Wednesday, July 17, 2024

Indian Journal of Anaesthesia (IJA) WEEKLY QUIZ #23

 

Indian Journal of Anaesthesia (IJA)
WEEKLY QUIZ  #23

IJA Quiz Masters - 

Dr. Muralidhar Thondebhavi S, Dr. Manshad Showkath, Dr. Shilpa GK Bhat, Dr. Bhavna Gupta, Dr. Tushar Chokshi
 
Dr. Rakesh Garg
Editor-in-Chief
Indian Journal of Anaesthesia

 

Q1 Which statement is true regarding the use of the erector spinae plane block (ESPB) in shoulder surgeries compared to the interscalene block based on recent studies and findings?

A. ESPB is primarily used to block the C5–C6 nerve roots directly.

B. ESPB has a higher incidence of phrenic nerve palsy compared to the interscalene block.

C. ESPB provides equivocal analgesia to the interscalene block with fewer adverse effects.

D. The local anaesthetic spread in ESPB can be easily appreciated without the need for imaging or dye studies.

Answer: C

Explanation:

  • Option A: Incorrect. ESPB is not primarily used to block the C5–C6 nerve roots directly. The shoulder is innervated by these roots, and blocking them would provide analgesia, but ESPB is noted for its effectiveness in shoulder surgeries and partial phrenic nerve sparing.
  • Option B: Incorrect. ESPB is associated with fewer adverse effects, including a lower incidence of phrenic nerve palsy, compared to the interscalene block.
  • Option C: Correct. Studies have shown that ESPB can provide analgesia equivalent to the interscalene block with fewer adverse effects such as hoarseness of voice, Horner’s syndrome, and difficulty in breathing.
  • Option D: Incorrect. The spread of local anaesthetic in the ESPB cannot be easily appreciated without imaging or dye studies, as noted in the provided material.

https://journals.lww.com/ijaweb/fulltext/2024/06000/postoperative_analgesic_efficacy_of.13.aspx

Kulkarni, Maitreyi; D’souza, Nita J1; Diwan, Sandeep2. Postoperative analgesic efficacy of ultrasound-guided, low-volume C5–6 root block in combination with erector spinae plane block in complex shoulder surgeries. Indian Journal of Anaesthesia 68(6):p 583-584, June 2024. | DOI: 10.4103/ija.ija_1193_23

 

Q2 Which of the following statements is true regarding the perioperative anaesthetic management of a patient with Hajdu Cheney syndrome (HCS) undergoing scoliosis correction surgery?

A. A standard Macintosh laryngoscope is preferred for intubation due to better visualization in patients with HCS.

B. High tidal volumes are recommended to manage the restrictive lung disease typically seen in HCS patients.

C. Patients with HCS often require larger-sized endotracheal tubes due to their craniofacial abnormalities.

D. A video laryngoscope or fibreoptic scope should be used for tracheal intubation due to airway management challenges associated with HCS.

Answer: D

Explanation:

  • Option A: Incorrect. A video laryngoscope or fibreoptic scope is preferred for intubation in HCS patients due to the airway management challenges posed by their craniofacial abnormalities.
  • Option B: Incorrect. A lung protective ventilation strategy with low tidal volumes is recommended for managing the restrictive lung disease in HCS patients.
  • Option C: Incorrect. Smaller-sized endotracheal tubes are often required due to the craniofacial abnormalities associated with HCS.
  • Option D: Correct. Due to the significant airway management challenges in HCS patients, such as micrognathia and cervical instability, a video laryngoscope or fibreoptic scope should be used for tracheal intubation.

https://journals.lww.com/ijaweb/fulltext/2024/06000/anaesthesia_for_a_patient_of_hajdu_cheney_syndrome.14.aspx

Chaturvedi, Apoorv; Subramaniam, Rajeshwari1; Pandey, Ravindra2; Naskar, Sreyashi3. Anaesthesia for a patient of Hajdu Cheney syndrome scheduled for scoliosis surgery-A case study. Indian Journal of Anaesthesia 68(6):p 585-586, June 2024. | DOI: 10.4103/ija.ija_5_24

 

Q3 Which of the following findings was derived from the bibliometric analysis of optic nerve sheath diameter (ONSD) monitoring research using VOSviewer?

A. The co-occurrence of keywords showed that 'Traumatic brain injury' was the least frequently occurring keyword.

B. The overlay visualisation analysis revealed that most publications on ONSD monitoring originated before 2014.

C. The cluster density visualisation indicated eight distinct clusters related to ONSD research.

D. The sensitivity and specificity of ultrasonography-assessed ONSD for detecting increased ICP were found to be 90% and 92%, respectively.

Answer: C

Explanation:

  • Option A: Incorrect. 'Traumatic brain injury' was one of the top 10 keywords identified in relation to the author keyword ‘optic nerve sheath diameter’.
  • Option B: Incorrect. The overlay visualisation analysis depicted the co-occurred keywords for the last ten years (2014–2023), during which most of the publications in this field originated.
  • Option C: Correct. The co-occurrence of keywords among the eight clusters using the VOSviewer was identified, indicating eight distinct clusters related to ONSD research.
  • Option D: Incorrect. The sensitivity and specificity of ultrasonography-assessed ONSD for detecting increased ICP were found to be 85% and 88%, respectively, not 90% and 92%.

https://journals.lww.com/ijaweb/fulltext/2024/06000/research_trends_in_optic_nerve_sheath_diameter.12.aspx

Magoon, Rohan; Jose, Jes1; Suresh, Varun2. Research trends in optic nerve sheath diameter monitoring – A bibliometric study. Indian Journal of Anaesthesia 68(6):p 579-582, June 2024. | DOI: 10.4103/ija.ija_205_24

 

Q4 Which of the following statements about the validation of the Hindi version of the QoR-40 questionnaire is incorrect?

A. The correlation coefficient for test-retest reliability on the third postoperative day (POD3) was 0.21.

B. Cronbach's alpha for the internal consistency of the questionnaire was found to be 0.82.

C. The correlation between the QoR-40 score on POD3 and the length of hospital stay was 0.67.

D. The questionnaire demonstrated content validity, with 90% of respondents finding it easy to understand.

Answer: C

Explanation:

  • Option A: Correct. The correlation coefficient for test-retest reliability on POD3 was indeed 0.21.
  • Option B: Correct. Cronbach's alpha for the internal consistency of the questionnaire was found to be 0.82.
  • Option C: Incorrect. The correlation between the QoR-40 score on POD3 and the length of hospital stay was -0.67, indicating a negative correlation, not a positive one.
  • Option D: Correct. The questionnaire demonstrated content validity, with 90% of respondents finding it easy to understand.

https://journals.lww.com/ijaweb/fulltext/2024/06000/hindi_translation_and_cultural_adaptation_of_the.5.aspx

Govil, Nishith; Rathore, Rishika; Tiwari, Ajeet1; Garg, Pankaj K.1; Parag, Kumar; Mishra, Priyanka. Hindi translation and cultural adaptation of the quality of recovery score-40 (QoR-40 score): A validation study. Indian Journal of Anaesthesia 68(6):p 533-539, June 2024. | DOI: 10.4103/ija.ija_1100_23

 

Q. 5 Which of the following statements is NOT true according to the study ‘ To compare the efficacy of the between-the-fingers grip with the conventional pen-holding grip to hold an endotracheal tube for orotracheal intubation’

 

A) Between-the-fingers grip proved to be an equally good method  as compared to the standard method of holding tube for intubation.

B) Provides better control and alignment than fixed curvature in the conventional method.

C) The modified grip allows the operator to change the curvature of the ETT as it nears the glottic opening

D) external assistance in the form of BURP is always required.

Ans : D

https://journals.lww.com/ijaweb/fulltext/2024/06000/to_compare_the_efficacy_of_the_between_the_fingers.4.aspx

Thakur, Soumya; Tewari, Prabhat; Shamshery, Chetna; Mishra, Prabhakar1. To compare the efficacy of the between-the-fingers grip with the conventional pen-holding grip to hold an endotracheal tube for orotracheal intubation: A randomised controlled trial. Indian Journal of Anaesthesia 68(6):p 527-532, June 2024. | DOI: 10.4103/ija.ija_1079_23

 

Q 6. Which intravenous fluid is commonly favored in the management of traumatic brain injury (TBI) patients due to its lower risk of hyperchloremic metabolic acidosis and acute kidney injury (AKI) when infused in larger volumes?

 

A) 0.9% normal saline (NS)

B) 5% dextrose in water (D5W)

C) Lactated Ringer's (LR) solution

D) Plasmalyte

 

Ans : D

https://journals.lww.com/ijaweb/fulltext/2024/06000/comparison_of_the_efficacy_of_0_9__normal_saline.8.aspx

Sakkanan, Naveen Vivek1; Swaminathan, Srinivasan1; Bidkar, Prasanna Udupi1; Vairappan, Balasubramaniyan2; Sathiaprabhu, A3; Dey, Ankita4. Comparison of the efficacy of 0.9% normal saline with balanced crystalloid (Plasmalyte) in maintaining the metabolic profile in head injury patients undergoing evacuation of acute subdural haematoma – A randomised controlled trial. Indian Journal of Anaesthesia 68(6):p 553-559, June 2024. | DOI: 10.4103/ija.ija_1160_23

 

Q7. Which of the following statements regarding Postoperative adverse events is NOT true?

 

A)   postoperative adverse events accounts to approximately 7.7% of global deaths annually.

B)   three leading causes are major bleeding, myocardial injury after noncardiac surgery (MINS) and sepsis.

C)   About half of all adverse postoperative events in hospitalised patients occur in hospital wards

D)   A delay of 30 mins in recognising deterioration increases the risk of adverse outcomes.


Ans : D

https://journals.lww.com/ijaweb/fulltext/2024/06000/comparison_of_the_efficacy_of_0_9__normal_saline.8.aspx

Sakkanan, Naveen Vivek1; Swaminathan, Srinivasan1; Bidkar, Prasanna Udupi1; Vairappan, Balasubramaniyan2; Sathiaprabhu, A3; Dey, Ankita4. Comparison of the efficacy of 0.9% normal saline with balanced crystalloid (Plasmalyte) in maintaining the metabolic profile in head injury patients undergoing evacuation of acute subdural haematoma – A randomised controlled trial. Indian Journal of Anaesthesia 68(6):p 553-559, June 2024. | DOI: 10.4103/ija.ija_1160_23

 

Q. 8 What does a Brain Relaxation Score (BRS) of 3 indicate?

 

A) Perfectly Relaxed brain

B) Satisfactorily relaxed brain

C) Firm brain

D) Bulging brain

 

Ans : C)

 

https://journals.lww.com/ijaweb/fulltext/2024/06000/comparison_of_the_efficacy_of_0_9__normal_saline.8.aspx

Sakkanan, Naveen Vivek1; Swaminathan, Srinivasan1; Bidkar, Prasanna Udupi1; Vairappan, Balasubramaniyan2; Sathiaprabhu, A3; Dey, Ankita4. Comparison of the efficacy of 0.9% normal saline with balanced crystalloid (Plasmalyte) in maintaining the metabolic profile in head injury patients undergoing evacuation of acute subdural haematoma – A randomised controlled trial. Indian Journal of Anaesthesia 68(6):p 553-559, June 2024. | DOI: 10.4103/ija.ija_1160_23

 

 

 

Q.9  Tissue inhibitor of Metalloproteinases - 2 has been demonstrated to have a sensitivity of ------ % for predicting AKI beyond a threshold value of 0.3 (ng/ml)2/1000 and a specificity approaching -----% for a threshold value ≥2 (ng/ml)2/1000. 

 

A)    89 and 95

B)    85 and 99

C)     95 and 89

D)    99 and 85

 

Ans : A

 

https://journals.lww.com/ijaweb/fulltext/2024/06000/incidence_of_acute_kidney_injury_and_its.11.aspx

 

Parab, Swapnil Y.; Majety, Sarat Chandra; Ranganathan, Priya; Jiwnani, Sabita1; Pramesh, CS1; Shetmahajan, Madhavi. Incidence of acute kidney injury and its associated risk factors in patients undergoing elective oesophagectomy surgeries at a tertiary care cancer institute – A pilot prospective observational study. Indian Journal of Anaesthesia 68(6):p 572-578, June 2024. | DOI: 10.4103/ija.ija_98_24

 

 

Q 10. Who drafted the Original Quality of Recovery - 40 Score ( QoR-40) ?

 

A) Cornback

B) Likert

C) Myles

D) Bartlett

 

Ans : C)

 

https://journals.lww.com/ijaweb/fulltext/2024/06000/hindi_translation_and_cultural_adaptation_of_the.5.aspx

Govil, Nishith; Rathore, Rishika; Tiwari, Ajeet1; Garg, Pankaj K.1; Parag, Kumar; Mishra, Priyanka. Hindi translation and cultural adaptation of the quality of recovery score-40 (QoR-40 score): A validation study. Indian Journal of Anaesthesia 68(6):p 533-539, June 2024. | DOI: 10.4103/ija.ija_1100_23

 

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