Anaesthesia Blueprints Anaesthesia BlueprintsJoin free

Module 08 · Anaesthesia Blueprints

Coexisting medical disease: exam notes and MCQs

Prepare coexisting medical disease for postgraduate anaesthesia examinations with structured notes, exam-style questions and referenced explanations from standard textbooks and current guidelines.

Practise all 39 Coexisting medical disease questions free →

Exam notes in this module

Diabetes and the surgical patient
Assessment, drugs before surgery, insulin infusions, glucose targets, ketoacidosis and newer agents (SGLT2 inhibitors, GLP-1 agonists).
Endocrine emergencies: phaeochromocytoma, thyroid storm, adrenal and carcinoid crises
Preparation, intra-operative crises and their specific treatments.
Obesity and obstructive sleep apnoea
Physiology, screening, drug dosing, airway and ventilation strategy, and safe recovery.
Liver disease and anaesthesia
Pathophysiology of cirrhosis by system, risk scoring (Child–Pugh, MELD), optimisation, drug choice and intraoperative management.
COPD, asthma and the surgical patient
Preoperative assessment and optimisation, regional vs general anaesthesia, ventilation strategy, bronchospasm management and postoperative care.
Geriatric anaesthesia, frailty and postoperative delirium
Physiology of ageing, frailty assessment, drug dosing, perioperative neurocognitive disorders and delirium prevention.

Sample questions

Q1. In morbidly obese patients, which position improves both laryngoscopic view and safe apnoea time?

  1. Supine flat
  2. Trendelenburg
  3. Ramped (head-elevated) position with ear aligned to sternal notch
  4. Lateral decubitus
Show answer

Answer C: Ramped (head-elevated) position with ear aligned to sternal notch

Ramping (building up under the shoulders and head so the external auditory meatus is level with the sternal notch) improves laryngoscopic view compared with the sniffing position and, with head-up tilt, increases FRC and prolongs the time to desaturation after pre-oxygenation.

Exam style: NEET-SS Anaesthesia

Q2. CICO is declared. The cricothyroid membrane cannot be confidently palpated. DAS 2025 recommends:

  1. Needle cricothyroidotomy with jet ventilation
  2. A vertical midline skin incision (up to 8 cm, caudad to cephalad), then blunt dissection to identify the membrane
  3. Percutaneous tracheostomy
  4. A transverse skin incision only
Show answer

Answer B: A vertical midline skin incision (up to 8 cm, caudad to cephalad), then blunt dissection to identify the membrane

Scalpel–bougie–tube with full neuromuscular block and maximal neck extension. If membrane palpability is uncertain, a vertical skin incision is the default; after blunt dissection, identify the membrane with the index finger, make a transverse stab incision, then railroad a 6.0 mm cuffed tube over a bougie and confirm with capnography.

Exam style: NEET-SS Critical Care

Q3. Before elective surgery, an SGLT2 inhibitor (e.g. dapagliflozin) should usually be:

  1. Continued on the day of surgery
  2. Omitted the day before and the day of surgery (FDA: 3 days for most agents) because of euglycaemic ketoacidosis risk
  3. Replaced by metformin
  4. Stopped 4 weeks before
  5. Doubled to prevent hyperglycaemia
Show answer

Answer B: Omitted the day before and the day of surgery (FDA: 3 days for most agents) because of euglycaemic ketoacidosis risk

SGLT2 inhibitors can cause euglycaemic DKA perioperatively (fasting, stress). UK CPOC: omit the day before and day of surgery; FDA labelling: stop ≥ 3 days before (ertugliflozin 4 days). Check ketones if unwell, even with normal glucose; restart once eating and drinking.

Exam style: FRCA (Primary/Final)

Study the whole module

Join free to unlock all 39 questions, notes with diagrams and flowcharts, viva and OSCE stations, and live simulators.

Join the free beta →