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
Mac of sevoflurane?
2%
26
Mac of Desflurane?
6%
27
Nitrous MAC?
104%
28
Isoflurane MAC?
1.15%
29
Enflurane MAC?
1.6%
30
How do non depolarising muscle relaxants work?
Nondepolarizing muscle relaxants act as competitive antagonists bind to the ACh receptors but do not open ion channels so end plate not affected.
31
How do depolarising muscle relaxants work?
ACh receptor agonists, not metabolised quickly by ach-esterase and so extended depolarisation and the end plate cannot repolarise resulting in the block.
32
Depolarising muscle relaxant example?
SUX- only one used clinically
33
Usual size for female and male ett?
7.5 and 8mm internal diameter
34
Why is glycopyrollate used with neostigmine?
combat brady casues by neo
35
Why does neostigmine work/
Stops ach-esterase ACH increases quickly and competes with the rocuronium, atracurium etc for the space.
36
Ephedrine causes a rise in what and how?
Rise in hr and contractility alpha and beta and this causes rise in BP
37
Metaraminol causes?
BP rise vasoconstriction (direct and indirect mainly alpha)
38
Phenylephrine actions?
Rise in BP fall in HR (direct action on alpha)
39
Low BP and LOW HR give?
Ephedrine
40
Low BP High HR give?
Phenylephrine or metaraminol
41
Long acting muscle relaxant?
Pancuronium
42
Intermediate acting relaxant ?
Ver and roc
43
Local anaesthetic toxicicty?
- 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
Management of LA toxicity?
STOP infusion or injection, maintaine airway give oxygen, IV access, control seizures (small profofol) IV intralipid
45
Main pre-op points?
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
ASA grades how many?
6
47
Asa grade 2?
Mild top moderate disease no limitation
48
ASA 3?
Severe systemic disease some functional impact
49
Grade 6?
Brain dead
50
4/5 asa?
Severe threat to life and moribund
51
Solids and milk hours before surgery?
6hrs
52
Breast milk before surgery?
4hrs
53
CFF how many hours before op?
2hrs
54
Alcohol how many hour before op?
24 delays emptying
55
Can ahve how many mls to take a tablet before op?
30mls
56
Most accurate measurement of tube placement ett?
End tidal co2
57
NCEPOD interventions types?
Immediate (AAA) Urgent (fracture) Expedited (tendon repair) Elective