Elsevier Anesthesia Exam Study Guide
2025/2026 – Complete Questions with Correct
Answers, Explanations, and Key Concepts.
1. Train of four fade is characteristic feature of:
A. Non depolarizing block
B. Depolarizing block
C. Malignant hyperthermia
D. Both depolarizing and non-depolarizing block
A. Non depolarizing block
2. Not True regarding sevoflurane:
a. MAC is higher than isoflurane
b. Blood gas coefficient is higher than desflurane
c. Potency more than isoflurane
d. Sevoflurane is less cardio depressant than isoflurane
c. Potency more than isoflurane
Minimum alveolar concentration (MAC):
This is a measure of potency. It is defined as "at steady-state, the minimum alveolar
concentration of the volatile anaesthetic that prevents reaction to standard surgical stimuli (skin
incision) in 50 per cent of subjects at sea level (1 atm).
According to MAC value:
Desflurane> Sevoflurane > Enflurane > Isoflurane > Halothane
That is Halothane is the most potent. and Desflurane is the least potent.
According to the B/G coefficient
Desflurane < Sevoflurane < Isoflurane < Enflurane < Halothane.
3. Which of the following statements about propofol is not true:
A. Commercial preparations contains egg
,B. It is suitable agent for day care surgery
C. It is contraindicated in porphyria
D. It does not trigger malignant hyperthermia
C. It is contraindicated in porphyria
AIIMS MAY 2008
4. Order of sensitivity of nerve fibres to local anaesthetic in decreasing order -
A. Preganglionic sympathetic (B), pain (C and A-delta), sensory, motor
B. Pain (C and A-delta), Preganglionic sympathetic (B), motor
C. Preganglionic sympathetic (B), sensory, motor, pain (C and A-delta)
D. Pain (C and A-delta), sensory, motor
A. Preganglionic sympathetic (B), pain (C and A-delta), sensory, motor.
∙∙ In functional terms, it is autonomic (mediated by C and B fibers) → Sensory ( mediated by C
and A-delta fibers) → Motor ( A-alpha fibers).
This is the old concept:
NEWER CONCEPT:
∙ Sensitivity to Local Anaesthetic : A gamma & A delta > A alpha & A beta > B > C
Miller's Anaesthesia.
"Different fiber types are differentially sensitive to local anesthetic blockade.
In vivo experiments in which continuous superperfusion of peripheral nerve allows equilibration
with drug and experiments in which a drug bolus is delivered by percutaneous injection,
analogous to clinical peripheral nerve block, show unequivocally that small myelinated axons
(Aγ motor and Aδ sensory fibers) are the most susceptible to impulse annihilation. Next in order
of block are the large myelinated (Aα and Aβ) fibers, and the least susceptible are the small,
nonmyelinated C fibers.
,In fact, in this last group, impulses in the slowest conducting population (conduction velocity of
0.5 to 0.8 msec) are the most resistant to local anesthetic.
5. All are safety features in anaesthesia machine except:
a. Each gas is housed in an independent color coded, pin specific module
b. Medium priority alarm shall be activated within 5 sec when the oxygen pressure decreases
below a manufacturer- specific threshold pressure.
c. Agent specific filling devices help to prevent filling vaporizer with the wrong agent
d. The oxygen flowmeter's output changes accordingly when the supply pressure exceeds above
the threshold valve.
e. The oxygen flowmeter's output changes accordingly above the threshold valve.
d. The oxygen flowmeter's output changes accordingly when the supply pressure exceeds above
the threshold valve.
ALL INDIA 2007
6. Which one of the following is not an amide linked local anaesthetic:
A. Procaine
B. Lignocaine
C. Dibucaine
D. Bupivacaine
A. Procaine
Shortest acting--Chlorprocaine
7. A young boy undergoes eye surgery under day case anesthesia with succinyl choline and
propofol and after 8 hours he starts walking and develops muscle pain.What is the likely cause?
A. Due to the effects of eye surgery
B. Early mobilization
C. Propofol
D. Succinyl choline
D. Succinyl choline
, Drugs metabolised by pseudocholinesterase
1. Suxamethonium
2. Mivacurium
3. Atracurium
4. Propanidid
5. Procaine
6. Chloroprocaine
7. Amethocaine.
8. An elderly male on ventilator has received atracurium infusion for 3 days.He now develops
epileptic fits.Probable cause for his epilepsy is:
A. Accumulation of Atracurium
B. Allergy to drug
C. Ventilator failure
D. Accumulation of Laudanosine
D. Accumulation of Laudanosine
9. Which of the following opioids is not given intrathecally:
A. Sufentanil
B. Fentanyl
C. Remifentanil
D. Morphine
C. Remifentanil
Remifentanil
1. A recent synthetic opioid with strong affinity to mu opioid receptors
2. Metabolised by esterases in blood and other tissues
3. Antagonised by naloxone
4. It has rapid onset of action, a small volume of distribution and clearance and terminal half
life 8 to 20 min
5. It is 10 to 20 times more potent than alfentanil
6. Little change of blood pressure
7. It can cause muscle rigidity (wood chest syndrome)
10. Centrineuraxial (spinal and epidural) anaesthesia is not contraindicated in-
A. Patient on aspirin
2025/2026 – Complete Questions with Correct
Answers, Explanations, and Key Concepts.
1. Train of four fade is characteristic feature of:
A. Non depolarizing block
B. Depolarizing block
C. Malignant hyperthermia
D. Both depolarizing and non-depolarizing block
A. Non depolarizing block
2. Not True regarding sevoflurane:
a. MAC is higher than isoflurane
b. Blood gas coefficient is higher than desflurane
c. Potency more than isoflurane
d. Sevoflurane is less cardio depressant than isoflurane
c. Potency more than isoflurane
Minimum alveolar concentration (MAC):
This is a measure of potency. It is defined as "at steady-state, the minimum alveolar
concentration of the volatile anaesthetic that prevents reaction to standard surgical stimuli (skin
incision) in 50 per cent of subjects at sea level (1 atm).
According to MAC value:
Desflurane> Sevoflurane > Enflurane > Isoflurane > Halothane
That is Halothane is the most potent. and Desflurane is the least potent.
According to the B/G coefficient
Desflurane < Sevoflurane < Isoflurane < Enflurane < Halothane.
3. Which of the following statements about propofol is not true:
A. Commercial preparations contains egg
,B. It is suitable agent for day care surgery
C. It is contraindicated in porphyria
D. It does not trigger malignant hyperthermia
C. It is contraindicated in porphyria
AIIMS MAY 2008
4. Order of sensitivity of nerve fibres to local anaesthetic in decreasing order -
A. Preganglionic sympathetic (B), pain (C and A-delta), sensory, motor
B. Pain (C and A-delta), Preganglionic sympathetic (B), motor
C. Preganglionic sympathetic (B), sensory, motor, pain (C and A-delta)
D. Pain (C and A-delta), sensory, motor
A. Preganglionic sympathetic (B), pain (C and A-delta), sensory, motor.
∙∙ In functional terms, it is autonomic (mediated by C and B fibers) → Sensory ( mediated by C
and A-delta fibers) → Motor ( A-alpha fibers).
This is the old concept:
NEWER CONCEPT:
∙ Sensitivity to Local Anaesthetic : A gamma & A delta > A alpha & A beta > B > C
Miller's Anaesthesia.
"Different fiber types are differentially sensitive to local anesthetic blockade.
In vivo experiments in which continuous superperfusion of peripheral nerve allows equilibration
with drug and experiments in which a drug bolus is delivered by percutaneous injection,
analogous to clinical peripheral nerve block, show unequivocally that small myelinated axons
(Aγ motor and Aδ sensory fibers) are the most susceptible to impulse annihilation. Next in order
of block are the large myelinated (Aα and Aβ) fibers, and the least susceptible are the small,
nonmyelinated C fibers.
,In fact, in this last group, impulses in the slowest conducting population (conduction velocity of
0.5 to 0.8 msec) are the most resistant to local anesthetic.
5. All are safety features in anaesthesia machine except:
a. Each gas is housed in an independent color coded, pin specific module
b. Medium priority alarm shall be activated within 5 sec when the oxygen pressure decreases
below a manufacturer- specific threshold pressure.
c. Agent specific filling devices help to prevent filling vaporizer with the wrong agent
d. The oxygen flowmeter's output changes accordingly when the supply pressure exceeds above
the threshold valve.
e. The oxygen flowmeter's output changes accordingly above the threshold valve.
d. The oxygen flowmeter's output changes accordingly when the supply pressure exceeds above
the threshold valve.
ALL INDIA 2007
6. Which one of the following is not an amide linked local anaesthetic:
A. Procaine
B. Lignocaine
C. Dibucaine
D. Bupivacaine
A. Procaine
Shortest acting--Chlorprocaine
7. A young boy undergoes eye surgery under day case anesthesia with succinyl choline and
propofol and after 8 hours he starts walking and develops muscle pain.What is the likely cause?
A. Due to the effects of eye surgery
B. Early mobilization
C. Propofol
D. Succinyl choline
D. Succinyl choline
, Drugs metabolised by pseudocholinesterase
1. Suxamethonium
2. Mivacurium
3. Atracurium
4. Propanidid
5. Procaine
6. Chloroprocaine
7. Amethocaine.
8. An elderly male on ventilator has received atracurium infusion for 3 days.He now develops
epileptic fits.Probable cause for his epilepsy is:
A. Accumulation of Atracurium
B. Allergy to drug
C. Ventilator failure
D. Accumulation of Laudanosine
D. Accumulation of Laudanosine
9. Which of the following opioids is not given intrathecally:
A. Sufentanil
B. Fentanyl
C. Remifentanil
D. Morphine
C. Remifentanil
Remifentanil
1. A recent synthetic opioid with strong affinity to mu opioid receptors
2. Metabolised by esterases in blood and other tissues
3. Antagonised by naloxone
4. It has rapid onset of action, a small volume of distribution and clearance and terminal half
life 8 to 20 min
5. It is 10 to 20 times more potent than alfentanil
6. Little change of blood pressure
7. It can cause muscle rigidity (wood chest syndrome)
10. Centrineuraxial (spinal and epidural) anaesthesia is not contraindicated in-
A. Patient on aspirin
