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MCQs on Paediatric Anaesthesia

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

A 4-year-old, 16-kg child is scheduled for tonsillectomy. What is the most appropriate intraoperative maintenance fluid rate using the 4-2-1 rule?

a)

40 ml/h

b)

56 ml/h

c)

64 ml/h

d)

80 ml/h

2.

Which physiological factor most contributes to the rapid desaturation in neonates during apnoea under anaesthesia?

a)

Higher metabolic rate

b)

Lower residual volume

c)

Decreased cardiac output

d)

Increased dead space ventilation

3.

A 2-kg preterm neonate requires anaesthesia for inguinal hernia repair. What is the maximum safe dose of bupivacaine (0.25%) for a caudal block?

a)

0.5 ml

b)

1.0 ml

c)

2.0 ml

d)

2.5 ml

4.

During induction of a 5-year-old with sevoflurane, the child develops ventricular tachycardia. What is the most likely cause?

a)

Hypoxaemia

b)

Hypercarbia

c)

Sevoflurane overdose

d)

Undiagnosed long QT syndrome

5.

A 10-kg child is intubated with a 4.5-mm uncuffed endotracheal tube. What is the estimated length of insertion at the lips?

a)

10 cm

b)

12 cm

c)

14 cm

d)

16 cm

6.

Which of the following is the most significant risk factor for postoperative apnoea in a former preterm infant aged 48 weeks post-conception?

a)

Use of sevoflurane

b)

History of apnoea of prematurity

c)

Intraoperative fentanyl use

d)

Hypothermia

7.

A 3-year-old child with Down syndrome requires anaesthesia. Which airway management consideration is most critical?

a)

Risk of subglottic stenosis

b)

Atlantoaxial instability

c)

Micrognathia

d)

Increased oral secretions

8.

During laparoscopic appendectomy in a 12-kg child, the end-tidal CO2 rises to 60 mmHg. What is the most appropriate initial action?

a)

Increase tidal volume

b)

Decrease insufflation pressure

c)

Administer sodium bicarbonate

d)

Convert to open surgery

9.

A 6-kg infant receives a caudal epidural with 0.2% ropivacaine. What is the maximum volume to achieve a T10 sensory block?

a)

3 ml

b)

6 ml

c)

9 ml

d)

12 ml

10.

Which of the following is a contraindication to the use of succinylcholine in a 2-year-old child?

a)

Recent burn injury

b)

Upper respiratory tract infection

c)

Recent vaccination

d)

Peanut allergy

11.

A 5-year-old child develops bradycardia (HR 50 bpm) during induction with sevoflurane. What is the most appropriate initial management?

a)

Administer epinephrine

b)

Administer atropine

c)

Increase FiO2

d)

Deepen anaesthesia

12.

Which anaesthetic agent is most likely to cause emergence delirium in a 4-year-old child?

a)

Propofol

b)

Sevoflurane

c)

Isoflurane

d)

Ketamine

13.

A 2.5-kg neonate requires volume-controlled ventilation during anaesthesia. What is the appropriate tidal volume setting?

a)

10-15 ml

b)

15-20 ml

c)

20-25 ml

d)

25-30 ml

14.

During anaesthesia for pyloric stenosis repair in a 4-week-old, what is the most critical preoperative correction?

a)

Hypoglycaemia

b)

Metabolic alkalosis

c)

Hypernatraemia

d)

Hypokalaemia

15.

Which monitoring parameter is most likely to detect early hypovolaemia in a 10-kg child during major surgery?

a)

Heart rate

b)

Blood pressure

c)

Urine output

d)

Central venous pressure

16.

A 3-year-old with a history of asthma develops intraoperative bronchospasm. What is the most appropriate initial treatment?

a)

Intravenous salbutamol

b)

Inhaled salbutamol

c)

Intravenous hydrocortisone

d)

Increase sevoflurane concentration

17.

Which of the following is a key advantage of using a laryngeal mask airway (LMA) over endotracheal intubation in a 6-year-old for short procedures?

a)

Lower risk of laryngospasm

b)

Better airway protection

c)

Reduced airway trauma

d)

Improved ventilation control

18.

A 15-kg child receives 20 mg of intravenous lidocaine for ventricular ectopy during anaesthesia. What is the maximum additional dose that can be safely administered?

a)

10 mg

b)

20 mg

c)

30 mg

d)

40 mg

19.

During anaesthesia for strabismus surgery, a 5-year-old develops a heart rate of 40 bpm after ocular traction. What is the most likely cause?

a)

Hypoxaemia

b)

Oculocardiac reflex

c)

Vagal stimulation from intubation

d)

Propofol overdose

20.

A 7-year-old child with cerebral palsy requires anaesthesia for contracture release. Which is the most critical anaesthetic consideration?

a)

Risk of malignant hyperthermia

b)

Potential for difficult intubation

c)

Increased sensitivity to non-depolarising muscle relaxants

d)

Mandatory use of regional anaesthesia