprehensive to the patient
        B:-Disclosed to the patient
        C:-Blanket consent is legally valid
        D:-Absence of any outside control
        Correct Answer:- Option-C

Question88:-What is the first step in applying evidence based medicine concepts to answer a clinical questions ?
        A:-Ask a question
        B:-Asess the whole process
        C:-Apply the evidence
        D:-Acquire evidence
        Correct Answer:- Option-A

Question89:-Correct statement about percutaneous tracheostomy
        A:-Longer operative time
        B:-Absolute contra indication in unstable cervical spine injury
        C:-Increased incidence of wound infection
        D:-Poor cosmetic results
        Correct Answer:- Option-B

Question90:-Which set of laboratory abnormalities best reflects those that patients in thyroid storm typically present with ?
        A:-High Thyroid Stimulating Hormone (TSH), trilodothyronine (T3), and thyroxine (T4) concentrations
        B:-Low TSH, high T3 and high T4 concentrations
        C:-Low TSH, high T3 and low T4 concentrations
        D:-Low TSH, low T3 and low T4 concentrations
        Correct Answer:- Option-B

Question91:-A 33 year old man presents with ALF secondary to acetaminophen overdose. He is now 72 hours post - ingestion and is profoundly encephalopathic and unresponsive to pain on examination. An ICP monitor is placed, which shows acute elevations of 30 mm Hg. Which is most appropriate for the acute management of ICP elevations ?
        A:-Hypertonic saline continuous infusion to maintain serum sodium 145-155 mEq/L
        B:-Mannitol 0.5 mg/kg intravenously × 1
        C:-Hyperventilation to PaCO₂ of 25-30 mm Hg
        D:-Thiopental continuous infusion
        Correct Answer:- Option-B

Question92:-Rise in ETCO₂ during thyroid surgery can be due to all except
        A:-Anaphylaxis
        B:-Malignant hyperthermia
        C:-Thyrotoxicosis
        D:-Exhausted absorber
        Correct Answer:- Option-A

Question93:-Which one of these statements is correct for desflurane ?
        A:-It is useful in gas induction
        B:-It is used in a specific vaporizer
        C:-It is a gas at room temperature
        D:-It is heated to 25ºC within the vaporizer
        Correct Answer:- Option-B

Question94:-All are non invasive methods for calculating cardiac output except
        A:-LidCO
        B:-PiCCO
        C:-Thermodilution method
        D:-Bioimpedance method
        Correct Answer:- Option-D

Question95:-Regarding epidural blockade the wrong staement is
        A:-Low amplitude Electric current can be used to confirm epidural placement (1-10 mA)
        B:-Motor response < 1 mA means subdural/subarachinoid placement
        C:-Most common organism implicated in epidural infection following needle placement is streptococcus
        D:-Tunneling the catheter along with occlusive dressing prevents infection
        Correct Answer:- Option-C

Question96:-False statement regarding decontamination of flexible endoscopes.
        A:-Endoscopes are pressure tested before disinfection
        B:-They are stored vertically down after use
        C:-Chloride related compounds are used for decontamination
        D:-Pseudomonas and Klebsiella can be transmitted via endoscopes
        Correct Answer:- Option-C

Question97:-Identify the wrong statement regarding post dural puncture headache.
        A:-Intrathecal catheter insertion is associated with lesser incidence of headache
        B:-Diplopia is unilateral in most of the cases
        C:-To prevent headache needle insertion should be inserted with bevel parallel to the level of long axis of the spine
        D:-Visual disturbance is due to the involvement of trochlear nerve
        Correct Answer:- Option-D

Question98:-Regarding non invasive method for blood pressure monitoring which of the following statement is wrong ?
        A:-Penaz technique can be used for continuous blood pressure measurement.
        B:-While using oscillometry to calculate blood pressure monitoring the diastolic blood pressure is prone to inaccuracies.
        C:-DINAMAP (Devise for indirect non invasive automated MAP measurement) uses single cuffs for measurement.
        D:-Von Reckling Housen technique can be used to measure non invasive blood pressure continuously.
        Correct Answer:- Option-D

Question99:-In JVP wave form 'x' descend correlate with
        A:-Venous return
        B:-Ventricular filling
        C:-Atrial relaxation
        D:-Opening of tricuspid valve causing blood from the right atrium, to fill the ventricle
        Correct Answer:- Option-C

Question100:-Which option best represents the two signs or symptoms that would qualify this patient for a diagnosis of acetaminophen-induced Acute Liver Failure (ALF) ?
        A:-Jaundice and encephalopathy
        B:-Thrombocytopenia and encephalopathy
        C:-Coagulopathy and encephalopathy
        D:-Leukocytosis and encephalopathy
        Correct Answer:- Option-C