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A) Direct myocardial depression and reduction in systemic vascular resistance

B) Histamine release causing peripheral vasodilatation

C) Parasympathetic stimulation causing bradycardia and hypotension

D) Inhibition of adrenal catecholamine release

A) Hypokalaemia

B) Malignant hyperthermia in susceptible patients

C) Muscle fasciculations and transient rise in serum potassium

D) Prolonged neuromuscular blockade in all patients

A) Slower onset because less agent is dissolved in blood

B) Faster onset because less agent is dissolved in blood, allowing rapid brain equilibration

C) Similar onset as blood:gas coefficient does not affect induction speed

D) Faster onset due to greater lipid solubility accelerating brain uptake

A) Stage I – analgesia

B) Stage II – excitement

C) Stage III plane 2 – surgical anaesthesia

D) Stage IV – medullary depression

A) Remifentanil provides several hours of analgesia due to its high potency

B) Adequate multimodal analgesia must be established before stopping remifentanil, as it provides virtually no residual analgesia

C) Its active metabolite GR90291 provides analgesia for up to 6 hours

D) Oral morphine alone is sufficient as remifentanil potentiates its effects for 4 hours

A) Propofol 2.5 mg/kg

B) Thiopentone 5 mg/kg

C) Etomidate 0.3 mg/kg

D) Ketamine 2 mg/kg

A) A 25-year-old with acute alcohol intoxication

B) An 80-year-old woman receiving 0.1 mcg/kg/min remifentanil

C) A 35-year-old with chronic amphetamine use disorder

D) A healthy 40-year-old at normothermia

A) The desired plasma concentration in micrograms per millilitre

B) The desired effect-site concentration in nanograms per millilitre

C) The mg/kg/hour infusion rate

D) The bispectral index target value

A) Increase sevoflurane concentration to deepen anaesthesia

B) Administer dantrolene 2.5 mg/kg IV and discontinue all trigger agents

C) Administer propranolol for suspected sympathetic storm

D) Increase ventilation rate and observe

A) Bronchospasm due to asthma exacerbation

B) Laryngospasm

C) Pulmonary oedema

D) Pneumothorax

A) It prevents regurgitation by compressing the trachea

B) It occludes the oesophagus by compressing it against the body of the sixth cervical vertebra

C) It facilitates laryngoscopy by displacing the larynx posteriorly

D) It is applied until the patient is awake and protecting their airway

A) It has longer duration, reducing need for maintenance doses

B) It stimulates central sympathetic outflow, maintaining blood pressure and heart rate

C) It produces profound muscle relaxation without suxamethonium

D) It is the only IV agent safe for paediatric patients

A) Residual neuromuscular blockade

B) Hypothermia reducing anaesthetic metabolism

C) Intraoperative haemorrhagic stroke

D) Residual volatile agent due to low fresh gas flows during maintenance

A) Neostigmine can reverse any depth of block regardless of TOF count

B) Neostigmine should be given with an anticholinergic agent to counteract muscarinic effects

C) Neostigmine directly antagonises acetylcholine receptors at the NMJ

D) Neostigmine is contraindicated in myasthenia gravis

A) Suxamethonium and atracurium only

B) Rocuronium and vecuronium

C) All non-depolarising agents including atracurium and cisatracurium

D) Suxamethonium, rocuronium, and vecuronium

A) A 35-year-old with no PMH for elective hernia repair

B) A 28-year-old with family history of malignant hyperthermia for appendicectomy

C) A 70-year-old under spinal anaesthesia requiring sedation

D) A 55-year-old for laparoscopic appendicectomy with no significant history

A) It prevents movement in 95% of patients and virtually eliminates awareness risk

B) It prevents movement in 50% of patients but does not reliably prevent awareness

C) It is the minimum concentration for amnesia in all patients

D) It is equivalent to ED95 for blunting haemodynamic response to intubation

A) Proceed immediately to emergency front-of-neck airway

B) Maintain oxygenation, call for help, and attempt a supraglottic airway device

C) Continue attempting direct laryngoscopy with a different blade

D) Administer suxamethonium to achieve complete relaxation before further attempt

A) Using equal doses of two induction agents to reduce side effects

B) Combining inhaled and IV agents, opioids, and muscle relaxants to achieve hypnosis, analgesia, and relaxation with lower doses of each

C) Maintaining blood pressure within 20% of baseline with vasopressors

D) Balancing anaesthesia duration against patient recovery time

A) Three deep breaths of 100% O2 equal 3 minutes of tidal preoxygenation

B) Obese patients have reduced FRC and desaturate faster during apnoea than non-obese patients

C) Preoxygenation is unnecessary if RSI is completed within 30 seconds

D) Supine positioning is optimal for preoxygenation in obese patients