Peri-operative care

Question 1

Risk factors for difficult ventilation

Answer 1

OBESE

Obese
Beard
Edentate (no teeth)
Spine (poor neck movement)
Elderly

Question 2

Effect of acute alcohol on anaesthetic

Answer 2

Decreases effects of anaesthetic

Question 3

Effect of chronic alcohol on anaesthetic

Answer 3

Increases effects of anaesthetic

Question 4

ASA 1

Answer 4

Healthy pt

Question 5

ASA 2

Answer 5

Pt with mild systemic disease

Question 6

ASA 3

Answer 6

Pt with severe systemic disease

Question 7

ASA 4

Answer 7

Severe systemic disease that is constant threat to life

Question 8

ASA 5

Answer 8

Moribund pt not expected to survive with or without the operation

Question 9

ASA 6

Answer 9

Declared brain dead pt whose organs are being removed for donation

Question 10

ASA E

Answer 10

Added for emergency operations

Question 11

Most common blood borne virus

Answer 11

Hep B
Hep C
HIV

Question 12

Rx of Malignant Hyperthermia

Answer 12

Dantrolene

Question 13

Drugs causing malignant hyperthermia

Answer 13

Halothane
Suxamethonium
Anti-psychotics

Question 14

Cyanosed o2 sats

Answer 14

80-85 percent

Question 15

Different types of ventilation

Answer 15

NIPPV

IPPV

Question 16

NIPPV

Answer 16

Non-invasive intermittent positive pressure ventilation

Question 17

NIPPV types

Answer 17

BiPAP

CPAP

Question 18

IPPV involves?

Answer 18

Intubation and ventilation

Question 19

CPAP

Answer 19

continuous positive airway pressure

Question 20

BiPAP

Answer 20

Bi-level PAP

Question 21

CPAP use

Answer 21

hypoxia

Question 22

BiPAP use

Answer 22

Resp failure secondary to COPD exacerbation

Question 23

nasal cannulae normal flow rate

Answer 23

2-4l/min

Question 24

nasal cannulae FiO2

Answer 24

28-36%

Question 25

normal o2 mask flow rate

Answer 25

4 L/min

Question 26

normal o2 mask FiO2

Answer 26

35-40%

Question 27

Non-rebreather FiO2

Answer 27

up to 85%

Question 28

What group of pts need controlled O2 delivery

Answer 28

COPD CF Morbidly Obese

Question 29

When to stop warfarin before surgery

Answer 29

5 days before

Question 30

Mendelson's syndrome

Answer 30

chemical pneumonitis

Question 31

Smoking effect on anaesthetics

Answer 31

risk of bronchospasm

Question 32

Fluid restriction before surgery

Answer 32

no fluids within 2 hrs of op

Question 33

Food restriction before surgery

Answer 33

no food within 6 hrs of op

Question 34

Oral med restriction before surgery

Answer 34

no med within 30 mins | before could have with 30 mls of water

Question 35

Chewing gum restriction before surgery

Answer 35

no gum within 2 hrs

Question 36

Effect of trauma on gastric emptying

Answer 36

slows it down

Question 37

Prokinetics mech of action

Answer 37

speeds gastric emptying (used when risk of aspiration)

Question 38

Prokinetics example

Answer 38

Metoclopromide | Erythromycin

Question 39

When should antiacids be given before a surgery

Answer 39

immediately before op

Question 40

When should PPIs be given before a surgery

Answer 40

90 mins before anaesthesia

Question 41

When should prokinetics be given before a surgery

Answer 41

90 mins before anaesthesia

Question 42

When should anti-H2 be given before a surgery

Answer 42

90 mins before anaesthesia

Question 43

PE sx

Answer 43

Dyspnoea Pleuritic chest pain Haemoptosis

Question 44

CVS consequence of PE

Answer 44

Pulmonary HTN Right ventricular failure Low cardiac output Cardiac arrest

Question 45

RFs for VTE

Answer 45

Patient factors Associated disease Operation factors

Question 46

Patient factors for VTE

Answer 46

``` Age >60 Immobility/travel Pregnancy/puerperium BMI>30 Unopposed E2 ```

Question 47

Associated disease RFs of VTE

Answer 47

``` IBD Nephrotic Thrombophilia Malignancies MI/CVA ```

Question 48

Examples of thrombophilia

Answer 48

Protein C, S deficiency, | Factor V Leiden

Question 49

Operation RFs for VTE

Answer 49

Op >30mins | Joint replacement/abdo op

Question 50

Rapid induction

Answer 50

Thiopentone | Suxamethonium

Question 51

Lignocaine dose w, w/o adrenaline

Answer 51

3mg/kg | 7mg/kg with

Question 52

Bupivacaine dose w, w/o adrenaline

Answer 52

2mg/kg | 2mg/kg with

Question 53

Prilocaine dose w, w/o adrenaline

Answer 53

6mg/kg | 9mg/kg with

Question 54

Effect of adrenaline on LA

Answer 54

reduces systemic absorption allowing higher dose

Question 55

Dose of adrenaline in LA

Answer 55

1 in 200,000