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Anaes Flashcards

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1
Q

What does LMA stand for and what is it

A

Laryngeal Mask airway, a supraglottic airway device

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2
Q

Most common drug used for Total IntraVenous Anaesthesia(TIVA)

A

Propofol

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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

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4
Q

Where spinal cord ends in adults and children

A

Adults: L1
Children: L2-L3

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5
Q

Possible complication of a spinal block

A

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

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6
Q

Risk Factors for post Dural Puncture Headache

A

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

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7
Q

Antidote for Malignant Hyperthermia

A

Dantrolene

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8
Q

Most common anesthetic agents causing Malignant Hyperthermia

A

Inhalational agents

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9
Q

Anesthetic agents that are more likely to cause Malignant Hyperthermia

A

Inhalational agents eg sevaflurane, desflurane as well as succinylcholine

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10
Q

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

A

IV metoclopramide or IV ondansetron

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11
Q

Why is it important to ask for hx of recent URTI

A

Recent URTI may predispose to peri operative bronchospasm

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12
Q

Function of bite block in supra glottoc airway

A

Prevent negative pressure pulmonary edema

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13
Q

5 ways of confirming ETT placement

A

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

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14
Q

Scoring for supine Laryngeal view scoring

A

Cormack Lehane grading

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15
Q

Normal range of Biospectral Index(BIS)?

A

40-60

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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. ?
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17
Q

Difference between phenylephrine and ephedrine

A

Phenylephrine causes vasoconstriction and either normal HR or bradycardia

Ephedrine causes vasoconstriction and tachycardia

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18
Q

Antidote for rocuronium(non depolarising NMBA)

A

Sugammadex

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19
Q

Definitive Mx for difficult airway with repeated failed intubation attempts

A

Surgical Cricothyroidotomy/front of neck access

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20
Q

Triad of anaesthesia

A

Hypnosis, Muscle paralysis and Sedation

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21
Q

Pharmacokinetics vs Pharmacodynamics

A

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

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22
Q

Rough number of half lives taken to fully eliminate a drug

A

5 half lives( About 96% cleared)

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23
Q

Sites of drug elimination in the body

A

liver, Kidney and lungs

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24
Q

Alternative types of fentanyl that tend to act faster

A

remifentanil and sufentanil

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25
Elements of PONV score
26
What is MAC
Minimum Alveolar Concentration, the concentration of an inhalational agent at which 50% of patients will not respond to a painful stimulus
27
Durations of fasting
Clear feeds: 2hrs Light meal: 6hrs Heavy meal: 8hrs
28
Ideal BIS range for adequate anaesthesia
40-60%
29
Scoring system for PONV( Post Op Nausea and Vomiting)
Apfel score 1.Female Gender 2. Non smoker 3. History of PONV or motion sickness 4. Post op opioids
30
5 most common drug classes used to provide balanced anesthesia
Benzodiazepines Opioids Induction agents Neuromuscular blockers Sympathomimetics
31
Diastolic BP cutoff associated with periop MI
DBP>110
32
Ladders of pain control
Paracetamol Nsaids Opioids(Fentanyl, Oxycodone) +-Adjuncts eg Pregabalin, Gabapentin
33
Common analgesics used for peri and post operative pain mx
IV paracetamol Fast acting opioids: Fentanyl Ultra fast acting opioids: Alfentanil,sufentanil, remifentanil Long acting opioids: Oxycodone, Morphine
34
5 main drugs used in balanced anaesthesia
BZDs Opioids Induction agents NMBAs Sympathomimetics
35
Commonly used induction agents
Propofol Etomidate Ketamine Thiopental Volatile inhalational agents
36
Examples of volatile inhalational agents
Desflurane and sevaflurane
37
What does MAC stand for and it’s meaning
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
Ways of measuring depth of anaesthesia
BIS(Processed EEG) End tidal concentration of inhalational agent
39
Examples of depolarising NeuroMuscular Blocking Agents(NMBA)
Succinylcholine
40
Examples of non depolarising NMBAs
Rocuronium,Atracurium
41
NMBA of choice in rapid sequence intubation
Succinylcholine depolarizing NMBA due to its faster onset of action and shorter duration
42
Reversal agent for non depolairisng NMBAs
Neostigmine
43
Contraindications for Succinylcholine use
Risk of HyperK Burns victims Denerving injury Hx of Malignant Hyperthermia Pseudocholinesterase deficiency
44
Ropivacaine vs Lignocaine
Lignocaine is shorter acting
45
INR cutoff for proceeding with central neuroaxial block
INR must be <1.5
46
Treatment for negative pressure pulmonary edema
Continuous positive airway pressure (cPAP)
47
Most common cause of hypotension in PACU
Hypovolemia: Hemorrhagic shock or dehydration
48
Most important principle in pain management
Multimodal analgesia -paracetamol -NSAIDs -Opioids -Adjuncts -Nerve blocks
49
Antidote for opioid overdose
Naloxone
50
Example of cholinesterase inhibitor
Neostigmine
51
advantage of using etomidate as induction agent
Minimal cardiovascular effects, less likely to cause hypotension
52
Target intra op MAP
>60
53
Target intra op temp
35-36 deg
54
Target intra op urine ouput
0.5ml/kg /hr
55
Side effects of etomidate
Adrenal suppression, high risk of PONV, myoclonus
56
Best induction agent for RSI
??? Ketamine if pt is not catecholamine depleted
57
Major concern in knee dislocation
Popliteal artery injury
58
Triple therapy for neck fasc
Penicillin G, clindamycin and ceftazidime Clindamycin especially impt due to its anti toxin effect
59
Pre op fasting period
Heavy meals: 8hrs Light meals: 6hrs Breast milk: 4hrs Clear feeds: 2hrs
60
Side effects of volatile inhalational agents
1. PONV 2. Malignant Hyperthermia 3. HyperK
61
Reversal of Succinylcholine
Neostigmine+glycopyrrulate

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