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3rd Year Medical Specialties > Anaesthetics > Flashcards

Anaesthetics Flashcards

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USMLE® Step 1 flashcards
1
Q

What is general anaesthesia?

A

Centrally acting drugs causing loss of sensation to the whole body

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2
Q

What is regional anaesthesia?

A

Local anaesthesia applied to nerves supplying area

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3
Q

What drugs are used in anaesthetics?

A

Inhalation/IV anaesthetics
Muscle relaxants
Local
Analgesics

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4
Q

What techniques/equipments are used in anaesthetics?

A 
Tracheal intubation
Ventilation
Fluid therapy
Regional anaesthesia
Monitoring
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5
Q

What is the Triad of anaesthesia?

A

Hypnosis
Analgesia
Relaxation

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6
Q

What are the common problems of anaesthesia?

A

Polypharmacy
Muscle relaxation -> ventilation
Separation of relaxation & hypnosis

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7
Q

General anaesthetics act on which part of the triad?

A

Relaxation

Hypnosis

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8
Q

How do general anaesthetics act?

A

Interfere with neuronal ion channels
Hyperpolarise Cl- channels
Bind GABA receptors (IV)

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9
Q

How is cerebral function affected by general anaesthesia?

A

Affected from top down
Complex first - hearing later
Reflexes spared

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10
Q

What are the benefits of intravenous anaesthesia?

A

Rapid onset, recovery

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11
Q

How is IV anaesthesia metabolised?

A

Hepatic metabolism

Renal excretion

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12
Q

In what order do IV anaesthetics enter different compartments of the body?

A

Blood
Viscera
Muscle
Fat

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13
Q

Where are inhaled anaesthetics excreted?

A

Lungs

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14
Q

Arterial concentration of inhaled anaesthetics equates to what?

A

Alveolar partial pressure

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15
Q

What is MAC?

A

Minimum alveolar concentration

Measure of potency (low number = high potency)

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16
Q

How are patients awakened from inhaled anaesthetics?

A

Stop administration

Washout of conc. gradient

17
Q

What are the common forms of IV anaesthetic?

A

Propofol

Opiate

18
Q

What are the central effects of General Anaesthetic?

A

Depress CVS
Reduce sympathetic outflow
Negative inotrope
Reduced vasoconstrictor tone (vasodilation)

19
Q

What are the direct effects of General Anaesthetic?

A

Negative inotrope
Vasodilation
Venodilation

20
Q

What are the effects of venodilation?

A

Decreased venous return, decreased cardiac output

21
Q

What are the effects of vasodilation?

A

Decreased peripheral resistance

22
Q

What are the respiratory effects of GA?

A

Respiratory depressants
Paralyse cilia
Decrease FRC

23
Q

When are muscle relaxants indicated?

A

Ventilation and intubation

When immobility is essential

24
Q

In which surgeries is immobilisation essential?

A

Laparotomy
Neurosurgery
Body cavity surgery

25
Q

What problems are associated with muscle relaxants?

A

Awareness
Incomplete reversal may require ventilation
Apnoea

26
Q

Opiates affect which of the anaesthetic triad?

A

Hypnosis

Analgesia?

27
Q

Local anaesthetics affect which of the anaesthetic triad?

A

Analgesia

Relaxation

28
Q

Why is intraoperative analgesia used?

A

Prevention of arousal
Opiates contribute to hypnotic effect
Suppress reflex responses to painful stimuli

29
Q

What are the benefits of local anaesthesia?

A

Retain awareness
Lack of global effects
Spare respiratory function

30
Q

What are the negatives of local anaesthesia?

A

Derangement of CVS physiology

Toxicity

31
Q

Toxicity of local anaesthesia is associated with what?

A 
Absorption > metabolism
Dose used
Rate of absorption
Patient weight 
Drug used
32
Q

What are the signs of local anaesthesia toxicity?

A 
Circumoral/lingual numbness
Light headedness
Tinnitus
Visual disturbances
Muscular twitching
Drowsiness
Cardiovascular depression
Convulsions
Coma
Cardiorespiratory arrest
33
Q

Which fibres are affected by local anaesthesia?

A

Thick fibres spared (motor)

Pain blocked

34
Q

What are the effects of neuraxial block?

A

Inspiration spared
Expiratory function impaired (loss of abdominal muscle function)
Decreased FRC
Increased V/Q mismatch

35
Q

What are the main types of local anaesthesia?

A 
Local anaesthesia
Field blocks
Plexus blocks
Limb blocks
Neuraxial blocks

3rd Year Medical Specialties (18 decks)

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