Anaes Flashcards

1
Q

What does LMA stand for and what is it

A

Laryngeal Mask airway, a supraglottic airway device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common drug used for Total IntraVenous Anaesthesia(TIVA)

A

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why it is important to know where the spinal cord ends

A

For spinal blocks, has to be done below where the spinal cord ends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where spinal cord ends in adults and children

A

Adults: L1
Children: L2-L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Possible complication of a spinal block

A

Post Dural Puncture Headache/ Spinal headache, 1-3% chance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk Factors for post Dural Puncture Headache

A

1) Young Patient
2) Female
3) Pregnant
4) Large needle gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antidote for Malignant Hyperthermia

A

Dantrolene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common anesthetic agents causing Malignant Hyperthermia

A

Inhalational agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anesthetic agents that are more likely to cause Malignant Hyperthermia

A

Inhalational agents eg sevaflurane, desflurane as well as succinylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What to give the patient to reduce the likelihood of postoperative nausea and vomiting

A

IV metoclopramide or IV ondansetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is it important to ask for hx of recent URTI

A

Recent URTI may predispose to peri operative bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Function of bite block in supra glottoc airway

A

Prevent negative pressure pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

5 ways of confirming ETT placement

A

DIRECT VISUALISATION
Misting of ETT
Equal chest rise
5 pt auscultation
End tidal CO2 indicator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Scoring for supine Laryngeal view scoring

A

Cormack Lehane grading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Normal range of Biospectral Index(BIS)?

A

40-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of Respi distress post thyroidectomy

A
  1. Neck hematoma
  2. Acute hypocalcemia from parathyroids
  3. Vocal chord palsy from RLN injury
  4. Tracheomalacia from long-standing goitre
  5. ?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Difference between phenylephrine and ephedrine

A

Phenylephrine causes vasoconstriction and either normal HR or bradycardia

Ephedrine causes vasoconstriction and tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antidote for rocuronium(non depolarising NMBA)

A

Sugammadex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Definitive Mx for difficult airway with repeated failed intubation attempts

A

Surgical Cricothyroidotomy/front of neck access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Triad of anaesthesia

A

Hypnosis, Muscle paralysis and Sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pharmacokinetics vs Pharmacodynamics

A

Kinetics: What body does to the drug
Dynamics: What drug does to the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rough number of half lives taken to fully eliminate a drug

A

5 half lives( About 96% cleared)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sites of drug elimination in the body

A

liver, Kidney and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Alternative types of fentanyl that tend to act faster

A

remifentanil and sufentanil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Elements of PONV score

A
26
Q

What is MAC

A

Minimum Alveolar Concentration, the concentration of an inhalational agent at which 50% of patients will not respond to a painful stimulus

27
Q

Durations of fasting

A

Clear feeds: 2hrs
Light meal: 6hrs
Heavy meal: 8hrs

28
Q

Ideal BIS range for adequate anaesthesia

A

40-60%

29
Q

Scoring system for PONV( Post Op Nausea and Vomiting)

A

Apfel score

1.Female Gender
2. Non smoker
3. History of PONV or motion sickness
4. Post op opioids

30
Q

5 most common drug classes used to provide balanced anesthesia

A

Benzodiazepines
Opioids
Induction agents
Neuromuscular blockers
Sympathomimetics

31
Q

Diastolic BP cutoff associated with periop MI

A

DBP>110

32
Q

Ladders of pain control

A

Paracetamol
Nsaids
Opioids(Fentanyl, Oxycodone)

+-Adjuncts eg Pregabalin, Gabapentin

33
Q

Common analgesics used for peri and post operative pain mx

A

IV paracetamol

Fast acting opioids: Fentanyl

Ultra fast acting opioids: Alfentanil,sufentanil, remifentanil

Long acting opioids: Oxycodone, Morphine

34
Q

5 main drugs used in balanced anaesthesia

A

BZDs
Opioids
Induction agents
NMBAs
Sympathomimetics

35
Q

Commonly used induction agents

A

Propofol
Etomidate
Ketamine
Thiopental
Volatile inhalational agents

36
Q

Examples of volatile inhalational agents

A

Desflurane and sevaflurane

37
Q

What does MAC stand for and it’s meaning

A

Minimum Alveolar Concentration

Concentration of volatile inhalational agents at which 50% of patients will not have a skeletal muscle response to a surgical incision

38
Q

Ways of measuring depth of anaesthesia

A

BIS(Processed EEG)
End tidal concentration of inhalational agent

39
Q

Examples of depolarising NeuroMuscular Blocking Agents(NMBA)

A

Succinylcholine

40
Q

Examples of non depolarising NMBAs

A

Rocuronium,Atracurium

41
Q

NMBA of choice in rapid sequence intubation

A

Succinylcholine depolarizing NMBA due to its faster onset of action and shorter duration

42
Q

Reversal agent for non depolairisng NMBAs

A

Neostigmine

43
Q

Contraindications for Succinylcholine use

A

Risk of HyperK
Burns victims
Denerving injury
Hx of Malignant Hyperthermia
Pseudocholinesterase deficiency

44
Q

Ropivacaine vs Lignocaine

A

Lignocaine is shorter acting

45
Q

INR cutoff for proceeding with central neuroaxial block

A

INR must be <1.5

46
Q

Treatment for negative pressure pulmonary edema

A

Continuous positive airway pressure (cPAP)

47
Q

Most common cause of hypotension in PACU

A

Hypovolemia: Hemorrhagic shock or dehydration

48
Q

Most important principle in pain management

A

Multimodal analgesia
-paracetamol
-NSAIDs
-Opioids
-Adjuncts
-Nerve blocks

49
Q

Antidote for opioid overdose

A

Naloxone

50
Q

Example of cholinesterase inhibitor

A

Neostigmine

51
Q

advantage of using etomidate as induction agent

A

Minimal cardiovascular effects, less likely to cause hypotension

52
Q

Target intra op MAP

A

> 60

53
Q

Target intra op temp

A

35-36 deg

54
Q

Target intra op urine ouput

A

0.5ml/kg /hr

55
Q

Side effects of etomidate

A

Adrenal suppression, high risk of PONV, myoclonus

56
Q

Best induction agent for RSI

A

???

Ketamine if pt is not catecholamine depleted

57
Q

Major concern in knee dislocation

A

Popliteal artery injury

58
Q

Triple therapy for neck fasc

A

Penicillin G, clindamycin and ceftazidime

Clindamycin especially impt due to its anti toxin effect

59
Q

Pre op fasting period

A

Heavy meals: 8hrs
Light meals: 6hrs
Breast milk: 4hrs
Clear feeds: 2hrs

60
Q

Side effects of volatile inhalational agents

A
  1. PONV
  2. Malignant Hyperthermia
  3. HyperK
61
Q

Reversal of Succinylcholine

A

Neostigmine+glycopyrrulate