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Alice's finals cards > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

How long should someone not be eating for before and operation?

A

6 hours

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2
Q

How long should someone be completely NBM for before an operation?

A

2 hours (no clear fluids!)

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3
Q

Which type of induction is done if someone cannot be fasted?

A

Rapid sequence induction

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4
Q

Why is preoxygenation done before being put under?

A

This gives them a reserve of oxygen for the period between when they lose consciousness and are successfully intubated and ventilated (in case the anaesthetist has difficulty establishing the airway).

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5
Q

Which types of medication are given as pre-medication before the patient is put under and why?

A

Benzos
Opiates (alfentanyl)
Alpha-2-adrenergic agonists (clonidine)

These are given to relax the patient and reduce pain which makes the intubation easier

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6
Q

What is the biggest concern in rapid sequence induction (RSI) and how is this overcome?

A

Aspiration

Cricoid pressure

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7
Q

What is the triad of general anaesthesia?

A

Hypnosis
Muscle relaxation
Analgesia

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8
Q

What are the two most common options for IV general anaesthetic?

A

Propofol
Ketamine

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9
Q

What are the common options for inhaled general anaesthetic?

A

Sevoflurane
Desflurane (bad for environment)
Nitrous oxide (for children)

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10
Q

Name a depolarising muscle relaxant?

A

Suxamethonium

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11
Q

Name 2 non-depolarising muscle relaxants

A

Rocuronium and atracurium

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12
Q

Which agent can be used to reverse the effects of suxamethonium?

A

Neostigmine

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13
Q

Which agent can be used to reverse the effect of non-depolarising muscle relaxants?

A

Sugammadex

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14
Q

Which agents carry the largest risk of malignant hypothermia?

A

Volatile anaesthetics (isoflurane, sevoflurane and desflurane)
Suxamethonium

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15
Q

How is malignant hyperthermia treated?

A

Dantrolene

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16
Q

What are the symptoms of malignant hyperthermia?

A

Hyperthermia
Increased CO2 exhalation
Tachycardia
Muscle rigidity
Acidosis
Hyperkalemia

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17
Q

Where is the local anaesthetic injected in a spinal block?

A

Into the CSF in the sub arachnoid space after the point where the spinal cord ends (usually between L3 and 4 or L4 and 5

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18
Q

What is the difference between an epidural and a spinal block?

A

In an epidural, local is injected outside of the dura mater so not in the CSF.

In a spinal, the LA is injected into the CSF in the subarachnoid space

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19
Q

Which agent is commonly used in an epidural?

A

Levobupivacaine (with or without fentanyl)

20
Q

What are the common adverse effects of an epidural?

A

Headache (if the dura is punctured, this leads to a dural tap)
Hypotension
Motor weakness in the legs
Nerve damage
Infection
Haematoma

21
Q

How do you measure a guedel?

A

Mouth to angle of the jaw or tooth to tragus

22
Q

What is the contraindication for inserting an nasopharyngeal airway?

A

Base of skull fracture

23
Q

What are the 4 plans in a difficult airway?

A

A- laryngoscopy and tracheal intubation

B- supraglottic airway

C- face mask ventilation

D- cricothroidotomy

24
Q

Which types of medications can be given through a central line but not a cannula?

A

Meds which are too irritating for peripheral circulation

Inotropes, amiodarone, fluids with high K+

25
Q

What is chronic pain?

A

Pain which is present for 3 months or more

26
Q

What is allodynia?

A

Allodynia refers to when pain is experienced with sensory inputs that do not normally cause pain (e.g., light touch).

27
Q

Which fibres transmit dull pain?

A

C fibres

28
Q

Which fibres transmit sharp pain?

A

A-delta fibres

29
Q

Which tracts does pain travel up to the brain in?

A

Spinothalamic and spinoreticular

30
Q

What are the two ways of measuring pain?

A

Visual analogue scale and numerical rating scale

31
Q

What are the 3 steps of the analgesic ladder?

A

Step 1: non opioid medications such as paracetamol and NSAIDs

Step 2: Weak opioids such as codeine and tramadol

Step 3: strong opioids such as morphine, oxycodone, fentanyl and buprenorphine

32
Q

In which patients are NSAIDs contraindicated?

A

Asthma
Renal impairment
Heart disease
Uncontrolled HTN
Stomach ulcers

33
Q

What are the key side effects of opioids?

A

Constipation
Pruritus
Nausea
Altered mental state
Respiratory depression

34
Q

Which agent is used to reverse the effects of opioids?

A

Nalaoxone

35
Q

What should the breakthrough dose of opioids be?

A

1/6 of the background dose

36
Q

What are the key side effects of NSAIDs?

A

Gastritis
Stomach ulcers
Exacerbation of asthma
Hypertension
Renal impairment

37
Q

What is the equivalent dose of 10mg of oral morphine for IV morphine?

A

5mg

38
Q

What is the equivalent dose of 10mg of oral morphine for oral codiene

A

100mg

39
Q

What is the equivalent dose of 10mg of oral morphine for oral tramadol?

A

100mg

40
Q

What is the equivalent dose of 10mg of oral morphine for oxycodone oral?

A

6.6mg

41
Q

What is the equivalent dose of 10mg of oral morphine for diamorphine?

A

3mg

42
Q

What is the 3 step pain management programme for secondary chronic pain caused by osteoarthritis?

A

Oral paracetamol and topical NSAIDs

Oral NSAIDs and PPI

Opiates and codiene

43
Q

What are the 4 first-line treatments for neuropathic pain?

A

Amitriptyline
Duloxetine
Gabapentin
Pregabalin

44
Q

Why is TPN given through a central line?

A

It is irritating to veins so can cause thrombophlebitis

45
Q

What are the short term complications of ventilator associated lung injury?

A

pulmonary oedema and hypoxia

Alice's finals cards (23 decks)

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