MHMS • 2022 • Paper-IV (Technical)
48-year-old woman with temporomandibular joint dysfunction and limited mouth opening is scheduled for thyroidectomy for goitre. Due to concern for a difficult laryngoscopy, the anaesthesiologist elects to perform an awake oral fibreoptic intubation. To reliably blunt the afferent limb of the cough reflex, the anaesthesiologist should perform a bilateral block of the
A)
Internal and external branches of the superior laryngeal nerve
B)
Glossopharyngeal nerve and internal branch of the superior laryngeal nerve
C)
Glossopharyngeal nerve and external branch of the superior laryngeal nerve
D)
Superior laryngeal nerve and the recurrent laryngeal nerve
Glossopharyngeal nerve and internal branch of the superior laryngeal nerve correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
The majority of paediatric cardiac arrests occur during which phase ?
A)
Induction
B)
Maintenance
C)
Emergence
D)
Rates are equal during all 3 phases
Induction is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
In patients who are critically ill, the most common pharmacologic agents for pain and first-line agents for non-neuropathic pain are
A)
NSAIDs
B)
Sedatives
C)
Opioids
D)
Muscle relaxants
In ICU, opioids are first-line for non-neuropathic pain; NSAIDs are adjuncts due to renal/bleeding risks.
MHMS • 2022 • Paper-IV (Technical)
Which of the following conditions require a higher PEEP to be applied in recruiting collapsed alveoli?
A)
Asthma
B)
Acute Respiratory Distress Syndrome
C)
Bronchiectasis
D)
Emphysema
ARDS with alveolar collapse and shunt requires higher PEEP for lung recruitment; asthma/emphysema require low or no PEEP to avoid air trapping.
MHMS • 2022 • Paper-IV (Technical)
What is the first sign of inhalation anaesthetic induction in a child?
A)
Disappearance of eyelash reflex
B)
Shallow, rapid breathing
C)
Appearance of nystagmus
D)
The patient does not react to verbal stimuli
Disappearance of eyelash reflex correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Which of the following is false with use of opioid for chronic pain
A)
Opioids not first-line or routine therapy for chronic pain
B)
Avoid concurrent benzodiazepines and opioids whenever possible
C)
Not necessary to discuss expected benefits and risks with patients
D)
Prescribe lowest effective dose
Not necessary to discuss expected benefits and risks with patients is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
The primary benefit of positive end-expiratory pressure (PEEP) during mechanical ventilation is
A)
Improved elimination of CO2
B)
Improved venous return and cardiac output
C)
Prevention and reversal of alveolar collapse (atelectasis)
D)
Reduction in peak inspiratory pressure
Prevention and reversal of alveolar collapse (atelectasis) correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
For a normal inhalational induction your N2O should be at ______ and your O2 should be at ______ respectively to start out with
A)
70%, 30%
B)
50%, 50%
C)
40%, 60%
D)
0 %, 100 %
50%, 50% is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
Intraoperative anaesthetic management of a patient undergoing cerebral aneurysm repair includes all, except
A)
Maintenance of hypotension
B)
Mannitol for facilitating surgical exposure
C)
Maintaining mild hypothermia
D)
Patient remaining intubated for 24 hours postoperatively
Patient remaining intubated for 24 hours postoperatively is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
What is the incidence of Malignant Hyperthermia in children?
A)
1: 50,000
B)
1: 100,000
C)
1: 15,000
D)
1: 250,000
1: 100,000 correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
At what time frame following the postsurgical period does persistent postsurgical pain become defined as being “chronic pain”?
A)
1 to 2 weeks
B)
3 to 4 weeks
C)
1 to 2 months
D)
6 to 12 months
6 to 12 months correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
The MAC for all anaesthetic agents are highest at what age?
A)
6-12 months
B)
4-6 years
C)
1-4 years
D)
0-6 months
0-6 months is the relevant physiological, anatomical, pharmacological, or anaesthetic principle for this question.
MHMS • 2022 • Paper-IV (Technical)
During maintenance of a general inhaled anaesthetic for an urgent non-obstetric surgery, one would expect this difference in the pregnant patient versus a nonpregnant patient
A)
Slower emergence from anaesthesia
B)
Minimal changes in depth of anaesthesia
C)
Faster induction of anaesthesia
D)
There is to be no difference
There is to be no difference correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
Regarding monitoring for paediatric inhalation induction
A)
Temperature monitoring is essential during induction.
B)
It is unwise to upset anxious children by placing a blood pressure cuff before induction.
C)
A baseline ECG must be obtained before induction, especially in anxious children
D)
It is unnecessary to obtain pre-induction blood pressures in neonates, often difficult to obtain due to motion.
A baseline ECG must be obtained before induction, especially in anxious children is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
A 70-year-old male, who is diabetic for the last 20 years, is scheduled for an elective surgery. Which of the following is not a sign of autonomic diabetic neuropathy?
A)
History of recurrent diarrhoea
B)
History of postural hypotension
C)
History of recurrent constipation
D)
History of urinary retention
History of recurrent diarrhoea is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
A 64-year-old female is undergoing a left video-assisted thoracoscopy for a suspicious pulmonary nodule. Immediately after positioning the patient laterally, which of the following alarms indicate a malposition of the double-lumen tube (DLT)?
A)
High CO2 alarm
B)
Low O2 alarm
C)
Low tidal volume alarm
D)
Unable to drive bellows alarm
Unable to drive bellows alarm correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
The following is not disadvantage of NPPV
A)
Reduced need for sedation
B)
Claustrophobia
C)
Delay in intubation
D)
Possible upper extremity oedema, axillary vein thrombosis and tympanic membrane dysfunction
Reduced need for sedation is an advantage of NPPV, not a disadvantage.
MHMS • 2022 • Paper-IV (Technical)
Iatrogenic contributions to maternal supine hypotension syndrome can be minimized by
A)
Left hip elevation
B)
Left-uterine displacement
C)
Regional anaesthesia
D)
General anaesthesia
Left-uterine displacement is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
Which statement concerning the adult failed airway is incorrect?
A)
Airways such as the laryngeal mask airway and oesophageal obturator airway are always useful in the event of a failed airway.
B)
Awake intubation may be done by the nasotracheal route.
C)
Care should be taken before intubation to assess the airway for ease of ventilation as well as intubation.
D)
Cricothyrotomy is the crucial rescue procedure when intubation and ventilation fail.
Awake intubation may be done by the nasotracheal route. is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Patients with obstructive sleep apnoea (OSA)
A)
Are at increased risk of left-heart failure
B)
Have the same perioperative complication rate as patients without OSA
C)
May have an increased likelihood of difficult intubation
D)
Rarely require continuous positive airway pressure (CPAP) after bariatric surgery
May have an increased likelihood of difficult intubation is the correct choice based on the standard clinical or subject-matter fact tested.
MHMS • 2022 • Paper-IV (Technical)
When providing general anaesthesia during pregnancy, minimum alveolar concentration (MAC) is
A)
Increased
B)
Decreased
C)
Unchanged
D)
Unclear
Decreased correctly describes the definition or characteristic asked in the question.
MHMS • 2022 • Paper-IV (Technical)
A child with a recent URI undergoing anaesthesia would be at an increased risk for all of the following except:
A)
Laryngospasm
B)
Gastro-oesophageal reflux
C)
Atelectasis
D)
Bronchospasm
Atelectasis is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Ventilator associated pneumonia develops at least after how many hours of endotracheal intubation?
A)
24 to 48 hours
B)
36 to 72 hours
C)
48 hours
D)
72 hours
VAP is defined as pneumonia occurring >48 hours after endotracheal intubation with new infiltrate plus infection signs.
MHMS • 2022 • Paper-IV (Technical)
All the following are inhibitory neurotransmitters in the pain pathway, except
A)
Norepinephrine
B)
Adenosine
C)
Serotonin
D)
Calcitonin gene-related peptide
Calcitonin gene-related peptide is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
MHMS • 2022 • Paper-IV (Technical)
Which statement is false regarding early enteral nutrient administration in a critically ill patient
A)
Preserving gastrointestinal integrity and
B)
Barrier function and maintaining intestinal immunologic defences
C)
Decreasing infectious outcomes in critically ill patients
D)
Rapid recovery in a coma patient
Rapid recovery in a coma patient is the exception/incorrect statement; the other choices are consistent with the usual finding or principle.
