5.6.2013(anesthesia) 28 Flashcards
Muscle relaxation in myasthenia pts if needed during Sx
1/10th of dose of atracurium
Ketanserine is used in
Carcinoid syndrome
Muscle relaxant CI in obstetrics
Gallamine(crosses placenta)
Muscle relaxant used in arterial Sx
Pancuronium(to maintain arterial pressure)
Muscle relaxant with maximum histamine release
d-tubocurarine
NDMR used in RSI
Rocuronium
Rapacuronium
Muscle relaxant used in hypotensive anesthesia
d tubocurarine
Rate of flow in oxygen flush
35-75L/min
High pressure system
Cylinder
Wall pipes
Low pressure system
Valves
Flowmeters
Vaporisers
Analgesic anaesthetic agents
ketamine
Trilene
N2O
Ether
Antianalgesic anaesthetic agent
Thiopentone
Rx of seizures in bupivacaine toxicity
Thiopentone
Midazolam
Propofol
Gases filled as liquid in cylinder
O2
N2O
CO2
Cyclopropane
Percentage of lignocaine used for urethral analgesia
1-2% jelly
Concentrations of lignocaine available
1% 2% 4% 5% 10%
Anesthesia of intact skin
Eutectic mixture of LA
2.5% lidocaine+2.5% prilocaine
Anesthesia of cut skin
TAC
LET
TAC
Tetracaine 0.5%
Adrenaline 1/2,00,000
Cocaine
LET
Lidocaine 4%
Epinephrine 1/20,000
Tetracaine 0.5%
Side effects of opioids for which tolerance does not develop
Miosis
Constipation
Convulsions
Concentration of Epinephrine used along with LA
1:2,00,000
Remifentanyl is metabolised by
RBC esterase
LA never used as surface anaesthetics
Procaine
Mepivacaine
Bupivacaine
Betablockers with membrane stabilising activity
Propranolol Metoprolol Labetolol Acebutalol Pindolol
Possess Membrane stabilising or Local Anesthetic Property
Concentration of adrenaline in bronchial asthma(inhalational)
1:100
1:1000 conc of adrenaline is used for
Anaphylactic shock i.m and subcutaneous
1:10,000 concentration of adrenaline used in
Anaphylactic shock I.V
cardiac arrest- Intracardiac
Potency of remifentanyl
Alfentanyl<remifentanyl=fentanyl
Renally eliminated Betablockers
Nadolol Sotalol Atenolol Acebutalol Betaoxalol Bisoprolol Celiprolol
Not Soluble ABC
No of chest compressions in children
90/min including neonate
30breaths
Totally 120events/min
Universal compression-ventilation ratio
30:2 for all excluding newborn
Newborn CPR guidelines
Only till the baby remains in hospital
Circulation in infants assessed by
Brachial or femoral
Compression ventilation ratio in infants
15:2
CPR in ventilated patients
Continuous compressions
8-10 ventilations per min
pH below which NaHCO3 can be given
<7.15
Fluids in hypovolemic shock
NaCl
RL
colloid
Not a part of criteria for brainstem death
ECG
Philadelphia criteria for brain death
Lack of reflexes
Pupil fixed and dilated
Isoelectric EEG
Confirmatory tests for brainstem death
Isoelectric EEG
abscence of cerebral circulation by IV radioisotope cerebral angiography or four vessel contrast cerebral angiography
Harvard criteria for brainstem death
Absence of postural reflexes like decerebration
Mismatched blood transfusion during Peroperative period,earliest manifestation
Oozing from operative site
In conscious individual earliest manifestation of mismatched BT
Lumbar pain due to ureteric colic secondary to oliguria
Factors increasing absorption in anesthesia circuits
Resistance in circuit
Small size granules
Low flow rate
CO2 absorption decreased by
High flow rate and tidal volume
Dead space
Channelling
Desflurane is broken down to CO by
Ba(OH)2
Components of sodalime
94% CaOH2
5% NaOH as catalyst
1% KOH
Sodalime reacts with trilene to form
Phosgene
Sodalime shouldn’t be used with
Sevoflurane
Trilene
Chloroform
Baralyme composition
80% CaOH2
20% BaOH2
Antibodies in fulminant form of halothane hepatitis
Halothane altered protein antigen
Halothane use within __________ months is a contraindication
3 months
Muscle relaxants with minimal CVS effects
Vecuronium>doxacurium>rocuronium
Principle of boyles apparatus
Continuous flow,during both inspiration and expiration
Boyle apparatus is a ____________ resistance system
Low
Time for which EMLA should be in contact with skin for analgesic effect
45-60min
Spinal cord in autopsy is approached through
Posterior approach
Common form of acute arsenic poisoning
Gastric
Antidotes for arsenic poisoning
Hydrated ferric oxide
Dimercaprol
Stages of chronic arsenic poisoning
- gastrointestinal
- catarrhal
- skin
- neurological
Postmortem appearance of stomach in arsenic poisoning
Red velvety mucosa
Garlic odor is seen in
arsenic poisoning
Kerosene odor in which poisoning
OPC
KEROSENE
Phenolic odour in which poisoning
Carbolic acid
Rotten egg odour in which poisoning
Hydrogen sulphide
Fishy odour in which poisoning
Zinc phosphide
Burnt rope odour in which poisoning
Cannabis
Bitter almonds odour in which poisoning
Cyanide
Fruity odour in which poisoning
Ethyl alcohol
Criminal negligence IPC
304A
Factors favouring adipocere formation
Warm
Moist
Anaerobic environment
Bacteria involved in adipocere formation
Cl.perfringens(produce lecithinase)
Adipocere formation is not seen in
Foetus <7months
Adipocere first forms in
Subcutaneous tissues of cheeks
Breast
Buttocks
Abdomen
Time taken for adipocere formation
Adult limb:3-6months
12 month for whole body
Conditions required for mummification
High temperature
No moisture
Free air circulation around body
Substances favouring mummification
Arsenic
Antimony poisoning
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