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Anaesthetics > Assessment of surgical patient > Flashcards

Assessment of surgical patient Flashcards

1
Q

Malignant hyperthermia

A

Reaction to volatile anaesthetic agents and neuromuscular blocking drugs
High temperature and muscle contractions

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2
Q

Suxamethonium apnoea

A

Deficiency in enzymes to break down suxamethonium

Prolonged paralysis of skeletal muscle

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3
Q

Wilson’s score <5

A

Easy laryngoscopy

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4
Q

Wilson’s 8-10

A

Severe difficulty in laryngoscopy

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5
Q

Factors in Wilson score

A 
Weight
Head and neck movement
Jaw movement
Receding mandible
Buck teeth
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6
Q

Mallampati score

A

Ease of endotracheal intubation

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7
Q

What does irregular pulse indicate

A

AF

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8
Q

Slow rising pulse

A

Aortic stenosis

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9
Q

Pounding pulse

A

Aortic regurgitation and CO2 retention

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10
Q

Thready pulse

A

Intravascular hypovolaemia

In sepsis

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11
Q

Causes of raised JVP

A

RSHF

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12
Q

Causes of tricuspid regurgitation

A

Infective endocarditis

Rheumatic heart disease

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13
Q

Murmur in aortic stenosis

A

Ejection systolic murmur

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14
Q

Murmur in aortic regurgitation

A

Early diastolic murmur

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15
Q

Mitral stenosis murmur

A

Mid-diastolic murmur

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16
Q

Mitral regurgitation murmur

A

Pan-systolic murmur

17
Q

Third heart sound indicates

A

CHF

18
Q

Pericardial rub or muffled heart sounds indicate

A

Pericarditis

19
Q

What are the side effects of NSAIDs

A 
Interactions with other medication (warfarin)
Gastric ulceration (PPI cover)
Renal impairment
Asthma sensitivity
Bleeding risk 
I-GRAB
20
Q

What does NSQIP
NCEPOD
Duke activity status
Assess

A

NSQIP: post-op complications (ACS)
NCEPOD: risk of death within 30days (SORT)
Duke activity status: function post surgery, <30 is bad

21
Q

What drugs need to be stopped pre-operatively?

A

Clopidogrel- 7 days before
Hypoglycaemic
OCP/HRT stopped 4 weeks before due to DVT risk
Warfarin: stopped 5 days prior, INR needs to be <1.5
ACE/ARB omitted 24hours before to reduce risk of hypotension
DOAC stopped 24-48hours before
Stop aspirin 7-10days prior, unless it’s for secondary prevention
Stop ticagrelor 5 days pre-op

22
Q

What are the principles of anaesthesia

A 
Induction
Maintenance
Analgesia
Neuromuscular blockage
Emergence
23
Q

Seldinger technique

A

Medical procedure used to get safe access to blood vessels and other hollow organs

24
Q

What happens in sign out

A

Increase flow of oxygen in circulation to get rid of anaesthetic agent
Neostigmine to reverse effects of NMB, plus glycopyrrolate (anticholinergic) to block unwanted muscarinic effects of neostigmine

25
Q

How is a spinal anaesthetic administered

A 
T10 and below paralysis
Decreased risk of complications
L4/5
Vasodilatation, reduced risk of DVT or ischaemic complications
Don’t need ventilation
26
Q

General anaesthetic

A

Drug-induced coma
Decreases brainstems response to an increase in C02
Need ventilation

27
Q

Post op assessment

A

History
Allergies
Medications
PMH
Last meal/drink
Events leading up to admission/ current situation/ current positive examination findings
Ask about operation, complications, post-op instructions, drug use,d recover

28
Q

BOXED in post-op assessment

A 
Bedside tests (basic obs, ECG), bloods 
Orifices (sputum, swab results, urine culture/output, drain output, stool output
X-RAY (imaging and special tests)
Escalation plan
Do not attempt CPR
29
Q

What two systems are affected by lidocaine overdose?

A

CNS and CVS

30
Q

How does lidocaine affect the CNS?

A

Light headedness
Dizziness
Drowsiness

31
Q

How does lidocaine overdose affect CVS

A

Hypotension
Bradycardia
Myocardial depression

32
Q

How long do the effects of lidocaine usually last?

A

2 hours

33
Q

How long does lidocaine take to work, and how long is it’s duration of action?

A

4 minutes

1-2 hours

Anaesthetics (3 decks)

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