Fundamental of Anaesthetics

Question 1

Name two risk scoring methods for surgery

Answer 1

Possum

ASA

Question 2

What kind of periop control would you do for someone with HTN?

Answer 2

Keep BP within 20% of normal BP

Question 3

When do you treat someone with HTN waiting for surgery?

Answer 3

if BP is above 160/80

Question 4

With anti-coag, what periop control do you do?

Answer 4

Keep INR/APTR below 1.5

Question 5

Periop control for sickle cell patients before surgery

Answer 5

Keep patietn warm, hydrated,, infection free, give analgesia

Haematological review

Question 6

What things are you looking out for during FH?

Answer 6

Suxamethonium apnoea

Malignant HTN

Question 7

Why is next flexion bad in someone with neck RA?

Answer 7

Can cause neck dislocation!!

Question 8

How do you prescribe opiods?

Answer 8

Does
Form
Strength
Total quantity or dosage units in both words and figures

Question 9

What is the oropharyngeal airway? When do you use it? What does it to?

Answer 9

Gadelle airways 
3-5 sizes (coloured)
Airway adjunct 
Sits underneath the tongue 
Sized from angle of mandible to middle of mouth

Question 10

When do you use a bag mask valve?

Answer 10

If they are apnoeic

Question 11

What is an endotracheal tube?

Answer 11

Coughed tube in a trachea
endotracheal tube

it does allow a definitive airway

Question 12

What is iGel?

Answer 12

Sits above vocal cords, hence it is NOT a definitive airway

Question 13

What safety list has WHO set out?

Answer 13

Five steps to safety

Question 14

What things would you consider for VTE prophylaxis?

Answer 14

Mobility
Risk factors
Bleeding risk

Question 15

Step 1 in pain ladder

Answer 15

Non opiod

Question 16

Step 2

Answer 16

weak opiod

codeine

Question 17

Step 3

Answer 17

Strong opiod

e.g. oxycoedein,

Question 18

Which anti nausea drugs are used if morphine causes nausea?

Answer 18

Ondansetrol
Cyclizine
Dexamethazone
Metaclopramide
Prochloraperazine

Question 19

What is NNT?

Answer 19

Number needed to treat - the lower the number, the better e.g. 6 patients need to be treated t get 1 patient to feel better

Question 20

What are the SE of these drugs?

Answer 20

LOOK IT UP ON THE LECTURE SLIDE

Question 21

If the procedure is more than 30 mins, what do you use to warm the patient?

Answer 21

Bair hugger

Fluid warming

Question 22

What do you do if the procedure is v long?

Answer 22

Consider fluid warming

Question 23

How would you manage someone with exacerbation of asthma before surgerY?

Answer 23

O
S
H
I
T
M

Question 24

How do you treat a tension pneumothorax?

Answer 24

2nd ICS MCL

needle aspiration

Question 25

What two things do you need to confirm sepsis?

Answer 25

LOOK IT UP

Question 26

What two things do you need to confirm sepsis?

Answer 26

Two or more of: Temp above 38 or below 36 HR above 90 RR above 20/m or pCO2 below 32mmHg WBC above 12 000 or below 4000/mmcubed

Question 27

What do you do within three hours if sepsis is identified?

Answer 27

Lactate levels Blood cultures Administer broad spec Abx

Question 28

What do you do within six hours if sepsis is identified?

Answer 28

Apply vasopressors Reassess volume status and tissue perfusion Remeasure lactate if elevated

Question 29

Contraindications to ABG sampling

Answer 29

``` Local infection Distorted anatomy Presence of AV fistulas Peripheral vascular disease of that particular limb Severe coagulopathy Recent thombolysis ```

Question 30

Complications after ABG

Answer 30

``` Haematoma Nerve damage Arteriospasm Aneurysm of artery Fainting or vasovagal response ```

Question 31

What are the ways in which oxygen can be delivered?

Answer 31

``` Nasal cannulae Hudson facemask Venturi facemask Non-rebreathable mask cPAP BiPAP ```

Question 32

Describe the flow rate of nasal cannulae

Answer 32

Nasal cannulae | Low flow rate

Question 33

What oxygen delivery is used in COPD?

Answer 33

Venturi mask

Question 34

What is CPAP?

Answer 34

High pressure, positive pressure all the time to keep airway open??

Question 35

When is CPAP used?

Answer 35

Type 1 respiratory failure | Hypoxic failure

Question 36

What is BIPAP?

Answer 36

Bilevel positive airways pressure | High positive pressure on inspiration and lower postive pressure on experiation

Question 37

When do you use BiPAP?

Answer 37

Used in type 2 resp failure e.g. COPD exacerabation