MHMS • 2022 • Paper-IV (Technical)
Type(s) of symptomatic pain conditions that best describes “chronic” pain often includes
A)
Neuropathic pain alone
B)
Nociceptive pain alone
C)
Neuropathic or nociceptive pain
D)
Somatic or visceral pain
Neuropathic or nociceptive pain is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
Which one of the following modes of ventilation is triggered by time, limited by pressure and inspiratory effort ?
A)
Controlled Mandatory Ventilation
B)
Synchronous Intermittent Mandatory Ventilation
C)
Assist Control Mode
D)
Pressure Control Mode
Pressure Control ventilation is time-triggered, pressure-limited and time-cycled; tidal volume varies with compliance.
MHMS • 2022 • Paper-IV (Technical)
In all chronic pain there are problems in the nervous system except
A)
Complex regional pain syndrome (CRPS)
B)
Fibromyalgia
C)
Migraine
D)
Rheumatoid arthritis
Rheumatoid arthritis is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Advantage of SIMV is
A)
Less interference with normal cardiac-vascular function
B)
Increased work of breathing
C)
Rests muscles of respiration completely
D)
VT decreases with or increases with lung resistance/compliance
Less interference with normal cardiac-vascular function correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Preoperative assessment of patients with diabetes mellitus should include
A)
An assessment of functional status
B)
24-Hour creatinine clearance
C)
Pulmonary function testing
D)
Cancellation of the surgical case if HbA1c >10%
An assessment of functional status is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
Which of the following is incorrect regarding recovery position?
A)
Place nearest arm at right angle
B)
Put the back of other hand straight on side of the victim
C)
Bend the far knee, grasp the far leg and roll them onto their side
D)
Open airway
Place nearest arm at right angle is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Primary goals of ventilatory support are all except
A)
Adequate oxygenation/ventilation
B)
Reduce work of breathing
C)
Asynchrony between patient and ventilator
D)
Avoidance of high end-inspiration alveolar pressures
Reduce work of breathing is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Potential complications of use of a pneumatic tourniquet include all of the following except
A)
Tourniquet pain that is relieved by performing a peripheral nerve block
B)
A compression nerve injury
C)
Development of arterial thromboembolism
D)
Pulmonary embolism
A compression nerve injury is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
When monitoring the paediatric patient, where should the precordial stethoscope be placed?
A)
Left sternal border 2nd or 3rd intercostal space
B)
Right sterna border 2nd or 3rd intercostal space
C)
Left midclavicular line 5th intercostal space
D)
Depends upon what you are trying to monitor
Depends upon what you are trying to monitor is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
Increases in intraocular pressure (IOP) following succinylcholine administration for tracheal intubation can be minimized by all of the following, except
A)
â-Adrenergic blocker
B)
Nondepolarizing relaxant
C)
Detachment of extraocular muscles from the globe
D)
Lidocaine
Nondepolarizing relaxant is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
One of the following is a primary risk factor for difficult mask ventilation
A)
Limited mouth opening
B)
Thyromental distance less than 3 fingerbreadths
C)
High arched palate
D)
Inability to bring mandibular incisors anterior to the maxillary incisors
Inability to protrude mandible (bring lower incisors anterior to upper) impairs jaw thrust and mask seal, a classic MOANS predictor of difficult mask ventilation.
MHMS • 2022 • Paper-IV (Technical)
Most commonly missed nerve with interscalene approach to brachial plexus
A)
Ulnar
B)
Median
C)
Musculocutaneous
D)
Radial
Ulnar is the standard/commonest association or the most appropriate choice for this presentation.
MHMS • 2022 • Paper-IV (Technical)
What is the most important componenent of physical examination for down syndrome patient?
A)
Airway examination and neck stability
B)
Assessing degree of mental retardation
C)
Obtaining history from parents regarding any heart conditions
D)
Assessing for reflux and signs of URI
Airway examination and neck stability is the standard/commonest association or the most appropriate choice for this presentation.
MHMS • 2022 • Paper-IV (Technical)
Chronic pain indications for insertion of a spinal cord stimulator include all of the following, except
A)
Phantom pain
B)
Complex regional pain syndrome
C)
Chronic visceral pelvic pain
D)
Compartment syndrome pain
Compartment syndrome pain is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Nociceptive pain can be divided into two categories
A)
Somatic pain and visceral pain
B)
Somatic and neuropathic
C)
Inflammatory and radicular
D)
Acute and chronic
Somatic pain and visceral pain is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
A 7 year old child must not eat solid food for how many hours prior to procedure?
A)
6 hours
B)
8 hours
C)
3 hours
D)
4 hours
3 hours is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
In which of the following situations is applying continuous positive-airway pressure (CPAP) to the nondependent lung most ideal for improving oxygenation?
A)
Bronchopleural fistula
B)
Open lobectomy
C)
Massive pulmonary haemorrhage
D)
Sleeve resection
Sleeve resection correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
After rapid sequence induction of general anaesthesia, a patient is unable to be intubated. Subsequent attempts at ventilation by face mask and a supraglottic airway device are also unsuccessful. One of the following statements regarding transtracheal jet ventilation and surgical cricothyrotomy in this situation is most correct
A)
Transtracheal jet ventilation does not require a patent natural airway
B)
Ventilation through a surgical cricothyrotomy allows both inhalation and exhalation to occur
C)
The development of laryngospasm during ventilation through a cricothyrotomy would rapidly cause pulmonary over inflation and barotrauma
D)
Transtracheal jet ventilation can be continued for a longer period of time than can ventilation via a cricothyrotomy
Transtracheal jet ventilation does not require a patent natural airway correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Regarding Epidural Abscess - which is wrong-
A)
Diagnosis is dependent on triad of back pain, fever, and paralysis
B)
Occurs at a rate of 1:1000-3000 (OR 1:2000 -1:5000)
C)
Worse outcomes if advanced age
D)
Usually gram positive cocci
Diagnosis is dependent on triad of back pain, fever, and paralysis correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Which of the following statements is false regarding ventilation/perfusion relationship in a lateral decubitus position during spontaneous ventilation?
A)
Ventilation/perfusion matching remains the same
B)
Contraction of dependent hemi diaphragm is more efficient
C)
Dependent lung is on a more favourable part of the compliance curve
D)
The lower lung receives less ventilation and more perfusion than the upper lung
Dependent lung is on a more favourable part of the compliance curve is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Preferred inhalational anaesthetic agent in a patient with hyperthyroidism is
A)
Desflurane
B)
Ketamine
C)
Sevoflurane
D)
Meperidine
Meperidine correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Use of a laryngeal mask airway would be most appropriate for airway management in the following patient
A)
An obese patient with acute appendicitis who, after rapid sequence induction, cannot be intubated
B)
An elderly patient with restrictive lung disease scheduled for inguinal hernia repair
C)
An obese male patient with a hiatal hernia and GERD scheduled for umbilical hernia repair
D)
A full-term parturient brought to the OR for emergent caesarean section because of foetal bradycardia
An obese patient with acute appendicitis who, after rapid sequence induction, cannot be intubated is the preferred standard management for this clinical situation.
MHMS • 2022 • Paper-IV (Technical)
The main adverse effect of sedation with dexmedetomidine in a mechanically ventilated patient is
A)
Bradycardia
B)
Hypotension
C)
Respiratory depression
D)
Long duration of action
Dexmedetomidine is alpha-2 agonist causing bradycardia and hypotension; minimal respiratory depression is its advantage.
MHMS • 2022 • Paper-IV (Technical)
The surgeon is performing a right total knee arthroplasty under a combined spinal–epidural anaesthetic. The surgical team is providing you with information that within the next 15 minutes they plan to place bone cement (polymethylmethacrylate) to anchor the prosthesis. The most likely immediate side effect that may occur is
A)
Hypotension
B)
Increased work of breathing and hypercapnia
C)
Cardiac arrhythmias
D)
Decreased pulmonary shunt
Increased work of breathing and hypercapnia correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
The ocular effects of ketamine includes
A)
Pupillary constriction
B)
Blepharospasm
C)
Decrease in intraocular pressure
D)
Myoclonus
Pupillary constriction is the correct choice based on the standard clinical or subject-matter fact tested.
