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VIVA IN ANAESTHESIOLOGY
QUESTIONS AND ANSWERSON ABG,DRUGS,ECG,X-RAY&OTHERS
Dr.R.SELVAKUMAR
X-RAY INTERPRETATION
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1. HEART APPEARS BIGGER IN A-P VIEW X-RAY.
TRUE OR FALSE
TRUE. DUE TO THE INCREASED DISTANCEFROM THE FILM
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2. HOW WILL YOU KNOW THE FILM IS TAKEN IN FULL INSPIRATION?
IF THE FILM IS TAKEN IN FULL INSPIRATION,ANTERIOR ENDS OF LEFT 6 RIBS ARE VISIBLEABOVE THE LEFT DOME OF DIAPHRAGM
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3. WHAT ARE THE STRUCTURES WHICH CONTRIBUTE THE RIGHT HEART BORDER OF THE CARDIAC SHADOW IN X-RAY?
1. SVC2. RIGHT PULMONARY ARTERY3. RIGHT ATRIUM4. IVC
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RIGHT HEART BORDER....
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4. HOW WILL YOU DIAGNOSE “CARDIOMEGALY”IN CHEST X-RAY?
C-T RATIO MUST BE MORE THAN 50%
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CT RATIO....
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5. HOW MUCH FLUID IT TAKES TO OBLITERATE THE CARDIOPHRENIC ANGLE?
ATLEAST 150 -200 ML OF PLEURAL FLUID
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6. AIR BRONCHOGRAM IS GENERALLY VISIBLE IN
A.PNEMONIC CONSOLIDATIONB.PLEURAL EFFUSIONC.LUNG ATELECTASIS
PNEMONIC CONSOLIDATION
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7. IDENTIFY BOTH THE X-RAYS:What is the difference between them?
CARDIOGENIC AND NON-CARDIOGENICPULMONARY OEDEMA
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8. IDENTIFY THE XRAY AND HOW WILL YOUCLINICALLY CONFIRM THE DIAGNOSIS?
PNEUMOTHORAX –NEEDLEIN 2ND INTERCOSTAL SPACE PREPP-16
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9. DIAGNOSE THIS CLINICAL CONDITION:
HAEMOPNEUMOTHORAX
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11. IDENTIFY THE PROBLEM
MULTIPLE RIB FRACTURES
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10. DIAGNOSE THIS CLINICAL CONDITION:
BILAT RIB FRACTURE?FLAIL CHEST
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12. WHAT IS THE PURPOSE OF THIS CHEST X-RAY?
To confirm the ETT position
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13.IDENTIFY THE PROBLEM:
TRACHEAL COMPRESSION BY THE ENLARGED THYROID
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MRI NECK
HOW WILL YOU INDUCE & INTUBATE?
NEVER PARALYSE.ELECTIVE TRACHEOSTOMY
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15. WHAT IS THE CLINICAL DIAGNOSIS?
MITRAL STENOSIS
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16. MENTION THE TYPE OF ANESTHESIA FORTHIS COIN RETRIEVALA. TIVA B. G.A SPONTANEOUS C. G.A-CONTROLLED
G.A -SPONTANEOUS
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17. METHODS OF OXYGENATION DURING THISF.B RETRIEVAL
APNOEIC OXYGENATIONSIDEARM VENTILATIONJET VENTILATION
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18. WHAT IS THE PROBLEM IN THIS PATIENT IF HE IS POSTED FOR AN EMERGENCYSURGERY?
PATIENT ON ANTICOAGULANTS
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19. WHAT IS THE PROBLEM OF GIVINGREGIONAL ANAESTHESIA FOR THIS PATIENT?
UNBLOCKED VAGUS AND UNDERSURFACEOF DIAPHRAGMNEED FOR HIGH BLOCK
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20.HOW WILL YOU INTUBATE THIS PATIENT?
INTUBATION WITHOUT NECK EXTENSIONWITH MILS
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II. ARTERIAL BLOOD GAS INTERPRETATION
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21.WHATS THE DIFFERENCE BETWEENALLEN’S AND MODIFIED ALLEN’S TEST?
The Allen's test assesses collateral circulation in the hand, in 2 steps. Step 1 occludes the radial artery for several minutes and compares the hand color to the other hand. The hand is said to have sufficient collateral circulation through the ulnar artery if there is no change in color. Step 2 occludes the ulnar artery. A change in hand color means the potential for radial artery occlusion is high. That is a positive Allen's test, which contraindicates radial-artery puncture
MODIFIED ALLEN’S TEST
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OCCLUSION OF BOTH ULNAR AND RADIAL ARTERIESIN A BLANCHED FIST. THEN RELEASE OF ULNAR ARTERY.FLUSHING WITHIN 15 SECONDS IS NORMAL.
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22. EXCLUDE THE TYPE I RESPIRATORY FAILUREFROM THE REST
1. BENZODIZEPINE POISONING2. PNEUMONIA3. COPD4. HIGH SPINAL CORD LESION
PNEUMONIA
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23. FIND OUT THE NORMAL ANION GAP ACIDOSISAMONG THE FOLLOWING:
1. ILEOSTOMY2. METHANOL POISONING3. LACTIC ACIDOSIS4. BROMIDE INTOXICATION
ILEOSTOMY
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24.FOLLOWING ARE THE SIDE EFFECTS OF BICARB THERAPY FOR TREATING METABOLICACIDOSIS:
25.INTRACELLULAR ACIDOSIS26.HYPEROSMOLARITY27.ALKALOSIS28.SHIFT OF ODC TO RIGHT
SHIFT OF ODC TO THE RIGHT
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25. READ THE FOLLOWING ABG REPORT
pH...7.2paCO2...26paO2...72HCO3...16BE..-10.5FIO2...0.30 -
METABOLIC ACIDOSIS WITHRESP.ALKALOSIS
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26. COMMENT UPON THE FOLLOWING ABG
pH...7.32paCO2....68paO2...65HCO3...31.5BE..7.1FIO2...0.21SaO2...95%
Chronic respiratory acidosis with Compensatory metabolic alkalosis
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27. DIAGNOSE THE FOLLOWING ACID-BASE DISORDER:
pH..7.21pCO2...52paO2..56HCO3...18BE...-4.2FIO2...0.3
Super added acute metabolic acidosis in a patientWith chronic respiratory acidosis with met.alkalosis
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28.WHAT IS THE ABNORMALITY IN THE FOLLOWING ABG
pH...7.41paO2...122paCO2...34HCO3...23.4BE...-0.8FIO2..0.21
Air contamination in the blood sample
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29. WHAT IS THE IMPACT OF TOO MUCH HEPARININ THE SYRINGE MEANT FOR TAKINGBLOOD SAMPLE FOR ABG?
1. SPURIOUS ALKALOSIS2. INCREASED SODIUM LEVEL3. DECREASED CALCIUM LEVEL4. SPURIOUS ACIDOSIS
INAPPROPRIATE LOW pH.
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30.WHAT IS THE FORMULA TO CALCULATE THEHCO3 DOSE TO TREAT THE METABOLIC ACIDOSIS?
B.D X BODY WEIGHT X 0.3
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31. WHICH DRUG POISONING PRODUCES RESPIRATORY ALKALOSIS?
ASPIRIN -SALICYLATES
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ELECTROCARDIOGRAPH INTERPRETATION
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32. DIFFERENCES BETWEEN TWO E.C.GTRACES:
ATRIAL PREMATURE BEAT
VENTRICULAR
ABNORMAL P WAVE ABSENT P WAVENORMAL QRS WIDE QRSNORMAL T WAVE OPPOSITE TO QRSSHORT COMPENSATORY PAUSE
FULL COMPENSATORY PAUSE
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33. DIAGNOSE THE FOLLOWINGARRHYTHMIA
MULTIFOCAL VENTRICULAR EXTRA-SYSTOLES
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34. WHAT IS GOING ON HERE?
R ON T PHENOMENON LEADING TO V.T
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35. DIAGNOSE THE FOLLOWING ECG AND DRUGOF CHOICE FOR THE TREATMENT.
ATRIAL FIBRILLATIONDofetilide ,Flecainide , Ibutilide Propafenone ,Amiodarone
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36. WHAT IS THE FIRST DOSE OF DEFIBRILLATION?
120-200J IF IT IS A BIPHASIC DEFIBRILLATOR
360 J IF IT IS A MONOPHASIC
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37.DOSE OF ADRENALINE IN ACLS-2015
1 mg EVERY 3-5 MINUTES
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38. DIAGNOSE THE FOLLOWING ECG:
PACEMAKER SPIKES
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39. ECG RECORDED AFTER INTERCOSTAL NERVE BLOCK.WHAT COULD BE THE REASON?
BUPIVACAINE TOXICITY-I DEGREE HEART BLOCK
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40. WHICH INHALATIONAL AGENT IS NOTORIOUSIN CAUSING THE FOLLOWING ARRHYTHMIA?
HALOTHANE-SINUS BRADYCARDIA
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41. WHAT IS THE FIO2 OFEXPIRED AIR RESUSCITATION?
14-16%
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42. WHAT IS THE CHEST COMPRESSION RATEIN ACLS 2015?
100 -120 /MIN
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43.WHAT IS THE NEW GUIDELINE ADDED IN ACLS-2015
Use of Social Media to Summon Rescuers2015 (New): It may be reasonable for communities to incorporate social media technologies that summon rescuers who are in close proximity to a victim of suspected OHCA and are willing and able to perform CPR
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44.WHAT IS THE DOSE OF INTERNAL CARDIACDEFIBRILLATION?
5 J
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45. WHAT ARE THE NON-PHARMACOLOGIC METHODSOF TREATMENT OF THIS ARRHYTHMIA?
VAGAL MANOEUVRES-VALSALVA,CAROTID SINUS MASSAGE
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DRUGS
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46. WHAT IS THE PROBLEM OF LONG TERMINFUSION OF PROPOFOL IN I.C.U?
PROPOFOL INFUSION SYNDROME-Impaired mitochondrial fatty acid metabolism
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47. WHAT IS THE ACTIVE METABOLITE OF DIAZEPAM?
DESMETHYL DIAZEPAM
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48. FIND OUT THE DRUG:
1. ANTAGONISTIC ACTION AT GABA A AND GABA B
2. ALSO USED TO REVERSE THE CNS DEPRESSANTEFFECT OF ALCOHOLIC INTOXICATION
FLUMAZENIL
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49. WHAT IS THE THERAPEUTIC RANGE OF PLASMA LEVEL OF MAGNESIUM AND ONE WHICH CAUSES RESPIRATORY PARALYSIS?
THERAPEUTIC-4 – 6 meq/lTOXIC – 20 – 25 meq/l
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50. WHICH DRUG IS ADDED TO DROPERIDOL AND FENTANYL TO MAKE IT A COMPLETE NEUROLEPTANAESTHESIA?
INHALATIONAL AGENT ESPECIALLYNITROUS OXIDE
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51. NAME TWO OTHER DRUGS WHICH ARE METABOLISED BY PSEUDOCHOLINE ESTERASE:
MIVACURIUMMEPIVACAINE
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52. WHY THE ENZYME “PEUDOCHOLINE ESTERASE”IS NAMED SO?
• PRESENT IN THE PLASMA• SUBSTRATE NON-SPECIFIC
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53. WHAT IS THE NORMAL DIBUCAINE NUMBER?
80
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54. WHAT IS THE PRIME METABOLIC PATHWAYOF ATRACURIUM?
ESTER HYDROLYSIS
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55. NAME ANY OTHER TWO CONDITIONS WHEREANTICHOLINEESTERASES ARE USED APART FROMREVERSAL?
MYASTHENIA GRAVISSNAKE BITE
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56. RULE THE ODD MAN OUT:
1.MEPIVACAINE2.ETIDOCAINE3.TETRACAINE4.LIGNOCAINE
TETRACAINE- ESTER GROUP
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57. NAME THE LOCAL ANAESTHETIC DRUGINVENTED BY DRUG RESEARCH LABORATORY,LUCKNOW:
CENTBUCRIDINE
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58. WHAT IS THE pKa OF LIGNOCAINE?
7.8
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59. WHICH REGIONAL NERVE BLOCK CAUSES THE HIGHEST PLASMA LEVEL OF L.A IN A SHORTEST TIME?
INTERCOSTAL NERVE BLOCK
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60. WHAT ARE THE TWO TYPES OF PRIMARYALKALOIDS FOUND IN THE EXTRACT OF POPPY?
PHENANTHRENESBENZYL ISOQUINOLONES
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61. WHICH ANAESTHETIC DRUG WAS BLAMEDFOR THE DEATH IN THE WAR CASUALITIES OF PEARL HARBOUR?
THIOPENTONE
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62. ARRANGE IN ASCENDING ORDER WITH REGARDS TO OIL:GAS PARTITION COEFFICIENT:
1. ISOFLURANE2. DESFLURANE3. HALOTHANE 4. SEVOFLURANE
1. DESFLURANE - 18.72. SEVOFLURANE - 473. ISOFLURANE – 90.84. HALOTHANE - 224
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63. COMPLETE THE STATEMENT REGARDING ATROPINE...
HOT AS A HARE....
HOT AS A HAREMAD AS A HENBLIND AS A BATRED AS A BEETDRY AS A BONE....
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64. WHAT IS THE DOSE OF VASOPRESSIN IN CPR?
40 UNITS –I.V PUSH
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66. WHAT IS THE ADRENALINE DOSE IN EPIDURAL TEST DOSING?
15 µg IN 3 ML OF 1.5 % LIGNOCAINE
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67. WHICH DRUG ACTS AS FAST AS I.M KETAMINEIN PRODUCING SEDATION IN PAEDIATRIC CASES?( NOT IN USE NOW...)
PARALDEHYDE
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68.NAME THE DRUG STORED AS A CRUDE EXTRACT IN THIS UTENSIL:
CURARE
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69. DOSE OF SUGGAMADEX
2 – 4 mg / k.g
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pentafluoroisopropenyl fluoromethyl ether (PIFE, C4H2F6O),
COMPOUND-A
70. WHAT IS THE COMMON NAME FOR THE ABOVECHEMICAL?
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CAPNOGRAPH,PFT & SONOANATOMY
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71. IN WHICH TYPE OF CAPNOGRAM,TIME DELAY IS MINIMAL?
MAINSTREAM CAPNOGRAM
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72. FIND OUT THE POSSIBLE REASON FOR THISKIND OF TRACE..
LOWER AIRWAY OBSTRUCTION –SHARK FIN APPEARANCE
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HYPOVENTILATIONMALIGNANT HYPERPYREXIA
73.IDENTIFY THIS SIGNATURE CAPNOGRAM:
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CHECK ALL THE CAUSES FOR REBREATHING
74. HOW TO RECTIFY THE PROBLEM?
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ATTEMPTED SPONTANEOUS BREATHIN A PARALYSED PATIENT-CURARE CLEFT
75. WHY THIS CLEFT APPEARS IN THE EXPIRATORY PLATEAU?
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BAIN HUMP
76. IDENTIFY THIS SIGNATURE CAPNOGRAM:
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LOOSE CONNECTION BETWEEN SAMPLING LINEAND CAPNOGRAPH ONE LUNG TRANSPLANT ETT CLOSE TO CARINA
77. WHY THERE ARE TWO PEAKS?
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reverse phase 3 slope seen in patients with emphysema.
78. IDENTIFY THE ABNORMALITY IN THIS CAPNOGRAM:
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CAPNOGRAM IN A SPONTANEOUSLYBREATHING ADULT
79. COMMENT UPON THIS CAPNOGRAM:
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PIG TAIL CAPNOGRAM-CRUSHED SAMPLING TUBE
80. WHAT IS THE NAME OF THIS TYPE OF WAVEFORM AND WHAT IS THE REASON?
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INSPIRATORY VALVE MALFUNCTION-EXTENDING THE ALVEOLAR PLATEAUOF PHASE-III
81. WHAT IS THE PROBLEM HERE?
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82. IDENTIFY THE PROBLEM IN THIS FLOW-VOLUME LOOP
FIXED AIRWAY OBSTRUCTION
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83. IDENTIFY THE PATHOLOGY
AIRWAY OBSTRUCTION DURING FORCED EXPIRATION -ASTHMA
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84. IDENTIFY THE RESTRICTIVE PATTERN
INCREASED STEEPNESS IN THE FLOW CURVESAND REDUCTION IN BOTH TLC AND FRC.
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85. IDENTIFY THE PROBLEM
VARIABLE EXTRA THORACIC OBSTRUCTION
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86. IDENTIFY THE PROBLEM IN THIS TEG
HYPERCOAGULATION STATE
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87. READ THIS TEG PICTURE
FIBRINOLYSIS
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88. DIAGNOSE THE FOLLOWING CONDITION
THROMBOCYTOPENIA
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89.IDENTIFY THE NERVE
FEMORAL NERVE
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90. WHAT TYPE OF BLOCK IS DEMONSTRATED HERE ?
TAP BLOCK
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91. WHAT IS BEING MEASURED HERE?
DEPTH OF SUBARACHNOID SPACE
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92. WHAT DO YOU MEAN BY SEASHORE SIGN?.
In M-Mode- Motionless parietal tissues over the pleural line and granular lung behind.
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93. When will you get this picture?
Absence of lung sliding and loss of granular pattern-PNEUMOTHORAX
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94.WHAT IS BEING CONFIRMED HERE?
ENDOTRACHEAL TUBE PLACEMENT
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95. READ THE ABNORMAL CVP TRACE
CONSTRICTIVE PERICARDITIS
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96. READ THE CVP TRACE
CANNON WAVES
MISCELLANEOUS
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97. WHICH ANAESTHETIC DRUG HE IS USING FOR THE HUNTING?
CURARE
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98.WHICH DRUG IS EXTRACTEDFROM THIS PLANT?
D-TUBOCURARINE
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99.WHAT ARE THE ACTIVEALKALOIDS IN THIS PLANT?
ATROPINE,SCOPOLAMINE
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100. WHICH DRUG IS INVOLVED IN THIS STORY?
MANDRAGORA PLANT -SCOPOLAMINE
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101. GREAT DISCOVERY STARTED FROM THIS PLANT. WHAT IS THAT DRUG?
ERYTHROXYLON COCA- COCAINE
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102. WHICH DRUG IS RELATED TO THIS BEAUTIFUL PLANT?
MORPHINE –PAPAVER SOMNIFERUM
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103. WHAT IS THE SPECIALITYIN THIS SPRAY?
•ONCE IT WAS USED AS AN INDUCTION AGENT•NOW USED AS AN CRYOANALGESIC
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104. TELL ME ONE INHALATIONAL AGENTWITH A BOILING POINT MORE THAN WATER:
METHOXYFLURANEBOILING POINT -104.8 CO:G PARTITION COEFFICIENT- 950
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105. STATE OF WASHINGTON USES THIS DRUGTO EXECUTE THE DEATH SENTENCE IN A SINGLE DOSE OF 5 gram. WHAT IS THIS DRUG?
THIOPENTONE
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106.WHO IS THE MAN WHO SUGGESTED CHLOROFORM TO SIMPSON?
DAVID WALDIE
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107.WHAT WAS THE TYPE OF ANAESTHESIAGIVEN TO MAHATMA GANDHI FOR HISAPPENDICECTOMY ON 12TH JANUARY,1925?
OPEN DROP CHLOROFORM
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108. WHEN AND WHERE ETHER WAS USED IN INDIAFIRST TIME?
22nd MARCH,1847- MEDICAL COLLEGE HOSPITAL,CALCUTTA
JAI HO...
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ALL THE BEST
dr.r.selvakumarprofessor of anaesthesiologyk.a.p.viswanatham govt medical college,trichy
