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Sample Questions from RxPG DNB January 2004 Book

Author: RxPG DNB, Posted on Wednesday, February 11 @ 21:42:24 IST by RxPG  

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DNB Part 1

1) Topic: anaesthesia

Which of the following is seen in raised intra cranial tension:
a)hypotension
b)bradycardia
c)tachycardia
d)tachypnoea


reference: Lee 12th edition pg 442
quality: spotter

discussion:
Raised ICP causes headache, vomiting, papilloedema, drowsiness, bradycardia & hypertension.
Neurogenic pulmonary edema may occur.

explanation:
a)hypotension : Due to Cushing’s reflex, there is hypertension;wrong choice!
b)bradycardia : due to compression of the vasomotor center in medulla,we get bradycardia in raised ICT;correct option.
c)tachycardia : not seen; wrong option.
d)tachypnoea : again there is depression of respiration in raised ICP;

correct choice: (b) bradycardia

2)topic:anaesthesia
Blood transfusion reaction in a patient under general anesthesia is charcterised by all except:

a)severe hypotension
b)tachycardia
c)increased oozing from the wound
d)increased cyanosis



reference:Lee’s 12th edition pg 30
quality:spotter

discussion:
signs of incompatible transfusion in a patient under anesthesia are :

1)immediate rapid severe & progressive hypotension
2)tachycardia
3)oozing from wound
4)urticarial rash
5)bronchospasm,raising airway pressures on IPPV.
6)later,jaundice & oliguria in 5-10% of these patients.

This strongly resembles anaphylactic reactions.

correct choice: (d) increased cyanosis

3)topic:anaesthesia
The local anesthetic associated with vasoconstriction & mydriasis :

a)lignocaine
b)procaine
c)cocaine
d)bupivacaine


reference:Lee’s synopsis 12th edition pg :592
quality:spotter

discussion:
cardiovascular effects of cocaine:
· small doses increase pulse rate,raises blood pressure
· potentiate the effects of adrenaline on capillaries.
· cutaneous vasoconstriction prevents heat loss.
· hypertension & vasospasm may lead to vascular accidents.

effects on eye:
· mydriasis due to sympathetic stimulation.
· blanching of conjunctiva from vasocnstriction
· clouding of corneal epithelium.
· ulceration of cornea,together with excellent analgesia


correct choice: (c) cocaine



4)topic:anatomy
Pes anserinus is related to :

a) cervical sympathetic trunk
b) facial nerve
c) trigeminal nerve
d) chorda tympani



reference:keith l.moore 3rd edition,pg 482
quality:spotter

discussion:
Pes anserinus(feet of a goose) is referred to the terminal branching pattern of the facial nerve in the substance of the parotid gland,forming a surgical plane (FACIO VENOUS PLANE OF PATEY),dividing the parotid into a superficial and a deep lobe.
explanation:
1) cervical sympathetic trunk : is known as ansa cervicalis.
2) facial nerve : correct choice;explained above.
3) trigeminal nerve :wrong option
4) chorda tympani : it’s a branch of facial nerve,which is secretomotor to the submandibular and sublingual glands;and also carries taste sensation from anterior 2/3rd of the tongue.not related to pes anserinus.

correct choice:(b) facial nerve




5)topic:anatomy
Not attached to mastoid process is :

a)splenius capitis
b)temporalis
c)sternocleidomastoid
d)longissimus capitis


reference:osteology by poddar,pg 52
quality:spotter

discussion:
The mastoid is divided into following parts for convenience :

I)External surface: It gives insertion to Sternocleidomastoid,Splenius capitis and longissimus capitis muscles.

II)Mastoid Notch : a deep notch which lies on the medial aspect of the process;the notch and the part below it gives origin to the Posterior belly of diagastric muscle.

III)Occipital groove: a shallow groove below the notch;lodges the occipital artery.

correct choice:(b) temporalis




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