Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ACC > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

What are the three elements of general anaesthesia?

A
  1. Amnesia
  2. Analgesia
  3. Akinesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do induction agents do?

A

induce loss of consciousness (amnesia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common induction agent?

A

propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the safe dose of propofol?

A

1.5-2.5mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

True or false: Propofol increases post-operative vomiting and nausea

A

FALSE - It decreases PONV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does propofol effect a patient’s heart rate and blood pressure?

A

It causes them to drop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the second choice of induction agent?

A

Thiopentone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the safe dose of thiopentone?

A

4-5mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

which induction agent will take effect faster - propofol or thiopentone?

A

Thiopentone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What induction agent should be considered in a patient needs a rapid sequence induction?

A

Thiopentone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why is thiopentone useful for neurosurgery?

A

It has anti-epileptic properties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long should induction agents take to send a patient to sleep?

A

15-20 seconds!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does induction happen so quickly?

A

They are lipid soluble and can quickly cross the blood brain barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does thiopentone effect the heart rate and blood pressure of a patient?

A

drop in BP but increase in HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is thiopentone contradicted?

A

porphyria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which induction agent is associated with dissociative anaesthesia?

A

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which induction agent is associated with the emergence phenomenon?

A

Ketamine - it is only used in 1-2% of patients as a result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which has a slower onset - Ketamine or etomidate?

A

Ketamine - approx 90 seconds for induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the safe dose of ketamine?

A

1-1.5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What effect does ketamine have on a patient’s heart rate and blood pressure?

A

It will increase both HR and BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

With which of these induction agents would you expect pain on injection? 1. Etomidate 2. Ketamine 3. Thiopentone 4. Propofol

A
  1. Etomidate and 4. Propofol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long do induction agents last?

A

4-10 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you maintain amnesia after induction?

A

Inhalation (volatile) agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the safe dose of etomidate?

A

0.3mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what induction agent should be used if a patient has a history of cardiac disease or cardiac failure?

A

etomidate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Etomidate should never be used for critically ill patients with septic shock - why?

A

Etomidate is steroid based, continuous infusion can lead to adrenocortical dysfunction which can prevent the body bringing the BP back to normal and thus worsening shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What induction agent may be considered for a short procedure?

A

Ketamine as it is short-acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Why is etomidate rarely used?

A

adrenocortical suppression and high incidence of PONV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why would a patient require a rapid sequence induction?

A

If a patient had a full stomach for any reason

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which volatile agent can be used without IV access?

A

Sevoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which volatile agent has a sweet smell?

A

sevoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

which volatile agent is the most appropriate for a transplant operation? why?

A

Isoflurane as it has the least effect on organ blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which volatile agent would be most appropriate for the use in a long operation?

A

Desflurane as it’s low lipid solubility leads to a rapid onset and offset

34
Q

why is analgesia necessary?

A

Analgesia is required for insertion of the airway, intra-operative pain and post-operative pain.

35
Q

How long does it take for analgesic agents to take effect?

A

1- 5 minutes, so they are generally given before induction agents

36
Q

What are the 2 groups of muscle relaxants?

A

depolarising and non-depolarising

37
Q

Is suxamethonium depolarising or non-depolarising?

A

depolarising

38
Q

what is the safe dose of suxamethonium?

A

1-1.5mg/kg

39
Q

What is used to reverse the effect of non-depolarising medications?

A

neostigmine and glycopyrrolate

40
Q

what is glycopyrrolate?

A

It is an anti-muscarinic that is given to increase HR when given with neostigmine [to overall reverse non-depolarising akinesis medications] as neostigmine can cause bradycardia

41
Q

what is neostigmine?

A

an anti cholinesterase - this will block acetylcholinesterase so there will be an increase in acetylcholine in the synapse. As this is involved in the parasympathetic nervous system it can cause bradycardia

42
Q

What are the side effects of neostigmine?

A

nausea and vomiting

43
Q

Why are vaso-active drugs necessary in anaesthetics?

A

to treat the hypotension caused on induction

44
Q

What is the action of ephedrine?

A

It has direct and indirect action on both alpha and beta receptors to increase BP (by increasing contractility) and increasing HR

45
Q

what is the action of phenylephrine?

A

Direction action on the alpha receptors to increase blood pressure (via vasoconstriction) and decrease HR (reflex)

46
Q

Which vast-active drug is longer acting:

Ephedrine or phenylephrine?

A

phenylephrine

47
Q

Which vast-active drugs are most likely to be used on ICU?

A

Noradrenaline, adrenaline or dobutamine

48
Q

What is the action of metaraminol?

A

increase BP and decrease HR by direct and indirect action on the alpha receptors

49
Q

What is the first choice of anti-emetic?

A

Ondansetron

50
Q

What is the second choice anti-emetic?

A

dexamethasone

51
Q

What is the 3rd choice anti-emetic?

A

Cyclizine

52
Q

What is the order of administration when using an LMA?

A
  1. Oxygen
  2. Opioid
  3. Induction agent
  4. Volatile agent
  5. Bag Valve Mask Ventilation
  6. LMA insertion
53
Q

What is the order of administration when using intubation?

A
  1. Oxygen
  2. Opioid
  3. Induction agent
  4. Volatile agent
  5. Bag Valve Mask Ventilation
  6. Muscle relaxant
  7. ET intubation
54
Q

How would you pre oxygenate a patient of a RSI?

A

Use a face mask for 3 minutes or 5 full capacity breaths until the end tidal o2 concentration is >90

55
Q

Why do we pre oxygenate patients before RSI?

A

to replace the functional residual capacity with oxygen

56
Q

What medications are used for RSI?

A

Thiopentone (4-5mg/kg), Propofol (1.5-2.5mg/kg) and suxamethonium (1.15mg/kg)

57
Q

What is the technique for RSI?

A
  1. Pre oxygenation
  2. Drugs
  3. Cricoid pressure
  4. Apnoeic ventilation
  5. Intubation
58
Q

Which volatile agent can also be used as an induction agent?

A

Sevoflurane

59
Q

Which short acting analgesia is most commonly used?

A

fentanyl, commonly used with midazolam

60
Q

Which long acting analgesias is commonly used?

A
  1. Morphine

2. Oxycodone

61
Q

What is fentanyl often used in combination with? What is the dose of this drug?

A

Midazolam, 1mg IV administered over 2 minutes

62
Q

What is the antidote for opioids?

A

Naloxone

63
Q

What is the most common post-op analgesic drugs combination?

A
  1. Paracetamol
  2. NSAIDs
  3. Dihydrocodeine
64
Q

What is diclofenac?

A

an NSAID

65
Q

What is parecoxib?

A

an NSAID

66
Q

What is Ketorolac?

A

an NSAID

67
Q

What is lignocaine?

A

a local anaesthetic

68
Q

What is the max dose of lignocaine without adrenaline?

A

3mg/kg

69
Q

What is the max dose of lignocaine with adrenaline?

A

7mg/kg

70
Q

What kind of duration does lignocaine have?

A

short

71
Q

What is bupivacaine?

A

a local anaesthetic

72
Q

What is the max dose of without adrenaline bupivacaine?

A

2mg/kg

73
Q

what is the max dose of bupivacaine with adrenaline?

A

2mg/kg

74
Q

What is prilocaine?

A

a local anaesthestic

75
Q

what is the max dose of prilocaine with adrenaline?

A

6mg/kg

76
Q

What is the max dose of prilocaine without adrenaline?

A

9mg/kg

77
Q

Why is adrenaline given with some local anaesthetics?

A

to prolong the duration of action - it does this via vasoconstriction which increases the time it will take for the anaesthetic to become metabolised

78
Q

How do you work out the max dose of local anaesthetic for a patient?

A

Concentration (%) x 10 (to convert to mg/ml)

79
Q

What are the early symptoms of local anaesthetic toxicity?

A

tingling sensation around mouth and ringing in ears

80
Q

What is the antidote for local anaesthetics?

A

intralipid

ACC (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions