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a) Describe the anatomy of coronary blood flow and its implications for anaesthesia. [3+2] b) Describe the metabolic stress response to trauma, highlighting its key phases and physiological changes. [3+2]

a) Trigeminovagal reflex. [5] b) Postoperative visual loss. [5]

Oculocardiac reflex — pathway, prevention, and intraoperative management.

Coronary circulation — anatomy with diagram. Factors determining myocardial oxygen demand and supply.

Spinal cord anatomy — extent, layers, roots, main divisions, sympathetic chain. Anaesthetic significance.

Kidney functions. Counter-current mechanism in kidney (with diagrams). Renal changes in elderly.

Surgical stress response — methods to attenuate, benefit when controlled. Neuroendocrine response to surgery.

A 45-year -old male, smoker for last 24 years with COPD, is posted for repair of ventral hernia. Discuss the anesthetic concerns, pre-operative evaluation, optimization and recommended intra-operative ventilatory strategies in this patient. [2+2+3+3]

Describe the pathophysiology , diagnosis, clinical features and current guidelines in the management of ARDS. [2+2+2+4]

a) How is carbon dioxide transported in the blood? [5] b) What is Haldane ef fect? How is it related to the Bohr ef fect? [3+2]

a) What is dif fusion capacity of lung? What are the factors which af fect the dif fusing capacity? [2+3] b) What are the factors which influence respiratory function during anaesthesia? [5]

1. a) Draw a neatly labeled diagram to show the distribution of ventilation and perfusion in a normal lung. [5] b) Explain the surface anatomy relevant to performing central neuraxial blocks, including identification of key landmarks. [3+2]

1. a) Outline ventilation strategies for ARDS. [5] b) Diagnosis & management of fat embolism. [5]

a) Explain the physiology of ventilation-perfusion (V/Q) matching in the various zones of the lungs. [5] b) What happens to V/Q ratio during one lung anesthesia? [2] c) Discuss the ef fect of changes in functional residual capacity and dead space ventilation on ventilation perfusion matching. [3]

a) Write briefly about the oxygen cascade with the help of a well labelled diagram. [3] b) What are the various techniques/devices used for oxygenation? [4] c) Apneic oxygenation. [3]

Distribution of ventilation and perfusion in normal lung (diagram). Factors affecting V/Q ratio. Hypoxic pulmonary vasoconstriction.

a) Define functional residual capacity (FRC). Enumerate the factors that affect FRC with their clinical implications. [2+4] b) What are the methods to optimize FRC before and under general anaesthesia? [4]

1. a) With the help of a neatly labelled diagram describe the oxygen dissociation curve and enumerate the factors effecting it. [3+2] b) Enumerate the differences between adult and pediatric airway with their clinical implications. [5]

a) Noninvasive ventilation. [5] b) Remifentanil. [5]

Oxygen therapy: a) What are the indications of oxygen therapy? [3] b) Define variable performance oxygen delivery device and give examples. [4] c) Write briefly on HFNO. [3]

a) Define dyspnoea. Differentiate dyspnoea of cardiac and respiratory origin. [2+3] b) Enumerate various types of Laryngoscope blades/laryngoscopes available and describe the McCoy laryngoscope. [2+3]

a) Oxygen Dissociation Curve. [3] b) Enumerate the factors that affect the oxygen dissociation curve. [4] c) What is transfusion trigger and its relevance with regard to oxygen delivery? [3]

A 65-year-old male patient has been posted for cataract surgery. He is a known case of COPD and diabetes mellitus(Type -2) for past 10 years and is on treatment for both i.e. metformin, rosiglitazone, inhalers of bronchodilator and steroids. Discuss the preoperative assessment and anaesthetic plan for this patient. [4+6]

a) What are flow volume loops? [3] b) Draw flow volume loops (with labelling) in a normal subject, in a patient with COPD and in a restrictive lung disease patient. [4] c) What are the effects of age and posture on FRC and closing capacity? [3]

1. a) What is hypoxic pulmonary vasoconstriction? What is the effect of anaesthesia on it? [2+3] b) Enumerate the interventions that can help prevent atelectasis during anaesthesia? [5]

a) Briefly discuss the pathophysiological changes in obesity and their anesthestic implications. [6] b) What is STOP BANG Score? [4]

a) Closing volume. [5] b) Anti hypoxia mechanisms in anesthesia machines. [5]

a) Describe oxygen hemoglobin dissociation curve with help of a labelled diagram. [6] b) Enumerate the factors that can shift the oxygen dissociation curve. [4]

a) Describe the lung protective strategies for ARDS. [7] b) What is metabolic flow anaesthesia? [3]

Discuss the perioperative management of a 60-year-old male smoker with acute exacerbation of COPD scheduled for radical cholecystectomy. [10]

a) Intra-operative bronchospasm. [5] b) Post-dural puncture headache [5]

a) P/F ratio and its importance. [5] b) Aladin cassette. [5]

a) What are the indications for pulmonary function testing? [3] b) Enumerate the various bedside pulmonary function tests. [4] c) Discuss the breath holding time test. [3]

a) What is oxygen content of arterial blood? How do you calculate it? [2+3] b) What is peak expiratory flow rate (PEFR) and what is its significance? [2+3]

Discuss the preoperative assessment and anesthetic management of a 50 year old man, chronic smoker with COPD, posted for cortical mastoidectomy. [5+5]

a) Zones for ventilation and perfusion in normal lung. [5] b) Functional residual capacity and its importance in Anaesthesia. [5]

Oxygen dissociation curve — diagram, factors causing shift. Oxygen flux and significance. Pasteur point.

Functional residual capacity (FRC) — definition, significance, factors affecting. Closing volume and its significance.

Positive End Expiratory Pressure (PEEP) — physiology and applications. Significance.

Flow-volume loops and anaesthetic importance. Pulmonary function tests in COPD. Bedside PFTs.

Ventilator-induced lung injury (VILI). Driving pressure and plateau pressure significance.

Bronchial asthma — management for laparotomy for intestinal obstruction. Intraoperative bronchospasm management.

Functional residual capacity. Closing volume. Factors affecting each. Clinical significance in anaesthesia.

Happy hypoxia. Oxygen cascade and (A-a)DO2 importance. Types of hypoxia.

THRIVE (Trans-nasal Humidified Rapid Insufflation Ventilatory Exchange). High flow nasal oxygen (HFNO).

A 35-year -old male patient was admitted in emer gency department with increasing abdominal pain and no passage of flatus or faeces since past 5 days. On evaluation, it revealed that he was a case of severe mitral stenosis. He is listed as semi-emer gency laparotomy in view of intestinal obstruction. Discuss his preoperative assessment, preparation and intraoperative anaesthetic management. [2+3+5]

a) Define cardiac output. What are the factors af fecting cardiac output? [1+4] b) Write briefly about the non-invasive methods of cardiac output measurement. [5]

a) Define hypertensive emer gency . Discuss the pathophysiology of hypertensive emer gency . [2+2] b) Discuss the relative advantages and disadvantages of sodium nitroprusside, nitroglycerin and labetalol in hypertensive crisis. [6]

a) Draw the algorithm for the management of an adult patient with pulseless electrical activity . [5] b) Discuss the post cardiac arrest intensive care. [5]

a) Problems encountered after cardiopulmonary bypass (CPB). [5] b) Low cardiac output syndrome after CPB and its treatment. [5]

a) Write any four methods to prevent hemodynamic response to laryngoscopy and intubation. [4] b) Write about pre-operative management of dual antiplatelet therapy in elective and emer gency sur gery. [6]

a) Cardioplegia. [5] b) Trans-esophageal echocardiography application in anesthesia. [5]

Discuss the anesthetic concerns, preoperative preparation and anesthetic management in a 60-year -old male patient with a permanent pacemaker posted for laproscopic cholecystectomy . [3+2+5]

a) What are the anaesthetic concerns for patients taking ACE inhibitors? [5] b) Define Hypoxic Pulmonary Vasoconstriction (HPV) and its physiological role during anaesthesia. [2+3]

What are the indications, physiological ef fects and technique of insertion of intra-aortic balloon pump? [4+3+3]

a) What are the various methods of pre-operative cardiac risk stratification in a patient with cardiac disease posted for non cardiac sur gery. [5] b) Discuss any one scoring system for cardiac risk stratification. [5]

Haemodynamic and metabolic changes following aortic cross clamping. Therapeutic interventions.

1. a) Briefly discuss the pre-anesthetic evaluation of a 68 year old patient, with history of myocardial infarction 6 months back, scheduled to undergo transurethral resection of prostate (TURP). [5] b) Enumerate the causes of hypokalemia and discuss its management. [2+3]

a) Discuss the diagnosis and management of intraoperative myocardial infarction. [6] b) Hepatorenal syndrome. [4]

Draw the Algorithm of Comprehensive Cardiopulmonary Life Support (CCLS) guidelines from the Indian Resuscitation Council Federation. Discuss the key parameters for good-quality CPR. [6+4]

a) Methods to prevent haemodynamic response to laryngoscopy and intubation. [5] b) Atrial fibrillation - types and management. [2+3]

a) What are the components and principle of invasive blood pressure (IBP) monitoring? [4+2] b) Enumerate the advantages and disadvantages of IBP monitoring. [2+2]

a) What are the techniques for controlled hypotensive anaesthesia? [4] b) Indications, contraindications and complications of controlled hypotensive anaesthesia. [2+2+2]

Cardio pulmonary resuscitation (CPR): a) Enumerate 5 ’H’ and 5 ‘T’ of cardiac arrest. [5] b) With the help of a flow chart, discuss the AHA advanced cardiac life support 'adult bradycardia algorithm'. [5]

Define stress response to laryngoscopy and intubation, its clinical effects and various methods to attenuate it. [2+3+5]

How are implantable cardiac pacemakers and implantable cardioverter defibrillators classified? What information should be sought relating to these devices preoperatively? What precautions should you take perioperatively when anaesthetising patients with these devices? [4+3+3]

a) Ischemic preconditioning. [5] b) Role of ultrasound in anesthesia and intensive care. [5]

a) Levosimendan. [5] b) Microcuff paediatric endotracheal tube. [5]

a) Non invasive cardiac output monitoring. [5] b) Uterine atony. [5]

Pre-operative cardiac evaluation for non-cardiac surgery. ACC/AHA guidelines, RCRI. Risk stratification.

Intraoperative hypertension management (previously normotensive patient). Intraoperative cardiac ischaemia monitoring and management.

Cardiac conduction system. Management of paroxysmal SVT. Atrial fibrillation — causes, diagnosis, treatment.

Non-invasive cardiac output monitoring. Pulse contour cardiac output monitoring (PiCCO). Pulmonary artery catheter with diagram. Cardiac output measurement techniques.

Management of pulseless VT/VF. Management of intraoperative ventricular dysrhythmias. ACLS protocol.

Off-pump CABG — indications, technique, advantages and disadvantages.

Preload and afterload — definition. Determinants of left ventricular diastolic function.

1. Discuss the advantages and disadvantages of opioid free anaesthesia and enumerate the various techniques used for it. [5+5]

a) Define minimum alveolar concentration (MAC). Enumerate factors af fecting MAC. What is its significance in anaesthesia? [2+2+3] b) Aldrete score. [3]

a) What are the anaesthetic techniques using opioids? List the dif ferent routes of applications of opioids. [3+3] b) What are the factors which af fect the pharmacokinetics and pharmacodynamics of opioids? [4]

a) What is Hof fman's elimination? Write the mechanism of action of sugammadex. [2+3] b) What is context half life? Discuss propofol infusion syndrome. [2+3]

a) Compare sevoflurane and desflurane with respect to MAC, blood-gas solubility , and their clinical applications in anesthesia. [1+1+3] b) Discuss the ef fect of liver function on anaesthetic drugs. [5]

a) Enumerate the causes and management of inadequate reversal of anesthesia. [5] b) Target controlled infusion. [5]

a) Sugammadex versus neostigmine for neuromuscular blockade reversal. [5] b) Advantages of enteral nutrition over parenteral nutrition in ICU patients. [5]

a) Closed-loop drug delivery systems. [5] b) Advanced Airway Imaging. [5]

a) Elimination Half-Life and its clinical relevance. [5] b) Saddle Block. [5]

a) Total Intravenous Anaesthesia. [5] b) Iontophoretic Drug Delivery System. [5]

1. a) What is Total Intravenous Anaesthesia (TIVA)? Describe target-controlled infusion. [2+3] b) Enumerate the indications, advantages and disadvantages of TIVA. [1+2+2]

a) Define Minimal Alveolar Concentration (MAC) of inhaled anaesthetic agents. [2] b) Enumerate physiological and pharmacological factors affecting MAC. [4+4]

a) Different roles of Magnesium in Anaesthesiology. [5] b) Segmental spinal anaesthesia. [5]

a) Opioid free anaesthesia. [5] b) Enumerate the causes and discuss the management of a patient in Type I respiratory failure. [2+3]

a) Draw a neatly labelled diagram of a neuromuscular junction. [3] b) What is dual block? [3] c) Write short note on sugammadex. [4]

a) Transdermal patches in Anaesthesia practice. [5] b) Patient-ventilator asynchrony. [5]

a) Alpha-2 adrenergic receptor agonists. [5] b) Toxicity of amide group of local anaesthetics. [5]

a) Closed loop anaesthesia delivery systems. [5] b) Goal directed fluid therapy. [5]

a) Helium and Xenon as anaesthetic gases. [5] b) Recent techniques for management of postdural puncture headache. [5]

1. What are the various routes of administration of morphine? Mention the doses. Discuss the pharmacokinetics and pharmacodynamics of epidural morphine. [3+3+4]

Discuss the causes, signs and symptoms and management of inadequate reversal of neuromuscular blockade during general anaesthesia in an adult patient. [3+2+5]

a) What is the mechanism of action of sugamadex? [3] b) Discuss the role of sugamadex in anaesthetic practice with specific relevance to difficult airway scenarios and intense neuromuscular blockade for short surgical procedures. [3+4]

Compare & Contrast: a) Sevoflurane and Desflurane. [5] b) Sugammadex and neostigmine. [5]

a) Dexmedetomidine. [5] b) Emergence delirium. [5]

a) Context sensitive half-life. [5] b) Effect of burns on neuromuscular junction and neuromuscular block. [5]

a) Liposomal bupivacaine. [5] b) Sugammadex. [5]

Role of Dexmedetomidine in anaesthetic practice. Compare dexmedetomidine with clonidine. (Also asked: Dec 2022)

Sugammadex — mechanism, clinical use. (Also asked Aug 2021, Dec 2022)

TIVA — technique and drugs used. Target Controlled Infusion (TCI). Compare TIVA with TCI.

Mechanism of action, pharmacokinetics of propofol. Effects on organ systems. Clinical use.

ACE inhibitors. Classify anti-arrhythmic drugs. Beta-blockers — classification, benefits in IHD. Perioperative beta-blocker recommendations.

a) Principle of pulse oximeter . [3] b) Mention the factors af fecting pulse oximetry under anesthesia. [3] c) Train of four monitoring. [4]

a) What are the unique physical properties of desflurane which require a special type of vaporiser? What are the factors which influence desflurane vaporiser output? [3+2] b) What are volatile anaesthetic reflectors? Where are they used? [5]

a) What is the pressure and volume of a full oxygen and nitrous oxide cylinder attached to an anesthesia workstation? [2] b) What is pin index system? Write the pin number of any 4 gases. [2+1] c) Discuss the working principle of a variable bypass vaporizer . [5]

1. a) Draw a well labelled diagram of the neuromuscular junction. [4] b) Enumerate any four techniques of neuromuscular monitoring. Write briefly about any one technique with special reference to its clinical indication. [2+4]

a) Describe the anatomy of neuromuscular junction and draw a labelled diagram of the same. [3+2] b) Enumerate the patterns of neuromuscular stimulation used for NM monitoring during anaesthesia and write in short about any one of them. [2+3]

a) Describe the safety features of a modern anaesthesia workstation. [5] b) What is low flow anaesthesia? Discuss its advantages and disadvantages. [2+3]

a) Discuss Boyle’ s Law and its application in anaesthesia. [5] b) Explain the Venturi principle as applied to oxygen delivery devices. [5]

a) Discuss the limitations of pulse oximetry and suggest potential strategies to overcome them. [3+2] b) Describe the clinical uses of end-tidal CO₂ (ETCO₂) monitoring in ventilated patients and explain the phases of a normal capnography waveform. [3+2]

a) What are the advantages and disadvantages of the closed breathing circuit? [5] b) Describe the Mapleson D circuit and give its functional analysis. [5]

What is the role of Ultrasound in perioperative care? Discuss the advantages and limitations of haemodynamic management using ultrasonography in the perioperative care of surgical patients. [4+6]

a) Discuss accidental awareness during anaesthesia, and its prevention. [5] b) Advantages and disadvantages of colloids intravenous(IV) fluids. [5]

a) Enumerate the methods to monitor the depth of anesthesia and write briefly about one of them. [2+3] b) Enumerate the risk factors for accidental awareness during general anesthesia (AAGA). [3] c) Briefly describe post traumatic stress disorder (PTSD). [2]

Rotameters: Types, arrangement, floats used and safety features. [3+2+2+3]

What is low flow anaesthesia? Discuss the prerequisites, advantages and concerns when using low fresh gas flow anesthesia. [2+(2+3+3)]

a) What is the principle of ultrasound? Enumerate the types of probes available with their respective indications. [2+4] b) Enumerate perioperative uses of ultrasound. [4]

Define explicit and implicit awareness during general anaesthesia. What may increase the likelihood of awareness? List the techniques used to assess the depth of anaesthesia and comment on their value. [4+3+3]

a) Discuss the components of the circle system. [3] b) Discuss the location of the oxygen analyser at different parts of the circle system. [4] c) What is low-flow anaesthesia? [3]

1. a) Role of ultrasonography of neck vessels in Anaesthesiology. [5] b) Diagnosis of brain death. [5]

a) Briefly discuss the principle of capnography. [3] b) Draw a labelled diagram of normal capnogram. [3] c) Enumerate the common causes for intra-operative increase in the end-tidal CO 2. [2+2]

a) Functional analysis of Bain's circuit. [5] b) Management of post spinal hypotension. [5]

a) Gas laws and anaesthesia. [5] b) Bain's coaxial circuit. [5]

a) Oxygen concentrators. [5] b) Opiate receptors. [5]

a) Temperature monitoring. [5] b) eFAST examination. [5]

Desflurane vaporiser — structure, physical principles of functioning. Aladin cassette. Anaesthesia vaporizers — classification.

Capnography — principle, components of time capnogram with labelled diagram.

Awareness under anaesthesia — risk factors, depth of anaesthesia monitoring (BIS, entropy). Stages of anaesthesia.

Ultrasonography — principle, clinical uses in anaesthesia and ICU. Point-of-care USG. Role of ultrasound in airway assessment.

Pulse oximetry — Beer-Lambert law, principles, limitations. Perfusion index. Cerebral oximetry.

Safety features in modern anaesthetic machines to prevent hypoxic gas mixture. Oxygen supply failure prevention systems.

BIS (Bispectral index) — what it is, clinical importance. Entropy. EEG-based index systems for depth of anaesthesia.

Medical gases in anaesthesia — oxygen sources, liquid oxygen storage tank. Oxygen concentrator, pressure swing adsorption plant. Graded oxygen therapy.

a) Chi square test, paired T test, triple blind study , p value. [2+2+2+1] b) LAST . [3]

a) What is p-value? How do you interpret it? [2+3] b) What do you understand by odds ratio? When is it used? [5]

a) ANOV A. [5] b) Define p-value and confidence interval. [2+3]

a) The importance of accurate and detailed anaesthesia documentation. [5] b) Role of audit and feedback in anaesthesia practice. [5]

a) What is power analysis and why is it important when designing a clinical trial? [4] b) What is the significance of P value? [3] c) What is a normal distribution curve? [3]

a) Compare and contrast between Case control and Cohort study. [5] b) What is randomization and its different types? What are the advantages of randomization? [3+2]

a) Write briefly about the 'Power of a study' and its significance. [3+2] b) Write briefly about ‘Five steps to safer surgery’ of the surgical safety checklist. [5]

a) What are various reporting guidelines for publications as per EQUATOR Network? [4] b) Elaborate on CONSORT guidelines. [6]

a) What is primary and secondary research? [3] b) Explain various components of a research question for an experimental study. [3] c) What are Type I and Type II errors in research? [4]

a) Consent in Anaesthesia. [5] b) Desflurane vaporizer. [5]

a) Discuss the importance of statistical evaluation in research projects. [5] b) Discuss briefly about written informed consent. [5]

a) Randomized controlled trial. [5] b) ANOVA. [5]

Power of a study. Sample size calculation. Formulae for thesis. Randomization and blinding.

Meta-analysis. Standard deviation and standard error. Impact factor of a journal.

Informed consent — legal and ethical aspects. Consent of unknown patient. Legal age for consent in India.

Record keeping and documentation in anaesthesia. Ethical aspects of anaesthesia care. Ethics in organ transplantation, research subjects.

Quality in anaesthesia — domains. Audit. Crisis resource management (CRM) — key points.

Parametric vs non-parametric tests. Student's t-test. ANOVA. Chi-square test.

p-value, null hypothesis — importance and interpretation. Type I and Type II error.

Evidence-based medicine — how to apply to clinical practice. Role of EBM in anaesthesia.

1. a) Define dif ficult airway . Make a flow chart of dif ficult airway algorithm to explain the management of a "cannot ventilate, cannot intubate" situation after induction general anesthesia and muscle relaxation. [2+6] b) Upper Lip Bite Test. [2]

a) Discuss airway management of a patient with multiple facial fractures after road traf fic accident. [4] b) Discuss massive transfusion in this patient. [4] c) How do we evaluate allowable blood loss? [2]

Give a detailed functional analysis of video-laryngoscope and its advantages in anesthesia practice. [5+5]

Indications, methods, complications and care of tracheostomy . [2+2+3+3]

a) What are the indications for tracheostomy in ICU? [3] b) Care of tracheostomy in ICU. [3] c) Complications of tracheostomy . [4]

1. A 54-year -old lady with a lar ge thyroid swelling and retrosternal extension with hyperthyroidism is posted for total thyroidectomy . a) Discuss the pre-operative assessment and airway management in this patient. [5] b) Describe the clinical presentation, diagnosis and management of post thyroidectomy tracheomalacia. [5]

1. A 6-year -old child is posted for release of contracture of front of neck following burns sustained three months back. On examination, the neck extension is limited and the mouth opening is two finger breadth. a) What are the anesthetic concerns in this child? [5] b) Discuss the anesthesia technique with special reference to airway management. [5]

1. a) What are the predictors of dif ficult airway? [5] b) Plan airway management for a patient with Mallampati Grade IV . [5]

a) Anesthesia concerns in laser sur gery. [5] b) Six minute walk test. [5]

a) Describe the perioperative management of an adult male under going laser excision of laryngeal papilloma. [5] b) What are the anaesthetic concerns in a pediatric patient with hydrocephalus posted for V-P shunt procedure? [5]

1. a) Define elderly and discuss the airway concerns in them. [1+4] b) Define colloid. Enumerate the types of colloid and write a short note on Pentastarch. [1+2+2]

a) Discuss post extubation laryngospasm and its management. [5] b) Enumerate the complications of massive blood transfusion. [5]

Write briefly about OSA, apnea hypopnea index (AHI), STOP-Bang Questionaire and its anesthetic implications. [2+4+4]

1. a) Role of Ultrasonography(USG) in airway assessment. [5] b) Discuss use of vasopressors in septic shock as per surviving sepsis campaign guidelines. [5]

Classify supraglottic airway devices(SADs). What are the modifications done in 3rd generation SADs? Enumerate the possible complications associated with use of SADs. [3+4+3]

a) Possible causes of airway obstruction following thyroid surgery and management. [ 3+3] b) Discuss the anaesthesia technique for modified electro-convulsive therapy (ECT). [4]

a) Discuss 'STOP-BANG score' and its utility in pre-anesthetic assessment. [3+2] b) Write briefly about nerve palsies/injuries that may occur under anesthesia due to different surgical positions. [5]

1. Discuss in brief the relevant contributions of the following scientists in anaesthesia: a) Mallampati. [5] b) Archie Brain. [5]

a) Difficult Bag Mask Ventilation. [5] b) Regulation of Coronary blood flow. [5]

Discuss the anaesthetic management of a 30-year-old lady with bilateral temporomandibular joint ankylosis posted for arthroplasty. [10]

a) Discuss the pre-requisites and the procedure for the removal of the tracheostomy tube. [5] b) Emergence Delirium. [5]

a) Enumerate the second generation supraglottic airway available in clinical practice. Discuss which out of these is most suitable for controlled ventilation. [5] b) Sample size estimation. [5]

Define: Difficult airway, difficult bag and mask ventilation, difficult laryngoscopy, difficult endotracheal intubation, difficult SGA placement. Draw the AIDAA adult unanticipated difficult airway algorithm. [5+5]

a) Describe a method of preoxygenation before induction of general anaesthesia. [4] b) What is the physiological basis of preoxygenation before anaesthesia? [3] c) How could the adequacy of oxygenation be assessed? [3]

a) Describe the nerve supply of the larynx with the help of a diagram. [5] b) How would you prepare the airway of an adult patient for awake intubation? [5]

Enumerate the airway assessment modalities and outline strategies for safely managing a difficult airway in an adult patient scheduled for elective surgery. [4+6]

a) What is intubation difficulty score (IDS) and what is its clinical importance? [5] b) Discuss the diagnosis and management of amniotic fluid embolism. [2+3]

a) Cricoid pressure. [5] b) TURP syndrome. [5]

a) Intubation difficulty score (IDS). [5] b) Second generation supraglottic airway device. [5]

1. a) Describe the nerve innervation of larynx with the help of a diagram. [2] b) Briefly discuss the signs and symptoms of bilateral complete and bilateral incomplete recurrent laryngeal nerve palsy. [3] b) How would you prepare the airway of an adult patient for awake intubation? [5]

Innervation of larynx. Palsies following nerve injury. Sensory and motor nerve supply of larynx.

Difficult airway algorithms.

Various videolaryngoscopes — enumerate, compare (channelled vs non-channelled). Compare Airtraq with C-MAC.

Define anatomical extent of upper airway. Functions of nose. Anterior larynx and nerve supply of larynx.

Airway blocks for awake fibreoptic intubation. Unanticipated difficult intubation algorithm (with diagram).

Enumerate newer supraglottic airway devices — features, advantages, uses. LMA Protector vs I-Gel. LMA Blockbuster. Baska Mask.

Fibreoptic bronchoscope — structure and uses. Fiberoptic intubation technique. Macintosh laryngoscope.

Percutaneous dilatational tracheostomy (PDT) — indications, technique, complications. Cricothyroidotomy. Surgical cricothyroidotomy.

Management strategies of extubation in a patient with difficult airway.

TM joint ankylosis with interincisor gap 5mm — preparation for awake fiberoptic intubation. Extubation planning when mouth opening increases post-surgery.

Various bedside airway assessment tests. Role of ultrasonography in airway assessment.

Airway management guidelines for COVID-19 positive patients (PPE, video laryngoscope, role of THRIVE).

Rapid sequence induction (RSI) — definition, indications, pitfalls, and precautions.

Neuraxial ultrasound. Adductor canal block — sono-anatomy.

1. a) Draw a well labelled diagram of brachial plexus. [5] b) Enumerate the dif ferent routes of brachial plexus block. What are the possible complications of interscalene block? [1+4]

a) Describe the events that result in nerve action potential. [5] b) Discuss about the mechanism of action of local anesthetic agents. [5]

a) Draw a well labelled diagram of the epidural space. Write briefly about any three methods for identifying the epidural space. [3+3] b) Epidural test dose. [4]

a) Programmed intermittent epidural bolus technique. [5] b) Remimazolam. [5]

a) Adductor canal block. [5] b) Three legged stool test. [5]

a) Erector spinae plane nerve block. [5] b) Post operative jaundice. [5]

a) Indications for stellate ganglion block. [3] b) Describe the technique with help of a diagram. [3] c) Discuss complications of stellate ganglion block. [4]

a) What are the important considerations for safely performing neuraxial block in patients on anticoagulation therapy? [5] b) Explain the role of magnesium sulfate in obstetric patients and discuss its anesthetic implications. [5]

a) What is baricity? Describe the relevance of baricity in spinal anaesthesia. [2+3] b) Describe the management of perioperative anaphylaxis. [5]

a) Enumerate the methods for providing brachial plexus block and discuss any one of them. [2+3] b) What is 'LAST' and discuss its management? [1+4]

1) a) Draw a neatly labelled diagram of the brachial plexus. Enumerate the various approaches to the brachial plexus block. [3+3] b) Discuss Jackson Rees Circuit with a suitable diagram. [4]

a) Compare and contrast Ropivacaine and Bupivacaine. [5] b) Discuss the anaesthetic implications of autonomic neuropathy. [5]

a) Describe the anatomy of caudal epidural space with a suitable diagram. [5] b) What is Lee’s Cardiac risk index and its clinical application? [4+1]

a) Describe the flow of cerebro-spinal fluid (CSF). [5] b) Enumerate the factors affecting the spread of local anaesthetic drugs in the CSF. [5]

a) Describe the epidural space and its contents. [5] b) Write briefly with the help of diagrams about the flow volume loop in lung spirometry and discuss their interpretation. [5]

Discuss anatomy of sacral hiatus. What are the indications, contraindications and complications of caudal anaesthesia in children. [2+(3+2+3)]

Toxicity of local anaesthetics and management. Local anaesthetic systemic toxicity (LAST).

Anatomy of brachial plexus with diagram. Approaches to brachial plexus block. Complications of supraclavicular approach.

a) Describe mechanism of action of local anaesthetics. [5] b) Effects of various additives to local anaesthetics. [5]

a) Discuss the recent anti-coagulation guidelines for regional anaesthesia. [5] b) What is the role of remifentanil in labour analgesia? [5]

a) Rapid sequence spinal anaesthesia. [5] b) Adductor canal block. [5]

a) With the help of a diagram describe the USG guided erector spinae plane block. [5] b) What is BIS? Discuss its importance in anaesthesia. [2+3]

a) Costoclavicular approach to brachial plexus block. [5] b) Total intravenous anesthesia. [5]

a) Describe the anatomy of the paravertebral space with the help of a diagram(s). [3] b) Describe the indications and technique of ultrasound guided paravertebral block. [1+3] c) Enumerate the complications that may occur while giving paravertebral block. [3]

Transversus abdominis plane (TAP) block — indications, technique, complications.

Bier's block (IVRA) — volume and concentration of lignocaine, concerns when deflating tourniquet.

Stellate ganglion — anatomy, technique, complications. (Also asked: Dec 2022)

Anatomy of epidural space. Various techniques to identify the space.

Erector spinae plane block (ESPB) — anatomy, indications, contraindications, complications. (With diagram)

Compare epidural block with subdural block and total spinal.

Peribulbar block — technique and complications. Sub-tenon block.

Walking epidural. Patient-controlled epidural analgesia (PCEA). Somatosensory and motor evoked potential monitoring.

Anatomy of brachial plexus with diagram. Various approaches to brachial plexus block. Describe any one.

Paravertebral space anatomy. Post-operative analgesia for carcinoma breast.

a) Discuss the management of hepatic encephalopathy . [5] b) Describe the various tests to confirm brain death. [5]

a) Enumerate the causes of acute hepatic failure. [3] b) What are the principles of management of acute hepatic failure in the ICU? [7]

a) Hypothyroidism and anaesthetic implications. [5] b) Dexamethasone in anaesthesia practice. [5]

a) Portal hypertension. [5] b) Anticoagulation in the ICU. [5]

a) Preoperative evaluation and preparation of a 38-year -old female with hyperthyroidism for subtotal-thyroidectomy . [3+3] b) Enumerate postoperative complications of subtotal-thyroidectomy . [4]

a) What are the risk factors for postoperative hepatobiliary complications? [5] b) Aetiology of post operative jaundice. [5]

A 75-year -old patient is posted for TURP surgery under spinal anesthesia. Enumerate complications that can occur intra-operatively . Discuss their clinical presentation and management. [2+4+4]

Describe the anesthetic concerns and management in a 50-year -old male with alcoholic cirrhosis and portal hypertension, who is posted for open reduction and internal fixation of fracture of both bone of forearm. [5+5]

a) Preanaesthetic evaluation of a thyrotoxic patient scheduled for thyroidectomy . [5] b) TURP syndrome and its management. [2+3]

a) Preoperative evaluation for diabetic autonomic dysfunction in a 65-year -old type II diabetic female under going oesophagectomy for carcinoma oesophagus. [5] b) Management of post-dural puncture headache in a young male who was operated for inguinal hernia under spinal anaesthesia. [5]

Autonomic neuropathy — preoperative evaluation, non-invasive tests, anaesthetic implications.

a) Thyroid storm. [5] b) Anion gap. [5]

A 48-year-old patient known case of chronic kidney disease on hemodialysis, is posted for percutaneous nephrolithotomy (PCNL). Discuss the anaesthetic concerns and technique for conduct of anaesthesia for this patient, with rationale. [5+5]

a) Enumerate the objectives and measures for pre-operative optimization of a pheochromocytoma patient. [5] b) Describe anaesthetic technique for intra-operative management of pheochromocytoma. [5]

a) What are the characteristics of an ideal irrigation fluid used in TURP? Enumerate the various irrigation fluids used. [3+3] b) What is TURBT and what is the special concern for the surgeon and the anaesthesiologist? [4]

1. A 35-year-old female is diagnosed with carcinoma gall bladder and has jaundice with total bilirubin levels of 4.9 mg/dL. She is being planned for the Whipple procedure. Discuss the preoperative assessment, optimisation strategies and the anaesthetic plan. [3+3+4]

Discuss pre-anaesthetic assessment, preparation and management of a 16-year-old male scheduled for phaeochromocytoma excision. How will you manage post-anaesthetic complications? [(2+2+4)+2]

Discuss pre-anaesthetic assessment, preparation, anaesthetic management and postoperative complications in a 20-year-old female with myasthenia gravis posted for thymectomy. [3+2+3+2]

Discuss preoperative evaluation and anaesthetic management of a 45-year-old male patient with chronic failure scheduled for live-related renal transplant. [4+6]

1. What are the preoperative, intraoperative and postoperative anesthesia considerations for thymectomy in an adult patient with myasthenia gravis? [3+4+3]

A 45 year old male, known case of Type II diabetes mellitus is posted for inguinal hernia repair surgery. a) What are the anesthetic considerations in this case? [4] b) Discuss the preoperative assessment and anesthetic management. [2+4]

a) Define acute renal failure. [3] b) Discuss renal protective strategies during peri-operative period. [7]

a)Thyroid storm. [5] b) Intra-operative measures to reduce Intracranial pressure. [5]

a) Describe clinical manifestations of diabetic autonomic neuropathy. [5] b) Describe the evaluation of a patient with autonomic neuropathy in the preoperative period. [5]

Portal hypertension / Lieno-renal shunt — preoperative evaluation, preparation, anaesthetic plan. Modified Child-Pugh criteria.

Hepatorenal syndrome — etiology, diagnosis, management. Obstructive jaundice — liver function tests, anaesthetic goals.

Liver transplant — anaesthetic management of chronic alcoholic male. Anhepatic phase of liver transplant. Hepatopulmonary syndrome.

Phaeochromocytoma — preoperative evaluation, preparation, monitoring, anaesthetic management (laparoscopic/robotic adrenalectomy).

Diabetes mellitus — perioperative management. Diabetic ketoacidosis — clinical features, management. Non-ketotic hyperosmolar coma. Intraoperative blood sugar regimes.

Thyroid surgery — hyperthyroidism evaluation, thyroid storm, multinodular goitre with retrosternal extension, post-thyroidectomy complications.

a) Blood conservation strategies. [5] b) Complications of sitting position and lithotomy position in anaesthesia and its prevention. [5]

a) Discuss transfusion of synthetic colloids (HES, Dextran) vs natural colloids (blood, blood products, albumin). [5] b) Use of dexmedetomidine in the operation theatre and ICU. [3+2]

a) Buf fer systems in the body . [5] b) Mechanism of action of local anaesthetics. [5]

a) Define point-of-care coagulation testing (POCCT) and explain its significance during the perioperative period. [2+3] b) Describe the changes that occur in blood stored for 28 days and discuss the potential implications of transfusing this blood to a patient. [2+3]

a) What are the complications of massive blood transfusion? [6] b) Briefly discuss fibrinogen replacement therapy . [4]

a) Define hyperkalemia. Enumerate the ECG changes associated with it and discuss the management of hyperkalemia. [1+2+3] b) Application of Pulse oximetry in Clinical practice. [4]

Discuss the recent updates in the fluid compartmental model and fluid management. What are the newer modalities and tools for guiding fluid management in the perioperative period? [5+5]

Enumerate dynamic and static parameters of fluid responsiveness. Write briefly about the PiCCO monitor and its clinical utilisation. [5+5]

a) Enumerate the causes and clinical features of hyponatremia. [3+2] b) Discuss the diagnosis and treatment of hyponatremia. [2+3]

a) What is blood component therapy? Describe via a flow chart how different blood components are obtained from whole blood. [2+4] b) How are platelets stored? Enumerate indications and complications of platelet transfusion. [1+3]

a) What is patient blood management (PBM) and what are the 3 pillars of PBM? [2+3] b) Discuss in brief permissive hypercapnia. [5]

a) Enumerate the various methods of assessing fluid responsiveness. [4] b) Discuss the role of ultrasound in assessing fluid responsiveness as an alternative to CVP. [6]

a) Discuss the importance of blood substitutes. [5] b) Describe the role of TPN in ICU. [5]

a) Hyperkalemia. [5] b) Metabolic acidosis. [5]

a) Massive blood transfusion and its complications. [5] b) EtCO 2 monitoring. [5]

a) Pre-operative advice for patients on anticoagulant therapy. [5] b) Massive blood transfusion. [5]

Coagulation cascade (classical). Perioperative coagulation monitoring. TEG / ROTEM — diagram, clinical applications.

Intraoperative blood loss — allowable blood loss calculation, methods of reducing, transfusion trigger.

Sickle cell anaemia — pathophysiology, anaesthetic concerns, crisis management.

Hyponatraemia — symptoms/signs, calculation of sodium deficit, replacement. Causes, management by serum sodium levels.

Approach to metabolic acidosis on ABG analysis. Anion gap — definition, calculation, conditions causing change.

Buffer systems in the body. Renal compensation for metabolic acidosis. Carbonic acid-bicarbonate buffering system.

TRALI (Transfusion Related Acute Lung Injury) — definition, pathogenesis, management. Post-obstructive pulmonary oedema.

Heparin-induced thrombocytopenia. Oral Factor Xa inhibitors. Hyperchloraemic metabolic acidosis. Hydroxyethyl starch — types, uses, adverse effects.

Goal-directed fluid therapy during major abdominal surgery. Body fluid compartments (diagram and techniques).

DVT — deep vein thrombosis, risk factors and prophylaxis strategies. VTE prevention. Disseminated intravascular coagulation (DIC).

Massive blood transfusion — definition, risks, complications, management protocol. Chronological changes in stored blood.

Hyperkalaemia — ECG changes, intraoperative management. Causes, signs, symptoms of hyperkalaemia.

Fresh frozen plasma — indications, contraindications. Blood component therapy — steps for separation. Blood products and uses.

a) Write anaesthetic considerations of laparoscopic sur gery. [6] b) Risk factors and management of post-operative nausea and vomiting. [2+2]

a) Pneumoperitoneum and its peri-operative implications. [5] b) Conscious Sedation. [5]

a) Enumerate various surgical positions (with example) in the operation theatre. [4] b) What are the precautions and complications associated with prone positioning? [3+3]

a) Discuss the preoperative investigations and optimization in a 50 year old obese female with BMI of 35 and hypertension, scheduled to undergo laparoscopic cholecystectomy. [3+3] b) Discuss the postoperative analgesic management in a 3 year old boy posted for left inguinal herniotomy. [4]

Describe the anaesthetic considerations for a patient undergoing robot-assisted radical prostatectomy. [10]

Briefly describe the anaesthesia concerns for robotic-assisted surgery for prostate malignancy. [10]

a) Complications related to sitting position under anaesthesia. [5] b) Positioning related nerve injury during anesthesia and its management. [5]

What are the physiological changes associated with pneumoperitoneum? Discuss in brief, the anesthetic concerns and management of a 35 year old, ASA I lady scheduled for laparoscopic cholecystectomy. [4+6]

Complications of steep Trendelenburg / prone position in neurosurgery.

Pneumoperitoneum — implications, haemodynamic changes, role of anaesthesiologist. Laparoscopic cholecystectomy anaesthesia.

Laparoscopic bariatric / gastric bypass surgery — morbidly obese patient. Obesity — anaesthetic considerations, classification.

Robotic surgery — concerns and management. Robotic prostatectomy anaesthetic concerns. Robotic resection of pheochromocytoma.

Various patient positions — complications. Prone position complications in lumbar discectomy / neurosurgery.

A twenty-five-year -old primigravida with 34 weeks gestation with severe pre-eclampsia is scheduled for caesarian section. Discuss the anaesthetic implications and management. [5+5]

a) Discuss the factors predisposing a pregnant patient to the risk of regur gitation and aspiration. [6] b) Write in brief about the role of magnesium sulfate in patients with eclampsia and its anaesthetic implications. [4]

a) What is EXIT procedure? [3] b) How would you manage anaesthesia for intrauterine fetal sur gery? [7]

A 26-year -old lady with 24 weeks pregnancy is posted for laparoscopic appendicectomy following acute appendicitis. a) Which trimester of pregnancy is considered to be the safest for a non obstetric sur gery in a pregnant patient and why? [1+2] b) Discuss the anesthetic management of this patient. [7]

a) Ambulatory labor analgesia. [5] b) Sensory evoked potential. [5]

a) What is supine hypotension syndrome and how is it managed during anesthesia? [2+3] b) Define the oculocardiac reflex and explain its neural pathway . [2+3]

Discuss the anesthetic management of a multigravida with 34 weeks of gestation with Hb 6gm% posted for emergency LSCS due to fetal distress. [10]

Enumerate modalities available for pain relief during labor. How will you conduct labor analgesia for a 32-year-old female in true labor, with 2cm os dilation and 50% effacement of cervix, who has presented to labor room and demands analgesia? Enumerate possible complications. [3+5+2]

a) The physiological changes in the cardiovascular system in pregnancy and its clinical relevance. [5] b) The placental transfer of anesthetic drugs and its implications. [5]

Write briefly about supine hypotension syndrome. Discuss the diagnosis and management of post spinal hypotension in a pregnant patient undergoing cesarean section. [3+(3+4)]

A 22-year-old female pregnant patient presented to the hospital for an ANC check-up. She wanted to have labour analgesia. Discuss the various plans for providing labour analgesia. [10]

A 22-year-old female pregnant patient presented to the labour room in emergency with abdominal pain. She was diagnosed with PIH and was receiving treatment in her follow-up in the ANC clinic. On examination, the obstetrician diagnosed her as having fetal distress and planned for an emergency cesarean section. Discuss the perioperative plan for the patient, including assessment, anaesthesia and analgesia. [3+4+3]

A female patient aged 32 years, with five months of amenorrhea, suffered from Koch’s mid-dorsal spine and developed paraplegia. She is scheduled for anterolateral decompression surgery. Discuss preoperative preparation, anaesthetic management and postoperative care. [3+4+3]

Anaesthetic management of patient with severe mitral stenosis (mitral valve area ≤1 sq.cm) for LSCS. Pathophysiology of mitral stenosis.

a) Describe the cardiovascular changes in a pregnant patient and its anaesthetic implications. [5] b) With the help of a diagram, describe the functional analysis of the 'bag valve mask' or self- inflating bag. [5]

a) What are the current guidelines for acid aspiration prophylaxis in a parturient undergoing cesarean delivery? [4] b) Discuss the anesthetic considerations of 20 weeks pregnant patient undergoing non-obstetric surgery. [6]

1. a) Define anaemia in pregnancy. Enumerate classification of anaemia in pregnancy based on its etiology. [2+3] b) Discuss the anaesthetic concerns in a pregnant female with anaemia. [5]

a) Discuss the resuscitation of a collapsed 25-year-old female with post partum hemorrhage. [5] b) Describe the management of flail chest. [5]

Enumerate the anesthetic considerations & anesthetic management of a 28-year-old pregnant patient with severe anemia posted for elective cesarean section. [5+5]

Anaesthetic management of severe pre-eclampsia / eclampsia for emergency LSCS. PIH classification and magnesium regimes.

Uteroplacental blood flow / circulation. Physiological anaemia of pregnancy. Placental transfer of anaesthetic drugs.

Placenta praevia with accreta — preoperative preparation, anaesthetic plan, anticipated complications.

COVID-19 positive pregnant patient for emergency LSCS — anaesthetic management in ICU with BiPAP.

Labour analgesia — methods, epidural technique in labour. Labour analgesia in morbidly obese parturient.

Pathophysiology of pre-eclampsia and eclampsia. CVS changes in pregnancy. Physiological changes in pregnancy (CVS and respiratory).

Ovarian hyperstimulation syndrome — clinical features and treatment. Anaesthetic management for ovum retrieval / oocyte retrieval in IVF suite.

1. Discuss pre-operative evaluation, preparation, intraoperative and post operative anaesthetic management of a 3-year -old child posted for sacro coccygeal tumour . [2+3+3+2]

1. a) What are the dif ferent methods to assess pain in a pediatric patient? [6] b) Describe any one score for post operative pain assessment in the pediatric patient. [4]

1. Write briefly about the pre-operative evaluation, intra-operative management and postoperative care of a 20-day-old preterm neonate posted for repair of lumbar meningomyelocele. [3+5+2]

a) Discuss the causes of rapid desaturation following apnea in a pediatric patient as compared to an adult. [5] b) Enumerate two methods for assessment of post-operative pain in the pediatric age group and write briefly about management of acute post-operative pain in a pediatric patient. [2+3]

A 2-year -old child posted for cleft palate repair sur gery. Discuss: a) The pre-operative assessment. [3] b) Anesthetic management [5] c) Post operative analgesia [2]

a) Compare inhalational versus intravenous induction in paediatric patients. [5] b) Management of intraoperative awareness during total intravenous anaesthesia (TIV A). [5]

a) Postoperative analgesia in a boy with hypospadias posted for urethroplasty . [5] b) Discuss the strategies to prevent intraoperative hypothermia in neonates. [5]

a) When does the neonatal pattern of circulation convert to an adult circulation in the pediatric patient? [4] b) What is transitional circulation and what are the intra-operative factors that can af fect the conversion of a neonatal circulation to an adult circulation? [2+4]

Post-tonsillectomy bleed — management of a 5–6 year old child for re-exploration.

a) Anesthetic considerations in a 2-year-old child posted for cleft palate repair. [7] b) Oxygen toxicity. [3]

A 3-year-old child presents with respiratory distress and child is planned for emergency bronchoscopic removal of foreign body in right main bronchus. Discuss the anaesthetic concerns, technique of anaesthetizing this patient and possible complications. [3+5+2]

a) Anaesthetic considerations in a 2-year-old child, with history of seizure disorder posted for MRI brain. [5] b) Micro cuff endotracheal tube: its salient features and indications. [3+2]

a) Enumerate the acyanotic and cyanotic congenital heart malformations in the newborn. [4] b) Discuss the differences between infant and adult cardiopulmonary resuscitation. [6]

1. Discuss the assessment, optimisation and anaesthetic management of a two-day-old neonate for primary tracheoesophageal fistula repair. [3+2+5]

A 2-Kg one day old male baby with gastroschisis is scheduled for repair. Discuss the perioperative management. [10]

A 5-year-old child is posted for cataract surgery. a) Discuss the anesthetic considerations in this patient. [6] b) Briefly describe the oculo-cardiac reflex. [4]

A 6 year old child underwent tonsillectomy. Three hours later in the post anesthetic care unit, nursing officer notices bleeding from oral cavity. Describe the pre-operative assessment, preparation and anesthetic management of this suspected case of bleeding from tonsillar fossa. [3+3+4]

a) Discuss the anaesthetic implications due to the anatomical variations in the neonatal airway. [5] b) What are the age related respiratory changes in a geriatric patient? [5]

a) Pain assessment in infants. [5] b) VAP bundle in ICU. [5]

a) Enumerate the anaesthetic concerns in a neonate with congenital trachea-oesophageal fistula posted for fistula repair. [5] b) What is the role of TEE in cardiac anaesthesia? [5]

a) Effect of anesthetic agents on developing brain. [5] b) Oxygen flux. [5]

a) Emergence delirium in children. [5] b) Scavenging systems in an operation theatre. [5]

Meningomyelocoele / meningocele in neonate — preoperative, intraoperative, postoperative concerns.

Paediatric airway differences from adult. Cuffed vs uncuffed ETTs in children. Anatomy of paediatric airway.

APGAR score and its relevance. Neonatal resuscitation guidelines.

Anaesthetic management of a child (2–4 years) for removal of foreign body from bronchus. Video assisted bronchoscopy in children.

Anatomical differences in the airway between neonate and adult. Respiratory physiology differences.

a) Discuss factors af fecting hypoxic pulmonary vasoconstriction. [5] b) Discuss equipments available to achieve one lung ventilation in adults and children. [5]

a) Hypoxemia during one lung ventilation. [5] b) Blood conservation strategies during sur gery. [5]

a) Various methods used to optimize oxygenation during one lung ventilation. [5] b) Minimizing carbon footprint in anaesthesia practice. [5]

1. a) What are the indications for one lung ventilation? Enumerate the techniques for pediatric lung isolation. [2+3] b) How do you treat hypoxemia during one lung ventilation? [5]

A 35-year-old male is diagnosed with carcinoma lung. Her PFT reveals FEV1 of 78% of predicted with FVC of 65% of predicted. He has been a chronic smoker for the last 20 years. He is posted for VATS lobectomy. How will you assess and optimise the patient? Discuss the anaesthetic plan. [(3+3)+4]

Discuss preoperative evaluation of carcinoma lung patient posted for pneumonectomy. [10]

Post-thoracotomy complications. Post-thoracotomy pain management.

a) Bronchial blockers. [5] b) Post exposure prophylaxis following needle stick injury from a patient with HIV positive status. [5]

Lung isolation techniques — in adults and in 2-year-old children. Various methods.

One lung ventilation — indications, physiological changes, methods to improve oxygenation during OLV.

a) Define cerebral perfusion pressure. Write briefly about Cushing’ s triad of ICP . [2+3] b) Describe the blood supply of spinal cord. [5]

Discuss the anaesthetic implications of a patient scheduled for posterior cranial fossa sur gery. Describe various methods to detect and treat venous air embolism. [5+5]

a) Management of intraoperative air embolism in an adult patient under going posterior fossa tumor sur gery. [5] b) Compare the use of colloids versus crystalloids in hypotensive patients. [5]

a) Discuss the non-pharmacological measures to reduce intracranial pressure in a post traumatic head injury patient. [5] b) Patient preparation for awake fiberoptic intubation. [5]

Anaesthetic considerations and management of a 38-year-old female patient planned for resection of pituitary adenoma. [5+5]

a) What is cerebral autoregulation? [5] b) Write briefly about the effect of various intravenous anesthetic agents on the cerebral autoregulation. [5]

What is the checklist for “Tight Brain” during neurosurgery? Discuss the methods for rapid reduction of ICP and brain volume. [5+5]

a) Describe the factors that may lead to: [4] i) venous air embolism, and ii) arterial air embolism. b) What is paradoxical air embolism, and how does it occur? [3] c) Explain the physiological basis for the use of capnography in the detection of venous air embolism. [3]

Explain the circulation of cerebrospinal fluid in humans using a diagram. Discuss the anaesthetic management of a 3-year-old child posted for ventriculo-peritoneal (VP) shunt surgery. [5+5]

a) What is cerebral autoregulation? [5] b) Implications of inhalational agents on cerebral autoregulation. [5]

a) Anaesthesia and intraoperative neuro physiological spinal cord monitoring. [5] b) Inferior venacava collapsibility index. [5]

Intracranial pressure (ICP) — factors determining, pharmacological and non-pharmacological measures to reduce ICP. Cerebral autoregulation.

Venous air embolism — predisposing factors, diagnosis, management. Positions for infratentorial tumours and complications of sitting position.

Awake craniotomy — nerves blocked, monitoring during surgery, indications.

Postoperative cognitive dysfunction (POCD) — effects of anaesthetic agents, measures to minimize.

Define lethal triad for trauma patient. Write briefly about damage control resuscitation and damage control sur gery. [2+(4+4)]

Discuss perioperative anaesthetic considerations and management of an 85-year -old male patient for knee replacement with CAD and Parkinson disease. [5+5]

Enumerate risk factors, diagnosis and management of intraoperative fat embolism. [2+3+5]

Discuss the pre-operative optimization of a 70-year -old hypertensive patient posted for total hip replacement. Write briefly about the anticipated intraoperative complications and their management. [2+4+4]

a) Outline the principles and steps involved in the resuscitation of a burn patient with inhalational injury . [5] b) Discuss the management protocol for malignant hyperthermia, including pharmacological and supportive measures. [5]

Pathophysiology and management of patient who has sustained acute burns. [5+5]

A 65-year-old male patient is posted for total hip replacement. He has a known case of coronary artery disease (CAD) and underwent PTCA one year back, and a drug-eluting stent was placed. He was a known hypertensive and presently receiving oral aspirin, clopidogrel, atenolol and losartan as drug therapy. Discuss the preoperative assessment and anaesthetic plan for this patient. [5+5]

Fat embolism — diagnosis and management. Bone cement implantation syndrome (BCIS).

a) Discuss the pre-anaesthetic evaluation of a 70 year old chronic smoker with systemic hypertension for 10 years on medications, posted for total hip replacement (THR) surgery. [5] b) Discuss the diagnosis and management of TURP syndrome. [5]

a) Bone Cement Implantation Syndrome. [5] b) End of life counselling. [5]

Kyphoscoliosis / scoliosis surgery — evaluation, intraoperative concerns, neurophysiological spinal cord monitoring.

Trauma — multi-system trauma, initial assessment, airway concerns. Damage control resuscitation. Acute traumatic coagulopathy.

Burns management — airway management, anaesthesia plan for debridement, skin grafting. Contracture release.

Spinal fusion / scoliosis surgery — evaluation, intraoperative concerns, neurophysiological monitoring.

a) What are the ASA minimum monitoring standards for the conduct of anesthesia? [2] b) Write advantages and disadvantages of day care sur gery. [4] c) Write any 2 dischar ge criteria scores for day care sur gery. [4]

A 65-year -old patient with diabetes mellitus, controlled on oral hypoglycemic drugs, is scheduled for open hernia repair as a day care patient. Discuss anesthetic management and criteria for dischar ge of this patient. [5+5]

a) Evaluate the potential causes and management strategies for delayed emer gence following laparotomy . [3+2] b) Discuss the approaches for managing postoperative nausea and vomiting, including pharmacological and non-pharmacological interventions. [5]

a) Risk factors and management of post operative nausea and vomiting. [5] b) Management of ventricular tachycardia. [5]

a) Modified Aldrete scoring system. [5] b) Venous air embolism and its management. [5]

a) Describe Aldrete score and what is its modification. [5] b) Write briefly about the criteria for ambulatory surgery. [5]

Discuss the indications, advantages and disadvantages of general anaesthesia for electroconvulsive therapy. [3+4+3]

a) Sedation Score. [5] b) Management of PONV. [5]

1. a) Enumerate the inpatient and outpatient discharge criteria after spinal anaesthesia. [5] b) What is the pathophysiology of lung involvement in a COVID patient? What type of respiratory failure is predominantly seen in such patients? [3+2]

a) Anaesthesia in MRI suite. [5] b) Management of unanticipated difficult intubation in a full term pregnant patient with fetal distress undergoing emergency LSCS. [5]

a) Enumerate the possible causes of delayed recovery from anaesthesia. [5] b) Discuss the causes and management of intra-operative hypertension in a previously normotensive patient. [5]

a) Discuss anaesthesia for modified ECT. [5] b) What is Glasgow Coma Scale and discuss its clinical importance. [3+2]

Discharge criteria for day care / ambulatory surgery. Fast-tracking concept after ambulatory anaesthesia.

Post anaesthesia care unit (PACU) discharge criteria. Post anaesthesia discharge scoring system (PADSS).

Non-operating room anaesthesia (NORA) — challenges, role of anaesthesiologist.

MRI suite — limitations, hazards, anaesthetic management of a child with hydrocephalus for MRI.

1. a) Abdominal compartment syndrome. [5] b) High anion gap metabolic acidosis. [5]

a) Continuous renal replacement therapy . [5] b) Use of magnesium in anaesthesia and ICU. [5]

a) Describe acute kidney injury and its assessment in the critical care unit. [5] b) Discuss the management of 50-year -old admitted in ICU with flail chest. [5]

a) Discuss indications and contraindications of total parenteral nutrition in ICU. [3+3] b) Write advantages of enteral feeding in comparison to parenteral. [4]

a) Nosocomial infections in ICU. [5] b) Hyponatremia and its management in ICU. [5]

Pathophysiology and the management of central line associated bloodstream infection. [5+5]

a) Weaning criteria in ICU. [5] b) HACOR scoring for non-invasive ventilation. [5]

a) What is ventilator associated pneumonia (V AP)? [2] b) How can it be prevented? [4] c) Discuss the management of VAP. [4]

Briefly discuss management of: a) Diabetic ketoacidosis. [5] b) Intra-operative bronchospasm. [5]

Brain death — criteria, steps for diagnosis and certification. Anaesthetic management of brain dead patient for organ harvesting. Brain dead patient counselling for organ donation.

What are the diagnostic criteria for clinical diagnosis of brain death? [10]

1. a) Point of care ultrasound in intensive care unit. [5] b) qSOFA and its clinical relevance. [5]

a) Prone ventilation. [4] b) Automatic tube compensation (ATC). [2] c) APRV mode. [4]

a) APACHE scoring. [5] b) HFNC. [5]

Discuss the criteria and tests used to diagnose brain death in adults. [5+5]

a) Myasthenic crisis. [5] b) Management of diabetic ketoacidosis. [5]

a) Define sepsis, what is qSOFA and its relevance. [2+4] b) Universal precautions in anaesthesia. [4]

A 40-year-old patient has been on ventilatory support in the ICU since last two weeks. What are the factors that determine readiness for weaning from mechanical ventilation in an ICU patient? Discuss the steps for weaning from mechanical ventilation for this patient. [4+6]

a) Principles of renal replacement therapy. [5] b) Principles of cardiopulmonary resuscitation in pregnant patient. [5]

Define sepsis and septic shock. Enumerate the components of score recommended for screening in the recent sepsis guidelines. Describe the initial resuscitation in a sepsis patient. [2+3+5]

Permissive hypercapnia. Recruitment manoeuvres. Lung protective strategies in ARDS.

ARDS — Berlin definition, etiopathogenesis, severity classification, ICU management, ventilatory management, lung protective strategies. PF ratio significance.

Mechanical ventilation — indications, modes of ventilation, initiation. Weaning from ventilatory support — criteria, principles, failed weaning.

Sepsis — definition, qSOFA. Septic shock — role of vasopressors (noradrenaline, dopamine, dobutamine). APACHE score. SIRS.

Sedation in ICU — measures to assess sedation, commonly used agents. Delirium in ICU.

Renal replacement therapy — indications, modes (CRRT). RIFLE criteria for acute renal injury.

ECMO — modalities of extracorporeal life support. Role of ECMO in severe hypoxaemia, COVID, swine flu.

Non-invasive ventilation — definition, prerequisites, complications. Indications for NIV. COVID-19 management with NIV.

Assessment of volume responsiveness in mechanically ventilated patient. Dynamic indices in surviving sepsis guidelines.

COVID-19 management — CT changes, protocol for pneumonia, ventilatory strategies, biomarkers, steroid therapy. Post-COVID patient for surgery.

WHO step-ladder — chronic pain, advanced cancer pain relief.

a) Neurogenic claudication and its management. [5] b) Role of N-methyl D aspartate receptors in pain. [5]

a) What is complex regional pain syndrome? [5] b) Discuss the treatment of complex regional pain syndrome. [5]

a) Anaesthesiologists as a palliative care physician. [5] b) Limitations and hazards of providing anaesthesia in MRI suite. [5]

a) Define pain and enumerate elements of pain. [3+2] b) Visual Analogue Scale (V AS) and its interpretation. [2+3]

a) Discuss the methods for providing post operative analgesia in a patient posted for right sided total knee arthroplasty. [5] b) Discuss the preoperative preparation of a patient with wet gangrene left foot in diabetic ketoacidosis posted for below knee amputation. [5]

a) Discuss the post-operative pain management modalities in a 58-year-old female with carcinoma right breast planned for modified radical mastectomy. [5] b) Post-spinal shivering. [5]

a) WHO ladder for pain management. [5] b) Drug dose modification in obese patients. [5]

a) Discuss the organization of acute pain services. [6] b) Universal precautions for healthcare professionals. [4]

a) Define trigeminal neuralgia and discuss its management. [5] b) Describe radial artery cannulation. [5]

Describe the anatomy and physiology of pain and pain transmission. Discuss various modalities of neuropathic pain management. [(3+3)+4]

a) Discuss the methods of providing post operative analgesia in a patient undergoing modified radical mastectomy for carcinoma of the right breast. [5] b) Describe the preoperative investigations and optimization of a morbidly obese patient posted for gastric bypass surgery. [5]

Define pain. Differentiate between nociceptive and neuropathic pain. Discuss the setting up of a multidisciplinary care setup for management of patients with chronic pain? [1+2+7]

Pain assessment tools — VAS, postoperative pain, assessment in children and non-communicating adults. Pain assessment in infants.

Neuropathic pain — various interventional pain management techniques. Herpes zoster treatment in pain clinic.