ASSISTANT PROFESSOR IN ANAESTHESIA (NCA) – MEDICAL EDUCATION

FINAL ANSWER KEY
Question Paper Code: 52/2019/OL
Category Code: 153/2018
Exam: Assistant Professor in Anaesthesia NCA
Medium of Question: English
Date of Test 01-11-2019
Department Medical Education
Alphacode A
Question1:-The trachea begins at the level of the cricoid cartilage and extends to the carina at the level of the
A:-6th thoracic vertebra
B:-5th thoracic vertebra
C:-4th thoracic vertebra
D:-3rd thoracic vertebra
Correct Answer:- Option-B
Question2:-Sternomental distance of less than _____ cm are associated with difficult intubation
A:-16 cm
B:-15.5 cm
C:-14 cm
D:-12.5 cm
Correct Answer:- Option-D
Question3:-Which of the following is not true about preoxyenation
A:-An end tidal oxygen concentration greater than 85% maximizes apnea time
B:-Is essential in rapid sequence induction
C:-May be given by tidal volume ventilation through facemask for 3 minutes
D:-May be given by 8 vital capacity breaths over 60 seconds
Correct Answer:- Option-A
Question4:-The glossopharyngeal nerve supplies all of the following except
A:-Posterior third of the tongue
B:-Anterior surface of the epiglottis
C:-Vallecula
D:-Glottic surface of the epiglottis
Correct Answer:- Option-D
Question5:-Recovery from blockade following spinal anaesthesia occurs in the following order
A:-Motor, touch, pinprick, cold
B:-Motor, touch, cold, pinprick
C:-Cold, pinprick, touch, motor
D:-Cold, touch, pinprick, motor
Correct Answer:- Option-A
Question6:-While assessing motor blockade following central neuraxial blockade: Inability to raise extended leg and
move knee; able to move feet is a Modified Bromage scale of
A:-0
B:-1
C:-2
D:-3
Correct Answer:- Option-C
Question7:-Which of the following factors increase headache after spinal puncture?
A:-Age, younger more frequent
B:-Males > females
C:-Insertion and use of catheters for continuous spinal anaesthesia
D:-Timing of ambulation
Correct Answer:- Option-A
Question8:-Cervical plexus block provides anaesthesia in the distribution of
A:-C 2-6
B:-C 3-6
C:-C 2-4
D:-C 2-5
Correct Answer:- Option-C
Question9:-Kayak sign is seen in which of the following ultrasound guided regional block
A:-Femoral block
B:-Popliteal block
C:-Supraclavicular block
D:-Transversus abdominis plane block
Correct Answer:- Option-D
Question10:-The most troublesome complication that limits the dose of epidural fentanyl in labour analgesia is
A:-Itching
B:-Fetal bradycardia
C:-Maternal hypotension
D:-Maternal bradycardia
Correct Answer:- Option-A
Question11:-Tuffiers line joins the
A:-Posterior superior iliac spines
B:-Anterior superior iliac spines
C:-Sacral cornua
D:-Ischial tuberosities
Correct Answer:- Option-B
Question12:-Which of the following non technical skills is the glue that holds all components together
A:-Communication
B:-Team working
C:-Situation awareness
D:-Decision making
Correct Answer:- Option-A
Question13:-The boiling point of sevoflurane is
A:-50.2°C
B:-48.5°C
C:-58.6°C
D:-22.8°C
Correct Answer:- Option-C
Question14:-The following is not true about the low pressure section of the gas supply system
A:-It is the least vulnerable area of the anaesthesia machine
B:-A leak in the LPS can cause delivery of a hypoxie mixture
C:-It is located downstream all safety features except oxygen analyzer
D:-A leak can cause inadequate concentration of anaesthetic agent
Correct Answer:- Option-A
Question15:-Which of the following separates the intermediate pressure system from the low pressure system
A:-Flow meter tubes
B:-Vaporizer
C:-second stage pressure regulators
D:-Flow control valves
Correct Answer:- Option-D
Question16:-All of the following are essential components of the circle system except
A:-Inspiratory and expiratory unidirectional valves
B:-Oxygen analyzer
C:-Adjustable pressure limiting valve
D:-Canister containing carbon dioxide absorbent
Correct Answer:- Option-B
Question17:-Which of the following summarizes the relative efficiency of the mapleson systems for spontaneous ventilation
to prevent rebreathing
A:-DFE>BC>A
B:-CB>A>DFE
C:-A>DFE>CB
D:-A>CB>DFE
Correct Answer:- Option-C
Question18:-Pharyngeal function is restored to normal when adductor pollicis TOF function is
A:->0.6
B:->0.7
C:->0.8
D:->0.9
Correct Answer:- Option-D
Question19:-In the ambulatory surgical setting the most significant cause of delayed discharge is
A:-Postoperative pain
B:-Nausea and vomiting
C:-Cognitive dysfunction
D:-Hypertension
Correct Answer:- Option-A
Question20:-The most vulnerable organ to laser is
A:-Heart
B:-Eye
C:-Skin
D:-Lungs
Correct Answer:- Option-B
Question21:-Which of the following is not an exclusion criteria for robotically assisted endoscopic CABG
A:-Severe aortic and mitral valve disease
B:-Morbid obesity
C:-Severe peripheral vascular disease
D:-Ejection fraction <40% Correct Answer:- Option-D Question22:-Obstructive sleep apnea is defined as A:-Episodic complete cessation of airflow during breathing for 10 seconds or longer occurring 5 or more times per hour of sleep with decrease of at least 4% in oxygen saturation B:-Episodic complete cessation of airflow during breathing for 15 seconds or longer occurring 5 or more times per hour of sleep with decrease of at least 5% in oxygen saturation C:-Episodic complete cessation of airflow during breathing for 10 seconds or longer occurring 10 or more times per hour of sleep with decrease of at least 4% in oxygen saturation D:-Episodic complete cessation of airflow during breathing for 15 seconds or longer occurring 10 or more times per hour of sleep with decrease of at least 5% in oxygen saturation Correct Answer:- Option-A Question23:-Clinical criteria for diagnosing metabolic syndrome include the all of the following except A:-Abdominal obesity B:-Raised triglycerides C:-Raised HDL cholesterol D:-Hypertension Correct Answer:- Option-C Question24:-Anaesthetic drug dosing is based on ideal body weight for all the following drugs except A:-Propofol B:-Midazolam C:-Vecuronium D:-Remifentanil Correct Answer:- Option-B Question25:-Which of the following coagulation factors is decreased during pregnancy A:-VII B:-XI C:-IX D:-X Correct Answer:- Option-B Question26:-What is the change that occurs to central venous pressure during pregnancy A:-Unchanged B:-Increased by 5% C:-Increased by 10% D:-Decreased by 5% Correct Answer:- Option-A Question27:-The largest increase in cardiac output occurs during which phase of pregnancy A:-Second trimester B:-Thrid trimester C:-First stage of labour D:-Immediately after delivery Correct Answer:- Option-D Question28:-In massive obstetric haemorrhage the ratio of blood products to be transfused is 1 platelet plasmapheresis for every _____ units of PRBCs A:-1-2 B:-2-4 C:-4-6 D:-6-8 Correct Answer:- Option-C Question29:-Which of the following drugs has minimal placental transfer A:-Volatile anaesthetics B:-Benzodiazepines C:-Local anaesthetics D:-Heparin Correct Answer:- Option-D Question30:-Which of the following is a major criteria for diagnosis for fat embolism A:-Respiratory insufficiency B:-Pyrexia C:-Tachycardia D:-Jaundice Correct Answer:- Option-A Question31:-Which of the following characteristics is more typical of infant airway compared to adult airway A:-Larynx is located more caudad in the neck B:-Smaller tongue relative to the oral cavity C:-Narrowest portion of the trachea is at the level of the vocal cords D:-Vocal cords have more caudad and anterior attachment Correct Answer:- Option-D Question32:-According to the Glasgow coma scale, spontaneous eye opening has a score of A:-5 B:-4 C:-3 D:-2 Correct Answer:- Option-B Question33:-All of the following are goals for early resuscitation in trauma except A:-Maintain systolic blood pressure between 80 to 100 mm Hg B:-Maintain platelet count more than 1,00,000 per high power field C:-Maintain prothrombin and partial thromboplastin times within normal range D:-Maintain normal serum ionized calcium Correct Answer:- Option-B Question34:-During triage in mass casualty patients that require immediate attention are triaged under which colour A:-Green B:-Yellow C:-Red D:-White Correct Answer:- Option-C Question35:-Which component of the triple manoeuvre to maintain airway patency is used in a polytrauma patient A:-Head tilt B:-Chin lift C:-Jaw thrust D:-All of the above Correct Answer:- Option-C Question36:-Treatment of choice in a patient having atrial fibrillation with ischaemic chest pain and hypotension is A:-Cardioversion B:-Beta Blocker C:-Amiodarone D:-Anticoagulation Correct Answer:- Option-A Question37:-Minimum time required for neurologic prognostication in post arrest cardiac care is A:-24 hrs B:-48 hrs C:-72 hrs D:-96 hrs Correct Answer:- Option-C Question38:-Dose of vasopressin in cardiac arrest is A:-80 units to replace first or second dose of epinephrine B:-40 units to replace first or second dose of epinephrine C:-20 units to replace first or second dose of epinephrine D:-10 units to replace first or second dose of epinephrine Correct Answer:- Option-B Question39:-Potentially reversible causes of cardiac arrest include A:-Hypovolemia B:-Hypoxia C:-Tension pneumothorax D:-All of the above Correct Answer:- Option-D Question40:-Antiarrhythymic of choice in arrhythmia resistant to defibrillation after epinephrine administration is A:-Adenosine B:-Amiodarone C:-Lignocaine D:-Magnesium Correct Answer:- Option-B Question41:-Elevated anion gap metabolic acidosis is caused by all the following except A:-Rental tubular acidosis B:-Lactic acidosis C:-Methanol poisoning D:-Salicylate poisoning Correct Answer:- Option-A Question42:-All the following are causes of metabolic acidosis except A:-Hypovolaemia B:-Septic Shock C:-Severe Hypoxia D:-Hypoalbuminemia Correct Answer:- Option-D Question43:-Stewart Fencl approach as Analytical tool in acid-base chemistry is a ..... A:-Descriptive approach B:-Semi Quantitative approach C:-Quantitative approach D:-Qualitative approach Correct Answer:- Option-C Question44:-All the following are measures to monitor cerebral metabolism except A:-Intra cerebral `PO_(2)` monitor B:-Jugular venous oxymetry C:-Trans-cranial Doppler D:-Near infra-red spectroscopy (NIRS) Correct Answer:- Option-D Question45:-All the following are causes of increase in partial pressure of end tidal `CO_(2)` except A:-Fever B:-Pulmonary embolism C:-Malignant hyperthermia D:-Thyrotoxicosis Correct Answer:- Option-B Question46:-Mixed venous `O_(2)` saturation (`SvO_(2)` ) is the oxygen saturation of blood at the A:-Proximal pulmonary artery B:-Proximal pulmonary vein C:-Right atrium D:-Superior vena cava Correct Answer:- Option-A Question47:-Bispectral index (BIS) 80 means A:-General Anesthesia B:-Light/Moderate sedation C:-Awake state D:-Burst suppression Correct Answer:- Option-B Question48:-Cannon 'a' wave in cvp monitoring is seen in A:-Atrioventricular dissociation B:-atrial fibrillation C:-tricuspid stenosis D:-pericardial constriction Correct Answer:- Option-A Question49:-ECG changes in hyperkalemia except A:-Tall, peaked T waves B:-Prolonged PR interval C:-elevation of U wave D:-Widened QRS Correct Answer:- Option-C Question50:-Anaesthetic drugs that trigger malignant hyperthermia except A:-Succinyl choline B:-Rocuroronium C:-sevofluorane D:-Halothane Correct Answer:- Option-B Question51:-Train of four ratio fade indicates A:-Control response B:-Partial non depolarizing block C:-Partial depolarizing block D:-None of the above Correct Answer:- Option-B Question52:-Child torcutte Pugh classification includes except A:-Ascites B:-Bilirubin C:-Albumin D:-ALT Correct Answer:- Option-D Question53:-Which of the following inhalational agents is the induction agent of choice in children? A:-Methoxyflurane B:-Sevoflurane C:-Desflurane D:-Isoflurane Correct Answer:- Option-B Question54:-Which of the following side effect is seen with fentanyl? A:-Chest wall rigidity B:-Tachycardia C:-Pain on injection D:-Hypertension Correct Answer:- Option-A Question55:-Which of the following inhalational agents has the minimum blood gas solubility coefficient? A:-Isoflurane B:-Sevoflurane C:-Desflurane D:-Nitrous oxide Correct Answer:- Option-C Question56:-Halothane causes except A:-Hypotension B:-Tachycardia C:-Broncodilatation D:-Malignant hyperthermia Correct Answer:- Option-B Question57:-Which one of the following local anesthetics belongs to the ester group? A:-Procaine B:-Bupivacaine C:-Lignocaine D:-Mepivacaine Correct Answer:- Option-A Question58:-Induction agent of choice in hypovolemic shock A:-Propofol B:-Thiopental C:-Fentanyl D:-Ketamine Correct Answer:- Option-D Question59:-Compound A is related to A:-Halothane B:-Isofluorane C:-Sevofluorane D:-Ether Correct Answer:- Option-C Question60:-Ideal ventilatory strategy in ARDS A:-High volume, low rate B:-Low volume, High rate C:-Normal volume, normal rate D:-Normal volume, High rate Correct Answer:- Option-B Question61:-Loss of resistance method to identify epidural space was perfected by A:-Fernand Cathelin B:-Achillo F Doglliotti C:-August Bier D:-Leonard Corning Correct Answer:- Option-B Question62:-World Anesthesia day is celebrated every year on A:-April 7 B:-December 1 C:-October 16 D:-May 26 Correct Answer:- Option-C Question63:-Which of the following is an unpaired cartilage forming larynx A:-Cricoid cartilage B:-Arytenoid cartilage C:-Corniculatecartilage D:-Cuneiform cartilage Correct Answer:- Option-A Question64:-Suprascapular nerve arises from A:-Posterior cord of brachial plexus B:-Lower trunk of brachial plexus C:-Upper trunk of brachial plexus D:-Medial cord of brachial plexus Correct Answer:- Option-C Question65:-Anatomic dead space for a 70 kg man is approximately A:-70 ml B:-100 ml C:-140 ml D:-240 ml Correct Answer:- Option-C Question66:-Cerebrospinal fluid is produced from A:-Choroid plexus B:-Arachnoid villi C:-Foramen Munroe D:-Foramen Lluschka Correct Answer:- Option-A Question67:-The extent of sympathectomy following spinal anaesthesia is described as extending A:-2 to 6 dermatomes above sensory block level B:-2 to 6 dermatomes below sensory block level C:-1 to 2 dermatomes above sensory block level D:-1 to 2 dermatomes below sensory block level Correct Answer:- Option-A Question68:-Hydrolysis by plasma cholinesterases is the primary elimation route for all the following drugs except A:-Succinylcholine B:-Mivacurium C:-Procaine D:-Lignocaine Correct Answer:- Option-D Question69:-Which of the following drug is contraindicated in patients with porphyria A:-Thiopentone Sodium B:-Propofol C:-Ketamine D:-Midazolam Correct Answer:- Option-A Question70:-Megaloblastic anemia can occur in patients with prolonged exposure to A:-Cyclopropane B:-Nitrous Oxide C:-Halothane D:-Sevoflurane Correct Answer:- Option-B Question71:-Reversal agent for Recuronium is A:-Naloxone B:-Sugammadex C:-Flumazenil D:-Atipamezole Correct Answer:- Option-B Question72:-At constant temperature, the volume of a fixed amount of a perfect gas varies inversely with its pressure. This law is known as A:-Charles' law B:-Gay Lussac's law C:-Avagadro's law D:-Boyle's law Correct Answer:- Option-D Question73:-Relationship between pressure within a sphere and the tension in the wall is described by A:-Laplace's law B:-Delton's law C:-Poiscuille's law D:-Fick's law Correct Answer:- Option-A Question74:-Following muscles are used for inspiration except A:-Diaphragm B:-Scalene muscles C:-Internal intercostal muscles D:-External intercostal muscles Correct Answer:- Option-C Question75:-The p50 (the partial pressure of oxygen in blood at which 50% hemoglobin is saturated with oxygen) for normal adult hemoglobin is A:-5 mm Hg B:-15 mm Hg C:-47 mm Hg D:-27 mm Hg Correct Answer:- Option-D Question76:-Smoking cessation on the day before surgery results in which of the following effects A:-Decreased postoperative respiratory complications B:-Decreased carboxyhemoglobin concentrations C:-Decreased need for post operative ventilation D:-Decreased Sputum volume Correct Answer:- Option-B Question77:-Which of the following volatile anesthetic is the most potent depressant of the normal baroreceptor response A:-Sevoflurane B:-Halothane C:-Isoflurane D:-Desflurane Correct Answer:- Option-B Question78:-During liver transplantation on a 56 year old man the Thromboelastograph (TEG) tacing showed fibrinolysis. The parameter of TEG measuring clot strength is A:-R value B:-Alpha angle C:-Maximum Amplitude (MA) D:-K Value Correct Answer:- Option-C Question79:-Which of the following insulin replacement therapies has the longest duration of action A:-Insulin Lispro B:-Resular Insulin C:-Neutral Protamine Hagedorn (NPH) D:-Insulin Glargine Correct Answer:- Option-D Question80:-What metabolic condition is most likely associated with large amounts of normal saline infusion in an otherwise healthy patient A:-Metabolic alkalosis B:-Non-Anion gap metabolic acidosis C:-High Anion gap metabolic acidosis D:-Increased strong Iron difference Correct Answer:- Option-B Question81:-The motto on the seal of the ASA is A:-Vigilance B:-Alertness C:-Watchfulness D:-Compassion Correct Answer:- Option-A Question82:-the hallmark of parasympathetic activation is the release of A:-Serotonin B:-adrenaline C:-Dopamine D:-Acetylcholine Correct Answer:- Option-D Question83:-The sympathetic nervous system originates from A:-Pons B:-Medulla C:-Thoracolumbar region in spinal cord D:-Lumbosacral region in spinal cord Correct Answer:- Option-C Question84:-Receptor preference for Dexmedetomidine is A:-1600:1 `prop` 2 receptors relative to `prop` 1 receptors B:-200:1 `prop` 2 receptors relative to `prop` 1 receptors C:-1600:1 `prop` 1 receptor relative to `prop` 2 receptors D:-200:1 `prop` 1 receptor relative to `prop` 2 receptors Correct Answer:- Option-A Question85:-All of the following is true about cerebral blood flow except A:-Receives approximately 15% of cardiac output B:-Is approximately 50 mL/100 g/min C:-Gray matter receives 80% and white matter receives 20% of blood flow D:-Ketamine decreases Cerebral Metabolic Rate and cerebral blood flow Correct Answer:- Option-D Question86:-What percentage of `CO_(2)` is transported as bicarbonate ion in blood? A:-5% B:-20% C:-75% D:-90% Correct Answer:- Option-D Question87:-The greatest amount of ventricular filling occurs in which phase of diastole A:-Isovolumic relaxation B:-Rapid filling phase C:-slow filling, or diastasis D:-Final filling during atrial systole Correct Answer:- Option-B Question88:-In mallampathi scoring visualisation of soft palate, faucial pillars, uvula obscured by base of tongue is A:-Grade 1 B:-Grade 2 C:-Grade 3 D:-Grade 4 Correct Answer:- Option-B Question89:-ENIGMA trial evaluated the use of which anaesthetic agent A:-Etomidate B:-Nitrous oxide C:-Isoflurane D:-Morphine Correct Answer:- Option-B Question90:-All of the following are true about inhaled anaesthetic agents except A:-Increase rate of mucous clearance B:-Reduce tidal volume and minute ventilation C:-Diaphragmatic function is well preserved D:-Inspiratory rib cage muscles are depressed Correct Answer:- Option-A Question91:-Techniques to prevent post operative nausea and vomiting include all except A:-Use regional anaesthesia alone B:-Avoid use of nitrous oxide for anaesthesia maintenance C:-Use of inhalation agent instead of propofol if general anaesthesia used D:-Try to avoid paralysis if clinically indicated Correct Answer:- Option-C Question92:-Which of the following bronchial blockers have a bifurcated tip? A:-Arndt blocker B:-Cohen blocker C:-EZ blocker D:-Uniblocker Correct Answer:- Option-C Question93:-Haemodynamic goals in a patient with aortic stenosis include all except A:-Sinus Rhythm B:-Maintain heart rate C:-Avoid increasing systemic vascular resistance D:-Maintain venous return Correct Answer:- Option-C Question94:-All of the following are electrolyte imbalances seen in an infant with severe vomiting except A:-Hyponatremia B:-Hyperchloremia C:-Hypokalemia D:-Metabolic alkalosis Correct Answer:- Option-B Question95:-Which of the following irrigating fluids cause transient post operative visual syndrome A:-Distilled water B:-Glycine C:-Sorbitol D:-Mannitol Correct Answer:- Option-B Question96:-How many days must ticlopidine be stopped before administering neuraxial block? A:-Don't stop B:-7 days C:-14 days D:-21 days Correct Answer:- Option-C Question97:-Parkland formula for resuscitation in burns patients uses which fluid A:-Crystalloid B:-Colloid C:-Crystalloid and colloid D:-Albumin Correct Answer:- Option-A Question98:-Which of the following is not part of the lethal triad in a trauma patient A:-Acidosis B:-Coagulopathy C:-Hypothermia D:-Haemorrhage Correct Answer:- Option-D Question99:-Which of the following criteria is assessed as part of the modified Aldrete Scoring System A:-Respiration B:-Pain C:-Nausea and vomitting D:-Surgical bleeding Correct Answer:- Option-A Question100:-The pin index safety system for carbon dioxide is A:-1.5 B:-2.5 C:-1.6 D:-2.6 Correct Answer:- Option-C

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