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Finals Studying - Condensed > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

assessment scale of n+v

A 
0 = no n or v 
1 = n only 
2 = v once 
3 = v more than once
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2
Q

Mx of n+v in intracranial tumours

A

dexamethasone

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3
Q

mechanism and use of metoclopramide in n+v

A

D2-antagonist (anti-dopaminergic)

  • prokinetic/promotes bowel motility
  • 1st line in low risk chemo induced n+v
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4
Q

mechanism and use of ondansetron in n+v

A

5HT3 antagonist

- chemotherapy induced nausea (high risk pts)

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5
Q

mechanism and use of cyclizine in n+v

A

anti-histamine

- inner ear induced nausea

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6
Q

mechanism and use of haloperidol in n+v

A

typical antipsychotic

- used in palliative care n+v

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7
Q

rating pain scale

A 
0 = no pain rest, no pain movement 
1 = no pain rest, slight pain movement 
2 = slight pain rest, moderate pain movement 
3 = pain at rest, severe pain movement
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8
Q

1st step in WHO pain ladder

A

pain score 0-1

non-opioid e.g. paracetamol 1g 6hrly

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9
Q

2nd step in WHO pain ladder

A

pain score 1-2
non-opioid
+
mild opioid (e.g. codeine or tramadol)

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10
Q

3rd step in WHO pain ladder

A

non-opioid
+
strong opioid (e.g. morphine)

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11
Q

how is oramorph usually given

A

10mg/5mls

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12
Q

what is MST

A

modified release morphine

- given bd

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13
Q

dose of breakthrough analgesia

A

1/6th of total daily dose of morphine

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14
Q

standard PCA prescription

A

1mg morphine bolus / 5 min lockout

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15
Q

conversion codeine to morphine

A

divide by 10

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16
Q

conversion morphine to oxycodone

A

divide by 2

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17
Q

order for opening airway

A 
head tilt 
chin lift
jaw thrust 
oropharyngeal airway
nasopharyngeal airway 
laryngeal airway (guedel)
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18
Q

what airway device is not used in patients with GORD

A

laryngeal airway
- poor control against gastric reflux
(use endotracheal tube)

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19
Q

when is nasopharyngeal airway contraindicated

A

BOS #

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20
Q

how to size an oropharyngeal airway

A

between incisor teeth and angle of mandible

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21
Q

how long should warfarin be with-held for pre-op

A

5d

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22
Q

what is INR target pre-surgery for someone on warfarin

A

<1.5

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23
Q

if INR high in someone on warfarin pre-op, what do u give

A

oral vit K

24
Q

when do u restart warfarin post op

A

on the same day of the procedure, if there is no bleeding

25
Q

normal urine output

A

0.5ml/kg/hr

26
Q

for a 70kg man - daily water requirement

A

2000-2500ml/day

27
Q

daily Na requirement

A

1-2 mmol/kg

28
Q

daily K requirement

A

1-2 mmol/kg

29
Q

Na, K, Cl and Ca levels in plasma

A

Na - 135-147
K - 3.5-5
Cl - 92-109
Ca - 1.9-2.3

30
Q

contents of 0.9% saline

A 
Na 154
Cl 154
K 0 
Ca 0 
Lactate 0
31
Q

contents of 5% glucose

A 
Na 0 
Cl 0 
Ca 0 
K 0 
Lactate 0

used for pure dehydration

32
Q

contents of hartmann’s

A 
Na 131
Cl 110
K 5
Lactate 29 
Ca 0
33
Q

contents of colloid

A 
Na 154
Cl 154
K 0 
Lactate 0 
Ca 0
34
Q

what 3 things should be considered when prescribing fluids

A
  1. basal requirements
  2. existing deficit
  3. predicted losses
35
Q

when are maintenance fluids given

A

if pt isnt drinking enough

must match daily requirements of Na, K and water over 24h

36
Q

replacing fluid loss - how is this given

A

as a stat bolus - hartmanns

37
Q

presentation paracetamol overdose

A

non-specific

  • vomiting
  • fever
  • ringing in ears
  • unconsciousness
38
Q

what is the toxic metabolite of paracetamol and what detoxifies it

A

NAPQI

detoxified by glutathione

39
Q

when to do paracetamol OD blood test

A

4h - if 100% paracetamol at this time they get Tx

40
Q

how long does paracetamol take to be absorbed - what things affect this time

A

30mins

substances that delay gastric emptying - opiates, alcohol

41
Q

when checking paracetamol level, what also always gets checked

A

aspirin level

42
Q

Mx paracetamol Od

A

N-acetylcysteine (Parvolex)

  • replenishes glutathione
  • gvien in 3 stages
43
Q

Mx opiate OD

A

naloxone

44
Q

Mx TCA OD

A

sodium bicarbonate

45
Q

presentation TCA OD

A 
large pupils 
tachy 
urinary retention 
arrhythmia 
hypotension 
dry skin
46
Q

If pt having seizures in TCA OD, what do u give

A

lorazepam + muscle relaxant + barbituate infusion

47
Q

Mx BZD OD

A

flumazenil

48
Q

why is flumazenil only given in iatrogenic OD

A

flumazenil can cause seizures which are then untreatable.

49
Q

Mx tetanus

A

IVIG

50
Q

prophylaxis following injury:

Mx if tetanus immune status complete and any wound

A

none required

51
Q

prophylaxis following injury:

Mx if tetanus status inadequate and clean wound

A

none required

52
Q

prophylaxis following injury:

Mx if tetanus status inadequate and tetanus prone site

A

immediate reinforcing dose of vaccine

53
Q

prophylaxis following injury:

Mx if tetanus status inadequate and high risk tetanus prone site

A

immediate reinforcing dose of vaccine + IVIG at diff site

54
Q

prophylaxis following injury:

Mx if no immune tetanus status and clean wound

A

immediate reinforcing dose of vaccine

55
Q

prophylaxis following injury:

Mx if no immune tetanus status and tetanus prone site

A

immediate reinforcing dose of vaccine + IVIG at diff site

Finals Studying - Condensed (22 decks)

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