Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Last Leg > Anaesthesia > Flashcards

Anaesthesia Flashcards

1
Q

Does not have any CI

A

General anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q 
LOC ✔
Loss of reflex ✔
Amnesia ✔
Analesia
Muscle relaxn
A

Components of GA

✔ = All drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Multiple drugs in titration for diff components of anaesthesia

A

Balanced anaesthesia

Dr John Lundy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Triad of GA

A

Narcosis
Relaxn
Analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Methods of Induction

A
  1. IV - faster, smoother, less anxiety
    PREFFERED, BEST
  2. Inhalational - in peds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Methods of Maintainance

A
  1. IV

2. Inhalational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TIVA = Propofol

A

Induction + Maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pre O2

A

100% O2 mask with patient’s own efforts

  • 3 to 5 min Normal TV breathing
  • 4 full VC breaths
  • 8 full breaths/ 1 mintute
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Steps of GA

A 
1 Attach monitors 
2 Secure IV
3 Pre O2
4 Induction
5 Maintain
6 Reversal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Min of __% of O2 out of A. machine

A

30%

Except 25% in high combustion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Inhalational A. agents

A
  1. Potent

2. Carrier gas (due to long pathway)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Potent A. inhalational agents

A 
NEW 
Halo
Iso
Sevo
Des
NOT USED NOW Enflurane and Methoxy

OLD
Ether
Chloroform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Carrier gases

A

N2O

Xenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

High combustion operation triad

A

FUEL - tube/cuff/drape
OXIDANT - O2/N2O/Volatile agent
IGNITION - laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MAC

A

Min alveolar conc to produce UNCONSCIOUSNESS (no movement on Std Sx Stimulus in 50% of popluation
MAC = 1/POTENCY = DOSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MAC = HISD

A

MAC increases, and potency decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Overall
Most potent
Least potent

A

Most potent - Methoxyflurane

Least potent - N2O (104 MAC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Conditions DECREASING MAC (decrease dose)

A 
Hypoxia
Hypercapnia
Hypovolemia
Hypothermia
Hyperthermia (upto 42 deg) 
HypoNa
HyperCa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Condn INCREASING MAC

A

> 42 deg - Heat stroke

Hypernatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Age = 1/MAC (6% per decade)

Order

A

Infant > Neonate > Adult > Elderly

HIGHEST MAC - Infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why low MAC in Pregnancy

A
  1. Preogesterone sedates the brain

2. Increase sensitivity to drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Acute Alcoholism

Any drug contributing to any effect of GA (NSAID, opioid)

A

Low MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Chronic Alcoholism
Amphetamine
HyperNa

A

High MAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Endocrines and MAC?

A

No EFFECT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MAC50 = MAC
MAC95
Submaximal MAC

A

MAC95 = 1.3 - 1.5 MAC50

Submaximal MAC = (just less that reqd dose of drug) causes compensatory Sympathetic stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

GA

Sleep

A

Beta - Alpha - Theta - Delta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Meyer Overton Rule

A

Potency of A. agent = Lipid solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

B-G partition coefficient
Blood - Gas solubility
Diffusion Coefficient

A

One of the factors affecting Speed of INDUCTION

Alv conc = CNS conc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

High BG coefficient

A

Slow speed of induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

BG coefficient

HISD

A

BG decreases and spleed increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q
  1. Jasmine smell
  2. Rotten egg smell (laryngeal spasm)
  3. Sweet smell
A
  1. Sevo
  2. Des (irritant)
  3. Halo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

a. Induction Inhalational agent of choice for ALL cases, NO EXCEPTION, NO CI
b. Most appropriate inhalational agent in Peds

A

Sevoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Maintenance inhalational agent of choice

A

Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q 
Fast recovery (Day care Surgery)
POST OP DELIRIUM + HALLUCINATION
A

Sevo and Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Cardiac Output and Speed of induction?

A

High CO = Slower speed of induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

CNS Conc and ventillation

CNS conc and Second gas effect

A

Directly proportional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Halogenated ethane

A

Halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Halogenated Ethers

A

All except Halothane

  • Iso
  • Sevo
  • Des
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Isomer of Enflurane

A

Isoflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Structural analogue of Isoflurane (FLURONATED ISOFLURANE)

A

Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q 
STABLE 
Least metabolized 
Most fluorinated
Least F release
Least inflammable
A

Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Highest fluride release

Least F content

A

Methoxyflurane

BANNED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Boiling point (B.P.)

A 
HIS = 50 +- 2 deg 
Des = 23 deg (Room temp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Desflurane B.P.

A
  • Tec 6 special vapouriser for delivery of DESFLURANE
  • Highest Vapour Pressure
  • Has to be electrically heated to 35 deg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q 
Color codes 
Halo
Iso
Sevo
Des
A

Halo - RED
Iso - PURPLE
Sevo - YELLOW
Des - BLUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Most unstable

Preservative = Tymol 0.01%

A

Halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Stability

HISD

A

H - Most instable
I - Quite stable
S - Quite stable
D - Most Stable :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Metabolism of Halothane

A

> 30% Acyl halide + Surface Ag of liver

Autoimmune Hepatitis VERY COMMON :(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Metabolism of Isoflurane

A

0.1%

Neither Hepato/Nephrotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Metabolism of Sevoflurane

A

Compound A released
NEPHROTOXIC (Max - Methoxy>Sevo)
But can be used in Kidney # tho

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Not metabolised :))

A

Desflurane :)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Smell

HISD

A

H - Good
I - Irritant
S - Sweet
D - Irritant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Uses

HISD

A

H - I+M
I - M
S - I+M (I. Agent of Choice)
D - M (M. Agent of Choice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

30-40% hepatitis

Acute, self-limiting in which liver funtion is deranged 3-6 wks post exposure to Halo

A

Type I HH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Acute NECROTISING/FULMINANT hepatitis

1 in 35,000-45,000

A 
Type II HH 
Predisposing: 
1. Obese 
2. Female
3. Middle age (Peds is Protected)
4. Pre-existing liver #
5. Re-exposure <3 months of use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Effect on CNS by gaseous A. agents

🧠

A 
CNS uncouplers
⬇️CMRO2
⬆️⬆️CBF
⬆️⬆️ICP
⬇️EEG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

CNS Coupling

A

CBF = CMRO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Gaseous for NeuroSx

  1. CI
  2. Agent of Choice
  3. m/c inhalational
A
  1. CI - Halothane
  2. Agent of Choice - DESFLURANE (safest) > Iso > Sevo
  3. m/c - Isoflurane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Preferred in ICP/ Neuro Sx

A

TIVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Agents as Antiepileptics

  1. Seizures
  2. Epilepsy
A 
Seizure = Sevo
Epilepsy = Enflurane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Agents decreasing EEG

A

All inhalational EXCEPT (increasing EEG)

  1. N2O
  2. Ketamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Decrease in EEG

A

Hypoxia
Hypercapnia
Hypothermia
Hypovolemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Increase in EEG

A

Early staged of 4H’s - sympath stimulation
Ketamine
N2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Effect on CVS
HISD
🫀

A

H - UNSTABLE

ISD - Stable :))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q 
Direct myocardial depressant 
⬇️SAN activity
⬇️HR, CO and BP 
⬆️sensitivity to catecholamines on heart 🔄 ARRYTHMIAS 
CI - CV Sx
A

Halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q 
⬇️Systemic vascular resistance 
⬇️MAP
⬇️BP
⬆️HR 
Can be used for CV Sx
A

ISD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Most cardiostable

A

Desflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Coronary steal phenomenon

A

Isoflurane

Use cautiously not CI tho

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Effect on RS by all HISD

🫁

A
  1. Depress Resp centre
  2. Blunt hypoxic and hypercapnic drive (TIVA maintains 🤍)
  3. All bronchodilators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Best bronchodilator

Agent of choice in asthma

A

Halothane

2nd Sevo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Hypoxic and hypercapnic drive

A

Worst blunting by Halothane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Thoracic Sx

A

TIVA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

CI in liver disease

A 
Halothane 
#Dual blood supply
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Inhalation agent for hepatic Sx

Agent of choice?

A

ISD
Desflurane - agent of choice :)
PBF ⬆️ due to Adenosine vasodiln
Hepatic artery ⬇️ (hypoxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Nephrotoxic

A

Sevo

Compound A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Uterine relaxant

A

Halothane

PPH😥 also avoided in CSection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

LOC
LORP
Amnesia

Muscle relaxation

A

All inhalational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Analgesia in inhalational

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Controlled hypotension
(For vascular surgical sites FESS)
Doc?

A

Doc - SNP
GTN
Esmolol

✔️ultra short acting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Most potent
Most F release
Most Nephrotoxic - high output, diuretic resistant, vasopressin resistant
RENAL FAILURE 😞

A

Methoxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Epilepsy

Isomer of isoflurane

A

Enflurane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Pharmacogenetic disease
AD
Drugs?

A

Malignant hyperthermia

  1. SCh
  2. All HALOGENATED inhalational
  3. Lignocaine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q 
Hyper CO2 
HTN 
Hyperthermia 🥵 
HR⬆️
Arrhythmia
A

Hypermetabolism in MH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q 
Acidosis 
Hyper K 
Myoglobinuria 
Rhabdomyolysis 
Renal failure 
HYPO Ca
A

Cell lysis in MH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Management of MH

A

Stop trigger agent
Start IV Dantrolene
Symptomatic Rx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Agent of choice in MH

A

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q 
Good analgesic 
Good muscle relaxation 
CardioSTABLE ♥️
Maintains hypoxia and hypercapnic drive 😇
Very GOOD Bronchodilator 
Cheap
A

Ether

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Very slow induction and recovery 🤡
Irritant ➡️ laryngospasm
Hyper stimulates mucus and serous (trachea and bronchi)
Highly inflammable 🔥

A

Ether

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Good speed 🦸‍♂️ and smell 👃🏻
Unstable :(
Ventricular arrhythmia refractory to Rx 😥
Most HEPATOTOXIC

A

Chloroform

🤧

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

N2O
Newer agent
1. BG
2. CVS

A

BG - 0.45 ➡️ fast agent
Sympathomimetic - ⬆️BP ⬆️HR CV unstable
Good analgesic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Absolutely CI in laser Sx

A

N2O

Highly combustible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Entonox

A

50:50 or (70:30)
N2O:O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Blue body white shoulder

Pin index: 7

A

Entonox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Entonox uses

A

Good analgesic for dental and labour
Supporter of combustion (CI laserSx)
Expands air cavities (35x more sol than N2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Absolutely CI In

  1. Pneumothorax/pericardium
  2. Intestinal obstruction
  3. Vitreoretinal
  4. Laser
  5. Cochlear implant
A

Entonox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Inhibits B12 dependent enzymes
• Peri neuropathy
• Megaloblastic anemia
Bone marrow suppression

A

Entonox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Effects of N2O

A

Second gas 😇
Diffusion hypoxia 🧟‍♀️
Fink effect/ Third gas ⛽️

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

During INDUCTION

Effect on accompanying gas to increase conc of said gas in alveoli

A

Second gas effect

Good effect
⬆️ speed of induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

During REVERSAL

Hypoxia due to rapid diffusion of N2O from blood ➡️ alveoli during reversal

A

Diffusion hypoxia

Rx and Px - 100% O2 😷

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q 
MAC - 70 
BG: 0.19 (fastest agent) 
Better analgesic 
Not supporter of combustion 
CV stable 🫀
Metabolically inert 
Environmental friendly 🌳
A

Xenon

Very very costly 💵

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q
  1. GABA mimetic

2. NMDA facilitatory

A
  1. All inhalational and IV

2. Xenon and Ketamine and N2O (slightly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

IV agents

A

Opioids

Non opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Morphine

Fentanyl and congeners

A

Opioids

Fenta - CV stable ♥️🫀

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Non opioids (4)

A

Sodium’s thiopentone
Propofol
Etomidate
Ketamine

CV unstable ;(

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Ultrashort barbiturate
pH > 10.5 (NS/ distilled water)
Vial 🧪 recon 2.5%

A

Sod thiopentone

  • induction dose : 4-5mg/kg
  • 1 brain arm circulation = 11 sec to become unconscious but regains in 4-5 min
  • re distribution (all IV ✔️)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Thiopentone uses

A
  1. Induction
  2. Neuro protection
  3. Narcoanalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Doc Neuro protection by primary mech of ⬇️ brain 🧠 meta by 50%

A

All GA ate Neuro protection but THIOPENTONE is best

Antianalgesic 🤔

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Truth serum in sub anaesthetic doses

A

Scopolamine
⬇️
Thiopentone (safest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

CNS couplers

A 
All IV agents 
⬇️CMRO2
⬇️EEG 
⬇️CBF and ICP 
Cerebroprotective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

CI in Shock

A

IV agents
Peripheral vasodilation
⬇️BP ant ⬇️HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

CI bronchial asthma

A

All IV agents

  1. Depress resp centre
  2. Blunt HH drive
  3. Bronchoconstriction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

CI AIP/ Porphyria

A

Enzyme inducers
IV agents

Hepatic/Renal - no untoward effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Wonderful A. Agent
Milky white 🥛 liquid
Diisopropylalcohol

A

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Additives in propofol

A

EGS
Egg lecithin- egg allergy NOT A CI
Glycerol
Soyabean oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Single best agent - Day Care Sx

Why?

A 
Propofol 
1. Rapid meta/No residual effect 
20% extrahepatic and 80% liver and kidney 
2. ONLY DRUG that #CTZ 🤮🚫 
3. Pleasant recovery (euphoria ➕)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Propofol effect on CNS

A

CNS coupler - cerebroprotective 🧠 ❤️

⬇️CMRO2
⬇️CBF
⬇️ICP
⬇️EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Propofol on CVS

CI in SHOCK 💥

A

Peripheral vasodilation
⬇️BP
⬇️HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Propofol on RS

A

Resp centre depressed
BronchoDILATOR 🫁
Hypoxic pul vc maintained
UPPER AIWARY REFLEXES 🚫 (Endoscopies!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q 
AA of choice in;
Day care Sx 
Neuro Sx 
Thoracic Sx 
Endoscopy 
Pre existing liver and kidney # 
Malignant hyperthermia 
Porphyria 
Normal patient
A

TIVA

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Used in
1 Sedation in ICU
2. Antiemetic
3. Anti pruritic

A

Propofol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Local pain on IV injection

Bradykinin in intima

A

Propofol

Premix with 2% 1ml Ligno + 10ml 1% propofol

122
Q

Propofol infusion syndrome

A 
After >48h of use (Peds) 
⬇️
Metabolises accumulate 
⬇️ ➖(inhibits) 
Mito enzymes 
⬇️
Lactic acidosis
123
Q

Imidazolone derivatives
Milky white 🥛
Local pain on IV

A

Etomidate

124
Q

Etomidate on CVS

A

Cv stable🫀:)

Only drug!

125
Q

Adrenal gland suppression
⬇️➖
11 B hydroxylase

A

Etomidate
Mild-mod cv compromise -
Cortisol ➕ VIT c

126
Q 
Phencyclidine derivative 
Multiple routes (all except SC) 
Dissociative anaesthesia 
Increases all pressures 
Sympathomimetic
Good ANALGESIC
A

Ketamine

Thalamo-cortical dissociation
⬆️BP, IOP, HR, ICP

127
Q

In absence of catecholamines acts as myocardial depressant

A

Ketamine

128
Q

CNS effect of Ketamine

A

💀

⬆️CMRO2, CBF, ICP, EEG

129
Q

CI
Epilepsy
Elective Neuro Sx

A

Ketamine

130
Q

IV induction of choice in Cyanotic CHD

A

Ketamine

All other thoracic Sx - CI 💀

131
Q

Best bronchodilator

A

Ketamine

132
Q

AA of choice in

  1. Acute shock
  2. B. Asthma
  3. Sedation and analgesia
A

Ketamine

133
Q

Ketamine CI

A 
Critically ill (myo dep)
IHD CAD 
HTN 
Epilepsy 
Elective Neuro Sx
Glaucoma
134
Q

Causes post op delirium and hallucination

Rx?

A

Ketamine
Rx
BZD iv
Midazolam

135
Q

Dexmedetomidate

A

a2:a1 = 1640:1 (Clonidine = 1:90)

Pure alpha 2 agonist

136
Q

Good analgesic
Good sedative
Min hemodynamic alteration
Min resp depression

A

Dexmedetomidate

137
Q

CONSCIOUS SEDATION

Agent of choice for stereodatic surgery

A

Dexmed

138
Q

Mc combo of TIVA

A

Propofol + Remifentanyl

139
Q

TIVA advantages

A 
⬇️CMRO2 ⬇️CBF,ICP cerebroprotective 
Maintains pul vc Drive 
Maintains auto regulation in LIVER 
Safe in MH 
Rapid metabolism 
⬇️PONV
Pleasant recovery
140
Q

Accidental intra arterial injection 💉 of Thiopentone

What will u do?

A 
1st sign Pallor 
1st symptom Pain 
- leave cannula in situ 
- 500U Heparin 
- 10ml 1% Ligno (pain) 
- Arterial dilators PAPAVERINE 
- Stellate ganglion block 
⬇️ (fails) 
- Brachial plexus block
141
Q

Drugs given IA

A

None

Heparin

142
Q

Signs of successful ganglion block

A 
Flushing 
⬆️Temp and redness of limbs 
Horners (loss of ciliospinal reflex) 
Conjunctival congestion 👁 
I/L Nasal stuffiness 
I/L redness of TM
143
Q

Guttman sign

Muller sign

A

I/L Nasal stuffiness

I/L redness of TM

144
Q

Types of NM Blockers

A

Depolarising (Sch)

Non depolarising

145
Q

SCh

MOA 
Fasciculation? 
Post op myalgia 😞
Reversal by neostigmine
TOF  a. Repose b. Ratio 
NM monitoring 
PTF (post tetanus fasciculation)
A 
MOA - Persistent depolarisation of Nm 
Fasciculation? ➕
Post op myalgia 😞 ➕
Reversal by neostigmine 🚫
TOF  a. Repose ➖ b. Ratio = 1 (B/A)
NM monitoring ➖
PTF (post tetanus fasciculation) ➖
146
Q

Non depolarising

MOA 
Fasciculation? 
Post op myalgia 😞
Reversal by neostigmine
TOF  a. Repose b. Ratio 
NM monitoring 
PTF (post tetanus fasciculation)
A 
MOA Competetive antagonism 
Fasciculation? ➖
Post op myalgia 😞 ➖
Reversal by neostigmine ➕🙂
TOF  a. Repose ➕ b. Ratio <1 
NM monitoring ➕
PTF (post tetanus fasciculation) ➕
147
Q

Fastest shortest NM#

A

SCh (mirror image of Ach)
Suxamethonium
Scoline

148
Q

SCh
Onset
Duration

A

30-40s
5-6 min

Metabolism by PseudoCh esterase (85-95%)
Produced - LIVER
Present - PLASMA

149
Q

Paralysing dose of SCh

A

1.5-2mg/kg

150
Q

SCh apnea

A

Single normal dose of SCh producing prolonged apnea

Rx Ventillation

151
Q

SCh apnea
Acquired
Inherited

A

Acquired - deficiency of 🔱ChE

Inherited - Atypical 🔱ChE

152
Q

Phase 1
Agent
TOF
PTF

A

Depolarising
➖
➖
SCh not used for maintenance

153
Q

Phase 2 block
Agent
TOF
PTF

A

NDM
➕
➕
Only SCh shows phase 2

154
Q
  1. Single normal dose
  2. Multiple normal dose
  3. Single large dose
A
  1. SCh apnea

2. and 3. Phase 2 block

155
Q

SE of SCh

A

Fasciculation
Post op myalgia
⬆️ICP ⬆️IOP ⬆️IGP
↪️(after ketamine)

156
Q

HyperK caused by?

A

SCh

157
Q

Exaggerated hyperK

A 
Muscle dystrophy 
NM diseases 
Paraplegia 
Trauma 
Burns
158
Q

Why avoid SCh in <3-4 boy?

Why avoid in trauma and burns 🥵?

A

Risk of unDx DMD

Immediate COD ☠️ : HyperK

159
Q

What can trigger MH if gene is present?

A

SCh

160
Q

Why SCh premixed with atropine?

A

Due to Brady by SCh

161
Q 
RSI intubation 
(Rapid sequence induction)
A

FULL STOMACH + Emergency 🆘

Use SCh

162
Q

Rationale behind the Use of RSI

A

To prevent aspiration

163
Q

RSI Steps

A
  1. PreO2 😷 (replace N2 in alveoli)
  2. Sellick/ cricoid pressure - BURP
  3. IV thiopentone + IV SCh
  4. PPV by BMV - CONTRAINDICATED 💀
  5. Laryngoscope + Intubate
164
Q

SCh uses
Shelf life - 2-4 deg: 2 y
Room temp: 6 months

A

RSI
Anticipated diff airway
Very short GA (ECT, intubate, trach)

165
Q

Non depolarising/ competitive

A

Amino steroid

Benzylisoquinolines

166
Q

Amino steroids NDMB

CVS stable 😌 no histamine release (except PAN)

Meta by liver and kidney

A

Long: Pan and Pipe
Inter: Vecu and Roc mc
Short: Rapa

Pancuronium- vagal block, hypotension and tachycardia

167
Q

Benzylisoquinolines

Histamine release 😣
Cvs unstable

A

Long: dTC (1st discovery), doxa
I: atra and cisatra (safe in liver and kidney)
Short: miva

168
Q

Fastest acting NMB
Fastest acting NDMB
2nd fast NDMB

A

SCh - 30-45 sec
Rapa- not used clinically
Rocu

169
Q

What can replace SCh in RSI

A

Rocuronium

170
Q

IV drugs causing pain on injection

A

Rocuronium
Propofol
Etomidate

171
Q

Causes bronchospasm and abandoned for clinical use

A

Rapacurium

172
Q 
Releases histamine CVS unstable 
HOFFMAN DEGRADATION 
m/S of choice in 
1. Acute/chronic liver/kidney #
2. Preg 
3. Peds 
4. Old age 
5. HYPERSENSITIVITY to NEOSTIGMINE 
Produces LAUDANOSINE ➡️ Epilepsy on accumulation
A

Atracurium

173
Q 
More potent than Atra 
Lesser laudanosine 
No histamine release 
No CVS unstable 
HOFFMAN ✅
A

Cisatracurium

174
Q 
Atra
Mixture of isomers 
More histamine 
Cvs unstable 
Less potent 0.5-0.6
More laudanosine
A 
Cisatra 
Cis isomer 
No or less histamine 
Cvs stable 
More potent 0.1-0.15 mg 
Less laudanosine
175
Q

Onset 4-5 min
Shortest acting among NDMB 18min
Meta by 🔱E

A

Mivacurium

176
Q

Types of ChE

A

Acetyl: NMJ #ACh
Butyryl 🔱: in plasma, but produced by liver
Tissue: RBC WBC

177
Q

Butyryl ChE 🔱E examples

A

SCh
Miva
Ester LA except cocaine
Propanidid

178
Q

Tissue ChE examples

A

Esmolol

Remifentanyl

179
Q

Drugs potentiating NMB

A

Antibiotics ATP (AGs, Tetra, Polypeptides)
Antiarrythmics (CCB,Quinine)
Inhalational anaesthetic

⬆️Mg
Acidosis
⬇️thermia 🥶
Myasthenia Gravis (1/3rd dose)

180
Q

Resistant to depolarising MB

More susceptible to NDMB

A

MG

181
Q

Reversal agents

A

Neostigmine + Atropine/ glycopyrolate (muscarinic SE#)
INDIRECT

Sugamadex DIRECT

182
Q

Cyclodextrin compd
Aminosteroid structure- acts only against aminosteroid gp
Best against VECU&ROCU
DIRECT reversal agent

A

Sugammadex

183
Q

ET tube parts

  • nasal (dirty 🤮)
  • oral (Dr Ivan Magill)
A 
Murphy eye (proximal, better visibility, bevelled) 
Cuff (prevents aspiration) globular/cylindrical 
Glottis opening (3-4cm above carina) 
Distal universal connector 22mm internal dia

Length 30cm
Optimum pressure 25-30cmH2O
Low pressure high vol

184
Q

Morning sniff/ barking dog
AOJ - E/NJ - F
Hold laryngoscope in left hand (non dominant)
Introduce from RIGHT angle of mouth to middle
Locate epiglottis and AE fold
Hinge tip of laryngoscope in AE fold and lift laryngoscope
Visualise glottis opening

A

Steps of introduction of laryngoscope

185
Q

Sits 3-4 cm above carina
Seal in trachea to prevent aspiration
Optimum cuff pressure 25-30 cm h2o

A

Placement of ETT

Dead space ⬇️1/2
Resistance ⬆️ 1/r^4
WOB ⬆️

186
Q

Sure shot confirmation of correct placement of ETT

A

Capnography

187
Q

Narrowest part of airway in child

A

Glottis
Use straight blade MILLER BLADE
Cuffed tube ✔️ (old - uncuff in <6y for subglottis ❌)

188
Q

Flexetallic/armour/reinforced

A 
Prevent kinks 
- NeuroSx 
- head and neck Sx 
- dental 
- prone Sx 
NOT ABD SX
189
Q

Double lumen tube

A

Only in thorax Sx
And lung separation

Correct placement - fibreoptic bronchoscopy

190
Q

RAE tube/ Pre bent

A

Cleft lip Sx

191
Q

Indication of intubation

A
  1. GA
  2. Secure airway in IPPV
  3. Protect airway from aspiration
  4. Pul toileting
192
Q

Management of diff airway

A

A. Re optimisation
B. Alt airway use LMA
C. Sx securement of airway
Tracheostomy or cricothyroidectomy

193
Q 
Supraglottic airway device 
Tip sits on hypopharynx
Easy to insert and fast 
Less invasive 
Less complication 
ASPIRATION NOT PREVENTED 1-2h
Not definitive airway 
Dr. Archie Brian - classic lma
A

LMA

Proseal = ETT (preventing aspiration ❇️)

194
Q

Indication of LMA

A

GA
Secure airway for PPV
Aid to intubation (Fast trach LMA)

195
Q 
LMA size 
<5kg 
5-10
10-20
20-30
30-50
50-70
>70
>100
A 
1
1.5
2
2.5
3
4
5
6

Total 8 sizes

196
Q

LMA vs ETT
3
4
5

A

ETT

  1. 5 - 6.5 mm
  2. 5 - 7.5
  3. 5 - 9
197
Q

Maxillofacial #
C spine #
Elective

A

Tracheostomy
Manual inline stabilise ➡️ orotrach intubation
Nasal fibre optic intubation

198
Q

Types of circuit

A

Open obsolete
Semi closed MAPELSON
closed Circle ⭕️ system

199
Q 
Less economical 
More OT pollution 
Light weight 
Simple and portable 
No need of advanced monitoring
A

Semi closed

200
Q

More economical
Less OT pollution
Heavy bulky complex and fixed
Needs of advanced monitoring for exp gases

A

Closed or circle ⭕️

201
Q 
Mapleson 
A
B
C
D
F
A

ADULTS
A - Magills SPONT VENTI
B&C useless
D - Bains CONTROLLED VENTI

PEDS (<6y, <20kg)
E - Ayres T piece
F - Jackson Reeves modfn of Ayre SPONT & CONTROLLED

202
Q

Magills

A

FGF = 3 MV

203
Q

Bains

A

FGF = 1.8 MV

204
Q

Controlled ventillation circuits

A

Dead Babies Can’t Assist

DBCA

205
Q

Spontaneous ventilation circuits

A

A Dog Can Bite spontaneously

ADCB

206
Q

Jackson Reeves

Spontaneous
Controlled

A

Spontaneous
FGF = 3-4 MV

Controlled
FGF = 2-3 MV

207
Q

Single most imp determinant of exp flow

A

FGF

208
Q

Mc absorbent of co2 in closed

A

Sodalime mc
Barylime
Amsorb

209
Q 
Pink granules not powder! 
Naoh 4% 
Koh 1% 
Caoh2 rest 
Water 11-18% 
SILICA - hardness to prevent dust fromn 
DYE - check exhaustion
A

Soda lime

210
Q

Naoh function in sodalime

A

Prevents chemical pneumonitis

211
Q

____g sodalime ➡️ ___L of co2

A

150g

21L

212
Q

Signs of sodalime exhaustion

A

Sympath stimulation

  1. Bp⬆️ HR⬆️
  2. Sweating in anaesthetised pt
  3. ⬆️ oozing from Sx site
  4. Change in color of granules
  5. Change in capnograph
213
Q

Predisposing factors for co prodn in closed circuit

A
  1. DIE (des, iso, enflurane)
  2. Very ⬆️ conc or DIE
  3. Dry co2 absorber
  4. Barylime
214
Q

1st anaesthesia machine

A

Boyles machine

215
Q

High pressure system

A 
Gas cylinder (steel + Mb) high tensile 
MRI comparable (Ti/Al) 
Size A-HH 
Type E cylinder attached to A. Machine 
2000psi
216
Q

Black body white shoulder
2,5
2000
Min mandatory pressure to start case under Gs = 1000psi (type E for GA: 100psi with flow rate - 2-3L/min last for 2-3h)

A

O2 cylinder

217
Q

Blue color
3,5
760 psi

A

N2O cylinder

218
Q

Grey color with black and white shoulder

1,5

A

Air cylinder

219
Q

Grey color

1,6 (>7%) or 2,6 (<7%)

A

Co2 cylinder

220
Q

Orange color
3,6
Not in clinical use

A

Cyclopropane

221
Q

Brown color
2,4 (70+30)
4,6 (60+40)

A 
Heliox (He+O2) 
⬇️viscosity 
⬇️resistance 
⬇️WOB 
⬇️Turbulence
222
Q

Intermediate pressure system

A

Pipeline supply

55-60 psi

223
Q 
Color coding of pipelines 
Yello 
Blue 
Black 
White
A

Yello VACUUM
Blue N2O
Black AIR
White O2

224
Q

DISS

A

Diameter index safety system

Safety system which prevents incorrect attachment of pipeline to A. machine

225
Q

Low pressure system

A 
O2 and N2O flow control valve
Vaporiser
Common gas outlet 
Emergency O2 flush 
Hypoxia guard

Order given by Boyle.

226
Q

Flow meter function

A

Tells about the true flow of gas
🥢
Thores tube

227
Q

Hypoxia guard

A

Basal O2 flow to A. Work station
N2O opens in fixed proportion of O2
O2 safely alarms/ analyser

228
Q

Emergency O2 flush

A

Min - 15L at 10-12 psi
Max - 35L at 55-60 psi (INTERMEDIATE Pres system)

Anatomically present at low pressure system

229
Q

Most A machines are downstream

High P ➡️ Low P except?

A

Boyles ↗️ upstream

230
Q

Monitors mandatory by ASA

A 
ECG 
Pulse ox 
Non invasive BP 
Temp 
Capnography

BIS exceptional

231
Q

BIS

A 
Bispectral index 
Parietal Frontal and temporal areas 
Target 40-60
(0-100) (coma - conscious and alert) 
Monitors depth of Anaesthesia
232
Q

Measures intra op awareness
(Modified EEG)
Titration of A agents
Fast post op recovery

A

BIS uses

233
Q

Expired CO2 vs Time

A

Capnograph

MULTISYSTEM monitor

234
Q

Ddx flat capno

A 
Stoppage of mech venti 
Circuit discontinuity 
Accidental extubation
Absolute only (not partial) Bronchospasm 
Cardiac arrest 
Eso intubation
235
Q

Normal Capno

A

35-45 mmHg
Box shape with base line at 0

X axis volume
Y axis ETCO2 (⏩ metabolism)

236
Q

⬆️ETCO2

A

Hyper metabolic state

237
Q

⬇️ETCO2

A

Hypo meta

Hypoperfusion

238
Q

Normal shape

Double conc of ETCO2

A

MH

239
Q

Sudden small boxes or fall of ETCO2

A

Neuro Sx

Air embolism

240
Q

Raise in baseline

A

Co2 rebreathing
Soda lime exhaustion
FGF inadequate
Unidirectional valve incompetence

241
Q

Shark fin

A

Partial obs of lung
Bronchospasm
ET obstruction
COPD

242
Q

Curare cleft

A

Return of spont respi

Repeats NM blocker

243
Q

Biphasic capnogram

A

Severe kyohoscoliosis

244
Q

Pulse ox or Plethysmograph or spo2

A

O2 sat in arterial blood
Infrared red 🩸
1. Law of plethysmograph (sense pulse of blood)
2. Law of oximetry BEER LAMBER LAW

245
Q

Inaccuracies of spo2

A 
Hypoperfusion
Hypothermia
Other Hb (smoker ) 
Dark skin 
Skin pigmentation 
Dye 
Mail polish 
Polycythemia

NOT BY
ANEMIA
JAUNDICE

246
Q

Tee

A

Most sensitive for periop cardiac monitoring

Most sens monitor for intra op air embolism

247
Q

Air embolism
0.1 ml/kg BW
>0.9

A

0.1 ml/kg BW: CO near normal
TEE 🤩

> 0.9: CO⬇️⬇️
Capno
BP

248
Q

ECG

Lead 2
Lead V5
Lead V4&5

A

Lead 2 Arrythmia
Lead V5 70% sens MI
Lead V4&5 99% sens MI

249
Q

PAE

A

ASA grading:
Current physical status
Risk with Sx

250
Q

ASA grades
1-6 Elective
Emergency

A 
1 localised prob 
2 controlled co morb with min or no limitation 
3 comorb with mod limitation 
4 constant threat to life 
5 only Sx can save him 
6 coma for Tx
251
Q

Airway eval

A

Mallampatti SIZE OF TONGUE wrt oral cavity

1 hard soft uvula tonsil fauces pillar
2 hard soft uvula fauces
3 hard soft
4 hard

12 Normal
34 large tongue

252
Q

Pre anaesthetic orders
Npo
Adult
Child

A

Adult
8h solid
6h liquids

Child 
8 solid 
6 liquid 
4 Breast milk 
2 clear fluid
253
Q 
Prev meds orders 
Oral HTN 
OHA 
Anti dep psych epileptic 
Anticoag 
Thyroid
A 
Oral HTN TILL DAY OF SX 
OHA 
mild and mod - stop 24 h prior 
Severe - shift to INSULIN 
Anti dep psych epileptic TILL DAY OF SX 
TCA - STOP 🛑 3wks before (arrhythmia 💀) 
Li - STOP 24h prior
Thyroid - TILL DAY OF SX
254
Q

Anticoags

Aspirin 
Clopidogrel
Ticlopidine 
Warfarin 
Lmwh 
Ufh
A 
Aspirin TILL DAY OF SX 😌
Clopidogrel 7 days 🛑 
Ticlopidine 14 days stop 🛑 
Warfarin 3-4 days 🛑 
Lmwh 12 h prior 🛑 
Ufh 6h prior stop 🛑
255
Q

Steroid

All other drugs

A 
Continue peri op supplementation 
CI 
DM 
Active infection 
Immune def

All others - TILL DAY OF SX

256
Q

Regional anaesthesia

A

Peripheral
LA

CNB
Spinal
Epidural

257
Q

Action Best on active nerve fibre
Depends on 1. Voltage gated. 2. Time dep
Adding vc prolongs Adr/ phenylephrine

A

LA

258
Q

Types of Na channels

A

Active FAST 💨
Inactive SLOW
Resting SLOW

259
Q

Advantage of LA

A

Less toxicity system
⬆️ duration
Fast onset
Better intensity

⬆️⬆️PAIN 😥 on injection
CI end arteries

260
Q

Adv of adding soda bicarbonate to LA

A

Fast onset
Longer duration
More intense
LESS PAIN

261
Q

Order of block

A

BCA
B - Pre gang
C - post gang and PAIN SLOW
A - abcd

ANS ➡️ sensory ➡️ Motor ASM
Temp COLD ➡️ Pain ➡️ Touch ➡️ Proprio

262
Q

LIGNO

LIDO

A

Ligno - 2% ASM

Lido - 1% AS (M spared) Dofferential block

263
Q

Blocking sensory sparing motor

A

Differential block

264
Q

Systemic absorption of LA

A

IV > Tracheal > Intercostal > paracervical > caudal > brachial plexus > lumbar epidural > sciatic > SC

265
Q

Esters vs Amides

A

Amide - 2i

Ester -1i

266
Q

Esters

A

SA
Cocaine 1st LA, vc
Procaine
Chloroprocaine SHORTEST

LA
Benzocaine
Tetracaine

267
Q

Meta by pseudo choline esterase (except cocaine)
PABA release + (ALLERGY)
Not much clinical use

A

Esters

268
Q

LA of choice in day care Sx

A

Chloroprocaine

269
Q

Amides

No PABA :))

A

IA
Ligno SAFEST
Mepiva
Prilocaine

LA
Bupivacaine WORST
Ropivavaine
Dibucaine

270
Q

LA of choice in IVRA or BIER BLOCK

A

Lignocaine

271
Q

C/I for IVRA

A

Bupivacaine

  1. Sickle cell
  2. PVD
  3. Scleroderma
272
Q

LA Causing methHbnemia

A

Benzocaine
Prilocaine
EMLA

273
Q

SE of LA in CNS

A

Apprehension
Peri oral numbness
Seizure
Tinnitus

274
Q

SE of LA in CVS

A

Arrhythmia

Cardiac arrest

275
Q

CC/CNS ratio
8
2

A

8 Ligno SAFEST

2 Bupi MOST DANGER ⛔️

276
Q

Max safe dose of Ligno

  1. Alone
  2. With Adr
A
  1. 4.5mg/kg

2. 7 mg/kg

277
Q

EMLA cream
Contact pd
Surface anaesthesia
Max SA

A 
Only on intact skin 
Ligno:Prilo = 1:1 
2.5% and 2.5% each 
Contact pd = 1 h 
Surface anaesthesia 2-4mm depth 
Max SA - 2000cm2
278
Q

CI to EMLA

A

Abrasion
Mucous membrane
Neonate (infant can use)

279
Q

Most cardio toxic ♥️
CI IVRA
0.5%
0.25%

A

Bupivacaine

  1. 5% ASM
  2. 25% AS (M is spared)
280
Q 
La of choice in differential block 
S- isomer of bupivacaine 
Less cardio toxic 
Less motor block 
Less potent
A

Ropivacaine

281
Q

Central neuraxial blockade

A

Epidural (catheter is left in situ)

Spinal

282
Q 
Drug in SAS 
Immediate onset 
Min quantity of drug used 
Less toxic 
Drug made heavy/ hyperbaric (dextrose) 
Easy to do less failure 
Fixed duration 
Intra op anaesthesia 
Segmental block NOT possible 
More hemodynamic imbalance 
QUINCKE SPROTTER WHITTACKRE
A

Spinal

283
Q 
Skin 
SC fascia 
Supra infra spinatous lig 
Lig flava
Duramater
Arachnoid matter
CSF return 
SAS
A

Spinal

284
Q 
Drug in epidural space 
Delayed onset 
Per segment 1.5-2ml drug 
More drug more systemic toxicity 
Plain drug used 
More experience needed 
Can be prolonged with catheter 
Intra op + post op analgesia 
SEGMENTAL block possible 
Less hemodynamic imbalance 
TUWHYS 18 G
A

Epidural

285
Q 
Skin 
S fascia 
S/I ligament 
Lig flavum 
Loss of resistance (give way) 
Epidural space
A

Epidural

286
Q

Complication of CNB

A 
Hypotension mc (fluids pressors ionotropes) 
Bradycardia 
Resp depression 
Urinary retention mc POST OP 
Total spinal high spinal all 31# 
Systemic toxicity 
Vasovagal 
Infection 
PDPH
287
Q

PDPH

A

Post dural puncture headache
Low csf
Low icp
Rare nowadays

288
Q

Absolute CI to CNB

A 
Raise ICP 
Local infection of site 
Hypovolemia shock 
RELATIVE 
Coag dis 
Pts REFUSE 
Severe heart dis (graded epidural)
289
Q

Drugs used in epidural

A

LA

Opioids

290
Q

⬆️hemodynamic imbalance
Muscle paralysed
Narrow dosing time

A

LA in epidural

291
Q 
Hemodynamic imbalance ⬇️
Muscle spared ✔️ 
Wide dosing time 
Causes CNS depression 
Acts at substantia gelatinosa
A

Morphine/Opioid in CNB

292
Q

Post op analgesia MAJOR pain
Adult
Child

A

Adult - epidural Opioid

Child - IV Opioid infuse

293
Q

Post op analgesia MINOR pain
Adult
Child

A

Both - IV IM Oral Rectal NSAID

294
Q

Labour analgesia types

A

Systemic- IV fentanyl- needs fetal resuscitation Resp dep

Regional - GOLD STD
Epidural LA+Opioid

295
Q

Modes of ventilation
Fully controlled
Intermediate
Fully spontaneous

A 
CMV 
SIMV 
PCV 
PSV 
PAP
296
Q

TV 500
12bpm

Disadv
Needs ms paralysis heavy sedation 
Creates VQ mismatch 
Causes disuse atrophy 
Weaning not possible
A

CMV

Controlled mode ventilation

297
Q

Overcomes all disadv of CMV

Syncs with pt breathing

A

SIMV

Synchronised intermittent minute ventilation

298
Q 
ARDS and Peds BEST 
Lung protective mode 
Upper limit of pressure - 50 mmHg 
Rate 12bpm (HIGH PEEP LOW TV ) 
Stops as soon as upper limit is reached until just adeq venti is reached 
Not weaning mode
A

PCV
Pressure controlled
Volume cycled

299
Q 
Pressure support ventilation 
Just ⬇️ WOB 
WEANING 
Pts effort + 15/5/10
\+ve pressure in upper and lower lobe
A

PSV

Pressure support

300
Q

+ve pressure only in upper airway

A

CPAP

Last Leg (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions