NEET PG Anesthasia Syllabus

Anesthasia syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Anesthasia in NEET PG, not a summary of it.

1. 1

   Introduction to Anesthesia

   2 topics

   • History of Anesthesia
     • Evolution of anesthesia techniques and drugs
   • Principles of Anesthesia
     • Goals of anesthesia (analgesia, amnesia, muscle relaxation, and homeostasis)
     • Stages of anesthesia
     • Monitoring techniques
2. 2

   Preoperative Evaluation

   3 topics

   • Preoperative assessment
     • Patient history (medical, surgical, and anesthesia history), physical examination, and laboratory investigations
   • Assessment of comorbidities
     • Cardiovascular, respiratory, renal, hepatic, and endocrine disorders
   • Optimization of medical conditions
     • Preoperative medication management, control of hypertension, diabetes, and other systemic diseases
3. 3

   Anesthetic Pharmacology

   3 topics

   • General Anesthetics
     • Inhalational Anesthetics
     • Intravenous Anesthetics
     • Adjunctive Drugs
   • Local Anesthetics
     • Mechanism of Action
     • Pharmacokinetics
     • Types
     • Adverse Effects
   • Neuromuscular Blocking Agents
     • Depolarizing Agents
     • Non-Depolarizing Agents
4. 4

   Anesthetic Techniques

   3 topics

   • General anesthesia
     • Inhalational anesthesia
     • Intravenous anesthesia
     • Balanced anesthesia techniques
   • Regional anesthesia
     • Spinal anesthesia
     • Epidural anesthesia
     • Peripheral nerve blocks
     • Local infiltration anesthesia
   • Monitored anesthesia care (MAC)
     • Sedation techniques for conscious sedation during minor procedures
5. 5

   Airway Management

   3 topics

   • Endotracheal Intubation
     • Indications
     • Equipment
     • Techniques
     • Complications
   • Supraglottic Airway Devices
     • Laryngeal Mask Airway (LMA)
     • Intubating LMA
     • Complications
   • Difficult Airway Management
     • Recognition of Difficult Airway
     • Strategies
     • Emergency Airway Algorithms
6. 6

   Anesthetic Complications

   3 topics

   • Hypotension
     • Causes
     • Diagnosis
     • Management
   • Hypoxemia
     • Causes
     • Diagnosis
     • Management
   • Malignant hyperthermia
     • Pathophysiology
     • Clinical features
     • Diagnosis
     • Management
7. 7

   Postoperative Care

   2 topics

   • Post-anesthesia care unit (PACU)
     • Monitoring (vital signs, pain assessment)
     • Management of postoperative complications (pain, nausea, vomiting)
     • Discharge criteria
   • Pain management
     • Analgesic techniques (opioids, nonsteroidal anti-inflammatory drugs)
     • Patient-controlled analgesia (PCA)
     • Regional anesthesia techniques for postoperative pain relief
8. 8

   Special Situations in Anesthesia

   3 topics

   • Pediatric Anesthesia
     • Anesthetic considerations in children (dose calculation, airway management)
     • Management of congenital abnormalities
   • Obstetric Anesthesia
     • Anesthesia techniques for cesarean section (spinal anesthesia, epidural anesthesia)
     • Management of preeclampsia
     • Fetal monitoring
   • Geriatric Anesthesia
     • Anesthetic considerations in elderly patients (physiological changes, comorbidities)
     • Management of postoperative delirium
9. 9

   Anesthesia for Specific Surgical Procedures

   3 topics

   • Cardiothoracic anesthesia
     • Anesthetic management for coronary artery bypass grafting (CABG)
     • Anesthetic management for valve replacement
     • Anesthetic management for thoracic surgery
   • Neurosurgical anesthesia
     • Anesthetic considerations for craniotomy
     • Anesthetic considerations for intracranial aneurysm clipping
     • Anesthetic considerations for spinal surgery
   • Orthopedic anesthesia
     • Anesthetic techniques for joint replacement surgery (total hip arthroplasty)
     • Anesthetic techniques for joint replacement surgery (total knee arthroplasty)
     • Management of acute pain
10. 10

    Emerging Trends in Anesthesia

    2 topics

    • Enhanced Recovery after Surgery (ERAS)
      • Multimodal perioperative care pathways to optimize patient outcomes and reduce length of hospital stay
    • Point-of-Care Ultrasound (POCUS)
      • Use of ultrasound for vascular access
      • Use of ultrasound for nerve localization
      • Use of ultrasound for diagnosis of pneumothorax during anesthesia

Anesthasia flashcards for NEET PG

22 of 51 cards from the Anesthasia deck — real questions with worked answers.

1. Who administered the first successful public demonstration of ether anesthesia, and where and when did it occur?

   William T. G. Morton demonstrated ether anesthesia on October 16, 1846, at Massachusetts General Hospital (the 'Ether Dome'), removing a neck tumor from patient Gilbert Abbott.

2. Which physician introduced chloroform into obstetric anesthesia, and who famously received it during childbirth?

   James Young Simpson introduced chloroform in 1847; John Snow administered it to Queen Victoria during the birth of Prince Leopold in 1853 ('anaesthesia a la reine').

3. Define the three components ('triad') of balanced general anesthesia.

   Hypnosis (unconsciousness/amnesia), analgesia (pain control), and muscle relaxation (akinesia), often with control of autonomic reflexes.

4. What does the ASA Physical Status Classification system grade, and what do ASA I through VI represent?

   It grades a patient's preoperative physical status. ASA I = healthy; II = mild systemic disease; III = severe systemic disease; IV = severe disease that is a constant threat to life; V = moribund, not expected to survive without surgery; VI = brain-dead organ donor. Suffix 'E' = emergency.

5. According to ASA fasting guidelines, what are the minimum fasting times before elective anesthesia for clear liquids, breast milk, and solid/fatty food?

   Clear liquids: 2 hours; breast milk: 4 hours; infant formula/light meal/non-human milk: 6 hours; fatty or fried solid meal: 8 hours.

6. What is the Mallampati classification used for, and what do its four classes describe?

   It predicts difficulty of intubation by oropharyngeal visualization. Class I: soft palate, fauces, uvula, pillars seen; II: soft palate, fauces, uvula; III: soft palate and base of uvula; IV: only hard palate visible. Higher class = higher difficulty.

7. Name the components of the 'LEMON' mnemonic for predicting a difficult airway.

   L = Look externally; E = Evaluate 3-3-2 rule; M = Mallampati; O = Obstruction/Obesity; N = Neck mobility.

8. What is the '3-3-2 rule' for airway assessment?

   3 fingerbreadths between incisors (mouth opening), 3 fingerbreadths from mentum to hyoid bone, and 2 fingerbreadths from hyoid bone to thyroid notch. Failure to meet these predicts difficult intubation.

9. Per ACC/AHA guidelines, what functional capacity threshold (in METs) generally allows a patient to proceed to surgery without further cardiac testing?

   A functional capacity of 4 METs or greater (e.g., climbing two flights of stairs) without symptoms is considered adequate.

10. For how long before elective surgery are clopidogrel and aspirin typically withheld, and what is the general rule for elective surgery after coronary stent placement?

    Clopidogrel ~5-7 days; aspirin often continued or stopped 7 days for high-bleeding-risk procedures. Elective surgery is delayed at least 1 month after bare-metal stents and ideally 6 months (minimum 3-6 months) after drug-eluting stents to allow dual antiplatelet therapy.

11. Define MAC (minimum alveolar concentration) for inhalational anesthetics.

    The alveolar concentration of an inhaled anesthetic at 1 atm that prevents movement in response to a surgical (skin) incision in 50% of patients. It is a measure of anesthetic potency.

12. List the approximate MAC values for nitrous oxide, sevoflurane, isoflurane, and desflurane.

    Nitrous oxide ~104%; desflurane ~6%; sevoflurane ~2%; isoflurane ~1.15%; (halothane ~0.75%). Lower MAC = higher potency.

13. Name four clinical factors that increase MAC and four that decrease MAC.

    Increase MAC: hyperthermia, chronic alcohol use, hypernatremia, infancy (peaks ~6 months), MAOIs/acute amphetamine, red hair. Decrease MAC: increasing age, hypothermia, pregnancy, opioids/sedatives, acute alcohol intoxication, hyponatremia, lithium, hypotension.

14. What is the Meyer-Overton correlation regarding inhalational anesthetics?

    The potency of an inhalational anesthetic correlates directly with its lipid solubility (oil:gas partition coefficient): higher lipid solubility = greater potency = lower MAC.

15. How does the blood:gas partition coefficient affect speed of induction with inhaled anesthetics?

    A lower blood:gas partition coefficient (e.g., desflurane 0.42, nitrous oxide 0.47) means faster onset and recovery; a higher coefficient (e.g., halothane 2.4) means slower induction/emergence.

16. What is the mechanism of action of propofol, and what makes it suitable for short procedures?

    Propofol potentiates GABA-A receptor chloride currents. Its rapid onset, short duration due to rapid redistribution and metabolism, and antiemetic properties make it ideal for induction and short procedures/TIVA.

17. Which IV induction agent best preserves cardiovascular stability, and what adrenal side effect limits its infusion?

    Etomidate provides hemodynamic stability (useful in shock/cardiac disease) but causes adrenocortical suppression by inhibiting 11-beta-hydroxylase, so continuous infusion is avoided.

18. What is the mechanism and key clinical feature of ketamine anesthesia?

    Ketamine is an NMDA receptor antagonist producing 'dissociative anesthesia' with analgesia and amnesia while maintaining airway reflexes and sympathetic tone (raises BP/HR). It causes bronchodilation and emergence hallucinations.

19. What is the mechanism of action of local anesthetics?

    They reversibly block voltage-gated sodium channels on the internal side of the neuronal membrane, preventing depolarization and propagation of the action potential. They bind preferentially to the open/inactivated state (use-dependent block).

20. How are local anesthetics chemically classified, and give an example of each class.

    Esters (metabolized by plasma pseudocholinesterase, e.g., procaine, tetracaine, cocaine, benzocaine) and amides (metabolized by the liver, e.g., lidocaine, bupivacaine, ropivacaine, prilocaine). Amides have two 'i's in the name.

21. State the maximum safe doses of lidocaine with and without epinephrine.

    Plain lidocaine: ~4.5 mg/kg (up to ~300 mg); lidocaine with epinephrine: ~7 mg/kg (up to ~500 mg). Epinephrine slows systemic absorption.

22. What are the signs of local anesthetic systemic toxicity (LAST) and its first-line antidote?

    Progressive CNS signs (perioral numbness, tinnitus, metallic taste, seizures) then cardiovascular collapse (arrhythmias, hypotension). Treatment: stop injection, manage airway/seizures, and give 20% intravenous lipid emulsion (Intralipid). Bupivacaine is the most cardiotoxic LA.

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