INI-CET 2017 — Anesthesiology

Q: You are asked to put a 22-gauge cannula in a patient. Which of the following cannula will you put?

C. ***C*** - This cannula is blue, which correlates to a **22-gauge** size according to standard color-coding for IV cannulas. - A **22-gauge** cannula matches the specific requirement in the question and is generally used for patients with fragile veins, pediatric patients, or for slow infusions. *A* - This cannula is green, typically indicating an **18-gauge** size. - An 18-gauge cannula provides a larger bore for faster fluid administration but is **too large** for the 22-gauge requirement specified. *B* - This cannula is pink, which corresponds to a **20-gauge** size according to standard color-coding. - A 20-gauge cannula is commonly used for routine infusions but is **larger than the requested 22-gauge** size. *D* - This cannula is yellow, indicating a **24-gauge** size, the smallest common size. - A 24-gauge cannula is **smaller than the requested 22-gauge** and is primarily reserved for very fragile veins and infants. [Practice more Anesthesiology PYQs on OnCourse]

Q: The position of the patient as shown below is favored for which of the following conditions?

Raised ICP. ***Raised ICT*** - The image depicts the patient in a **reverse Trendelenburg position** (head elevated). This position is often used to reduce **intracranial pressure (ICP)** by promoting venous drainage from the brain. - Elevating the head above the trunk aids in gravity-assisted drainage of cerebral venous blood and cerebrospinal fluid, thereby lowering ICP and preventing complications like brain herniation. *CHF* - Patients with **congestive heart failure (CHF)** often prefer a **Fowler's position** (sitting upright) to ease breathing and reduce pulmonary congestion, not the reverse Trendelenburg as shown. - Lying flat or with feet elevated in CHF can worsen dyspnea and increase cardiac workload due to increased venous return. *Air embolism* - For suspected **air embolism**, the patient is typically placed in the **Trendelenburg position** (head down, feet up) with a left lateral tilt to trap air in the right ventricle and prevent it from entering the pulmonary circulation. - This position helps prevent air from crossing into the left side of the heart thereby reducing the risk of systemic arterial air embolization. *Neurosurgery* - While neurosurgery often involves specific patient positioning, the depicted position isn't uniquely favored for neurosurgery in general. Positioning depends on the surgical site. - The **reverse Trendelenburg** is specifically used when reducing ICP is a primary goal during or after neurosurgical procedures, but not all neurosurgeries. [Practice more Anesthesiology PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

You are asked to put a 22-gauge cannula in a patient. Which of the following cannula will you put?

The position of the patient as shown below is favored for which of the following conditions?