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Final FRCA > Misc > Flashcards

Misc Flashcards

1
Q

In which neuromuscular condition can sux be used safely?

A

Myasthenia gravis and in fact may need 2x normal dose
However in ELS need to use a reduced dose although again can be used

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2
Q

In which conditions must you avoid anti cholinesterases and why?

A

Myotonic dystrophy and myotonic congenita
Can lead to hyperkalaemia
Myasthenia gravis - can actually prolong block and lead to cholinergic crisis

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3
Q

Myotonic dystrophy and myotonic congenita inheritance

A

Both autosomal dominant
MD - chromosome 19
MC - chromosome 17

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4
Q

Drugs to avoid in patients with prolonged QT

A

Ketamine
Suxamethonium
Methadone
Most antiemetics but not cyclizine or dex
Oxytocin
Macrolides

Avoid anticholinergics and adrenergic drugs - CAN use meteraminol and phenyl safely however

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5
Q

Systemic sclerosis/Scleroderma features

A

Limited scleroderma - CREST
Calcinosis, Raynauds, oesophageal dysmotility, sclerodactyly and telangectasia

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6
Q

Most concerning complications of systemic sclerosis (responsible for most mortality)

A

Pulmonary fibrosis
Myocardial disease
PAH

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7
Q

What is systemic sclerosis

A

A rare autoimmune condition leading to inflammation and progressive multi system connective tissue disease
Small vessel vasculopathy and abnormal collagen deposition leading to fibrosis of skin and organs

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8
Q

Risk factors for abnormal placental adherence

A

Placenta praevia
Previous C section
IVF
Advanced maternal age
Previous endometrial surgery Ie myomectomy or ablation
Multiparity
Ashermans syndrome

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9
Q

Classes of chemotherapy agents

A

See photo

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10
Q

Functions of the spleen

A
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11
Q

Drugs used in Parkinson’s

A
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12
Q

NAP 5 findings

A
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13
Q

What operations are highest risk for CPSP?

A

Amputation
Thoracotomy
Mastectomy
Cholecystectomy
Inguinal hernia
Vasectomy
Caesarean

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14
Q

Safety re ABO compatibility for transfusion of FFP/cryo/platelets

A

FFP and cryo should be ABO compatible ideally but if not possible, AB is universal donor, Rh compatibility is not required
Platelets should ideally be ABO compatible but any can be used in emergency, just may not see such good increment

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15
Q

What is Marfans

A

Autosomal dominant disorder
Connective tissue disorder
Defect in fibrillin 1 gene on chromosome 15

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16
Q

Clinical features of marfans

A
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17
Q

Criteria for CRT device

A

NYHA classification class III or IV
Patient in sinus rhythm with wide QRS(ie LBBB) or normal QRS with vent dyssynchrony on ECG
EF < 35%
Already on max medical therapy

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18
Q

Symptoms of TCA overdose

A

Hypotension
Tachycardia
ECG changes inc wide QRS
Cardiac depression
Vent arrhythmias
Mydriasis
Reduced consciousness
Hyperreflexia
Seizures

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19
Q

MOA of TCAs

A

Inhibition if pre-synaptic reuptake of noradrenaline and serotonin

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20
Q

Packed red cells storage
- temp and solution

A

4 degrees to inhibit bacterial growth and reduce RBC energy use
Solution - usually citrate, phosphate, dextrose and adenine
Citrate prevents clotting and phosphate is a buffer
Others are nutrients
Store - for up to 35 days

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21
Q

FFP storage

A

-20 degrees
Use immediately when thawed
AB is universal donor

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22
Q

Cryo storage

A

-30 degrees for up to 1 year
Contains high levels of factor 8, vWF and fibrinogen
AB is universal donor

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23
Q

What is in prothrombin complex concentrate and when to give it

A

Clotting factors 2/7/9/10 and protein C and S
For reversal of raised INR in bleeding patient on warfarin

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24
Q

Platelet storage

A

At room temp (22degrees) for up to 5 days with continuous agitation to avoid clumping
Ideally ABO matched but can use any

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25
Q

Transfusion reaction associated lung injury

A
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26
Q

What are the nervous system changes in the development of phantom limb pain/neuropathic pain
- in peripheral/spinal cord and central NS

A
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27
Q

Sickle cell genetics

A
28
Q

Causes of oxygen debt post exercise

A
29
Q

Mechanism of action of metformin and dose on day of surgery?

A
30
Q

MOA of gliclazide (sulphonylurea) and whether to give on day of surgery

A
31
Q

Dapagliflozin MOA and dosing on day of surgery
Also what class??

A
32
Q

What is carcinoid syndrome?

A
33
Q

What is used to treat carcinoid syndrome? And what is the dose in carcinoid crisis?

A

Octreotide
20-50mcg in crisis

34
Q

What are the symptoms of carcinoid syndrome? And carcinoid crisis

A

Syndrome
- flushing
- lacrimation
- rhinorrhoea
- diarrhoea
-hypotension
- shortness of breath

Crisis
- hypotension
- Tachycardia
- sweating
- Confusion
- breathing difficulties & bronchospasm

35
Q

What vasopressors are safe and which unsafe in pt with carcinoid tumour?

A

Safe - phenylephrine and vasopressin

Unsafe - adrenergic agents (use with extreme caution)

36
Q

What hormones are secreted by carcinoid tumours?

A
37
Q

What is the score to identify candidates for acute liver transplant in paracetamol toxicity? And what are the parameters?

A
38
Q

Causes of pulmonary hypertension

A
39
Q

Clinical features of pulmonary HTN?

A
40
Q

Phosphodiesterase 5 inhibitor
MOA and example

A

sildenafil

Increases cGMP levels
NO is a potent vasodilator that acts via cGMP

41
Q

Symptoms + signs of myasthenia gravis

A
42
Q

Symptoms of myasthenic crisis

A
43
Q

Lipid emulsion for LA-ST
Concentration
Bolus dose
Infusion rate
Max dose

A
44
Q

Toxic doses of LA with and without epi
Lidocaine
Bupivicaine
Ropivicaine
Prilocaine

A
45
Q

Coeliac plexus nerves

A

Greater/lesser/least splanchnic

46
Q

Define the term vo2 peak

A

Peak rate of oxygen uptake measured when the individual exercised up to symptom limitations or fatigue

47
Q

Define anaerobic threshold

A

The VO2 at which oxygen demand exceeds supply and anaerobic metabolism takes place

48
Q

Define VE/VCO2

A

The ratio of minute ventilation to carbon dioxide production
Ie a measure of gas exchange efficiency during exercise

49
Q

VE/VCO2 cut off for high risk

A

> 34 predicts post op morbidity and mortality

50
Q

Post brain stem death physiological changes

A
51
Q

Describe the 4 stages of spinal shock

A
52
Q

What is autism spectrum disorder

A

Lifelong disability
Triad of difficulty with social interaction, social communication and social imagination
May have low or normal IQ

53
Q

Thoracoscore parameters

A

Age (years)
Sex
ASA Classification
Performance Status Classification
Dyspnea score
Priority of surgery
Procedure class
Diagnosis group
Comorbidity Score

54
Q

Indications for one lung ventilation

A
55
Q

What is the pathophysiology of phantom limb pain?

A
56
Q

Boundaries of epidural space

A
57
Q

CRPS criteria - criteria and categories of signs

A
58
Q

Transplant criteria for non paracetamol acute liver failure

A
59
Q

How does gas exchange occur with HFOV

A

Bulk flow
Taylor dispersion
Pendelluft mixing
Molecular diffusion
Cardiogenic mixing

60
Q

Hazards of MRI

A
  • Displacement im force from static magnetic field - Ie projectiles
  • Induced current from time varying magnetic fields Ie leading to cause arrhythmia
  • acoustic noise
  • heating from radiofreq fields
  • helium escape
61
Q

Contraindications to MRI

A

Ferromagnetic eye fragments
Cochlear implants
Ferromagnetic aneurysm clips

62
Q

Moffett’s solution - what is the mix?

A

Cocaine 1-2ml of 5%
Adrenaline 1ml of 1:1000
Sodium bicarbonate 8.4% 2ml

63
Q

Define preload/afterload/MAP definitions

A
64
Q

Define major haemorrhage and massive transfusion

A
65
Q

Vaughn Williams classification and where they act on cardiac cycle

A

Final FRCA (1 decks)

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