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Acute Care (Y4) > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

At what level does the spinal cord end?

A

L2/3

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2
Q

At what spinal level are spinal anaesthetics typically given?

A

L3/4

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3
Q

What kind of anaesthetic agent are typically used in spinal anaesthetics?

A

Local anaesthetic (Lidocaine, tetracaine, and bupivacaine etc.)

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4
Q

Into which space is spinal anaesthesia administed?

A

Sub-arachnoid space (between arachnoid and pia mater)

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5
Q

Where is the spinal epidural space found?

A

Between the dura and arachnoid mater

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6
Q

What are the major complications of spinal/epidural anaesthesia to be aware of?

A

Meningitis, post-puncture headache

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7
Q

How long before general/regional anaesthesia should patients avoid food?

A

6 hours

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8
Q

How long before general/regional anaesthesia should patients avoid water?

A

2 hours

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9
Q

Which common medications should be withheld before anaesthesia?

A 
Anti-hypertensives, esp. ACEIs and diuretics
NSAIDs
Anti-platelet agents
Anti-coagulants
Metformin
Insulin
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10
Q

For how long before surgery should Aspirin be with-held?

A

7-10 days

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11
Q

For how long before surgery should Warfarin be with-held?

A

5 days

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12
Q

For how long before surgery should Clopidogrel be with-held?

A

7 days

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13
Q

For how long before surgery should DOACs be with-held?

A

2 days

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14
Q

Which classification is used to describe patient’s physical fitness for anaesthesia?

A

ASA

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15
Q

What is the triad of general anaesthesia?

A

Hypnosis, paralysis, analgesia

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16
Q

Give examples of volatile sedating agents.

A

Nitrous Oxide (Obs/Paeds), Sevoflurane

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17
Q

Give examples of IV sedating agents.

A

Profolol, Etomidate, Ketamine

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18
Q

What is the primary mechanism of profolol?

A

GABA-mediated

19
Q

What is the main side effect of profolol to be aware of?

A

Hypotension

20
Q

Which agents may be used during surgery to raise BP?

A

Metaraminol, ephedrine

21
Q

Nociceptive pain is relayed by which kind of nerve fibres?

A

A-delta and C fibres

22
Q

In which tract would pain signals travel up the spinal cord?

A

Spinothalamic tract

23
Q

Which part of the pain pathway influences your pain threshold?

A

Modulation

24
Q

What is meant by modulation in the pain pathway?

A

Inhibitory signal/descending inhibition to decrease pain

25
Q

Opioids in spinal anaesthesia can evoke which side effect?

A

Itch

26
Q

What are the main differences between epidural and spinal for patients?

A

Epidural takes 15 mins to work, spinal is instant. Epidural usually fitted with catheter to allow further administration

27
Q

How long before surgery should COCP/HRT be stopped?

A

4 weeks due to VTE risk

28
Q

Which rare but life-threatening side effect is associated with halogenated volatile agents?

A

Malignant hyperthermia

29
Q

Which IV sedating agent also contains anti-emetic properties?

A

Propofol

30
Q

Thiopental is contra-indicated in which group of patients?

A

Asthmatics (causes bronchoconstriction)

31
Q

Give a side effect of etomidate.

A

Adrenal suppression

32
Q

Which sedating agent may be favoured in trauma?

A

Ketamine (as does not cause hypotension)

33
Q

Depolarising agents such as suxamethonium may lead to which side effect?

A

Malignant hyperthermia

34
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene

35
Q

What is the most common site for IO access?

A

Proximal tibia

36
Q

What should you do if a peri-operative transfusion is unlikely?

A

Group & save

37
Q

What should you do if a peri-operative transfusion is likely?

A

Cross-match 2 units

38
Q

What should you do if a peri-operative transfusion will definitely be needed?

A

Crossmatch 4-6 units

39
Q

What are the step-wise airway management steps?

A 
Head tilt, chin lift
Jaw thrust
OPA
NPA
iGel
Intubation
Surgical airway
40
Q

How is an oropharyngeal (Guidel) airway sized?

A

Incisor to ear

41
Q

How is an oropharyngeal (Guidel) airway inserted?

A

Inserted upside down and turned round

42
Q

How is a nasopharyngeal airway measured?

A

Nostril to ear

43
Q

Nasopharyngeal airways are contra-indicated in…

A

Base of skull #

44
Q

What size of iGel will the average adult require?

A

4

Acute Care (Y4) (3 decks)

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