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AIIMS > 3.6.2013(anesthesia) 26 > Flashcards

3.6.2013(anesthesia) 26 Flashcards

0
Q

Mechanism of action of Etomidate

A

GABA receptors

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1
Q

Etomidate causes endocrine suppression by

A

11 beta hydroxylase

17 alpha hydroxylase

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2
Q

Steroid inhibitors

A 
Metyrapone
Aminoglutithimide
Trilostane
Ketoconazole 
Etomidate
Mifepristone(glucocorticoid antagonist)
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3
Q

Metyrapone inhibits steroid synthesis by

A

Inhibiting 11 beta hydroxylase

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4
Q

Adverse effects of Etomidate

A 
Myoclonus
Hiccups
Adrenal suppression 
Pain on injection
Thrombophlebitis
Postoperative nausea and vomiting
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5
Q

IV anaesthetic causing pain on arterial injection

A

Thiopentone

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6
Q

IV anaesthetic agent causing thrombophlebitis on intravenous injection

A

Etomidate

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7
Q

IV anaesthetic agent cause pain without thrombophlebitis on intravenous injection

A

Propofol
Methohexital
Thiopental

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8
Q

Antidote for Etomidate induced adrenal suppression

A

Vitamin C

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9
Q

Highest incidence of nausea and vomiting among induction agents

A

Etomidate

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10
Q

Pain relief in thoracotomy

A
  1. Neuraxial block(epidural is gold standard)

2. opioids

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11
Q

Intrathecal opioid of choice after thoracotomy

A

Morphine

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12
Q

High dose of Sch

A

7-10mg/kg

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13
Q

Risk of phase 2 block with Sch

A 
Prolonged exposure(30-60min)
Large dose
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14
Q

CI for nasotracheal intubation

A

Severe mid facial trauma

CSF rhinorhea

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15
Q

Ideal airway procedure in a pt with mid facial trauma

A
  1. cricothyroidectomy

2. orotracheal intubation

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16
Q

Inhalation anaesthetic agent causing coronary steal

A

Isoflurane

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17
Q

Best uterine relaxant among inhalational anaesthetics

A

Halothane

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18
Q

Best muscle relaxant among inhalational agents

A

Ether

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19
Q

Irritant inhalational agents

A

Desflurane
Isoflurane
Ether
Enflurane

DIE

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20
Q

Volatile agent of choice in liver disease

A

Isoflurane(least decrease in portal blood flow)

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21
Q

Induction agents that can be used in liver failure

A

Propofol

Etomidate

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22
Q

Benzodiazepine that can be used in liver failure

A

Lorazepam(undergoes only phase 2 glucuronidation)

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23
Q

Opioid that can be given in liver failure

A

Remifentanyl

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24
Q

Inhalational anaesthetics that can be used in liver failure

A

Desflurane
Sevoflurane
Isoflurane
N2O

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25
Q

Portal flow is maximally reduced by

A

Halothane

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26
Q

Type of anesthesia contraindicated in boy with sickle cell trait

A

IV regional anesthesia

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27
Q

Contraindications for IVRA

A

Sickle cell disease
Raynaud
Scleroderma

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28
Q

Agents used in IVRA

A
  1. 5% prilocaine

0. 5% lignocaine

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29
Q

Drugs causing methhemoglobinemia

A 
Nitrites/nitrates
Benzocaine,prilocaine
Dapsone
Primaquine and related antimalarials
Sulfonamides
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30
Q

Mill wheel murmur heard in

A

Air embolism

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31
Q

Local anaesthetic first used clinically

A

Cocaine

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32
Q

Muscle relaxants independent of kidney and liver function

A

Atracurium
Cis atracurium
Mivacurium

33
Q

Minimum histamine release among muscle relaxant

A

Vecuronium

34
Q

Amount of air necessary to produce significant injury in air embolism

A

5ml/kg

35
Q

Most sensitive NONINVASIVE method to detect air embolism

A

Doppler ultrasound

36
Q

Most sensitive method to detect air embolism

A

Transesophageal echocardiography

37
Q

First sign in air embolism

A

Low end tidal Co2

38
Q

Methods to detect air embolism

A
  1. TEE
  2. PAC
  3. mass spectrometry for end tidal nitrogen(sa sensitive as PAC)
39
Q

Dead space is increased by

A

Old age
Jaw protrusion
Increased lung volume
Standing

40
Q

Decreased dead space is caused by

A

Hyperventilation

41
Q

Most common complication of celiac plexus block

A

Hypotension

42
Q

Indications of celiac plexus block

A

Pancreatitis

Ca pancreas

43
Q

Complications of celiac plexus block

A 
Hypotension
Hematoma
Retroperitoneal hemorrhage(rare)
Injury to aorta,IVC
Diarrhoea
Paraplegia and transient motor block
Aortic dissection
44
Q

Baroreceptor reflexes are inhibited by which induction agent

A

Propofol

45
Q

Indication for CPAP

A

All preterm infants <35wks with any sign of respiratory distress

46
Q

Indications for CPAP in children

A 
RDS
If paO2<50mm on a FiO2 of .40
pulmonary Edema
Atelectasis
Apnea of prematurity
Recent extubation
Tracheomalacia
Transient tachypnea of newborn
47
Q

Metabolite of prilocaine responsible for methhemoglobinemia

A

Orthotoludene

48
Q

Principle of capnogram

A

Co2 absorbs IR rays

49
Q

Phases of capnograph

A

Phase 1: dead space- baseline of capnograph
Phase 2: expiratory upstroke-mixture of dead space and alveolar
Phase3: expiratory plateau-mostly alveolar gas
Phase 4: inhalational phase

End tidal : end of expiratory plateau

50
Q

Adequacy of CPR based on ETCO2

A

Level should return to 10mm Hg or more after 20min of CPR

51
Q

capnograph in bronchial asthma

A

Shark fin appearance

52
Q

Systemic absorption of LA

A

Intrapleural>intercostal>pudendal>caudal>epidural>brachial plexus>sciatic femoral>infiltration

53
Q

Components children hospital eastern Ontario pain scale(CHEOPS)

A 
Cry
Facial
Child verbal
Torso
Touch
Legs
54
Q

A child is said to be in pain if(according Cheops)

A

In children 1-7yrs,score greater than 4 indicates pain

55
Q

Air collections that can be expanded by N2O

A 
Pneumothorax
Air embolus
Obstructed middle air
Obstructed loop of bowel
Intracranial air
Pulmonary bleb
56
Q

CI for N2O anesthesia

A

Vitro retinal Sx
Middle ear Sx
Micro laryngeal Sx

57
Q

Effect of N2O anesthesia in middle ear Sx

A

Serous otitis media
Disarticulation of stapes
Impaired hearing

58
Q

Most commonly used gases in vitro retinal Sx

A

Filtered room air
Sulphur hexafluoride
Perfluropropane

59
Q

Side effect of rapacuronium

A

Intense bronchospasm

60
Q

Shortest acting NDMR

A

Mivacurium

61
Q

Fastest acting NDMR

A

Rocuronium

62
Q

Shortest and fastest acting NMB

A

Sch

63
Q

Pancuronium unique features

A

Least histamine release

Maximal vagal block and tachycardia

64
Q

Vagal and ganglionic stimulation caused by which NMB

A

Sch

65
Q

Most potent muscle relaxant

A

Doxacurium

66
Q

Least potent muscle relaxant

A

Sch

67
Q

Least potent NDMR

A

Rocuronium

68
Q

Maximum ganglionic blockade is caused by which MR

A

d-tubocurarine

69
Q

Most common cause of postoperative renal failure

A

Decreased renal perfusion

70
Q

Sodium carbonate is added to which induction agent to increase solubility

A

Thiopentone

71
Q

Substance added to increase lipid solubility

A

Sulphur

72
Q

Effect of ketamine on CVS

A

Direct myocardial depressant action
Vasodilatation

But it is a reuptake inhibitor

73
Q

Renally eliminated muscle relaxant

A

Doxacurium
Tubocurarine
Pancuronium

74
Q

Muscle relaxant eliminated hepatically

A

Rapacuronium

75
Q

Muscle relaxants with both Renal and liver elimination

A

Pipecuronium
Vecuronium
Rocuronium

76
Q

Side effects of oxygen therapy

A

Hypoventilation
Absorption atelectasis
Pulmonary toxicity
ROP

77
Q

Muscle observed commonly for neuromuscular blockade

A

Adductor pollicis

Most commonly monitored nerve- ulnar

78
Q

Muscle to show earliest reversal following neuromuscular blockade

A

Orbicularis oculi

79
Q

Drawbacks of nasotracheal intubation

A

Sinusitis
Mucosal damage
Restricted movement of endotracheal tube

AIIMS (13 decks)

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