anasthesia

Question 1

who can give anesthetic in ont

Answer 1

1. royal college
2. fam+1
3. anesthesia assitant

Question 2

def ana

Answer 2

not just putting someone to sleep

- eliminating senses - mostly pain

Question 3

3 steps to approach to ana

Answer 3

1. pre-op assessment
2. optimized?
   - if not, postpone
   - if so, consider surg. issues
3. plan ana

Question 4

4 core parts to pre-op assessment

Answer 4

1. hx, Px, possible investigations
2. assess meds/allergies
3. assess comorbidiites
4. assess if medica l staus is optimized

Question 5

possible options after assessment

Answer 5

• surg
• futher investigations
• alter plan
• delay
• cancel surg

Question 6

9 parts of planning ana

Answer 6

1. type
2. pre-meds
3. monitors
4. airway mgmt
5. induction of ana
6. maintenance
7. emergence
8. pain mgmt
9. postop dispostion

Question 7

5 types of ana

Answer 7

1. local
2. regional
3. monitored
4. general
5. some combo

Question 8

4 types of regional

Answer 8

1. nerve blocks
2. indiv. nerve
3. plexus
4. spinal

Question 9

what is monitored care

Answer 9

sedation - IV benzo, opiods

Question 10

2 parts of pre-meds

Answer 10

1. usual meds- they keep taking

2. anxiolysis

Question 11

2 types of monitors

Answer 11

1. usual - BP, O2, ECG, temp

2. special - arterial, central vein

Question 12

4 issues with airway magmt

Answer 12

1. intubate?
2. asleep or awake intubation
3. scopes?
4. type pf tube

Question 13

3 types of post op pain mgmt

Answer 13

1. opiods
2. nerve block
3. local

Question 14

4 options for after

Answer 14

1. home
2. ward
3. step down
4. ICU

Question 15

5 effects of general

Answer 15

1. amesia
2. anathesia (lack of awareness)
3. analgesia
4. areflexia (paralysis)
5. autonomic blunting

Question 16

keys to amnesia

Answer 16

1. benzos
   - antegrade
   - anxiolytic as well

Question 17

2 keys to sleep

Answer 17

1. induction
   - propofol
2. maintenance
   - vapors

Question 18

5 types of anastheis

Answer 18

1. opiods
2. NSAIDS
3. aceto
4. local
5. regional

Question 19

3 reasons to paralyse

Answer 19

1. facilitates intubation
2. can help with some surg
3. prevent patient movement

Question 20

what does pt movement no indicate

Answer 20

lack of muscle relaxants

- means inadequate anasthesia or analgesia

Question 21

2 types of muscle relaxants and MOA

Answer 21

1. reversiable - Ach-r antagonists

2. irrerversible - bind t o acr and cause depolarization

Question 22

probs with irreversible

Answer 22

lasts at least 10 minutes and that might be too long

Question 23

why blunt auto relaxes

Answer 23

certain stim can jack HR and BP - can cause problems if have CAD

Question 24

2 types of meds to blunt autp

Answer 24

1. short acting - opiods

2. long acting - b-blockers

Question 25

2 main areas of SE

Answer 25

1. resp

2. CV

Question 26

3 rest related SE

Answer 26

1. aspiration
2. airways obstruction
3. resp depression

Question 27

key points about malignant hyperthemia

Answer 27

• pharmocogenic
• can happen after multiple times being fine
• triggered by succcylcholine or vapors
• due to loss of intracellular control of Ca
• ssevere reaction

Question 28

6 effects of MH

Answer 28

1. hypermetabolic state
2. acidosis
3. hemodynamic instability
4. skeletal muscle rigitiy
5. rhabdo
6. acute renal failure

Question 29

see case

Answer 29

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