Numberwang Flashcards
MAC in 100% O2
- Des
- Sevo
- Iso
- Xe
- N2O
Des 6.6 Sevo 2.0 Iso 1.1 Xe 71 N2O 105
B:G (speed of onset/offset)
- Des
- Sevo
- Iso
- Xe
- N2O
Des 0.45 Sevo 0.7 Iso 1.4 Xe 0.12 N2O 0.47
O:G (potency)
- Des
- Sevo
- Iso
- Xe
- N2O
Des 29 Sevo 80 Iso 98 Xe 1.9 N2O 1.4
Neuraxial blockade levels
- LSCS
- MROP
- Labour
- EVAR
- TURP
LSCS: T4 cold, T6 pinprick, down to S3 MROP: T6 Labour: T10 (pain is T10-L1 1st stage, S2-4 2nd stage) Cervical cerclage: T10 EVAR: T10 TURP: T10
Elimination t1/2 (m)
- Morphine
- Fentanyl
- Alfentanil
- Remi
Morphine 170
Fentanyl 190
Alfentanil 100
Remi 10
Clearance (ml/kg/min)
- Morphine
- Fentanyl
- Alfentanil
- Remi
- Thio
- Pethidine
Morphine 16 Fentanyl 13 Alfentanil 6 Remi 40 Thio 3 Pethidine 10
Vd (L/kg)
- Morphine
- Fentanyl
- Propofol
- Pethidine
- Tramadol
- Alfentanil
- Remi
- Thio
Morphine 4 Fentanyl 4 Propofol 4 Pethidine 4 Tramadol 4 Alfentanil 0.6 Remi 0.3 Thio 2
Plasma protein binding (%)
- Morphine
- Fentanyl
- Alfentanil
- Remi
- Propofol
- Thio
- Pethidine
- Tramadol
- Lidocaine
- Bupivacaine
Morphine 35 Fentanyl 83 Alfentanil 90 Remi 70 Propofol 98 Thio 85 Pethidine 40 Tramadol 20 Lidocaine 65 Bupivacaine 95
pKa
- Aspirin
- Midazolam, alfentanil
- Remi
- Thio, diamorphine
- Lidocaine
- Morphine
- Bupivacaine, ropivacaine
- Fentanyl
- Pethidine
- Propofol
Aspirin 3.0 Midazolam, alfentanil 6.5 Remi 7.1 Thio, diamorphine 7.6 Lidocaine 7.9 Morphine 8.0 Bupivacaine, ropivacaine 8.1 Fentanyl 8.4 Pethidine 8.7 Propofol 11.0
Unionised fraction at pH 7.4 (%)
- Morphine
- Fentanyl
- Alfentanil
- Remi
Morphine 23
Fentanyl 9
Alfentanil 89
Remi 68
Relative lipid solubility
- Morphine
- Fentanyl
- Alfentanil
- Remi
- Pethidine
- Diamorphine
Morphine 1 Fentanyl 600 Alfentanil 90 Remi 20 Pethidine 30 Diamorphine 200
Cobb angle
10 degrees minimum for diagnosis of scoliosis
Surgery when >45-50 degrees
>60 = significant respiratory compromise
COSHH max agent concs (ppm)
- Halothane
- N2O
- Enflurane/isoflurane
Halothane 10
N2O 100
Enflurane/isoflurane 50
BP (degrees C)
- Des
- Sevo
- Iso
- Xe
- N2O
Des 23 Sevo 58.5 Iso 48.5 Xe -108 N2O -89
SVP at 20C (kPa)
- Des
- Sevo
- Iso
Des 88
Sevo 21
Iso 33
Steroid equivalence (mg) Pred, hydrocort, methylpred, dex
Pred 5
Hydrocort 20
Methylpred 4
Dex 0.75
Oral opioid equivalence (ratios)
Morphine, oxycodone, tramadol, codeine
Buprenorphine and fentanyl patches
Morphine 1
Oxycodone 2
Tramadol 0.15
Codeine 0.1
Transdermal:
Buprenorphine 5mcg/h patch = 12mg Oramorph
Fentanyl 50mcg/h patch = 180mg Oramorph
Umbilical vessel SpO2
Vein 70%
Artery 45%
Incidence of inherited diseases
- Down’s syndrome
- CF
- MD
- CHD
- HCM
- SCD
- Bicuspid AV
- Autism
- RA
- MH
Down’s 1 in 1000 live births
CF 1 in 2500 live births (1 in 25 carrier allele)
MD 1 in 8000 prevalence
CHD 1% live births
HCM 1 in 500 prevalence (25% cases obstructive)
SCD 1 in 2000 live births
Bicuspid aortic valve 0.5-2.5%
Autism 1%
RA 1-2%
MH 1 in 5000-10,000 susceptible; 1 in 40,000-100,000 GAs
Prevalence of acquired diseases
- Diabetes
- Post tonsillectomy bleed
- Asthma
- COPD
- IHD
- HTN
- Obesity
- AF
- PD
- OSA
- Dementia
- AS and aortic sclerosis
- GBS
- MG
- Phaeo
- Latex allergy
- Penicillin allergy
- Anaphylaxis
- Alcohol misuse
- PONV
Diabetes 9% (90% type 2)
Post tonsillectomy bleed 0.5-2%
Asthma 12% (>1400 deaths/y)
COPD 2% (diagnosed; much more undiagnosed)
IHD 4%
HTN 30%
Obesity 27%
AF 5.5% (50% perm, 25% persis, 15% paroxys)
PD 1% of >65s
OSA 5-10%
Dementia 1% (7% of >65s)
AS 3% >65s, aortic sclerosis 25% of >65s (9% progress to AS)
GBS 1-2 in 100,000 (3-5% mortality)
MG 1 in 1000
Phaeo 1 in 100,000
Latex allergy 4.3% (9.7% in healthcare workers)
Penicillin allergy 10% reporting rate (90% of which are not truly allergic)
Anaphylaxis 1/5000-1/20,000, 3:1 female preponderance
Alcohol misuse 9% men, 4% women
PONV 30%
Commonest cancers
Breast 15%
Lung 13%
Prostate 13%
Bowel 11%
% metabolised
- Des
- Sevo
- Iso
- Xe
- N2O
Des 0.02 Sevo 5 Iso 0.2 Xe 0 N2O 0
Molecular weights
- Des
- Sevo
- Iso
- Xe
- N2O
Des 168 Sevo 200 Iso 184 Xe 131 N2O 44
Oral bioavailability (%)
- Morphine
- Methadone
- Tramadol
- Pethidine
- Codeine
Morphine 30 Methadone 75 Tramadol 70 Pethidine 50 Codeine 50 (but only 10% metab to morphine)
Oxygen consumption (adult/child)
Adult: 3.5 ml/kg/min
Child: 6 ml/kg/min
NNT
Carbamazepine in TGN: 1.8
Gabapentin in PHN: 4
Mortality
- 30d postop emergency laparotomy
- 30d postop emergency laparotomy 10-15%