ANAESTHESIA Flashcards
Inherited disorder of skeletal muscle only triggered by certain anaesthetic drugs
malignant hyperthermia
malignant hyperthermia
accumulation of calcium in muscle cells
malignant hyperthermia results in
hypermetabolism
muscle rigidity
muscle breakdown
malignant hyperthermia signs
increase in expired CO2 concentration
tachycardia
increased O2 requirement
temperature increase
what drug is administered for malignant hyperthermia
dantrolene
pre-medication for anaesthesia
benzodiazepines
anaesthesia medications
propofol
thiopental
etomidate
inhalation drugs to induce and maintain anaesthesia
oxygen air or nitrous oxide
stage I of anaesthesia
loss of consciousness
stage II of anaesthesia
excitement/ delirium
coughing, vomitting and struggling
stage III of anaesthesia
laryngeal reflex lost
pupils dilate
stage IV of anaesthesia
cessation of respiration to death
short acting muscle relaxants
suxamethonium
long acting muscle relaxants
atracurium/ rocuronium
NCEPOD
national confidential enquiry into patient outcome and death
what is the national framework for referral for pts
NCEPOD
SBAR
situation
background
assessment
recommendation
what is required for a fasting pt in pre-operative care
maintenance fluids and a fluid assessment
maintenance fluid therapy
0.18% saline with 4% dextrose +_ K+(20-40mmol/l) based on 1mg/kg/hour
Inflammation of the appendix commonly caused by an obstruction of the appendix
appendicitis
where does appendicitis pain present
right iliac fossa
appendicitis symptoms
right iliac fossa pain
nausea
anorexia
constipation OR diarrhoea
pyrexia
tachycardia
appendicitis investigation
FBC - shows leukocytosis
UE
USS
pregnancy test
appendicitis management
NBM
analgesia
hydration
antibiotics
epigastric pain which radiates to the back
pancreatitis
pancreatitis symptoms
epigastric pain which radiates to the back
profoundly unwell due to third spaces loss
what presents on a blood test with pancreatitis
elevates serum amylase
pancreatitis treatment
IV fluid replacement
analgesia
NBM
o2
flank pain that originates over the costovertebral angle and extends towards groin/ testicle
renal colic
RUQ pain
cholecystitis
cholecystitis symptoms
RUQ pain
fever and tachycardia
types of bowel pain
somatic
visceral
neuropathic
somatic bowel pain
body surface or MSK system
visceral bowel pain
internal organs
neuropathic bowel pain
spinal cord and peripheral nerves
what type of analgesia is aspirin
anti-platelet medication
what disease is diclofenac contraindicated for
CV disease
why is pethidine not recommended post op
its metabolised in the renal system
opiates are a
analgesic
what does opiate toxicity present as
reduced consciousness
pin-point pupils
hypotension
siezures
muscle spasms
cyanosis
why does opiate toxicity cause cyanosis
respiratory depression
tx for opiate toxicity
naloxone 0.4-2mg IV at intervals of 2-3 minutes
what is naloxone used for
opiate toxicity
max dose of naloxone
10mg
what side effect is common with opiates
constipation
why does hypocholemic alkalosis develop with nausea and vomiting
body is depleted of water and HCL
why does vomiting cause hypokalaemia
loss of potassium
the sepsis 6
give high flow O2
take blood cultures
give IV antibiotics
measure lactate
measure urine output
SIRS with a presumes or known source of infection
SEPSIS
diagnostic criteria for sepsis
temperature <36 or >38
HR >90bmp
resp rate >20 bpm
WCC <4 or >12
blood glucose >7.7mmol/l
types of haemorrhage
primary
reactive
secondary
primary haemorrhage
continuous bleeding which occurs during surgery
reactive haemorrhage
bleeding appears stable until BP rises
secondary haemorrhage
occurs 1-2 weeks post op and usually due to infection
A-E approach for major haemorrhage
activate major haemorrhage protocol
give IV access ASAP
cross-match blood
how is haemorrhage classified
basketts classification
signs of DVT
swollen calf
warm/tender calf
pitting oedema
erythema
DVT prophylaxis med
Heparin SC 500u/12 hr until mobile
sudden obstruction of a pulmonary artery or one of its branches
pulmonary embolism
pulmonary embolism cause
blood-borne clot or foreign material
pulmonary embolism symptoms
shortness of breath
pleuritic chest pain
dizziness
pulmonary embolism signs
pyerxia
reduced lung sounds
sinus tachycardia
ECG changes
fluctuating stage of mental confusion
delirium
delirium causes
surgery
infection
alcohol with drawl
B12/ thiamine def
hypoglycaemia
hypoxia
stroke
myocardial injury
delirum tx
haloperidol 0.5-2mg +/- chlordiazepoxide reducing regime and Pabrinex IV
