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Leeds MBCHB Year 4 ACC > Anaesthesia > Flashcards

Anaesthesia Flashcards

(68 cards)

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1
Q

3 key components to GA

A

Amnesia - lack of response and recall
Analgesia
Akinesis - paralysis

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2
Q

3 key monitoring requirements for BEFORE GA

4 during

A

ECG
SPO2
NIBP

Gases (O2 CO2 and vapour)
Pressure
Nerve stimulator
Temperature

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3
Q

4 main induction agents

A

Propofol
Thiopentone
Ketamine
Etomidate

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4
Q

Why is propofol most used

A

Excellent suppression of air way reflexes

Reduced PONV

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5
Q

3 key propofol side effects

A

Drop in HR and BP
Pain on injection
Involuntary movements

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6
Q

Thiopentone advantages (2)

A

Faster than propofol (used for RSI)

Anti-epileptic properties

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7
Q

Thiopentone disadvantages

A

Drop in BP (RISE IN HR)
Rash
If intra arterial gangrene and thrombosis
Contraindicated in porphyria

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8
Q

Ketamine advantages

A 
Rise in HR/ BP (does not drop like most)
Good analgesia (can be used as sole anaesthetic)
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9
Q

Ketamine disadvantages

A

Slow onset (90 seconds)
N and V
Emergence phenomenon

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10
Q

Etomidate advantages

A

Haemodynamically stable
Lowest incidence of hypersensitivity reactions
Rapid onset

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11
Q

Etomidate disadvantages

A

Pain on injection
Spontaneous movement
Adrenal suppression
PONV

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12
Q

Best induction agent for HF patients

A

Etomidate

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13
Q

Which induction agent cannot be used in patients with porphyria

A

Thiopentone

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14
Q

Which induction agent causes a rise in HR and BP

A

Ketamine

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15
Q

Which induction agents cause PONV

A

Ketamine and etomidate

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16
Q

Which induction agent does not affect HR or BP

A

Etomidate

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17
Q

What is 1 MAC

A

The minimum alveolar concentration that causes 50% of patients analgesia and 100% of patients amnesia

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18
Q

Which induction agent is used when IVA cannot be obtained

A

Sevoflurane (kids)

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19
Q

Which inhalation agent is sweet smelling

A

Sevoflurane

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20
Q

Which inhalation agent is fastest acting

A

Desflurane

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21
Q

Which inhalation agent has least effect on organ blood flow

A

Isoflurane

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22
Q

Best inhalation agent for long operations

A

Desflurane (but high CO2 output)

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23
Q

Why are analgesic drugs required for intubation

A

Suppress response to laryngoscopy and airway insertion (as well as surgical pain)

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24
Q

Why would remifentinil be given before propofol

A

Takes longer to act (1-5 mins instead of 15 seconds)

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25
Which NSAID can be given IV
Parecoxib and ketorolac
26
What must be done before giving muscle relaxants
Ensure ability to ventilate
27
What are the two types of akinesis agents
Depolarising (sux) and non depolarising
28
Advantages and disadvantages of sux
RSI as rapid onset and rapid offset Muscle pains, fasciculations, hyperkalemia, malignant hyperthermia, rise in ICP
29
Reversal agent for non depolarising muscle relaxants (rocuronium)
Nesostigmine (and glycopyrrolate)
30
Longest acting non depolarising akinesis agent
Pancuronium
31
Shortest acting non depolarising akinesis agent
Mivacurium
32
3 most commonly used vaso active drugs (not adrenaline)
Ephedrine Phenylephrine Metaraminol
33
Other than adrenaline, drug which can be used in severe hypotension
Dobutamine
34
Vasoactive drugs which causes rise in BP by vasoconstriction
Phenylepherine (drop in HR) | Metaraminol
35
Vaso active drug that causes rise in BP and HR
Ephedrine
36
Vasoactive drug that causes drop in HR
Phenylepherine
37
Key difference between ephedrine and phenylephrine
Phenylepherine causes drop in HR | Ephedrine cause increase in HR
38
What is Sugammadex and why would it be used
Does not inhibit ACHase so anti-musc agent not needed like when using neostigmine Associated with less side effects
39
Why can neostigmine not be given alone
Inhibits acetylcholinesterase so need to give an anti-musc like glycopyrrolate
40
In pain reception, where is the first 2 relay stations
Dorsal horn and then thalamus (then brain for perception)
41
What are the 2 chemical key parts of a LA
Lipidsoluable hydrophobic aromatic Charged hydrophilic amide Joined by either ester or amide
42
Max dose of lignocaine
3mg/kg
43
Max dose of bupivacaine
2mg/kg
44
Max does of prilocaine
6mg/kg
45
How man mg/ml in 1ml of 1% of x
times by 10 so that 10mg/ml
46
How to tell which LAs are amides
Have X...I...X... caine | Basically have an I in them
47
Which protein do most GAs inhibit and how
GABA by allowing CL- ions in
48
Score used to determine likely ease of intubation
Mallampati score
49
What is the difference between dead space and a shunt
Dead space has good ventilation but no blood | Shunt has good blood but poor ventilation
50
In patients with multiple allergies, which type of LA should be used
Amide (not esters)
51
Is Bupivacaine long acting and what is its max dose
Yes 2mg/kg
52
How to LA work
Block NA channels
53
Safe dose of lignocaine without adrenaline
3mg/kg
54
Safe dose of Lignocaine with adrenaline:
7mg/kg
55
Safe dose of Bupivacaine / levobupivacaine ( with or without adrenaline):
2mg/kg
56
Safe dose of Prilocaine
6mg/kg
57
What electrolyte abnormality can sux cause
Hyperkalemia
58
What ASA grade is pregnancy
2
59
What BMI is ASA 2
30-40
60
What ASA grade would a patient with well controlled diabetes be
2
61
What is ASA 6
Organ retrieval
62
What ASA grade would mean patient is not expected to survive without operation
5
63
Quickest acting anaesthetic agent
Sodium thiopentone
64
LA safe doses pneumonic
3726 3: L 7: L with adrenaline 2: Bupivacaine 6: priolocaine
65
Drug used to treat malignant hyperthermia
dantrolene
66
Is sux depolarising or non depolarising
Depolarising
67
Side effects of non depolarising muscle relaxants
Hypotension (apparently )
68
How long before an operation can a patient have milk tea
6 hours

Leeds MBCHB Year 4 ACC (5 decks)

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