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MBBS Y5 > Surgery - Anaesthetics > Flashcards

Surgery - Anaesthetics Flashcards

1
Q

what are the 2 types of anaesthesia?

A
  • general| - regional
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2
Q

what is true NBM pre-operatively?

A
  • 6h no food| - 2h no clear fluids
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3
Q

which medications can be offered pre-op? give the indication for each one

A

NAME?

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4
Q

why and when is rapid sequence induction used?

A

NAME?

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5
Q

key complication in RSI? how can this be avoided?

A
  • aspiration of stomach contents into lungs| - apply cricoid pressure
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6
Q

what is the triad of GA?

A

NAME?

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7
Q

what is the role of hypnotic agents in GA?

A

to make the pt unconscious

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8
Q

hypnotic agents which can be administered IV?

A

used to induce LOC:- propofol- ketamine- thiopental sodium- etomidate (rare)

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9
Q

hypnotic agents which are inhaled?

A

mostly used to maintain LOCvolatile:- sevoflurane- desflurane- isofluranenon-volatile:- nitrous oxide

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10
Q

where do muscle relaxants act?

A

NMJ

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11
Q

name a depolarising muscle relaxant

A

suxamethonium

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12
Q

name a non-depolarising muscle relaxant

A
  • rocuronium| - atracurium
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13
Q

how can a muscle relaxant’s actions be reversed?

A
  • neostigmine| - sugammadex (only for non-depolarising ones)
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14
Q

give examples of analgesic agents used in GA?

A

all opiates:- fentanyl - alfentanil- remifentanil- morphine

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15
Q

which antiemetics are used prophylactically post-op?

A

NAME?

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16
Q

drug class of ondansetron?

A

5HT3 (serotonin) receptor antagonist

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17
Q

drug class of dexamethasone?

A

corticosteroid

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18
Q

drug class of cyclizine?

A

H1 (histamine) receptor antagonist

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19
Q

who should cyclizine be used with caution in?

A
  • pts with HF| - elderly
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20
Q

who should dexamethasone be used with caution in?

A
  • pts with DM| - immunocompromised pts
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21
Q

how can you test if the muscle stimulant has worn off?

A

NAME?

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22
Q

describe train-of-four stimulation

A
  • try to stimulate a nerve 4 times| - if the muscle responses get weaker with each stimulation, it means the relaxant has not yet worn off
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23
Q

what is malignant hyperthermia?

A

rare but dangerous hypermetabolic response to anaesthesia

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24
Q

which agents carry a risk of malignant hyperthermia?

A

NAME?

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25
Q

presentation of malignant hyperthermia?

A
  • increased body temp LMAO- increased CO2 exhalation- high HR- muscle rigidity- acidosis- high K+
26
Q

management of malignant hyperthermia?

A

dantrolene

27
Q

how is a peripheral nerve block carried out?

A

NAME?

28
Q

indications for a spinal block?

A
  • C-sections- TURP- hip fracture repairs
29
Q

how is a spinal block carried out?

A

NAME?

30
Q

typical indication for an epidural?

A

woman in labour with vaginal delivery

31
Q

how is an epidural carried out?

A
  • catheter inserted into epidural space (OUTSIDE of CSF and spinal cord)- levobupivacaine inserted +/- fentanyl
32
Q

key risks of using epidural in labour?

A
  • prolonged second stage of labour| - increased chances of needing instrumental delivery
33
Q

why is it important that a pt is able to do a straight leg raise under epidural anaesthesia?

A
  • if not, catheter may be in subarachnoid space| - needs urgent anaesthetic review
34
Q

example of LA?

A

lidocaine

35
Q

examples of indications for LA use?

A

NAME?

36
Q

indications for a tracheostomy?

A

NAME?

37
Q

what can an arterial line be used for?

A

NAME?

38
Q

where might a central venous catheter (central line) be inserted?

A

NAME?

39
Q

define chronic pain

A

pain that has been present for 3+ months

40
Q

what is allodynia?

A

when pain is experienced with sensory inputs which should not cause pain, e.g. light touch

41
Q

features of neuropathic pain?

A

NAME?

42
Q

what are the 3 steps of the WHO analgesic ladder?

A
  1. non-opioids (paracetamol, NSAIDs)2. weak opioids (codeine, tramadol)3. strong opioids (morphine, oxycodone, fentanyl, buprenorphine)
43
Q

which adjuvants can be used to treat neuropathic pain?

A

NAME?

44
Q

common side effects of NSAIDs?

A

NAME?

45
Q

in which pts are NSAIDs inappropriate / contraindicated?

A

NAME?

46
Q

which drugs are co-prescribed with NSAIDs?

A

PPIs (e.g. omeprazole)

47
Q

key side effects of opioids?

A

NAME?

48
Q

how is opioid overdose reversed?

A

naloxone

49
Q

how are opioids prescribed in palliative care?

A
  • background opioids| - plus rescue doses for breakthrough pain
50
Q

how is the rescue dose of an opioid calculated for palliative care?

A

rescue dose = 1/6 of total background dose over 24 hrs

51
Q

how is bradycardia secondary to patient-controlled analgesia overuse managed?

A

atropine

52
Q

common areas affected by chronic pain?

A

NAME?

53
Q

describe the analgesic ladder for treating pain secondary to OA

A
  1. PO paracetamol + topical NSAIDs2. add PO NSAIDs (+PPI)3. consider opioids
54
Q

which 4 medications are used first-line in the treatment of neuropathic pain?

A

NAME?

55
Q

1st line treatment for trigeminal neuralgia?

A

carbamazepine (different to other neuropathic pain conditions!)

56
Q

describe the different “levels” of patient care needs in a hospital

A
  • level 1 = ward-based care- level 2 = HDU - level 3 = ICU (highest level of support needed)
57
Q

common reasons for ICU admission?

A

NAME?

58
Q

how can enteral nutrition be given in the ICU setting?

A

NAME?

59
Q

why is TPN given via central line rather than a cannula?

A
  • it irritates peripheral veins| - causes thrombophlebitis
60
Q

complications of mechanical ventilation?

A

NAME?

61
Q

which drug can be administered to treat agitated pts with delirium in ICU setting?

A

dexmedetomidine

MBBS Y5 (27 decks)

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