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My notes - med > Surg > Flashcards

Surg Flashcards

1
Q

head injury, lucid interval

A

Extradural (epidural) haematoma

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2
Q

elderly, alcoholic, head injury, insidiuous onset symptom

A

Subdural haematoma

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3
Q

epigastric pain worse w eating

A

gastric ulcer

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4
Q

epigastric pain relieved w eating

A

duodenal ulcer

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5
Q

High risk of strangulation hernia

A

femoral

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6
Q

Periumbilical brusing

A

Cullens sign - pancreatitis

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7
Q

Flank brusing

A

Grey Turners sign - pancreatitis

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8
Q

Most common prostate CA

A

adenocarcinoma

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9
Q

Prostate CA Ix-dx

A 
Pelvic pain, urinary sx
PSA measure (>4)
DRE
Trans rectal USS + biopsy
MRI/CT and bone scan for staging
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10
Q

Prostate CA usually in ? zone

A

peripheral

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11
Q

Gleason score

A

awarded 1 score (1-5) for most dominant, and 1 for second most dominant (1-5), add them together. 10 worst prog.

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12
Q

Prostate CA tx in elderly, multiple co morb, low Gleason

A

watch and wait

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13
Q

Prostate CA Radiotherapy SE

A

proctitis, rectal malignancy

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14
Q

Prostate CA Surgical SE

A

ED

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15
Q

IX for ureteric stone

A

US then non-contrast CT to confirm

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16
Q

Meds for renal colic

A

NSAIDs
If admitted: IM diclofenac
Alpha blocker to help pass it

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17
Q

Renal colic Ix

A 
Urine dip and culture
serum CR and E (renal func)
FBC/CRP (infection)
Calcium/urate: underlying causes
Clotting factors and blood cultures if ?sepsis
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18
Q

Renal stone <5mm

A

pass within 4 weeks

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19
Q

Renal stones tx

A

Shockwave lithotripsy (SE solid organ injury, ureteric obstruction)

Uteroscopy (for pregnancy or where shockwaves not good, or complex case…stent left in situ for 4 weeks)

Percutaneous Nephrolithotomy (lithotripsy but inside)

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20
Q

renal stone <2cm in aggregate tx

A

lithotripsy

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21
Q

renal stone <2cm in preggo

A

Uteroscopy

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22
Q

Complex renal calculi and staghorn calculi

A

percutaneous nephrolithotomy

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23
Q

Ureteric calculi <5mm

A

manage expectantly

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24
Q

Oxalate stone tx

A

Cholestyramine (lower urinary oxalate secretion)

Pyridoxine (same)

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25
Q

Uric acid stones tx

A 
Allopurinol
Oral bicarb (alkalinization)
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26
Q

Calcium stones tx

A

increase fluids
low animal protein, low salt
thiazides

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27
Q

Breast lesion, 18-25 year olds, mobile.

A

Fibroadenoma

Core biopsy if >4cm

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28
Q

Slit like retraction of nipple, cheese like discharge

A

Duct ectasia

Age related alteration of breast

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29
Q

Halo sign on mammogram

A

Breast cyst - compresses underlying fat

Aspirate if symptomatic

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30
Q

Achalasia

A

failure of LES to open when swallowing food

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31
Q

Statin for CVD

A

Atorvastatin 80mg

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32
Q

See both sides of bowel wall

A

Riggler’s sign - pneumoperitoneum

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33
Q

Parkland fluid replacement over 24 h formula (only for crystalloids - hartmans/ringers)

A

SA% x weight x 4ml

give 50% over 8h, 50% over 16h

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34
Q

Burn resusc goal:

A

urine output of .5-1ml/kg/hr in adults

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35
Q

First 24 hours post burn fluid:

A

crystalloid

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36
Q

After 24 hr burn fluid:

A

colloid .5ml x SA x weight

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37
Q

Maintenance crystalloid burn fluid eq:

A

1.5ml x SA x weight

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38
Q

Colloids

A

Albumin

FFP

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39
Q

Crystalloids

A

NaCl .9%
Ringers lactate
Hartmans
Glucose preparations

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40
Q

Aortic transection

A

Lucid then die
Deceleration injury
Widened mediastinum on XR

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41
Q

Duodeno-jejunal flexure disruption

A

Deceleration injury

Intra abdominal fluid but hemodynamically stable-ish

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42
Q

Hemopericardium

A

Tamponade

muffled heart sounds, paradoxical pulse, jugular vein distension

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43
Q

Normal diameter of abdominal aorta

A
  1. 5cm F

1. 7cm M

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44
Q

How long before surgery can you drink “clear fluids”

A

2h

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45
Q

Elective surgery prep:

A 
Bloods: FBC, UE, LFT, Clotting, Group & save
Urine
Preg test
Sickle cell test
ECG/CXR
DVT assessment
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46
Q

DM and surgery

A

high risk infx in poor control
Omit drugs and check levels
Insulin IV infusion, K supplement

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47
Q

Firboadenoma

A

Mobile
Firm
No malignancy risk

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48
Q

Fibroadenoma Tx

A

> 3cm - surgical excision

Phyllodes tumour - wide excision

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49
Q

Breast cyst

A

Smooth, discrete lump
Can be fluctuant
Small increase in CA risk

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50
Q

Breast Cyst tx

A

Aspirate

If blood stained or keep refilling - biopsy or excision

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51
Q

Sclerosing Adenosis

A

Breast lump/pain
Mammographic changes mimic carcinoma
Cause distortion of lobular unit without hyperplasia
No CA risk

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52
Q

Sclerosing Adenosis tx

A

biopsy lesion

dont need to be excised

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53
Q

Epithelial hyperplasia breast

A

Lumpiness or discrete lump

High risk of CA

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54
Q

Epithelial hyperplasia breast tx

A

If no atypical ft - conservative

If atypical - surgical resection

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55
Q

Breast fat necrosis

A

Traumatic aetiology
Mimics carcinoma
Can increase in size at first

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56
Q

Breast fat necrosis tx

A

imaging + core biopsy

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57
Q

Duct papilloma

A

present w nipple discharge
can have mass if large
Discharge usually from single duct
No risk CA

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58
Q

Duct papilloma tx

A

Microdochectomy

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59
Q

CT head immediately

A 
GCS <13 initialy
GCS <15 at 2hr post
Suspected open/depressed skull #
Any sign of basal skull#
Seizure after trauma
Focal neuro deficit
More than 1 vom
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60
Q

Basal skull # ft

A

hemotympanum
panda eyes
CSF leak from nose or ears
Battle’s sign (brusing @ mastoid)

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61
Q

CT head within 8h

A

> 65
hx bleeding or clotting disorder
dangerous mechanism (cyclist hit by car, ejection from car, fall from height >1m)
30 in retrograde amnesia of events right before injury
On warfarin

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62
Q

Rectal prolapse

A

Elderly females

Constipaition, pain, incont, discharge of mucus, bleeding

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63
Q

TPN issues

A

altered LFTs and hepatic function

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64
Q

Acute cholecystitis sx

A

Systemically unwell
Pain RUQ
Murphy’s sign
LFTs usually normal

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65
Q

Acute cholangitis

A

jaundice

pain

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66
Q

Acute cholecystitis causes

A

90% from gallstones
hospitalised or severely ill
infection of gall
CMV

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67
Q

Acute cholecystitis tx

A

IV abx

Early laparoscopic cholecystectomy within 1w

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68
Q

Anasthetic CI in penetrating eye injury/acute angle glaucoma

A

Suxamethonium - increases ocular pressure

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69
Q

ASA 1

A

healthy, non smoker, minimal alcohol

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70
Q

ASA 2

A

mild disease without functional limitations (smoker, social alcohol drinker, preg, obese, controlled DM/HTN, mmild lung dx)

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71
Q

ASA 3

A

Severe systemic disease (poor DM/HTN, COPD, >40BMI, hepatitis, alcohol abuse, pacemaker, reduced EF, renal disease, MI, CVA)

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72
Q

ASA 4

A

Severe systemic disease that is constant threat to life (recent MI, CVA, cardiac ischemia reduced EF, sepsis, DIC, ARD)

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73
Q

ASA 5

A

Not expected to survive w/o operation (ruptured AAA, massiva trauma, intra cranial bleed w mass effect, ischemic bowel)

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74
Q

ASA 6

A

Brain dead for organ harvesting

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75
Q

Criteria for brain stem death testing

A

Deep coma of known aetiology
Reversible causes excluded
No sedation
Normal electrolytes

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76
Q

Brain death testing

A

Fixed pupils not responding to light
No corneal reflex
Absent oculo-vestibular reflex (no eye mvmt after 50ml ice cold water to each ear)
No response to supra-orbital pressue
No cougb reflex to bronchial stim or gag reflex to pharyngeal stim
No resp effort when disconnected from ventilator

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77
Q

Lidocaine time

A

1h

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78
Q

Max dose lidocaine

A

3mg/kg (200mg max)
20ml of 1%
10ml of 2%

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79
Q

Lidocaine + adrenaline

A

lasts longer, reduced blood flow - DO NOT USE near extremities –> ischemia

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80
Q

Diverticular disease

A

Sigmoid

Change in bowel, rectal bleeding, abdo pain

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81
Q

Organic ED

A

gradual onset, lack of erection, normal libido

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82
Q

Psychogenic ED

A

sudden onset, decreased libido, good quality spontaneous/self stim erection, major life events, issues in relationship, psych problems, history of premature ejac

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83
Q

ED causing drugs

A

SSRI
BB
Alcohol
Smoking

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84
Q

ED Ix

A

10y CVD risk

Free testosterone between 9-11am –> if low, repeat w FSH, LH and prolactin

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85
Q

ED tx

A

PDE-5 inhibitors (sildenafil/viagra)

Vacuum erection device

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86
Q

Extradural/epidural hematoma CT

A

so extra - bulges into brain

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87
Q

Extradural/epidural hematoma ft

A

raised ICP, can have lucid interval
Between dura and skull
Accel-Decel or blow to side of head
Usually temporal, rupture of middle meningeal artery

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88
Q

Subdural hematoma CT

A

Subtle, stays along edge, crescent moon

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89
Q

Subdural hematoma ft

A 
outermost meningeal layer
frontal/parietal lobes
Old age, alcoholism, anticoagulation
Slow onset of sx
Fluctuating consciousness/ confusion
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90
Q

Subarachnoid hem ft

A 
sudden occipital headache
Severe headache
N/V
Meningism (photophob, neck stiff)
Coma
Seizure
Sudden death
Spontaneous in context of ruptured cerebral aneurysm
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91
Q

Intracerebral hematoma

A

Collection of blood in substance of brain
HTN, vascular lesion (aneurysm, AV malformation), cerebral amyloid, trauma, brain tumour, infarct)
Present like stroke or decreased consciousness

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92
Q

Intracerebral hematoma CT

A

hyperdense (bright) within substance of brain

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93
Q

Muscle relaxant for rapid sequence induction for intubation

A

Suxamethonium

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94
Q

Propofol

A

sedating agent

95
Q

Etomidate

A

sedating agent

96
Q

Suxamethonium MOA

A

short acting depolarising muscle relaxant
Binds nicotinic ACh receptors - persistent depolrization
Fast onset

97
Q

Tubcurarine, atracurium, vecuronium, pancuronium

A

Muscle relaxant
competitive antagonist of nicotinic ACH receptors, non-depolarizing
slow onset, long duration

98
Q

If surgical patient not fasted, use

A

ETT - secures airway and protects from asipration

99
Q

Do NOT give in hx of hyperpyrexia for surg

A 
Inhaled GA (halothane, thiopental)
Depolarising muscle relx (suxamethonium)
100
Q

Appendicitis ft

A

tachy, low fever, RIF pain

Rovsing’s sign (pain in RIF when palpate LIF)

101
Q

Acute pancreatitis ft

A 
alcohol or gallstones
epigastric pain
vomiting
tenderr, ileus, low fever
Cullens and Grey turner
102
Q

Nephroblastoma (Willms)

A 
<4y
mass + hematuria
Pyrexis
Early mets to lung
Nephrectomy
Younger has better prog
103
Q

Rectal fissure tx

A

stool softener
GTN or Diltiazem
Botulinum toxin if no response
Internal sphincterotomy

104
Q

Solitary rectal ulcer

A

chronic constipation + straining

Biopsy needed

105
Q

Fissure in ano ft

A

Bright red blood
Painful bleeding after poop, small amt
Midline posterior

106
Q

Hemorroids ft

A 
Bright red blood
Post poop blood on paper and in toilet
Possibly altered BM habit
Hx straining
No local pain
107
Q

Crohns ft

A

Bright red or mixed blood
Bleeding w/ other sx (altered BM, malaise, Hx of fissures, abscesses)
Can see fissure or fistula, indurated muscosa, strictures, skip lesions

108
Q

UC ft

A

Bright red blood mixed w stool
Diarrhea, weight loss, nocturnal incont, passage of mucous
Proctitis, continuous mucosal lesion

109
Q

Rectal CA ft

A

Bright red blood, mixed
Altered BM, tenesmus, sx of mets
Lesion mucosal
Polyps

110
Q

Rectal bleed Ix

A

DRE
Proctosigmoidoscopy
Colonoscopy if alterned BM

111
Q

Rectal CA Ix

A

MRI of rectum for margins and nodal disease

CT CAP

112
Q

Hemorrhoids tx

A

lifestyle
Internal: Injection slcerotherapy or rubber band ligation
External: hemorroidectomy - HALO or stapled

113
Q

IBD tx

A

medical mgmt

Surgert for fistulating Crohns

114
Q

Rectal CA tx

A

anterior resection or abdomino perineal excision of colon and rectum
Total mesorectal excision

115
Q

HER2 +ve chemo

A

Trastuzumab (herceptin)

116
Q

ER +ve BCA chemo

A 
Tamoxifen (pre/peri meno)
aromatase inhibitors (post meno) - anastrozole
117
Q

BCA + no axillary LN

A

Preop axillary US - if +ve then have sentinel node biopsy to assess

118
Q

BCA + axillary LN

A

axillary node clearance - can lead to lymphedema and functional arm impairment

119
Q

BCA Multifocal tumour surgery

A

Mastectomy

120
Q

BCA Central tumour surgery

A

Mastectomy

121
Q

BCA large lesion in small breast

A

Mastectomy

122
Q

BCA DCIS >4cm

A

Mastectomy

123
Q

BCA solitary lesion

A

wide local excision

124
Q

BCA peripheral tumour

A

wide local excision

125
Q

BCA small lesion in large breast

A

wide local excision

126
Q

DCIS <4cm

A

wide local excision

127
Q

When to give radiotherapy in BCA

A

after wide local excision OR mastectomy of T3/T4 OR 4+ +ve LN

128
Q

Tamoxifem SE

A

endometrial CA
VTE
Menopausal sx

129
Q

Pfannenstiel

A

C-section

130
Q

Kocher scar

A

cholecystectomy

131
Q

Rooftop + midline

A

Pancreatectomy

132
Q

Lanz

A

appendix

133
Q

Gable

A

rooftop incision

134
Q

McEvedy’s scar

A

groin - femoral hernia

135
Q

Rutherford Morrison scar

A

Renal transplant

136
Q

Contraindication to circumcision

A

Hypospadias

137
Q

Indications for circumcision

A

phimosis
Balanitis xerotica obliterans
paraphimosis
recurrent balanitis

138
Q

Hasselbach’s triangle

A

Med: rectus abdominis
Lat: inferior epigastric vessels
Inf: inguinal lig

139
Q

Hernia within hasselbach’s

A

direct

140
Q

Hernia outside hasselbach’s

A

indirect

141
Q

Peyronie’s disease

A

noncancerous

fibrous scar tissue develops on penis causing curved painful erections

142
Q

Bilious vomiting on 1st day of life

A

intestinal atresia

143
Q

Duodenal atresia

A

Presents within hours
AXR w double bubble
duodenoduodenostomy

144
Q

Malrotation w volvulus

A

Due to incomplete rotation during embryogenesis
Presents 3-7 days
Peritonitis, hemodynamic instability
Ladd’s procedure

145
Q

Jejunal/ileal atresia

A

From vascular insufficiency in utero
Within 24h
AXR show air-fluid level
Laparotomy w resection and anastomosis

146
Q

Meconium ileus

A

Usually CF
Within 24-48h w abdo distension, bilious vom
AXR shows air-fluid levels. Sweat test for CF
Surgical decompression, resection if serosal damage

147
Q

Necrotising enterocolitis

A

Common in premature, shows in 2nd week
AXR dilated bowel loops, pneumatosis, portal venous air
Supportive tx, laparotomy if perf or deterioration

148
Q

Thrombosed hemorrhoid <72h

A

analgesia and ref for excision, after 72 hr just ice, stool soft, analgesia

149
Q

Duct ectasia tx

A

Reassurance
Young and bothersome: microdochectomy
Older and bothersome: duct excision

150
Q

Emergency bowel perf surgery

A

Hartmann’s

Resection and formation of end colostomy/ileostomy, then it can be reversed later

151
Q

Rectal CA chemo

A

5FU and oxaliplatin

152
Q

Rectal CA involving sphincter complex or very low tumours:

A

Adomino-perineal excision of rectum

153
Q

Rectal CA T1/T2 N0 tx

A

no radiation, straight to surg

154
Q

CA in cecal, ascending or proximal transverse colon

A

Right hemicolectomy

Ileo-colic anastomosis

155
Q

CA in distal transverse or descending colon

A

Left hemicolectomy

Colon-colon anastomosis

156
Q

CA in sigmoid

A

high anterior resection

colo-rectal anastomosis

157
Q

CA in upper rectum

A 
Anterior resection (total mesorectal excision including LN and mesorectal fat)
colo-rectal anastomosis
158
Q

CA in low rectum

A 
anterior resection (low TME)
colo-rectal anastomosis +/- defunctioning stoma
159
Q

CA at anal verge

A

abdomino-perineal excision of rectum

No anastomosis

160
Q

Snowstorm sign and LN in axilla

A

ruptured implant

161
Q

Intraductal papilloma

A

Clear or blood stained discharge from single duct

No risk of malignancy

162
Q

Goserelin

A

Prostate Ca

GnRH agonist providing neg feedback to anterior pituitary

163
Q

Localised prostate CA (T1/T2) tx

A

Conservative: watch & wait
radical prostatectomy
Radiotherapy (external beam and brachy)

164
Q

Localised advabces prostate ca (T3T4)

A

hormonal therapy
radical prostatectomy (ED is comp)
Radiotherapy (ext/brachy - risk if bladder, colon and rectal CA)

165
Q

Metastatic prostate ca hormone therapy

A

GnRH agonist (Goserelin) - cover w anti-androgen initially
Anti-androgen - cyproterone acetate - prevents DHT binding
Orchidectomy

166
Q

Gastrostomy

A

Gastric decompression/ fixation
Feeding
Loc: epigastrium

167
Q

Loop jejunostomy

A

Rare - V high output
Following emergency laparotomy
Any location

168
Q

Percutaneous jejunostomy

A

For feeding, site in proximal bowel

LUQ

169
Q

Loop ileostomy

A 
Defunction colon (rectal Ca)
RIF
170
Q

End ileostomy

A

After complete excision of colon or where ileocolic anastomosis not planned
Defunction colon
RIF

171
Q

End colostomy

A

When colon diverted or resected and anastomosis not primarily achievable
LIF or RIF

172
Q

Loop colostomy

A

defunction distal segment of colon

Anywhere

173
Q

Cecostomy

A

Last resort, if colostomy not possible

RIF

174
Q

Mucous fistula

A

Decompress distal segment of bowel following colonic division or resection
Where closure of distal resection is not possible
Any region

175
Q

Hematuria + polycythemia

A

renal adenocarcinoma

176
Q

Causes of hematuria

A

Trauma (renal tract, blunt/penetrating injury, RTA bladder trauma,pelvic fracture)
Infx (TB)
Malig (RCC, transitional cell urothelial, SCC/adenocarcinoma of bladder, prostate, penile SCC)
Glomerulonephritis
Stones
Structure (BPH, vascular malformation, renal vein thrombosis, systic renal lesions PCK)
Coagulopathy
Drugs (tubular necrosis-aminoglyc,chemo, intersitial nephritis-penicillin, NSAID, sulphonamide, anticoags)
Gyne (endometriosis
Iatrogenic (catheter, radiotherapy)

177
Q

AAA repair indications

A

> 5.5cm
Symptomatic
Rapidly growing

178
Q

Subdural hematoma vessels

A

bridging veins

179
Q

Berry aneurysm location

A

circle of willis

180
Q

extradural hematoma location

A

middle meningeal artery

181
Q

cushing reflex

A

hypertension and bradycardia

182
Q

Indications for splenectomy

A

uncontrollable splenic bleeding
hilar vascular injuries
devascularised spleen

183
Q

Cerebral salt wasting syndrome

A

Common after subarachnoid hemorrhade

Lose sodium and water - kidneys still functioning so urine output high, fluid depletion

184
Q

SIADH

A

kidneys hold onto too much H2O, end up diluting serum sodium and having concentrated urine (high)

185
Q

SAH spontaneous causes

A 
Intracranial aneurysm (85%. Assoc w adult polycystic kidneys, ehlers danlos, coarctaiton of aorta)
AV malformation
pituitary apoplexy
arterial dissection
Mycotic aneurysms
Perumesenphalic
186
Q

SAH dx

A

CT head - acute blood in basal cisterns, sulci, ventricular system. Can be negative
LP - 12 hr after sx, xanthrochromia (rbc breakdown product)
Normal/raised opening pressure
Refer to neurosurg as soon as confirmed

187
Q

SAH tx

A

if aneurysm - coil or clipping

Prevent vasospasm w nimodipine (CCB), induced HTN, hypervolemia, hemodilution

188
Q

SAH complications

A 
Re-bleed - usually in first 12h, repeat CT if suspected
Vasospasm - 1-2w
Hyponatremia - SIADH
Seizures
Hydrocephalus
Death
189
Q

portal HTN and lower GI bleding

A

rectal varices

190
Q

Portal HTN ft

A 
ascites
splenomegaly
caput medusae
usually caused by cirrhosis
high ALT and ALP
Low albumin due to liver dmg
Rectal varices
191
Q

Small internal hemorrhoid tx

A

low conc. phenol in oil injection

192
Q

88% aqueous phenol uses

A

ablation of nail bed in toe nail surgery

193
Q

Local anesthetic toxicity tx

A

IV 20% lipid emulsion

194
Q

Benzo toxicity tx

A

Flumazenil

195
Q

Heparin reversal

A

IV protamine sulfate

196
Q

Lidocaine MOA

A

affects NA channels in axon

197
Q

Bupivacaine MOA

A

binds inracellular part of Na channel and blocks Na into cell –> prevents depolarization
**cardiotoxic, not used in regional block

198
Q

Pale stool + dark urine

A

Cholangitis

199
Q

Jaundice, fever, RUQ pain

A

Cholangitis, Charco’t triad

200
Q

RUQ pain, Murphy’s sign, fever

A

Cholecystitis

201
Q

Infection of biliary tree

A

Ascending cholangitis

Usually e-coli

202
Q

Cholecystitis tx

A

cholecystectomy

203
Q

Cholangitis tx

A

ERCP

204
Q

AF post colon surgery

A

Anastamotic leak, day 5-7

205
Q

Ischemic colitis ft

A

severe abdo pain

passage of bloody stools

206
Q

Testicular lump + gynecomastia

A

Testicular CA

increase estrogen:androgen ratio

207
Q

testicular germ cell tumors

A

seminomas

non-seminomas (embryonal, yolk sac, teratoma, choriocarcinoma)

208
Q

testicular non germ cell tumours

A

leydig cell tumour

sarcoma

209
Q

Seminoma survival

A

95% if caught early

210
Q

Germ cell tumours marker

A

AFP (60%), LDH (40%)

211
Q

Seminoma markers

A

hCG in 20%

212
Q

Prostatitis

A

Tender boggy prostate
Can have referred pain to perineum, penis, rectum, back, abdomen
Obstructive voiding
fever/rigors

213
Q

Prostatitis tx

A

14 days cirpofloxacin or ofloxacin (quinolone)

214
Q

Critical limb ischemis

A

ABPI 0.3

Gangrene, impalpable pulses

215
Q

Foot w Hyperemia + ulceration

A

ABPI 0.5

Severe vascular disease

216
Q

T2DM c leg pain at rest, worse at night

A

ABPI >1.2 due to vessel calcification

217
Q

Indirect hernia

A

through inguinal canal

218
Q

Direct hernia

A

through posterior wall of inguinal canal

219
Q

Coffee bean sign w 3 dense lines converging towards site of obstruction

A

sigmoid volvulus

220
Q

Sigmoid volvulus assoc with:

A 
older
chronic constipation
Chagas disease
Neuro disease (PD, Duchenne)
Psych (schizo)
221
Q

Cecal volvulus assoc

A

all ages
adhesions
preg

222
Q

Sigmoid volvulus tx

A

rigid sigmoidoscopy w rectal tube insertion

223
Q

Cecal volvulus

A

right hemicolectomy

224
Q

Colon Ca monitoring marker

A

CAE

225
Q

anasthetic induction/facilitate intbubation of hemodynamically unstable

A

ketamine

226
Q

Maintain anesthesia

A

desflurane

227
Q

Propofol

A 
GABA agonist
rapid onset
anti-emetic properties
myocardial depression, hypotension
maintains sedation, or for daycase
228
Q

Sodium thiopentone

A

rapid onset - good for rapid sequence induction
Myocardial depression, hypotension
not for maintenance
minimal analgesia

229
Q

Ketamine

A 
NMDA antagonist
induction
strong analgesia
good for hemodynamically unstable
can cause dissociative anesthesia resulting in nightmares
230
Q

Etomidate

A

Good for cardiac safety
no analgesia
not for maintenance
post op vom

231
Q

Pancratitis fluids

A

crystalloids

232
Q

Becks triad

A

raised JVP, muffled heart sounds, hypotension

In cardiac tamponade

233
Q

Cushings triad

A

low RR, bradycardia, HTN

Seen in raised ICP

My notes - med (14 decks)

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