4.6.2013(anesthesia) 27 Flashcards
(98 cards)
0
Q
Biggest anesthesia cylinder
A
H
smallest : AA
1
Q
Most commonly used cylinder in anesthesia machines
A
E
2
Q
Color of oxygen cylinder
A
Black body with white shoulder
2,5
3
Q
Color of N2O cylinder
A
Blue
3,5
4
Q
Color of CO2 cylinder and pin index
A
Grey
Pin index: 2,6 if CO27.5%
5
Q
Color of air cylinder and pin index
A
Gray body with black and white shoulder
1,5
6
Q
Color of cyclopropane cylinder and pin index
A
Orange
3,6
7
Q
Color of Entonox cylinder and pin index
A
Blue body with blue and white shoulders
7
8
Q
Color of helium cylinder and pin index
A
Brown
He80.5% 4,6
9
Q
Pressure of oxygen cylinder
A
2000psi
Same as air
10
Q
Pressure of N2O cylinder
A
760psi
Same with CO2
11
Q
Liquid oxygen is stored at temperature of
A
-119 degrees
12
Q
Longest acting LA
A
Dibucaine
most potent and most toxic
13
Q
Color of halothane vaporiser
A
Red
14
Q
Color of vaporiser for Isoflurane
A
Purple
15
Q
Color of vaporiser for sevoflurane
A
Yellow
16
Q
Most volatile anesthetic agent? I.e very high SVP
A
Desflurane
17
Q
Color of desflurane vaporiser
A
Blue
18
Q
Dibucaine number
A
Normal:80
Heterozygous:60
Homozygous:20
19
Q
Differentiation of genetic and non genetic causes of scoline apnea
A
Plasma cholinesterase
Dibucaine number
20
Q
Shortest acting LA
A
Chlorprocaine
21
Q
Longest acting LA
A
- dibucaine
- tetracaine
- bupivacaine
Delhi To Bombay
22
Q
Potency of LA
A
Dibucaine>etidocaine=tetracaine=bupivacaine
23
Q
Normal CO2 in capnography
A
32-42mmHg(3-4mm less than arterial PCO2)
24
High baseline of ETCO2
Exhausted absorbent
Incompetent expiratory valve
Insufficient fresh gas flows into mapleson system
Problems with inner tube of bains system
25
Curare notch is seen during
```
Spontaneous ventilation
PNEUMOTHORAX
Cervical transverse lesion
Flail chest
Hiccup
```
It is due to asynchrony btw diaphragm and intercostal muscles
26
LA systemic toxicity is increased by
```
Hypoxia
Hypercarbia
Acidosis
Renal failure
Extreme age
```
27
Cardiodepressant effect of bupivacaine is aggravated by
```
Acidosis
Hypoxia
Hypercarbia
Pregnancy
IHD
conduction blocks
```
28
Rx of systemic local anesthetic toxicity
20% lipid emulsion
29
Anti arrhythmic of choice in systemic LA toxicity
?Bretylium
30
Wrights respirometer
| False high,false low values
False high-high flow rates
| False low-low flow rates
31
Respirometers are used to monitor
Anemometer
Expiratory volume
It can be used to calculate flows also
32
First sign of LA toxicity
CNS
33
Drugs not to be used in bupivacaine cardiotoxicity
Lidocaine
| Amiodarone
34
Systemic effect of inhaled NO
Least
| No systemic vasodilation
35
Potency of xenon anesthesia
Low
36
Xenon weight compared to air
4.5 times Heavier than air
37
Management of chronic pain
```
Intrathecal hyperbaric phenol
Anterolateral cordotomy
Epidural fentanyl
PCA(patient controlled analgesia)
Anticonvulsant drugs
Antidepressant drugs
TENS
sympathetic
Cryoanalgesia
```
38
Systemic effect of NO is reduced due to
Binding of NO by Hb
39
Heliox
21%O2
| 79%helium
40
Entonox
50% N2O
| 50% oxygen
41
Viscosity and density of heliox
Viscosity is similar to air but low density
42
Use of heliox
COPD,asthma
SCUBA divers
To reduce WOB in mechanically ventilated pts
43
Desflurane reacts with dry sodalime to produce
CO
44
Anticonvulsants used in chronic pain
```
GABApentin
Valproate
Pregabalin
Lamotrigine
Topiramate
```
45
Antidepressants used for Rx of chronic pain
Amitryptiline(spinal cord injury pain)
| Duloxetine(diabetic painful neuropathy)
46
Egg lecithin allergy contraindicated use of
Propofol
47
Anesthetic agents CI in porphyria
```
Barbiturates
Ketamine(Harrison)
Etomidate
Pentazocine
Ropivacaine
```
48
Safest IV induction agent in porphyria
Propofol
49
Antibacterial substance in propofol emulsion
Disodium edetate
50
Antiemetic intravenous agent
Propofol
51
Bain is type __________ of mapleson system
D
52
Most efficient mapleson system for controlled ventilation
D
53
Efficiency of Mapleson circuits in controlled ventilation
D>B>C>A
Dog Bites Can Ache
54
Efficiency of mapleson systems in spontaneous ventilation
A>D>C>B
All Dogs Can Bite
55
Flow rates in mapleson system
Spontaneous: 2-3times minute ventilation
Controlled: 1-2 times minute ventilation
56
Flow rate in mapleson A
Flow rate = MV
57
Other name for mapleson A
Magill
58
Mapleson system of choice in postoperative recovery room
C(waters to and fro)
59
Mapleson system used in infants and children
E(ayres T piece)
60
Mapleson F
Jackson Rees modification
61
LMA protects against
```
Pharyngeal secretions(partial)
Not against gastric secretions
```
62
Contraindications for LMA
```
Pharyngeal pathology(abscess)
Pharyngeal obstruction
Full stomach(pregnancy,hiatal hernia)
Low pulmonary compliance
```
63
Role of LMA
Alternative to ET tube not a substitute
64
LMA size to be used in neonates
1
65
LMA is available in
8 sizes
66
LMA sizes used in adults
4,5,6
67
LMA sizes used in children
```
1(neonates)
1.5
2
2.5
3
```
68
Pin is found on
Anesthetic machine
69
Onset of effect of epidural
15-20min
70
Pin index for nitrogen
1,4
71
Critical intra gastric pressure for aspiration
>20cm of H2O
72
Contraindications in RSI(rapid sequence intubation)
Bag and mask ventilation
73
Induction agent of choice for cerebral protection
Thiopentone
Propofol also protective
74
Agents that increase ICP
Halothane
Ketamine
ether
75
Bevelling in ET tubes
Oral tubes:45degrees
| Nasal tubes: 30 degrees
76
ET tube used in thoracic surgery
Double lumen tube for one lung ventilation
77
ET tube with narrow distal end used in children
Coles tube(narrow subglottis)
78
ET tube used in head and neck surgeries where acute neck Flexion is required
Spiral embedded or flexometallic armored tube
79
ET tubes used for lip surgeries
RAE(ring,Adair ,elwyn)
South facing- used for upper cleft lip and cleft palate Sx
North facing- used for lower lip Sx
80
Hypotension anesthesia
BP reduced by 1/3rd of Preoperative value
Systolic 80-90mm Hg
MAP 50-65mm Hg
81
Indications of hypotensive anesthesia
```
Cerebral aneurysm or AV malformation Sx
Coarctation of aorta or PDA repair
Nasopharyngeal angiofibromas
Pheochromocytoma
Jehovah witness
```
82
Inhalational agent of choice for hypotensive anesthesia
Isoflurane
Others:
Halothane
Enflurane
83
Ligamentum nuchae is formed by
Supraspinous and interspinous ligaments
84
Mechanical complications of central line
Cardiac tamponade
| Arrythmias
85
Most common complication of subclavian central line
Pneumothorax
86
Delayed complications of central line
Venobronchial fistula
Carotid artery-IJV fistula
Pseudoaneurysm
Aortoarterial fistula
87
Critical temperature
The temperature above which distinct liquid and gas phases don't exist.
Above critical temp a liquid cannot be formed by increase in pressure.
But with enough pressure a solid can be formed
88
Critical temperature of Oxygen
-119degrees
89
Critical temperature of N2O
36.5
90
Critical temperature of air
-140.6degrees
91
Critical temperature of nitrogen
-146.9degrees
92
Critical temperature of CO2
31.04degrees
93
Confirmation of positioning of DLET
Flexible Fibrooptic bronchoscope
94
Most commonly used DLT
Robert shaw type
95
Sizes of DLT
39F for men
37F women
28F pediatrics
96
Methods to ensure correct positioning of ET tube
```
Ascultation
Chest radiography
Use of underwater seal
Characteristic feeling of bag
Fluoroscopy
Selective capnography(cannot detect bronchial intubation)
Chest inflation on positive pressure
```
97
Earliest signs of MH
MMR
Unexplained tachycardia
ETCO2 rise
