NEET-PG 2012 - Anesthesiology PYQs Practice Questions

Q: Which of the following is true about coeliac plexus block?

Most common side effects include diarrhea and hypotension. ***Most common side effects include diarrhea and hypotension*** - A coeliac plexus block interrupts **sympathetic innervation** to the upper abdominal organs, which can lead to parasympathetic dominance. - This imbalance often results in **increased gastrointestinal motility (diarrhea)** and **vasodilation (hypotension)** as common side effects. *Located retroperitoneally at the level of L3* - The coeliac plexus is typically located **retroperitoneally** at the level of the **T12-L1 vertebrae**, not L3. - Its position is generally superior to the renal arteries, which are closer to L1-L2. *Usually done unilaterally* - A coeliac plexus block is almost always performed **bilaterally** or with a single posterior approach aiming for bilateral spread to effectively block the plexus. - The coeliac plexus is an extensive network, and a unilateral block would likely provide inadequate pain relief. *Useful for painful conditions of the lower abdomen* - The coeliac plexus primarily innervates **upper abdominal organs** (e.g., pancreas, liver, stomach, small intestine, kidneys, adrenal glands). - It is therefore generally **ineffective for lower abdominal pain**, which is innervated by different sympathetic plexuses (e.g., superior and inferior hypogastric plexuses). [Practice more Anesthesiology PYQs on OnCourse]

Q: What is the potential respiratory complication associated with the use of Trilene in combination with Sodalime?

Airway irritation and inflammation. ***Airway irritation and inflammation*** - The interaction between **Trilene (trichloroethylene)** and **soda lime** in a closed anesthetic circuit can produce **dichloroacetylene**. - **Dichloroacetylene** is a highly toxic compound that can cause severe airway irritation, inflammation, and even **necrosis** of the respiratory tract. *Renal toxicity* - While some halogenated anesthetics (e.g., methoxyflurane) are associated with **renal toxicity** due to fluoride ion release, this is not the primary or most severe respiratory complication of Trilene with soda lime. - The main concern with Trilene and soda lime is the formation of a **toxic airway irritant**. *Hepatotoxicity* - **Halothane** is more classically associated with **hepatotoxicity** (halothane hepatitis) due to metabolism into toxic intermediates. - **Trilene** itself is not primarily known for causing severe hepatotoxicity, and the interaction with soda lime does not specifically target the liver for toxicity. *Myocardial depression* - Many inhaled anesthetics, including Trilene, can cause some degree of **myocardial depression**. - However, this is a general effect of the anesthetic on cardiac function and is not a unique or specific complication arising from the **interaction with soda lime** that produces dichloroacetylene. [Practice more Anesthesiology PYQs on OnCourse]

Q: Calcium homeostasis disturbance is the predominant pathophysiological mechanism in

Malignant hyperthermia. ***Malignant hyperthermia*** - Malignant hyperthermia is caused by a genetic defect in the **ryanodine receptor (RYR1)** in skeletal muscle, leading to an uncontrolled release of **intracellular calcium** from the sarcoplasmic reticulum. - This excessive calcium release results in sustained muscle contraction, increased metabolism, and a rapid rise in body temperature. *Duchenne Muscular Dystrophy (DMD)* - DMD is primarily caused by a mutation in the **dystrophin gene**, which leads to the absence or severe deficiency of the **dystrophin protein**. - This deficiency results in muscle fiber fragility, cycles of degeneration and regeneration, and eventual replacement of muscle with fibrous and fatty tissue, rather than a primary calcium homeostasis disturbance. *Limb Girdle Muscular Dystrophy* - This group of disorders is characterized by progressive weakness and wasting of muscles, primarily affecting the **shoulders and hips**. - The pathophysiology involves genetic defects in various proteins that are crucial for muscle function and integrity, such as **sarcoglycans** or **calpain-3**, not primarily calcium dysregulation. *Tibial Muscular Dystrophy* - Tibial muscular dystrophy is a rare, late-onset disorder characterized by progressive weakness of the **anterior tibial muscles**. - It is typically caused by mutations in the **TTN gene**, encoding for the protein **titin**, which plays a vital role in muscle elasticity and structural integrity, rather than a primary calcium imbalance. [Practice more Anesthesiology PYQs on OnCourse]

Q: Cocaine was first used as a local anesthetic by?

Carl Koller. ***Carl Koller*** - **Carl Koller** (1857-1944), an Austrian ophthalmologist, is credited with the first clinical use of cocaine as a local anesthetic in 1884. - He demonstrated its efficacy for topical anesthesia in eye surgery, revolutionizing surgical practices. *Holmer Wells* - **Horace Wells** (not Holmer) was an American dentist who pioneered the use of **nitrous oxide** as an anesthetic in dentistry in the 1840s, preceding Koller's work with cocaine. - His contributions were focused on general anesthesia for pain relief during tooth extractions. *Morton* - **William T.G. Morton** was another American dentist who famously demonstrated the use of **ether** as a surgical anesthetic in 1846. - His work popularized surgical anesthesia, but it was not related to cocaine as a local anesthetic. *None of the options* - This option is incorrect because Carl Koller is historically recognized as the pioneer for the clinical use of **cocaine as a local anesthetic**. [Practice more Anesthesiology PYQs on OnCourse]

Q: What is the critical temperature of Nitrous Oxide (N2O)?

-36.5°C. **-36.5°C** - The **critical temperature** of **nitrous oxide (N2O)** is **36.5°C**, which is the temperature above which it cannot be liquefied by pressure alone. - This value is important for understanding the **physical state** and safe handling of N2O, as deviations can lead to phase changes or storage issues. *-118°C* - This temperature is significantly lower than the actual critical temperature of N2O and is incorrect. - This value might be related to the **boiling point of other gases** but not the critical temperature of N2O. *-36°C* - While close, **-36°C** is not the precise critical temperature for nitrous oxide. - This small difference can be significant in contexts requiring **exact physical properties** of gases. *-30°C* - This temperature is incorrect and is higher than the actual critical temperature of N2O. - At this temperature, N2O would still behave as a **liquefiable gas** under sufficient pressure, indicating it is below its critical point. [Practice more Anesthesiology PYQs on OnCourse]

Question 1

Which of the following is true about coeliac plexus block?

Accepted Answer

Most common side effects include diarrhea and hypotension

Answer

Usually done unilaterally

Answer

Located retroperitoneally at the level of L3

Answer

Useful for painful conditions of the lower abdomen

Question 2

What is the potential respiratory complication associated with the use of Trilene in combination with Sodalime?

Accepted Answer

Airway irritation and inflammation

Answer

Renal toxicity

Answer

Hepatotoxicity

Answer

Myocardial depression

Question 3

Calcium homeostasis disturbance is the predominant pathophysiological mechanism in

Accepted Answer

Malignant hyperthermia

Answer

Duchenne Muscular Dystrophy (DMD)

Answer

Limb Girdle Muscular Dystrophy

Answer

Tibial Muscular Dystrophy

Question 4

Cocaine was first used as a local anesthetic by?

Accepted Answer

Carl Koller

Answer

Holmer Wells

Answer

Morton

Answer

None of the options

Question 5

What is the critical temperature of Nitrous Oxide (N2O)?

Accepted Answer

-36.5°C

Answer

-118°C

Answer

-36°C

Answer

-30°C

Question 6

Which of the following cannot be given by epidural anaesthesia?

Accepted Answer

Remifentanil

Answer

Morphine

Answer

Alfentanil

Answer

Fentanyl

Question 7

Ayre's T-piece is which type of circuit

Accepted Answer

Type E

Answer

Type A

Answer

Type B

Answer

Type D

Question 8

Stages of anesthesia were established by

Accepted Answer

Diethyl ether

Answer

Nitrous oxide

Answer

Halothane

Answer

Chloroform

Question 9

Which of the following is NOT a contraindication for spinal anaesthesia?

Accepted Answer

Hypertension

Answer

Raised intracranial tension

Answer

Bleeding disorder

Answer

Infection at injection site

Question 10

Which circuit is specifically designed for anaesthesia in infants?

Accepted Answer

Ayres t piece

Answer

Bains circuit

Answer

Magill circuit

Answer

Water's circuit

NEET-PG 2012 — Anesthesiology