D.N.B. Question Paper

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1. Drugs & Machine (Equipments), Airway, Monitoring

1. 2. 3. 4.

Enumerate the problems with muscle relaxants (Dec.05). Neuromuscular Transmission (Dec.99). Elimination of atracurium from the body (Dec.99). Name the adrenergic agonist & antagonists. Describe in detail their uses in anaesthesia practice (June05). Adrenergic agonists (June06). blockers its relation in anaesthesia (Dec.96). Ca++ Channel blocker drugs & anaesthesia (June95;98). Complications of Local anaesthetics (June99). Role of 2 agonist in present day anaesthesia. (Dec.04). Pipecurium (June95;96) Midazolam. (Dec.97) Remifentanil. (Dec.98) Rocuronium. (Dec.98) Narcotic antagonists (June97;98). Effect of intrathecal neostigmine. Compare propofol with midazolam (Dec.99) Merits & demerits of halothane & Isoflurane (Dec.95) Sevoflurane vs. Desflurane (Dec.2000). Various routes of administration of morphine. Discuss the pharmacokinetics & pharmacodynamics of epidural morphine (Dec.96).

5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19.

Page 1 of 33

20. 21.

Neurotoxicity of halogenated anaesthesia (Dec.96). Propofol (June96), Propofol as compared to thiopentone (Dec.99).

22.

Interactions of pre-existing drug therapy with anaesthetic agents & techniques (June96). Mechanism of action of local anaesthetic agents (Dec.97). Manifestations & treatment of - adrenergic agonist toxicity (June97). Sevoflurane (June97). Desflurane (Dec.02). Untoward effects of IV Sod-bicarbonate. (Dec.97). Hepatotoxicity of halothane (Dec.97). Drug Interactions (June 2006). Interaction of depolarizing with nondepolarizing muscle relaxants (Dec.95). Minimum alveolar concentration. (Dec.96) Hoffman degradation. (Dec.96) Venturi principle & its applications. (Dec.95;99;04;06). Co-axial Circuits (June98). Type of plenum vaporizers (Dec.95). Evaluation of rota meter (Dec.99). Merits & demerits of LMA (Dec.96). Sterilization of anaesthesia equipments (Dec.98). Disinfection (Dec.01). Assessment & management of difficult intubation (Dec.95).

23. 24. 25. 26. 27. 28. 29.

30. 31. 32. 33. 34. 35. 36. 37. 38. 39.

Page 2 of 33

40.

Describe airway management of a patient of ankylosing spondylitis with severe restriction of neck movement posted for THR (Dec.96). Airway management in an unconscious patient (Dec.98). Cheek out produce to be followed routinely before using anaesthesia machine & other monitor equipments (Dec.2000). Safe anaesthetic procedure. Preoperative visits. Tracheostomy care.

41. 42.

43. 44. 45.

46.

Nephrotoxicity (Dec.02).

of

halogenated

inhalational

anaesthetic

agents

47. 48. 49. 50. 51. 52. 53.

Transdermal opioid (Dec.03). Central anticholinergic syndrome (Dec.05). Adenosine & its use. Pre-treatment of esmolol in NMJ, IOT & CVS. Safety measures in modern anaesthesia machine (Dec.03). Prevention of fire in OT. How will you anaesthetize airway of a 40 yrs old man for awake intubation (Dec.06). Describe management of Cannot intubate cannot ventilate condition in operation theatre (Dec.06). Low flow anaesthesia, advantages & disadvantages (Dec.06) Describe methods of humidification (Dec.06) Assessment of airway (June05); Bed side test & its uses (June 05). Operation theatre safety (Dec.05).

54.

55. 56. 57. 58.

Page 3 of 33

59. 60. 61. 62.

Assessment & management of difficult intubation. Evaluation of difficult airway. Operation room pollution (Dec.99). Describe the intrathecal & epidural opioid in clinical practice & their complications (June06).

Page 4 of 33

2. MONITORING

1. 2.

Assessment of intraoperative awareness (Dec.05). What are minimal monitoring standards? Describe objective & methods. (Dec.95;98;05) Methods of ICP monitoring. Uses & complications of ICP monitoring device (June05). Temperature regulation in adults. Predisposing factors, diagnosis & management of malignant hyperpyrexia.

3.

4.

5.

List & brief statement and effectiveness of each of the means available for detecting awareness during anaesthesia. (Dec.05) What do you mean by awareness during anaesthesia? Mention the monitors in use to measure the depth of anaesthesia (June06; 95; 99)

6.

7.

What are the ways by which you can measure the depth of anaesthesia during intraoperative period (June05). Physical principle of pulse oximetry (June05). Pulmonary artery pressure monitoring (June06), Pulmonary artery catheter (Dec.98).

8. 9.

10.

Describe complications of cannulation of Internal Jugular Vein (Dec.04). Methods of CVP cannulation, uses, limitations & complications (Dec.96;99; June05). Methods of monitoring of neuromuscular transmission during anaesthesia (Dec.04). Neuromuscular junction function (June95) Somato-sensory evoked potential (Dec.97;98). Positional hazards under anaesthesia (Dec.97). Role of capnography during anaesthesia (Dec.96).Page 5 of 33

11.

12. 13. 14.

15. 16.

Simulators in anaesthesia education (Dec.97). Computer based patient record in anaesthesia (Dec.97).

17.

Write down the physiology of sleep. How does it differ from anaesthesia? What changes occur in various stages of anaesthesia? (Dec.99). Respiratory monitoring. Modified bipolar standard limb leads system & its usefulness for intraoperative monitoring. Jugular venous satuation monitoring. Capnography. (Dec.2000) Limitation of pulse oximetry. (Dec.01). BIS.

18. 19.

20. 21. 22. 23.

Page 6 of 33

3. PAIN & REGIONAL ANAESTHESIA

1.

Pre emptive analgesia. Discuss various methods of post op pain relief. What do you under stand with term pre emptive analgesia? (Dec.95; Dec.04, Dec05, June.06)

2. 3. 4. 5. 6.

Anaesthetist role in pain & palliative care (Dec.05). Acute pain management services (June.06). Antithrombotic prophylaxis & neuraxial anaesthesia (June.06). Spinal Anaesthesia in children. (June.06). Complications of extradural anaesthesia (Dec.95; June.06).

7. 8. 9. 10. 11. 12.

Phantom limb pain (June.06). Patient controlled analgesia (Dec.96; 98; Dec.04). Caudal epidural anaesthetic practice (Dec.04). Pain relief in rib # . (Dec.95) Mechanism of reflex sympathetic dystrophy (June.07). Describe the nerve innervations of foot with diagram & discuss the local anaesthetic block at the ankle for amputation of gangrenous toes in a patient. (Dec.99; Dec.06). Pulmonary function changes during neuraxial blockade (June.99). Intravenous regional anaesthesia (June.95; Dec.97;98) Continuous subarachnoid blockade (Dec.96) Post dural puncture headache (June.99). Management of local anaesthetic toxicity (Dec.2000).

13. 14. 15. 16. 17.

Page 7 of 33

18. 19. 20. 21.

WHO regimen for chronic pain management (Dec.95; June.97). Stellate ganglion block, indication & complication (June.95). Trigeminal Neuralgia clinical features & management (Dec.96). Epidural anaesthesia for post operative pain relief (Dec.96). Epidural use of opioid for post operative pain relief (Dec.06). WHO three step ladder pattern for pain relief in advanced cancer (June.97). Epidural pressure & various factors affecting the same (Dec.98). Spinal opioid receptors. (June99). Complication, evaluation of RL, low molecular weight dextran, 3.5 % polygel for spinal preloading. CSEA / Modified CSEA (Dec.03). Anatomy of brachial plexus & its importance to anaesthesiologist. Caudal block (DEC.03). Indications & methods of mandibular block. Peripheral nerve injury under general anaesthesia (Dec.02) Describe role of anaesthetist in preoperative pain management. Discuss various methods of pain relief following upper abdominal surgery. Management of pain in burn. Three in one block. Total Intravenous Anaesthesia. (TIVA) (96; 2000; 04; June.06)

22.

23. 24. 25.

26. 27. 28. 29. 30. 31.

32. 33. 34.

Page 8 of 33

4. CARDIOVASCULAR SYSTEM & THORACIC ANAESTHESIA

1.

Pre anesthetic evaluation of a patient of mitral stenosis for MTP & Sterilization (Dec.05). Anesthestic consideration of a patient on pacemaker for TURP, (Dec.05). Anaesthetic management of TURP with PPI (Dec.04) Anaesthesia consideration in a patient for surgery for # NOF one year after CABG. Pre operative evaluation of a patient with valvular heart disease (Dec.05). Explain usefulness of TEE in Cardiac surgery (Dec.05). Risk factors for venous thromboembolism & classify the current methods of prevention with examples. A patient who has heart transplant requires non cardiac surgery. What precaution must be undertaken by any anaesthetist for this surgery? Define preoperative hypertension. management (Dec.05). Describe the causes &

2.

3.

4.

5. 6.

7.

8.

9.

Classify congenital heart disease. Explain with diagram the blood flow before & after delivery in patent with patient ductus arteriosus (PDA). (Dec.04; June05). Management of a case of essential hypertension scheduled for upper abdominal surgery (June05). Clinical features of infective endocarditis. Principle, guidelines to use antibiotics as prophylaxis against during surgery (June05). Pre-operative assessment, preparation specific to thoraco-abdominal esophagectomy. Describe your anaesthetic problem during operation (June05). Preoperative evaluation & preparation of a patient with fallots tetra logy (June06).

10.

11.

12.

13.

Page 9 of 33

14.

Monitored anaesthesia care is 80 yrs old man with Ischemic heart disease for cataract surgery (Dec.04). Etiol