RESPIRATORY PHYSIOLOGY

https://www.ucl.ac.uk/anaesthesia/people/RespPhysiolLong.pdf

CALCIUM CHANNEL BLOCKERS AND AEC INHIBIORS ANAESTHETIC IMPLICATIONS

CALCIUM CHANNEL BLOCKERS

Are a diverse group of structurally unrelated compounds that selectively interferes with the inward calcium movement across the myocardial and vascular smooth muscles.

Calcium plays a key role in the electrical excitation of the cardiac cell and vascular smooth muscle cells.

Introduction

Role of Ca⁺⁺ in Cardiac and Smooth Muscle

• Changes in intracellular Ca⁺⁺ regulate contraction through different mechanisms in cardiac and smooth muscle:
• In cardiac muscle, Ca⁺⁺ binding to troponin C relieves troponin inhibition of actin-myosin interactions

WHY DNB IS TOUGHER ?

http://www.indiamedicaltimes.com/2013/05/06/guest-article-why-dnb-exam-is-made-tougher-than-msmd-exam-by-dr-kalyan-r-kone/

2008 DECEMBER DNB ANAESTHESIA QUESTION PAPER

DNB JUNE 2008

PAPER I
1. 20 year female with Angiofibroma nose coming for surgery.
 what are the blood conservation strategies used?
2. Clinical features,and management of paracetamol poisoning
3. 30 yr female coming for  carcinoid tumour - anaesthetic Mx.
4. Management  & Pathophysiology of post anaesthetic shivering
5. 3 year old coming for  caudal epidural block.-Technique & Complications
6.Portal hypertension coming for L-R shunt. Preop evaluation & preparation.
7.Mediastinoscopy –Anaesthetic Mx.3 year old for PDA correction.
8. TEE
9. ULTRASOUND (Principle & Uses)

PAPER II
1.50-year-old COPD patient on Ventilator-ENTERAL NUTRITIONAL PLAN. Advantage& Disadvantage.
2.PRE EMPTIVE ANALGESIA –current status.
3.WEANING CRITERIA from prolonged ventilation.
4.1 day old child with CDH –Anaesthetic preparation & Mx.
5.SEVERE ECLAMPSIA – Caesarean – Anaesthetic Mx.
6.LIPID EMULSION – mechanism & dosage in LA Toxicity.
7.CLONIDINE in anaesthesia & ICU.
8.PARKINSON’S Disease-Anaesthetic Mx.
9.Anaesthesia guidelines for Mx of patient with CORONARY STENT.
10.THYROID STORM-Manifestation & Mx.

 PAPER III
1.Enumerate the symptoms of SHOCK & discuss the methods to assess the systemic perfusion.
2.Mx of ANAPHYLAXIS.
3.PERMISSIVE HYPERCAPNIA.
4.TRANSDERMAL DELIVERY of drugs
5.30-year-old Asthamatic for LAP CHOLECYSTECTOMY- Preop evaluation & preparation.
6.METHEMOGLOBINEMIA & anaesthesiologist.
7.Discuss the Regulaion of CERBRAL BLOOD FLOW.
8.DEXMEDETOMIDINE –clinical applications & complications
9.I- GEL AIRWAY.
10.DVT –Diagnosis , Prevention & Mx.


PAPER IV
1.Resuscitation of TERM PREGNANT PATIENT
2.Classify VAPORIZERS. Briefly describe the change with the ALTITUDE.                 
3.Describe LUMBAR PLEXUS with the help of a diagram. Techniquesfor LUMBAR PLEXUS BLOCK.
4.EVIDENCE BASED MEDICAL EDUCATION
5.N2O: Current Status
6.Adverse effects of NEUROMUSCULAR BLOCKING DRUGS.
7.Planning of PACU.
8.Problems of CHRONIC HEMODIALYSIS
9.PERCUTANEOUS DIALATATIONAL TRACHEOSTOMY
10.Clinical tests for AUTONOMIC FUNCTION

TOPIC WISE ANAESTHESIA PREVIOUS QUESTION PAPAERS

TOPIC WISE ANAESTHESIA PREVIOUS QUESTION PAPAERS  AS AVAILABLE FROM       https://archive.org/details/DNBQUESTIONPAPERTopicWise

1. CONSENT

1).Vicarious liability for negligence(June 1994).

2).Utility of anaesthetic records(Dec 1994).

3).Computer based patient record for anaesthesia(Dec 1997).

4).Informed consent(Dec 2000)(June 2010).

5.Describe consent in anaesthesia practice including ethical and legal aspects(Dec 2010)

2. GENERAL TOPICS

1)Effect of anaesthesia and surgery on immunological mechanism(June 1995).

2)Simulator in anaesthesia education(June 2010).

3)Stress response to trauma and surgery(June 2006).

4)Safe anaesthetic procedure(Dec 1999).

5)Stress management in anaesthesia practice(Dec 2003).

6)Stress and anaesthesiologists(June 2003)(June 2005). 

CHAPTER WISE QUESTIONS FOR DNB EXAMINATION IN ANAESTHESIOLOGY

 Airway management
 
1. Describe the anatomy of larynx with difference in adult and children. What is importance of recurrent laryngeal nerve in anaesthesia Practice
2. Evaluation of difficult airway
3. Difficult intubation
4. Trachesotomy techniques and complications
5. Discuss the preoperative assessment and the method of anaesthesia in Patient with T M Ankylosis for the Release of Ankylosis
6. Predictive factors & intubation difficulty
7. Causes of airway obstruction following thyroid surgery and its managementc.
8. Anatomy of larynx. Enumerate with diagrams the types of vocal cord palsies
9. Management of an adult with smoke inhalational injury
10. Problems of anaesthesia in dental chair
11. List the bed side test available to predict the difficult intubations. Comment on their use
12. Anaesthetic Management of two years old child who is scheduled for Therapeutic Bronchoscopy following inhalation of foreign body 2 days ago child could not exhibit any sign of airway obstruction
13. Airway management in an unconscious patient
14. Discuss the patho-physiology and management of inhalational injury. (25 marks)
15. Vocal cord palsies with the aid of diagrams of direct laryngoscopic view.


 Basics and general aspects
 
1. Infections related to anaesthetic practice
2. Plasma expanders
3. Discuss the pathophysiology and management of anaphylactoid reactions in anaesthesia
4. Disinfection
5. Prevention of fire and explosion hazards in operation theaters
6. Pre-operative evaluation of Autonomic function
7. Pollution in Anaesthesia
8. O2 toxicity
9. Role of kidney in acid base balance
10. Possible causes of delayed recovery from general anaesthesia
11. Temperature regulation in adults, Predisposing factors, diagnosis and management of malignant hyperpyrexia
12. Oxygen cascade, Oxygen transport and Oxygen dissociation curve
13. What is minimum monitoring standard? Describe the objectives and methods.
14. The factors influencing tissue oxygenation
15. Risk and management of pulmonary aspiration
16. Application of venturi principle in anaesthetic practice
17. Pre-operative visits
18. Oxygen therapy
19. Plasma proteins and anaesthesia
20. Post anaesthetic vomiting
21. Write down the physiology of sleep. How does it differ from anaesthesia?
22. What phases occur in various stages of anaesthesia
23. Total intravenous anaesthesia
24. Occupational hazards to anaesthetist
25. Post operative jaundice
26. Pulmonary edema in intra operative and immediate post operative period
27. What is malignant hyperthermia? Discuss its clinical features and laboratory finding. Why it is important for the anesthetist to know about this syndrome?
28. Air Embolism under anesthesia
29. Discuss the Aetiology and Management of various Cardiac Arrhythmias occurring during anaesthesia
30. Management of Mismatched Blood Transfusione.
31. Occupational Hazards to Anesthetist
32. Defibrillation
33. Central anticholinergic syndrome in the post operative period
34. HIV and anaesthesia
35. Stress management in anaesthesia practice
36. Recognition and management of anaphylaxis during general anaesthesia
37. Post-OP shivering
38. Hepatitis B and anaesthesiologist
39. Intra operative bronchospasm
40. Current concepts in cardio-pulmonary resuscitation
41. Temperature regulation in adults, Predisposing factors, diagnosis and management of malignant hyperpyrexia
42. Anaesthetic considerations in obesity
43. What are the potential causes of delayed resumption of spontaneous ventilation after abdominal surgery with general anaesthesia. Discuss the problem, its diagnosis and management
44. Discuss in brief the problems of adult patient with Downs syndrome for multiple teeth extraction
45. Preoperative preparation of a diabetic patient with history of bleeding varices lino-renal shunt operation.
46. Anaphylactic reaction on the operation table.
47. Risk factors for Venous Thrombo Emolism and classify the current method of prevention with examples.
48. What are the diagnostic features that would lead to identify Malignant Hyperthermia during (or) immediately after Anaesthesia and state the guidelines of Management?
49. Assessment of intra operative awareness
50. Define perioperative hypertension. Describe the causes and management
51. Describe in detail the occupational hazards to Anaesthesiologists
52. Modified guidelines of Cardio-pulmonary Brain Resuscitation- 2005
53. Diagnosis and management of an acute attack of Malignant Hyperthermia
54. Discuss the causes of delayed recovery from anaesthesia and the management
55. What are the causes of hypercarbia during the intraoperative period. Discuss the effects and management
56. Stress response to trauma and surgery
57. Air embolism during anaesthesia
58. Complications and sequalae of blood transfusion
59. Discuss the anaesthetic techniques and postoperative problems in an obese patient for large hernia of interior abdominal wall.
60. Complication of blood transfusion.
61. Problems of laparoscopic surgery and monitoring techniques used during the procedure
62. Discuss the aetiology and management of supra ventricular arrythmia's during surgical procedures
63. Disseminated intra-vascular coagulation
64. naesthetic problems in an anemic patient
65. Prevention and treatment of intra-operative myocardial infarction
66. Preoperative preparation and evaluation of a patient with history of exertional angina for surgery under general anesthesia
67. Describe airway management of a patient of Anyklosing spondylitis with severe restriction of neck movement posted for total hip replacement
68. Management of intra-operative bronchospasm
69. Pathophysiology of venous air embolism. Mention the methods of detection, prevention and treatment.
70. Iatrogenic complications in anaesthesia
71. Recent trends in blood transfusion and blood products
72. Somatosensory evoked potential
73. Autologous blood transfusion
74. Awareness during anaesthesia
75. Blood component therapy
76. Crystalloid and colloid
77. Safe anaesthetic procedure
78. Bronchospasm during anaesthesia and immediate post-operative period and its management
79. Autologus blood transfusion
80. Attenuation of Laryngoscopic reaction to intubation
81. Discuss the pathogenesis, clinical features and management of Mendelson's syndrome.
82. Autologous blood transfusion
83. Aetiology and management of hypotension during anaesthesia
84. Beta receptor blockade its relationship in anaesthesia
85. Post anaesthetic vomiting
86. Advanced life support
87. Management of multi focal ventricular ectopics during anaesthesia
88. Minimum patient monitoring during anaesthesia
89. Malignant hyperthermia
90. Embolisms during anaesthesia
91. .Discuss the current concepts and modified guidelines of cardiopulmonary brain resuscitation.
92. Current concepts in the diagnosis and treatment of malignant hyperthermia
93. Awareness and wakefullneSS under anaesthesia
94. APACHE score (acute Physiology and chronic health evaluation)
95. Advanced life support
96. What is myesthenia gravis? What are its clinical features? Discuss the preoperative investigations, preparation and anaesthetic management of such a case presenting for an interval appendisectomy and management of the likely complications
97. Management of multi focal ventricular ectopics during anaesthesia
98. Malignant hyperthermia
99. Embolisms during anaesthesia
100. Current concepts in the diagnosis and treatment of malignant hyperthermia
101. Autologus blood transfusion
102. Plasma proteins and anaesthesia
103. Define morbid obesity. Enumerate the changes that occur in the respiratory, cardiovascular and metabolic systems in obesity. A 40 years old patient with a height of 158 cms. And weighing 150 kgs. Is scheduled for pyelothotomy. How will you evaluate this patient preoperatively. Discuss the anaesthetic management and the expected problems in such a case
104. Supine Hypotension Syndrome
105. .Define hypertension. How will you evaluate and prepare pre-operatively a 40 year old female patient scheduled for abdominal hysterectomy. Discuss the anaesthetic and post-operative management of such a case. (
106. Management of Mendelson's syndrome
107. Perioperative blood conservation
108. Interactions of pre-existing drug therapy with the anaesthetic agents and techniques
109. Water and electrolyte disturbances and their pre-anaesthestic correction in small gut obstruction.
110. Oxygen therapy
111. Oxygen therapy in post operative period
112. Uses, advantages and disadvantages of plasma expanders
113. Hypotension during anaesthesia
114. .Discuss anatomy of the diaphragm with a diagram. How does it behave under different stages of anaesthesia?
115. Spinal opiate receptors
116. Neuro-muscular transmission

DNB ANAESTHESIOLOGY PREVIOUS QUESTIONS JUNE 2010

1.Describe the  PEA algorithm.

2.Anaesthetic management of a case of esophagogastrectomy

3.Anaesthetic management of congenital diaphragmatic hernia in a newborn.

4.Enteral nutrition advantages over parenteral nutrition, and complications.

5.The role of anaesthesiologist in HELLP syndrome.

6.Simulators in anaesthesia

7.Intra operative considerations in an obese patient  posted for bariatric surgery.

8.Newer trends and concepts in pre-emptive analgesia

9.Methods to prevent allogenic transfusion

10.Anaesthetic management of a pregnant patient for appendicectomy.

11.Nitric oxide

12.Enumerate the differences between acute and chronic pain.How you give post operative analgesia for abdominal surgery.

13.Dexmeditomedine

14.short notes on    a) I-GEL
                                b) BIS

15.Describe the technique of peribulbar block.Enumerate the complications.

16.Uses of ultrasound in anaesthesia

17.Local anaesthesia toxicity management. Role of intra lipids.

18.What are the criteria for brain death. Discuss role of anaesthetist in multiple organ harvesting.

19. What is triage? what are the different methods employed? discuss.

20.CPCR 2005 changes.

21.Describe the technique and advantages of percutaneous tracheostomy.

22. Blood products.. uses..

23. AHA guidelines for non cardiac surgery.

24.Describe the anatomy of brachial plexus with the help of diagram.Describe any one technique for block.

25.With the help of diagram  classify the breathing circuits.Describe Bain's circuit.

26.What are the safety features on modern anaesthesia machines?

27.Describe the cerebral circulation and factors affecting it?

28. Describe the criteris used for weaning from ventilator. Describe RSBI.

29.Causes and management of hypokalemia

30.Mendelsons aspiration syndrome.

31.Informed consent

32. Bed side pulmonary function evaluation

33.Management of a case acute anaphylaxis

34.With the help of diagrams describe the patterns of neuromuscular blockade.

35. Describe the causes and management of intraop desaturation.

DNB ANAESTHESIA PREVIOUS YEAR WISE QUESTIONS

RECENT YEAR QUESTIONS 2005-2014 ARE AVAILABLE HERE IN THIS BLOG..GO TO THE HOME PAGE OF THIS BLOG..YEAR WISE QUESTIONS FROM 1996-2000 AND FROM 2001 TO 2006  CAN BE SEEN AT http://dnbanesthesiology.blogspot.com/

DETAILED TOPIC NOTES ARE AVAILABLE IN
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