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d b review > 29. Anesthesiology > Flashcards

29. Anesthesiology Flashcards

1
Q

A drug which, when applied “locally” in a concentration without toxic effects, reversibly blocks the conduction of nerve impulses (*both sensory and motor)

A

Local anesthetics

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2
Q

Action of local anesthetics: Blocks what?

A

Blocks sodium channels preventing depolarization (intracellular)

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3
Q

Injectable form of local anesthesia

A

Ionized form or Water soluble

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4
Q

Unionized free base form

A

Lipid soluble

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5
Q

Aka “acid dissociation constant”

Determines acidity of compound (ability to donate protons)

A

pKa

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6
Q

aka “power of hydrogen”

A

pH

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7
Q

pKa is aka

A

Acid dissociation constant

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8
Q

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦: 50%
Unionized: 50%

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9
Q

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦: >50%
Unionized: <50%

  • kaya di nageeffect ung anes pag may infection
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10
Q

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦: <50%
Unionized: >50%

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11
Q

BQ: Order of Loss of Sensation

“PaT ToPS”

A 
(“PaT ToPS”)
Pain
Temperature
Touch
Pressure
Skeletal muscle tone
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12
Q

Increase dosage of anesthesia in bloodstream

A

Toxicity

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13
Q

Toxicity:

A

Toxicity:
✅Rapid induction of LA
✅Vessel deposition
✅Over dosage

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14
Q

Maximum number of carpules

A

7

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15
Q

Overdosage effects:
CNS-
Cardiac-

A

CNS: Anxiety
Heart: ⬇️fxn of heart > ⬇️blood to brain ➡️ Syncope

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16
Q

BQ: Most common medical emergency in the dental clinic

A

Syncope

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17
Q

Management of syncope

A

Trendelenburg position

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18
Q

H1 receptor : Bronchoconstriction and vasodilation

Examples of H1 blocker?

A

Diphenhydramine
Cetirizine
Loratadin

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19
Q

H2 - sTWOmach = ⬆️gastric sec = pain

Examples of H2 blockers?

A

Cemetidine

Ranitidine

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20
Q

Preservative of LA

- prevents contamination from microbes

A

Methylparaben

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21
Q

BQ: Antioxidant of vasoconstrictors (reducing agent)

A

Sodium bisulfites

Sa boards iniiba lang spelling ng “bisulfites”

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22
Q

Ester has highest incidence of LA allergic reaction because of

A

PABA (similar to methylparaben)

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23
Q

Bacteriostatic Drug that mimics PABA (⬆️allergy)

A

Sulfonamides

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24
Q

Most common vasoconstrictor

A

Epinephrine

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25
Q

BQ: Most impt function of vasoconstrictors?

A

Increase duration of effect of LA

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26
Q

BQ: What is the maximum dosage of vasoconstrictors for NORMAL Patients?

A

0.2mg or 200mcg

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27
Q

BQ: What is the max dosage of vasoconstrictors for CARDIOVASCULAR COMPROMISED patients?

A

0.04mg or 40mcg

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28
Q

Maximum number of cartridges given to CARDIOVASCULAR COMPROMISED patients

A

2 cartridges

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29
Q

BQ: What is the max number of LA carpule for AVERAGE pxs?

A

7 carpules

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30
Q

BQ: True or False. All local anesthetics are vasoCONSTRICTORS.

A

False!
[All LAs are vasoDILATORS]
#except: Cocaine (vasoconstrictor)

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31
Q

LA with vasoconstrictor or epinephrine is contraindicated to pxs with

A

Hyperthyroidism ❌

✅hypertension

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32
Q

BQ: 2% Lidocaine with 1:100,000 epi = 1.8ml

Mg of lidocaine?

A

20mg x 1.8ml = 36mg lidocaine

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33
Q

1: 100,000 Epi = ____mg

A

0.01mg

34
Q

1:10,000 epi = ___mg

A

0.1mg

35
Q

1:1000 epi = ___mg

A

1mg

36
Q

mg of Epi in 1:100,000

A

{0.01mg x 1.8ml} = 0.018mg of epi

37
Q

Generic name of Citanest

A

Prilocaine

38
Q

“Weak vasodilator”

A

Mepivacaine

39
Q

Amide local anes without vasoconstrictor

A

3% Mepivacaine

40
Q

BQ: “longest acting anesthesia”

A

Bupivacaine

41
Q

BQ: shortest acting AMIDE / amide with shortest duration of action

A

Mepivacaine 3%

42
Q

BQ: LA contraindicated to pediatric patients

A

Bupivacaine

43
Q

LA sometimes used for Toc douloureux

A

Bupivacaine

44
Q

BQ: LA “rapidly metabolized by the body”

A

Articaine (metabolized by plasma and liver)

45
Q

BQ: What amide local anes is combined to produce Topical anesthesia

A

Lidocaine + Prilocaine

46
Q

BQ: What is the most common local anesthesia?

A

Lidocaine

47
Q

BQ: Which amide LA is safe for children and patients with cardiovascular problems

A

Mepivacaine

48
Q

BQ: Only LA that is a vasoconstrictor

A

Cocaine

Mepivacaine

49
Q

1st LA

A

Cocaine

50
Q

Synergist to catecholamines = ⬆️BP (not used anymore)

A

Cocaine

51
Q

“1st synthetic LA”

A

Procaine

52
Q

“Shortest acting LA”

A

Procaine

53
Q

Most common topical anesthesia

A

Benzocaine

54
Q

BQ: remember: majority of LA used today are:

A

Tertiary amines (amide)

55
Q

Short needle = _mm

A

Short: 20mm

56
Q

Long needles: _mm

A

Long : 32mm

57
Q

Ultrashort = _mm

A

Ultrashort - <20mm

58
Q

Most commonly fractured gauge of needle

A

30g

59
Q

Most common site of needle fracture

A

Hub

60
Q

Gauge used for high risk of positive aspiration (eg. APLASTIC ANEMIA)

A

25g

61
Q

BQ: What needle is used in mandiblock in PEDIA

A

Child: 27g Short

[Adult: 27g Long]

62
Q

BQ: What needle is used for intraligamentary injection?

A

30g ultrashort

63
Q

BQ: What is the level of the needle when doing classic mandibular blocking in CHILDREN?

A

45 degrees - below occ plane

64
Q

BQ: What is the angulation of the needle when doing classic mandiblock in ADULTS?

A

Parallel to occ plane

65
Q

BQ: 1st IANB fails: what will you do next?

A

Inject HIGHER

Baka nagmigrate ung pterygomn space bec of bony deposition

66
Q

Most common Complication assoc with PSAN block

A

Hematoma

67
Q

“true asan block”

A

Infraorbital nerve block

68
Q

BQ: Reference in infraorbital nerve block

A

1st PM

2nd option: distal of canine

69
Q

BQ: Most common complication assoc with Infraorbital nerve block

A

Ecchymosis

70
Q

Infraorbital nerve block includes what nerves

A

Asan ✅

Msan (sometimes)

71
Q

BQ: Rx app of “nasopalatine duct cyst”

A

Heart shape rx app

72
Q

Cyst located in the incisive foramen

A

Nasopalatine duct cyst

73
Q

“Nerve of scarpa”

A

Nasopalatine nerve

74
Q

“Anterior palatine nerve”

A

Greater palatine nerve

75
Q

“Posterior palatine nerve”

A

Lesser palatine nerve

76
Q

BQ: GPNB blocks:
A. Post 2/3 of hard palate
B. Post 2/3 of hard palate ON THE SIDE OF INJECTION

A

B!!! On the side of injection!

77
Q

Why contralateral side in mandiblock?

A

To prevent BELL’S PALSY

78
Q

Most common muscle involved in trismus

A

Medial pteygoid muscle

79
Q

“True mandibular blocking”

A

Gow gates technique

- block V3 (nerve trunk)

80
Q

“Closed mouth mandibular blocking”

A

Akinosi vazirani

81
Q

Technique used for pxs with trismus or for pediatric pxs

A

Akinosi vazirani

82
Q

Reference point of Akinosi vazirani

A

Mx area or occ plane

d b review (38 decks)

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