Fundamentals of Anaesthesia - Clinical Anaesthesia

Question 1

What is a MET?

What does 1 MET equate to?

How many METS for 100m walk on level ground? Climb stairs or walk uphill? Strenuous exercise?

Answer 1

MET = Metabolic equivalent unit

Expressed in terms of oxygen utilisation. 1 MET = 3.5ml/kg of O2/min

1 MET = 100m on level
4 MET =stairs/hill
>10 MET = strenuous exercise

<4MET is associated with increased perioperative risk.

Question 2

How is the system for grading of laryngoscopy view known?

What are the grades?

Answer 2

Cormack & Lehane grading

1 = whole glottis
2 = glottis incompletely visible
3 = Epiglottis but not glottis visible
4 = Epiglottis not visible

Question 3

Factors associated with difficult mask ventilation (5)

Answer 3

Obesity
Beard
Edentulous
Snoring
Age >55

Question 4

What are the Mallampati classes (4)?

Answer 4

Class 1: Faucial pillars, soft palate and uvula visible

Class 2: Faucial pillars and soft palate visible, uvula masked by base of tongue

Class 3: Only soft palate visible

Class 4: Soft palate not visible

Question 5

Wilson risk factors (5)

Answer 5

Obesity
Restricted head and neck movement
Restricted jaw movement
Receding mandible
Buck teeth

Question 6

Cut off distances that predict difficult airways for: Thyromental
Sternomental
Hyomental

Answer 6

Thyromental <6.5cm
Sternomental < 12cm
Hyomental <4cm

Question 7

Pre-op starvation timings for adults(2)?
And children(4)?

Answer 7

Adults
Clear fluids and water up to 2 hours preoperatively
Food, sweets and milky drinks up to 6 hours preoperatively

Children
Clear fluids and water up to 2 hours preoperatively
Breast milk up to 4 hours preoperatively
Formula/cow’s milk up to 6 hours preoperatively
Food and sweets up to 6 hours preoperatively

Question 8

Why is chewing gum contraindicated before surgery?

Answer 8

INcreases gastric fluid volume