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Free Practice Questions for PGIM MD Anaesthesiology

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Key Facts: PGIM MD Anaesthesiology Exam

3

Examined subjects

10

Clinical Sciences OSCE stations

9

Minimum total closed mark to pass

ALS

Mandatory COAISL certificate

The PGIM Selection Examination in MD (Anaesthesiology) assesses Applied Physiology, Applied Pharmacology and Applied Physics & Clinical Measurements through MCQ theory papers, an OSVE in each subject and a 10-station Clinical Sciences OSCE. Marking uses closed marks: a candidate needs 3 or more in all three MCQ subjects to progress and a total of at least 9 across the three components to pass.

Sample PGIM MD Anaesthesiology Practice Questions

Try these sample questions to review concepts for the PGIM MD Anaesthesiology exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1During which phase of the left ventricular cardiac cycle is myocardial oxygen consumption per unit time at its highest?
A.Isovolumetric contraction
B.Rapid ventricular ejection
C.Reduced ventricular ejection
D.Isovolumetric relaxation
Explanation: Isovolumetric contraction generates peak ventricular wall tension (afterload) against closed mitral and aortic valves, requiring maximal ATP hydrolysis and peak myocardial oxygen consumption rate. According to Laplace's law, wall stress is highest when intraventricular pressure rises steeply before aortic valve opening. Once ejection begins, ventricular radius decreases, which reduces wall stress and instantaneous oxygen demand.
2According to Guyton's model of vascular function, which intervention increases the mean systemic filling pressure (MSFP) without significantly altering vascular resistance?
A.Administration of a pure arteriolar vasodilator
B.Rapid intravenous infusion of 1000 mL crystalloid
C.Infusion of a high-dose pure alpha-1 adrenergic agonist
D.Institution of positive end-expiratory pressure (PEEP) at 10 cmH2O
Explanation: Mean systemic filling pressure (MSFP) is the equilibrium pressure throughout the systemic circulation when cardiac output is zero, determined by total blood volume and systemic vascular compliance. Rapid infusion of intravenous crystalloid expands intravascular volume, increasing the 'stressed volume' in the capacitance vessels and directly shifting the vascular function curve to the right without primarily changing vascular resistance. In Guyton's venous return curve, this raises the x-intercept (MSFP) and enhances the driving pressure for venous return (MSFP - RAP).
3A 68-year-old patient with severe calcific aortic stenosis and coronary artery disease develops acute intraoperative tachycardia of 125 beats/min and hypotension (BP 80/50 mmHg). Which physiological alteration most severely compromises subendocardial perfusion in this patient?
A.Disproportionate shortening of diastolic perfusion time combined with reduced coronary perfusion pressure
B.Elevated coronary vascular resistance due to metabolic vasoconstriction
C.Increased systolic ejection time causing retrograde systolic coronary flow
D.Decreased left ventricular end-diastolic pressure reducing transmyocardial gradient
Explanation: Left ventricular coronary perfusion occurs almost exclusively during diastole because intramyocardial pressure exceeds intracavitary pressure during systole, particularly in the subendocardium. Tachycardia selectively shortens diastolic filling time, while hypotension lowers aortic diastolic pressure, crashing the coronary perfusion pressure gradient (Aortic Diastolic Pressure - LVEDP). In concentric LV hypertrophy from aortic stenosis, baseline LVEDP is already high, making this combination catastrophic for subendocardial perfusion.
4Which molecular event is the primary mediator of increased force generation in the Frank-Starling mechanism of the intact myocardium?
A.Increased sensitivity of cardiac troponin C to intracellular calcium at longer sarcomere lengths
B.Greater release of calcium ions from the sarcoplasmic reticulum via RyR2 channels
C.Increased phosphorylation of phospholamban by protein kinase A
D.Upregulation of the sodium-calcium exchanger (NCX) during ventricular filling
Explanation: The Frank-Starling law describes the relationship between end-diastolic volume (sarcomere stretch) and stroke volume. At the molecular level, length-dependent activation is primarily mediated by increased affinity of cardiac troponin C (cTnC) for calcium and decreased lateral spacing between actin and myosin filaments, allowing more cross-bridge attachments at any given cytosolic calcium concentration. Unlike inotropic stimulation, the Frank-Starling mechanism operates without an increase in peak intracellular calcium transient.
5Which nerve carries afferent sensory baroreceptor signals from the carotid sinus to the nucleus tractus solitarius in the medulla oblongata?
A.Glossopharyngeal nerve (CN IX)
B.Vagus nerve (CN X)
C.Hypoglossal nerve (CN XII)
D.Accessory nerve (CN XI)
Explanation: Afferent baroreceptor fibres from the carotid sinus travel via the sinus nerve of Hering, which joins the glossopharyngeal nerve (cranial nerve IX) to synapse in the nucleus tractus solitarius (NTS) of the medulla. In contrast, baroreceptors located in the aortic arch transmit afferents via the vagus nerve (cranial nerve X). Activation of the NTS excites the nucleus ambiguus and inhibits the rostral ventrolateral medulla, causing bradycardia and vasodilation.
6Functional residual capacity (FRC) in an adult corresponds to the sum of which two lung volumes?
A.Expiratory reserve volume and residual volume
B.Tidal volume and inspiratory reserve volume
C.Inspiratory reserve volume and residual volume
D.Tidal volume and expiratory reserve volume
Explanation: Functional residual capacity (FRC) is the volume of gas remaining in the lungs at the end of a normal tidal expiration when respiratory muscles are relaxed. It represents the equilibrium point between the outward elastic recoil of the chest wall and the inward elastic recoil of the lungs, and mathematically equals the expiratory reserve volume (ERV) plus residual volume (RV). In an average 70 kg adult, normal upright FRC is approximately 2.2 to 2.4 litres.
7A mechanically ventilated patient has an end-inspiratory pause applied. The ventilator shows a peak inspiratory pressure (PIP) of 34 cmH2O, a plateau pressure (Pplat) of 22 cmH2O, PEEP of 6 cmH2O, and a delivered tidal volume of 480 mL. What is the patient's static respiratory compliance (Cstat)?
A.30 mL/cmH2O
B.17 mL/cmH2O
C.22 mL/cmH2O
D.40 mL/cmH2O
Explanation: Static compliance of the respiratory system is calculated as Tidal Volume divided by Driving Pressure, where Driving Pressure = Plateau Pressure - PEEP: Cstat = Vt / (Pplat - PEEP). Here, Cstat = 480 mL / (22 - 6 cmH2O) = 480 / 16 = 30 mL/cmH2O. Peak inspiratory pressure is not used to calculate static compliance because PIP includes airway resistive pressure in addition to elastic recoil.
8In which clinical scenario does closing capacity exceed functional residual capacity during normal tidal breathing, predisposing the patient to dependent airway collapse and shunt?
A.An anaesthetized, paralysed 72-year-old patient positioned supine
B.An awake, healthy 25-year-old athlete standing upright
C.A healthy non-smoking 30-year-old patient positioned in 30-degree reverse Trendelenburg
D.A healthy adolescent undergoing knee arthroscopy under spinal anaesthesia
Explanation: Closing capacity (CC = Closing Volume + Residual Volume) increases progressively with age due to loss of elastic tissue tethering small terminal airways. In the supine position, closing capacity equals FRC at approximately 44 years of age, and in the upright position at approximately 66 years. General anaesthesia and neuromuscular blockade further reduce FRC by 15-20% due to cephalad diaphragm displacement, causing CC to far exceed FRC in an elderly supine patient, leading to atelectasis and physiological shunt.
9Patients with severe restrictive lung disease naturally adopt which pattern of breathing to minimize their total work of breathing?
A.Rapid, shallow breathing
B.Slow, deep breathing with prolonged expiration
C.Irregular breathing with intermittent breath-holding
D.Normal frequency with markedly enlarged tidal volume
Explanation: Total work of breathing comprises elastic work (distending the lung and chest wall) and resistive work (overcoming airway and tissue frictional resistance). In restrictive lung diseases (such as pulmonary fibrosis), lung compliance is markedly reduced, which exponentially escalates elastic work at large tidal volumes. Therefore, the respiratory centre minimizes total mechanical work by selecting a higher respiratory frequency with smaller tidal volumes (rapid, shallow breathing).
10Which change causes a rightward shift of the oxyhaemoglobin dissociation curve (facilitating oxygen unloading to tissues)?
A.Increased erythrocyte 2,3-diphosphoglycerate (2,3-DPG) concentration
B.Development of acute severe hypothermia (core temperature 32°C)
C.Acute respiratory alkalosis with arterial pH of 7.55
D.High concentration of carboxyhaemoglobin in the circulation
Explanation: A rightward shift of the oxyhaemoglobin dissociation curve indicates decreased affinity of haemoglobin for oxygen, facilitating oxygen unloading to metabolically active tissues at higher partial pressures. Elevated 2,3-DPG binds to the beta-chains of deoxyhaemoglobin and stabilizes the low-affinity T (tense) quaternary conformation. Other factors shifting the curve to the right include hyperthermia, acidosis (Bohr effect), and hypercapnia.

About the PGIM MD Anaesthesiology Exam

The Selection Examination in MD (Anaesthesiology) is conducted by the Postgraduate Institute of Medicine, University of Colombo, to select medical officers for the MD (Anaesthesiology) training programme leading to board certification in Anaesthesiology in Sri Lanka. It is set and sat in English under the 2022 Anaesthesiology Prospectus.

Exam sponsor: Postgraduate Institute of Medicine, University of Colombo. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Three subjects are assessed - Applied Physiology, Applied Pharmacology, and Applied Physics & Clinical Measurements. Each subject has an MCQ theory component and an Objective Structured Viva Examination (OSVE). In addition there is a 10-station Objective Structured Clinical Examination (OSCE) in the Clinical Sciences. Candidates who clear the MCQ threshold proceed to the OSCE and OSVE.

Time Limit

Durations are not published by the PGIM; the MCQ papers are held first, with the OSCE and OSVE on later scheduled dates.

Passing Score

A closed mark of 3 or more in all three MCQ subjects is required to proceed to the OSCE and OSVE. A pass requires a total closed mark of at least 9 across the three components, no more than one component below 3, no component below 2, a closed mark of 3 in each of the three theory subjects, a closed mark of 3 in six of the ten OSCE stations, and a closed mark of 3 in every OSVE panel.

Exam / Certification Fees

Rs. 17,500 registration + Rs. 80,000 examination fees + an application fee stated as Rs. 8,500 in the fee schedule of Circular 48/2026 (Rs. 9,500 in the same circular's payment instruction). Rs. 34,500 of the examination fee is paid at application and the Rs. 45,500 balance after passing the MCQ; non-state sector +50%.

Exam sponsor website

Reported exam pass rate: Merit-based; 25 Ministry of Health places were offered in the August/September 2026 sitting.. The PGIM publishes merit lists and pass index numbers per sitting rather than percentage pass rates. This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Theory MCQ + OSVE subject

Applied Physiology

Cardiovascular, respiratory, renal, neurophysiological and acid-base physiology applied to anaesthesia and critical care.

Theory MCQ + OSVE subject

Applied Pharmacology

Intravenous and inhalational anaesthetics, neuromuscular blockers and reversal, opioids, local anaesthetics, and cardiovascular and vasoactive drugs.

Theory MCQ + OSVE subject

Applied Physics & Clinical Measurement

Gas laws, cylinders and pipelines, vaporisers and breathing systems, monitoring (pulse oximetry, capnography, invasive pressure) and electrical safety.

10-station Clinical Sciences OSCE

Clinical Practice & Resuscitation

Airway assessment and management, difficult-airway algorithms, resuscitation, anaphylaxis, malignant hyperthermia and local anaesthetic systemic toxicity.

Preparing for the PGIM MD Anaesthesiology Exam

What You Need to Know

  • Passing score: A closed mark of 3 or more in all three MCQ subjects is required to proceed to the OSCE and OSVE. A pass requires a total closed mark of at least 9 across the three components, no more than one component below 3, no component below 2, a closed mark of 3 in each of the three theory subjects, a closed mark of 3 in six of the ten OSCE stations, and a closed mark of 3 in every OSVE panel.
  • Assessment: Three subjects are assessed - Applied Physiology, Applied Pharmacology, and Applied Physics & Clinical Measurements. Each subject has an MCQ theory component and an Objective Structured Viva Examination (OSVE). In addition there is a 10-station Objective Structured Clinical Examination (OSCE) in the Clinical Sciences. Candidates who clear the MCQ threshold proceed to the OSCE and OSVE.
  • Time limit: Durations are not published by the PGIM; the MCQ papers are held first, with the OSCE and OSVE on later scheduled dates.
  • Exam / certification fees: Rs. 17,500 registration + Rs. 80,000 examination fees + an application fee stated as Rs. 8,500 in the fee schedule of Circular 48/2026 (Rs. 9,500 in the same circular's payment instruction). Rs. 34,500 of the examination fee is paid at application and the Rs. 45,500 balance after passing the MCQ; non-state sector +50%. Official sources

Using Our Practice Resources

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PGIM MD Anaesthesiology: Suggested Study Strategy

1Focus deeply on pharmacokinetics: volume of distribution, clearance, context-sensitive half-time, and redistribution kinetics of propofol and fentanyl.
2Review the mechanisms of action, metabolism, and Hoffman elimination of neuromuscular blocking drugs such as atracurium and vecuronium.
3Understand the physical principles behind the variable-bypass vaporizer and temperature compensation mechanisms.
4Master oxygen delivery concepts: alveolar gas equation, oxyhaemoglobin dissociation curve shifts, and dead space calculations.
5Rehearse the ALS algorithm and difficult airway guidelines issued by the Difficult Airway Society (DAS).

Frequently Asked Questions

What is the format of the PGIM MD Anaesthesiology selection examination?

Three subjects - Applied Physiology, Applied Pharmacology and Applied Physics & Clinical Measurements - are each assessed by an MCQ theory paper and an Objective Structured Viva Examination, alongside a 10-station Clinical Sciences OSCE.

What prerequisites are required before applying for the examination?

Candidates must hold an SLMC-registered MBBS, have completed internship plus one year of post-internship clinical practice, and hold valid ALS certification from COAISL.

What is the passing score for the theory component?

Marking uses the PGIM closed-mark scale rather than percentages. A closed mark of 3 or more in all three MCQ subjects is needed to reach the OSCE and OSVE, and a pass requires a total closed mark of at least 9 across the three components with the per-component minima set out in Circular Letter No. 48/2026.

How many attempts are permitted for the PGIM selection examination?

Under current PGIM regulations, eligible candidates are permitted a maximum of six attempts at barrier selection examinations.

Are these official PGIM exam papers?

No. These are independent practice questions authored by OpenExamPrep to assist candidates preparing for the PGIM MD Anaesthesiology selection exam.

Does this practice bank simulate the official PGIM examination format?

No. The official selection examination combines MCQ theory papers with an Objective Structured Viva Examination and a 10-station OSCE, and is marked on a closed-mark scale. This is an independent English-language, four-option MCQ study bank by OpenExamPrep covering the same applied sciences; it is not an official paper, a format simulation, or a substitute for viva and OSCE practice.