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MRCS Critical Care Exam Questions and Answers (New 2025)
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MRCS Critical Care Exam Questions and Answers (New 2025)
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MRCS Critical Care Exam Questions andAnswers (New 2025)
What is the difference between the terms anaesthesia and
anaesthetics? - Correct Answer ✅ Anaesthesia: Total/partial
loss of sensation.
Anaesthetics: Agents that induce anaesthesia.
What are the different types of anaesthesia? - Correct
Answer ✅ Topical: renders part of the body surface
insensitive to noxious stimuli.
Local: A small area of the body is rendered insensitive
without loss of consciousness.
Regional: A larger area using plexus blocks, Bier's block, or
spinal anaesthesia.
General: Systemic insensitivity with loss of consciousness.
What are the 3 goals of anaesthesia? - Correct Answer ✅
Analgesia: Insensitivity to noxious stimuli.
Sedation: Reversible loss of consciousness.
Paralysis: Muscle relaxation.
,MRCS Critical Care Exam Questions and
Answers (New 2025)
What factors might influence the type of anaesthetic used? -
Correct Answer ✅ Procedure duration.
Procedure location.
ASA status.
Surgeon/Anaesthetist preference.
Patient preference.
What are the classifications of local anaesthetics? - Correct
Answer ✅ Amides: Lidocaine, bupivacaine, prilocaine.
Esters: Cocaine, procaine.
How do local anaesthetic work? - Correct Answer ✅ They
cause reversible inhibition of cell membrane Na+ channels,
which prevents generation and propogation of action
potentials.
What factors affect the efficacy and potency/duration of LAs?
- Correct Answer ✅ Na+ channels are proteins, which
mean that LAs with greater protein affinity have better
efficacy.
,MRCS Critical Care Exam Questions and
Answers (New 2025)
LAs with greater lipid solubility are more potent and have a
longer duration of action.
What forms do LAs exist in? - Correct Answer ✅ 2 forms:
cationic and ionised base.
Why is the pH of the area of LA injection important? - Correct
Answer ✅ The state that LAs are in are affected by the pH
of their surrounding. In an acidic environment, LAs cannot
penetrate the cell membrane which makes them ineffective.
NaHCO3 may be added to LA preparations to increase pH and
therefore increase their efficacy.
Describe the possible complications of LA. - Correct Answer
✅ Neurological: Perioral & Glossitic paraethesia, light-
headedness, dizziness, drowsiness, seizures, tinnitus,
tremors, confusion & coma.
Cardiovascular: Bradycardia, hypotension, VFib, Asystole.
What is the usefulness of adding adrenaline with local
anaesthetic agents? - Correct Answer ✅ It produces
, MRCS Critical Care Exam Questions and
Answers (New 2025)
localised vasoconstriction, thereby decreasing absorption of
local anaesthetic from the site of infiltration and improving
duration of anaesthesia. It also reduces blood loss
intraoperatively. Skin pallor induced by adrenaline also helps
identify areas successfully infiltrated.
When is adrenaline with local anaesthetic contraindicated? -
Correct Answer ✅ 1. Tissues with end-arteries, e.g. digits
and penis.
2. Degloving and flap injuries.
3. Haematoma blocks.
Which LA should be used for haematoma blocks? - Correct
Answer ✅ Prilocaine. It has faster hepatic metabolisation
and has lower direct neurotoxicity than lidocaine.
What caution should be considered with the use of prilocaine?
- Correct Answer ✅ It may produce methaemoglobinaemia,
which is of particular concern in children.
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