Friday [03/09/2021]

Question 1

What is RSI?

Answer 1

Way of intubating patient

Question 2

Indications for intubation and mechanical ventilation

Answer 2

A – airway protection and patency
B – respiratory failure (hypercapnic or hypoxic), increase FRC, decrease WOB, secretion management/ pulmonary toilet, to facilitate bronchoscopy
C – minimise oxygen consumption and optimize oxygen delivery (e.g. sepsis)
D – unresponsive to pain, terminate seizure, prevent secondary brain injury
E — temperature control (e.g. serotonin syndrome)
F — For humanitarian reasons (e.g. procedures) and for safety during transport (e.g. psychosis)

Question 3

Pros for doing an RSI out of theatre

Answer 3

FOR RSI

Lack of airway protection despite patency (swallow, gag, cough, positioning , and tone)hypoxia
hypoventilation
need for neuroprotection (e.g. target PaCO2 35-40 mmHg)
impending obstruction (e.g. airway burn, penetrating neck injury)
prolonged transfer
combativeness
humane reasons (e.g. major trauma requiring multiple interventions)
cervical spine injury (diaphragmatic paralysis)

Question 4

Against doing RSI out of theatre

Answer 4

urgent need to OT and theatre is available anatomically or pathologically difficult airway (e.g. congenital deformity, laryngeal fracture)
close proximity to OT
paediatric cases (especially <5 years of age)
hostile environment
poorly functioning team
lack of requisite skills among team
emergency surgical airway is not possible (e.g. neck trauma, tumour)

Question 5

Factors that make it difficult for emergency intubation

Answer 5

Dynamically deteriorating clinical situation, i.e., there is a real “need for speed”
Non-cooperative patient
Respiratory and ventilatory compromise
Impaired oxygenation
Full stomach (increased risk of regurgitation, vomiting, aspiration)
Extremely short safe apnea times
Secretions, blood, vomitus, and distorted anatomy

Question 6

The 9Ps for the RSI

Answer 6

Remembered as the 9Ps:

Plan
Preparation (drugs, equipment, people, place)
Protect the cervical spine
Positioning (some do this after paralysis and induction)
Preoxygenation
Pretreatment (optional; e.g. atropine, fentanyl and lignocaine)
Paralysis and Induction
Placement with proof
Postintubation management
Some add a 10th P for (cricoid) pressure after pretreatment but this procedure is optional and has many drawbacks (see Cricoid Pressure)

Question 7

What is crocoid pressure and why’s it not always used?

Answer 7

Cricoid pressure should not be a standard part of airway management during intubation (for instance it is not routinely recommended in the NSW HEMS prehospital RSI manual)

This is an example of an intervention introduced with little evidence, handed down from teacher to student over the years as a pseudoaxiom. Pseudoaxioms need to be criticised, studied and discarded where appropriate.

Some argue that the “best practice compromise for now is to train CP appropriately using recommended guidelines and technique, apply it for RSI as standard and remove it as needed”, however this is likely to be more dangerous as it will lead to distortion of the airway initially, delaying first pass intubation and the cricoid pressure will decrease lower esophageal pressure increasing the risk of regurgitation on release.
If used, cricoid pressure must be released if there is vomiting, if there is difficulty visualising the cords, if BVM ventilations are required or if an LMA is to be placed
Make up your own mind! (and adhere to your local departmental guidelines)

Question 8

How many people minimum does an RSI need?

Answer 8

airway proceduralist
airway assistant
drug administrator

Question 9

Mneumonic for doing an RSI

Answer 9

SOAPME

O2 MARBLES

Question 10

Parts of the SOAPME pnuemonic

Answer 10

Suction — at least one working suction, place it between mattress and bed
Oxygen — NRBM and BVM attached to 15 LPM of O2, preferably with nasal prongs for apneic oxygenation
Airways — 7.5 ET tube with stylet fits most adults, 7.0 for smaller females, 8.0 for larger males, test balloon by filling with 10 cc of air with a syringe — Stylet – placed inside ET tube for rigidity, bend it 30 degrees starting at proximal end of cuff (i.e. straight to cuff, then 30 degree bend) — Blade – Mac 3 or 4 for adults – curved blade — Miller 3 or 4 for adults – straight blade — Handle – attach blade and make sure light source works — Backups – ALWAYS have a surgical cric kit available! — have video laryngoscope, LMA and bougie at bedside
Pre-oxygenate – 15 LPM NRBM
Monitoring equipment/Medications — Cardiac monitor, pulse ox, BP cuff opposite arm with IV — Medications drawn up and ready to be given
End Tidal CO2

Question 11

Parts of the O2 MARBLES pnuemonic

Answer 11

Oxygen
masks (NP, NRB, BVM); monitoring
airway adjuncts (e.g. OPA, NPA, LMA); Ask for help and difficult airway trolley
RSI drugs; Resus drugs
BVM; Bougie
Laryngoscopes; LMA
ETTs; ETCO2
Suction; State Plan

Question 12

What is the ideal RSI induction agent?

Answer 12

smoothly and quickly render the patient unconscious, unresponsive and amnestic in one arm/heart/brain circulation time
provide analgesia
maintain stable cerebral perfusion pressure and cardiovascular haemodynamics
be immediately reversible
have few, if any, side effects

Question 13

Induction agents used in RSI

Answer 13

Ketamine
Thiopentone
Propofol
Fentanyl
midazalom
Etomidate

Question 14

Paralytic agents used in RSI

Answer 14

Suxamethonium
Rocuronium
Vecuronium

Question 15

Which test can be used to see if a patient is actually diabetic?

Answer 15

Insulin C test _ think it’s called

Question 16

Ix to do if think it’s liver failure from paracetamol OD?

Answer 16

Clotting [INR]
ALT?AST
Serum paracetamol

Question 17

Why should you not give benzos to patients who are hypoglycaemic and agitated/

Answer 17

Body will use dextrose given and she’ll go into a hypoglycaemic state

Question 18

Which patients in particular need intubating?

Answer 18

Risk of aspiration

Question 19

High base excess, low pH, CO2 high what’s going on here?

Answer 19

Metabolic acidosis

Question 20

How to correct emergency hyperkalaemia?

Answer 20

Calcium gluconate -> insulin with glucose -> salbutamol

Question 21

How to correct slow forming hyperkalaemia?

Answer 21

Patiromer

Question 22

Typical causes for hyperkalaemia?

Answer 22

Typical reasons for hyperkalemia are chronic kidney disease and application of drugs that inhibit the renin–angiotensin–aldosterone system (RAAS) – e.g. ACE inhibitors, angiotensin II receptor antagonists, or potassium-sparing diuretics – or that interfere with renal function in general, such as nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 23

How does calcium gluconate work?

Answer 23

• Helps stabilise calcium carbonate helps stabilise cardiac membrane and prevent cardiac arrhythmias

Question 24

How should it given calcium gluconate?

Answer 24

For Adult

10–20 mL, calcium gluconate 10% should be administered, dose titrated and adjusted to ECG improvement.

Question 25

How to initially treat a coagulatpathy?

Answer 25

- Clotting and INR - Give her some vitamin K for her INR - Replace her platelets - Call a haematologist

Question 26

What is the starting dose of Parvolex?

Answer 26

- 150mg/kg inusfed in 200mL in 1 hour

Question 27

How does NAC work?

Answer 27

- Glutathione donor

Question 28

Long-term management of patietns with really bad liver failure? What are the criteria

Answer 28

- 40% of people die with liver transplant - Only certain centres do it - Criteria: pH has to be below 7.3, PTT something else, and other criteria about

Question 29

How can breathlessness be objectively classified?

Answer 29

MRC grading

Question 30

How can you globally assess functional status?

Answer 30

- Katz Index of Independence in ADL more used scale for basic functional activities of older patients. - Instrumental activities of daily living [IADLs] can uncover more subtle disabilities. Assessed using the Lawton-Brody Instrumental ADLs.

Question 31

Given that this man is having knee replacement elective surtgery, what measures can be taken to ensure he is in good phyiscal condition for it?

Answer 31

- Stay as active as he can, strengthening muscles around knee will aid recovery -> gentle exercises like walking - Can be referred to physio to help - Lose weight - Prepare home life after surgery including moving hazards, clear path around furniture, safety rails bathrooms - Cut down on smoking/alcohol to lower risk of blood clots other Cx - Adjust medications including NSAIDs, blood thinners, other medications which increase the risk of bleeding.

Question 32

Pre-assessment, man is snoring loudly what relevance might this have? How cam you take this further?

Answer 32

- Could be a sign of OSA -> if having sleeping difficulties - Could be obstructing mouth anatomy and narrow airway -> make it difficult to put oxygen tube down his throat and also to intubate - Would need to examine mouth and see how easy it is to access patient’s throat

Question 33

What is the Mallampati score?

Answer 33

- Would need to examine mouth and see how easy it is to access patient’s throat

Question 34

What would recommend generally unhealthy man having knee replacement on general anesthesia?

Answer 34

- Either done under general or spinal/epidural - Spinal: less likely to be drowsy, remain in full control of breathing, some evidence less bleeding - General: will need oxygen, pain relief - Probably recommend spinal to due to breathing problems

Question 35

9. Oral steroids can cause adrenal suppression and subsequent inadequate response during stress, such as the peri-operative period. What should Mr Jones team do about this?

Answer 35

- “Stress-dose” of stress to mitigate this rare but potentially fatal complication

Question 36

How to manage thromboprophylaxis with an epidural?

Answer 36

- Epidural and spinal anaesthetic techniques should not be carried out within 12 hours of a prophylactic dose of enoxaparin. Likewise epidural catheters should not be removed within 12 hours of a prophylactic dose of enoxaparin. Wait >4 hours after any of these procedures before giving next dose of enoxaparin. In most cases, administration of enoxaparin at 6pm will avoid any difficulties here - If regional anaesthesia is used, pharmacological prophylaxis must be timed to minimise the risks of epidural haematoma

Question 37

What are the two different types of epidural?

Answer 37

Regular and combined spinal epidural

Question 38

What are some regular epidurals?

Answer 38

After the catheter is in place, a combination of narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. A narcotic such as fentanyl or morphine is given to replace some of the higher doses of anesthetic, like bupivacaine, chloroprocaine, or lidocaine. Advertisement - Continue Reading Below This helps reduce some of the adverse effects of the anesthesia. You will want to ask about your hospital’s policies about staying in bed and eating.

Question 39

What are some combined spinal-epidurals?

Answer 39

A spinal block is sometimes used in combination with an epidural during labor to provide immediate pain relief. A spinal block, like an epidural, involves an injection in the lower back. While you sit or lie on your side in bed, a small amount of medication is injected into the spinal fluid to numb the lower half of the body. It brings good relief from pain and starts working quickly, but it lasts only an hour or two and is usually given only once during labor. The epidural provides continued pain relief after the spinal block wears off.

Question 40

Benefits of using epidural anaeshtesia?

Answer 40

Allows you to rest if your labor is prolonged. By reducing the discomfort of childbirth, some women have a more positive birth experience. Normally, an epidural will allow you to stay alerted and remain an active participant in your birth. When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability, and fatigue. An epidural can allow you to rest, relax, get focused, and give you the strength to move forward as an active participant in your birth experience. The use of epidural anesthesia during childbirth is continually being refined, and much of its success depends on the skill with which it is administered.If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and

Question 41

Risks of having epidural anaesthesias?

Answer 41

Epidurals may cause your blood pressure to suddenly drop. For this reason, your blood pressure will be routinely checked to help ensure adequate blood flow to your baby. If there is a sudden drop in blood pressure, you may need to be treated with IV fluids, medications, and oxygen. You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect. If symptoms persist, a procedure called a “blood patch”, which is an injection of your blood into the epidural space can be performed to relieve a headache. After your epidural is placed, you will need to alternate sides while lying in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop. You might experience the following side effects: shivering, a ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating. You might find that your epidural makes pushing more difficult and additional medications or interventions may be needed, such as forceps or cesarean. Talk to your doctor when creating your birth plan about what interventions he or she generally uses in such cases. For a few hours after the birth, the lower half of your body may feel numb. Numbness will require you to walk with assistance. In rare instances, permanent nerve damage may result in the area where the catheter was inserted. Though research is somewhat ambiguous, most studies suggest that some babies will have trouble “latching on” causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries, and episiotomies.

Question 42

What is shock?

Answer 42

Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do not get enough oxygen and nutrients to function properly. Many organs can be damaged as a result. Shock requires immediate treatment and can get worse very rapidly

Question 43

How many people routinely die form shock?

Answer 43

As many 1 in 5 people who suffer shock will die from it.

Question 44

Types of shock do you know?

Answer 44

- Obstructive shock - Cardiogenic shock - Distributive shock - Hypovolemic shock

Question 45

What rate, %, and when used Hudson?

Answer 45

30-40% oxygen, flow rate 5-10l/min

Question 46

What rate, %, and when used nasal Venturi?

Answer 46

24-60% oxygen, flow rate varies with colour, oftne use din COPD

Question 47

What rate, %, and when used non-rebreather?

Answer 47

85-90%, 15l flow rate, bag on mask with valves stopping almost all rebreathing of expoired air used for acutely unwell patients

Question 48

What rate, %, and when used non-invasive ventilation [CPAP/BiPAP]?

Answer 48

CPAP - positive pressure all the time to help keep airways open used in acute pulmnary oedema and sleep apnoea BiPAPA - high pressure pressure on inspiration and lower positvie pressure on expiration - used in acute execerbations of OCPD and ARDS

Question 49

What rate, %, and when used invasive ventilation?

Answer 49

Fully controlled oxygen delivery up to 100% Ventilation bag or machine is attached to an artifical airway to ventilate lungs Used in intensive care and theatre

Question 50

What rate, % and when used nasal cannula?

Answer 50

24-3% oxygen Flow rate 1-4l/min will dry nose, 2l is more comfrotable used in non-acute situations if only mildly hypoxic

Question 51

What to be aware of when putting on non-rebtreather masks?

Answer 51

Saturations should be 94-98% not 100% | do not keep patient on 15l longer than necessary as over-oxygenateding for prolonged periods can be harmful

Question 52

What would CXR for penuomthorax show?

Answer 52

- A linear shadow of visceral pleura with lack of lung markings peripheral to the shadow may be observed, indicating collapsed lung - An ipsilateral lung edge may be seen parallel to the chest wall - In supine patients, deep sulcus sign (very dark and deep costophrenic angle) with radiolucency along costophrenic sulcus may help to identify occult pneumothorax; the anterior costophrenic recess becomes the highest point in the hemithorax, resulting in an unusually sharp definition of the anterior diaphragmatic surface due to gas collection and a depressed costophrenic angle - Small pleural effusions commonly are present and increase in size if the pneumothorax does not re-expand - Mediastinal shift toward the contralateral lung may also be apparent - Airway or parenchymal abnormalities in the contralateral lung suggest causes of secondary pneumothorax; evaluation of the parenchyma in the collapsed lung is less reliable

Question 53

Causes of increased anion gap and metabolic acodisos?

Answer 53

Causes of metabolic acidosis -> increased anion gap [see in lactic acidosis] - Diabetic ketoacidosis - Lactic acidosis - Aspirin OD - Heart disease - Severe infection like sepsis - Ca - Chronic alcoholism - Intense exercise or physical activity

Question 54

What could cause CXR consolidation right upper lobe?

Answer 54

- pneumonia - pulmonary oedema - pulmonary haemorrhage - aspiration - Ca

Question 55

Red flags for sepsis?

Answer 55

Slurred speech/confusion Extreme shivering/muscle pain Passing no urine Severe breathlessness or sleepiness It feels like you’re going to die/pass out Skin mottled or discoloured Other red flags: very high/low temperature, repeated vomiting, seizures, rash which doesn’t fade when press against it. In children, signs may be different.

Question 56

BUFALO 6 for sepsis

Answer 56

- Blood cultures: at least two required, ideally before antibiotics given – but do not delay if patient is very ill. Includes a mycobacterium sample. - Urine output [measure hourly] - Fluid resuscitation - Antibiotics - Lactate measurement - Oxygen: correct hypoxia [keep above 94%]

Question 57

Other Ix to do for sepsis?

Answer 57

- Urine dipstick | - More invasive investigations to look for source of infection including LP, bronchoscopy, laparoscopy, LN biopsy

Question 58

What is the mean arterial pressure

Answer 58

- The average blood pressure in an individual during a single cardiac cycle.

Question 59

How to determine MAP?

Answer 59

- MAP determined by the cardiac output, systemic vascular resistance [SVR] and central venous pressure [CVP] according to the relationship: MPA = [COxSVR] + CVP. Because CVP often near 0mmHg, often simplified to MPA = COxSVR.

Question 60

What does a MAP need to be to perfuse normal person?

Answer 60

- believed that MAP greater than 70mmHg is enough to sustain organs of average person. MAP normally between 65-110mmHg. - if not ischaemia could ensue

Question 61

What are METs?

Answer 61

- Physical activity measured in metabolic equivalents [METs] which are multiples of the resting state of oxygen consumption; 1 MET [the resting state] equals about 3.5mL/kg/min of O2. Normal working and living activities [excluding recreational activities] rarely exceed 6 METs. Light to moderate housework is about 2 to 4 METs; heavy housework or yard work is about 5 to 6 METs.

Question 62

For hospitalised patients, what should their METs be?

Answer 62

- For hospitalized patients, physical activity should be controlled so that heart rate remains < 60% of maximum for that age (eg, about 160 beats/min for people aged 60); for patients recovering at home, heart rate should remain < 70% of maximum.

Question 63

What does ECG show in AF, IHD and HTN?

Answer 63

AF - Missing P waves - Irregularly irregular pulse - Fibrillatory waves IHD - ST elevation/depression - Pathological Q wave [<25% size R wave] evidence previous MI HTN - Might have LVH

Question 64

Why is it important to check U+Es pre-operatively?

Answer 64

- See if patient has renal impairment as this will affect Tx [need to use LMWH or unfractionated heparin] for VTE prophylaxis -> can reduce LMWH/UFH with people that have renal impairment. Might have renal vascular disease. - On diuretic/ACE inhibitors could affect his renal function - See if diabetic, dehydrated or have any electrolyte disturbances should be aware of

Question 65

Should patients pre-operatively routine have an echocardiogram?

Answer 65

- 1.9.1 Do not routinely offer resting echocardiography before surgery. - 1.9.2 Consider resting echocardiography if the person has: o a heart murmur and any cardiac symptom (including breathlessness, pre-syncope, syncope or chest pain) or o signs or symptoms of heart failure. Before ordering the resting echocardiogram, carry out a resting electrocardiogram (ECG) and discuss the findings with an anaesthetist. - Yes, I think it’s important - Actually, it’s not indicated in this patient therefore. Though in clinical practice, most anaesthetists would give an echo

Question 66

Why should stop ACEii and ARBs before surgery?

Answer 66

Associated with severe hypotension

Question 67

At waht elvel would you transfude a man?

Answer 67

- 70/80, 80 is especially with person that has IHD

Question 68

Immediate actions low SHEWS score possible MI/PE

Answer 68

- Oxygen HF 15l/minute - Inflate the bag before giving the O2 - 2222 [ask for medical emergency team] - IV access - ECG - Wouldn’t be unreasonable to put defib straight on him if he’s really unwell - Make sure man sat up as much as possible

Question 69

Possible MI first Ix?

Answer 69

- ECG - Troponin - CXR - ABG

Question 70

If patient shows pulmonary oedema on CXR how should manage?

Answer 70

- Start a diuretic: furosemide 40/80mg IV bolus - GTN infusion - Diamorphine 2.5-5mg morphine in small increments [worth giving him antiemetics as well] - At this moment in time, treat heart failure -> move to ACS

Question 71

What is CPAP and how can it help pulmonary oedema?

Answer 71

- Positive pressure pushes it back out the lungs - Increases fluid capacity of lungs - Helps lung mechanics - Has a CV affect: reducing afterload/pre-load - Patients improve quickly, less likely on ventilator

Question 72

What should do next if patient doesn't improve on CPAP?

Answer 72

Invasive ventilator

Question 73

What is troponin and what does it signify?

Answer 73

- Cardiac enzyme | - Any heart ischaemia/injury

Question 74

Anaesthetic agent CI in hypertensives is ?

Answer 74

Ketamine

Question 75

Which is the colour of nitric oxide colour coding?

Answer 75

Blue

Question 76

CI to vasconstricotrs in local anesthesia is?

Answer 76

Digital nerve block | - other ones inlcude toes, pinna, penis, nose

Question 77

Preferred muscle relaxants in a paitent with liver dysfunction/renal failure?

Answer 77

Atracurium | - undergoes non-sepcific ester hydrolysis and non-enzymatic degradation [Hoffman degradation]

Question 78

LSCS cannot be carried out under which technique?

Answer 78

Caudal anaesthsia as is ontl used in perineal surgery

Question 79

Laryngeal mask airway used for securing airway of patient with large tumour oral cavity?

Answer 79

NO, used in CPR, diffiulct intubation, child undergoing elective surgery though

Question 80

All of the following are the disadvantages of anesthetic ether, except: Induction is slow Affects blood pressure and is liable to produce arrhythmias Cautery cannot be used Irritant nature of ether increases salivary and bronchial secretions

Answer 80

Affects bp and is libale to produce arryhtmias

Question 81

Which one of the following anaesthetic agents causes a rise in the Intracranial pressure Propofol Lignocaine Sevoflurane Thiopentone sodium

Answer 81

``` Sevofluraneothers: Isoflurane Halothane Nitrous oxide Ketamine ```

Question 82

One of the fastest acting inhalational agent is Sevoflurane Ether Halothane Isoflurane

Answer 82

Sevoflurane

Question 83

Which of the following agents is not used to provide induced hypotension during surgery? Esmolol Hydralazine Mephentermine Sodium nitroprusside

Answer 83

Mephentermine is acts as an agonist on alpha and beta adrenergic receptors. This causes increased in cardiac output and blood pressure. Hence it cannot be used to induce hypotension.

Question 84

Which of the following agents is used for the treatment of postoperative shivering? Suxamethonium Pethidine Atropine Thiopentone

Answer 84

Pethidine []tramadol is the drug of choice

Question 85

Which of the following intravenous induction agents is the most suitable for day care surgery ? Diazepam Propofol Morphine Ketamine

Answer 85

Propofol

Question 86

It is an intravenous anesthetic Precipitates coronary insufficiency Inhibits cortisol synthesis Causes pain at site of injection

Answer 86

Precipitates coronary insufficeincy

Question 87

The following are used for treatment of postoperative nausea and vomiting following squint surgery in children except Propofol Ketamine Dexamethasone Ondansetron

Answer 87

Ketamine can cause nausea and vomiting following administration.

Question 88

Which one of the following local anesthetics belongs to the ester group? Bupivacaine Procaine Lignocaine Mepivacaine

Answer 88

Procaine: | -ester means one i and amide means double ii

Question 89

Which one of the following antibacterials should not be used with d-tubocurarine? Cefotaxime Doxycycline Streptomycin Norfloxacin

Answer 89

Stretomycin

Question 90

Which one of the following muscle relaxant has the maximum duration of action? Atracurium Vecuronium Rocuronium Doxacurium

Answer 90

Doxacurium

Question 91

Which of the following is not an indication for endotracheal intubation? Pneumothorax Maintenance of a patent airway To provide positive pressure ventilation Pulmonary toiletting

Answer 91

Pneuothorax

Question 92

Which of the following anesthetic agents does not trigger malignant hyperthermia ? Thiopentone Suxamethonium Isoflurane Halothane

Answer 92

Thiopentone

Question 93

Which side effect is commonly seen with fentanyl? Pain in abdomen Hypertension Tachycardia Chest wall rigidity

Answer 93

Chest wall rigidity

Question 94

Which of the following is not true about Xenon anaesthesia Non explosive Slow induction and slow recovery Low blood gas solubility Minimal cardiovascular side effects

Answer 94

Slow induction and slow recovery | - xenon is very close to being an ideal anaesthetic agent

Question 95

Which of the following in anaesthesia will produce decreased EEG activities N2O Early hypoxia Ketamine Hypothermia

Answer 95

Hypothermia

Question 96

Last muscle to be rendered akinetic with a retrobulbar anesthetic block is Superior rectus Superior oblique Inferior oblique Levator palpebral superioris

Answer 96

Superior oblique

Question 97

Which of the following neuromuscular blocking agent has the shortest onset of action ? Vecuronium Mivacurium Succinylcholine Rapacuronium

Answer 97

Succinylcholine

Question 98

Which of the following inhalational agents has the minimum blood gas solubility coefficient? Desflurane Sevoflurane Nitrous oxide Isofluran

Answer 98

Desflurane

Question 99

Methemoglobinemia caused by Procaine Bupivacaine Prilocaine Lignocaine

Answer 99

Prilocaine

Question 100

Merits of nasotracheal intubation is Good oral hygiene Less infection Less mucosal damage and bleeding More movement or displacement of endotracheal tube

Answer 100

Good oral hygeiene