Baics Of General Anaesthesia

Question 1

What are the 4 stages of Anesthesia

Answer 1

• Analgesia
• Excitement
• Surgical Anaesthesia
• Medullary Depression

Question 2

Nimbex

Answer 2

Cisatracurium

Question 3

Define the word anesthesia

Answer 3

Anesthesia is described as a temporary and reversible loss of awareness and reflex reactions to noxious stimuli

Question 4

List three types of ion channels

Answer 4

Ligand gated channels.
Voltage gated channels.
Metabotropic (Gprotein) receptor gated channels

Question 5

Define hyperpolarization

Answer 5

It’s a natural phenomenon in which the membrane potential is made more negative. This increases the need of more stimulus to obtain an action potential. It is the opposite of depolarization.

Question 6

What is the name of the main inhibitory neurotransmitter in the central nervous system?

Answer 6

Gamma, amino, butyric acid
GABA

Question 7

Where can you find gabba sub type a receptors?

Answer 7

On the post synaptic neuronal membranes

Question 8

What happens when GABA binds to the receptors found on the post synaptic neuron membranes

Answer 8

It’s activates chloride channels (GABA gated chloride channels)

Negatively charged chloride ions enter the neuron through open channels, cause hyper polarization of the nerve membrane, rendering the neuron less excitable

Question 9

How do benzodiazepines achieve the effects of hyper polarization

Answer 9

Benzodiazepines increase the frequency of opening of the chloride channels

(FREN zodiazepine)

Question 10

How do barbiturates cause hyperpolarization in the post synaptic neuron

Answer 10

Barbiturates achieve its effect by increasing the duration of the opening time of the channels

(Barbi DUR ates)

Question 11

Benzodiazepines, barbiturates, etomidate and propofol, depress central nervous system activity, by increasing the action of GABA.

Unlike the other IV anesthetics, how does ketamine function

Answer 11

Ketamine depresses central nervous system activity by suppressing excitatory synaptic transmission mediated by L glutamate

Question 12

Ketamine depresses central nervous system activity by suppressing excitatory synaptic transmission mediated by

Answer 12

L-glutamate

Question 13

How does L glutamate function

Answer 13

Binding of El glutamate to channel protein sites on the post, an optic nerve cell membrane activates calcium channels.
The influx of positively charged calcium ions into the cell through these open channels, cause depolarization of the membrane potential and facilitates neuronal excitation

Question 14

Which channels does GABA act on?

Answer 14

Chloride channels

When GABA binds to its post synaptic receptor, it causes an influx of chlorine into the cell, which causes hyperpolarization

Question 15

How does N methyl D aspartate work?

Answer 15

NMDA is a L glutamate agonist having its own binding site

Question 16

How does ketamine work?

Answer 16

It is an L glutamate antagonist, having its own binding site

Question 17

Describe, or define ketamine as an anesthetic agent

Answer 17

Ketamine is a dissociative and inhibits post sign up excitatory action of L glutamate

Question 18

Describe two types of non-competitive antagonist

Answer 18

Type one can be described as an antagonist that binds irreversibly to the main binding site

Type two can be described as an antagonist that binds to an allosteric site that causes changes

Question 19

What is the relationship between minimum angular, concentration, and lipid solubility of an anesthetic agent?

Answer 19

The minimum alveolar concentration required to maintain anesthesia, is lower for more lipids, soluble inhalation agents

Question 20

There are four stages of anesthesia describe stage one

Answer 20

Analgesia the state of analgesia last from onset of jest to loss of eyelash reflex

Question 21

How do you characterize stage two of anesthesia?

Answer 21

Stage two of anesthesia is described as the excitement stage it’s characterized by agitation and delirium.
(RDDR)
Respi Irregular (start)
Dilated pupils
Divergent eyes
Respi Regular (end)

Question 22

The surgical anesthesia stage three is divided into how many planes

Answer 22

4 planes

Plane 1, Plane 2, Plane 3, Plane 4

Question 23

Describe plane one in stage three of anesthesia

Answer 23

rhythmic respiration
rapid eye movement

Question 24

Describe a plane two in stage three anesthesia

Answer 24

This plane lasts from the cessation of rapid eye movement to onset of paresis of intercostal muscles

Question 25

Describe plain three of stage three anesthesia

Answer 25

This last, from the onset of paresis of intercostal muscles to paralysis of these muscles

Question 26

Describe plan for in stage three anesthesia

Answer 26

This last, from paralysis of intercostal muscles, the paralysis of the diaphragm, the patient ceases to breathe at the end of this plane

Question 27

Describe stage four of anesthesia

Answer 27

This is titled in pending death. It is the stage of impending death that lasts from the onset of apnea to failure of circulation, and represents medullary depression.

Question 28

What is the Seldinger technique

Answer 28

An over-wire technique of catheter insertion to obtain safe percutaneous access to vessels and hollow organs. The Seldinger method of guide-wire catheterization - CVP

Question 29

What does pulmonary capillary wedge pressure measure?

Answer 29

Left Ventricular End Diastolic Pressure

Question 30

What is the formula for Cardiac Output

Answer 30

SV x HR

Question 31

What is the formula for blood pressure

Answer 31

CO x SVR

Question 32

What does a decreased SV in the setting of a low PCOP / LVEDP indicate ?

Answer 32

Hypovolemia and the need for volume administration

Question 33

What does a “full heart”, high PCOP/LVEDP and low SV indicate?

Answer 33

The need for positive inotrope
Epinephrine ie, because of a cardiogenic shock

Question 34

How do you treat a normal or increased stroke volume in the setting of hypotension ?

Answer 34

Administer Vasoconstrictors (Vasopressin, Angiotensin II)

Question 35

List one way that haemodynamic performance can be assessed that is less invasive than Pulmonary Artery Catheterizaetion

Answer 35

Transpulmonary Thermodilution CO measurement

Pulse contour analyses of the arterial pressure waveform