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.
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%.
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.
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
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
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
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)
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)
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
