🇮🇳 NEET PG · subject
NEET PG Anesthasia Syllabus
The Anesthasia syllabus for NEET PG in full: 10 chapters, 27 topics and 70 sub-topics, every one listed below, plus 51 Anesthasia flashcards with answers.
Anesthasia syllabus: all 10 chapters
Expand any chapter to see its topics and sub-topics.
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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
- History of Anesthesia
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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
- Preoperative assessment
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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
- General Anesthetics
-
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
- General anesthesia
-
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
- Endotracheal Intubation
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Anesthetic Complications
3 topics- Hypotension
- Causes
- Diagnosis
- Management
- Hypoxemia
- Causes
- Diagnosis
- Management
- Malignant hyperthermia
- Pathophysiology
- Clinical features
- Diagnosis
- Management
- Hypotension
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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
- Post-anesthesia care unit (PACU)
-
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
- Pediatric Anesthesia
-
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
- Cardiothoracic anesthesia
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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
- Enhanced Recovery after Surgery (ERAS)
NEET PG Anesthasia flashcards — 51 questions with answers
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.
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').
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
Show the other 31 Anesthasia flashcards
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.
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.
What is the mechanism of depolarizing neuromuscular blockers, and what is the prototype drug?
Succinylcholine binds and persistently activates the nicotinic ACh receptor, causing sustained depolarization (initial fasciculations then flaccid paralysis, 'phase I block'). It is not reversed by anticholinesterases.
List three serious adverse effects of succinylcholine.
Hyperkalemia (dangerous in burns, crush injury, denervation), malignant hyperthermia trigger, bradycardia, increased intraocular/intracranial/intragastric pressure, and prolonged apnea in pseudocholinesterase deficiency.
How do non-depolarizing neuromuscular blockers work, and how are they reversed?
They competitively antagonize ACh at the nicotinic receptor (e.g., rocuronium, vecuronium, atracurium). Reversal: anticholinesterases (neostigmine, with glycopyrrolate/atropine) or sugammadex for aminosteroid agents (rocuronium/vecuronium).
What is the mechanism of sugammadek (sugammadex), and which blockers does it reverse?
Sugammadex is a modified gamma-cyclodextrin that encapsulates aminosteroid neuromuscular blockers (rocuronium > vecuronium), rapidly reversing even profound block. It does not reverse benzylisoquinolinium agents like atracurium.
What is Monitored Anesthesia Care (MAC), and how does it differ from general anesthesia?
MAC is a planned procedure where an anesthesia provider gives sedation/analgesia and monitors the patient who maintains protective airway reflexes and spontaneous breathing, with the ability to convert to general anesthesia if needed. Unlike GA, consciousness/airway may be preserved.
Compare spinal and epidural anesthesia in terms of injection site, onset, and dose.
Spinal: small dose injected into subarachnoid (intrathecal) space below L2, rapid dense onset, single shot. Epidural: larger dose into epidural space (any level), slower segmental onset, catheter allows continuous/titrated dosing. Spinal carries higher risk of post-dural puncture headache.
What are the standard ASA basic intraoperative monitors required during anesthesia?
Oxygenation (pulse oximetry, inspired O2 analyzer), ventilation (capnography/EtCO2), circulation (ECG, blood pressure at least every 5 min), and temperature. A qualified anesthesia provider must be present throughout.
What is the gold-standard confirmation of correct endotracheal tube placement?
Sustained waveform capnography showing exhaled CO2 over several breaths confirms tracheal (not esophageal) placement; bilateral chest auscultation and chest rise are supportive.
What are the laryngoscopic (Cormack-Lehane) grades of glottic view?
Grade 1: full glottis visible; Grade 2: posterior glottis/arytenoids; Grade 3: only epiglottis; Grade 4: no glottic structures (only soft palate). Grades 3-4 predict difficult intubation.
What is a supraglottic airway device, and give a common example with a key limitation.
A device (e.g., laryngeal mask airway, LMA) that sits above the glottis to provide ventilation without tracheal intubation. It is fast and less stimulating but does not fully protect against aspiration of gastric contents.
What is the most critical priority in the ASA Difficult Airway Algorithm when a 'cannot intubate, cannot oxygenate' (CICO) situation occurs?
Emergency invasive airway access (cricothyrotomy) to restore oxygenation. Throughout, the priority is maintaining oxygenation and calling for help, with options including LMA, video laryngoscopy, and awake intubation.
What is rapid sequence induction (RSI) and its purpose?
RSI is induction with preoxygenation, a rapid-acting induction agent plus a fast-onset paralytic (succinylcholine or high-dose rocuronium), and immediate intubation, to minimize the apneic interval and aspiration risk in patients with full stomachs. Cricoid pressure may be applied.
List four common causes of intraoperative hypotension under anesthesia.
Decreased preload (hypovolemia/hemorrhage, vena caval compression), decreased afterload/vasodilation (anesthetic agents, anaphylaxis, sepsis, neuraxial block), decreased contractility (myocardial depression/ischemia), and decreased heart rate/arrhythmia.
Define hypoxemia by SpO2/PaO2 and list the five main physiologic causes.
Hypoxemia = PaO2 < 60 mmHg or SpO2 < 90%. Causes: hypoventilation, V/Q mismatch, right-to-left shunt, diffusion limitation, and low inspired oxygen (FiO2). Shunt responds poorly to supplemental O2.
What is malignant hyperthermia, its triggers, and the genetic defect involved?
A hypermetabolic crisis of skeletal muscle triggered by volatile anesthetics and succinylcholine, caused by mutations in the ryanodine receptor (RYR1), leading to uncontrolled sarcoplasmic calcium release. It is autosomal dominant.
List the early clinical signs of malignant hyperthermia and the specific drug treatment.
Earliest sign: rising EtCO2 (hypercarbia); also tachycardia, masseter/generalized rigidity, hyperthermia (late), acidosis, hyperkalemia. Treatment: stop triggers, give dantrolene (2.5 mg/kg IV, repeat to 10 mg/kg), hyperventilate with 100% O2, cool, and treat hyperkalemia/arrhythmias.
What is the role of the PACU (post-anesthesia care unit), and what scoring system gauges discharge readiness?
The PACU provides close monitoring during recovery from anesthesia (airway, hemodynamics, pain, nausea). The modified Aldrete score (activity, respiration, circulation, consciousness, oxygen saturation; each 0-2) assesses discharge readiness, typically a score >=9.
What are the most common risk factors and first-line prophylaxis for postoperative nausea and vomiting (PONV)?
Apfel risk factors: female sex, non-smoker, history of PONV/motion sickness, postoperative opioids. Prophylaxis: ondansetron (5-HT3 antagonist), dexamethasone, droperidol; use multimodal combinations for high-risk patients.
Describe the WHO analgesic ladder for pain management.
Step 1: non-opioids (paracetamol/NSAIDs) +/- adjuvants for mild pain; Step 2: weak opioids (codeine/tramadol) + non-opioids for moderate pain; Step 3: strong opioids (morphine) + non-opioids for severe pain. Adjuvants added at any step.
What is multimodal analgesia and why is it preferred?
Combining analgesics with different mechanisms (e.g., paracetamol, NSAIDs, opioids, regional blocks, gabapentinoids, ketamine) to achieve additive/synergistic pain relief while minimizing the dose and side effects of any single agent, especially opioids.
What is the formula for an uncuffed endotracheal tube internal diameter and tube length in children over 2 years?
Uncuffed ETT internal diameter (mm) = (age/4) + 4; tube depth at lips (cm) = (age/2) + 12, or 3 x tube ID. For cuffed tubes, subtract 0.5 from the diameter formula.
What is the formula for maintenance fluid in children (Holliday-Segar / 4-2-1 rule)?
4 mL/kg/hr for the first 10 kg, plus 2 mL/kg/hr for the next 10 kg, plus 1 mL/kg/hr for each kg above 20 kg.
Why are infants more prone to rapid desaturation during apnea than adults?
Infants have higher oxygen consumption per kg, lower functional residual capacity (FRC) relative to closing capacity, and proportionally smaller oxygen reserves, leading to faster desaturation during apnea.
What physiological changes of pregnancy increase aspiration risk and reduce apnea tolerance during obstetric anesthesia?
Decreased lower esophageal sphincter tone and delayed gastric emptying increase aspiration risk; reduced FRC plus increased oxygen consumption cause rapid desaturation. MAC is reduced ~30-40% and there is greater sensitivity to local anesthetics.
What is aortocaval compression (supine hypotension syndrome) in pregnancy and how is it prevented?
In the supine position after ~20 weeks, the gravid uterus compresses the inferior vena cava and aorta, reducing venous return and causing hypotension. Prevented by left uterine displacement (left lateral tilt of ~15 degrees).
Name three key physiologic changes in geriatric patients that affect anesthetic management.
Decreased MAC and anesthetic requirement, reduced cardiac/renal/hepatic reserve and drug clearance, decreased lung elasticity and impaired thermoregulation, and increased sensitivity to sedatives. Doses should be reduced and titrated.
In neurosurgical anesthesia, state the cerebral perfusion pressure (CPP) formula and the normal target range.
CPP = MAP - ICP (or CVP, whichever is higher). Normal CPP is ~60-80 mmHg; maintaining adequate CPP while controlling ICP is a key anesthetic goal.
What are the core principles of Enhanced Recovery After Surgery (ERAS) protocols?
Preoperative counseling and carbohydrate loading (avoid prolonged fasting), multimodal opioid-sparing analgesia, regional/minimally invasive techniques, normothermia and euvolemia, early removal of drains/catheters, and early postoperative mobilization and feeding to speed recovery.
What is Point-of-Care Ultrasound (POCUS) used for in anesthesia, and name two common applications?
POCUS is bedside ultrasound for real-time diagnosis and procedural guidance. Applications: ultrasound-guided vascular access and regional nerve blocks, gastric content/aspiration risk assessment, focused cardiac (FoCUS) and lung assessment, and airway evaluation.
Same Anesthasia syllabus in other exams
The Anesthasia outline above is identical in these 3 exams:
NEET PG Anesthasia FAQ
What is in the NEET PG Anesthasia syllabus?
NEET PG Anesthasia is split into 10 chapters: Introduction to Anesthesia, Preoperative Evaluation, Anesthetic Pharmacology, Anesthetic Techniques, Airway Management, Anesthetic Complications, Postoperative Care, Special Situations in Anesthesia, Anesthesia for Specific Surgical Procedures and Emerging Trends in Anesthesia. Together they contain 27 topics and 70 sub-topics.
How many chapters are in NEET PG Anesthasia?
10 chapters, containing 27 topics and 70 sub-topics. The largest chapter is Preoperative Evaluation, with 3 topics.
Are there flashcards for NEET PG Anesthasia?
Yes — a 51-card Anesthasia deck, printed in full in the flashcards section of this page and available in the Examius app with spaced repetition. The free plan covers one exam of your choice, including its flashcards; Examius Pro, a one-time purchase, unlocks every other exam and deck.