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Anaesthetics (internship) > Mid-block > Flashcards

Mid-block Flashcards

1
Q

Propofol induction dose

A

1.5-2.5 mg/kg

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2
Q

Thipentone induction dose

A

3-5mg/kg

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3
Q

Etomidate induction dose

A

0.2-0.3 mg/kg

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4
Q

Ketamin induction dose

A

1-2mg/kg

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5
Q

Indications for an RSI

A
  • pregnancy beyond first trimester
  • emergency surgery/trauma patients
  • unstarved patient
  • difficult airway management
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6
Q

Definition of a starved patient for an elective surgery

A
  • solids: 6 hours
  • non-human milk: 6 hours
  • breastmilk 4 hours
  • clear fluids: 2 hours
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7
Q

Causes of hypoxia in the recovery room

A
  • hypoventilation (pain, atelectasis, residual NM blockade, residual drug effects)
  • airway obstruction (tongue, laryngosmasm)
  • pulmonary oedema
  • PE (V:Q mismatch)
  • aspiration
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8
Q

Atropine: size, concentration and adult dose

A

1ml
10mg/ml
20ug/kg

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9
Q

Mac of iso, halothane, sevo

A

1.2
0.75
2

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10
Q

5 factors that decrease MAC

A
  • pregnancy
  • neonates
  • eldery
  • hypothermia
  • hypothyroidism
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11
Q

Use of neostigmine

A

Reversal of non-depolarising muscle relaxants

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12
Q

5 factors that decrease MAC

A
  • pregnancy
  • neonates
  • elderly
  • hypothermia
  • hypothyroidism
  • sedatives
  • acute opioid/alcohol use
  • chronic amphetamine use
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13
Q

Contraindications for a spinal anaesthesia

A
  • local sepsis/infection
  • INR
  • unable to convert to GA (unskilled/no equipment)
  • obstructive cardiac lesion (MS/AS)
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14
Q

Airway evaluations that help to assess the airway

A
  • MP
  • thyromental distance
  • inter-incisor distance
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15
Q

Contraindications for a spinal anaesthesia

A
  • local sepsis/infection
  • INR >1.5, platelets <75
  • allergy to LA
  • uncooperative patient
  • unable to convert to GA (unskilled/no equipment)
  • obstructive cardiac lesion (MS/AS)
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16
Q

Signs of local anaesthetic toxicity

A
  • circumoral paraestheia and metallic taste
  • tinnitus
  • visual disturbance
  • confusion and slurring
  • hypertension
  • tachycardia
17
Q

Indications for ETT

A
  • controlled ventilation
  • protection of the airway (aspiration etc)
  • maintainance of patent airway (prone, head/neck ops, ENT surgery)
  • post-op ventilation in ICU
18
Q

Complications during intubation

A
  • trauma to tissue
  • intubation response
  • increased resistance to breathing (narrow/kinked tube)
  • obstruction of ETT (foreign body, secretions(
  • oesophageal intubation
  • failed intubation
19
Q

Complications after extubation

A
  • laryngospasm
  • aspiration
  • hoarseness
  • tracheal oedema
  • vocal cord ulceration
  • tracheal stenosis
20
Q

Indications of LMA

A
  • fasted patients without GORD for short-moderate procedures
  • rescue
  • resus (to avoid interruptions in chest compressions
21
Q

Indications for surgical airways

A
  • prolonged ventilation in ICU
  • head and neck deformity/trauma
  • impossible intubation
  • difficult weaning from ventilation
  • emergency rescue
22
Q

Indications for surgical airways

A
  • prolonged ventilation in ICU
  • head and neck deformity/trauma
  • impossible intubation
  • difficult weaning from ventilation
  • emergency rescue
23
Q

Definition of MAC

A

the stead-state minimum concentration at sea level that prevents the movement to a standard surgical stimulus in 50% of non-premedicated adults

24
Q

Factors that increase MAC

A
  • infancy
  • hyperthermia
  • hyperthyroidism
  • chronic alcohol/opioid use
  • acute amphetamine use
  • hypernatramia
25
Q

Indications for muscle relaxants

A 
Patient factors (risk of aspiration)
Anaesthetic factors (control of ventilation, facilitates ETT,abnormal positioning)
Surgical factors (microsurgery, laparotomyis, orthos, ECT, cardiac surgery)
26
Q

Indications for muscle relaxants

A 
Patient factors (risk of aspiration)
Anaesthetic factors (control of ventilation, facilitates ETT,abnormal positioning)
Surgical factors (microsurgery, laparotomyis, orthos, ECT, cardiac surgery)
27
Q

Where are nicotinic receptors found?

A

Autonomic ganglia

Skeletal muscles

28
Q

Where are muscarinic receptors found?

A

heart
smooth muscle (bronchi and GIT)
glands

29
Q

Management of LA toxicity

A
  • stop injecting
  • call for help
  • ABCS
  • maintain airway (intubate if necessary)
  • 100% oxygen
  • may need to hyperventilate
  • ensure IV access
  • control convulsions with diazepam/midazolam/propofol
  • manage hypotension with vasopressors
  • use adrenaline if necessary
  • if arrested: start CPR
  • may need magnesium and intralipid for bupivicaine toxicity
  • intralipid (20%) 1.5ml/kg over 1 minute
  • start infusion at 0.25ml/kg (max 8ml/kg)
30
Q

Factors that reduce FRC

A
  • Supine position
  • lithotomy and trendelenbury
  • muscle relaxants
  • intubation
  • abdominal distension
  • pregnancy
  • abdominal pain
31
Q

Causes of hypoxia

A
  • stagnant (thrombosis, embolism, arrest)
  • anaemic hypoxia (not enough Hb)
  • hypoxaemic (no O2)
  • cytotoxic (cyanide)
32
Q

MOA of ephedrine

A

Releases noradrenaline from sympathetic terminals (a-adrenergic and B effects), direct effect on alpha and B recepors (vasoconstruction and increase CO)

33
Q

MOA of PEP

A

selective A1 receptor agonist, vasoconstricts to raise the SVR

34
Q

Management of anaphylaxis

A
  • ABCs
  • call for help
  • adrenaline (1mg in 20ml and give 0.5-1ml at a time)
  • aggressive IV fluid replacement
  • hydrocort 100mg IV/ promethazine 25mg IV
  • bronchodilator
  • glucagon 1-2mg slow IV
35
Q

What to give for malignant hyperthermia

A

Dantroleme (2.5mg/kg)

36
Q

Spinal volumes in obstetrics

A

2ml 0.5% bupivicaine with 8% dextrose and fentanyl 10ug (0.2ml)

37
Q

Standard minute volume

A

70ml/kg/minute

Anaesthetics (internship) (1 decks)

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