BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU

Month and year of exam. May-2024 MOCK TEST

Course : Diploma Time : 5 minutes
Discipline : Anesthesiology Total marks: 10
Pass marks : 06
Paper : OSPE Code No.: .......................
Station No. : 1(one)
Answer key
Device A
Q 1. Give the Full name of the 1
Ans. Central venous catheter
Q2. Mention its site of insertion 1
Ans a. Subclavian vein b. internal jugular vein
Q 3. Name the technique of insertion of this device 1
Ans . Seldinger technique
Q4. Mention four most dangerous complication of subclavian vein catheterization 2
Ans a. Pneumothorax. B. Hemothorax
c. Sub cutaneous emphysema d. Hematoma

Device no 2
Q 1. Give the Full name of the Device B 0.5
Ans. Laryngeal mask airway (LMA)
Q 2. What type of device it is.. 0.5
Ans. Supraglottic airway
Q 3. Mention its four variation / Types 0.5x4=2
Ans.a……Classic LMA……b…………Flexible LMA…………
c. Intubating LMA d. Proseal LMA e. Reinforced LMA
Q 4. Mention two definitive indication of its uses 0.5x2=1

Ans a. difficult intubation b. Day case surgery

Q 5. Write two condition where this device is not suitable. 0.5x2=1

Ans. A. Emergency surgery/ full stomach B. hiatus hernia / morbid Obesity C.

Prolnged ventilation
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. May -2024 MOCK TEST
Course : Diploma
Disciplines : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06

Station No. : 2 (Two) ANSWER KEY

Instruction to examinee : In this station you have two different drugs . Answer the
questions accordingly

1. Which group the drug A belongs to? 1

Ans- Amide group of LAA- 2% Lignocaine HCL

2. What is its maximum recommended safe dose? 2

Ans-a Plain – 5 mg/kg b. With adrenaline -7 mg/kg

3. Mention its two uses other than anesthetic purpose during general anesthesia 2

Ans-a) attenuation of intubation reflex b. antiarrhythmic to control perioperative PVC

and VT

4. What are the main two causes of local anesthetic toxicities? 2

Ans- a) Drug Overdose (Repeated Injection, Inappropriate dose calculation)

b) Inadvertent intravascular injection

5. Which group the drug BS belongs to 0.5

Ans. Benzodiazepine

6. Mention its two uses in anesthesia 1

Ans a, induction / co induction produces unconsciousness b. Procedural sedation

7. Mention onset of action of this when administered by common three routs 1.5

IV 5 minute b, IM 15 minute C. Orally 20 minutes

 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU

Month and year of exam. May-2024 MOCK TEST

Course : Diploma
Discipline : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06

Code No.: .......................

Station No. : 3 (Three) Answer Key

Instruction to examine: In this a station you will find radiological Image on laptop.
Answer accordingly:

Q.1. Provides radiological report on this image 0.5x8 = 4

Ans a. Chest x-ray P/A view
b. Normal penetration
c. Bony structure normal
d. Trachea centrally position
e. Both lung field homogenous /clear
f. Heart shadow normal
g. Diaphragm normal in position
h. A wire with electronic device and wire in the heart
chamber/Pacemaker in situ

Q2. Mention the four indication of uses of this device 1x4=4

a. Extreme bradycardia with syncope

b. Complete Heart Block
c. Acute MI with unstable arrhythmia
d. Severe tachycardia (AF) / post cardiac surgery

Q3. What precautions you will take when using diathermy 0.5x4=2

a. Bipolar diathermy
b. Less frequency
c. Small duration
d. Away from heart
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU

Month and year of exam. July-2024 MOCK TEST

Course : Diploma
Discipline : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06

Code No.: .......................

Station No. : 4 (Four) Answer key
Instruction to examiner: Requested to mark in the answer sheet for each stem checked by the examinee of
machine. After checking you will ask the following questions to the candidate. At the end of each
performance, please rearrange the station and wait for the next candidate. 3minutes for check and 2 minutes
for answer the questions.

Sequence of performing events Done Partially Not

Done Done
1. Switch the ON / OFF switch to ‘OFF’. (optional) 0.25 00 00
2. Check that all cylinders are securely and correctly mounted, all 1 00 00
parts of the machine are intact.
3. Turn all gas cylinders ‘ON’ in turn and check that its gauze 1 0.25 00
registers an adequate supply of gas (at least 50% for O2).
4. Turn on each gas cylinder ‘OFF’ in turn and observe gauze for 0.5 0.25 00
evidence of high pressure leak (indicated by drop of pressure)
5. Turn all flow control Valves “OFF ”, check no gas flow is 0.5 0.25 00
indicated on flow meters.
6. Adjust flow of all gases through their full range (or 2-3 full 0.5 00 00
terns) and check for any erratic movement of flows.
7. Turn ‘ON’ the O2 cylinder and adjust the O2 flow meter @ 0.5 0.25 00
4L/Min. No flow in the N2O flow meter,
8. Turn on N2O cylinder and check that the flow meter register a 0..5 0.25 00
low flow. No Change in the O2 flow meter.
9. Turn off O2 cylinder and check that O2 bobbin completely falls 0.5 0.25 00
to the bottom
10. Check breathing system regarding any leak and attached 0.5 0.25 00
appropriately at common gas outlet
11. Maintain sequence (optional) 0.25 00 00
Question:
Q 1. How hypoxia is prevented by this machine?
Ans : O2 failure alarm, hypoxic guard ( N2O on O2 regulator), pin index, FiO2 monitor 0.5x3=1.5

Q2. What are the important of rebreathing bag

Ans .a. Reservoir of anesthetic gases(cost effective /Less pollution) b. manual ventilation c visual
assessment ventilation d. Assessment of air way pressure or air way obstruction 0.5x3=1.5

Q3What is Oxygen flush valve

Ans . To deliver high flow (30 -70 L/min) oxygen at high pressure (400 Kpa/4 bar)min 1
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. July-2024 MOCK TEST
Course : Diploma
Discipline : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06

Station No. : 5 (five) ANSWER KEY

.
Scenario: A 70 years old man was ventilated in ICU after major surgery . During his
treatment process ventilator suddenly produce a alarm and patient monitor was showing
SPO2 92% and following waves of EtCO2 were found.

A. Scenario

Q. 1. What is your diagnosis? 2

Ans : Disconnection of ventilator / ETCO2

Q. 2. Explain this in favor of your finding? 2

Ans : No ventilation/ no breathing No ETCO2 wave but SPO2 will gradually falls

B. Scenario : After your action the monitor was showing following ETCO2 Wave

Q. 3. Now what is your diagnosis?

Ans : Hypercabia / Hypoventilation 1

Q. 4. Mention two disease conditions responsible for this pattern. 2

Ans : a. COPD b. malignant hyperpyrexia / type-two respiratory failure

Q5 What are your management plans with this change? 1x3=3

Ans Adjust ventilation / hyperventilation / increased respiratory rate/ tidal volume / minute volume/
PEEP
Uses ventilator supporting drugs: Sedation /muscle relaxant /bronchodilator
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. July-2024 MOCK TEST
Course : Diploma
Discipline : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06

Station No. : 6(six) ANSWER KET

Examiner’s copy: Scenario:
Instruction to the examiner:
You will observe the management sequence of this patient by the examinee. After
management you will ask following questions.
Check list (4 minutes):
SL Sequence of events Properly Not Not
done properly done
done
a) Check the victim for responsiveness (shake and 0.5 00 00
shout)
b) Assess breathing and circulation: Open the airway 0.5 0.25 00
by head tilt-chin lift / jaw thrust and
Assesses breathing (look, listen, feel)
and feel carotid pulse simultaneously
c) Shout for help and call 999 1 0.5 00
d) Give 30 chest compressions at the centre of the 1 00 00
chest
e) Deliver two breathing appropriately to expand the 0.5 0.25 00
chest if Ambu bag is available
f) Repeat the sequences (30:2) for 2 minute / 5 cycle 0.5 0.25 00
g) Feel carotid pulse if not palpable 0.5 00 00
h) This should be continue until ambulance is arrive 0.5 00 00
Questions to be answered -
1. What are the expected outcome of chest compression ? 0.5x3=1.5
Ans : a. Generation of cardiac output b. initiation of rhythm c. entry of air in lung
2. What is the difference between an AED and manual defibrillator? 2
Ans : AED is a automatic external defibrillator which atomically analyze the patients
rhythm and decide to deliver shock. However manual defibrillator, doctor must
analyze rhythm and give the decision of shock including amount of energy.
1. Mention 3 important investigations after return of spontaneous circulation in
emergency department.
Ans : a.Blood gas b.x-ray chest c. blood sugar d. 12 lead ECG e. S. electrolyte
0.5x3=1.5
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. July-2024 MOCK TEST
Course : Diploma Time : 5 minutes
Discipline : Anesthesiology Total marks: 10
Pass marks : 06
Paper : OSPE
Station No. : 07 (seven ) ANSWER KEY
OT Scenario: A 30 years old patient of a ASA grade 1 is lying on the OT
table for herniotomy and herniorrhapy operation as day case surgery.
A. checklist Point to be observe

Point Properly partially Not

done
1 Self introduction and identification 0.5 0.25 00
2 Take brief history 1 0.5 00
3 Measure the vital parameter like BP , pulse 1 0.5 00
4 Explain to patient about anesthetic technique / quarry no 0.5x4=2 .1 00
1 of the patient .Provide anesthesia four way
A,With loss of consciousness General Anesthesia
B. Spinal Anesthesia with consciousness rapid action
paralyses lower part of body
C. Epidural Anesthesia with consciousness gradual
action and take time with paralyses lower part of body

D. Local/ field block : safe but not fully effective ,traction

pain , surgical windrow limited /less surgeon choice
5 1+1 1 00
Explains the suitable anesthesia for this patient /Answer
the quarry no 2.( I went to go home day after surgery
so which on will be best for me)
GA safe, effective, short lasting effect , less post
operative complication and ready early to
discharge

Spinal / epidural : safe ,effective with low cost

but it more invasive, prolong action and chance of
hypotension delay discharge

6 Answer the Quarry NO 3 ( any other reason for spinal not 1 0.5 00
to suitable for me ) Yes some side effective may restrict
your daily activities like PDPH, residual block,
retention of urine

8 Assurance to the patient 0.5 0. 25 00

Q1. Please identify the drug suitable drugs for this patient ? Ans Propofol , LMA .Trach .fentanyle 1.5

Q2. Mention the post operative analgesic for this patient? Ans NSAID 0.5
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. July-2024 MOCK TEST
Course : Diploma
Discipline : Anesthesiology Time : 5 minutes
Total marks: 10
Paper : OSPE Pass marks : 06
Station No. : 8( Eight ) ANSWER KEY

Instruction. You find a following ECG tracing on monitor of 50 years old man during surgical
procedure under general anesthesia . Answer accordingly

Q1. Mention the diagnosis

Ans. Ventricular extrasystole /Wide QRS complex /PVC 1/0.5
Q2 Mention two important causes of this patient 1X2=2
Ans. a. Inadequeate level / light level of anesthesia
b. Inhalation anesthetic drug/ Electrolyte imbalance
Q3 How can manage this condition
Ans .a. Provide Adequate level of anesthesia /Depth of anesthesia/avoid inhalational drugs 1+1
b. Iv lignocaine

In Next day patient complain respiratory distress with sweating and 12 lead ECG showing

Q4. What is the ECG diagnosis

Ans. Acute anterior MI 1/0.5

Q.5 How you confirm the diagnosis

Ans . By Estimation of cardiac enzyme S.Troponine I and CKMB 1+1

Q6. Your 1st line of management is

0.5X4=2

a) Morphine, b) O2, c) Nitrate , d) Aspirin

 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU

Month and year of exam. July-2024 MOCK TEST

Course : Diploma Time : 5 minutes
Discipline : Anesthesiology Total marks: 10
Pass marks : 06
Paper : OSPE
Station No. : 9(nine) Answer key

Scenario; A 40 years old man was operated two days back for abdominal pathology and he has history
of Type I diabetes. Now he developed fever, nausea, sweating and respiratory distress .and have a
following blood report.
pH : 7.21 PaO2 :77 mmHg PaCO2 : 28 mm Hg HCO 3 : 9.2 mmol/l

FiO2 : normal air BE : -23.3 mmol/l Hb :14 gm/dl. RBS:19mmol/l

Q1. What is your diagnosis? 1.5

ANS. Severe metabolic acidosis may be due to diabetic ketoacidosis
Q2, Explain the PaCO2 finding? 1.5
ANS. Increased respiratory rate causes washout CO2 / hyperventilation /Respiratory compensation
/used of HCO3 / H+ stimulate central respiratory center
Q3. Mention other causes of this condition 1
Ans . Severe sepsis or septicemia with super added uncontrolled diabetic

Q4. What are the expected other clinical findings in favor of your diagnosis ? 2
Ans Tachycardia , Hypotension / shock, increased respiratory rate, dehydration, crepitation or rhonchi or
reduced breath sound and impair consciousness or abdominal distention /wound infection

Q5. What additional investigation is to support this diagnosis ? 2

Ans . a. X-ray chest and abdomen , CBC , S lactate and Blood for C/S with ketone bodies, and s.
creatinine
6.When this patient need ICU support? 2
Ans. Hemodynamic instability or septic shock , Metabolic acidosis or hypoxia is not corrected by
conservative treatment or need Artificial ventilation
 BSA-CCPP and Department of Anesthesia ,Analgesia and Intensive Care Medicine, BSMMU
Month and year of exam. July-2024 MOCK TEST
Course : Diploma Time : 5 minutes
Discipline : Anesthesiology Total marks: 10
Pass marks : 06
Paper : OSPE
Station No. : 10(ten ) ANSWER KEY

Scenario: A 10 years old boy undergone tonsillectomy operation has failed to

breathe at the end of the operation. You have already ventilated this patient for 2
hours in the OT but spontaneous breathing yet to start, He has no history of
previous anesthesia. His mother is waiting and is very worried for delay in
operation theatre.

Sl Sequence Properly Not Not

No answered properly Answered
answered
1 Self Introduction & make a rapport with 1 0 0
mother
2 Answer to the query 1 2 1 0
(Explain the unwanted situation to mother
regarding possible drugs (SUXA) side
effect, hereditary defect resultant delayed
recovery/prolonged apnoea
and give assurance)
3 Answer to the query 2 (currently going 2 .5 0
treatment : Mechanical ventilation to be
continued, time consuming, baby is being
monitored properly.
4 Answer to the query 3 ICU treatment 2 1 0
Yes – Plasmapharesis (if not possible),
Fresh Blood transfusion from nonrelative )
5 Answer to the query 4 1 .5 0
(End with advice –
a. Investigations for abnormal
enzyme / enzyme deficiency
b. For any future operation, must
inform today’s situation to doctor)
6 Answer mother’s question with patience & 1 0 0
confidence
7 Listen to mother if she understands & 1 0 0
asked subsequently having any question