Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NMF: acute care > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

What is a day surgery case?

A

planned admission where someone undergoes theatre and goes home the same day

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

What is a day of surgery admission (DOSA)?

A

when a patient attends hospital to be admitted on the day of their surgery rather than staying the night before

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

What are the advantages of DOSA?

A 
better sleep
less anxious
reduced infection risk
reduced falls and delirium risk in elderly
more cost effective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the disadvantages of DOSA?

A

shorter time for consent
patient may be late
incorrect fasting
incorrect medication taken the day of

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

How long must a patient fast

a) food?
b) milk?
c) clear liquid?

A

a) 6 hours
b) 4 hours
c) 2 hours

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

When are patients ideally seen at the pre admission clinic?

A

6-8 weeks

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

What is the purpose of the PAC?

A

patient told about side effects of anaethesia and fasting requirements

determine if any other important issues ie
airway difficulties, drug reactions, post-operative nausea risk

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

what should be screened for patients ASA grade 3 or patients having major surgery?

A

anaemia screen
Haemostasis (coagulation and LFTs)
Kidney function (or if at risk of AKI
ECG

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

What puts patients at risk for an AKI?

A 
intraperitoneal surgery
CKD (eGFR<60)
Diabetes
Heart failure
Age 65 or over
Liver disease
Nephrotoxic drugs (ACEi, NSAIDs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which factors need to be considered before discharge?

A 
pain controlled
no N+V
no complications
accceptable SEWS
passed urine
someone at home for 24hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which drugs should be omitted day of surgery?

A 
ACE inhibitors
Angiotensin 2 antagonists (ARBs)
Diuretics unless for heart failure 
Aspirin, clopidogrel, dipyridamole, warfarin.
Lithium
NSAIDs
non-essential eg. vitamins, HRT, laxatives..
oral contraceptives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does reflux affect anaesthetics?

A

may decide to intubate

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

What are the characteristics of acute pain?

A

sudden onset
known cause
controlled by normal analgesics

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

What are the 3 pillars of general anaesthesia?

A
  1. not being aware
  2. analgesia
  3. paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What proportion of patients who present to a surgeon are surgically managed?

A

1 in 3

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

What proportion of patients go home on the day of their surgery?

A

70%

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

If a patient stops breathing, what keeps them alive?

A

functional residual capacity of the lungs

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

How can functional residual capacity be increased? what does this achieve?

A

give patient 100% oxygen to replace air in the FRC will give the patient longer to stay alive

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

What is the risk of continuing cardiovascular medications during surgery?

A

hypotension

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

Which drug must be stopped before surgery because it causes prolonged hypotension?

A

ACE-i

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

What is the difference between aspirin and other NSAIDs?

A

aspirin irreversibly blocks platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How long before surgery is aspirin stopped? Why?

A

7 days
risk of bleeding
wait this long for half life of platelets not half life of aspirin

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

How many half lives would reduce a drug’s plasma concentration to an acceptable level?

A

5

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

Why are diabetic patients undergoing surgery at risk of

a) hypoglycaemia?
b) hyperglycaemia?

A

a) fasted means they cannot take medication

b) stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is an LMA?
a laryngeal mask airway: supraglottic airway device
26
What is the difference between an LMA and intubation?
LMA sits above the glottis in the oesophagus whereas intubation involves inserting an endotracheal tube past the glottis
27
What is the glottis?
middle part of larynx where vocal cords are
28
What is the tidal volume?
amount of air inspired/expired with each breath during normal breathing
29
What is the vital capacity?
max amount of air expired after max inspiration
30
What is the inspiratory reserve volume?
maximum volume of gas inspired after normal expiration so it is on top of the tidal volume ie. inspiratory capacity - tidal volume
31
What is the expiratory reserve volume?
maximum volume of gas expired on top of tidal volume ie. expiratory capacity - tidal volume
32
What is the residual volume?
the volume of gas that remains in the lungs after max exhalation ie. keeps lungs open to stop resistance
33
What is the functional residual capacity?
the amount of air in the lungs after normal breathing ie. their residual volume + the expiratory reserve volume
34
What proportion of lung volume is the FRC?
40%
35
Which nerves stimulate B2 adrenoreceptors in the smooth muscle of the lung? what does this do?
sympathetic stimulation increases diameter of airways --> bronchodilation
36
Which receptors are stimulated by parasympathetic nerves in the lung's smooth muscle?
muscarinic receptors which decrease diameter of airways --> bronchoconstriction
37
Where are alpha1 receptors found? what do they do?
vascular smooth muscle | increase contraction
38
Where are alpha2 receptors found? what do they do?
CNS | dec sympathetic outflow (inhibit noradrenaline release)
39
Where are beta 1 receptors found? what do they do?
cardiac cells | inc heart rate, inc contractility, inc renin release
40
Where are beta 2 receptors found? what do they do?
vascular and bronchodilator smooth muscle | vasodilation + bronchodilation
41
What kind of neurotransmitter is GABA?
inhibitory: when it interacts with receptors of a neurone it makes it less likely to fire an action potential or release neurotransmitters
42
What is a GABA A receptor?
ionotropic: opens channel allowing negative Cl ion to flow into the cell, hyperpolarising it and making it less likely to fire an action potential
43
What are GABA B receptors?
g-protein coupled receptors that allow positive K+ to flow out of the neurone to hyperpolarise it and make it less likely to fire an action potential
44
What is atelectasis?
alveoli collapse or do not expand properly
45
What affect does smoking have on post-operative nausea and vomiting?
it decreases it
46
Why is it important to minimise gastric acid before surgery?
to prevent pulmonary acid aspiration which can cause a type of pneumonia called Mendelson syndrome
47
Should medication be given to a patient who is fasted for theatre?
yes | can be given with a sip of water
48
Should aspirin be stopped before surgery?
can be given if needed to reduce risk of post-op MI
49
How long before surgery should clopidogrel be stopped?
7 days
50
What warfarin patients are high risk?
- AF or valve disease w past arterial thrombosis - VTE in last 3 months - mechanical non-bio prosthetic valve - multiple prosthetic heart valves
51
How should a patient usually on warfarin be managed post-op if there is no excess bleeding?
restart warfarin day of procedure and give prophylactic heparin
52
Why is it important that a diabetic patient isnt a) hypo b) hyper peri-operatively?
a) can cause irreversible brain damage | b) wound infection + cardiac complications
53
How should glycaemic control of a diabetic patient be assessed before surgery?
HbA1c - if >75mmol/mol its poor - if >108mmol/mol needs control before proceed
54
What is important when considering PaO2?
inspired O2
55
Is pH a linear scale?
no it is logarithmic
56
How should naloxone be given?
dose = 400mcg | give in 40mcg boluses
57
Do anaphylaxis and sepsis cause vasodilation or vasoconstriction?
vasodilation
58
What is cardiac output equal to?
HR x SV
59
What is mean arterial blood pressure equal to?
CO x SVR
60
What is the dose and route of administration of adrenaline during a) cardiac arrest? b) anaphylaxis?
a) 1mg IV | b) 0.5mg IM
61
The ABGs of a patient in sudden cardiac arrest having had no bystander CPR and with no preceding ABG abnormality will likely demonstrate?
mixed respiratory and metabolic acidosis due to ischaemia and apnoea
62
How long before surgery should COCP be stopped?
4 Weeks
63
How long before surgery should clopidogrel be stopped?
7 days
64
How long before surgery should warfarin be stopped?
5 days

NMF: acute care (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions