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ACC > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

Safe dose Lidocaine?

A

3mg/kg

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2
Q

Safe dose Lidocain plus adren?

A

7mg/KG

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3
Q

Bupivicaine/Levo with or without adren?

A

2mg/kg

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4
Q

Prilocaine dose?

A

6mg/kg

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5
Q

Mallampati class 1?

A

Pillars, soft palate, uvula

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6
Q

Mallampati class 2?

A

Pillars soft palate, tip of uvula masked

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7
Q

Mallampati class 3?

A

Only soft palate seen

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8
Q

Mallampatti class 4?

A

No soft palate visible

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9
Q

Mg/ml of lidocaine in 1% and 2%?

A

10mg/20mg per ml

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10
Q

Mg/ml 0.5% Bupivicaine?

A

5mg/ml

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11
Q

Pt risk factors for PONV

A

Female, Previous PONV / Motion sickness, non smokers, obesity

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12
Q

Post op fluid requirements?

A

30-40ml/kg water, 1-2mmols Na/kg, 1mmol/kg K

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13
Q

Types of surgery increased PONV?

A

ENT, eye, laparotomy, gynaecological

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14
Q

Propofol induction dose?

A

1.5-2.5mg/kg

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15
Q

Thiopentone induction dose?

A

4-5mg/kg

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16
Q

Sux dose?

A

1-1/5mg/kg

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17
Q

Ketamine dose and effect on HR/BP?

A

1-1.5mg/kg rise in BP and HR Bronchodilation very good analgesia

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18
Q

Etomidate dose?

A

0.3mg/kg

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19
Q

Pros of etomidate?

A

Haemodynamic stability, low sensitivity

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20
Q

Cons of etomidate?

A

PONV, Adrenocortical depression, pain on injection and movement

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21
Q

Porphyria pts should never receive what?

A

Thiopentone

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22
Q

Sevoflurane used for?

A

Induction- smells sweet

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23
Q

Desflurane used for, characteristics??

A

Long ops, rapid on and off

24
Q

Property of isoflurane?

A

Low effect on blood flow to organs.

25
Q

Mac of sevoflurane?

A

2%

26
Q

Mac of Desflurane?

A

6%

27
Q

Nitrous MAC?

A

104%

28
Q

Isoflurane MAC?

A

1.15%

29
Q

Enflurane MAC?

A

1.6%

30
Q

How do non depolarising muscle relaxants work?

A

Nondepolarizing muscle relaxants act as competitive antagonists bind to the ACh receptors but do not open ion channels so end plate not affected.

31
Q

How do depolarising muscle relaxants work?

A

ACh receptor agonists, not metabolised quickly by ach-esterase and so extended depolarisation and the end plate cannot repolarise resulting in the block.

32
Q

Depolarising muscle relaxant example?

A

SUX- only one used clinically

33
Q

Usual size for female and male ett?

A

7.5 and 8mm internal diameter

34
Q

Why is glycopyrollate used with neostigmine?

A

combat brady casues by neo

35
Q

Why does neostigmine work/

A

Stops ach-esterase ACH increases quickly and competes with the rocuronium, atracurium etc for the space.

36
Q

Ephedrine causes a rise in what and how?

A

Rise in hr and contractility alpha and beta and this causes rise in BP

37
Q

Metaraminol causes?

A

BP rise vasoconstriction (direct and indirect mainly alpha)

38
Q

Phenylephrine actions?

A

Rise in BP fall in HR (direct action on alpha)

39
Q

Low BP and LOW HR give?

A

Ephedrine

40
Q

Low BP High HR give?

A

Phenylephrine or metaraminol

41
Q

Long acting muscle relaxant?

A

Pancuronium

42
Q

Intermediate acting relaxant ?

A

Ver and roc

43
Q

Local anaesthetic toxicicty?

A
  • Tinnitus, blurred vision, tongue parenthesis, circumoral numbness
  • Sudden alteration in mental status, severe agitation or LOC
  • Sinus bradycardia, conduction blocks, asystole and ventricular arrhythmias (fibrillation)
  • Respiratory arrest
44
Q

Management of LA toxicity?

A

STOP infusion or injection, maintaine airway give oxygen, IV access, control seizures (small profofol) IV intralipid

45
Q

Main pre-op points?

A

CBS, PND, orthopnoea,
exercise tolerance

asthma copd, chest,

dentures teeth neck mouth opening.

Anaesthetic history-

GI
Meds allergies examination

PMH- Stroke, thyroid, jaundice, diabetes, epilepsy

46
Q

ASA grades how many?

A

6

47
Q

Asa grade 2?

A

Mild top moderate disease no limitation

48
Q

ASA 3?

A

Severe systemic disease some functional impact

49
Q

Grade 6?

A

Brain dead

50
Q

4/5 asa?

A

Severe threat to life and moribund

51
Q

Solids and milk hours before surgery?

A

6hrs

52
Q

Breast milk before surgery?

A

4hrs

53
Q

CFF how many hours before op?

A

2hrs

54
Q

Alcohol how many hour before op?

A

24 delays emptying

55
Q

Can ahve how many mls to take a tablet before op?

A

30mls

56
Q

Most accurate measurement of tube placement ett?

A

End tidal co2

57
Q

NCEPOD interventions types?

A

Immediate (AAA) Urgent (fracture) Expedited (tendon repair) Elective

ACC (2 decks)

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