Anaesthetic Flashcards

1
Q

Propofol onset

A

Rapid

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2
Q

Propofol use

A

Maintenance in theatre and ITU

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3
Q

Adverse effects propofil

A

Painful injection

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4
Q

Metabolites propofol

A

little accumulation

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5
Q

Myocardial depression popofol

A

moderate

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6
Q

Added benefit propofol

A

anti-emetic

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7
Q

Sodium thiopentone use and why

A

Rapid sequence induction
rapid onset

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8
Q

Myocardial depression sodium thiopentone

A

Marked

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9
Q

Can Sodium thiopentone be used as maintenance?

A

No

myocardial depression and build up of metabolites

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10
Q

Analgesic effects of sodium thiopentone

A

Little

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11
Q

Use of ketamine

A

haemodynamically unstable patients
little myocardial depression
strong analgesic properties

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12
Q

Side effect ketamine

A

dossociative - nightmares

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13
Q

Benefits of etomidate

A

good cardiac safety
reduce hormone production to damped stress response

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14
Q

Downsides of etomidate

A

no analgesia
post op vomiting
adrenal suppression

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15
Q

Plain lidocaine dose

A

3mg/kg

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16
Q

Lidocaine with adrenaline dose

A

7mg/kg

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17
Q

Prilocaine plain dose

A

6mg/kg

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18
Q

Prilocain with adrenaline dose

A

9mg/kg

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19
Q

Bupivacaine dose with adrenaline

20
Q

Bupivicaie dose plain

21
Q

Use of prilocaine

A

local

less cardiotoxic
IV regional anaestheisa

22
Q

Reversal prilocaine

A

methylene blue

23
Q

management toxicity local anaesthetic

A

stop injecting
high flow oxygen
cardiac monitoring
bolus 1.5ml/kg lipid emulsion
lipid emulsion infusion

24
Q

How does bupivocaine work?

A

prevents sodium influx therefore prevents depolarisation

25
duration of action of bupivocaine
long
26
why is bupivocaine contraindicated in regional block
cardiotoxic
27
how does levobupivocaine differ to bupivocaine
less cardio toxic
28
why can hugher does of lidocaine be given with adrenaline
limit systemic absorption
29
drug interactions with lidocaine
beta blockers ciprofloxacin phenytoin
30
features of lidocine toxicity
CNS activity then depression cardiac arrythmias
31
metabolism and excretion of lidocaine
hepatically metabolised protein bound renally excreted
32
How does lidocaine work
amide blocks sodium in axon
33
What type of necrosis happens in ischaemic injury
coagulative
34
What type of necrosis happens in the brain
colliquative
35
Wat condition is associated with caseous necrosis?
TB
36
What organism is accociated with wet gangrene
clostridium perfringens
37
Why is gangrenous tissue black?
iron sulfide released from Hb breakdown
38
What condition is fibrinoid necrosis associated with?
malignant hypertension
39
what type of necrosis has a smudgy eosinophilic appearance
fibrinoid
40
What is the process of apoptosis
energy dependent activation of endonuclease breaks down DNA
41
apoptosis mediators
p53 - puts damaged cells into apoptosis BCL-2 - hibits apoptosis
42
diseases of increased apoptosis
HIV neurodegenerative
43
diseases of decreased apoptosis
neoplasia autoimmune
44
Options for radiacl radiotherapy
hodgkins mets from seminoma following orchidectomy skin head an dneck laryngeal
45
options for palliative radiotherapy
bony mets cerebral mets ulcerating or fungating breast ca lung ca (cough and haemoptysis)