Anaesthetics & pain

Question 1

Induction agent used in asthma patients

Answer 1

Ketamine due to bronchodilatory effects

Question 2

MOA of ketamine

Answer 2

NMDA receptor antagonist

Question 3

MOA of propofol

Answer 3

enhance GABA inhibitory neurotransmission

Question 4

Contraindication to suxamethonium

Answer 4

Hyperkalaemia or at risk of

Question 5

Overdamping of an arterial line does what to the SBP/DBP/ MAP

Answer 5

Underestimation of the systolic blood pressure

Overestimation of the diastolic blood pressure

No impact on MAP

Question 6

Underdamping of an arterial line does what to the SBP/DBP/ MAP

Answer 6

Overestimation of the systolic blood pressure

Underestimation of diastolic blood pressure

Question 7

Arterial wave form

Top line
Bottom line
Notch
Downward slope

Answer 7

Question 8

Elevation of the baseline on capnography means?

Answer 8

Insufficient expiratory time

Question 9

Shark fin waveform capnography means?

Answer 9

Obstruction of expiratory circuit
Presence of foreign body in the upper airway
Kinked or occluded artificial airway

Question 10

Main reason for the use of muscle relaxant in RSI

Answer 10

Improve view of the larynx

Question 11

Types of muscle relaxants

Suxamethonium

Rocuronium

Answer 11

Depol = ACh receptor agonists (this is why anticholinesterase doesn’t work)

Non-depol = competitive antagonists to ACh

Question 12

How to calculate tube size for children (>1yr)

Answer 12

(Age/4)+4

Question 13

Max dose of lidocaine mg/kg

w/ adrenaline

Answer 13

3mg (maximum 200 mg)

7mg (maximum 500mg)

Question 14

Paediatric pain management dosing

Intranasal diamorphine

intravenous morphine

paracetamol

ibuprofen

codeine

oral morphine

Answer 14

0.1 mg/kg in 0.2 ml sterile water

0.1-0.2 mg/kg

20mg/kg

10mg/kg

only 12+, 1mg/kg

0.2-0.5 mg/kg

Question 15

Pain scales to be used in children

Answer 15

Wong-Baker Faces Pain Rating Scale
Numeric rating scale
Behavioural scale

Question 16

How much 1% lidocaine does 1ml contain?

Answer 16

1 ml of plain 1% lidocaine solution contains 10 mg of lidocaine hydrochloride.

Question 17

Entonox is what mix of O2 & NO2 ?

Answer 17

Entonox is a 50/50 mix of oxygen and nitrous oxide

Question 18

How long does entonox work after it’s stopped being inhaled?

Answer 18

60 secs

Question 19

The following are contraindications to the use of Entonox:

Answer 19

Reduced conscious level
Diving injury
Pneumothorax
Middle ear disease
Sinus disease
Bowel obstruction
Documented allergy to nitrous oxide
Hypoxia
Violent/disabled psychiatric patients

Question 20

Thiopentol MOA

Answer 20

Thiopental sodium binds at a distinct binding site associated with a chloride ionophore at the gamma-aminobutyric acid A (GABAA) receptor, increasing the duration of time for which the chloride ionophore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged.