DNB

ANESTHESIA
2019

AR
AK
THEORY
IW
D
L
U
SH
AN
R
D
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-I
TIME: 3 HOURS
ANS/J/19/01/I
MAX. MARKS: 100
IMPORTANT INSTRUCTIONS

 This question paper consists of 10 questions divided into Part “A” and part “B”, each part
containing 5 questions.
 Answers to questions of part A and part B are to be strictly attempted in separate answer sheet(s)
and the main + supplementary answer sheet(s) used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheet(s) of part B or Vice versa shall not be
evaluated.

AR
 Answer sheets of Part A and Part B are not to be tagged together.
 Part A and Part B should be mentioned only on the covering page of the respective answer sheets.
 Attempt all questions in order.
 Each question carries 10 marks.


AK
Read the question carefully and answer to the point neatly and legibly.
 Do not leave any blank pages between two answers.
 Indicate the question number correctly for the answer in the margin space.
 Answer all the parts of a single question together.
 Start the answer to a question on a fresh page or leave adequate space between two answers.

IW
Draw table/diagrams/flowcharts wherever appropriate.

Write Short notes on:

D
PART A

1. a) Anatomy of brachial plexus with diagram. 4+2+4

L

b) What are the different approaches for giving brachial

plexus block?
U

c) Approach of brachial plexus block for a patient listed for

shoulder surgery.
SH

2. a) Describe oxygen dissociation curve. Draw a neat 4+6

diagram.
b) Factors affecting oxygen dissociation curve.
AN

3. Various techniques to monitor use of neuromuscular blocking 10

agents during anaesthesia.

4. a) Nerve supply of foot with diagram. 5+5

R

b) Technique of ankle block.

D

5. a) Factors determining intracranial pressure (ICP). 4+6

b) Preoperative preparation and anesthetic management of
a patient of extradural haematoma with raised ICP for
emergency craniotomy.

P.T.O

-1-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION
HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-I

Please read carefully the important instructions mentioned on Page ‘1’

 Answers to questions of Part A and part B are to be strictly attempted in separate answer sheets and the
main + supplementary answer sheets used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheets of Part B or vice versa shall not be evaluated.

PART B

6. a) Classify intravenous anaesthetic agents. 3+7

AR
b) Compare Thiopentone sodium and Propofol in tabular
form.

AK
7. a) Anatomy of coronary circulation with diagram. 4+6
b) Factors determining oxygen demand and supply of
myocardium in a patient of coronary artery disease
scheduled for laparotomy.

8. a) What are the coaxial breathing circuits?

b) Functional analysis of Bain’s Circuit.
IW 4+6
D
9. a) Students ‘t’ test. 5+5
b) Calculation of sample size for research study.
L

10. a) Informed consent. 5+5

U

b) How will you counsel the father of a brain dead patient

lying in an ICU for organ donation?
SH

************
AN
R
D

-2-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION
HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019
ANAESTHESIOLOGY
PAPER-II
ANS/J/19/01/II
Time: 3 hours
Max. Marks:100

IMPORTANT INSTRUCTIONS
 This question paper consists of 10 questions divided into Part “A” and part “B”, each part containing 5
questions.
 Answers to questions of part A and part B are to be strictly attempted in separate answer sheet(s) and
the main + supplementary answer sheet(s) used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheet(s) of part B or Vice versa shall not be
evaluated.
 Answer sheets of Part A and Part B are not to be tagged together.

AR
 Part A and Part B should be mentioned only on the covering page of the respective answer sheets.
 Attempt all questions in order.
 Each question carries 10 marks.
 Read the question carefully and answer to the point neatly and legibly.
 Do not leave any blank pages between two answers.

AK
 Indicate the question number correctly for the answer in the margin space.
 Answer all the parts of a single question together.
 Start the answer to a question on a fresh page or leave adequate space between two answers.
 Draw table/diagrams/flowcharts wherever appropriate.

Write short notes on:

PART A
IW
D
1. a) Define and classify chronic kidney disease (CKD). 4+6
b) Anaesthetic management of a 30-year-old male CKD
L

patient for intertrochanteric fracture femur.

U

2. a) What is oculocardiac reflex? 3+7

SH

b) Pre-operative preparation and management of a 6-year-

old female patient for strabismus surgery.

3. What is HELLP (Hemolysis Elevated Liver Enzymes Low 5+5

AN

Platelets) syndrome? How will you manage a 36 weeks

parturient with HELLP syndrome for emergency caesarean
section?

4. a) Various classification of anaesthetic vaporizers. 5+5

R

b) Functioning of Desflurane vaporizer.

D

5. Describe pulmonary function tests in a patient of Chronic 5+5

Obstructive Pulmonary Disease (COPD). How will you
manage postoperative pain in a 65-year-old male patient of
COPD operated for right inguinal hernia repair?

P.T.O

1
- -
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-II

Please read carefully the important instructions mentioned on Page ‘1’

 Answers to questions of Part A and part B are to be strictly attempted in separate answer sheets and the main +
supplementary answer sheets used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheets of Part B or vice versa shall not be evaluated.

PART B

6. A 50-year-old diabetic female patient is posted for nail bed 2+2+6

abscess drainage on day care basis.

AR
a) How will you investigate and prepare her
preoperatively?
b) What is your plan of anaesthesia?

AK
c) What are the discharge criteria for day care patients?

7. Discuss haemodynamic changes occurring during 4+6

laparoscopic surgery. How will you plan and manage

IW
anaesthesia for a 53-year-old female patient posted for
total laparoscopic hysterectomy?
D
8. a) Write differences between thermoregulation in adult 5+5
and pediatric patient.
b) Describe different methods for maintenance of body
L

temperature during anaesthesia.

U

9. Discuss preoperative optimization and anaesthesia 10

management in a 70-year-old male patient with permanent
SH

pacemaker posted for total knee replacement surgery.

10. Describe liver function tests with interpretation for 5+5

AN

diagnosis of hepatobiliary disorders. Discuss anaesthetic

goals in a patient with obstructive jaundice.

************
R
D

- - 2
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019
ANAESTHESIOLOGY
PAPER-III
ANS/J/19/01/III
Time: 3 hours
Max. Marks:100

IMPORTANT INSTRUCTIONS
 This question paper consists of 10 questions divided into Part “A” and part “B”, each part containing 5
questions.
 Answers to questions of part A and part B are to be strictly attempted in separate answer sheet(s) and
the main + supplementary answer sheet(s) used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheet(s) of part B or Vice versa shall not be
evaluated.


AR
Answer sheets of Part A and Part B are not to be tagged together.
 Part A and Part B should be mentioned only on the covering page of the respective answer sheets.
 Attempt all questions in order.
 Each question carries 10 marks.
 Read the question carefully and answer to the point neatly and legibly.

AK
 Do not leave any blank pages between two answers.
 Indicate the question number correctly for the answer in the margin space.
 Answer all the parts of a single question together.
 Start the answer to a question on a fresh page or leave adequate space between two answers.

IW
Draw table/diagrams/flowcharts wherever appropriate.

Write Short notes on:

PART A
D
1. A 24-year-old primigravida having mitral stenosis is 10
L

admitted with 35 weeks of pregnancy. She is planned for

elective caesarean delivery. Discuss her anaesthetic
U

management and post-operative pain relief.

SH

2. Describe the challenges in non-operative room anaesthesia 10

(NORA).
AN

3. Write preoperative evaluation and optimization of a 30-year- 5+5

old male patient of pheochromocytoma. Discuss
anaesthetic goals and challenges for robotic assisted
excision of pheochromocytoma.
R

4. a) What is drug induced sleep endoscopy (DISE)? 2+5+3

b) Write evaluation of a patient before DISE.
D

c) Which are the drugs used for DISE?

5. a) Sugammadex 5+5
b) Fink effect

P.T.O.

1
- -
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-III

Please read carefully the important instructions mentioned on Page ‘1’

 Answers to questions of Part A and part B are to be strictly attempted in separate answer sheets and the main +
supplementary answer sheets used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheets of Part B or vice versa shall not be evaluated.

PART B

6. A 77-year-old male patient of benign prostatic hypertrophy 10

AR
is posted for Trans urethral resection of prostate (TURP).
Write preoperative evaluation and anaesthesia
management for TURP.

AK
7. a) Alpha agonists. 5+5
b) Baska mask.

8. How will you evaluate and manage one-year-old child with 7+3

IW
cleft palate listed for palatoplasty? Write postoperative
pain management.
D
9. An 18-year-old female patient with 40% flame burns is 4+6
brought to the emergency medicine department.
a) How will you manage her airway?
L

b) Write your plan of anaesthesia management for

U

debridement of burns tissue after 3 days of admission.

SH

10. Discuss anaesthetic management of a 40-year-old male 10

listed for posterior fossa craniotomy for excision of a brain
tumour in sitting position.
AN

************
R
D

- - 2
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-IV

TIME: 3 HOURS ANS/J/19/01/IV

MAX. MARKS: 100
IMPORTANT INSTRUCTIONS

 This question paper consists of 10 questions divided into Part “A” and part “B”, each part
containing 5 questions.
 Answers to questions of part A and part B are to be strictly attempted in separate answer sheet(s)
and the main + supplementary answer sheet(s) used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheet(s) of part B or Vice versa shall not be
evaluated.

AR
 Answer sheets of Part A and Part B are not to be tagged together.
 Part A and Part B should be mentioned only on the covering page of the respective answer sheets.
 Attempt all questions in order.
 Each question carries 10 marks.


AK
Read the question carefully and answer to the point neatly and legibly.
 Do not leave any blank pages between two answers.
 Indicate the question number correctly for the answer in the margin space.
 Answer all the parts of a single question together.
 Start the answer to a question on a fresh page or leave adequate space between two answers.

IW
Draw table/diagrams/flowcharts wherever appropriate.

Write short notes on:

D
PART A

1. What is neuropathic pain? Discuss various interventional 4+6

L

pain management technique for neuropathic pain.

U

2. What is the cause of hypoxemia in an acute respiratory 5+5

SH

distress syndrome (ARDS)? Describe protocol for lung

protective ventilation in ARDS .

3. Prepare a TPN regimen for a 52-year-old female patient of 10

AN

body weight 60kg. She is not malnourished and has no

volume restriction.

4. What are various modalities of providing extracorporeal life 5+5

R

support? How will you provide extracorporeal membrane

oxygenation (ECMO) in a patient of severe hypoxemia
D

following H1N1 infection?

5. Describe pulmonary artery catheter with diagram. What are 5+5

various techniques of measuring cardiac output?

P.T.O.

-1-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION
HALL.
FINAL EXAM NATIONAL BOARD OF EXAMINATIONS
JUNE 2019

ANAESTHESIOLOGY
PAPER-IV

Please read carefully the important instructions mentioned on Page ‘1’

 Answers to questions of Part A and part B are to be strictly attempted in separate answer sheets and the
main + supplementary answer sheets used for each part must be tagged separately.
 Answers to question(s) of Part A attempted in answer sheets of Part B or vice versa shall not be evaluated.

PART B

6. How will you maintain a brain dead organ donor in ICU 10

AR
awaiting harvesting of organs for transplantation?

7. Pathophysiology and management of postoperative visual 5+5

AK
loss.

8. What are various techniques to monitor depth of 5+5

anaesthesia? Discuss bispectral index (BIS) and its usage

9.
during anaesthesia.
IW
Write guidelines for managing anti-platelets agents and 10
D
anticoagulants in patients requiring neuraxial blockade.

10. a) Newer insulin 5+5

L

b) Gantacurium
U

************
SH
AN
R
D

-2-
POSSESSION/USE OF CELL PHONES OR ANY SUCH ELECTRONIC GADGETS IS NOT PERMITTED INSIDE THE EXAMINATION
HALL.
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR
D
R
AN
SH
U
L
D
IW
AK
AR