Anesthesiology Flashcards
How many years is anesthesiology residency?
4 years - 3 clinical years and 1 fellowship year
What is the difference between deep sedation and general anesthesia?
Deep sedation: Responsive to painful stimuli, airway patency is likely maintained, cardiovascular function is maintained, and spontaneous ventilation may be adequate
General anesthesia: Unresponsive to all stimuli, need to hold airway open with a ventilator for breathing, patient is likely hemodynamically unstable
Why is it important to get a patient history before anesthetizing?
Check for history of malignant hypothermia
What do the Mallampati classes mean?
Range from Class 1 to Class 4, with
Class 1 is easy airway / easy view of larynx,
Class 4 is difficult larynx to visualize and will likely be a difficult airway.
What dictates what tests are ordered prior to the procedure?
A grid is given which shows all necessary tests.
I.e. young women might need pregnancy tests
People with certain high risk procedures might need to be blood typed for “plan B” measures if the patient starts bleeding out
What is MSBOS?
Maximal surgical blood ordering schedule - list that predicts the number of units of blood needed for each procedure
What are the ASA Physical Status classifications?
Class 1: Normal healthy patient
Class 2: Mild systemic disease (smokers are immediately here, controlled diabetes / HTN)
Class 3: Severe systemic disease (uncontrolled diabetes / HTN)
Class 4: Severe disease which is a constant threat to life (i.e. renal failure)
Class 5: Patient expected not to survive without operation
Class 6: Braindead
What is hydromorphone?
An opioid which is 7 times more potent than morphine
Where is intrathecal anesthesia given?
Spinal or subdurally -> in the lumbar cistern (between L3 and L4)
Epidural given between L5 and S1
What is the preferred method of anesthesia for C-section?
Regional anesthesia
What does CSHT mean for anesthesia and what is it for propofol?
Context sensitive half time -> how long it should take to wake up from an induction anesthetic after a procedure of a given length
Propofol - 11 minutes for a 1 hour procedure
Why might thiopental be used rather than propofol?
Cerebral protection -> reduces cerebral ischemia
When is ketamine of use?
When the patient is hemodynamically unstable -> sympathomimetic effect to keep the heart pumping
What two agents are typically given IV during the procedure to maintain hemodynamic stability?
Propofol and a narcotic to prevent shock response (analgesic)
How are sedative hynotics typically reversed?
They spontaneously redistribute from brain (i.e. midazolam, thiopental)
